Kaohsiung J Med Sci
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Traumatic spinal subdural hematoma is rare and its mechanism remains unclear. This intervention describes a patient with mental retardation who was suffering from back pain and progressive weakness of the lower limbs following a traffic accident. Magnetic resonance imaging of the spine revealed a lumbar subdural lesion. ⋯ The isolated traumatic spinal subdural hematoma was not associated with intracranial subdural hemorrhage. A spinal subdural hematoma should be considered in the differential diagnosis of spinal cord compression, especially for patients who have sustained spinal trauma. Emergency surgical decompression is usually the optimal treatment for a spinal subdural hematoma with acute deterioration and severe neurological deficits.
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This article provides the history of arsenicosis in Mainland China and the research situation in the recent 10 years. The first large area of arsenicosis caused by high levels of arsenic in drinking water in Mainland China was discovered in Kuitun, Xinjiang Province, in 1983. ⋯ Until 2006, the survey areas of wells with arsenic concentration greater than 50 μg/L in drinking water have involved 16 provinces in Mainland China. The molecular epidemiological studies on relationship between arsenic metabolism and manifestations of arsenicosis caused by chronic exposure to high level of arsenic in drinking water and the studies on arsenic exposure and related health effects in different arsenic exposure populations are summarized in this review.
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Kaohsiung J Med Sci · Mar 2011
Electromyographic endotracheal tube placement during thyroid surgery in neuromonitoring of recurrent laryngeal nerve.
Intraoperative neuromonitoring (IONM) is widely used in thyroid surgery. This study aimed to investigate the influence of neck extension on electromyographic (EMG) endotracheal tube displacement and to determine the necessity of routinely checking the final electrode position after the patient had been fully positioned. A consecutive 220 patients undergoing thyroidectomy were enrolled. ⋯ Successful monitoring was achieved in all patients after the final optimal position of electrodes was ensured routinely. The electrode position can be severely displaced after the patient has been fully positioned. Verification of ideal position of electrodes before the beginning of the operation is a necessary step to guarantee functional intraoperative neuromonitoring.
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Kaohsiung J Med Sci · Jan 2011
Lumbar epidural space was narrower in parturients than that in nonpregnant women by ultrasound assessment.
Labor epidural is commonly used to provide both regional anesthesia and postoperative pain relief. Epidural space is supposed to be narrower and deeper in a parturient than that in a nonpregnant woman. The aim of this study was to explore the difference of epidural spaces between parturient and nonpregnant women by ultrasound assessment. ⋯ Epidural space is narrower and deeper at lumbar interspaces in obstetrics by ultrasound examination. The quality of ultrasound images did not differ significantly between the groups. These quantitative results improve the understanding of the differences between two groups that have been previously known qualitatively and may help in avoiding complications.
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Kaohsiung J Med Sci · Dec 2010
Electromyographic study of differential sensitivity to succinylcholine of the diaphragm, laryngeal and somatic muscles: a swine model.
Neuromuscular blocking agents (NMBAs) might diminish the electromyography signal of the vocalis muscles during intraoperative neuromonitoring of the recurrent laryngeal nerve. The aim of this study was to compare differential sensitivity of different muscles to succinylcholine in a swine model, and to realize the influence of NMBAs on neuromonitoring. Six male Duroc-Landrace piglets were anesthetized with thiamylal and underwent tracheal intubation without the use of an NMBA. ⋯ The sensitivity of the muscles to succinylcholine, ranked in order, was: the vocalis muscles, the triceps brachii muscle, the trapezius muscle and the diaphragm. We demonstrated a useful and reliable animal model to investigate the effects of NMBAs on intraoperative neuromonitoring. Extrapolation of these data to humans should be done with caution.