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Biomedical subjects

M H Huang

Publications and source records attributed to M H Huang.

At least 37 records · Page 2Linked to original sources

Clinical significance of serum soluble interleukin 2 receptor-alpha in esophageal squamous cell carcinoma.

Although the serum level of soluble interleukin-2 receptor alpha (sIL-2Ralpha) has been shown to correlate with progression and prognosis of several cancers, data to support its clinical significance to esophageal squamous cell carcinoma (ESCC) are limited. This study was conducted to assess the prognostic value and source of sIL-2Ralpha in patients with ESCC. From January 1986 to June 1997, 125 patients with histopathologically confirmed ESCC were enrolled for study. Ninety-three patients underwent en bloc esophagectomy, and 32 patients with unresectable tumor underwent palliative surgery. Four (4.3%; 4 of 93) patients died of surgical complications. Serum levels of sIL-2Ralpha were measured by ELISA. Expression of IL-2Ralpha, IL-2Rbeta, and IL-2Rgamma in the pathological section was determined, respectively, by immunohistochemistry (IHC) and in situ hybridization (ISH). Compared with the healthy control group (1020 +/-476 pg/ml, n = 103), ESCC patients tended to have significantly higher serum sIL-2Ralpha concentrations (1424 +/- 798 pg/ml, n = 121). The sIL-2Ralpha level was correlated with age, Tumor-Node-Metastasis classification, tumor stage, reading score of the IHC staining, and survival but not with the pathological grade or lymphovascular invasion. Prognosis was worse for patients with high sIL-2Ralpha levels (> or =1500 pg/ml) than for those with low serum sIL-2Ralpha levels (< 1500 pg/ml; P = 0.0209). It can be used as an independent prognostic factor of ESCC. In the pathological sections, expression of IL-2Ralpha, IL-2Rbeta, and IL-2Rgamma was detected in 17 (18.1%), 83 (89.2%), and 83 (89.2%) cases, respectively, by IHC, and the message of IL-2Ralpha was identified in tumor cells by ISH in 30.1% (28 of 93) of the cases. Serum concentrations of sIL-2Ralpha are frequently elevated in ESCC patients and are correlated with disease progression and survival. These data indicate that, in addition to activated T cells, cancer cells could be an important source of sIL-2Ralpha in ESCC patients.

Aged↗

Squamous cell carcinoma of the right upper lung congenital tracheal bronchus.

Tracheal bronchus, directly arising from the abnormal tracheal wall, is a rare congenital anomaly of the airway. Lung cancer developing in a tracheal bronchus is even more rare. A 68-year-old man had a mass shadow over the right upper lung on chest radiography. Bronchoscopy revealed an abnormally displaced bronchus stemming from the right side of the tracheal wall, 2 cm above the carina. Arising from this tracheal bronchus was a tumor, a biopsy of which showed squamous cell carcinoma. During surgery, a bronchus arising from the right lateral wall of the trachea and supplying the apical segment of the right upper lobe was found. There was a tumor occluding the lumen of the tracheal bronchus, causing distal obstructive pneumonitis. The patient underwent right upper lobectomy with closure of the tracheal bronchus and radical lymph node dissection. The subsequent pathologic examination of the specimen revealed squamous cell carcinoma with surrounding pneumonitis. Bronchogenic cancers developing in a tracheal bronchus are rarely reported in the English language literature. Surgical resection appears to be the treatment of choice.

Bronchi↗

Efficiency and effectiveness of stroke rehabilitation after first stroke.

PURPOSE: To investigate predictive variables of rehabilitation efficiency and achievement of rehabilitation potential following stroke rehabilitation. METHODS: We prospectively studied 110 first-stroke patients consecutively admitted to the inpatient rehabilitation department of our university hospital from 1 January to 31 December 1997. Functional recovery was measured as improvement in the ability to perform the Functional Independence Measure (FIM) instrument. Major medical (side of paralysis, stroke etiology, risk factors, Brunnstrom motor recovery stage, etc.), rehabilitative (initial FIM subscore, interval from stroke onset to rehabilitation commencement, rehabilitation stay, etc.), and demographic (age, years of education, occupation, marital and living status, care-giver, etc.) variables were examined. RESULTS: The mean FIM score was 57.7 +/- 24.5 at admission and 77.3 +/- 26.3 at discharge. The mean rehabilitation efficiency (0.7 +/- 0.7) and effectiveness (30.6 +/- 24.0%) of stroke rehabilitation were determined. Rehabilitation efficiency and rehabilitation effectiveness were significantly predicted by length of stay and arm motor recovery stage, and by age and arm motor recovery stage, respectively. The variance explained only 21% of the rehabilitation efficiency and 24% of the achievement of rehabilitation potential. CONCLUSIONS: The results of this study suggest that the large proportion of the unexplained variance in rehabilitation efficiency and effectiveness is due to nonmedical factors influencing the selection of patients for rehabilitation.

Adult↗

Factors influencing functional independence outcome in stroke patients after rehabilitation.

The purpose of this study was to identify predictive variables relevant to functional independence outcomes for stroke patients following rehabilitation therapy. We prospectively studied 150 stroke patients consecutively admitted to the inpatient rehabilitation department of a university hospital from January 1 to December 31, 1997. Functional ability was assessed with the Functional Independence Measure (FIM) instrument on admission, on discharge of inpatient rehabilitation program, and at the 6 months follow-up visit after discharge. Severity of stroke was determined by using the Canadian Neurological Scale (CNS) on admission. In addition, major medical and sociodemographic factors were documented during hospitalization as independent variables. Of the 142 subjects surveyed, 23 (16.2%) stroke patients achieved functional independence at home when re-visited. Univariate test and multiple logistic regression analyses indicated that the significant factors affecting functional independence included age of onset, occupation, prior heart problems, the presence of medical complications, bilateral hemiplegia, and the functional ability (FIM score) and the severity of stroke (CNS score) on admission. The results of this study suggest that the admission CNS and FIM scores are useful in the prediction of functional independence outcome for stroke survivors following rehabilitation therapy.

Activities of Daily Living↗

Is total knee replacement more painful than total hip replacement?

BACKGROUND: During its use in pain management the patient-controlled analgesia (PCA) devices are capable of registering the course of treatment at patient request, the condition of drug delivery and total amount of drug being given. The patients could determine the need of medication to their own satisfaction while forced treatment by the bias of the health care personnel is avoided and the safety of patients is further warranted. In pain relief with this device, the number of requests for analgesia and the dose of analgesic used can be easily measured. Therefore, it is more objective to compare the pain intensity among different types of operation when PCA device is used. Using PCA morphine consumption as a parameter, we attempted to elucidate the difference of intensity of pain associated with total hip and total knee replacements by comparing their morphine requirement. METHODS: In this prospective cohort study, 50 patients who underwent either total hip replacement (THR, n = 24) or total knee replacement (TKR, n = 26) were enrolled. After recovery from general anesthesia when the patients first complained intense pain in the recovery room, morphine was given intravenously in titration with a calculated loading dose in 30 min to achieve an acceptable analgesia (VAS < or = 3) followed by morphine PCA at 1 mg bolus with a lockout interval of 6 min. The patients were then followed for 48 h. During and at the end of the course the data relevant to pain score, total dose, demand, delivery, and adverse effects were recorded for assessment. RESULTS: With the use of PCA, the pain scores were similar in both surgical groups in the 48 h observation. Total consumption of morphine in THR was 13.2 +/- 8.1 mg as against 19.7 +/- 5.7 mg in TKR in postoperative day 1 and 25.2 +/- 12.7 mg as against 34.1 +/- 13.9 mg in postoperative day 2 (P < 0.05, t-test). Demand/delivery ratio was not statistically significant between the 2 groups at 24 and 48 h (t-test). Minor adverse effects were seen in both groups but the differences were not significant. CONCLUSIONS: Using PCA morphine consumption as parameter, we can distinguish the magnitude of pain intensity between 2 major orthopedic surgeries. The deeper and more extensive operation would in total hip replacement does not mean that it is a more painful procedure than total knee replacement. Several speculations are proposed.

Aged↗

[Phylogenetic relationships among Viperidae, Crotalinae based on mitochondrial 12S rRNA sequence variations].

This paper analyzed the phylogenetic relationships and classification of pit vipers (Viperidae, Crotalinae) based on mitochondrial 12S rRNA gene sequence variations. We have sequenced mtDNA 12S rRNA gene about 370 bp fragment from Gloydius saxatilis Emelianov, Gloydius shedaoensis Zhao, Gloydius ussurriensis (Emelianov), Trimeresurus stejnegeri Schmidt and Deinagkistrodon acutus, Gloydius brevicaudus (Stejneger) from two different localities, respectively. Combined with the sequence of Dinodon semicarinatus from GenBank, we have constructed two molecular phylogenetic trees using both Maximum-parsimony analysis and Neighbor-joining. Our results support the following conclusions: (1) Deinagkistrodon is a valid genus; (2) we also discussed the origin of Gloydius shedaoensis and showed it is a subspecies of Gloydius saxatilis; (3) Gloydius brevicaudsu and Gloydius ussurriensis are classified two species.

Animals↗

The effect of electroacupuncture on shoulder subluxation for stroke patients.

In this study, we evaluated the effect of electroacupuncture on shoulder subluxation for stroke patients. Twenty hemiplegic patients with shoulder subluxation were randomly and equally divided into two groups. The subjects in the control group received conventional therapy, and the subjects in the study group were treated with electroacupuncture and conventional therapy for four weeks. The visual analog scale (VAS) for shoulder pain, motor function status, anthropometry, and X-ray assessment were used to evaluate the status of shoulder subluxation before and after treatment. The results indicated that the pain scores decreased in the study groups significantly more than those in the control group. The degrees of shoulder reduction, including the measurement of anthropometry and X-ray assessment in the study group, were more than those of the control group. However, the motor function status showed no significant difference between two groups. It is concluded that electroacupuncture can be an effective adjuvant management in the treatment of shoulder subluxation for stroke patients.

Adolescent↗

Comparison of patient-controlled analgesia (PCA) with tramadol or morphine.

PURPOSE: To compared the clinical efficacy of tramadol and morphine using a patient-controlled analgesia (PCA) delivery system. METHODS: In a prospective, randomized, double blind study, we evaluated 80 adult patients scheduled for elective hip or knee arthroplasty with general inhalational anesthesia. When patients complained of pain in the recovery room, patients were randomized to receive either tramadol or morphine by titration in 30 min to achieve analgesia (VAS < or =4). Equivalent volumes containing either 30 mg x ml(-1) tramadol or 1 mg x ml(-1) morphine were used for PCA with a lockout interval of 10 min. The patients were followed six-hourly for 48 hr for VAS, satisfaction rate, analgesic dose, and side effects. RESULTS: Patients obtained adequate analgesia with either drug. More patients had very good satisfaction scores in the morphine group in the recovery room (43% vs. 23%, P<0.05) and at 24 hr (40% vs. 20%, P<0.05) than those in the tramadol group. More nausea was evident in the tramadol group (48% vs. 11% in recovery room and 28% vs. 12% in 24 hr, P<0.05) than in the morphine group. Vomiting was also more (28% vs. 5% in recovery room, 15% vs. 3% in 24 hr, P<0.05). Morphine produced more sleepiness (45% vs. 23% in recovery room, P<0.05 and 35% vs. 15% in 24 hr, P<0.05). CONCLUSION: Tramadol PCA can provide effective analgesia following major orthopedic surgery provided sufficiently high doses are given for loading and by patient demand. However, the incidence of nausea/vomiting is also higher causing decreased satisfaction.

Adult↗

Ultrasound effect on level of stress proteins and arthritic histology in experimental arthritis.

OBJECTIVE: To investigate the effect of ultrasound on the levels of stress protein in experimental arthritis and their relation to the therapeutic effects on arthritic cartilage repair. METHODS: Thirty-six rats with similar degree of early arthritis were divided at random into two groups. In group s, 18 rats received sonication; in group c, 18 control rats received sham sonication. The severity of induced arthritis was evaluated from bone scan with technetium-99m. The presence and changes of stress protein were identified from immunostain of SP72 antibody from frozen sections of arthritic cartilage and from electrophoresis of proteins extracted from chondrocytes of arthritic cartilage. The severity index, density of immunostained chondrocytes, and histopathologic changes at various periods were also studied in each group. RESULTS: The density of stress protein was increased markedly in treated rats after sonication and it was closely related to the repair of arthritic cartilage. Once the pathohistology of arthritic cartilage improved, stress protein declined significantly in the follow-up period. CONCLUSION: Therapeutic ultrasound can enhance stress protein production in arthritic chondrocytes. The extragenic production of stress protein was well correlated with the therapeutic effect of ultrasound to preserve chondrocytes and bring about the repair of arthritic cartilage.

Animals↗

Inhibition of 2-P-mercaptophenyl-1,4-naphthoquinone on human platelet function.

As widely assumed, platelets and coagulation system heavily influence the pathogenesis and progression of cardiovascular diseases. Some 1,4-naphthoquinone derivatives, such as vitamin K3, have been reported to increase the synthesis of coagulation proteins. In this study, we examine how 2-p-mercaptophenyl -1,4-naphthoquinone (NTP), a newly synthesized 1,4-naphthoquinone derivative, affects the platelet function in humans. A tapered parallel plate chamber which provided a range of shear stress covering the entire physiological range in human circulation is used to assess platelet adhesiveness on fibrinogen coated-surface. In addition, platelet aggregation and thromboxane B2 (TXB2) production by inducers are evaluated by the turbidimetric method and enzyme immunoassay kit, respectively. Moreover, platelets [Ca2+]i are measured using a dual-wavelength fluorescence spectrophotometer. Analysis results indicate that 1) NTP decreases the percentages of attached platelets at the locations in various shear stresses and the levels of platelet adhesiveness, denoted as the slope; 2) NTP can inhibit the platelet aggregation by ADP (2 microM) and collagen (25 microg/ml), and the IC50 are: 0.32 and 26.83 microg/ml, respectively; and 3) NTP markedly inhibits TXB2 formation and platelet [Ca2+]i elevation caused by ADP and collagen. Therefore, we conclude that NTP may inhibit platelet adhesiveness on fibrinogen coated-surface, aggregability, [Ca2+]i, and thromboxane production, and that it may be used as an antiplatelet agent.

Adenosine Diphosphate↗

Severe gastrointestinal bleeding resulting in total gastrectomy in a patient with major burns--a case report.

Gastrointestinal hemorrhage is a known but rare complication of major burns. This case report describes the management of this potentially life threatening problem in a young adult with 45% body surface area burns who developed massive gastrointestinal-tract bleeding. The patient required a total gastrectomy that was complicated by a burst abdomen. Despite undergoing a series of major insults. the patient survived and was eventually discharged from hospital with an acceptable level of morbidity. The problems faced by the burn centre team and the issues involved in the decision making process are discussed in the management of this unusually devastating complication.

Abdomen, Acute↗

Characterization of allergens from Penicillium oxalicum and P. notatum by immunoblotting and N-terminal amino acid sequence analysis.

BACKGROUND: Penicillium species are important causative agents of extrinsic bronchial asthma. However, little is known about the allergens of these ubiquitous fungal species. Objective The object was to analyse the composition, the allergenic cross-reactivity and the N-terminal sequences of allergens from two prevalent airborne Penicillium species, P. oxalicum and P. notatum. METHODS: The allergenic composition and the immunoglobulin (Ig)E cross-reactivity were analysed by immunoblot and immunoblot inhibition, respectively, using sera from asthmatic patients. The N-terminal amino acid sequences of major allergens were determined by Edman degradation. Allergens identified were also characterized by immunoblotting using monoclonal antibody (MoAb) PCM39 against the alkaline serine proteinase major allergen of P. citrinum. RESULTS: Among the 70 asthmatic sera tested, 18 (26%) and 17 (24%) had IgE immunoblot reactivity towards components of P. oxalicum and P. notatum, respectively. Major allergens (> 80% frequency of IgE-binding) from both species are the 34 and 30 kDa proteins of P. oxalicum and the 34 and 32 kDa proteins of P. notatum. IgE cross-reactivity among these major allergens and the 33 kDa major allergen of P. citrinum can be detected by immunoblot inhibition studies. The N-terminal amino acid sequences of the 34 kDa allergen of P. oxalicum and of the 32 and the 28 kDa allergens of P. notatum share homology with sequences of the vacuolar serine proteinase from Aspergillus fumigatus. The N-terminal amino acid sequence of the 34 kDa allergen of P. notatum shows sequence homology with that of alkaline serine proteinase from P. citrinum. Results obtained from immunoblotting showed that MoAb PCM39 reacted with the 34, 30 and 16 kDa IgE-binding components of P. oxalicum, and with the 34, 32 and 28 kDa IgE-binding components of P. notatum. CONCLUSIONS: Results obtained suggest that the 34 kDa major allergen of P. oxalicum may be a vacuolar serine proteinase. The 34 and the 32 kDa major allergens of P. notatum may be the alkaline and the vacuolar serine proteinases of P. notatum, respectively. The 30 and 16 kDa IgE-binding components of P. oxalicum and the 28 kDa IgE-binding component of P. notatum may be breakdown products of the 34 and the 32 kDa major vacuolar serine proteinase allergens of P. oxalicum and P. notatum, respectively.

Adult↗

Patient-controlled analgesia with morphine plus lysine acetyl salicylate.

UNLABELLED: Using a patient-controlled analgesia (PCA) delivery system, we evaluated the clinical advantages and disadvantages of morphine PCA compared with morphine plus lysine acetyl salicylate (LAS), a soluble aspirin. After major orthopedic surgery, 50 adult patients were enrolled in a prospective, randomized, and double-blinded study. When a patient in the recovery room complained of pain, an initial dose of morphine or the morphine/LAS mixture was titrated to achieve analgesia of visual analog score < or = 3 in 30 min. An equivalent volume PCA dose of either morphine 1 mg/mL or morphine 0.5 mg + LAS 90 mg/mL was used with a lockout interval of 10 min. Pain score, patient satisfaction, vital signs, and adverse effects were observed for 48 h. Adequate analgesia (visual analog scale score < or = 3) was achieved with either drug. Morphine consumption in the morphine/LAS group was significantly less than in morphine group (13.9 vs 18.4 mg in 24 h and 24.3 vs 32.4 mg in 48 h). Significantly more sedation was evident with the morphine group (P < 0.05). We conclude that injectable LAS can be used as an effective and safe adjuvant to morphine for PCA. This combination reduces dose requirements of morphine and hence some of its adverse effects. IMPLICATIONS: Injectable aspirin could be used as an effective and safe adjuvant to morphine for patient-controlled analgesia. This combination reduces the dose requirement of morphine and therefore some of the morphine-related untoward effects.

Adult↗

Prognosis of esophageal squamous cell carcinoma: analysis of clinicopathological and biological factors.

OBJECTIVE: Esophageal squamous cell carcinoma (ESCC) is rather common among the Chinese, but the therapeutic outcome is dismal. Knowledge of the prognostic factors in cancerous patients may influence therapeutic strategy. However, systemic analyses of clinicopathological and biological factors for patients with ESCC are few, and the results are controversial. METHODS: Between 1985 and 1996, 117 patients undergoing en bloc esophagectomy and gastric substitution were enrolled. None had neoadjuvant treatment. Postoperative adjuvant therapy was provided for patients at and beyond stages IIa. Clinical responses were followed routinely. Flow cytometry was used to measure DNA ploidy and synthesis-phase fraction (SPF) of the resected esophageal tissues from all patients. Immunohistochemistry was also used to examine the expression of proliferating cell nuclear antigen (PCNA), epidermoid growth factor receptor (EGFR), HER-2/neu, and p53 in the pathological sections. Clinical correlation was evaluated by chi2 with Fisher's exact test, and survival by log-rank test. RESULTS: The overall survival rates were 74% for 1 yr, 48% for 3 yr, and 38% for 5 yr. TNM tumor staging, the number of diseased lymph nodes (N < or = 3 or N > 3), degree of cell differentiation, DNA ploidy, SPF, and lymphovascular invasion were more useful than biological markers, such as PCNA, EGFR, HER-2/neu, and p53, for the prognosis of ESCC. Multivariate analysis revealed significant correlation of tumor staging and number of diseased lymph nodes with patient survival after surgery. CONCLUSIONS: En bloc esophagectomy may provide a rather satisfactory survival rate for patients with early stage ESCC. However, for patients with distant lymph node metastasis and those with more than three lymph nodes involved, radical surgical resection, even combined with postoperative chemoradiotherapy, cannot improve survival. The prognostic value of biological markers, including PCNA, EGFR, HER-2/neu, and p53, however, is limited.

Adult↗

Detection of Epstein-Barr virus in esophageal squamous cell carcinoma in Taiwan.

OBJECTIVE: Recently, an association between viral infection and the development of esophageal carcinoma has been reported, particularly the human papilloma virus (HPV) and Esptein-Bar virus (EBV). However, geographic variation in carcinogenesis is realized. In this study, we investigate the viral carcinogenesis and the biologic effect of viral infection on esophageal squamous cell carcinoma (ESCC) in Taiwan. METHODS: To determine the association of viral infection (EBV and HPV) with ESCC, we applied polymerase chain reaction (PCR), immunohistochemistry, and in situ hybridization (ISH) to examine 119 surgical specimens from different sites of esophagus in 31 ESCC patients. Additionally, an immunoperoxidase method was used to detect EBV latent membrane protein-1 (LMP-1), p53, CD45RO (UCHL-1), Fas ligand (Fas L), and RNA ISH with oligonucleotide sequences was used to detected interleukin-6 (IL-6) mRNA. RESULTS: By PCR, EBV DNA was detected in 11 cases (35.5%). Expression of EBERs in ESCC was further confirmed with ISH. Nonetheless, no LMP-1 expression was detected. On the other hand, human papillomavirus (HPV) was identified in only one case (3.2%) of ESCC. Furthermore, HPV was located by ISH in the distant normal region rather than in tumor cells. In EBV-positive cases, accumulation of p53 protein was detected in 10 lesions (91%); CD45RO+ lymphocytes together with expressions of FasL and IL-6 were respectively identified in 100%, 63.6%, and 54.5% of 11 EBV-positive lesions. Interestingly, in the EBV-negative cases (n = 20), p53 protein was detected in 40% of lesions; CD45RO 30%; FasL 50%, and IL-6 10%. CONCLUSIONS: In this study, no correlation was found between the presence of EBV in ESCC and the patients' age, sex, as well as survival. Although our results indicate that EBV could be associated with ESCC, the clinical role of EBV in ESCC remains to be determined.

Aged↗

Ca2+-induced Ca2+ release involved in positive inotropic effect mediated by CGRP in ventricular myocytes.

To investigate the effects and mechanisms of calcitonin gene-related peptide (CGRP) on ventricular contractility, ventricular myocytes isolated from adult rat and mouse hearts were exposed to CGRP. Myocyte contractility was assessed by a video edge motion detector, and the intracellular [Ca2+] transients were measured by a spectroflurophotometer in fura 2-loaded myocytes. CGRP exerted a potent concentration-dependent (10 pM-10 nM, EC50 = 44.1 pM) positive inotropism on rat ventricular myocytes. CGRP (1 nM) increased cell shortening during contraction by 140 +/- 40% above baselines and increased maximum velocity of contraction and relaxation by 98 and 106%, respectively. CGRP failed to produce any response in the presence of the CGRP1 receptor antagonist. CGRP induced similar inotropic response in mouse ventricular myocytes. CGRP increased the amplitude of [Ca2+] transients of ventricular myocytes by 120 +/- 25% above baseline and shortened the time of half-maximum myoplasmic Ca2+ clearance by 30 +/- 5%. Increase in intracellular Ca2+ mobilization by CGRP was dependent on Ca2+ influx through the activation of the L-type Ca2+ channel, because nifedipine blocked the CGRP-induced increase in [Ca2+] transients. Furthermore, CGRP failed to increase [Ca2+] transients after the inhibition of protein kinase A in ventricular myocytes. These data indicate that stimulation of mammalian ventricular myocardial CGRP1 receptors enhances [Ca2+] transients through the activation of protein kinase A, which in turn activates voltage-dependent L-type Ca2+ channels. These events lead to Ca2+-induced intracellular Ca2+ release and enhanced myocyte contraction and facilitated relaxation.

Animals↗

Cross-cultural similarity in the love attitudes scale: short form.

Recently, Hendrick, Hendrick, and Dicke presented two short forms of the Love Attitudes Scale, the first using 24 items with 4 items for each subscale and the second using 18 items with 3 items for each subscale. Their data indicated that the two short versions have even stronger psychometric properties than the original scale. This study reports an 18-item short form of the scale developed independently in Taiwan using 460 graduate and undergraduate students in the fall semester of 1997. The results demonstrated a remarkable cross-cultural similarity in the development and response to the short form of the scale and its applicability to a broader cultural setting.

Adult↗

The influence of rehabilitation therapy on the prognosis for stroke patients--a preliminary study.

The purpose of this prospective study was to investigate the influence of rehabilitation therapy on the prognosis for stroke patients. Sociodemographic and clinical factors were collected in a sample of 147 stroke patients (81 men and 66 women) admitted to the inpatient rehabilitation department at our university hospital over 10 days between January 1, 1997 and December 31, 1997. Functional Independence Measure (FIM) scores at discharge and gains during rehabilitation period were used as the prognosis index. Statistical techniques with univariate and multiple regression analyses indicated that significant predictors of discharge FIM scores include age, previous attacks twice or over, medical comorbidities, sensory and orientation impairments, and dementia. In addition, previous stroke attacks twice or over and sensory impairment were significant predictors of FIM gains during rehabilitation period. We concluded that: 1) age is a critical factor to determine the rehabilitation outcome, but may not be an important factor to predict the ability for the improvement through rehabilitation therapy; 2) the delay of rehabilitation therapy may not affect the potential for further improvement; 3) patients with low initial functional level may have poor final outcome, they may still have good rehabilitation potential to improve the functional level; 4) complications of stroke may affect the rehabilitation outcome and should be prevented; and 5) patients with impaired mental status should not routinely be excluded from rehabilitation programs.

Adult↗