J Formos Med Assoc
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Conventional end-tidal CO2 (Pe'CO2) monitoring is difficult and impractical in nonintubated patients who are either sedated or anesthetized while spontaneous respiration is maintained. An alternative technique using nasopharyngeal end-tidal carbon dioxide tension (PNe,CO2) has been developed. The present study evaluates the feasibility and validity of PNe,CO2 as a reliable respiratory monitoring method. ⋯ The difference between the two values, (a-e')PCO2 = 0.35 +/- 0.33kPa and (a-Ne')PCO2 = -0.1 +/- 0.51kPa, indicates that PNe,CO2 is more closely correlated to PaCO2 than conventional Pe'CO2. The reduced (a-Ne')PCO2 in group 2 may be explained by CO2 rebreathing and a reduced respiratory deadspace during anesthesia and spontaneous breathing. Interestingly, 60% of the (a-Ne')PCO2 measurements were negative values, suggesting that PNe,CO2 and a spatial V/Q mismatch is caused by sedation; higher CO2 production and CO2 rebreathing may explain the results.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
DNA polymorphisms of apolipoprotein B in the population of Taiwan.
Four apolipoprotein B (apoB) genetic polymorphisms, the AluI, XbaI, MspI and EcoRI restriction fragment length polymorphisms (RFLPs), were analyzed for 162 individuals in Taiwan by polymerase chain reaction. Allele frequency determination revealed that this population has 0.86 AluI- (A-), 0.99 XbaI- (X-), 1.0 MspI+ (M+), and 0.98 EcoRI+ (E+) alleles. Major genotypes were A-/A- (0.75), X-/X- (0.98), M+/M+ (1.0) and E+/E+ (0.96). ⋯ The XbaI allele frequency is similar to that found in the Japanese population (XbaI- 0.96), but is significantly different from that in Caucasians (XbaI- 0.31-0.54). Significant differences (p < 0.001) between the Taiwanese and Caucasians were also observed for the AluI, EcoRI and MspI RFLP alleles of the apoB gene. More heterozygous genotypes are observed in Caucasians than in the Taiwanese.
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Owing to different cultural backgrounds, epidemiological disease patterns as well as economic status, it is important to collect local data regarding Emergency Medical Services (EMS), in order to direct our planning and to establish an appropriate EMS policy. This study was conducted from 1 July 1991 through 30 June 1992. During the 109 days of the study, 12502 prehospital records from Taipei city's 119 ambulances were collected and analyzed. ⋯ The results provided the following information: 1) in 7.41% of the ALS cases, ECG monitoring accounted for 3.13%, CPR for 3.55%, and IV injections for 0.73%; 2) cases needing the use of an ambulance accounted for 16.26% of the total; 3) the response time was 4.89 minutes on average; 4) time spent on the scene was 3.78 minutes; 5) the transportation time was 9.76 minutes; and 6) the percentage of abuse was 29.09%. Based on these results we recommend the following: 1) in enacting the EMS law, the policy stipulating that one ambulance should be expected to serve a population of 50 thousand should be modified because of limited daily emergency calls; and 2) education of the lay public is needed to prevent ambulance abuse. These are the main issues that need to be focused on in the development of our EMS system.
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Postoperative management of kidney allograft recipients requires a reliable and rapid diagnostic method so that proper therapy can be initiated. In this study, we tried to correlate serum neopterin levels with different conditions after transplantation. Serial serum neopterin levels were assessed after operation. ⋯ In summary, the serum neopterin levels were persistently high in uremic and post-transplant ATN patients. Acute rejection episodes were correlated with an increased level of neopterin. It appears that daily measurement of the serum neopterin level may be useful for biochemical detection of immunologic complications in allograft recipients.
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Case Reports
Dorsal root entry zone lesions in the treatment of pain following brachial plexus avulsion and herpes zoster.
Fifteen patients with brachial plexus avulsion injury and four patients with postherpetic pain submitted to dorsal root entry zone surgery. Nashold's method was used in all cases. The initial results in the group with brachial plexus avulsion injury were satisfactory. ⋯ Three patients with postherpetic pain had good pain relief in the initial stage after surgery. Two of these four cases were found to have a recurrence of some pain, which could be relieved more or less by oral analgesics. No mortality or major complications were found in this series, although eight patients complained postoperatively of mild sensory weakness which disappeared within two weeks.