Chang Gung medical journal
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Nausea and vomiting are common chief postoperative complaints. The clinical literature indicates that postoperative nausea and vomiting (PONV) is common after orthopedic surgery. This study examines the clinical therapeutic efficacy of Ondansetron injected intravenously before the end of shoulder arthroscopy as antiemetic prophylaxis to help reduce the incidence of PONV. ⋯ Routine intravenous injection of Ondansetron 30 minutes before completion of shoulder arthroscopy can reduce the incidence of vomiting and overall PONV in patients. Additionally, the patients using Ondansetron demonstrated lower pain intensity and lower analgesic injection needs than the control group.
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Functional separation of the lungs may be accomplished by several methods. Patients with a stiff neck and limited mouth opening restrict options to a one-lung ventilation. We report the use of the WuScope video system, a new tool for facilitating double-lumen endotracheal tube placement for one-lung ventilation, in a patient who suffered from ankylosing spondylitis with a stiff, flexed neck and limited mouth opening for his recurrent spontaneous pneumothorax.
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To determine whether magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) are able to distinguish between adenocarcinoma originating from the uterine cervix and endometrium. ⋯ MRI may distinguish between most uterine adenocarcinoma originating from the cervix and endometrium using distinctive characteristics found on T2WI and DCE. When tumors show an ambiguous morphology, the ADC value of the tumor may be helpful for further differentiation.
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Percutaneous radiofrequency trigeminal rhizotomy offers high rates of complete pain relief for classic idiopathic trigeminal neuralgia. When performed under fluoroscopy, it may cause anxiety for an inexperienced neurosurgeon owing to lack of familiarity with the regional anatomy, lack of reliable landmarks on fluoroscopy, and perceived risks associated with inadvertent puncture of neurovascular structures near the foramen ovale. The purpose of this study is to describe a new procedure to maximize patient security and shorten operative time. ⋯ For percutaneous trigeminal rhizotomy, three-dimensional image reconstruction provides for precise placement of the rhizotomy needle in a safe and timely manner, which improves patient comfort and shortens operative time.
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To identify clinical features that distinguish children with appendicitis who visited the emergency department twice or more from those diagnosed on the first visit to the emergency department. ⋯ Misdiagnosed appendicitis is a problem in the emergency department. A shorter stay in the emergency department, fewer laboratory tests, less diagnostic imaging, and fewer physical findings may be responsible for misdiagnosed appendicitis late at night in the emergency department.