J Formos Med Assoc
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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.
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From January 1984 to June 1990, we observed 42 patients with meningeal carcinomatosis, 20 men and 22 women, aged 21 to 80 years (median age, 53 years). The two most common primary malignancies were lung cancer (50%) and breast cancer (31%). Sixty-four per cent was adenocarcinoma. ⋯ The follow-up period of the entire group of patients ranged from one day to 50 weeks. The median survival was four weeks. Based on this study, combined therapy with RT and IT MTX is indicated for breast carcinoma with meningeal carcinomatosis, but the therapeutic effects are uncertain for lung carcinoma and other malignancies.
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Because of unanswered questions about reference values for single-breath carbon monoxide diffusing capacity (DLCO) in Chinese, standardized DLCO measurements were carried out in a selected sample of 257 healthy nonsmoking Chinese aged 20-70 years. The methods of measurement essentially followed the American Thoracic Society (ATS) recommendations. The measured DLCO was corrected to a standard hemoglobin value. ⋯ Therefore, differences in DLCO values between Chinese and Caucasians may be explained by differences in lung volume rather than by ethnic variations in the inherent characteristics of the alveolar capillary membrane. Predicted values for Chinese should be obtained from equations established from this study rather than extrapolated from those of Caucasians. The results of this study will be of value to clinical laboratories dealing with pulmonary function testing for Chinese patients.
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From an overseas Chinese born in Thailand, an extraordinarily high level of A2 + E band (20.2%) was found during routine cellulose acetate Hb electrophoresis. With a suspicion of Hb E, the beta-globin gene was studied by using the polymerase chain reaction (PCR) and direct DNA sequencing method. ⋯ A normal sequence at the corresponding codon was noted in the other allele; hence, this patient is a heterozygote of Hb E. PCR and direct DNA sequencing provide a rapid method for detection of Hb E from a small amount of DNA.
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The beta-like globin gene cluster, consisting of five genes and a pseudogene, is located on chromosome 11 and is arranged in the order 5'-epsilon-G gamma-A gamma-phi beta-delta-beta-3'. With the fast and sensitive method of high-performance liquid chromatography (HPLC) in the gradient mobile system, we studied the G gamma values of fetal hemoglobin in 34 patients with Cooley's anemia, 100 normal adults and 100 newborns. There were 84 newborns with a mean G gamma value of 67.41 +/- 2.37%, 15 newborns with a G gamma value of 83.45 +/- 1.92% and one newborn with a G gamma value of 100%. ⋯ While the G gamma values for patients with Cooley's anemia were divided into two groups, 56.23 +/- 6.55% and 80.60 +/- 3.05%. There was no case having a G gamma value of 100%. Our results suggest that the expression of the gamma gene in Cooley's anemia is similar to that of the newborns.