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Biomedical subjects

R J Chen

Publications and source records attributed to R J Chen.

At least 73 records · Page 4Linked to original sources
PubMed1995

Unreamed interlocking nail versus external fixator for open type III tibia fractures.

We undertook a prospective study comparing the unreamed interlocking nail to Hoffmann external skeletal fixation (ESF) in the treatment of 36 consecutive patients with open type IIIA and IIIB tibia fractures. The choice of interlocking nail or Hoffmann ESF was randomized, ultimately producing four different patient groups: group 1, type IIIA fractures treated by interlocking nail; group 2, type IIIA fractures treated by ESF; group 3, type IIIB fractures with interlocking nail; and group 4, type IIIB fractures with ESF. The average length of follow-up was 20.5 months. The infection rate was highest in group 3 (3 of 8). The malrotation, malunion, and nonunion rates were highest in group 4 and lowest in group 1. These results suggest the unreamed interlocking nail is a good choice for the treatment of open type IIIA tibia fractures, but not recommended for the treatment of open type IIIB tibia fractures because of the high infection rate.

Adolescent↗
PubMed1995

Comparison of detection of human papillomavirus 16 DNA in cervical carcinoma tissues by Southern blot hybridisation and nested polymerase chain reaction.

An association between human papillomavirus (HPV) and cervical neoplasia has been widely reported and HPV DNA is commonly detected in cervical carcinoma tissues. However, estimates of the prevalence of HPV infection differs among various detection methods. Seventy cases of cervical carcinoma were screened for HPV 16 infection by Southern blot hybridisation (SBH) and nested polymerase chain reaction (PCR). According to SBH, the prevalences of HPV 16 DNA in stage I (n = 40) and stage II (n = 30) cervical carcinomas were 52.5 and 63.3%, respectively, and the overall prevalence was 57.1% (40 of 70). By nested PCR, the prevalences of HPV 16 infection in stage I and II cervical carcinomas were 87.5 and 93.3%, respectively, and the overall prevalence was 90.3%. The prevalence of HPV DNA detected by nested PCR was significantly greater than that detected by SBH. The combined concordance of positive and negative results between SBH and nested PCR was 61.4%. The discrepancy resulted mainly from 25 cases (35.7%) that were positive by PCR but negative by SBH. A small copy number of HPV DNA in the these 25 cases was documented by a semi-quantitative PCR method. The nested PCR was more sensitive than SBH and detected cases with low amounts of HPV DNA. The detection of HPV infection varied between these two prevailing detection methods and this should be kept in mind in assessing various epidemiological data concerning HPV infection.

Base Sequence↗
PubMed1995

Immunoelectrophoretic differentiation of alpha-fetoprotein in disorders with elevated serum alpha-fetoprotein levels or during pregnancy.

Our study aims to make differential diagnosis by immunoelectrophoresis for some common conditions with elevated levels of serum alpha-fetoprotein (AFP). One hundred and nine cases with elevated AFP levels were included in this study: yolk sac tumor (n = 8), hepatocellular carcinoma (n = 26), gastric cancer (n = 12), chronic hepatitis (n = 27) and normal pregnancy (n = 36). Lectin agarose gel electrophoresis, antibody-affinity blotting, and immunoreaction were used to identify the specific patterns of AFP in the respective conditions. The results showed that there were three possible bands: L1, L2 and L3. Yolk sac tumor produced a prominent L2 band and a light L3 band. Hepatocellular carcinoma produced a prominent L1 band and a light L3 band. Gastric cancer produced only an L1 band. Chronic hepatitis had a light L1 band and a pronounced L3 band. In pregnancy, the AFP pattern is similar to that of hepatocellular carcinoma. Immunoelectrophoresis is a useful method facilitating the differentiation of AFP origins.

Biomarkers, Tumor↗
PubMed1995

[The application of Edgewise technique auxillary with extra oral anchorage and class III elastic in the treatment of bimaxillary protrusion.].

In the treatment of growing bimaxillary protrusion patients,Edgewise technique auxillary with extra oral anchorage and class III elastic help to improve the patient's chin shape,recover his beauty of lower facial part and get a good occlusion along with the growing of mandible.The purpose of this study is:analysis the force system in the treatment and evaluate the result of the treatment with some typical cases.

English Abstract↗
PubMed1995

[Diagnosis of intraperitoneal injuries in patients with pelvic fractures].

It is difficult to diagnose blunt abdominal trauma in unstable patients with pelvic fractures. In the United States the standard diagnostic procedures for these patients were the physical examinations and diagnostic peritoneal lavages. However, abdominal echograms were prevalent in Europe and Japan. We reviewed 60 patients suspected blunt abdominal trauma in 804 pelvic fractures in the past four years. Eighteen DPLs and twenty-five abdominal echograms were done separately. Sensitivity, specificity, and accuracy were 100%, 40%, 66% for DPL and 94.7%, 50%, 84% for abdominal echograms respectively. Besides the better correlation with the results for echogram, it provides easy availability, noninvasiveness, and imaging function. Thus we recommend that the echogram be the first-line screening test DPL acts as a complementary test, especially in the cases of bowel perforation.

Abdominal Injuries↗
PubMed1995

Torsion of an ovarian borderline tumor with extreme serum tumor markers: a case report.

A postmenopausal woman with torsion of the left ovarian mucinous cystadenoma with borderline malignancy is reported. Extremely elevated serum tumor markers such as carcinoembryonic antigen (CEA) (398.0 ng/mL, normal < 3.0 ng/mL), carbohydrate antigen 19-9 (CA 19-9) (240 U/mL, normal < 37 U/mL) and tissue polypeptide antigen (TPA) (1,918 U/L, normal < 110 U/L) were found preoperatively. Imaging studies such as ultrasound and computed tomogram favored a diagnosis of ovarian malignancy, and advanced ovarian cancer was suspected prior to operation. Diagnosis of borderline malignancy was first made by frozen section during laparotomy. The patient recovered following simple total hysterectomy and bilateral salpingo-oophorectomy. Serum levels of the tumor markers became normal gradually following operation. To present knowledge, this is the first reported case with extremely high serum tumor markers in a postmenopausal woman with torsion of a stage-Ia ovarian mucinous cystadenoma of borderline malignancy. Rapid release of these tumor markers into circulation secondary to necrosis and degeneration of the tumor cells following torsion might account for such an unusual finding.

Aged↗
PubMed1995

Female genital tuberculosis: report of seven cases.

Seven cases of histologically proven genital tuberculosis (TB) encountered at the National Taiwan University Hospital in the past 16 years were reviewed. From a total of 54,576 gynecologic specimens submitted for pathologic examination, the occurrence of genital TB was 0.01%. Of these seven patients, one suffered from primary infertility and one from secondary infertility. The patient with primary infertility had been married for 29 years. The patient with secondary infertility underwent a tuboplasty due to bilateral hydrosalpinx. Genital TB was not diagnosed preoperatively in any of the seven cases. The preoperative diagnoses included: postmenopausal spotting, ovarian malignancy, cervicitis, ectopic pregnancy and hydrosalpinx with secondary infertility. This review suggests that genital TB is becoming rare in Taiwan. It is difficult to diagnose from clinical symptoms and is usually discovered on pathologic examination.

Adult↗
PubMed1995

Factors that influence the operative mortality after blunt hepatic injuries.

OBJECTIVE: To analyse causes of death and possible factors that influenced the operative mortality in patients with blunt hepatic injuries. DESIGN: Retrospective case study. SETTING: Medical center, Taiwan. PATIENTS: 109 adult patients with blunt hepatic injuries were treated surgically over the four year period from September 1987 to August 1991. MAIN OUTCOME MEASURE: Mortality. RESULTS: 36 patients (33%) had hepatorrhaphy or no repair, complex repairs were done for 73 patients (67%) and the overall mortality was 22% (24/109). Of those deaths, however, 4 were not liver-related, giving us a liver-related mortality of 19% (20/105). Fourteen of the liver-related deaths occurred within 24 hours of injury of hemorrhagic shock or coagulopathy. Six occurred after 24 hours of sepsis and multiple system organ failure. Multivariate analysis showed that higher initial aspartate aminotransferase (AST) and Injury Severity Score as well as increasing operative blood loss resulted in a worsening prognosis. CONCLUSION: The initial AST activity and Injury Severity Score as well as the total operative blood loss were the significant factors that influenced the operative mortality after blunt hepatic injuries in our study. Prompt, expeditious, and appropriate surgical management to control operative loss is the only way for the surgeon to reduce the mortality of blunt hepatic injuries.

Adolescent↗
PubMed1994

Malignant fibrous histiocytoma of the broad ligament.

Malignant fibrous histiocytoma of the broad ligament origin is extremely rare. We report a case of a 64-year-old female with a broad ligament tumor mass, who underwent complete excision of the mass, total hysterectomy, and bilateral salpingo-oophorectomy. Pathology showed a malignant fibrous histiocytoma of the broad ligament. The postoperative course was uneventful and no radiation or chemotherapy was given. She has been carefully monitored for 16 months and is without recurrence.

Broad Ligament↗
PubMed1994

Rapid purification of antiserum against Mycoplasma hyopneumoniae by an efficient absorption method.

A simple and efficient method for the removal of unwanted cross-reactive antibodies has been developed. The antiserum purification method was based on treatment of the antiserum with both sonicated extracts and boiling extracts of the Escherichia coli host cells used in immunoscreening the lambda EMBL3 library. We have demonstrated unambiguously that through this simple treatment, the rabbit anti-Mycoplasma hyopneumoniae antiserum can be effectively purified so that the amount of antibodies cross-reacted with Escherichia coli lysate proteins is drastically reduced. Compared with the traditional absorption methods, which require the chemical coupling of an absorbing agent to an insoluble support, and affinity purification methods, which have harsh denaturing condition, this method should greatly facilitate a successful immunoscreening experiment.

Animals↗
PubMed1994

Alpha-fetoprotein in women during pregnancy and in the neonate during intrapartum.

To evaluate alpha-fetoprotein (AFP) levels in women during pregnancy and in the neonate, 256 singleton pregnancies without medical, gynecologic, obstetric, or neonatal complications were studied. Sera for measuring maternal AFP (MAFP) levels were taken in midtrimester (16 to 18 weeks), third trimester (32 to 34 weeks), and during intrapartum (38 to 41 weeks). For measuring umbilical arterial AFP (UAAFP) and umbilical venous AFP (UVAFP) levels, sera of newborn were taken from the umbilical cord at delivery. AFP levels were measured by radioimmunoassay. Our results show that the MAFP levels at third trimester were higher than during intrapartum or midtrimester. Birthweights correlated well with MAFP levels in midtrimester. However, they did not significantly correlate with the MAFP levels at third trimester or intrapartum, nor with UAAFP or UVAFP levels. UAAFP levels were not significantly different from UVAFP levels. Intrapartum MAFP correlated well with UAAFP but not with UVAFP, birthweight, or parity. The concentration gradient between fetal and maternal serum during intrapartum is approximately 750:1. We conclude that MAFP levels in midtrimester can reflect birthweight. The data of normal AFP gradient may also be useful for diagnosing intrapartum fetomaternal hemorrhage.

Analysis of Variance↗
PubMed1994

Persistent gestational trophoblastic tumour with partial hydatidiform mole as the antecedent pregnancy.

OBJECTIVE: A 16 year review of persistent gestational trophoblastic tumour when the antecedent pregnancy was a partial hydatidiform mole. DESIGN: Cases of persistent gestational trophoblastic tumour with partial hydatidiform mole as the antecedent pregnancy were reviewed for the period 1976 to 1992. DNA ploidy was analysed by flow cytometry. SETTING: A University Hospital which is a reference centre for gestational trophoblastic tumour. SUBJECTS: The case notes of 207 women with persistent gestational trophoblastic tumour were reviewed. MAIN OUTCOME MEASURES: A rise (or failure to fall) of beta hCG titre, or sign of metastasis. RESULTS: Six (2.9%) women had partial hydatidiform mole as the antecedent pregnancy and all were initially judged to be low risk. However, two developed pulmonary metastasis; one woman developed persistent gestational trophoblastic tumour shortly after a hysterotomy, and none developed choriocarcinoma. The geometric mean of serum beta hCG concentrations at the initiation of chemotherapy was 868 mIU/ml (95% CI 114-1524). Of the six women, one achieved remission after total abdominal hysterectomy, and five after chemotherapy. The mean interval from starting treatment to remission was 68 days (95% CI 27.9-108.0). The initial beta hCG titre and interval were not statistically different from those found in cases of persistent gestational trophoblastic tumour when the antecedent pregnancy was not partial hydatidiform mole. Of the six, the DNA content was triploid in three and diploid in two. One of the two diploid cases required multiple courses of chemotherapy to achieve remission. CONCLUSION: Partial hydatidiform mole can have malignant sequelae and can develop very soon after treatment. Its DNA content can be either diploid or triploid, the lungs being the most common site of metastasis. After evacuation of partial hydatidiform mole, immediate chest X-ray and regular follow up of the serum beta hCG level is necessary.

Adult↗
PubMed1994

Fetal sex and maternal alpha-fetoprotein concentration at late normal singleton pregnancies.

The aim of this study is to investigate maternal and fetal clinical parameters on maternal serum alpha-fetoprotein (MAFP) levels at late pregnancies. The studied subjects were 36 to 40 weeks pregnant. The pregnancies were singletons without any medical or gynecologic disease. Delivery followed within three days after blood sampling. A total of 192 subjects were included. The MAFP levels were measured by radioimmunoassay. The results showed the average MAFP was 108.2 ng/ml (SE 4.8 ng/ml). Male-fetus-bearers had higher MAFP (mean 121.4, SE 8.2 ng/ml, n = 84) than female-fetus-bearers (mean 97.9, SE 5.43 ng/ml, n = 108) (p = 0.014). MAFP did not have significant correlation with fetal weight (p > 0.05) regardless of whether the fetus was a male (p > 0.05) or female (p > 0.05). By stepwise multiple regression, fetal sex was revealed to be the only factor that can affect MAFP (p = 0.0071). MAFP did not correlate with maternal age, gravidity, parity, maternal weight, total weight gain during pregnancy, gestational weeks, or fetal weight (all p > 0.05). Since fetal sex is the only factor that influences MAFP levels at uncomplicated late pregnancies, MAFP values should be interpreted with caution.

Female↗
PubMed1994

Does the loop electrosurgical excision procedure adversely affect the histopathological interpretation of cervical conization specimens?

OBJECTIVE: To assess the suitability of conized specimens obtained by loop electrosurgical excision procedure for histopathological interpretation. METHODS: We evaluated the histological pictures of 215 tissue sections obtained by loop electrosurgical excision procedure. These sections came from 32 cases of patients with various degrees of cervical intraepithelial neoplasia. All women included in our study had a satisfactory colposcopy and no cytological or colposcopic evidence of invasive cancer. We quantified the thickness of thermal damage in the tissue sections using a stage-mounted, calibrated grid microscope. RESULTS: At its greatest extent, thermal damage occurring next to incision lines ranged from 160 to 520 mu (mean 262, SE 14 mu). Two different zones of thermal damage were produced by LEEP: the carbonization and coagulation zones. The carbonization zone was located at the outermost layer and was very thin, measuring from 10 to 30 mu in depth. The coagulation zone was adjacent to the carbonization zone, was eosinophilic, and was significantly deeper than the carbonization zone at its points of greatest thickness (150 to 500 mu; p < 0.0001, Student's t-test). The depth of the coagulation zone correlated significantly with the depth of the carbonization zone (p = 0.041, least linear correlation). Tissue distortion was present in 53% (17/32) of the cases, and appeared only in the coagulation zone. CONCLUSION: Tissue structure from the diseased portions of the conized specimens was generally well preserved. The area of thermal damage was limited and thus did not result in diagnostic problems. We conclude that LEEP is a reliable method for obtaining tissue samples for histopathological examination.

Adult↗
PubMed1994

Evaluation of immunosuppressive acidic protein in human ovarian cancer.

This study was conducted to determine the levels of serum immunosuppressive acidic protein (IAP) in Chinese female controls and patients with ovarian tumors; and to examine the usefulness of serum IAP as an additional diagnostic test for ovarian cancer. Serum IAP was determined by a single radial immunodiffusion method. Blood samples were collected prior to surgery from patients with ovarian tumors and from female controls. A histologic diagnosis was made, and staging was performed on the basis of the FIGO staging system for ovarian cancer. The studied subjects included 33 healthy controls, 33 patients with benign ovarian tumors and 32 patients with ovarian cancer (stage I-III, and recurrent). The data were analyzed by Student's t test, Fisher's exact test and the one-way ANOVA test. The mean (+/- SD) level of serum IAP in controls was 330 +/- 61 micrograms/ml. The calculated normal upper limit (mean plus 2 SD) was 452 micrograms/ml. The mean value (867 +/- 392 micrograms/ml) in ovarian cancer was significantly higher than the controls (p < 0.001) or the benign ovarian tumors (333 +/- 95 micrograms/ml) (p < 0.001). Five (15.6%) of 32 patients with ovarian cancer had false-negative results. Three (9.1%) of 33 patients with benign ovarian tumors showed false-positive IAP levels. The pathologic diagnosis of these three patients revealed that two had endometrioma and one had mucinous cystadenoma with hemorrhagic necrosis. Three of four patients with epithelial ovarian cancer of borderline malignancy had IAP levels only slightly higher than the cut-off point of 452 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗