Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences
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Gaoxiong Yi Xue Ke Xue Za Zhi · May 1993
Case ReportsExtracranial internal carotid artery dissection secondary to neck massage: visualization of mural hematoma by MRI.
A 52-year-old man was admitted due to a severe pain in the right side of the neck and a progressive weakness of the left-side extremities. One week prior to admission, the patient began to use massage balls to relieve his long-lasting nuchal soreness. Carotid arteriography revealed a segment of tapered stenosis of the extracranial internal carotid artery with distal occlusion at the proximal middle cerebral artery. Magnetic resonance imaging (MRI) demonstrated a well-defined mural hematoma which is a distinctive feature of arterial dissection.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Feb 1993
Evaluation of prognostic indices based on pulmonary and hemodynamic variables in patients with adult respiratory distress syndrome (ARDS).
Patients with established ARDS have a high mortality rate. We continuously monitored hemodynamic and respiratory parameters of 30 patients in our ICU, all had acute respiratory failure during admission then progressively developed ARDS. We compared demographic characteristics, APACHE II (acute physiology and chronic health evaluation) score, ALI (acute lung injury) score, associated MSOF (multiple systems organ failure) in the disease process, pulmonary variables, and hemodynamic variables between survivors and nonsurvivors. ⋯ But those who had PEEP of 6 cm H2O or higher applied at the beginning of respiratory failure and those had PEEP of less than 10 cm H2O after development of ARDS had a better outcome (P < 0.04 vs. P < 0.05). Nevertheless, more controlled trials are needed before we make any conclusion about PEEP therapy.
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Sonographic characteristics of various chest diseases in 154 cases were analysed according to margin of the lesion, internal echogenecity, posterior echo enhancement, air bronchogram etc. We intended to present the basic sonographic patterns of common chest diseases. The study included 10 normal cases, 10 cases with lung abscesses, 31 cases of pneumonia, 24 cases of tumors, 11 cases of obstructive atelectasis, 8 cases of pleuropericarcadial effusions, 10 cases of minimal effusions, 6 cases with pleural thickening, 32 cases of massive pleural effusion with simple compression atelectasis and 12 cases of pneumonia with parapneumonic effusion. ⋯ The internal echogenecity of lung parenchyma in pneumonia with parapneumonic effusion was similar to that of pneumonia. Obstructive atelectasis, mass, consolidation and encapsulated effusion could be differentiated by chest sonography without much difficulty. Sonography could aid chest radiography by giving more morphologic information and was cheaper than computed tomography.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Oct 1992
Maximum inspiratory pressure: a neonatal criterion for weaning from mechanical ventilation.
Thirty-three newborn infants admitted to the neonatal intensive care unit of our hospital were studied. Mechanical ventilation was used for more than 24 hours for each patient. Maximum inspiratory pressure (MIP) was measured by means of a manometer at the oral end of the endotracheal tube just prior to extubation. ⋯ The patients in group I had a significantly lower MIP (P < 0.01) than group II, of the 28 patients in group I, 27 had MIP equal to or exceeding -35 cm H2O and only one case had MIP of -30 cm H2O. We conclude that measurement of MIP is a simple, useful and safe method for neonates to predict successful extubation from prolonged mechanical ventilation. A neonate with a MIP exceeding -35 cm H2O can be safely weaned from mechanical ventilation.
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Gaoxiong Yi Xue Ke Xue Za Zhi · Aug 1992
Case Reports[Schizophrenia and factitious cheilitis: a case report].
Factitious Cheilitis is a rare skin disorder which has been seen in patients with emotional disturbances, particularly in cases with neurotic and personality disorders. However, there have been no reports of factitious cheilitis seen in cases of schizophrenia. This study reports on a case of schizophrenic disorder, where the patient was observed to develop factitious cheilitis whilst subject to unstable psychiatric conditions. ⋯ After psychiatric and dermatologic care, her cheilitic condition improved. This study demonstrates that factitious cheilitis can be seen in a schizophrenic patient, specifically where hallucination and emotional instability coupled with long-term licking of the lips can result in factitious cheilitis. The relationship of skin disorder and psychiatric illness is discussed.