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Biomedical subjects

J Wong

Publications and source records attributed to J Wong.

At least 613 records · Page 34Linked to original sources
PubMed1986

Endoscopic retrograde cholangiopancreatography and endoscopic papillotomy in recurrent pyogenic cholangitis.

In recurrent pyogenic cholangitis (RPC), there is primary bacterial cholangitis resulting in the formation of strictures and stones in the intrahepatic as well as the extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) is a very useful investigation in the study of RPC. The location of stones and strictures and the morphology of the bile ducts are well delineated. Moreover, cholangitis liver abscesses and biliary-enteric fistulas, which are frequently encountered in RPC, are demonstrated. ERCP can also be used to differentiate RPC from ascariasis, clonorchiasis, hepatocellular carcinoma and cholangiocarcinoma, which sometimes have quite similar clinical pictures and can be confused with RPC. ERCP should be performed in every patient with RPC in order to plan surgical treatment. Endoscopic papillotomy (EPT) is indicated in RPC patients with residual common bile duct stones or papillary stenosis, and as primary treatment in selected high-risk patients. More studies are necessary to establish additional indications for EPT.

Ampulla of Vater↗
PubMed1986

Endoscopic retrograde cholangiopancreatography after acute pancreatitis.

To assess the usefulness of endoscopic retrograde cholangiography (ERCP) in the study of acute pancreatitis, 101 of a possible 114 patients (89 per cent) with acute pancreatitis underwent ERCP after recovery from acute illness. In 81 per cent, ERCP was performed within two weeks of recovery. The biliary tract was successfully demonstrated in 87 per cent of the patients and the pancreatic duct in 73 per cent. Roentgenograms of the biliary tract showed stones in the gallbladder in 40 per cent of the patients and in 36 per cent in the biliary ducts. In addition, the gallbladder was not visualized in nine patients. In eight of those patients, the gallbladder was subsequently shown to be abnormal. Other findings of the biliary system included one patient each with clonorchiasis, ascariasis and malignant disease. Changes in the pancreatic duct were detected in 11 per cent of the patients. Most of the changes were consistent with acute or chronic pancreatitis. Minimal morbidity was encountered. ERCP is very accurate in identifying the biliary causes of pancreatitis. In areas where a significant proportion of acute pancreatitis has biliary causes, it should be performed upon all patients soon after resolution of the acute illness to identify those patients who will benefit from early operation upon the biliary tract.

Acute Disease↗
PubMed1986

Proximal gastric vagotomy in emergency peptic ulcer perforation.

In order to evaluate proximal gastric vagotomy (PGV) performed under different clinical conditions, we compared the late results of 93 patients who underwent emergency PGV for perforated duodenal ulcers with those of 60 patients who had elective PGV. The emergency group of patients were slightly younger and there was a higher male predominance but they were otherwise comparable with those in the elective group. There were no operative deaths and the postoperative morbidity rate was low in both groups. Three patients had a recurrence in the emergency group, and seven occurred in those in the elective group during the first three postoperative years. The cumulative recurrence-free rate of the emergency group was not lower than that of the elective group. The performance of the individual surgeon exerted a strong influence on the incidence of recurrent ulceration. In properly selected patients, whether the surgeons perform PGV in emergency or elective situations appears to have little influence on the outcome.

Adult↗
PubMed1986

Invasion of reconstituted basement membrane matrix by metastatic human tumor cells.

A gel-like reconstituted basement membrane matrix containing type IV collagen, laminin, entactin, nidogen, and heparan sulfate proteoglycan was used to examine the invasive properties of human HT1080 fibrosarcoma cells. Within several hours after seeding, the tumor cells initiated a random migration, leaving behind channels etched in the surface of the matrix. Eventually the channels became interconnected into a complex network. As the tumor cells proliferated, the channels became filled until the surrounding matrix was gradually dissolved. Cells then migrated outward, forming the typical disorganized cell monolayer normally observed when fibrosarcoma cells are cultured on plastic surfaces. In contrast to the fibrosarcoma cells, normal skin fibroblasts, while able to attach to the matrix, exhibited minimal migration, tracking, and invasion during the same time period. When tumor cells were seeded onto thick layers of matrix, the cells ultimately invaded downward into the matrix, leaving behind open tunnels. At the front of the invading cells, long irregular pseudopodia projected in the direction of movement. Electron microscopy demonstrated these filopodial and lamellopodial projections to directly extend into the surrounding matrix, with focal clearing of the matrix in the immediate vicinity of these invading pseudopodia. Thus, tumor cell invasion of extracellular matrices, including basal lamina, may proceed by the formation of specialized pseudopodia that not only form adhesion contacts with the matrix but also provide an efficient mechanism for the focal hydrolysis of the matrix at the site of directed cell movement.

Basement Membrane↗
PubMed1985

Abdominal aortic aneurysm in Chinese patients.

From 1975 to 1983, 120 Chinese patients with infrarenal abdominal aortic aneurysm were seen, 72 of whom underwent aneurysmectomy; 45 were performed electively and 27 as emergencies. The operative mortality in the former was 4.4 per cent and the latter 33.3 per cent. All 27 patients who presented with rupture were operated on. However, only 45 of 93 patients (48.4 per cent) with intact aneurysm underwent surgery; the remainder were either unwilling (35) or unfit (13). Peptic ulcer disease was noted in 26.4 per cent of patients.

Aged↗
PubMed1985

Use of the pectoralis major muscle flap for repair of a tracheoesophageal fistula.

A case of tracheal rupture after a Lewis-Tanner esophagectomy in a patient with carcinoma of the esophagus was complicated by the formation of a tracheoesophageal fistula after initial direct repair. The fistula was successfully treated with a pectoralis major muscle flap moved into the superior mediastinum by a sternotomy and excision of the upper part of the sternum and adjacent costal cartilages.

Carcinoma, Squamous Cell↗
PubMed1985

A randomized controlled trial of a new approach to preoperative teaching and patient compliance.

A randomized controlled experiment evaluating the effects of a new approach to preoperative teaching on patient compliance is described. In this study, compliance was measured by the accuracy, regularity and willingness that patients showed in execution of the prescribed activities after surgery. A significant difference was found between the experimental and control patients in the regularity, willingness and accuracy with which they performed the prescribed postoperative exercises. The experimental patients were significantly more satisfied with this approach to preoperative teaching than the control patients. This study is seen to have implications for both nursing education and nursing service.

Aged↗
PubMed1985

An 85-day study of butylated hydroxyanisole in the cynomolgus monkey.

Groups of 8 cynomolgus monkeys (Macaca fascicularis) were given 500, 125 and 0 mg/kg body wt butylated hydroxyanisole (BHA) by gavage in corn oil 5 times/week for 20 days, after which the high dose was halved. No significant adverse clinical signs nor abnormal fibroscopic observations were noted before the experiment was terminated at 85 days. Blood levels of glucose, albumin, chloride, red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT) and mean corpuscular hemoglobin (MCH) were altered in a dose related manner but the altered values were well within normal ranges reported for this species. While histopathology showed no treatment related effects, the mitotic index was elevated 1.9-fold in the distal esophagus of monkeys in the high but not in the low dose group. Liver weights were increased in a dose related manner but liver monooxygenases, with the exception of decreased ethoxyresorufin deethylase activity, were all within normal limits. BHA given orally to monkeys at about the maximum tolerated dose failed to induce the massive changes noted with rats given 2% dietary BHA.

Animals↗
PubMed1985

Limitations of mammography in Chinese females.

The usefulness of mammography was evaluated in 50 Chinese female patients with breast disease. There was only 12% accuracy in the diagnosis of benign breast disease and an overall accuracy of 32% for all breast lesions. This low diagnostic rate is due to the difficulty in visualising mammographic detail in the small Chinese breast.

Adult↗
PubMed1985

Pyloric function five to eleven years after Ramstedt's pyloromyotomy.

Pyloric function after Ramstedt's pyloromyotomy was assessed in seven patients aged five to eleven years and compared to that in sixteen normal children. Gastric emptying (T 1/2) of liquid, as measured by the double sampling test, was faster in patients than in normal children. Duodenal reflux was calculated from the sodium content in gastric aspirates. At rest, it was greater in patients than in normal children. In the poststimulatory state, there was no difference. Gastric acid secretion was similar in both groups. Rapid gastric emptying might explain the high incidence of peptic ulcer reported in several series of long-term follow-up patients. Increased duodenal reflux at rest might account for a similar increased incidence in gastritis and dyspepsia.

Child↗
PubMed1985

Student unrest: a challenge for nurse educators.

Nursing students, like their college counterparts, are beginning to revolt against hierarchical authority and to claim a more active part in their educational planning. Nurse educators can no longer assume that their students will never revolt; they must face up to the challenge of developing strategies for proper management of student unrest. The authors propose some ways to deal with the complex issue of student unrest. These suggestions are made with emphasis on faculty-student relationship and the curriculum. Improved faculty-student relationships, proper utilization of student peer influence and student involvement in curriculum planning are some of the strategies proposed in this paper.

Canada↗
PubMed1985

In vitro activity of Sch 34343 and cefbuperazone against anaerobic bacteria.

The in vitro activities of Sch 34343, a new penem antibiotic, and cefbuperazone, a new cephamycin antibiotic, were determined against 459 clinical anaerobic bacterial isolates and compared with the activities of imipenem and cefoxitin, respectively, by an agar dilution method. Both penems showed potent and similar activity against all anaerobic bacteria tested, particularly Peptococcus spp., Bacteroides fragilis, and Clostridium perfringens. All organisms except a single strain of Fusobacterium necrogenes were inhibited by an 8 micrograms/ml concentration of either Sch 34343 or imipenem. Overall, gram-positive bacilli, particularly Lactobacillus species, Clostridium difficile, and Bifidobacterium and Actinomyces species, were relatively more resistant to either penem than other genera of anaerobic bacteria tested. Cefbuperazone demonstrated only modest activity against a wide spectrum of anaerobic bacteria. It had excellent and selective activity against B. fragilis and Bacteroides vulgatus but was highly inactive against Bacteroides distasonis and Bacteroides thetaiotaomicron within the B. fragilis group. Both cephamycins showed virtually no activity against C. difficile and Lactobacillus spp. Although cefbuperazone was more active against Bifidobacterium spp., it had less activity against Fusobacterium spp., Eubacterium spp., and all Bacteroides spp. other than B. fragilis and B. vulgatus.

Anti-Bacterial Agents↗
PubMed1985

Massive ascites due to omental endometriosis.

Endometriosis associated with massive ascites is an unusual combination. Only 12 cases have been reported since its first description by Brews in 1954. The authors report the first case where radical surgery was avoided because of successful hormonal therapy.

Adult↗
PubMed1985

Differences in the properties of muscarinic cholinergic receptors in the developing chick myocardium.

The number of muscarinic cholinergic receptors detected with [3H]quinuclidinyl benzilate (QNB) was constant in embryonic chick heart membranes but increased 2.5-fold by 3 days posthatching; the KD for [3H]QNB did not change. The affinities of the muscarinic receptors for agonists, as determined in in vitro [3H]QNB competition experiments, differed during development. The IC50 values were lowest for 10- to 14-day embryonic heart receptors, intermediate for 18- to 20-day embryonic receptors and highest for 3- to 7-day newborn heart receptors. These apparent differences in agonist affinity were not overcome by guanine nucleotides or monovalent cations alone, but were greatly diminished in the presence of a combination of guanylylimidodiphosphate plus NH4+. Modeling of [3H]QNB/oxotremorine competition curves indicated the presence of three agonist affinity states in membranes from embryonic heart and two in newborn hearts. The KD values for oxotremorine increased during development. The proportion of receptors displaying the highest affinity for oxotremorine was constant at all ages tested whereas the proportion displaying the lowest affinity decreased from 16% in membranes from 12-day embryonic hearts to zero in newborn hearts. The physiological significance of the differences in the properties of the receptors was investigated by assessing their ability to attenuate adenylate cyclase. The efficacy of agonists to attenuate basal adenylate cyclase increased 1.5-fold after birth, whereas the potency of agonists to produce this effect was similar at all ages tested.

Acetylcholine↗