Accuracy in diagnosis of acute appendicitis by comparing serum C-reactive protein measurements, Alvarado score and clinical impression of surgeons.

Objective: To compare the accuracy of a surgeon's clinical diagnosis of acute appendicitis with Alvarado's predictive model and C-reactive protein (CRP) measurements.

Method: The records of 231 adult patients between 14-75 years admitted to the hospital with suspected appendicitis from August 1999 to November 2001 were studied prospectively. Serum CRP measurements (217 patients) and Alvarado scores (231 patients) were performed before operations but were not taken into account prior to the decision to perform a laparotomy to compare the surgeon's clinical diagnosis.

Mastectomy without drain at pectoral area: a randomized controlled trial.

Objectives: Mastectomy is still one of the standard alternative procedures for the management of female breast cancer. Axillary node dissection is also performed to establish the accurate staging. After operation, the axilla must be drained because of lymphatic leakage.

Mediastinal tracheostomy.

Background: Advanced carcinoma of the lower neck with direct extension to the superior mediastinum is a major therapeutic challenge. Complete removal of the tumors requires a radical operation in order to remove the larynx, portions of trachea and esophagus, and to construct a tracheostomy stoma with intrathoracic trachea.

Methods: We present our experience and technique for removal of difficult tumors in this region and construction of mediastinal tracheostomy.

Combination chemotherapy as induction therapy for advanced resectable head and neck cancer.

Fifty-four previously untreated patients with locally advanced resectable squamous cell carcinoma of the head and neck (SCCHN) were enrolled into a prospective randomized controlled trial to evaluate whether induction chemotherapy improves the disease-free survival compared to the standard treatment (surgery + radiation). Thirty patients received chemotherapy, which consisted of cisplatin 20 mg/m2 day 1-5, bleomycin 10 mg/m2, continuous infusion from day 3-7, and methotrexate 40 mg/m2 given on day 15 and day 22. The cycle was repeated on day 29 for two cycles.