J Formos Med Assoc
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A 54-year-old male suddenly developed cramping abdominal pain followed by diarrhea. A segmental narrowing with multiple mucosal ulcers of the colon near the splenic flexure was noted on both barium enema and fiberoptic colonoscopy. Cramping abdominal pain and diarrhea persisted, associated with a body weight loss of 13 kg. ⋯ The artery showed an eccentric organized hematoma between the outer media and the adventitia. The lumen was occluded by organized thrombi. The pathologic findings were those of an organized dissecting hematoma (aneurysm), probably caused by segmental mediolytic arteriopathy.
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Intussusception is commonly the etiology of intestinal obstruction in infants and children. To investigate demographic data, clinicopathologic features and therapeutic prognosis of patients with intussusception, we reviewed 361 intussusceptions in 333 patients over an 11-year period. Most patients were below two years of age and there was a male preponderance of 1.6:1. ⋯ Postoperative complications and recurrent intussusception developed in some patients, and the overall mortality was 0.6%. The clinical characteristics of intussusception in children generally remained unchanged as compared to previous reports. Early identification of patients with risk factors for surgical treatment is important to decrease the need for intestinal resection.
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The clinical characteristics of 234 amputees admitted to the National Taiwan University Hospital during a 10-year period were analyzed. Diabetes mellitus accounted for 37.2% (87 cases) of the amputations and was the most commonly associated disease. Malignancy was the second cause of amputation (16.2%). ⋯ Four of the diabetic reamputations and nine of the non-diabetic reamputations were performed on the same side as the first amputation. The mean +/- standard error of admission days and total expenses for each episode of amputation were 36.2 +/- 2.7 days and 116.5 +/- 1.7 thousand New Taiwan dollars for the non-diabetics and 41.3 +/- 4.0 days and 134.0 +/- 16.0 thousand New Taiwan dollars for the diabetics, respectively. We concluded that: 1) diabetes mellitus was the main cause of amputation; 2) diabetes mellitus was associated with a higher rate of reamputations of the contralateral legs; and 3) a multidisciplinary foot-care team is essential for the management of lower leg amputations.
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A total of 1,342 blood samples from five aboriginal groups in Taiwan, comprising 522 of the Ami, 246 of the Bunum, 227 of the Atayal, 214 of the Paiwan and 133 of the Yami group, were collected. A complete blood count was performed in each case. In subjects with a mean corpuscular volume < 85 fl or hemoglobin (Hb) < 12 gm% (female) or 13 gm% (male), quantitation of Hb A2 and DNA analysis of alpha- and beta-globin genes were performed. ⋯ In the Paiwan, seven (3.3%) were alpha-thalassemia 1 carriers, and one (0.5%) was an alpha-thalassemia 2 carrier. In the Yami, none were either alpha- or beta-thalassemia carriers. Diverse genetic origin, intragroup breeding and malarial selection may play a role in the significant differences of thalassemia prevalences both between the Chinese and the aborigines, and among different groups of aborigines.
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Malignant pericardial effusion with cardiac tamponade is a life-threatening oncological emergency. Pericardiocentesis with sclerosing therapy is a life-saving palliative treatment procedure. ⋯ This patient developed pericardial constriction six months after mitomycin C pericardial sclerosis. It should be noted that pericardial constriction may occur if a patient survives long enough after successful pericardial sclerosis.