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T S Lee

Publications and source records attributed to T S Lee.

At least 19 recordsLinked to original sources
PubMed1992

Accuracy of capnography in nonintubated surgical patients.

Previous studies have reported mixed results when correlating etCO2 and PaCO2 in mechanically ventilated patients with underlying respiratory disease. However, the utility and accuracy of capnography in nonintubated patients, without chronic pulmonary disease, has received little attention. We studied 25 nonintubated surgical patients to (1) examine the correlation between PaCO2 and etCO2 and (2) describe the relationship between dead space (VD/VT), venous admixture and P(a-et)CO2. End tidal CO2 was lower than PaCO2 by an average of 3.6 mm Hg. Regression analysis found a close correlation between dead space and the P(a-et)CO2 gradient (r = 0.77, p < 0.001), while venous admixture was of lesser importance (r = 0.47). Capnographic estimates of PaCO2 can be useful for continuously monitoring the respiratory status of nonintubated spontaneously breathing patients weaned from mechanical ventilation. This may be of particular value in trauma victims and in selected surgical patients without underlying respiratory disease in whom other injuries require continued critical care.

Adolescent↗
PubMed1992

Mortality among workers in a thorium-processing plant--a second follow-up.

A second follow-up of mortality was carried out for workers employed in a thorium-processing plant between 1915 and 1973. The study group comprised 3796 workers (3119 men and 677 women). Of the whole group, 926 (761 men and 165 women) were deceased and 2620 (2161 men and 459 women) were still alive, while 250 (6.6%) were lost to follow-up. For the male workers, the standardized mortality ratio (SMR) for all causes of death was 1.12 with a 95% confidence interval (95% CI) of 1.05-1.21. The SMR for the male workers was also significantly increased for all cancers (SMR 1.23, 95% CI 1.04-1.43) and lung cancer (SMR 1.36, 95% CI 1.02-1.78). For the female workers, the SMR was 0.74 (95% CI 0.63-0.86) for all causes and 0.53 (95% CI 0.35-0.78) for all cancers. The results of a Poisson regression analysis showed that there was no significant effect of the selected factors on lung cancer mortality.

Cause of Death↗
PubMed1992

[Second hip fracture].

During the period from 1982-1990, a total of 1644 patients were admitted to our hospital with proximal femoral fractures. Trochanteric fractures were encountered in 54 per cent of the cases (887/1644) with a mean age of 68 years. Cervical fractures were encountered in 46 per cent of the cases (757/1644) with a mean age of 62 years. We found 28 patients who had been readmitted with a second hip fracture in this retrospective study, including twenty three males and five females. Two of these second hip fractures occurred on the same side as the initial fracture and twenty six occurred on the opposite side. The time interval between the first and the second hip fracture was shorter in males than that in females (1.7 years V.S. 2.7 years) and the interval also was shorter in those with a previous trochanteric fracture as compared to those with a previous cervical fracture (1.5 years V.S. 2.6 years). It appeared that a hip fracture reduced the risk of a subsequent hip fracture on the same side, and almost all second hip fractures were located on the opposite side of the patient (93 per cent). A possible reason for this "protective mechanism" is increased strength of the bone due to callus formation. A significant symmetry (trochanteric-trochanteric or cervical-cervical) was found between the first and the second hip fractures (69 per cent). We believe the symmetrical fracture pattern is due to senile osteoporosis, a kind of ongoing systemic weakening of the skeletal system among the elderly.

Aged↗
PubMed1992

Retraction.

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Retraction Notice↗
PubMed1991

[Clinical experience of the treatment of ipsilateral femoral shaft fractures after hip arthroplasty].

Femoral shaft fracture after hip arthroplasty is a rate problem. Between January 1983 and January 1989, twelve cases were admitted to Taichung Veteran General Hospital. The causes of the fractures were due to (1) a weakening of the bone stock secondary to stress risers from prior surgery, (2) prefracture evidence of loosening, and (3) high velocity trauma. The twelve cases were treated with different methods and were followed up within an average time of 21.6 months (ranging from 12 to 66 months). After the treatment, it was showed that 83.3% of the patients had satisfactory results (33.3% of the patients has good results and 50% of the patients had fair results.) A comparison of the superiority of different treatment methods and the short term results of this study was presented.

Adult↗
PubMed1991

[Acetabular roof reconstruction with femoral head bone-graft for severe acetabular deficiency in total hip replacement].

From July 1984 to September 1989 at Taichung Veterans General Hospital, 14 patients (15 hips) received femoral head bone-grafting by modified Harris method as a part of their total hip replacement for acetabular bony deficiencies. They were followed up for an average of 31.7 months (range from 7 to 66 months). The clinical results were classified as excellent (58.3%) and good (41.7%) by Harris hip scoring system. All the grafts presented as "solid incorporation" with the pelvic wall and only one of the grafts was assessed to be "definite resorption" (volume reduction greater than 50%) by radiologic study. The "biologic viability" of these grafts were proved to be positive by scintigraphy in three-dimensional technique (SPECT). According to our limited experience and primary follow-up studies, we found that good clinical results depend on ideal positioning of the acetabular component in the true acetabulum and femoral head bone-grafting is an ideal procedure for the reconstruction of severe acetabular dysplasia in total hip arthroplasty.

Acetabulum↗
PubMed1990

Freeze-thawing causes masking of membrane-bound outer carnitine palmitoyltransferase activity: implications for studies on carnitine palmitoyltransferases deficiency.

Carnitine-dependent transport of fatty acids into mitochondria is believed to require participation of two carnitine palmitoyltransferase (CPT) activities, one outer, overt (CPTo) and the other inner, latent (CPTi). For exposing the CPTi and monitoring of the total CPT activity, freeze-thawing and sonication have been frequently employed as membrane-disruptive procedures, particularly when examining for CPT-deficiency diseases. Our evaluations have shown, however, that freeze-thawing and sonication yield misleading data for both the CPT activities owing to their previously unrecognized masking and unmasking effects on CPT activities. Formation of vesicular/sheath structures with mixed membrane orientation that prevents the access of medium substrate to enzymes on both aspects of the membrane at the same time appears responsible for these results. That such procedures can yield inexact data when monitoring the latency and sidedness of other membrane-bound biocatalysts as well needs to be recognized. We show that in muscle mitochondria also, a malonyl-CoA-inhibitable CPTo activity resides in the outer membrane, while a malonyl-CoA-insensitive, CPTi, activity is present in the inner membrane. Our results rationalize why Zierz and Engel ((1987) Neurology 37, 1785) were unable to obtain evidences for a latent CPT activity in mitochondria particularly of muscles. Although simple methods to allow an unambiguous quantitation of the two CPT activities in tissue extracts remain unavailable, evaluation of the possibility that two different CPT deficiencies occur appears justified.

Acyltransferases↗
PubMed1990

[Tardy ulnar palsy treated by anterior subcutaneous transposition].

Twenty cases of tardy ulnar palsy were treated by anterior subcutaneous transposition in the past 6 years at the Veterans General Hospital-Taichung. These cases were followed up for at least 9 months after operation. Mean duration of follow up was 39.5 months. Age distribution was from 40y/o to 72y/o, mean age was 54.5y/o. Duration of symptoms was from 2 months to 72 months, mean was 20.3 months. Eight cases were attributed to the idiopathic type. 16 cases (80%) improved after operation. Four factors were analyzed to evaluate their status as a prognostic guide: age, duration of syndrome, severity before operation and precipitating factors. Only severity before operation correlated with prognosis, but good recovery can be achieved in severe cases. Anterior subcutaneous transposition is a good method for treating tardy ulnar palsy.

Adolescent↗
PubMed1990

Comparison of lower concentrations of lidocaine to suppress bucking before extubation during recovery of general anesthesia.

Thirty females, aged 25-50 years old, scheduled for abdominal total hysterectomy were randomly divided to two groups. For patients in group I, 2 mL 1% lidocaine solution was injected through the catheter on the tube to desensitize the trachea while surgeon started to close the peritoneum. In group II, 2 mL 2% lidocaine was used. The peak cuff pressures generated in the awakening group I patients were 49.0 +/- 2.5 cmH2 O (mean +/- SD) which shows greater than that in group II (27.9 +/- 7.2 cmH2 O), p less than 0.01. Bucking before awakening was also evaluated clinically. One hundred % (15/15) in group I patients bucked compared with 13.3% (2/15) in group II patients (p less than 0.01). Gag reflex was preserved in all patients and none suffered from aspiration postoperatively. Intratracheal administration of two mL 2% lidocaine through the catheter of modified endotracheal tube showed significant effect for suppressing bucking during recovery of general anesthesia.

Adult↗
PubMed1990

Evaluation of systemic hemodynamic effects on post-transplant perfusion to renal allograft.

Hemodynamic parameters and post-transplant renal perfusion were evaluated in 24 cadaver kidney transplantation. Cardiac output (CO), systemic vascular resistance (SVR) and mean arterial pressure (MAP), were continuously monitored in each patient via a transesophageal Doppler cardiac output monitor and radial arterial catheter. Seventeen were well perfused (Group 1) after releasing vascular clamps. Six among group 1 presented as the clinical picture of acute tubular necrosis. Seven were poorly perfused (Group 2). Post-anastomotic CO significantly increased in group 1, and decreased in group 2. SVR significantly decreased in group 1, and increased in group 2. MAP were not significantly different between group 1 and 2. Treatments based on hemodynamic derangement were initiated as soon as it was detected. Correction of CO was associated with the improvement of post-anastomotic renal perfusion, while SVR and MAP were not. Among the 7 poorly perfused kidneys, 5 became well perfused before leaving the operating room. The remaining 2 resumed their hemodynamic stability and renal function a few days later after oral captopril was administered. Two among the 6 acute tubular necrosis resumed renal function as long as hemodynamic stability was restored. Our study demonstrates that hemodynamic parameters are parallel to renal perfusion status. Restoration of hemodynamic derangement not only improves renal perfusion but also renal function. It is concluded that hemodynamic instability and graft ischemic time contribute to the variation of post-transplant perfusion to renal allograft. Non-invasive cardiac output monitor is a safe and reliable monitor which we recommend to be used during the operation of kidney transplantation.

Adult↗
PubMed1990

[Clinical experience of hemiarthroplasty with Bateman bipolar endoprosthesis].

Between April 1985 and August 1986, 97 patients (101 hips) were treated with Bateman bipolar hemiarthroplasty after diagnosis of femoral neck fracture and ischemic necrosis of the femoral head at Veterans' General Hospital, Taichung. Seventy hips were followed up for an average of 44 months (range from 36 to 53 months). 58.6% of the patients had excellent or good results, 21.4% had fair results and 20% poor results. Twelve cases (17.1%) with thigh pain were diagnosed as have loosening of the stem and this was verified by X-ray and 99m Tc-MDP bone scan examination. 2 of these twelve cases received revisional total hip replacement. Wearing of the acetabulum was noted in only 2 patients (2.9%). From the short-term follow-up study, we would suggest that good results can be obtained with improved cementing technique or a special stem design to fit the different indications.

Adult↗