J Formos Med Assoc
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Review Case Reports
Hepatic angiosarcoma presenting as hepatic rupture in a patient with long-term ingestion of arsenic.
Hepatic angiosarcoma (HAS) is a rare primary mesenchymal malignancy of liver with close association to arsenic intoxication. Although the southwest coastal area of Taiwan is well known for its prevalence of arsenic intoxication from drinking well water, few cases of HAS associated with arsenic ingestion have been reported. We report a case of HAS complicated by spontaneous hepatic rupture in a 68-year-old female farmer who presented with acute onset of abdominal pain and shock. ⋯ We also reviewed data collected by the National Cancer Registry Program from 1981 to 1999 and identified 25 additional reported cases. The median age of these patients was 55 years, and the male-to-female ratio was 1.9 (17:9). Whereas no case was found during this period in the blackfoot disease (BFD) endemic area, a hyperendemic area of arsenic intoxication in Taiwan, this case demonstrates the existence of cases of HAS associated with exposure to high levels of arsenic near the BFD area in Taiwan.
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Comparative Study
Comparison of critical conservative treatment versus emergency operation in children with ruptured appendicitis with tumor formation.
Management of ruptured appendicitis with tumor formation in children includes emergency appendectomy or initial conservative treatment, the choice of which remains controversial. This study compared the clinical courses of children with ruptured appendicitis with tumor formation (RATF) who received emergency appendectomy or initial conservative management. ⋯ In this study, conservative treatment of RATF in children was associated with a lower complication rate. Pathological analysis of the appendix suggests that interval appendectomy should be advocated in patients with successful initial conservative treatment.
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Many epidemiological studies have investigated the relationship between p53 codon 72 polymorphism and cervical cancer risk, but the findings are still conflicting. In contrast, data are lacking on the relationship between XRCC1 polymorphism and cervical neoplasm risk. This community-based nested case-control study examined the association between genetic polymorphisms of p53 codon 72 and XRCC1 codons 194, 280, and 399 and cervical intraepithelial neoplasm (CIN) susceptibility in Taiwanese women. ⋯ Our data suggest that p53 codon 72 and XRRC1 codon 194, 280 and 399 genotypes do not influence CIN risk in the Taiwanese population.