Zhonghua yi xue za zhi = Chinese medical journal; Free China ed
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Zhonghua Yi Xue Za Zhi (Taipei) · Feb 2000
Prediction of biochemical relapse for stage pT3 prostate cancer following radical prostatectomy.
Approximately 30% to 50% of clinically localized prostate cancers are found to be locally advanced after radical prostatectomy. Without adjuvant therapy, more than 30% of stage pT3 patients will have biochemical failure in a median follow-up of three years. Whether adjuvant therapy should be given remains controversial. Identification of prognostic indicators may be helpful to select patients at risk of biochemical failure for postoperative adjuvant therapy. ⋯ Patients with poorly differentiated tumors and/or seminal vesicle invasiveness are at higher risk of biochemical failure after radical prostatectomy. Our limited experience did not support the routine application of adjuvant therapy for this subgroup of patients. A larger sample size with a longer follow-up period is necessary to reach a definitive conclusion.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jan 2000
Case ReportsCombined spinal-epidural anesthesia for cesarean section in a patient with Takayasu's disease.
We describe a successful episode of anesthesia management in a parturient affected with Takayasu's disease who underwent elective cesarean section under combined spinal-epidural anesthesia. Takayasu's disease is characterized by chronic occlusive inflammation of the arteries (panarteritis) of unknown origin that usually involves the aorta and its main branches. ⋯ The impact of pregnancy on Takayasu's disease is unclear, but worsening of ischemic symptoms, cardiac failure, aggravation of hypertension and cerebral hemorrhage have been reported in sufferers who are in the later stages of pregnancy. Nonetheless, anesthesia management of a parturient with advanced Takayasu's disease presents a challenge to anesthetists.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jan 2000
Case ReportsCholesterol crystal embolization causing acute renal failure.
Acute renal failure due to cholesterol embolization is a complication of severe generalized arteriosclerotic disease. It occurs spontaneously, or more often, as a complication of major medical or surgical procedures such as angiography and vascular surgery. ⋯ We report two cases of acute renal failure in which cholesterol embolization was found in skin and renal biopsies. One patient's renal function stabilized, but not to the basal level and the other patient developed end-stage renal disease.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jan 2000
Case ReportsPhenotypic heterogeneity in a Chinese family with mitochondrial disease and A3243G mutation of mitochondrial DNA.
The A3243G mutation of mitochondrial DNA (mtDNA) has been shown to be responsible for or associated with mitochondrial myopathy, encephalopathy, lactic acidosis, strokelike episodes (MELAS) syndrome, diabetes mellitus (DM) and several other neuromuscular diseases. We used polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) to identify the A3243G mtDNA mutation and an electron microscope to examine mitochondrial derangement in the muscle biopsies of a 38-year-old man suspected to have MELAS syndrome with DM. We found great variability in the clinical presentation and in the proportion of mtDNA with the A3243G mutation in the matrilineal family members of the patient. ⋯ The hair follicles and blood cells of the patient and his mother showed the A3243G mutation in the tRNA(Leu)(UUR) gene. The proportions of the mutant DNA in the hair follicles and blood cells of the proband were 36.8% and 35.2%, respectively, and those of the patient's mother were 28.8% and 13.9%, respectively. We conclude that the A3243G mtDNA mutation may manifest with MELASDM or CPPDM in different matrilineal members of the same family as a result of differences in random segregation of the heteroplasmic A3243G mutant mtDNA in the affected tissues of patients.
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Zhonghua Yi Xue Za Zhi (Taipei) · Nov 1999
Use of the hospital anxiety and depression scale as a screening tool for patients with headache.
The Hospital Anxiety and Depression Scale (HADS) is becoming widely used in medical settings to screen for anxiety or depressive disorders. It has been shown to be a good screening instrument in different ethnic and disease populations. The objective of this study was to evaluate the validity and reliability of HADS in patients with headache at a headache clinic. ⋯ Depression and anxiety were quite common among patients with headache in a headache clinic. The HADS can be used as a screening instrument for depressive and anxiety disorders. Because of the low specificity, the HADS should not be used solely as an indicator of psychiatric comorbidity among patients with headache in a headache clinic. This is the first study that verifies the use of the HADS as a psychiatric screening tool in patients with headache by comparing the scores of the HADS with psychiatric diagnoses.