Zhonghua yi xue za zhi = Chinese medical journal; Free China ed
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Zhonghua Yi Xue Za Zhi (Taipei) · Aug 1998
Randomized Controlled Trial Clinical TrialEmergency medical resource use in Taipei city.
It is a worldwide trend to serve emergency patients at emergency department (EDs) staffed by board-certified emergency physicians (EPs). The question arises as to how many EPs are cost effective? This cannot be answered until utilization of emergency resources in the community is explored, so that appropriate plans for efficient ED use, staffing and training of EPs can be made. ⋯ VGH-T is a favorable training ground for EPs due to its high volume of adult and elderly, advanced life support eligible, ICU and high acuity patients. MMH is an ideal place for training in pediatric emergency medicine. Utilization of the 119 emergency response system is low. The number of patients with high acuity triage in Taipei City is low. However, Taipei City faces a shortage of acute care beds, especially ICU beds.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jul 1998
Effects of gamma knife radiosurgery for brain tumors: clinical evaluation.
Gamma knife radiosurgery is a safe and effective alternative to microsurgery in the management of selected intracranial lesions. In our initial three-year experience with gamma knife radiosurgery, 431 patients were treated using this method. This report presents the treatment results for three different types of brain tumors: benign meningiomas, malignant metastases and gliomas. ⋯ Gamma knife radiosurgery is effective for controlling tumor growth in benign meningiomas for up to three years after surgery. In selected cases of malignant metastasis and gliomas, most patients appeared to benefit from the treatment with symptomatic improvement and prolonged survival. Treatment strategy and dose selection in radiosurgery should be adjusted to optimize tumor control and avoid adverse radiation effects.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jun 1998
Case ReportsAcute subdural hematoma with subarachnoid hemorrhage caused by an intracranial aneurysm: a case report.
The occurrence of a subdural hematoma caused by the rupture of an intracranial aneurysm is rare. In our case, the patient is a 43-year-old woman who suffered from sudden onset of severe headache. ⋯ The subdural hematoma was evacuated and the aneurysm clipped. The patient made a full recovery.
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Zhonghua Yi Xue Za Zhi (Taipei) · Jun 1998
Can advanced hemostatic parameters detect disseminated intravascular coagulation more accurately in patients with cirrhosis of the liver?
Laboratory diagnosis of disseminated intravascular coagulation (DIC) is difficult in patients with cirrhosis of the liver due to the complicated hemostatic changes of DIC. More recently, newer molecular hemostatic markers have been used to improve the diagnosis of DIC. This study evaluated the ability of the more advanced hemostatic tests to diagnose DIC in patients with cirrhosis of the liver. ⋯ New tests are not necessary to improve the diagnosis of DIC in patients with cirrhosis of the liver.
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Zhonghua Yi Xue Za Zhi (Taipei) · Apr 1998
Case ReportsElimination of hypercapnia may postpone the clinical presentation of malignant hyperthermia: a case report.
Malignant hyperthermia is a rare complication in clinical anesthesia, especially associated with the administration of succinylcholine or inhalation anesthetics. A 19-year-old patient, suffering from traumatic mandible fracture, underwent open reduction under general anesthesia. Unfortunately, following administration of succinylcholine, he also suffered severe facial twitch and the first episode of hypercapnia. ⋯ However, two hours later, the hypercapnia recurred, combined with progressive elevation of body temperature. After administration of intravenous dantrolene 120 mg, the patient's condition became stable and the procedure was completed without sequelae. As the muscle contracture test is not available in Taiwan, the clinical grading scale is presented as an alternative diagnostic method for malignant hyperthermia.