Pericardiocentesis guided by two-dimensional contrast echocardiography.

The clinical application of two-dimensional contrast echocardiography to pericardiocentesis was investigated in 20 patients with pericardial effusion. Multiple views were obtained to determine the ideal needle entry route. During pericardiocentesis, after 5 to 10 mL of pericardial fluid was withdrawn, 3 to 5 mL of agitated saline solution was injected through the exploring needle into the pericardium and a cloud of echoes indicated the needle's position.

Five-year experience of human immunodeficiency virus type 1 national screening program implemented at Veterans General Hospital-Taipei.

From July 1986 through June 1990, 33,199 sera from various risk groups were collected in Veterans General Hospital-Taipei for detection of antibody against human immunodeficiency virus, type 1 (HIV-1). Sixty-five samples were proved positive by Western blot analysis. Among individual high risk groups, hemophiliacs had the highest positive rate of 20/60 (29.

Does propranolol maintain post-sclerotherapy variceal obliteration? A prospective randomized study.

Variceal recurrence and rebleeding are common after initial obliteration by injection sclerotherapy. To investigate whether propranolol can maintain variceal obliteration by sclerotherapy, 59 patients with oesophageal variceal bleeding after sclerotherapy were enrolled. Patients were allocated to propranolol treatment (30 patients) or served as controls (29 patients).

Evaluation of the potential role of enzyme-linked immunosorbent assay in serodiagnosis of tuberculosis.

The serodiagnosis of tuberculosis was evaluated by means of enzyme-linked immunosorbent assay of IgG antibody to mycobacterial antigen 60. The study population consisted of 63 patients with active tuberculosis comprising 43 pulmonary tuberculosis, 15 tuberculosis pleurisy, four miliary tuberculosis, and one tuberculous lymphadenitis. The control group consisted of 48 patients embracing 8 cases of inactive pulmonary tuberculosis, 31 cases of pulmonary disorders other than tuberculosis, and nine normal persons.

Intestinal, pancreatic, and hepatic effects of gastrointestinal hormones in a total parenteral nutrition rat model.

The adverse effects of long-term total parenteral nutrition (TPN) are well documented. Lack of gastrointestinal (GI) stimulation from oral feeding, reduction of GI hormone secretion, and interruption of enterohepatic circulation of bile may be found. TPN results in atrophy of the digestive system, intestinal bacterial overgrowth and translocation, liver cell damage, and gallstone formation.

Proximal slowing in carpal tunnel syndrome resulting from either conduction block or retrograde degeneration.

In the carpal tunnel syndrome (CTS), decreased conduction velocity (CV) of the median nerve in the forearm segment has been ascribed to an electrodiagnostic artefact rather than pathophysiological changes. Standard CV of the forearm segment is calculated by subtracting the distal latency, which may not represent an exact assessment of CV in the proximal median nerve. A new technique modified from the method of Stoehr et al.

Detection of airway CO2 partial pressure to avoid esophageal intubation.

During endotracheal intubation, checking the position of endotracheal tube is important in order to avoid accidental esophageal intubation. Exhaled CO2 pressures of 50 emergent intubation attempts were recorded in our pediatric intensive unit to evaluate the efficacy of capnography in the early detection of esophageal intubation. Adjustment of the tube position was performed when indicated.

[The effects of intravenous and intraperitoneal dexamethasone treatment on vecuronium in the anesthetized rat].

It is fairly widespread clinical practice to administer large doses of corticosteroids to patients in cases of shock; doses of hydrocortisone as high as 50 mg/kg given intravenously have been proposed and used; especially in cases of Myasthenia Gravis. Its effects on neuromuscular transmission is not yet fully understood. In order to determine the mechanism of this interaction, we undertook this investigation.

Effective renal plasma flow response and atrial natriuretic peptide in patients with uncomplicated acute myocardial infarction.

Effective renal plasma flow was determined by using I-131 labeled iodo-ortho-hippurate in 17 Chinese patients admitted to the coronary care unit with uncomplicated acute myocardial infarction. The first determination, immediately after admission, was significantly higher than the second determination done a week later, 444.5 +/- 153.

Intradiverticular tumors of the bladder: surgical implications--an eleven-year review.

An 11-year review of all vesical diverticula and bladder tumors was undertaken. Fourteen patients were found to have primary neoplasms arising in the diverticula. The most common type was transitional cell.

Seroprevalence of Chlamydia pneumoniae in Taiwan.

Chlamydia pneumoniae (TWAR) is a relatively newly discovered respiratory tract pathogen which was first isolated in Taiwan. In order to describe the seroepidemiology of C. pneumoniae in Taiwan, we evaluated 1,085 stored serum samples: 904 from patients, 97 from umbilical cord blood samples, and 84 from medical personnel at the Veterans General Hospital-Kaohsiung, between January 1 and April 30, 1991.

Tissue contents of endothelin vary according to thyroid hormone status in rat.

Endothelin-1 (ET-1) is a 21-residue peptide isolated from the conditioned medium of cultured porcine endothelial cells and is widely distributed throughout the body, with relatively high levels in the kidney and lung. In this study we examined the influence of thyroid hormone status on immunoreactive endothelin (ir-ET) levels in the plasma, lung, and kidney tissues of rats. Three weeks after surgical removal of the thyroid gland from male rats, the ir-ET levels in the lung and kidney were reduced by 39% and 42%, respectively.

The use of transesophageal echocardiography to evaluate the effectiveness of patent ductus arteriosus ligation.

The ligation of patent ductus arteriosus (PDA) is a comparatively easy operation, but some complications are possible. The most common complication is incomplete ligation of the PDA; others include inadvertent ligation of the descending aorta or left pulmonary artery, transient rise in systemic blood pressure and increased left ventricular afterload, and acute right heart failure due to pulmonary hypertension. The completeness of the PDA ligation is usually determined only by the operating physician's experience, including the use of an esophageal stethoscope or a finger on the lesion to feel for vibration.

"Numb, clumsy hands" and tactile agnosia secondary to high cervical spondylotic myelopathy: a clinical and electrophysiological correlation.

Four patients presented with a distinctive syndrome of "numb, clumsy hand" and tactile agnosia. Myelography and computed tomographic myelography (CTM) of the cervical spine documented major spondylotic compressive lesions mainly between the C3 and C5 levels. The cortical responses of dermatomal somatosensory evoked potentials (DSEPs) revealed progressively prolonged peak latencies and progressively decreased amplitudes of early components from C6 to C8 dermatomal stimulation.

[Laparoscopic cholecystectomy: experience of VGH-Kaohsiung].

One hundred consecutive patients underwent laparoscopic cholecystectomy from May 1991 to February 1992 at Veterans General Hospital--Kaohsiung. Ninety-seven of them presented on an elective basis, including eight patients undergoing endoscopic sphincterotomy with extraction of common bile duct stone before laparoscopic cholecystectomy. The remaining 3 patients were operated during acute cholecystitis episode.

Echocardiographic evaluation of thickened aortic valve and its relation to aortic stenosis and regurgitation.

To elucidate the aging changes of human aortic valves and their relation to aortic regurgitation (AR) or stenosis (AS), consecutive echocardiographic examinations in 1601 subjects were carried out. These patients were prospectively divided into 5 groups: adolescence (< 20, N = 38); adulthood (20-39, N = 131); middle age (40-59, N-222); old age (60-79, N = 1194) and octogenarian (> = 80, N = 16). The incidence of thickened aortic valve (TAV), to be overall, was 29%.

Intrathoracic schwannoma of vagus nerve.

Intrathoracic neurogenic tumors are relatively common mediastinal tumors generally located in the posterior mediastinum. The most common origin is the intercostal nerve or the sympathetic chain. These tumors rarely arise from vagus nerve in the anterior mediastinum.

Primary malignant melanoma of the vagina and cervix uteri: case report and literature review.

Malignant melanoma of vagina is rare. Malignant melanoma of the cervix is even rare. To date, only 96 cases of the former and 26 cases of the latter have been reported.

Clinical evaluation of fleroxacin in the treatment of bone and joint infections.

The objective of this open label, non-comparative study was to evaluate the efficacy and safety of fleroxacin 400mg administered orally once daily to patients with acute osteomyelitis and/or acute septic arthritis. Nineteen patients (10 males and 9 females) were evaluable for the analysis of clinical efficacy and safety. Of these, 7 (36.

Uninephrectomy enhances urolithiasis in ethylene glycol treated rats.

Uninephrectomy (uNX) usually induces compensatory hyperfunction of the remaining kidney in an attempt to preserve the homeostasis of body fluid composition. The present study used uninephrectomized Sprague-Dawley rats on a lithogenic diet (0.5% ethylene glycol, EG) to evaluate the influence on urinary stone formation and calcium oxalate crystal deposition of compensatory excretion of lithogenic substances in the remnant kidney.

[Acute abdomen with intraperitoneal bowel perforation-demonstration by CT scan].

Ninety-eight cases of surgically proved bowel perforation in VGH-Kaohsiung within one year were reviewed. Among them, 25 patients received abdominal CT scans before operation. Free gas or fluid could be demonstrated with CT scan in 80% of cases though sometimes the fluid was too scanty to be well recognized.

Injection sclerotherapy preceded by esophageal tamponade versus immediate sclerotherapy in arresting active variceal bleeding: a prospective randomized trial.

To investigate whether Sengstaken-Blakemore tube tamponade is needed before emergency sclerotherapy, 60 patients with active esophageal variceal bleeding were randomized to receive either immediate injection sclerotherapy (group A) or sclerotherapy preceded by balloon tamponade (group B). Three patients in group A (10%) were completely inaccessible to sclerotherapy. Initial success in stopping bleeding at 24 hours after sclerotherapy was 76% in group A and 81% in group B (p = 0.

[The incidence and cause of death following surgery for benign biliary tract disease].

A total of 4056 consecutive patients operated for benign biliary tract disease between January 1983 and June 1990 were reviewed retrospectively. There were 71 in-hospital deaths, representing 1.75% of morality rate.

Catheter-related complications of continuous ambulatory peritoneal dialysis.

Objective: To assess the effectiveness of continuous ambulatory peritoneal dialysis (CAPD) with particular reference to morbidity.

Design: Open study.

Setting: Two city general hospitals.