Zhonghua yi xue za zhi = Chinese medical journal; Free China ed
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Zhonghua Yi Xue Za Zhi (Taipei) · Aug 2001
Transthoracic and transesophageal echocardiographic diagnosis of aneurysm of the sinus of Valsalva: a review of five year experience.
Aneurysms of the sinus of Valsalva (SVA) are uncommon congenital lesions. The clinical presentations vary from asymptomatic to progressive heart failure following rupture of the aneurysm into an adjacent cardiac chamber. Retrograde aortogram is the diagnostic tool of choice preoperatively. Recent studies have demonstrated that the SVA can be accurately diagnosed using transthoracic two-dimensional, and color Doppler flow mapping, even for surgical preparation without cardiac catheterization. We report our 5-year experience of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in the evaluation of SVA. ⋯ TEE provides clearer definition for the detailed anatomy of the ruptured sac and co-existent cardiac lesions than TTE through high resolution and closer approach. We conclude that TEE is a powerful complementary diagnostic tool in the evaluation of patients with SVA. TEE also provides additionally useful information for guiding the surgical approach and for assessing the operative results even without cardiac catheterization.
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Zhonghua Yi Xue Za Zhi (Taipei) · Dec 2000
Krypton-81m ventilation and technetium-99m macroaggregated albumin perfusion scintigraphy for detection of pulmonary embolism: the first experience in Taiwan.
This study was designed to assess whether the self-made (Institute of Nuclear Energy Research, Taiwan) krypton (Kr)-81m could be used as a ventilation agent to detect patients with suspected pulmonary embolism (PE). In addition, xenon (Xe)-133 ventilation scintigraphy was also performed for comparison. ⋯ Self-made Kr-81m was safe and effective for ventilation scintigraphy in humans. When Kr-81m was used for the detection of PE, it was particularly advantageous when PE occurred in small areas of the lungs or when the patient with PE had concurrent obstructive airway disease.
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Zhonghua Yi Xue Za Zhi (Taipei) · Oct 2000
Randomized Controlled Trial Comparative StudyComparison of the efficacy and safety of oral granisetron plus dexamethasone with intravenous ondansetron plus dexamethasone to control nausea and vomiting induced by moderate/severe emetogenic chemotherapy.
Chemotherapy-induced nausea and vomiting can affect cancer patients' compliance with cytotoxic chemotherapy. Currently, there are some new antiemetic therapies for the treatment of chemotherapy-induced emesis. A single institution, randomized, open, parallel trial was done to compare oral granisetron plus intravenous (i.v.) dexamethasone with intravenous ondansetron for the prevention of moderate or severe emetogenic chemotherapy-induced acute and delayed emesis. ⋯ Oral granisetron plus i.v. dexamethasone and i.v. ondansetron plus i.v. dexamethasone are potentially equally effective antiemetic agents in the prevention of moderate or severe emetogenic chemotherapy-induced acute or delayed emesis. Oral granisetron with dexamethasone appears to be a suitable alternative antiemetic agent in cancer patients who receive moderately or severely emetogenic chemotherapy.
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Zhonghua Yi Xue Za Zhi (Taipei) · Aug 2000
Five-year follow-up of patients with recurrent postmenopausal bleeding.
The most common symptom of endometrial cancer is postmenopausal bleeding. For women who present with postmenopausal bleeding and a benign tissue diagnosis, recurrent bleeding is a worrisome problem. We evaluated such patients to search for a model of good management. ⋯ Although the initial tissue diagnosis might be benign, the possibility of endometrial cancer or complex hyperplasia cannot be ruled out for women with recurrent postmenopausal bleeding. Diagnostic D & C or endometrial biopsy combined with other tools (vaginal ultrasound, hysteroscopy, transvaginal sonohysterography) are more reliable for evaluating women with recurrent postmenopausal bleeding than D & C or endometrial biopsy only. If these diagnostic results are negative, a total hysterectomy with bilateral salpingo-oophorectomy should be considered to reduce the risk of endometrial cancer in women who present with recurrent bleeding.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jul 2000
Randomized Controlled Trial Comparative Study Clinical TrialComparison of bilevel positive airway pressure and volume ventilation via nasal or facial masks in patients with severe, stable COPD.
In the past decade, noninvasive positive pressure ventilation (NIPPV) has been successfully used in chronic obstructive pulmonary disease (COPD) with acute exacerbation. Nonetheless, its effect in stable COPD remains controversial. Theoretically, differences in the mode of ventilation such as pressure versus volume preset, or interfaces such as nasal versus full facial mask could have an impact on the efficacy of NIPPV. Few published studies have focused on this topic. ⋯ For patients with stable hypercapnic COPD, short-term use of BiPAP via either a nasal or facial mask markedly rests the inspiratory muscles, improves the respiratory pattern and reduces the sense of dyspnea for patients. In contrast, short-term use of PLV-100 via either a nasal or facial mask worsens the above parameters.