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Biomedical subjects

T G Wang

Publications and source records attributed to T G Wang.

At least 37 records · Page 2Linked to original sources
PubMed1996

Clinical experience in rehabilitation of spinal cord injury associated with schizophrenia.

OBJECTIVE: To identify the clinical features and rehabilitation outcomes in spinal cord injury (SCI) patients with preexisting schizophrenia. DESIGN: A retrospective study conducted by reviewing the charts of all patients diagnosed with both SCI and schizophrenia hospitalized from 1987 throughout 1994 in 2 rehabilitation units. SETTING: Rehabilitation wards of two hospitals in Taiwan. PATIENTS: Seventeen traumatic SCI patients with schizophrenia, including 7 men and 10 women. Patients without neurological deficits were excluded. INTERVENTION: All subjects received psychiatric intervention and intensive rehabilitation programs during hospitalization. MAIN OUTCOME MEASURES: The injury pattern and psychiatric condition were described. Abilities of locomotion, management of activities of daily living, and bladder control were measured. RESULTS: Fifteen injuries caused by a voluntary fall subsequently resulted in thoracolumbar insult. Ten incomplete paraplegics were able to ambulate with or without a device on discharge. Four subjects had poor bladder control. The outcome of self-care skills was worse in those with high level injury. Psychiatric symptoms were one of the main obstacles during rehabilitation. CONCLUSION: Voluntary fall that caused thoracolumbar injuries was the main cause of injuries in these patients. Psychiatric symptoms were present in the majority and might hinder the prognosis of treatment. Nevertheless rehabilitation programs were found to benefit subjects after their psychiatric problems were under control.

Activities of Daily Living↗
PubMed1996

Pre-thymic transcription of TCR genes by adult murine bone marrow cells.

In the adult mouse, the earliest thymocytes are derived from bone marrow-resident T lymphocyte precursor (pre-T) cells that immigrate to the thymus. There they undergo maturation through a series of developmental steps that include rearrangement and expression of the TCR genes, positive and negative selection, and functional maturation. Although these intrathymic processes have been extensively characterized, little is known about the T cell-specific events that take place in the bone marrow microenvironment. Of particular interest are the events surrounding transcription and rearrangement of the various TCR chains that are required for functional TCR expression. We have previously reported the transcription of incompletely rearranged TCR beta genes in pre-T cell-containing fractions of adult bone marrow. Here we demonstrate that the TCR gamma chain genes are also transcriptionally active in these cells. Like the TCR beta transcripts, TCR gamma transcripts are sterile, originating from unrearranged gamma loci. Interestingly, both RAG-1 and RAG-2 transcripts were also detected in this cell fraction, suggesting that sterile TCR transcription might be dependent upon the presence of a functional recombinase system. However, both C beta and C gamma sterile transcripts could be detected from the same bone marrow cell population isolated from RAG-1 gene deficient mice. Therefore, the expression of TCR genes can initiate at the earliest stages of T cell development, prior to exposure to the thymic microenvironment, and a functional recombinase system is not required for the production of these sterile TCR transcripts.

Animals↗
PubMed1995

Transcription of the TCR-beta locus initiates in adult murine bone marrow.

Successful expression of the TCR beta-chain gene is a multistep process that involves: 1) initial transcription of multiple, unrearranged gene segments, 2) rearrangement of V, D, and J gene segments to form a complete beta-chain gene, and 3) transcription of the fully rearranged beta gene. All of these events have been shown to occur in the thymus, where the majority of T cell development takes place; however, the extent to which any of these events may occur prethymically has not been established. To examine prethymic TCR-beta gene expression, RNA was isolated from a precursor T cell-enriched population (Thy 1low CD3-) of C58/J mouse bone marrow, and analyzed by reverse transcriptase-PCR. A transcript containing TCR-beta constant (C) region sequences but not variable (V) region sequences was amplified, suggesting that an unrearranged TCR-beta gene locus is transcriptionally active in this bone marrow population. The same product was detected in Thy 1+ CD3- bone marrow cells from nude mice, indicating that the thymic microenvironment is not necessary for initiation of TCR-beta gene transcription. This C beta transcript is not confined to pre-B cells, as it was identified in RNA isolated from Thy 1low CD3- B220- bone marrow cells. Germline V beta transcripts were also detected in RNA from this bone marrow population. Furthermore, Sca-1+ Lin- and Sca-1+ Lin+ bone marrow populations from both C58/J mice and nude mice also expressed the C beta transcript. DNA-PCR analyses with D beta-J beta primer sets revealed that partial rearrangement of the beta locus had occurred in all bone marrow populations analyzed. These data suggest that both transcription and partial rearrangement of the TCR-beta locus can initiate in bone marrow cells of adult mice, before exposure of these cells to the thymus.

Animals↗
PubMed1995

Noninvasive long-term ventilatory support for individuals with spinal muscular atrophy and functional bulbar musculature.

Ten individuals with spinal muscular atrophy (SMA) and chronic ventilatory insufficiency were trained in the use of assisted coughing techniques and received intermittent positive pressure ventilation (IPPV) via oral and/or nasal interfaces for a mean of 5.3 (range = 1 to 17) years. During this time they had significantly fewer respiratory complications than before introduction of noninvasive respiratory muscle aids despite the fact that 6 of the 10 went on to require more than 20 hours per day of ventilator use with less than 2 hours of ventilator-free breathing time (VFBT). All except two noninvasive IPPV users had vital capacities (VCs) less than 13% of predicted normal. They could, however, communicate verbally and take nutrition by mouth. All of the patients remained in the community. Five patients were gainfully employed and four were in school. We conclude that noninvasive respiratory muscle aids including noninvasive IPPV and assisted coughing techniques are effective and practical alternatives to tracheostomy for SMA patients with ventilatory failure but functional bulbar musculature.

Activities of Daily Living↗
PubMed1994

Pulmonary function and sleep disordered breathing in patients with traumatic tetraplegia: a longitudinal study.

The purpose of this study was to determine longitudinal changes in nocturnal blood gas tensions in individuals with stable traumatic tetraplegia. Ten individuals initially evaluated at least 6 months postinjury were reevaluated 5 years later. When initially evaluated, all the patients had normal daytime blood gases. Six (60%), however, had nocturnal oxyhemoglobin desaturations (dSATs) below 90%, 3 (30%) had mean nocturnal oxyhemoglobin saturation (SAT) below 90% for 10% or more of at least 1 hour, and 4 had maximum end-tidal carbon dioxide tensions (EtCO2) greater than 45mmHg. At 5-year follow-up evaluation, then a mean of 11.6 +/- 5.7 years postinjury, the vital capacities (VCs) of these individuals had improved significantly by a mean of 1242 +/- 545mL without treatment, and daytime blood gases were still normal for 9 out of 10 patients. Five of the individuals (50%), however, had an increased number of transient nocturnal dSATs and 8 of 9 (88%) re-studied by capnography were hypercapnic. We conclude that nocturnal dSAT and hypercapnia appear to be common in tetraplegia and may increase as the patient ages, despite significant increases in VC. Oximetry and capnography are useful in diagnosing nocturnal dSAT and in monitoring treatment.

Adult↗
PubMed1994

Chronic ventilator use in osteogenesis imperfecta congenita with basilar impression: a case report.

Osteogenesis imperfecta, a rare connective tissue disorder, is known to be associated sometimes with the invagination of the basilar skull. This deformity may disturb respiratory function secondary to brain stem compression and hydrocephalus. In addition, the deformed thoracic cage and fragile ribs make pulmonary care more complicated. A case of 24-year-old man is presented with brain stem compression syndrome secondary to osteogenesis imperfecta congenita with basilar impression. He developed respiratory failure and became tracheostomy positive-pressure ventilator dependent at the age of 21 years. He also suffered multiple skeletal abnormalities and mental retardation, and following the brain stem compression, severe quadriparesis. The patient's condition is stable since he has been using the ventilator and he is currently living in the community.

Adult↗
PubMed1994

Survival of individuals with spinal muscular atrophy on ventilatory support.

Six ventilator-assisted individuals (VAIs) with spinal muscular atrophy (SMA) are described. All six survived by using intermittent positive pressure ventilation via an indwelling tracheostomy for a mean of 11.7 +/- 17.7 yr despite frequent episodes of mucus plugging and pneumonia. Four of the VAIs also received all nutrition via indwelling gastrostomy tubes because of severe bulbar muscle weakness. Four VAIs used tracheostomy intermittent positive pressure ventilation with their tracheostomy cuffs deflated and could communicate verbally. Five of the six VAIs remained institutionalized from the onset of ventilatory use. Two SMA VAIs survived for 15 and 4 yr, respectively, despite need for ventilatory support since early infancy. All four SMA VAIs who could communicate remained socially active and one, gainfully employed. We conclude that for patients with advanced SMA markedly prolonged survival is possible with ventilatory assistance despite severe respiratory and bulbar muscle dysfunction.

Activities of Daily Living↗
PubMed1994

[General introduction to the clinical application of non-invasive respiratory aids].

Intermittent positive pressure ventilation via tracheostomy has been the most common method of providing ventilatory support for patients with respiratory failure since the late 1950s. It is the standard procedure for individuals who suffer from acute respiratory failure, impaired consciousness, and severe restrictive lung disease. However, numerous adverse complications from these invasive techniques have been reported in those who are long-term ventilator users. This paper describes the evolution and current application of non-invasive respiratory aids in both acute and long-term settings. The respiratory function can be aided by applying forces to the body or intermittent pressure to the air ways. The devices are negative pressure body ventilators which act on the body by creating negative pressure around the thorax and abdomen such devices effectively maintain the ventilation of individuals with respiratory failure, but have the shortcomings of bulkiness, high expense, and limitation on the users' activities. The non-invasive positive pressure ventilator applies intermittent pressure directly to the airway by a non-invasive interface; namely mouthpiece, nasal, or face masks. In this way, it can prevent patients from requiring either tracheostomy or endotracheal tube, but is not effective enough to ventilate patients with markedly decreased lung compliance because the high airway resistance provides air leakage from the non-invasive interface. Non-invasive respiratory aids should be the first choice to maintain ventilation for patients with respiratory failure secondary to neuromuscular disorder, because of their benefits of easy application, satisfactory results, fewer complications and early active rehabilitation. Increased understanding of non-invasive respiratory aids should assist in the management of patients with chronic respiratory failure.

Humans↗
PubMed1994

[Barium-pudding: a new medium for videofluoroscopic examination].

The evaluation of swallowing function is crucial in the management of dysphagic patients. It includes clinical assessment and laboratory tests that consist of fiberoptic endoscopic examination of swallowing (FEES) and videofluoroscopic examination. The "modified barium swallow" has been regarded as the standard procedure of videofluoroscopic examination since its introduction in 1983. The technique enables the entire process of deglutition to be observed with the benefits of safety, easily performance, and information. However, pitfalls developed in patients with pseudobulbar paralysis. Discrepancy always occurs between barium meals and real food and the refusal of swallow and misswallowing to the airway in videofluoroscopic examination sometimes occurs because of the unsatisfactory taste of barium meal. All these things make the procedure impractical and inaccurate. We developed a barium sulfate pudding that is better tasting, similar to real food as a pudding, is adequate to visualise on videofluoroscopic examination, and has the ability to represent the patient's capacity to swallow solid food. We present a case of hypoxic encephalopathy where the patient was considered to be in danger of aspiration when swallowing any consistency of foods. Barium-pudding study showed the patient had the ability to eat solid food with safety. We removed her nasogastric tube following barium-pudding assessment and successfully restored her oral feeding function within 2 weeks. Barium-Pudding is a better medium of videofluoroscopic examination by which to evaluate the swallowing function of solid food than Barium paste in patient, who have disturbed swallowing.

Aged↗
PubMed1994

[Clinical application of the ice water test in evaluation of neurogenic bladder dysfunction].

Ice water test (IWT) and cystometrography (CMG) were performed on 51 in patients with spinal cord injuries (SCI) to evaluate the sensitivity and specificity of the IWT in detecting detrusor reflex. A three-step grading system as established by Balmaseda et al was applied to determine the presence of detrusor activity on IWT. The test was considered 3+ when the catheter was expelled from the bladder within one minute following instillation of 90 mL of ice water; a 2+ test indicated voiding around the catheter after instillation of 90 mL of ice water; and a 1+ IWT was defined as voiding around the catheter or expelling the catheter after instilling another 210 mL of ice water into the bladder. The results showed that the sensitivity of IWT in detecting the presence of detrusor reflex in patients with neurogenic bladder dysfunction was 96% and the specificity was 79%. Among the four patients having false positive IWT, three of them were diagnosed with poor-compliance bladders. One patient with false negative IWT was found to have severe detrusor-sphincter dyssynergy. There was a significant difference in the strength of detrusor activity among the patients with 3+ IWT, with 2+ IWT, and with 1+ IWT. IWT is a useful technique to predict the existence of detrusor reflex in SCI patients. Its use as a supplement method to cystometrogram could be helpful in the bedside evaluation of patients with neurogenic bladder dysfunction.

Adult↗
PubMed1993

Longitudinal growth after replantation of immature extremities on rats.

Replantation of right hindlimbs in 76 immature rats was performed to study the factors affecting longitudinal growth of replanted extremities. There was a significant difference in tibia length between the replanted limb and the contralateral normal limb. The difference was significantly influenced by the ischemic interval (2 vs 4 hours), but not by suture method (intact vessels, vascular anastomosis with 10-0 nylon or 11-0 nylon). The replantation of immature extremities should be promptly undertaken because of the vulnerability of the epiphysis to ischemic insult.

Animals↗
PubMed1989

Allium vegetables and reduced risk of stomach cancer.

Interviews with 564 patients with stomach cancer and 1,131 controls in an area of China where gastric cancer rates are high revealed a significant reduction in gastric cancer risk with increasing consumption of allium vegetables. Persons in the highest quartile of intake experienced only 40% of the risk of those in the lowest. Protective effects were seen for garlic, onions, and other allium foods. Although additional research is needed before etiologic inferences can be made, the findings are consistent with recent reports of tumor inhibition following administration of allium compounds in experimental animals.

Adult↗
PubMed1989

[A case-control study of endometrial cancer in Beijing].

A case-control study was conducted among 150 woman suffered from endometrial cancer (EC) in Beijing from 1982.1.1-1985.12.31 and matched with two controls from the neighbourhood to explore the risk factors for EC. The data were analysed with X2 test and Linear Logistic Regression. Result of the study are listed. The risk factors directly related to EC might be obesity, nulliparity and low parity, early menarche, liver diseases. The risk factors indirectly related to EC might be irregular menstruation, premenstrual tension, dysfunctional uterine bleeding. The oral combined contraceptives showed a protective effect on EC. The results of the study support the EC etiology hypothesis of 'unopposed action of estrogen'.

Adult↗
PubMed1988

Diet and high risk of stomach cancer in Shandong, China.

A case-control investigation involving interviews with 564 stomach cancer patients and 1131 population-based controls was conducted to evaluate reasons for the exceptionally high rates of stomach cancer in Linqu, a rural county in Shandong Province in northeast China. Daily consumption of sour pancakes, a fermented indigenous staple, was associated with a 30% increase in risk. Risks of stomach cancer were also increased by 2- to 3-fold among persons with prior chronic gastritis or gastric ulcer, by 80% among those with stomach cancer in a family member, by 50% among men who smoked one or more packs of cigarettes/day, by 40% among those who preferred salty foods, and by 50% among families with moldy grain supplies. In contrast, risks tended to decrease in proportion to increasing consumption of fresh vegetables and fruits. This protective effect was more pronounced for vegetables, with those in the highest quartile of intake at less than one-half the risk of those in the lowest. Stomach cancer risks also declined with increasing dietary intake of carotene, vitamin C, and calcium, but not retinol. These findings provide leads to dietary factors that contribute to the high rates in Linqu, where stomach cancer is the leading cause of cancer and has not yet begun to decline as in other parts of the world.

Adult↗
PubMed1985

A case-control study of stomach cancer in Shandong Province.

Stomach cancer is the leading cause of death from cancer in China. Although the causes of this cancer are unknown, special opportunities exist for the evaluation of etiologic factors in Linqu County in Shandong Province where rates are exceptionally high. We have described here a newly initiated case-control study, which focuses on certain dietary items as risk factors for stomach cancer in Linqu.

China↗