Biomedical subjects

R S Jiang

Publications and source records attributed to R S Jiang.

18 recordsLinked to original sources

PubMed2001

Bacteriology of chronic sinusitis after amoxicillin-clavulanate potassium therapy.

The bacteriology of chronic sinusitis was studied after amoxicillin-clavulanate potassium therapy. Patients with chronic sinusitis were randomly divided into 2 groups. In the study group, 90 patients were given a 2-week course of amoxicillin-clavulanate potassium before functional endoscopic sinus surgery. In the control group, 113 patients did not take any antibiotics within 2 weeks before the surgery. Swab specimens were taken from the maxillary and ethmoid sinuses during surgery and sent for aerobic and anaerobic culture. In the study group, the culture rates of maxillary and ethmoid sinuses were 45.6% and 28.9%, respectively. In the control group, the culture rates of maxillary and ethmoid sinuses were 53.1% and 34.5%, respectively. The culture rates between the control group and the study group were not significantly different, either for the maxillary sinus or the ethmoid sinus. This showed that treatment with amoxicillin-clavulanate potassium did not change the bacteriology of chronic sinusitis.

Adolescent↗

PubMed2001

Endoscopic sinus surgery for the treatment of chronic sinusitis in geriatric patients.

Although endoscopic sinus surgery is a well-documented procedure for the treatment of chronic sinusitis in children and adults, no study has been conducted to specifically investigate its application in a geriatric population. We undertook to fill this void by analyzing the records of 1,112 patients who had undergone endoscopic sinus surgery for chronic sinusitis in our department between April 1988 and March 1998. We categorized these patients by age. There were 171 patients (15.4%) in the geriatric group (age: > or = 65 yr), 837 patients (75.3%) in the adult group (age: 17 to 64), and 104 patients (9.4%) in the pediatric group (age: < or = 16 yr). We found that the geriatric group experienced a disproportionately larger share of operative complications, but most of them were minor. Outcomes were similar in all three groups. We conclude that endoscopic sinus surgery is a safe and effective treatment for older patients with chronic sinusitis.

Adolescent↗

PubMed2001

Endoscopic optic nerve decompression for the treatment of traumatic optic neuropathy.

Optic nerve decompression has been accomplished by a variety of procedures. Since 1995, endoscopic optic nerve decompression (EOND) has been used to treat traumatic optic neuropathy (TON) patients in our hospital after medical treatment failed. To date, 17 TON patients have received EOND in our hospital and have been followed up for more than half a year. After decompression, vision improved in 9 patients, remained the same in 6, and became worse in 2. The dura was incidentally exposed during the operation in 1 patient. We conclude that it is easier and more precise to perform optic nerve decompression by EOND than by other optic nerve decompression procedures. However, its efficacy still needs further investigation.

Adolescent↗

PubMed2000

Functional endoscopic sinus surgery in children and adults.

Functional endoscopic sinus surgery (FESS) has become a popular procedure for the treatment of adults with chronic sinusitis. Recently, it has also been applied in the pediatric population. It has been used to treat chronic sinusitis in our department since April 1988. As of March 1998, 1,112 patients were available for analysis by file and questionnaire review. Of the 1,112 patients, 104 patients (9.4%) who were 16 years of age or younger at the time they first underwent FESS in our department were included in the pediatric endoscopic sinus surgery (PESS) group. The other 1,008 patients (90.6%) were included in the ordinary FESS group. In total, 121 PESS and 1,106 (adult) FESS operations were performed on these patients. Operative complications occurred in 5 PESS operations (4.1%) and 116 FESS operations (10.5%). The postoperative improvement rate was 84% in PESS and 77.1% in FESS. We conclude that PESS can be applied to treat chronic sinusitis effectively in the pediatric population and with less morbidity than FESS.

Adolescent↗

PubMed2000

Endoscopic sinus surgery for ethmoid sinus meningioma.

Meningiomas in the ethmoid sinuses are a challenge to manage. A 50-year-old man suffered from a left olfactory groove meningioma. He underwent a bilateral craniotomy to remove the tumor mass in August, 1997. During the follow-up period, a tumor was found in the right posterior ethmoid sinus. Endoscopic sinus surgery was performed to remove the tumor mass in August, 1998. Pathologic examination of the mass revealed a meningioma. No intraoperative or postoperative complications occurred, except for an episode of seizure.

Endoscopy↗

PubMed1999

Bacteriology of endoscopically normal maxillary sinuses.

The bacteriology of maxillary sinuses with normal endoscopic findings is reported in this study. When transantral sinoscopy was used to examine the maxillary sinuses, the whole maxillary sinus was inspected with different-angle endoscopes. If no lesion was seen over the whole maxillary sinus mucosa, no secretion existed in the maxillary sinus cavity, and the maxillary sinus ostium was wide open, the maxillary sinus was considered endoscopically normal. The bacteriology of these endoscopically normal maxillary sinuses was studied by passing cotton-tipped sticks through the cannula to collect swab specimens. In some cases, a biopsy forceps was also passed to obtain mucosal specimens. The specimens were sent to the laboratory for aerobic and anaerobic cultures. Between July 1990 and May 1998, 83 swab and 31 mucosal specimens were collected from 69 patients who had not taken any antibiotic within 10 days before endoscopy. The culture rates were 62.3 per cent (35/53) from swab specimens and 57.1 per cent (eight out of 14) from mucosal specimens in patients with the diagnosis of chronic paranasal sinusitis, and were 46.7 per cent (14/30) from swab specimens and 41.2 per cent (seven out of 17) from mucosal specimens in patients without this diagnosis. This study shows that endoscopically normal maxillary sinuses are not sterile.

Adolescent↗

PubMed1998

Primary ethmoid sinus craniopharyngioma: a case report.

A seven-year-old boy complained of intermittent epistaxis for several months. Computerized tomography (CT) scans showed increased soft tissue density over the left ethmoid sinus. Endoscopic sinus surgery was used to remove the mass completely. The pathological report was craniopharyngioma. No other focus of lesion was found, and he continues to do well.

Child↗

PubMed1998

Bacteriology of the maxillary and ethmoid sinuses in chronic sinusitis.

The bacteriology of chronic sinusitis was studied by using swab and mucosal specimens from both the maxillary and ethmoid sinuses. The specimens of the maxillary sinus were taken through translabial antroscopy. The specimens of the ethmoid sinus were taken after removing the ethmoid bulla during functional endoscopic sinus surgery (FESS). Eighty-six samples of each type of specimen were collected. Among the maxillary sinus samples, the culture rate was 60.5 per cent from the swab specimens and 36 per cent from the mucosal specimens. Among the ethmoid sinus samples, the culture rate was 58.1 per cent from the swab specimens and 75.6 per cent from the mucosal. The p-value by the Chi-Square test is higher than 0.01 (p = 0.015). As there were more isolates of Staphylococcus epidermidis from the mucosal specimens, they are not a better choice of specimen for sampling the ethmoid sinus than a swab specimen.

Adolescent↗

PubMed1994

Influence of age, gender, and ethnicity on nasal mucociliary clearance function.

Nasal mucociliary clearance functions were measured in 46 healthy Chinese adult subjects (21 women and 25 men; age range, 27 to 75 years). A single droplet of Tc-99m MAA was placed on the floor of the nasal meatus about 1 cm behind the mucocutaneous junction, and its course was followed with a gamma camera. The nasal mucociliary clearance function was presented as the velocity (mm/minute) of nasal mucociliary transport of the Tc-99m MAA droplet. The results showed the velocity to be 4.42 +/- 2.12 mm/minute (4.61 +/- 2.37 mm/minute in the right nostril; 4.24 +/- 1.83 mm/minute in the left nostril). When the patients were grouped according to age or gender the velocity was 4.8 +/- 1.9 mm/minute (right nostril), 4.4 +/- 1.9 mm/minute (left nostril) in the older subjects (60 years and older), and 4.4 +/- 2.7 mm/minute (right nostril), 4.1 +/- 1.8 mm/minute (left nostril). In the younger subjects (59 years old and younger) (P > 0.05) the velocity was 5.0 +/- 2.7 mm/minute (right nostril), 4.3 +/- 1.8 mm/minute (left nostril) in men and 4.1 +/- 2.0 mm/minute (right nostril), 4.2 +/- 2.0 mm/minute (left nostril), in women (P > 0.05). The authors concluded that the influence of age or gender on healthy Chinese adults is not apparent. In addition, the velocity of flow in Chinese adults is slower than those in other previously reported ethnic studies.

Adult↗

PubMed1993

[Chemical constituents of Sagittaria sagittifolia L].

One terpenoids has been isolated from the MeOH extract of Sagittaria sagittifolia by repeated chromatography on silica gel. Its structure was identified as sandaracopimaric acid on the basis of spectral and physical data. Sandaracopimaric acid has good immunosuppression action.

Diterpenes↗

PubMed1991

[Comparison of nasal mucociliary clearance before and after operation in chronic sinusitis].

Nasal mucociliary clearance is a first line of defence mechanism of the respiratory system against inhaled particles. It transports particles depositing into the nasal passages to the pharynx to be swallowed or expectorated, thus protecting the respiratory system from injury. Clearance function is affected by many factors such as the chronic inflammation of the paranasal sinuses. A group of 13 healthy volunteers (controls) and a group of 17 patients suffering from chronic sinusitis was investigated in the Department of Otolaryngology of Taichung Veterans General Hospital between June and October of 1990. A radioisotope method was used to measure the velocity of nasal mucociliary transport in the participants. This involved the use of radioisotope Tc99m combined with albumin particles and measurements were made in one nasal chamber at a time. The sinusitis patients were then surgically treated and they all improved. In all 25 tests were made in the control group and the mean velocity of their mucociliary transport was found to be 4.56mm/min. In the patients 28 measurements were made and their mean velocity was found to be 2. 67mm/min before the operation and 4.03mm/min after the operation. The difference between pre- and post-operative velocities was statistically significant as was the difference between the pre-operative velocities of the patients and those of the controls. The difference between controls and patients after the operation was not significant.

Adolescent↗

PubMed1990

[Functional endoscopic sinus surgery].

Treatment of chronic paranasal sinusitis (CPS) by functional endoscopic sinus surgery refers to removal of the pathologic tissue which interferes with the physiologic function of the sinuses in the ostiomeatal complex under direct vision by use of endoscopes to restore the ventilation and drainage of the sinuses. While the ventilation and drainage of the sinuses become normal, the lesions of sinus mucosa will recover spontaneously and the function of the sinuses will be restored. From May to August 1988, functional endoscopic sinus surgery was performed in 47 cases based on the operative methods described by Dr. Stammberger. We excised the uncinate process of middle meatus and entered the infundibulum. The pathologic tissue in the frontal recess was removed first. The anterior ethmoid sinus and posterior ethmoid sinus were cleared depending on the excisable extent of the lesion and the sphenoid sinus wound be opened if necessary. Middle meatal antrosomy was finally performed to enlarge the obstructed ostium of the maxillary sinus. Seventeen of them met the criteria: 1. a history of the disease for more than 3 months and not improving or recovering after medical treatment 2. no past history of surgical treatment for CPS 3. the etiology is not dentigerous or septal deviation. Because one patient lost to follow up, sixteen patients constituted the materials of this study. About 80% of patients were improved or asymptomatic. No serious complication occurred in all patients and the most common one was the adhesion between the middle turbinate and the lateral nasal wall.

Adolescent↗

PubMed1985

Etiologic studies of the 1983 and 1984 outbreaks of epidemic diarrhea in Guangxi.

Studies are reported on two outbreaks of epidemic diarrhea in China involving 19,007 patients. The first outbreak occurred in the northern part of the Guangxi Autonomous Region and extended south from April through September 1983. In June 1984 a second outbreak of 6,570 cases occurred in Guanyang, a county in the northern part of Guangxi. 125 fecal samples from the two outbreaks were cultured for bacteria; all of the samples except one were negative. Rotavirus particles were detected in 44.1% (15/34) of stool specimens examined by immune electron microscopy. The two outbreaks appeared to be caused by non-group-A rotaviruses, based on the pattern of electrophoretic migration of the RNA genome segments in polyacrylamide gels and on the lack of a detectable common group antigen(s) when tested by an enzyme-linked immunosorbent assay for group A rotaviruses. Complement-fixation tests also indicated that 37.5% of convalescent-phase sera from patients produced antibody to the isolated rotavirus. The total molecular weight of the RNA segments in the new Guangxi strain was calculated to be 10.69 X 10(6), with the 11 genome segments having molecular weights (X 10(6)) of 2.19, 1.83, 1.56, 1.53, 0.82, 0.81, 0.60, 0.46, 0.35, 0.30, and 0.24. This study also reports comparative detection rates for direct and immune electron microscopy and for PAGE. PAGE proved to be the most sensitive detection method for these new rotaviruses.

Adult↗

PubMedDate not supplied

Bacteriology of chronic sinusitis after ampicillin therapy.

The bacteriologies of the maxillary and ethmoid sinuses were studied in 74 chronic sinusitis patients who took ampicillin (500 mg every 6 hours) for 2 weeks preoperatively. The specimens from one ipsilateral maxillary and ethmoid sinuses were obtained when undergoing functional endoscopic sinus surgery. In 74 specimens of the maxillary sinus, 38 bacterial isolates were recovered. The culture rate was 46.0%. On the other hand, 34 bacterial isolates were taken from the ethmoid sinus specimens. The culture rate was 41.9%. As compared with a previous group who did not take any antibiotic preoperatively, the culture rate significantly decreased in the maxillary as well as the ethmoid sinus specimens. Not surprisingly, a significantly decreased sensitivity to ampicillin was also found in the recovered bacteria from both the maxillary sinus (23.7%) and ethmoid sinus (5.9%) specimens. These results demonstrate that antibiotic therapy with ampicillin could eradicate most sensitive bacteria in chronic sinusitis. However, persistence of resistant bacteria was demonstrated.

Adolescent↗

PubMedDate not supplied

Bacteriology of ethmoid sinus in chronic sinusitis.

This study was designed to study the bacteriology of the ethmoid sinus in chronic sinusitis with a new sampling method to decrease nasal contamination. The anterior nose was disinfected with povidone-iodine solution. Then, the sample of ethmoid sinus was obtained with a cotton-tip stick through a cannula that was put into the ethmoid cavity after removing ethmoid bulla. Thirty-nine patients of chronic sinusitis were included with a total of 69 specimens. Fifty-eight bacterial isolates were recovered. The cultural rate was 60.9%. The most frequently isolated bacteria were Streptococcus viridans, Klebsiella pneumoniae, Proteus mirabilis, and Hemophilus parainfluenzae. Conversely, only three isolates of Staphylococcus epidermidis were obtained. The results show that the new sampling method used in this study could decrease the chance of nasal contamination and might, at the same time, make the study of the bacteriology of the ethmoid sinus more accurate.

Adolescent↗

PubMedDate not supplied

Endoscopic sinus surgery and postoperative intravenous aminoglycosides in the treatment of atrophic rhinitis.

A total of 29 atrophic rhinitis patients were treated by endoscopic sinus surgery between 1990 and 1995. After the surgery, a 7 to 10-day course of systematic aminoglycoside was administered. Two cases were excluded, due to later occurrence of nasal lymphoma in one patient and incompleteness of postoperative antibiotic therapy in the other. Among those included, atrophic rhinitis occurred in the absence of prior surgery in 24 patients, and the condition was secondary to a previous intranasal surgery in the other three patients. After a 1 to 6-year follow-up (mean: 63.4 months), seven patients were successfully managed without any characteristic symptom or sign of atrophic rhinitis. Another 18 patients felt improved. Only two patients did not have any improvement. The rate of improvement was 92.6%. Overall, one patient suffered from a left retrobulbar hematoma after operation. Exposed orbital fat was observed in the other patient. The orbital complication rate was therefore 7.4%. No other major complication occurred in this series. The bacteriologic, radiological, antroscopic, and pathologic findings are also included here. It is concluded that endoscopic sinus surgery in combination with adequate postoperative antibiotic therapy can significantly treat atrophic rhinitis.

Adolescent↗

PubMedDate not supplied

Post-functional endoscopic sinus surgery methicillin-resistant Staphylococcus aureus sinusitis.

Methicillin-resistant Staphylococcus aureus (MRSA) is a highly virulent bacterium that is difficult to eradicate. It has become a common nosocomial pathogen, but it also causes sporadic infections in some outpatients. Among 358 chronic sinusitis patients who received functional endoscopic sinus surgery (FESS) for treatment between July 1995 and June 1997 in our department, 18 were infected postoperatively by MRSA by the end of August 1997. One patient was excluded because she received another nasal surgery, partial turbinectomy, and submucous resection of the nasal septum, after FESS. Most of 17 MRSA infected patients presented themselves with mucopurulent nasal discharge and/or nasal crust. The treatment was generally difficult because MRSAs were resistant to multiple antibiotics. When quinolone antibiotics were used to treat most patients, the improvement rate was 76.5%. We conclude that MRSA infections in post-FESS patients might affect the outcome of FESS.

Adolescent↗

PubMedDate not supplied

Endoscopic sinus surgery for rhinocerebral mucormycosis.

Rhinocerebral mucormycosis is a fulminant, often fatal, disease. Aggressive surgical debridement has been considered an important part of treatment. Traditionally, an external or transantral approach has been the classic method. Recently, endoscopic sinus surgery (ESS) has been tried on several occasions to reach the goal of radical resection. Since 1991, ESS has been used to treat 9 rhinocerebral mucormycosis patients in our department. Among them, ESS was the only surgical procedure in six patients. The other three patients were treated by ESS combined with a transantral procedure. As a result, eight patients (88.9%) have survived the disease. One patient died 5 days after ESS because of an internal carotid artery occlusion. We conclude that ESS can be used to treat rhinocerebral mucormycosis alone or in combination with the traditional surgical procedures. It has the advantage of less operative morbidity and greater operative accuracy.

Adult↗