Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Mar 1999
Acute hydrocephalus and chronic hydrocephalus with the need of postoperative shunting after aneurysmal subarachnoid hemorrhage.
During a 6-year period, 168 consecutive patients who presented with subarachnoid hemorrhage (SAH) and underwent surgical clipping of aneurysms were reviewed at a follow-up examination from 6 to 77 months (mean 38 months) after the ictus. Acute hydrocephalus was defined when the bicaudate index was greater than the 95th percentile for age on a computed tomographic scan within 72 hours of the hemorrhage. Forty (24%) patients developed acute hydrocephalus. ⋯ Ten of 29 (34%) patients with acute hydrocephalus required definite shunt replacement. However, less than 10% of patients without acute hydrocephalus needed shunting postoperatively. We recommend that patients with aneurysmal SAH should be followed up at least 6 months after the hemorrhage, especially in those patients with high risks of developing chronic hydrocephalus.
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Kaohsiung J Med Sci · Aug 1998
Clinical study of failure in continuous spinal anesthesia with bupivacaine.
Continuous spinal anesthesia (CSA) has been considered to be better in temporal and dose flexibility, as well as hemodynamic stability than single dose spinal anesthesia. However, the failure of spinal anesthesia is not a rare experience for anesthesiologists. Here we present our experience in solving the problem and discuss the possible causes for the failure. ⋯ Factors contributed to failure spinal anesthesia including failure of technique, errors of judgment, maldistribution and failure of local anesthetic itself. However, we thought that change of pH value of local anesthetic in CSF may play a great part in these failed CSAs. Despite the reasons for failure, we demonstrate that failure of continuous spinal anesthesia by 0.2% bupivacaine can be readily resolved by 1% lidocaine.
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Kaohsiung J Med Sci · Aug 1998
Injection pain with propofol: the effectiveness of thiopentone on induction.
One hundred and twenty-seven children aged 3-6 years were allocated to four groups. All of them received venous cannulation on the dorsum of the hand. On induction, the group L1, L2 and L3 patients received propofol 3 mg/kg mixed with lignocaine 0.15 mg/kg, 0.3 mg/kg, 0.6 mg/kg, respectively. ⋯ Increasing lignocaine dose reduced the incidence of pain graded as "moderate" or "severe" though there was no significant difference. The incidences of excitatory effect on propofol injection were reduced with increasing lignocaine dose and prior administration of thiopentone but there were no obviously differences among groups. We concluded that thiopentone reduced injection pain on propofol and should be recommended.
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Kaohsiung J Med Sci · Jul 1998
ReviewGenetic epidemiology of schizophrenia: review and reassessment.
When a rigorous methodological approach is utilized, a substantial majority of recent studies provide evidence for the familial transmission of schizophrenia. Although the absolute rates of schizophrenia among relatives of schizophrenics tend to be lower than those reported in the earlier studies due to the restrictiveness of contemporary definitions of schizophrenia, the risk to relatives compared to that of controls has remained quite consistent. This observation that relatives of schizophrenics have an elevated risk for schizophrenia compared to controls is consistent with theories of both genetic and environmental transmission. ⋯ Genetic linkage analysis promised to clarify the mechanisms of transmission, but early positive reports were subsequently overturned and, to date, there are no consistently replicated positive linkage findings for schizophrenia. There is now a world-wide search for the location of the genes on specific chromosomes which are responsible for schizophrenia. The clinical implications of current work to the future of locating a schizophrenic gene or genes will be discussed.
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Kaohsiung J Med Sci · Feb 1998
Randomized Controlled Trial Clinical TrialThe effects of Western music on postoperative pain in Taiwan.
Music is a method nurses can use to help relieve pain, however little is known about its effectiveness across cultures. In this study, Western music was tested for its effectiveness in reducing postoperative pain in 38 Taiwanese patients, and its acceptability was explored. A pretest and post-test experimental design was used with visual analogue scales to measure sensation and distress of pain. ⋯ Subjects from Taiwan were similar to subjects in a previous study in the United States in their liking for the music, and in reports of the helpfulness of the music for pain sensation and distress, but fewer Taiwanese found the music calming, and they had different choices: more chose harp music and fewer chose jazz than subjects in the U. S. study, and some would prefer Buddhist hymns or popular songs heard in Taiwan. Findings support the use of culturally acceptable music in addition to analgesic medication for the sensation and distress of postoperative pain.