Biomedical subjects
Publications and source records attributed to C Y Yuan.
1-Hexadecane-3-methylimidazolium bromide and 1-hexadecane-2,3-dimethylimidazolium bromide were used as new templates for the syntheses of periodic mesoporous organosilica (PMO) materials; using these new templates, ethane-bridged PMO materials were successfully synthesized and characterized under basic conditions.
Spindle cell carcinoma is a rare tumor commonly occurring in the upper aerodigestive tract. We report a 62-year-old male with spindle cell sarcomatous change located at the hepatic hilum, resulting in obstructive jaundice. The patient died after an extended resective operation. The rare disease and its histogenesis is discussed.
Fibrolamellar hepatocellular carcinoma is rare. By chance, a Chinese woman detected a mass in the right upper quadrant of the abdomen. Ultrasonography, computed tomography and magnetic resonance imaging revealed a solid tumor with a central fibrous scar locating at the posterior inferior subsegment of the right hepatic lobe. The tumor was successfully resected and histopathological examination revealed a fibrolamellar hepatocellular carcinoma. Our case shows that fibrolamellar hepatocellular carcinoma may also occur in Chinese as well as in Japanese and Westerners.
Dead on arrival (DOA) is a distressful situation for most medical personnel and families. There are few papers about this topic in Taiwan though most DOAs are unexpected and sudden with or without underlying disease as predisposing factors. From January 1, 1993 to December 31, 1993, 487 DOA patients were sent to 4 large hospitals in the Kaohsiung area (including Kaohsiung City and Kaohsiung County). A retrospective study was carried out through questionnaires. The incidence was 0.22%, the male to female ratio was 2.25, and the largest age group was 61 to 75 years old. Most patients were sent to nearby hospitals and sent by non-medical personnel with non-ambulance motor vehicles. It is hard to define the exact time from arrest to arrival at the hospital, but the initial cardiac rhythm was mostly asystole. Only 1.44% of DOA patients survived and only 9.24% responded to resuscitation. About 31.42% of patients had no evident cause of death, 40.04% non-trauma deaths, and 28.54% trauma deaths. Most of the underlying diseases were treated regularly by medical specialists if past history could be traced. Though our emergency medical service system (EMSS) has been active since 1990, there are still several drawbacks. Public education of cardiopulmonary resuscitation, easy access to EMSS, and appropriate management in hospitals must be stressed. With the improvement of prehospital care, EMSS, and in-hospital care, there will be a decrease in DOA patients.
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From May 1985 through July 1990, 28 episodes of Vibrio vulnificus infection in 27 patients were encountered in five major hospitals in Taiwan. The ages of patients ranged from 19 to 76 years; the ratio of male to female patients was 2:1. Eighteen episodes manifested as bacteremia and eight as wound infections alone. One patient each developed gastroenteritis and pneumonia after nearly drowning. Twenty-three patients exhibited skin manifestations. Twenty patients had underlying diseases. All patients were treated with antibiotics, and 14 also underwent some form of surgical treatment (incision and drainage, fasciotomy, debridement, or amputation). Thirteen of the 28 episodes were preceded by precipitating factors; most were due to ingestion of seafood or exposure of abraded skin to salt water. Ten of the 18 septicemic patients died--most within 48 hours of hospitalization. One patient without bacteremia who had a wound infection died. Results of in vitro susceptibility studies suggested that ampicillin or a third-generation cephalosporin would be effective. Susceptibility to aminoglycosides was observed for greater than 90% of isolates. We recommend combined therapy with a third-generation cephalosporin or ampicillin and an aminoglycoside along with appropriate surgical therapy for the treatment of V. vulnificus infection.
Hyperoxaluria is frequently seen in patients with inflammatory bowel disease, or after resection of the ileum. It is assumed to be responsible for the development of nephrolithiasis, nephrocalcinosis (oxalate nephrosis) and progressive renal impairment in these patients. Steatorrhea may aggravate the severity of hyperoxaluria. A 60-year-old male underwent massive resection of the jejunum and ileum 10 years prior to admission, due to strangulation of the small bowel, with occlusion of the superior mesenteric artery. He remained well except for steatorrhea which developed two-and-a-half years prior to admission, when microhematuria, proteinuria and oxaluria developed progressively. Since that time, the nephrolithiasis, nephrocalcinosis and renal failure have continued to worsen despite therapy with oxalate restriction and oxalate-binding agents. A renal biopsy, performed late in the clinical course, showed severe changes in the renal parenchyma. The decline in renal function proved irreversible. The unusual metabolic consequences of massive resection of the small intestine and their mechanisms are discussed.
Intrahepatic stones are one of the most distressing problems of biliary diseases in the Orient. Surgical treatment, though greatly advanced over the last ten years, still poses a relatively high incidence of residual and recurrent stones. There were 258 patients treated by surgery for intrahepatic stones over a seven-year period at Yuan General Hospital in Taiwan. Among them, 202 patients (78.3%) were adequately followed up. The patients included 82 men and 120 women with a mean age of 40.5 years. There were 111 cases (55.0%) involving only the left side, 37 cases (18.3%) involving only the right side and 54 cases (26.7%) involving both hepatic biliary trees. Hepatic resection, either segmentectomy or lobectomy (37 cases, 18.3%) and extended choledocholithotomy with or without drainage procedures (165 cases, 81.7%) were the surgical procedures carried out in these patients. Treatment failure was defined by the existence of stones, residual or recurrent in the bile ducts. The failure rate of extended choledocholithotomy (32/165, 23.6%) was higher than that of hepatic resection (3/37, 8.1%) although the difference was not statistically significant (p = 0.06). The addition of various drainage procedures did not appear to affect the outcome of extended choledocholithotomy (p = 0.23). A significant number of patients had intrahepatic strictures in the biliary tracts. (62 cases, 30.7%). The overall treatment failure rate in patients with intrahepatic biliary stricture was significantly higher (28/62, 45.2%, p = 0.001) than those without stricture (14/100, 14%). However, hepatic resection was associated with a significantly lower failure rate than other treatment modalities (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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