Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences
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We describe a 77-year-old patient with chronic neutrophilic leukemia (CNL). Diagnosis of CNL was made by marked increase of mature neutrophils without increased immature granulocytes, splenomegaly and elevated serum vitamin B12 level and by ruling out any infection or occult malignancy. The chromosome analysis showed one abnormal karyotype out of 14 metaphases. ⋯ The neutrophil count became normal gradually after hydroxyurea treatment. However, it still maintained a high percentage of mature neutrophils. Background literature and the prognosis of CNL are discussed.
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Dead on arrival (DOA) is a distressful situation for most medical personnel and families. There are few papers about this topic in Taiwan though most DOAs are unexpected and sudden with or without underlying disease as predisposing factors. From January 1, 1993 to December 31, 1993, 487 DOA patients were sent to 4 large hospitals in the Kaohsiung area (including Kaohsiung City and Kaohsiung County). ⋯ Though our emergency medical service system (EMSS) has been active since 1990, there are still several drawbacks. Public education of cardiopulmonary resuscitation, easy access to EMSS, and appropriate management in hospitals must be stressed. With the improvement of prehospital care, EMSS, and in-hospital care, there will be a decrease in DOA patients.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Dec 1994
ReviewUrban planning and vector control in Southeast Asian cities.
A large and growing proportion of the population in many Southeast Asian cities live in slums and squatter settlements and they suffer from excessive exposure to insect and rodent vectors which transmit disease from one host to another. In such settlements, the quality of life, which is poor anyway, is made even worse by the high incidence of vector-borne diseases. ⋯ There is an urgent need to rethink intersectoral and integrated approaches to the design and planning of healthy urban environments, covering such matters as basic infrastructure and services, urban land use planning and waste management, health-promoting housing and architecture, and the control of all other factors that determine human health and well-being. With cooperation between and among the communities, local governments, and nongovernmental organizations as the basis, the installation of low-cost sanitation and drainage systems, the organization of collection services for the disposal of garbage, the provision of house screening and other protective measures, and the removal of breeding sites can greatly reduce the threat of most urban vectors.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Jun 1993
[Staffing levels and patient needs in the intensive care unit].
The current study sought to utilize a patient classification system to investigate staffing and patient needs along with nursing care distribution in our intensive care units. The study employed a factor type analysis to design a patient need checklist (for our six ICUs) in order to determine staff load and nursing requirements. Snapshot observations were also taken to survey the distribution of nursing care time. ⋯ The understaffed units are all surgical units; the overstaffed ones, internal medicine units. To conclude the study, we examined the nature and complexity of nursing duties in the hopes of returning non-nursing responsibilities to the proper medical organizations. Our ultimate goal is to realize the full potential and improve the quality of our nursing personnel.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Jun 1993
[Value of fine needle aspiration cytology in the diagnosis and management of fibroadenoma of the breast].
Cytological and histopathological biopsies were obtained from 121 breast lumps clinically diagnosed as fibroadenomas. Of these 98.3 percent of the lesions were benign. The cytological diagnosis was benign in 95.1 percent of 101 (83.4% of total) cases confirmed as fibroadenomas, histopathologically, but inadequate for diagnosis in 4.9 percent. ⋯ The other 26 (21.5%) lesions in 21 patients, who were over 35 years in age, had 61.5 percent fibroadenomas, cytological results cast suspicion of fibroadenoma in 87.1 percent of these cases. The other 16 histopathologically diagnosed fibroadenomas in patients over 35 years of age showed 62.5% were cytologically suspected of being fibroadenomas (P < 0.025). As a result of this study it is reasonable to suggest that a typical clinical fibroadenoma can be treated conservatively in women under 35 years, but only if an adequate cytological smear obtained by fine needle aspiration does not show malignant of suspicious cells.