Risk stratification for predicting 30-day mortality of intracerebral hemorrhage.

Objective: The aim of this study was to develop a grading scale for predicting the 30-day mortality of spontaneous intracerebral hemorrhage (ICH) using initial evaluation data.

Design: Univariate and multivariate logistic regression models were used to identify independent risk factors and to construct a grading scale for predicting the outcome of ICH.

Setting: The Taichung Veterans General Hospital in Taichung, Taiwan.

Risk factors affecting adverse outcomes of cardiac surgery in patients aged 70 years and older.

Background: The elderly segment of the population in Taiwan is increasing rapidly. According to the latest information from the Directorate-General of Budget, Accounting and Statistics, Executive Yuan, Taiwan, 1,553,367 civilians of the total population of 22,879,510 (6.8%) are seventy years old and older in 2007.

Prediction for major adverse outcomes in cardiac surgery: comparison of three prediction models.

Background/purpose: Recent advances in medical treatment have altered the profile of patients referred for cardiac surgery. The proportion of high risk patients has increased dramatically. Numerous multifactorial risk scores have been developed to predict outcomes after cardiac surgery.

Massive pulmonary embolism during orthopedic surgery.

A 90-year-old female patient undergoing surgery for knee and hip fractures under general anesthesia sustained cardiac arrest intraoperatively. The transesophageal echocardiography performed during resuscitation revealed massive pulmonary embolism with a 2 x 3 cm oval-shaped thrombus in the bifurcation of pulmonary artery. Anticoagulant therapy was administered immediately.

The use of rocuronium and sevoflurane in acute intermittent porphyria--a case report.

Acute intermittent porphyria (AIP) is an inherited metabolic disorder caused by deficiency of porphobilinogen deaminase, an enzyme found in the synthetic pathway of heme. Acute attack of AIP may be precipitated by many factors during operation and anesthesia, including fasting, dehydration, stress, infection, and drugs. Acute attack of AIP is likely fatal.

Time course of spontaneous recovery of subacute fat embolism syndrome--a case report.

Pulmonary embolism is not uncommonly encountered in orthopedic patients with high risks, such as prolonged immobility, obesity, past or family history of thromboembolism, pelvic and long bone fractures. Here we report a young male patient with a residual cerebral arteriovenous malformation post-craniotomy suffered from acute severe hypoxemia after sustaining a simple fracture of the left femur shaft from a motorcycle accident. The emergent surgery was deferred in view of suspectable pulmonary embolism.

Depth of the thoracic epidural space in paramedian approach.

Study Objective: To define the depth of the thoracic epidural space in the paramedian axis.

Design: Retrospective study.

Setting: Operating room of a tertiary care medical center.

Repetitive junctional rhythm during forehead-lift surgery--a case report.

Forehead lift plastic surgery is regarded as a rather safe operation without serious cardiovascular complications. Although cardiac arrhythmias (e.g.

Metastatic hepatocellular carcinoma of the right atrium causing right ventricular outflow tract obstruction during induction of anesthesia--a case report.

Metastatic hepatocellular carcinoma (HCC) to the right atrium occurs rarely and may lead to lethal perioperative complications. A 61-year-old female who was about to undergo operation for resection of a right intraatrial tumor thought possibly to be metastatic hepatocellular carcinoma met with sudden protrusion of the tumor from the right atrial wall that sank into the right ventricle during induction of anesthesia. Right ventricular outflow tract obstruction developed and was quickly diagnosed by transesophageal echocardiography.