Journal of the Chinese Medical Association : JCMA
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Proper size selection is crucial to the effective use of a laryngeal mask airway (LMA). The current choice of LMA size is based on body weight; in addition, the sex-based selection has also been suggested. However, the relationship between body weight, sex, and the dimension of hypopharynx where the LMA is positioned are inconsistent. Here we examined a tongue width-based method to determine the optimal size for the classic LMA (cLMA). ⋯ The tongue width-based method is a convenient and efficacious alternative for selecting an optimal cLMA size in male adults.
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2,4-Dinitrophenol (2,4-DNP), a yellowish compound, has historically been used in the manufacture of dyes, explosives, and fungicides. As it uncouples mitochondrial oxidative phosphorylation, the compound was also used as an antiobesity agent early in the past century. ⋯ The Hong Kong Hospital Authority Toxicology Reference Laboratory recently confirmed two cases of self-administered 2,4-DNP with different clinical presentations to hospitals in the area. Here we describe those two cases, in an attempt to underscore the potential of misuse of this substance by body-conscious groups among the Chinese population.
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Early fetal structure evaluation is crucial. Fetal abnormalities might indicate chromosomal anomalies or abnormal fetal growth. The aim of this study was to establish the appropriate reference range of maxillary and mandibular angles among the Taiwanese population at 11(+0)-13(+6) weeks of gestation in normal singleton pregnancy as reference values for prenatal ultrasonographic examinations. ⋯ Normative data for ultrasonographic measurements of maxillary and mandibular angles among the Taiwanese population are presented. Our results may serve as reference values in congenital anomaly screening during prenatal examination.
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Randomized Controlled Trial
Evaluation of low tidal volume with positive end-expiratory pressure application effects on arterial blood gases during laparoscopic surgery.
Pneumoperitoneum (PNP) and patient positions required for laparoscopy can induce pathophysiological changes that complicate anesthetic management during laparoscopic procedures. This study investigated whether low tidal volume and positive end-expiratory pressure (PEEP) application can improve ventilatory and oxygenation parameters during laparoscopic surgery. ⋯ The application of low tidal volume + PEEP + high respiratory rate during laparoscopic surgeries may be considered to improve good results of arterial blood gases.
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Surgery is the main treatment for curing gastric cancer. Early diagnosis provides an excellent survival outcome via an improved detection of early gastric cancer and an improved resection rate. The extent of lymphadenectomy surgery has been under debate for a long time. ⋯ Adjuvant or perioperative chemotherapy should be prescribed for gastric cancer with Stage II or III disease, due to its marked benefits of reducing disease recurrence and increasing long-term survival. Patients with inoperable advanced gastric cancer should receive chemotherapy to improve their survival and quality of life if an acceptable performance status can be achieved. Targeted therapy with trastuzumab should be considered in patients with HER-2/neu overexpression who have a higher response rate and a longer survival.