The effect of types of banner ad, Web localization, and customer involvement on Internet users' attitudes.

In this study, three characteristics of Web sites were varied: types of banner ad, Web localization, and involvement in purchasing a product. The dependent variable was attitude toward the site. In laboratory experiments conducted in Thailand and Taiwan, participants browsed versions of a Web site containing different types of banner ads and products.

Differences in clinical profiles of patients with Protobothrops mucrosquamatus and Viridovipera stejnegeri envenoming in Taiwan.

Envenoming by Protobothrops mucrosquamatus and Viridovipera stejnegeri accounts for the majority of venomous snakebites in Taiwan. We conducted a retrospective study to systematically examine the clinical manifestations and responses to antivenom therapy after P. mucrosquamatus and V.

A rare case of massive retroperitoneal hemorrhage after bone marrow aspiration alone.

The use of dapsone is increasing even though overdose is rarely reported and physicians must be aware of its toxicity and management. Mortality can occur due to methemoglobinemia and hemolytic anemia. Although activated charcoal and methylene blue are recommended, the use of hemodialysis is reported only in few studies.

Oxidative stress and erythropoietin response in altitude exposure.

Purpose: Oxidative stress and erythropoietin (EPO) levels are increased following high altitude exposure. We hypothesized that the altitude-oxidative stress and EPO response would be associated with the presence or absence of acute mountain sickness (AMS) in subjects exposed at high altitude.

Methods: The study enrolled 29 healthy volunteers exposed at altitudes without strenuous physical exercise.

Unilateral thalamic hypometabolism in patients with temporal lobe epilepsy.

Background/purpose: Interictal brain 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is useful for localizing the focus of a seizure, and thalamic hypometabolism has been observed in temporal lobe epilepsy (TLE). In this study, we aimed to investigate the prevalence of thalamic hypometabolism and to assess the usefulness of this supplementary finding for lateralizing epileptic foci on FDGPET scans in patients with TLE.

Methods: This was a retrospective study of 47 patients who underwent anterior temporal lobectomy to treat medically intractable TLE.

Adrenomedullin enhances baroreceptor reflex response via cAMP/PKA signaling in nucleus tractus solitarii of rats.

Adrenomedullin (ADM), a 52-amino acid peptide, elicits differential cardiovascular responses when it is administered systemically or directly to the brain. We evaluated in the present study the hypothesis that ADM may modulate baroreceptor reflex (BRR) response through an ADM receptor-mediated cAMP/ protein kinase A (PKA)-dependent mechanism in the nucleus tractus solitarii (NTS), the terminal site for primary baroreceptor afferents, using Sprague-Dawley rats. Our immunoblot and immunohistochemical results showed that the two component proteins of the ADM(1) receptor complex, calcitonin receptor-like receptor (CRLR) and receptor activity modifying protein (RAMP)-2, were uniformly distributed and highly co-localized in the NTS.

Comparative clinical practice of residents and attending physicians who care for pediatric patients in the emergency department.

Objectives: The purpose of our study was to explore the effect of the physician's training level on the emergency management of common illnesses in the pediatric emergency department (ED). Our hypothesis was that physicians in training used more resources than attending physicians did in caring for pediatric patients in the ED.

Methods: We retrospectively reviewed all records of patients younger than 18 years who presented to the pediatric section in ED of Taipei Veterans General Hospital between January 1, 2004, and December 31, 2005.

Emergency femoral hemodialysis catheter placement complicated by prevesical hematoma.

The femoral vein is the most popular location for temporary catheterization during emergency hemodialysis. Common complications are infection, thrombosis, arterial puncture, and groin hematoma. We report herein a patient with femoral vein perforation and prevesical hematoma.

Emergency department (ED) utilization of oldest old men in a veterans care home in Taiwan.

ED is a common channel for older people to seek for medical services. However, unlike most care homes in the world, veterans care home in Taiwan has a constantly operating outpatient and inpatient services. Therefore, utilization of ED services among veterans care home may be different from most care home residents.

Antivenom therapy for crotaline snakebites: has the poison control center provided effective guidelines?

Crotaline snakebites (Protobothrops mucrosquamatus and Trimeresurus stejnegeri) are a common medical emergency in Taiwan that can be effectively treated by a bivalent F(ab)2 antivenom. We investigated the differences in the clinical outcomes of patients who received different therapeutic regimens of antivenom in a medical center where clinical toxicologists followed the poison control center (PCC) guidelines (medical group) and surgeons did not (surgical group). The medical records of inpatients with crotaline snakebites between 1991 and 2005 were reviewed and information on demographics, treatments, adverse effects of antivenom, and complications was abstracted and analyzed.

Metrology and Standards Needs for Some Categories of Medical Devices.

With rapid advances in meso-, micro- and nano-scale technology devices and electronics, a new generation of advanced medical devices is emerging, which promises medical treatment that is less invasive and more accurate, automated, and effective. We examined the technological and economic status of five categories of medical devices. A set of metrology needs is identified for each of these categories and suggestions are made to address them.

Percutaneous transhepatic gall bladder drainage: a better initial therapeutic choice for patients with gall bladder perforation in the emergency department.

Objectives: To investigate clinical features and outcomes in patients with acute cholecystitis with gall bladder perforation receiving open cholecystectomy or percutaneous transhepatic gall bladder drainage in the emergency department.

Methods: From 1996 through 2005, 33 patients with non-traumatic gall bladder perforation, among 585 patients with acute cholecystitis, were enrolled. Patients were divided into two groups: open cholecystectomy in 16 patients and percutaneous transhepatic gall bladder drainage in 17 patients.

Risk factors and prognostic predictors of unexpected intensive care unit admission within 3 days after ED discharge.

Objective: Our objective was to investigate the risk factors and prognostic predictors of unexpected intensive care unit (ICU) admission within 3 days after emergency department (ED) discharge.

Methods: From January 1, 2001, through December 31, 2005, patients admitted to the ICU unexpectedly within 3 days after being discharged from the ED were enrolled. Medical records of these patients were retrospectively reviewed.

Factors affecting the adoption of electronic signature: Executives' perspective of hospital information department.

The healthcare industry is experiencing a major transformation towards e-healthcare, which delivers and enhances related information through the Internet among healthcare stakeholders and makes the electronic signature (e-signature) more and more important. This paper uses a mature framework, Technology-Organization-Environment (TEO), in information system discipline to identify factors that affect hospitals in adopting e-signature. A survey was conducted on regional hospitals and medical centers in Taiwan to verify the validity of the research framework.

Results of adjusted-dose heparin for thromboembolism prophylaxis in knee replacement compared to those found for its use in hip fracture surgery and elective hip replacement.

The purpose of this study was to compare the results of adjusted-dose heparin (ADH) in the prevention of thromboembolism in knee replacement with those obtained for its use hip fracture surgery and elective hip replacement. Ultrasound was used to diagnose deep vein thrombosis (DVT) and ventilation/perfusion (V/Q) scan to diagnose pulmonary embolus (PE). Analysis of 438 operations was available.

Cessation of nail growth following Bajiaolian intoxication.

Bajiaolian (Dysosma pleianthum), a species in the Mayapple family (Podophyllum pelatum), has been widely used as a traditional Chinese herbal medication for the remedies of snake bite, tumor growth, post-partum recovery, and acne. It has also been used in western medicine, especially topically for various skin lesions. Both oral ingestion and dermal application may result in severe toxicity.

L-arginine causes amelioration of cerebrovascular dysfunction and brain inflammation during experimental heatstroke.

Cerebrovascular dysfunction ensuing from severe heatstroke includes intracranial hypertension, cerebral hypoperfusion, and brain inflammation. We attempted to assess whether L-arginine improves survival during experimental heatstroke by attenuating these reactions. Anesthetized rats, 70 min after the start of heat stress (43 degrees C), were divided into two major groups and given the following: vehicle solution (1 mL/kg body weight) or L-arginine (50-250 mg/kg body weight) intravenously.

Clinical correlation of radiological spinal stenosis after standardization for vertebral body size.

Aim: To determine the relationship between the degree of radiographic lumbar spinal stenosis, adjusted with an internal control for vertebral body size, and disability from lumbar stenosis.

Materials And Methods: one hundred and twenty-three consecutive patients with clinical and radiological confirmation of neural impingement secondary to lumbar stenosis were enrolled prospectively. Thecal sac anteroposterior (AP) diameter (TSD) and cross-sectional area (CSA), and vertebral body AP dimension (VBD) were determined.

Treatment of massive retroperitoneal hemorrhage from adrenal metastasis of hepatoma.

Spontaneous rupture of metastatic adrenal tumor with massive retroperitoneal hemorrhage and shock is an uncommon clinical event. Herein, we report a case of hepatocellular carcinoma (HCC), where left hepatic lobectomy and right adrenalectomy for metastatic HCC were performed in April and August 2002, respectively. Subsequently, the patient presented to the emergency room with acute-onset severe left flank and back pain in March 2004, accompanied by a falling hemoglobin level.

Diffuse Cerebral Cortex, Cerebellar Cortex and Basal Ganglia Injury: a Rare MR Imaging Manifestation of Heat Stroke.

We present a case of heat stroke with rare magnetic resonance (MR) imaging manifestations. In addition to abnormal high signals in bilateral cerebellum and basal ganglia seen on T2-weighted MR images (T2WI), the case showed diffuse cerebral cortical high signals on T2WI and diffusion-weighted images (DWI). Heat stroke with diffuse hypoperfusion to the brain due to diversion of blood circulation was hypothesized as the cause of brain injury, including the cerebral cortex.

Is spinal stenosis better treated surgically or nonsurgically?

For patients with clinical and radiographic lumbar spinal stenosis, is surgery or continued nonsurgical treatment a better option for improvements in baseline disability scores; and what proportion of patients treated surgically and nonsurgically get better, worse, or remain the same with time? We prospectively evaluated 125 consecutive patients for this non-randomized cohort study. Of the patients choosing surgery, 54 underwent decompression only and 42 had decompression and fusion for preexisting spondylolisthesis; twenty-nine patients declined surgery. At 2 years followup, the average improvements in Roland-Morris questionnaire score in the decompression only, decompression with fusion, and nonsurgical groups were 6.

ED presentations of acute renal infarction.

Objective: The objective of the study was to investigate initial clinical characteristics that can suggest an early diagnosis of patients with acute renal infarction presenting with flank and/or abdominal pain in the emergency department (ED).

Methods: From January 1, 1996, through December 31, 2005, 20 adult patients with renal infarction diagnosed by contrast-enhanced computed tomography in the ED were enrolled. Medical records, including demographic data, risk factors for thromboembolism, initial clinical presentations, laboratory data, treatment programs and outcomes, were retrospectively reviewed and analyzed.