J Formos Med Assoc
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Comparative Study
Characteristics of malignant lymphoma in eastern Taiwan: comparison between aborigines and nonaborigines.
To study the characteristics of malignant lymphoma in aboriginal and nonaboriginal patients in eastern Taiwan, the records of 90 patients treated from July 1986 to September 1994 were reviewed. Immunohistologic staining with UCHL-1 and L-26 was used to determine immunophenotype. There were 20 aboriginal and 70 nonaboriginal patients (22% vs 78%). ⋯ No distinct difference was found between aboriginal and nonaboriginal patients in overall response rate, complete response rate, disease-free survival or overall survival. Comparison of our results with other lymphoma studies in Taiwan revealed that the frequencies of HD and follicular lymphoma were higher in northern Taiwan studies than in southern and eastern Taiwan studies, and the frequency of primary extranodal lymphoma was much higher in eastern Taiwan than in other areas. While the rate of T cell lymphoma in NHL for nonaboriginal patients was similar to that of northern Taiwan studies, it was closer to that of southern Taiwan studies in aboriginal patients.
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Case Reports
Extracorporeal membrane oxygenation in the perioperative period of heart transplantation.
Mechanical circulatory support is occasionally needed in the perioperative period of heart transplantation. Between February and May 1995, three recipients of cardiac transplant at the National Taiwan University Hospital required the use of extracorporeal membrane oxygenation (ECMO) for temporary mechanical circulatory support in the perioperative period of heart transplantation. All three patients received ECMO through the percutaneous femoral veno-arterial route. ⋯ Patient 3 needed ECMO as a bridge to his first heart transplant after acute myocardial infarction complicated with cardiogenic shock, and again as a bridge to retransplantation because of acute failure of the first cardiac transplant and finally for a temporary circulatory support during rescue treatment for acute vascular rejection of the second cardiac transplant. All three patients were successfully treated with ECMO without major complications. In conclusion, ECMO provides excellent mechanical circulatory support for some situations in the perioperative period of heart transplantation.
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To understand the clinical characteristics and outcome of tuberculosis (TB) in patients with acquired immunodeficiency syndrome (AIDS) in Taiwan, we reviewed the medical records of 118 adult AIDS patients who were hospitalized at National Taiwan University Hospital between January 1988 and September 1995. Among them, 29 (24.6%) had TB. The mean age of the AIDS patients with TB was 37 years (range, 25-66 yr). ⋯ Atypical patterns (diffuse interstitial infiltrates mimicking Pneumocystis carinii pneumonia or other patterns) and normal chest radiographs were noted in nearly one-third of the patients with pulmonary TB. A good response to antituberculosis drugs and a favorable outcome were demonstrated in the patients, except for two with drug-resistant Mycobacterium tuberculosis infection. Early identification of TB in HIV-infected patients requires clinical awareness of the unusual clinical presentations, especially among patients in the advanced stages of AIDS.
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We retrospectively reviewed the results of 32 patients (38 feet), with hallux valgus angles between 35 degrees and 60 degrees, who were treated by standard distal chevron osteotomy and intra-articular lateral soft tissue release. The average follow-up period was 5.2 years (4-7 years). The preoperative intermetatarsal angle averaged 14.4 degrees, and the postoperative angle averaged 7.7 degrees. ⋯ Subjectively, the satisfaction rate in terms of symptom improvement, cosmetic appearance and function was over 90%. Avascular necrosis of the first metatarsal head was not found in our series, which indicated that additional lateral soft tissue release is not contraindicated in combination with chevron osteotomy. Based on the level of satisfaction in our series, we conclude that the combination of distal chevron osteotomy and intraarticular lateral soft tissue release has broader application than the chevron osteotomy alone for patients with hallux valgus deformity.
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In 1994, 102 outbreaks of food-borne disease involving 4,726 cases were reported to the Taiwan Department of Health. This is the highest number of outbreaks and cases in recent years in Taiwan. Of these outbreaks, 72.5% (74/102) were caused by bacterial pathogens, with Vibrio parahaemolyticus responsible for 56.7% (42/74), Staphylococcus aureus 20.3% (15/74), Bacillus cereus 14.9% (11/74) and Salmonella spp other than S. typhi and S. paratyphi 8.1% (6/74). ⋯ The median outbreak size was 10 cases. A high proportion (54%, 7/13) of the large outbreaks was associated with commercial lunch-boxes supplied to elementary and junior high schools. Health education to improve food sanitation and supervision of food sanitation practices need to be strengthened.