J Formos Med Assoc
-
Most patients with end-stage renal disease (ERSD) visiting our hospital for hemodialysis treatment during the SARS outbreak wore an N95 mask. Data on the physiological stress imposed by the wearing of N95 masks remains limited. This study investigated the physiological impact of wearing an N95 mask during hemodialysis (HD) on patients with ESRD. ⋯ Wearing an N95 mask for 4 hours during HD significantly reduced PaO2 and increased respiratory adverse effects in ESRD patients.
-
Acute type A aortic dissection presents a formidable challenge for the cardiac surgeon, although remarkable improvements have been achieved in diagnosis, surgical techniques and perioperative management. The aim of this study was to identify the most important variables associated with in-hospital mortality in patients undergoing surgery for this condition. ⋯ Multiple factors affect in-hospital mortality after surgery for acute type A aortic dissection. This study suggests that CPB time, diabetes mellitus and postoperative bleeding > or = 1500 mL are the main determinants of in-hospital death.
-
Review Case Reports
Hepatic angiosarcoma presenting as hepatic rupture in a patient with long-term ingestion of arsenic.
Hepatic angiosarcoma (HAS) is a rare primary mesenchymal malignancy of liver with close association to arsenic intoxication. Although the southwest coastal area of Taiwan is well known for its prevalence of arsenic intoxication from drinking well water, few cases of HAS associated with arsenic ingestion have been reported. We report a case of HAS complicated by spontaneous hepatic rupture in a 68-year-old female farmer who presented with acute onset of abdominal pain and shock. ⋯ We also reviewed data collected by the National Cancer Registry Program from 1981 to 1999 and identified 25 additional reported cases. The median age of these patients was 55 years, and the male-to-female ratio was 1.9 (17:9). Whereas no case was found during this period in the blackfoot disease (BFD) endemic area, a hyperendemic area of arsenic intoxication in Taiwan, this case demonstrates the existence of cases of HAS associated with exposure to high levels of arsenic near the BFD area in Taiwan.
-
Comparative Study
Comparison of critical conservative treatment versus emergency operation in children with ruptured appendicitis with tumor formation.
Management of ruptured appendicitis with tumor formation in children includes emergency appendectomy or initial conservative treatment, the choice of which remains controversial. This study compared the clinical courses of children with ruptured appendicitis with tumor formation (RATF) who received emergency appendectomy or initial conservative management. ⋯ In this study, conservative treatment of RATF in children was associated with a lower complication rate. Pathological analysis of the appendix suggests that interval appendectomy should be advocated in patients with successful initial conservative treatment.
-
Many epidemiological studies have investigated the relationship between p53 codon 72 polymorphism and cervical cancer risk, but the findings are still conflicting. In contrast, data are lacking on the relationship between XRCC1 polymorphism and cervical neoplasm risk. This community-based nested case-control study examined the association between genetic polymorphisms of p53 codon 72 and XRCC1 codons 194, 280, and 399 and cervical intraepithelial neoplasm (CIN) susceptibility in Taiwanese women. ⋯ Our data suggest that p53 codon 72 and XRRC1 codon 194, 280 and 399 genotypes do not influence CIN risk in the Taiwanese population.