117 cases of acute arsenic poisoning, caused by ingestion of food contaminated by As2O2, presented with abdominal pain, vomiting, nausea and diarrhea. The average level of urinary arsenic was 3.926 mg/L. The incidence of neuritis, poisoning hepatopathy and abdominal ECG was respectively 7.7%, 32.54%, 35.9%. All the cases recovered after oral or parenteral administration of dimecapto succinate (DMS) in six weeks. DMS is the drug of choice in the treatment of arsenic poisoning.

Adolescent↗

PubMed1993

Technetium-99m pertechnetate scan for ectopic gastric mucosa in children with gastrointestinal bleeding.

The detectability of ectopic gastric mucosa by Technetium (Tc)-99m pertechnetate abdominal scanning was investigated by reviewing 62 such scans in 52 pediatric patients with gastrointestinal hemorrhage. The histologic diagnoses and clinical conditions were correlated to the findings of the scans. There were 21 true-positives, 35 true-negatives, one false-positive and five false-negative studies. The overall sensitivity of this scan for the detection of ectopic gastric mucosa was 81%, the specificity was 97% and the accuracy was 90%.

Adolescent↗

PubMed1993

[Electroencephalographic study of bruxers during sleep].

A whole night recording of EEG, EMG and EOG of 7 bruxers during sleep with S-EEG equipment is made. Two of them have been evaluated after splint therapy. After analysing the sleep architecture, sleep progress and sleep index, it is found that: (1) S2 period is shorter, REM period is longer and the REM percentage is higher in comparison with the control group; (2) The total teeth grinding period is 213-691 secs and the frequency is 24-70 times per night, the occurrence of teeth grinding is scattered in different sleep stages; (3) The frequency and period of teeth grinding are decreased significantly after splint therapy; and (4) The occurrence of teeth grinding is a kind of functional disturbance of central nervous system rather than. The aroused response or transfer of sleep stages.

Adult↗

PubMed1993

[Experimental study on the action of EDTA-liposome to remove mercury from the mice given methylmercury chloride].

It was reported that experimental study on the action of EDTA-Liposome to remove mercury from the mice given methylmercury chloride showed that elimination of methylmercury chloride from brain, testicle, liver, kidney and blood of mice treated by EDTA-Liposome was more significant than that of mice treated by EDTA alone. Mercury level in feces of EDTA-Liposome treated group increased significantly (P < 0.001). The advantages of treatment with EDTA-Liposome were discussed. Applying EDTA-Liposome is an efficient method in therapy of metal poisoning.

Animals↗

PubMed1992

Liver transplantation in Taiwan: the Chang Gung experience.

Between March 1984 and February 1991, six orthotopic liver transplantations were performed at the Chang Gung Memorial Hospital in Taiwan. The indications for transplantation were Wilson's disease (5 patients) and biliary atresia (1 patient). Donors and recipients were matched only for size and ABO blood group compatibility, and the recipient operations were performed without the use of a venovenous bypass. Arterial reconstruction was carried out by end-to-end hepatic artery anastomosis (4), thoracic aortic conduit (1), or interposition of an iliac artery graft (1), whereas biliary reconstruction was accomplished by a choledochocholedochostomy using a T-tube stent (4) or a choledochocholedochostomy using an external cholecystostomy without stenting (2). Biliary complications occurred in three patients, and all required additional surgery. The average duration of donor-liver cold ischemia, operating time, and blood loss during surgery were 7 h and 50 min (range, 4.5-9 h), 13.5 h (range, 11.8-17 h), and 4,385 ml (range, 750-12,000 ml), respectively. The immunosuppressive regimens included a cyclosporin-steroid combination (n = 2) and a triple-drug combination (n = 4). All except one of the surviving patients experienced at least one rejection episode that was reversed by a methyl-prednisolone bolus and/or recycle. One patient developed a primary cytomegalovirus (CMV) infection that responded well to Ganciclovir treatment. Two of the patients died, one of injuries sustained in a traffic accident 3 years after transplantation, and the other of massive upper gastrointestinal bleeding. The overall survival value at 3 months was 83%, and the follow-up period ranged from 3 months to 7 years. All of the survivors have achieved complete rehabilitation and currently enjoy an excellent quality of life with normal liver function. Although the present study involved a small number of cases, our results indicate that liver transplantation can be successfully achieved in a high proportion of patients with acceptable morbidity, mortality, and cost in an Asian setting. The extreme shortage of donor organs is currently the most important obstacle limiting the application of liver transplantation in Taiwan.

Adolescent↗

PubMed1992

The efficacy of Kasai operation for biliary atresia: a single institutional experience.

To assess the efficacy of Kasai operation for biliary atresia, 60 cases during a 14-year period (1976 to 1989) at this institution were reviewed. Thirty-four (56.7%) underwent operation within 90 days of life, 11 (18.3%) between 90 and 120 days and 15 (25.0%) beyond 120 days. Fifty-six underwent hepaticoportojejunostomy and 4 underwent hepaticoportocholecystostomy. Follow-up was 1 to 14 years (mean, 7.2 years). The postoperative follow-up of these 60 patients was categorized into five groups: group A (16 patients, 26.7%) was characterized by survival greater than 3 years and without jaundice; group B (3 patients, 5.0%) was defined as survival greater than 3 years, but with jaundice; group C (11 patients, 18.3%) was defined by survival but follow-up less than 3 years, (this group was further divided into C1 [7 patients, 11.7%] if anicteric and C2 [4 patients, 6.7%] if icteric); group D (2 patients, 3.3%) was patients who underwent liver transplantation; and group E (28 patients, 46.7%) was the group of patients who died at time of review. Group A and group C1 were interpreted as success after Kasai operation; hence, the potential success rate in this series was 38.3% (23 patients). They were long-term survivers, and most of them performed normal activities appropriate for their ages. We conclude that approximately one third of patients with biliary atresia would benefit from or be cured by this operation, which should be the first attempt in the treatment of this disease entity.

Biliary Atresia↗

PubMed1992

Seventy-two patients' experience with an implantable drug delivery system for chemotherapy or total parenteral nutrition.

An implantable drug delivery system will play an important role for patients who need chemotherapy or prolonged total parenteral nutrition in the future. We implanted 72 injection capsules in 74 patients who were undergoing aggressive chemotherapy or total parenteral nutrition programs. These capsules were implanted in different positions, including central access in 67 cases, peritoneal cavity in 1, hepatic artery in 2, portal vein in 1 and intrathecal space in 1. The actual median functional survival of the injection capsules was 12.3 months (range, 2 months to 4 years). The total cumulative puncture numbers were 1651 (range, 5 to 153; median 23). There was no unsuccessful instance in infusion or injection. To date, 27 patients still survive. The complication rate was about 7% including 1 sepsis, 1 skin infection, 1 catheter thrombosis, 1 dislodgement of reservoir and 1 catheter-reservoir disengagement, which were all corrected by a secondary operation without mortality. Patency of the Port-A-Cath system was maintained using a regular flushing schedule once every 30 days. The results of this study suggest that the implantable drug delivery system can provide a safe and reliable method for venous access or even arterious access in patients requiring intermittent or prolonged intravenous therapy.

Adolescent↗

PubMed1992

[Blood lactate changes during incremental exercise in chronic obstructive pulmonary disease].

In order to evaluate whether the lactic acidosis is developed during incremental exercise test in COPD. 12 untrained subjects with COPD performed incremental maximal cycle ergometer tests. Ventilation (VE); O2 uptake (VO2), CO2 output (VCO2); and end-tidal CO2 fraction (FETCO2) were measured. Arterial lactate concentration and blood gas analysis were measured at rest, maximal exercise and recovery of exercise from an indwelling arterial catheter. of the degree of airway obstruction. (2) T40 and BEecf correlated well with lactate change (r = 0.83; 0.84, P < 0.05). (3) The change of VE, and RQ correlated with the lactate change (r = 0.81; 0.83, 0.72, P < 0.05), but not the VE/VO2, VE/VCO2, nor FETCO2, (r = 0.24; 0.06; 0.46, P > 0.05). We concluded that the blood lactate increased markedly in patients of COPD during increment exercise, and it was well corrected with the change of VE, VCO2 and RQ. The increased lactate could be indicated by the concomitant change of T40 and BEecf.

Aged↗

PubMed1992

Liver transplantation: the Chang Gung experience.

Explore the source record for details and available documents.

Adult↗

PubMed1992

Biliary complications following orthotopic liver transplantation.

Explore the source record for details and available documents.

Adult↗

PubMed1992

Respiratory changes and pulmonary complications following orthotopic liver transplantation.

In conclusion, we observed a worsening of LIS post-OLT, especially on the fourth postoperative day. The drop in this score implies a complicated course accompanied by a high mortality rate and increased medical expenses. Among the four components, oxygenation index and chest roentgenography score play an important and practical role. Measuring the AaD(O2) has its clinical merit, while the PEEP score and compliance of the respiratory system are of limited usefulness in this setting. The pleural effusions developed after OLT showed a trend towards increasing in amount until the sixth day and then gradually decreasing, except those cases with complications.

Blood Volume↗

PubMed1991

Persistent third branchial apparatus.

Neck sinuses, cysts or fistulae arising from the third branchial apparatus, have seldom been reported. Between 1979 and 1989, 16 cases were diagnosed as persistent third branchial apparatus based on a fistula open or in proximity to the pyriform sinus. There were 8 boys and 8 girls whose ages ranged from newborn to 13 years. Esophagogram was performed in 6; 4 showed a fistula tract leading to the pyriform sinus. Others were demonstrated at surgery. The main presentations were suppurative thyroiditis (5), lateral neck fistula (5), cyst (3), mass (1), abscess (1), and esophageal stricture (1). This was interpreted as a spectrum of disease that in the newborn may present as a cyst, and later in childhood as a fistula in the lower neck or recurrent suppurative thyroiditis if the fistula ends in the thyroid gland. It is imperative to search for this internal communication to the pyriform sinus to make a correct diagnosis and to avoid development of esophagocutaneous fistula postoperatively. With more awareness of this disease entity, the noted incidence should increase.

Adolescent↗

PubMed1991

Leiomyosarcoma of the broad ligament--report of two cases.

Leiomyosarcoma of the broad ligament (LBL) is a very rare tumor. Up to 1989, there had been only 7 cases reported in the English literature. During recent 12 years, we have had 15 cases of leiomyosarcoma in our department. Among them, there were two cases of LBL. The others were leiomyosarcoma of the uterine corpus. The first patient was 36 years old. She received total abdominal hysterectomy, bilateral salpingo-oophorectomy and paraaortic lymph node sampling followed by chemotherapy with adriamycin. Intra-abdominal recurrence with hepatic metastasis occurred 18 months after operation and she received palliative radiotherapy. The second patient was 65 years old and received subtotal hysterectomy, bilateral salpingo-oophorectomy, omental biopsy and suprapubic cystostomy followed also by chemotherapy with adriamycin. She received segmental resection of ileum and ileostomy due to intestinal obstruction caused by metastasis 5 months after her initial operation. Both patients were still alive when reported with 33 and 26 months of survival, respectively. The nature and management for LBL are scarcely reported, accumulation of cases and clinical experiences are needed.

Adult↗