Chang Gung medical journal
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Case Reports
Hyperkalemic cardiac arrest successfully reversed by hemodialysis during cardiopulmonary resuscitation: case report.
Severe hyperkalemia is a potential life-threatening cardiac emergency especially in the patients who suffer from a defective renal capacity to excrete potassium such as the dialysis patient. Various conventional therapies including intravenous sodium bicarbonate, insulin with glucose and several beta-2 agonists are commonly employed as transient measures to enhance shift of potassium from the extracellular to the intracellular compartment. If the potassium load is massive and situation is critical, emergency hemodialysis may be useful. ⋯ Hemodialysis was then initiated during cardiopulmonary resuscitation and the patient restored spontaneous heart beat 20 minutes later. There was no neurologic sequela after her recovery. Hemodialysis should be considered early in the course of cardiopulmonary resuscitation in severe hyperkalemia induced cardiac arrest if conventional therapies were judged to be ineffective.
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Comparative Study
Effects of induction anesthetic agents on outcome of assisted reproductive technology: a comparison of propofol and thiopental sodium.
The use of propofol, as compared to barbiturates (e.g. thiopental), for short surgical procedures has been associated with more rapid recovery from the procedure. Propofol, an intravenous anesthetic drug, is frequently used as an adjunct to transvaginal oocyte retrieval but little is known about its effects upon fertilization, embryo development, and pregnancy rate when used drug the for induction of general anesthesia. This study was conducted to compare the outcome of assisted reproductive technology (ART) with the use of propofol versus thiopental sodium for the induction of general anesthesia during oocyte retrieval. ⋯ There were no significant differences between these two groups for fertilization rate, cleavage rate, pregnancy rate, implantation rate and abortion rate. We suggest cautious use of propofol for the procedure of oocyte retrieval despite its associated more rapid post-operative recovery including less nausea/vomiting.
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Endogenous endophthalmitis is a rare but devastating complication of bacteremia. Klebsiella pneumoniae is reported to be the leading organism of endogenous endophthalmitis in Taiwan, and the prognosis of endogenous Klebsiella pneumoniae endophthalmitis is extremely poor. A 46-year-old male patient was hospitalized because of fever, chills, and consciousness disturbance for 1 day. ⋯ On hospital day 6, he complained of blurred vision in both eyes and floaters in the left eye for 1 day. After ophthalmic examination, bilateral endogenous endophthalmitis was diagnosed. After aggressive treatment with intravitreal antibiotics and trans pars plana vitrectomy, the visual outcome of both eyes was better than those of other reported cases.
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Nontraumatic avascular necrosis of the femoral head is a common disorder causing disability of the hip joint. The methods for optimally treating this disease in active young patients are still controversial. In this study we investigated the surgical outcome of vascularized pedicle iliac bone grafting for treating nontraumatic avascular necrosis of the femoral head. ⋯ Vascularized pedicle iliac bone grafting is a useful alternative treatment option for patients with avascular necrosis of the femoral head.