J Formos Med Assoc
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Case Reports
Total descending thoracic and abdominal aorta grafting in type III aortic dissection with aneurysm.
Single-stage complete replacement of the descending thoracic aorta and the abdominal aorta is a surgical challenge. A 65-year-old man developed acute DeBakey type IIIB aortic dissection and was treated medically. The affected aorta dilated progressively, reaching a maximal diameter of 7 cm 2 years later. ⋯ The descending thoracic aorta and the abdominal aorta were completely replaced with a Hemashield graft under deep hypothermic circulatory arrest. The postoperative course was complicated with transient left hemiparesis and upper gastrointestinal bleeding which were successfully treated by transarterial embolization. The results of this case indicate that complete replacement of the descending thoracic and abdominal aorta can adequately and safely treat type III aortic dissection.
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Several methods have been proposed to predict prognosis in patients with paraquat poisoning, but all have their limitations. This retrospective study evaluated the usefulness of Acute Physiology and Chronic Health Evaluation (APACHE) II scores in risk stratification for patients with paraquat poisoning. ⋯ This study has demonstrated that the APACHE II score is positively correlated with plasma paraquat concentration and ingested amount of paraquat. An APACHE II score of 20 or higher is a good predictor of in-hospital mortality.
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We describe the clinical characteristics of 5 Taiwanese children with glutaric aciduria type I treated in a single medical center. Macrocephaly was present in 5 of these patients, psychomotor retardation in 4, and neurological regression in 2. Diagnosis was made prenatally in 1 patient due to an affected sibling. ⋯ In addition, 2 novel mutations were detected. We conclude that GA I might not be as rare in Taiwan as previously thought. IVS10-2A>C is a common mutation in the Taiwanese population, whose genotypes are quite different from those of Caucasians.
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Early identification of predictive factors relevant to functional outcomes for stroke patients is important to the establishment of an effective continuing care program. The objective of this study was to identify the predictive factors related to functional outcome at discharge after stroke rehabilitation therapy. ⋯ The findings of this study imply that the admission FIM scores for inpatients receiving stroke rehabilitation can be used to predict functional outcomes at discharge from hospital.
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Small bowel obstruction (SBO) is a commonly encountered abdominal problem in the emergency ward. Phytobezoar is an uncommon cause of SBO which has specific radiographic findings on computed tomography (CT). This study evaluated the CT appearance of small bowel phytobezoar. ⋯ Fecal ball sign is accurate in the preoperative diagnosis of phytobezoar as the underlying cause of SBO. Early recognition of fecal ball sign in the CT study is of paramount importance in precise preoperative diagnosis in patients with SBO.