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Biomedical subjects

T C Chang

Publications and source records attributed to T C Chang.

At least 91 records · Page 5Linked to original sources
PubMed1997

Comparison of the beta-glucuronidase assay and the conventional method for identification of Escherichia coli on eosin-methylene blue agar.

The purpose of this study was to compare the IMViC (indole, methyl red, Voges-Proskauer and citrate utilization) tests with the beta-glucuronidase (GUD) assay for the identification of suspect Escherichia coli on Levine's eosin-methylene blue (EMB) agar. After testing 258 suspect E. coli colonies from raw meat and meat products, 163 and 44 were found to be E. coli and non-E. coli, respectively, by both methods. Nine isolates were IMViC positive (i.e., + + - - or - + - -) but GUD negative; among these isolates, six were confirmed to be E. coli by API 20E (bioMerieux, Marcy-I'Etoile, France) with the remaining three being non-E. coli. There were 42 isolates that were IMViC negative but GUD positive; among these isolates, seven were pure E. coli cultures, 33 were mixed cultures containing E. coli, and the remaining two were Proteus spp. The sensitivities for the identification of E. coli on EMB were 80.9% (169/209) and 97.1% (203/209), respectively, by the IMViC tests and GUD assay; whereas the specificities were 93.9% (46/49) and 95.9% (47/49), respectively, by the IMViC tests and GUD assay. It is proposed that the GUD assay can be an effective alternative to the conventional IMViC tests for the identification of suspect E. coli on EMB.

Agar↗
PubMed1997

Nuclear area measurements of parathyroid adenoma, parathyroid hyperplasia and thyroid follicular adenoma. A comparison.

OBJECTIVE: To determine whether nuclear area (NA) measurement could help to differentiate parathyroid adenoma, parathyroid hyperplasia and thyroid follicular adenoma in aspirated smears. STUDY DESIGN: Aspirated smears of 15 patients with parathyroid adenoma, 11 patients with parathyroid hyperplasia and 11 patients with thyroid follicular adenoma were included. NA of 100 cells in each case were measured by image analysis; then the mean and coefficient of variation were calculated. RESULTS: There was no statistically significant difference in the mean of NA between parathyroid adenoma and parathyroid hyperplasia, but the former displayed greater NA variation. Thyroid follicular adenoma revealed a significant elevation in the mean of NA when compared with parathyroid lesions and also shared the feature of greater NA variation when compared with parathyroid hyperplasia, as noted in parathyroid adenoma. CONCLUSION: Quantitative assessments on NA and calculation of their coefficient of variation are helpful in differentiating between parathyroid adenoma, parathyroid hyperplasia and thyroid follicular adenoma.

Adenoma↗
PubMed1997

Endotracheal tube size selection guidelines for Chinese children: prospective study of 533 cases.

Appropriate selection of the size of an endotracheal tube (ETT) for use in children is important both in general anesthesia and critical care practice. Past published data on guidelines for selecting ETT size in children are based on Caucasian measurements. As body build is generally different in Chinese children compared with Caucasians of the same age group, guidelines for Chinese children are needed. The aim of this study was to determine guidelines for ETT size selection by recording and comparing age, body weight, length, head girth and circumference of the right fifth finger of the child. Correlations between internal diameter (ID) of the chosen ETT and the child's data were calculated and compared. In this study, 533 Chinese children. American Society of Anesthesiolgists class I or II, aged from 3 months to 6 years, undergoing oral intubation for general anesthesia for minor pediatric surgery were enrolled. Our results showed that body length (height) had the best correlation to the size of an uncuffed oral ETT. Through stepwise regression, a formula. ETT ID = 2 + (body length (cm)/30), was obtained.

Asian People↗
PubMed1997

Clinical significance of thyrotropin-binding inhibitor immunoglobulin levels in newborns and their mothers.

We investigated whether determination of thyrotropin-binding inhibitor immunoglobulin (TBII) indices in newborns with hyperthyrotropinemia on neonatal screening, or those born to mothers with autoimmune thyroid diseases, and their mothers could predict the newborns' thyroid status. We selected 195 babies born between 1988 and 1996. TBII indices in the sera of these newborns and their mothers were tested at some time from Day 1 to Day 30 after birth, and followed up after that. The subjects were divided into four groups according to the TBII index. Group 1 consisted of 17 pairs of mothers and newborns who both had serum TBII indices greater than or equal to 15%, including four transiently hyperthyroid and 13 transiently hypothyroid newborns. Group 2 comprised 166 pairs who both had a TBII index less than 15%, including one euthyroid and 165 hypothyroid newborns. Eight of the 165 warranted permanent thyroxine therapy due to athyreosis or ectopic thyroid gland. Group 3 consisted of one pair in which the newborn's serum TBII index was 15% or higher but the mother's was less than 15%: the newborn was transiently hypothyroid. Group 4 comprised 11 pairs in which the newborns' serum TBII indices were greater than or equal to 15% but the mothers' were less than 15%. These 11 newborns were all transiently hypothyroid and nine of them warranted transient thyroxine replacement therapy. The results suggest that the long-term outcome of newborns is good when TBII indices are at least 15% in the mother and child because their thyroid dysfunction seems to be related to the transient presence of the transplacental TBII from the mother. When TBII indices in both mother and child are less than 15%, the newborns warrant further investigation due to the likelihood of permanent hypothyroidism.

Autoantibodies↗
PubMed1997

Computerised analysis of foetal heart rate variation: prediction of adverse perinatal outcome in patients undergoing prostaglandin induction of labour at term.

The aim of this study was to determine the value of antenatal numerical assessment of foetal heart rate variation in the prediction of adverse perinatal outcome in patients undergoing prostaglandin induction of labour at term. Two hundred and seven patients who underwent prostaglandin cervical ripening after 37 weeks gestation for the indications of pregnancy-induced hypertension, foetal growth retardation or post-dates pregnancy were included in this study. Prior to commencement of cervical ripening, a 30-minute cardiotocography tracing was recorded on the System 8000 machine and the long-term and short-term variations were calculated. Forty-three patients (20.8%) had a long-term variation of less than 30 ms; 9 (4.3%) had a short-term variation of less than 3 ms. The sensitivity and positive predictive values of long-term variation in the prediction of admission to neonatal special care unit were 25.6% and 23.2%, respectively. Corresponding values for short-term variation were 2.6% and 11.1%, respectively. The sensitivity and positive predictive values of long-term variation in the prediction of caesarean section for foetal distress were 33.3% and 9.3%, respectively. Corresponding values for short-term variation were 8.3% and 11.1%, respectively. Long-term and short-term variations appeared to be both poor predictors of adverse perinatal outcome. However, of 4 foetuses with both reduced antenatal heart rate variation and who were subsequently delivered by caesarean section for foetal distress in labour, all 4 were admitted to neonatal special care unit (NSCU). Foetuses with intrapartum evidence of foetal distress were more likely to be admitted to NSCU when antenatal foetal heart rate variation was reduced.

Adult↗
PubMed1997

Cervicovaginal foetal fibronectin in the prediction of preterm labour in a low-risk population.

The aim of this study was to evaluate the role of cervicovaginal fibronectin as a screening test in a low-risk population. Swabs were taken from the posterior fornix at 28 weeks gestation and foetal fibronectin levels were assayed using enzyme immunoassay. Eighteen patients (7.7%) delivered at less than 37 weeks of gestation, and 6 (2.4%) at less than 34 weeks of gestation. Five patients (2.1%) had a positive fibronectin test result. The sensitivity, specificity, positive predictive value and negative predictive value in the prediction of delivery less than 37 weeks of gestation were 16.7%, 99.1%, 60.0% and 93.4%, respectively. The sensitivity of foetal fibronectin in the prediction of delivery less than 34 weeks of gestation was higher (50%) compared with the prediction of delivery less than 37 weeks of gestation (16.7%). The low sensitivity of this test suggests a limited role for cervicovaginal fibronectin in the low-risk population. Further studies need to be carried out to assess whether multiple testing of cervicovaginal fibronectin at different gestational ages will further increase the sensitivity.

Cervix Uteri↗
PubMed1996

The role of DNA flow cytometry in borderline malignant ovarian tumors.

BACKGROUND: The role of flow cytometric DNA analysis in predicting prognosis of patients with borderline malignant ovarian tumors has been controversial. METHODS: Fifty cases of patients with borderline malignant ovarian tumors were analyzed by histology and by flow cytometry on paraffin embedded tissue. Multiple tissue blocks and serial sections were analyzed for each tumor. The results of DNA analysis were correlated to clinicopathologic data. RESULTS: DNA aneuploidy was demonstrable in 4 cases (8%) when the most atypical section was analyzed. The overall rate of aneuploidy was 14% if additional blocks and serial sections were studied. Two patients died from tumor. One of the two patients had an initial diagnosis of Stage IIc mucinous borderline tumor with DNA indices (DI) of 1.12, 1.42, and 2.04. She had a recurrence in the contralateral ovary 1 year later (DI = 1.83), and a second frankly malignant recurrence diffusely in peritoneum (DI = 1.89). The other patient had an initial diagnosis of Stage IIIc mucinous borderline ovarian tumor with pseudomyxoma peritonei. DNA diploidy was obtained in all of the samples from the primary tumor. An aneuploid peak (DI = 1.28) was demonstrated in only one serial section of the peritoneal implants. Of the other 5 patients who had aneuploid histograms but were disease-free, the DNA indices were 1.35, 1.14/1.18, 1.15, 1.20, and 1.31 and were demonstrable only in either 1 or 2 of the blocks or unproven on serial sections. All patients with diploid-peridiploid tumors were alive and disease free. CONCLUSIONS: Reproducible DNA aneuploidy of high DI may be predicting a poor outcome, whereas the significance of inconsistently reproducible aneuploidy of low DI remains to be determined. Further studies of prospective DNA analysis with adequate sampling are necessary to define the role of flow cytometry in patients with borderline malignant ovarian tumors.

Adolescent↗
PubMed1996

Malignant rhabdoid tumor of the uterine corpus.

Malignant rhabdoid tumor (MRT) was first described as a variant of Wilms' tumor but was subsequently found to be a highly malignant tumor composed of primitive cells that resemble rhabdomyoblasts. In the past decade, extrarenal MRTs were reported in different locations and organs throughout the body including the female genital tract. We here report an MRT that arose in the corpus uteri, the second such case reported.

Adult↗
PubMed1996

Squamous cell carcinoma arising in mature cystic teratoma of the ovary.

Treatment results of 26 patients with squamous cell carcinoma (SCC) arising in mature cystic teratoma of the ovary were analyzed. Four nulliparous patients with stage Ia tumors underwent conservative salpingo-oophorectomy. Following surgery, 2 patients had successful pregnancies. The remaining 7 patients with stage Ia tumors were observed after hysterectomy and bilateral salpingo-oophorectomy. Fifteen patients with stage Ic-IV tumors underwent cytoreductive surgery followed by cis-platinum-based chemotherapy with or without sequential radiotherapy. The mean survival was 63.9 months. The overall actuarial disease-free survival at 2 years was 69%, and by stage was as follows: stage I, 100% (13/13); stage II, 100% (2/2); stage III, 30% (3/10); and stage IV, 0% (0/1). A significant difference in disease-free survival was noted in stage (P = 0.0001). Optimal versus suboptimal operation was associated with a median Kaplan-Meier survival of 65 months versus 34.8 months, with actuarial disease-free survival at 2 years of 60 and 0%, respectively (P = 0.0210). Our study shows that 67% (16/24) of the patients had SCC antigen levels exceeding 2 ng/ml, which by stage was as follows: stage I, 5/11 (45%); stage II, 1/2 (50%); stage III, 9/10 (90%); and stage IV, 1/1(100%). After completion of treatment, all 8 patients with recurrent lesions had reelevated SCC antigen levels in series SCC antigen monitoring. In conclusion, positive prognostic factors of disease-free survival were optimal cytoreduction and lower FIGO stage. We suggest that multimodality therapy, including aggressive cytoreduction followed by cis-platinum-based chemotherapy with or without sequential radiotherapy, is recommended. In addition, we suggest that serum SCC antigen monitoring may be helpful in early detection of cancer recurrence.

Adult↗
PubMed1996

Comparison of the efficacy of tropisetron versus a metoclopramide cocktail based on the intensity of cisplatin-induced emesis.

Cisplatin-induced emesis is one of the most feared side effects in cancer treatment. High-dose metoclopramide may prevent only 30-40% of cases of acute emesis. Investigations to test the efficacy of new antiemetics are mandatory. We compared the efficacy, toxicity, and patients' preference for tropisetron, a new 5-hydroxytryptamine3 (HT3) receptor antagonist, with those of a combination of high-dose metoclopramide, dexamethasone, diphenhydramine, and lorazepam (metoclopramide cocktail) in a randomized crossover study for the control of nausea and vomiting during cisplatin-containing chemotherapy. A total of 62 chemotherapy-naive women were included and followed over 3 consecutive courses. Detailed analysis comparing the incidence of acute emesis for each 4 h period following cisplatin infusion was also performed. Complete protection from acute emesis was obtained in 48% of patients receiving tropisetron and 29% of patients receiving the metoclopramide cocktail over the first two courses of chemotherapy (P = 0.029). When the frequency of acute emesis in all patients was compared on a daily basis, no significant difference was found. When emesis frequency was compared over each 4 h period following infusion of cisplatin, tropisetron was superior to the metoclopramide cocktail during the first, the second, and the first and second periods (P = 0.0001, P = 0.01 and P = 0.0006, respectively). This superiority reversed after 12 h but did not reach statistical significance (P = 0.112). Tropisetron was more effective in controlling acute nausea, but metoclopramide provided better control of delayed emesis. A drop in efficacy over successive courses was observed in patients receiving metoclopramide first but was not seen in tropisetron-first patients. A tendency for tropisetron preference was observed. Tropisetron is more effective than the metoclopramide cocktail in the control of chemotherapy-induced vomiting within 8 h of the implementation of cisplatin and in the control of nausea on the 1st day. To improve the control of chemotherapy-induced emesis, further investigations on the additional tropisetron dosing at 8 h after cisplatin infusion or the combination use of tropisetron and other antiemetics by a continuous 4 h period of observation and comparison are mandatory.

Adult↗
PubMed1996

Cloning and sequencing of complete thyrotropin receptor transcripts in pretibial fibroblast culture cells.

Pretibial fibroblasts are considered to be targets of autoimmune attack in pretibial myxedema. A possibility of the pathogenesis of pretibial myxedema is that T cells, reacting with thyrotropin (TSH) receptor, will be targeting to the pretibial fibroblasts where, in the presence of antigen (TSH receptor), they will secrete various cytokines and stimulate fibroblasts to secrete glycosaminoglycans. We have demonstrated that TSH and TSH receptor antibody can bind to fibroblasts and the presence of RNA encoding the extracellular domain of the TSH receptor in fibroblasts derived from skin lesions of two patients with pretibial myxedema. The present study was designed to determine whether there are complete TSH receptor transcripts in pretibial fibroblasts obtained from patients with pretibial myxedema. RNA was prepared from pretibial fibroblasts obtained from 11 patients with pretibial myxedema and from four normal subjects, then reverse-transcribed by polymerase chain reaction using three sets of primers (-11/+8 and +754/+773; +353/+373 and +1265/+1285; +1000/+1017 and +2284/+2301). The overlapped 2312 bp cDNA sequence was expected to contain the genetic sequences of the signal peptide (+1/+60), extracellular domain (+61/+1254), transmembrane domain (+1255/+2046), and cytoplasmic domain (+2047/ +2292) of the TSH receptor. The sequences were determined using dideoxy sequencing method. All of the 2312 nucleotide sequences in 15 samples were consistent with the reported TSH receptor sequence of transcripts in thyroid. These data suggest that the complete TSH receptor transcripts are very possible to be present in the fibroblasts derived from pretibial skin.

Adult↗
PubMed1996

Rapid detection of Vibrio parahaemolyticus in oysters by immunofluorescence microscopy.

A method of indirect immunofluorescence microscopy was developed for the rapid detection of Vibrio parahaemolyticus in oysters. Affinity-purified antibodies against two outer membrane proteins (molecular mass 36 and 34 kDa, respectively) of V. parahaemolyticus were used as the primary antibodies to label the vibrio, and fluorescein isothiocyanate-conjugated goat anti-rabbit immunoglobulin G was used to reveal the antigen-antibody reaction. Of 85 strains of V. parahaemolyticus tested, all produced strong fluorescence under the fluorescence microscope. However, for 63 strains (including 27 vibrios) of other bacteria tested, 6 produced weak to moderate fluorescence. The sensitivity and specificity of the immunostaining technique were 100 and 90.5%, respectively. In the inoculation experiments, as low as 1.7 CFU/g of V. parahaemolyticus spiked in oysters could be detected by the immunostaining method after 18-h enrichment in alkaline peptone water containing 3% NaCl. The immunofluorescence microscopy is recommended for rapid screening of V. parahaemolyticus in oysters; a presumptive positive result could be obtained within 24 h.

Animals↗
PubMed1996

Detection of protein A produced by Staphylococcus aureus with a fiber-optic-based biosensor.

Staphylococcus aureus is a pathogen important in causing human infections and intoxication. A sensitive fiber-optic that produces evanescent waves was developed for the detection of protein A, a product secreted only by S. aureus. In the immunosensor, a 40-mV argon-ion laser that generated laser light at 488 nm was used together with plastic optical fiber and antibodies to protein A were physically adsorbed onto the fiber. The principle of the detection involved a sandwich immunoassay with fluorescein isothiocyanate conjugated with anti-(protein A) immunoglobulin G to produce signals of the antigen-antibody reaction. The detection limit was 1 ng of protein A per milliliter. The fiber-optic immunosensor could be used for rapid and specific detection of S. aureus in clinical specimens and foods.

Biosensing Techniques↗
PubMed1996

Metastatic choriocarcinoma with spontaneous splenic rupture following term pregnancy: a case report.

Choriocarcinoma is a rare neoplasm which often spreads extensively. The metastases sometimes appear in the abdominal cavity where they can cause dramatic symptoms. We here describe a patient who had received a cesarean section twelve days before and intraperitoneal hemorrhage was diagnosed when she visited Chang Gung Memorial Hospital's emergency department. At laparotomy, ruptured spleen with active bleeding was found and splenectomy was performed. The histopathologic study revealed a metastatic choriocarcinoma. Multiagent chemotherapy was administrated and the patient responded well. To our knowledge, this is the fourth reported case that metastatic choriocarcinoma resulted in spleen rupture presenting as the principal sign of acute hemoperitoneum. Metastatic choriocarcinoma with rupture should be considered a cause of intraperitoneal hemorrhage in women of child-bearing age.

Adult↗
PubMed1996

Embryonal rhabdomyosarcoma of the uterine corpus mistaken for small cell carcinoma: a case report.

Pure rhabdomyosarcomas of the female genital tract mostly occur in infancy and childhood, in the form of sarcoma botryoides (a variant of embryonal rhabdomyosarcoma), with vagina and cervix as typically involved sites. Such tumors rarely occur in the uterine corpus and cervix of adults. We would like to report a pure embryonal rhab-domyosarcoma of the uterine corpus that arose in a 31-year-old, gravida 1, para 1, female patient with widespread bony metastasis, and which was originally mistaken for metastatic small cell carcinoma to bone marrow.

Adult↗
PubMed1996

Staged operation for Graves' ophthalmopathy.

A four-staged operation is currently the most effective treatment available in the management of stable Graves' ophthalmopathy. This report describes the results of four-staged therapy in 51 patients with Graves' ophthalmopathy. Stage I, orbital decompression: 58 orbits in 32 patients underwent orbital decompression, with an average retroplacement effect of 4.2 +/- 2.2 mm (mean +/- SD). This procedure is effective to restore vision and correct the proptosis due to Graves' ophthalmopathy. Careful intraoperative titration of the retroplacement effect during orbital decompression is very important to achieve successful results. Stage II, strabismus surgery: 24 patients underwent strabismus surgery, including 11 with previous decompression surgery and six with previous simultaneous decompression and strabismus surgery. The overall success rate was 87% and previous decompression or strabismus surgery had no influence on the final results. Stage III, fissure width adjustment: 28 patients (45 eyes) received fissure width adjustment. Various procedures were performed and we found Müllerectomy with levator muscle stripping to be the most useful procedure for fissure width adjustment. The average improvement of fissure height was 3.1 +/- 1.8 mm. The rate of overall satisfactory results was 89%. There were five patients who received Staged IV cosmetic procedures with satisfactory results. Graves' ophthalmopathy is a chronic disease that needs thorough cooperation between doctor and patient. Careful evaluation of clinical parameters and individualized surgical goals are the keys to success.

Adult↗