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Biomedical subjects

Y M Cheng

Publications and source records attributed to Y M Cheng.

49 records · Page 3Linked to original sources
PubMed1994

A fixational method of tendon transfer in foot surgery.

Tendon transfer has been used for correcting foot deformities and improving foot function in paralytic and spastic foot problems. The traditional fixational method by Cole's pull-out button often induces pressure sores which make the button sink and loosens the transferred tendon, leading to poor surgical results. By using a metal eye cover and pull-out wire instead of button and suture material, the transferred tendon can be firmly fixed. Moreover, the concavity of the metal eye cover is suitable for the arch of the foot that provides a large contact surface & even pressure distribution to prevent the most common complications of the pull-out button method, the pressure sore.

Female↗
PubMed1994

Surgical reconstruction for chronic lateral instability of the ankle.

Chronic lateral instability of the ankle is not uncommon due to improper management of the acute ankle sprain. From July 1987 to December 1991, 45 cases of chronic lateral ankle instability that underwent surgical treatment were followed. The patients included 28 males and 17 females with an average of 24.6 y/o. The time interval from initial injury to surgery ranged from 3 months to 5 years with an average of 9.6 months. All the patients had persistent symptoms in spite of conservative treatment for at least 2 months. The method for reconstruction of the lateral stability of the ankle was the modified Evans' method using part of peroneal brevis tendon. These cases were followed-up for average 25.1 months (range from 13 Ms to 49 Ms). According to Good, Jones & Livingston's criteria for clinical evaluation, 95.6% of the patients obtained excellent or good results. But 11.1% of patients were subjectively unsatisfied and complained of over tightness and limitation of foot inversion. The modified Evans' method has been proven to be easy and effective for reconstruction of the laterally unstable ankle, but it should be performed in the neutral flexion of ankle to prevent an over tight correction of lateral stability.

Adolescent↗
PubMed1993

Ankle arthrodesis.

As a fused ankle provides a painless ankle joint with limited functional disability, ankle arthrodesis is still the treatment of choice for most disabling ankle arthritis. From January 1987 to December 1990, 45 cases of ankle arthrodesis were performed, including 27 male and 18 female patients, aged from 18 to 70 years with an average of 41.9 years. The causes leading to arthrodesis included 19 cases of post-traumatic arthritis, 3 rheumatoid arthritis, 7 osteoarthritis, 9 ankle infections (4 pyogenic and 5 tuberculosis), 4 ankle deformities, 2 avascular necrosis of the talus and 1 cases of Charcot joint. The methods included modified Blair's ankle arthrodesis (34 cases), compression arthrodesis (7 cases) either by Hoffman external fixation or triangular compression device, and intra articular arthrodesis by staple fixation (4 cases). The follow up period ranged from 17 Ms to 52 Ms with an average of 28.6 Ms. There were 2 cases who ultimately required amputation due to uncontrollable infection, and 2 cases of nonunion and one of them received refusion. There were 11 cases of delayed union (union time more than 6 Ms). The average union time was 5.6 Ms, ranging from 2 Ms to 10 Ms. Excluding the cases of amputation and nonunion, all patients had improvement in the ankle functional scale evaluation and 85.3% of the patients were satisfied with their present condition. The modified Blair's method of ankle arthrodesis has proven to be an effective method for treating ankle arthritis no matter what the cause. However, for cases of infection, compression arthrodesis with an external fixational device is superior.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Total ankle replacement: preliminary report of 3 cases.

Total Ankle Replacement has been quite limited used currently and ankle arthrodesis is still the treatment of choice for most disabling arthritic disease of the ankle because of the generally poor long term results of ankle replacement. In spite of its popularity, ankle arthrodesis has many disadvantages, including long immobilization, high pseudoarthrosis rate, and load shift with increased stress on the neighboring joints of ankle. Total ankle replacement may be tried on some selected cases, such as on older patients or on patients with bilateral ankle lesions, multiple joints involved arthritis, such as rheumatoid arthritis etc. This paper reports three ankle replacements with a two year follow up, and they all have encouraging short term results. In the future, the development of a more effective ankle replacement seems to be likely. But at the present time, only carefully choosing the available prosthesis and strictly selecting the indicated patient can make the total ankle replacement acceptable.

Adult↗
PubMed1992

Oblique sliding metatarsal osteotomy for pressure metatarsalgia.

The transverse arch of the foot is formed by metatarsals which heads lie in a straight line to endure most of the loading of the forefoot. Malalignment of one or more metatarsal heads will result in increased loading and produce local tender plantar callosity. The treatment of pressure metatarsalgia must aim for it's pathomechanic cause, that is, hyper-extension of metatarsophalangeal joint. We have modified the distal metatarsal osteotomy to treat 40 toes in 22 cases. Follow up for an average of 21.3 months (ranging from 18 months to 31 months) indicated 19 cases (86.4%) with satisfactory results. The 3 cases with unsatisfied results were all due to early removal of the pin. Maximum oblige sloping of the osteotomy makes the osteotomy slide more easily and ensures union. Intramedullary pinning and early weight bearing maintain the osteotomic alignment, prevent foot stiffness and allow the distal fragment telescopes to be adequately positioned to prevent over correction which leads to transfer lesion. Compared to other methods, modified metatarsal osteotomy is less invasive, preserves natural structure, is easily performed and easy cared for which leads to effective and stable results.

Adult↗
PubMed1991

Use of a cross-leg free muscle flap to reconstruct an extensive burn wound involving a lower extremity.

A young patient sustained a high-voltage burn with extensive destruction of the soft tissue in his left lower extremity. Occlusion of the anterior and posterior tibial arteries, loss of toe extensors and the superficial and deep peroneal nerves were noted, besides the exposure of the lower end of the tibia and metatarsal bones. In the absence of proper recipient vessels, a cross-leg free latissimus dorsi muscle flap with overlying skin and depending on the vessels of the contralateral foot was used successfully for reconstruction of the defect. The pedicle was divided 3 weeks after microvascular anastomosis and the flap survived completely. This technique permits transfer of free flaps to compromised wounds without available recipient vessels, and the latissimus dorsi muscle flap, with its characteristics of large size and copious vascularity, could be split to cover exposed bones in different areas simultaneously.

Adult↗
PubMed1990

Ipsilateral hip and femoral shaft fractures treated with compression hip screw and long side-plate.

Complex femoral fractures involving the hip and shaft are not rare findings in the emergency room. The primary problem in the care of these patients is the preservation of their lives. The fracture combination under discussion is only a part of the injury complex sustained by these individuals. After the acute problems have been brought under control, care of the fractured femur and hip must be planned. Recently, most centers have favored giving priority to hip fractures, rigid fixation and early mobilization. However, for the fixation implants, variable fixation methods have been reported but are imperfect. In the past 5 years we have had some experience using compression hip screws with long side-plate to fix the different injured parts of these dual shaft and hip fractures at the same time. It seemed that application of these devices in dual hip and proximal shaft fractures, which are devoid of physiological bowing of the shaft, would get the best results. But when they are applied to dual fractures of the hip and the middle portion of the shaft, certain techniques, like adequate distal fixation, the prebending of the plate, primary bone graft and mobilization of the non-weight bearing pattern should be strictly adhered to for assurance of early callus formation and prevention of implant failure.

Adult↗
PubMed1989

[Clinical observation on hypercortisolism treated with amino-glutethimide].

We reported the clinical results in 13 cases of hypercortisolism treated with amino-glutethimide (AG), which was developed by Tiantsin Research Institute of Medical Industry. Of the thirteen cases nine were confirmed by surgery and histology, and the others were diagnosed clinically. Clinical improvements have been achieved in ten of the thirteen cases over a therapeutic course of 8 to 12 wk with a daily dosage of 1.0 to 2.0 g of AG. Plasma and urinary corticosteroids, as well as plasma testosterone levels were significantly decreased after one-month treatment followed, however, by somewhat return and fluctuation. The high levels of blood glucose and serum insulin were declined after therapy consistent with the decrement of corticoids. Serum potassium levels in hypokalemic patients returned to normal after one month of therapy. Radial bone mineral contents in patients with low bone density returned or closed to normal after three-month treatment. The main side effects of AG are anorexia, nausea, drowsy, tierdness, skin rashes, etc, which are mild and transient. Adrenal hypofunction was seen in one case after treatment.

Adolescent↗
PubMedDate not supplied

Reappraisal of K-ras and p53 gene mutations in the recurrence of Dukes' B2 rectal cancer after curative resection.

BACKGROUND/AIMS: Recurrence of rectal cancer remains a major clinical problem. This study was conducted to evaluate the impact of K-ras and p53 mutations on the recurrence of rectal cancer. METHODOLOGY: A total of 166 resected Dukes' B2 stage rectal carcinomas were collected between January 1990 and April 1994. The stored frozen tissues were retrieved for immunocytochemistry of p53 and genomic analysis of K-ras and p53 genes. The data of K-ras and p53 gene mutations were correlated with clinicopathological variables. The concordance of immunocytochemistry with genomic analysis in the survey of p53-mutations was examined. The follow-up data were analyzed by Kaplan-Meier estimator. RESULTS: Sixty-nine patients (41.6%) developed recurrent tumor. A significantly higher recurrence rate (p = 0.0013) and shorter median recurrence time were noted in p53 mutated than non-mutated cancers. Mutations in K-ras gene do not significantly increase the risk of tumor recurrence (p = 0.1702). K-ras and p53 mutations are not associated with clinicopathological parameters (p > 0.05). Kappa statistic indicates highly significant reproducibility between immunocytochemistry and genomic analysis for p53 mutations (p < 0.0001). CONCLUSIONS: Presence of p53 mutation significantly increases the recurrence rate and shortens the recurrence time of the resected rectal cancers. Pre-operative routine check for p53 mutations by immunocytochemistry may be beneficial in choosing the optimal surgical strategy for rectal cancer.

Aged↗
PubMedDate not supplied

Clinicopathologic and carcinogenetic appraisal of DNA replication error in sporadic T3N0M0 stage colorectal cancer after curative resection.

BACKGROUND/AIMS: DNA replication error (RER) was found to play a role in the carcinogenesis of a subset of sporadic colorectal cancers. This study was conducted to evaluate the clinicopathologic implications of RER in T3N0M0 stage colorectal cancers. To better understand the carcinogenesis of sporadic colorectal cancer, the RER status was further correlated with the alterations of K-ras, p53 and deleted in colorectal cancer (DCC) genes which were frequently involved in the adenoma-carcinoma sequence. METHODOLOGY: Seventy-eight patients with curatively resected T3N0M0 stage sporadic colorectal cancer were accumulated. The stored frozen tissues were retrieved for analyses of 1) microsatellite instability at 7 distinct chromosomal loci, 2) loss of heterozygosity at DCC gene, 3) K-ras gene mutation, 4) p53 expression, and 5) DNA content. The RER status was correlated with various clinicopathologic and molecular genetic factors. The survival of patients stratified by RER status was analyzed by Kaplan-Meier estimator. RESULTS: The RER-positive tumor was detected in 32.1% (25/78) of patients. The RER-positive cancer patients presented with distinct clinicopathologic features including young age of tumor onset, proximal tumor location, mucin production in histology, a higher rate of synchronous and metachronous colorectal cancers, and an increased incidence of extracolonic primary cancer. Patients with RER-positive tumor were found to have an improved prognosis with the 5-year survival probability of 76% and 45% in RER-positive and RER-negative groups, respectively (p < 0.05). The RER-positive tumors tended to have normal p53 expression, DNA diploidy, and a lower DNA index. The rate for the loss of heterozygosity of DCC gene was significantly lower in RER-positive tumors. RER status was not associated with K-ras mutation. CONCLUSIONS: The clinicopathologic features and carcinogenesis of RER-positive sporadic colorectal cancers were considered different from those of RER-negative tumors. The presence of RER may identify a subset of less aggressive tumors with good prognosis in T3N0M0 stage colorectal cancers.

Adenocarcinoma↗