Biomedical subjects

L C See

Publications and source records attributed to L C See.

At least 37 records · Page 2Linked to original sources

PubMed1999

Survey of incisor trauma in second grade students of central Taiwan.

BACKGROUND: The purpose of this study was to investigate the prevalence and related factors of incisor trauma among 1200 second grade students in Taichung City, Taiwan. METHODS: The study population consisted of 1200 second grade students, 645 boys (53.8%) and 555 girls (46.3%), at four elementary schools in Taichung City, Taiwan. This survey was composed of two parts: (1) a questionnaire of dental traumatic history, and (2) a clinical examination of each subject to record any clinical evidence of traumatic dental injury on permanent incisors. RESULTS: The questionnaires indicated that 16.5% of the children had a positive history of dental trauma. The male to female ratio of a prior dental trauma was 1.4:1. The maxilla (78.2%) was affected more frequently than the mandible. Most of the injuries had occurred at home (63.7%). Clinical examinations disclosed that 3% of the subjects, 43 teeth in 37 children, had clinical signs and symptoms of dental trauma. Maxillary central incisors (77%) were the teeth most often affected. The most common type of crown injury was enamel fracture (67%). CONCLUSION: The prevalence of a history of dental trauma and clinical findings of incisor injury in this study was lower than that in previous reports. Home and school were the settings where dental injury was most likely to occur. Clinical signs and symptoms of dental trauma were found in 3% of the subjects. Maxillary incisors were the most commonly affected teeth, and 67% of these cases involved enamel fracture.

Age Factors↗

PubMed1998

Possible role of telomerase activation in the cancer predisposition of patients with hereditary nonpolyposis colorectal cancers.

BACKGROUND: Hereditary nonpolyposis colorectal cancer syndrome (HNPCC syndrome; also called Lynch syndrome) is one of the most common cancer predisposition syndromes. Most cases of cancer associated with this syndrome are due to the inheritance of germline mutations in genes that encode proteins required for DNA mismatch repair; defects in these proteins allow mutations to accumulate more rapidly in the DNA and influence the rate of cancer development. Recent studies indicate that the reactivation of the activity of telomerase, an enzyme involved in the synthesis of chromosomal ends, in somatic cells may play a role in carcinogenesis. In this study, we evaluated the expression of telomerase in normal and cancerous colorectal tissue specimens from HNPCC and non-HNPCC patients. METHODS: The polymerase chain reaction-based telomeric repeat amplification protocol was used to assay telomerase activity in colorectal tissue specimens from 33 non-HNPCC patients (23 normal, 26 polyps, and 37 cancer specimens) and from 24 HNPCC patients (24 normal, 0 polyps, and 28 cancer specimens). RESULTS: Thirty-one of 37 carcinoma samples from 18 non-HNPCC patients and 27 of 28 carcinoma samples from 24 HNPCC patients were found to be positive for telomerase activity. Whereas only one of 23 normal mucosa samples from 23 non-HNPCC patients was found to have (weak) telomerase activity, eight of 24 normal mucosa samples from 24 HNPCC patients were positive for telomerase; the difference between the two groups was statistically significant (two-sided P = .0226). IMPLICATION: This study generates the hypothesis that genetic defects in individuals with HNPCC syndrome facilitate the reactivation of telomerase activity, a process which may be associated with their predisposition to develop cancer.

Adult↗

PubMed1998

Different prognostic effect of postoperative chemoradiation therapy on diploid and nondiploid high-risk rectal cancers.

PURPOSE: DNA ploidy has been shown to play a role in the response to cytotoxic therapy in a variety of malignancies, including breast cancer and melanoma. However, the importance of DNA ploidy in rectal cancer is unknown. The aim of the present study was to determine whether ploidy status might be associated with response to postoperative chemoradiation in TNM Stages II to III rectal cancer. METHODS: This retrospective study analyzed data from 229 patients with TNM Stages II to III rectal cancer who underwent resection between 1979 and 1984. The ploidy status and treatment modalities in relation to outcome were assessed. RESULTS: The recurrence-free ten-year survival rate was 52.2 percent for patients with diploidy and 50.5 percent for patients with nondiploidy (P = 0.99). The ten-year survival rates for patients with diploidy and patients with nondiploidy were 55 and 19 percent (P = 0.016) in the chemoradiation group, and 51 and 60 percent (P = 0.15) in the nonchemoradiation group, respectively. In the chemoradiation group, DNA nondiploidy was associated with an increased recurrence rate (83.3 vs. 50.0 percent; P = 0.001). The interaction between DNA nondiploidy and chemoradiation remained important in predicting outcome in the Cox regression model. Factors independently correlated with a worse outcome included Stage IIIb (relative risk, 2.9; 95 percent confidence interval, 1.7-5; P = 0.0001), perineural invasion (relative risk, 2.5; 95 percent confidence interval, 1.6-4, P = 0.0001), distal tumor (relative risk, 1.7; 95 percent confidence interval, 1.1-2.7, P = 0.014), and nondiploidy with chemoradiation (relative risk, 2.9; 95 percent confidence interval, 1.2-7.2, P = 0.0213). CONCLUSIONS: These findings suggest that DNA nondiploidy is inversely correlated with long-term outcome among patients with high-risk rectal cancer receiving chemoradiation.

Adult↗

PubMed1998

In vitro culture growth of erythroid progenitors and serum erythropoietin assay in the differential diagnosis of polycythaemia.

BACKGROUND: We assessed the in vitro culture growth of erythroid progenitors [burst forming unit-erythroid (BFU-E)] and serum erythropoietin (EPO) levels in different groups of polycythaemia to determine the discriminative power in differential diagnosis of polycythaemia. METHODS: We used the methylcellulose culture technique to study the growth of endogenous erythroid colonies (EECs) and EPO-dependent BFU-E from bone marrow (BM) and/or peripheral blood (PB) cells from 40 patients with polycythaemia vera (PV), 13 with secondary polycythaemia (SP), 19 with pure erythrocytosis (PE), five with PE and PV evolution later (PE-PV), and 12 with relative polycythaemia (RP). The serum EPO levels were measured by radioimmunoassay before treatment in 47 patients, 23 SP patients, 19 PE patients, five PE-PV patients and 16 RP patients, as well as after treatment in 38 PV patients, five PE-PV patients and 12 PE patients. RESULTS: The results of the erythroid progenitor culture assay showed that the numbers of EPO-dependent BFU-E in BM did not differ significantly among groups. The PB BFU-E were significantly higher in PV than in SP or PE, and no statistical difference were found among patients with SP, PE and RP. There was a correlation between BM BFU-E and PB BFU-E in the individual PV and PE patients. EECs were present in all BM and PB cultures of untreated and phlebotomy-treated PV and PE-PV patients, but were absent in 6 of 17 PV patients who had received cytotoxic therapy. EECs were not found in SP, PE and RP. PB could substitute for BM in the EEC or the BFU-E assay. Both pretreatment and post-treatment serum EPO levels of PV and PE-PV were similar, which were significantly lower than SP, PE or RP. The serum EPO levels in treated PV or PE-PV patients who had normal haematocrit values were not significantly different from those in untreated patients. In contrast, the phlebotomy-treated PE patients had significantly higher serum EPO values than untreated PE patients. In the differentiation between PV and PE, the sensitivity, specificity, positive predictive value and negative predictive value of post-treatment serum EPO levels at a cut-off level of < or = 9 UL-1 were 74%, 92% and 52% respectively. The discriminative power of post-phlebotomy serum EPO levels was even higher with a positive predictive value of 80% and negative predictive value of 92% for the prediction of PV evolution in patients with pure erythrocytosis of unknown origin. CONCLUSION: The present study showed that apart from EEC assay, the post-phlebotomy serum EPO level was a sensitive and specific parameter in the differential diagnosis of polycythaemia, in particular for the identification of PV among patients with unclassifiable polycythaemia.

Adult↗

PubMed1998

Odor identification: perceptual and semantic dimensions.

Five studies explored identification of odors as an aspect of semantic memory. All dealt in one way or another with the accessibility of acquired olfactory information. The first study examined stability and showed that, consistent with personal reports, people can fail to identify an odor one day yet succeed another. Failure turned more commonly to success than vice versa, and once success occurred it tended to recur. Confidence ratings implied that subjects generally knew the quality of their answers. Even incorrect names, though, often carried considerable information which sometimes reflected a semantic and sometimes a perceptual source of errors. The second study showed that profiling odors via the American Society of Testing and Materials list of attributes, an exercise in depth of processing, effected no increment in the identifiability/accessibility beyond an unelaborated second attempt at retrieval. The third study showed that subjects had only a weak ability to predict the relative recognizability of odors they had failed to identify. Whereas the strength of the feeling that they would 'know' an answer if offered choices did not associate significantly with performance for odors, it did for trivia questions. The fourth study demonstrated an association between ability to discriminate among one set of odors and to identify another, but this emerged only after subjects had received feedback about identity, which essentially changed the task to one of recognition and effectively stabilized access. The fifth study illustrated that feedback improves performance dramatically only for odors involved with it, but that mere retrieval leads to some improvement. The studies suggest a research agenda that could include supplemental use of confidence judgments both retrospectively and prospectively in the same subjects to indicate the amount of accessible semantic information; use of second and third guesses to examine subjects' simultaneously held hypotheses about identity; use of category cuing or similar techniques to discover the minimum semantic information needed to precipitate identification; some use of subjects trained in quantitative descriptive analysis to explore whether such training enhances semantic memory; and judicious use of mixtures to explore perceptual versus semantic errors of identification.

Adult↗

PubMed1998

Early stage nasopharyngeal carcinoma: radiotherapy dose and time factors in tumor control.

OBJECTIVE: To evaluate radiotherapy dose and length of treatment in the control of early stage nasopharyngeal carcinoma (NPC) treated with a combination of external radiotherapy and brachytherapy, MATERIALS & METHODS: We reviewed the records of 133 patients with early stage nasopharyngeal carcinoma (stage I or II, AJC/UICC staging system) who received definitive radiotherapy in Chang Gung Memorial Hospital from 1979 to 1991. The median follow-up time was 7.1 years with a minimum of 2 years. All patients were treated with megavoltage external radiotherapy to the nasopharynx area (63-72 Gy) followed by high dose rate intracavitary brachytherapy (5-16.5 Gy in one to three fractions, spaced 1-2 weeks apart). The median total dose and time of irradiation was 75 Gy (69.8-81.4 Gy) and 11.6 weeks (7.8-20 weeks) respectively. Survival analysis was used to examine the effect of several variables on prognosis. RESULTS: The 5-year rates were 86.4% for local control, 84.7% for disease free survival, 88.5% for actuarial survival and 84.2% for overall survival. The treatment group (combination of time and dose of irradiation) was the most important prognostic factor according to Cox's proportional hazard model. Patients receiving radiation at a total dose of < or = 75 Gy completed in < 12 weeks showed the best prognosis. CONCLUSION: Treatment time and total treatment dose are both important factors in treating early stage NPC. Decreasing the total radiation time to < 12 weeks and not exceeding a radiation dose of 75 Gy gave the best results.

Adult↗

PubMed1998

Distribution patterns of primary and permanent dentition in children with unilateral complete cleft lip and palate.

OBJECTIVE: To investigate the distribution patterns of primary and permanent teeth in the cleft area and the numerical variation in teeth in unilateral complete cleft lip and palate (UCLP) patients. DESIGN: A survey of the dentition in UCLP patients. SETTING: Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan. PATIENTS: 137 UCLP patients who met the following criteria: (1) have had at least one panoramic film taken, (2) the first panoramic film illustrates either primary or early mixed dentition. Evaluation of both permanent and primary dentition was available in 91 cases. MAIN OUTCOME MEASURES: Two evaluators performed independent evaluations of number and distribution of teeth in UCLP patients. The hypothesis that there are two odontogenic origins for maxillary lateral incisors was proposed to explain the occurrence of distribution patterns of dentition in the cleft area and to explain differences between primary and permanent dentition in UCLP patients. RESULTS: Four distribution patterns in the cleft area were identified in both the primary and the permanent dentition. In the primary dentition, placement of the lateral incisor distal to the alveolar cleft was the predominant pattern (pattern y, 82.4%), followed by absence of the cleft side maxillary lateral incisor (pattern ab, 9.9%), presence of one tooth on each side of the alveolar cleft (pattern xy, 5.5%), and placement of the lateral incisor mesial to the alveolar cleft (pattern x, 2.2%). In the permanent dentition, the most common pattern was the absence of the maxillary lateral incisor on the cleft side (pattern AB, 51.8%), followed by lateral incisor placement distal to the alveolar cleft (pattern Y, 46%), lateral incisor placement mesial to the alveolar cleft (pattern X, 1.5%) and the presence of one tooth on each side of the alveolar cleft (pattern XY, 0.7%). The discrepancy between the distribution patterns of primary dentition and permanent dentition successors is 57.1%. Variations in tooth number in both primary and permanent dentition of UCLP patients occurred most often in the cleft area. Abnormalities in the number of teeth (hypodontia or hyperdontia) outside the cleft area were more common in the permanent dentition than in the primary dentition (24.1% versus 4.4%). CONCLUSIONS: Four distribution patterns in the cleft area were identified in both sets of dentition. Our findings of distribution patterns in UCLP patients support the hypothesis that there may be two odontogenic origins for maxillary lateral incisors. Clinicians involved in managing the dentition of UCLP patients should consider the high frequency of numerical variation both in and outside the cleft area before starting dental treatment.

Anodontia↗

PubMed1998

Preoperative embolization of meningiomas: comparison of superselective and subselective techniques.

We retrospectively compared the efficacy of preoperative superselective and subselective embolization for intracranial meningiomas. Between January and December 1996, 22 patients (7 men, 15 women, mean age 51 +/- 15.5 yr) underwent superselective embolization with 45 to 150 mm polyvinyl alcohol particles after superselective catheterization of the feeding vessels with a microcatheter system. Another 30 patients (12 men, 18 women, mean age 50 +/- 12.9 yr) underwent subselective embolization between January and December 1995 with 150 to 300 mm Gelfoam particles after catheterization of the terminal external carotid artery just proximal to the orifice of the maxillary artery with a 4- or 5-F angiocatheter. The mean intraoperative blood loss (918 versus 1450 mL, p < 0.05), amount of blood transfused (4.9 versus 7.5 units, p = 0.09), and surgical resection time (422 versus 529 min, p < 0.05) were all lower in the superselective group than in the subselective group, while the occurrence of fresh ischemic necrosis (59% versus 53%, p = 0.68), hemorrhage (77% versus 60%, p = 0.19), and embolic material (55% versus 13%, p < 0.05) on pathologic examination were higher in the superselective group. No procedure-related complications occurred in the superselective group, whereas two patients in the subselective group had postoperative scalp necrosis. Our findings show that superselective embolization is more effective than subselective embolization for preoperative endovascular devascularization of meningiomas, with significant reductions in intraoperative blood loss and surgery time. Preoperative embolization of meningiomas, if indicated, should be done with the superselective technique whenever feasible.

Adult↗

PubMed1997

Cycling injuries among junior high school children in Taiwan.

We surveyed the injuries sustained by 197 junior high school students (aged 12 to 15 years) while riding a bicycle within the previous 12 months, together with the same number of controls matched according to age and sex. The case sites and control sites, selected from routes control subjects would have taken if pursuing the same purpose as the case subject at the time of the accident, were also investigated. Male students and older students were found to be at higher risk. One-third of the injuries occurred while the students were traveling to school. Nearly 40% of the accidents happened between 15:00 and 19:00, and 52% occurred during the summer months. More than half of the accidents took place near street corners. Injuries were mainly (89%) to one of the limbs. Injuries were more severe among those with head injuries. None of the injured children wore a helmet while cycling. Most injuries (83%) were due to collisions with another vehicle. Motorcycles were involved in the collisions most often. When compared with the total number of registered vehicles, the proportion of trucks, light commercial vans, and taxis involved in the crashes was significantly higher. Drivers of the vehicles involved were primarily males, evenly distributed across all age groups. The volume of traffic was marginally heavier at case sites, but estimated average speeds of vehicles were similar between case and control sites. More obstacles, such as illegally parked vehicles and vendors' stalls, were found at case sites. In addition to wearing a helmet, other prevention strategies should be considered.

Accidents, Traffic↗

PubMed1996

The role of brachytherapy in early-stage nasopharyngeal carcinoma.

PURPOSE: To present the treatment results and assess the optimal radiation dose and the role of brachytherapy in early stage nasopharyngeal cancer (NPC). METHODS AND MATERIALS: One hundred eighty-three patients with Stage I and II (American Joint Committee on Cancer Staging System, 1987) NPC completed the planned radiotherapy in our institution from 1979 to 1991. In 133 patients, radiotherapy was given to the nasopharynx by external beam to 64.8-68.4 Gy. Further boost was done by high dose rate (HDR) brachytherapy for 5-16.5 Gy in one to three fractions. For the remaining 50 patients, a course of external radiotherapy to the nasopharynx for 68.4-72 Gy was given to nasopharynx. Age (>40 or not), sex, neck boost or not, brachytherapy, and irradiation dose were analyzed to determine significant factors that influence the probabilities of local control and actuarial survival. RESULTS: The 5-year disease-specific survival was 85.8% and local control was 83%. Only the brachytherapy and irradiation dose significantly affected the results. The use of the brachytherapy had significant impact on overall survival and local control. Furthermore, we compared the prognostic effect of various radiation dosage among Group I of 50 patients (<72.5 Gy, no brachytherapy, excluding four patients who received brachytherapy), Group II of 71 patients (72.5-75 Gy; one to two fractions of brachytherapy), and Group III of 58 patients (>75 Gy; three fractions of brachytherapy). Five-year disease-specific survival rates of Group I, Group II, and Group III were 77, 95.5, and 82.4%, respectively. Five-year local control rates were: 73.7, 93.9, and 79.5%. We found that the Group II had the best actuarial survival and local control rate (log-rank test,p < 0.05). Most patients receiving brachytherapy encountered foul odor because of nasopharynx crust; 12 of them had palate or sphenoid sinus floor perforation or nasopharynx necrosis. None of the patients without brachytherapy experienced the same complications. CONCLUSIONS: The optimal radiotherapy dose to the nasopharynx area in early stage NPC may be within 72.5 to 75 Gy by our treatment protocol. A dose of more than 75 Gy did not have significant local control or survival advantage. The use of brachytherapy to elevate radiation dose had significant local control and survival benefit for early stage NPC patients, but the fractionation size should be decreased to reduce the complications.

Adult↗

PubMed1996

Microcirculatory vasoconstrictor response: relationship with vital capacity and smoking.

Vasoconstrictor response (VR) induced by inspiratory gasp exhibited a strong positive correlation with vital capacity (VC) which reflects the magnitude of the input stimulus for VR (Lau et al., Clin. Sci. 89:233-237, 1995). Whether a stoichiometric relationship existed between VC and VR is not known. We examined this question in two studies by determining VC and microcirculatory blood flow with laser Doppler flowmetry in healthy subjects. We first studied 40 non-smokers of different gender and age and found that the variation in VR cannot be eliminated by normalization with VC. In the second study we examined 10 young male smokers as well as matched non-smokers of identical VC, we found that smokers had reduced VR. Taking together, the present studies demonstrated that vasoconstrictor response (VR) was not determined by vital capacity alone and that smoking adversely affected VR in the absence of altered VC.

Adult↗

PubMed1996

Risk factors for preterm birth in an upper middle class Chinese population.

OBJECTIVE: To examine the risk factors associated with preterm birth in an upper middle class Chinese population. STUDY DESIGN: From March 1994 to February 1995, a total of 301 cases (gestational age between 20 and 37 weeks) and 656 controls (gestational age at or greater than 37 weeks) were recruited at Mackay Memorial Hospital, Taipei, Taiwan. Using a case-control study design, logistic regression was used to examine the relative significance of various risk factors associated with preterm birth. RESULTS: Age and educational level were identified as significant risk factors for preterm birth. Multiple pregnancies, fetal congenital anomalies, placenta previa or abruptio placentae, and preeclampsia were found to be strongly associated with preterm birth (crude odds ratios between 6.37 and 25.89); vaginal bleeding during or after the first trimester, prior history of preterm delivery, and two or more previous first trimester abortions were associated with preterm birth to a lesser extent (crude odds ratios between 1.67 and 2.9). The magnitude of the increased risk associated with these variables in preterm birth did not show change to any great extent after age and educational level were adjusted for. Further stratification of these cases into groups with and without premature rupture of the membranes (PROM), showed that a multiple pregnancy was still the leading risk factor of preterm birth in both groups. Carrying an abnormal fetus was the next important risk factor for preterm birth in cases with PROM, but was less important in the group without PROM. However, placenta previa or abruptio placentae and preeclampsia were the next most important factors in the group without PROM. CONCLUSIONS: Unfavorable current obstetric conditions and a history of more than two prior abortions and preterm delivery were positively associated with preterm birth.

Abruptio Placentae↗

PubMed1996

Neglect of childhood strabismus: Keelung Ann-Lo Community ocular survey 1993-1995.

Strabismus is a major cause of amblyopia. Parents not aware of the adverse outcome of untreated strabismus is thought to be a major reason of their affected child not being discovered earlier. An ocular survey was therefore conducted to examine the relative neglect of strabismus by the public, using myopia as a reference eye disorder. Specific objectives included estimating the prevalence of these ocular diseases, comparing the self-reported rate to the test-based rate, and investigating how much parents knew about these ocular diseases. Between 1993 and 1995, 862 elementary students in the first, third, and sixth grade at Keelung Ann-Lo Community were screened. The prevalence of manifest strabismus was 1.62% (95% CI = 1.19% approximately 2.05%). Of those with strabismus, three (21.4%) knew that they had strabismus. Neither the prevalence nor the self-known proportion of strabismus changed substantially with school grade, suggesting that the majority of strabismus afflicted children remain unrecognized during their elementary school years. The amblyopia proportion in those with tropia was 42.9% and reduced to 21.5% after abnormal refractive error was excluded. Of six knowledge statements about each ocular disorder, parents answered 2.13 (SD = 1.40) strabismus statements correctly, which was significantly less than their response on myopia statements (4.32 with SD = 1.24) (p < .0001). Onset age of strabismus was the question answered least correctly, implying that parents are not aware of the timing of treating strabismus. Our findings suggest that childhood strabismus was neglected by the public before the implementation of National Health Insurance (NHI). Should a similar study continued to be conducted in the future, the efficacy of NHI in the early recognition and treatment on childhood strabismus can be evaluated.

Child↗

PubMed1996

Nasopharyngeal adenoid cystic carcinoma: five new cases and a literature review.

OBJECTIVE: Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare tumour, and its mainstay treatment is different from adenoid cystic carcinoma arising from another head and neck region. In this study, we analyzed 20 cases of NACC with complete clinical information, 5 from Chang Gung Memorial Hospital and 15 from the literature review. RESULTS: The time interval between first symptom and treatment ranged from 2 weeks to 8 years, with a median of 24 months. Compared with usual nasopharyngeal carcinoma, NACC has higher incidence of cranial nerve involvement (55%) and lower incidence of cervical adenopathy (15%). All patients were treated by radiotherapy and 6 patients received surgical treatment. The 5- and 10-year overall survival rates were 78% and 49.5%, respectively. Seven patients developed metastasis to lung or bone. After a minimum of 5 years' follow-up, the local control rate was 45.5% in patients receiving radiation dose > 70 Gy, and 28.6% in those receiving dose < or = 70 Gy, suggesting higher radiation dose is necessary to achieve better local control in NACC.

Adult↗

PubMed1995

[Head injuries in children and adolescents: causes and natures].

To investigate the nature of exposure factors, and effectiveness of countermeasures in head injuries in children and adolescent of Taiwan area, we conducted a retrospective study on 820 children and adolescents with head injuries consecutively admitted to Chang Gung Memorial Hospital from January 1985 to December 1989. We analyzed the data by chart review and divided the cases into four age-groups: group A (0-4 years old), group B (5-9 years old), group C (10-14 year old) and group D (15-17 years old). The boy to girl ratio was 2.43. The largest proportions of head injuries were the adolescents in group D. The most common cause of head injury was traffic accidents (74%); while the falls were contributed the main cause in other studies. In all group A, B and D, the majority of traffic accidents were pedestrian injury; while in group D, the motorcyclists or car drivers were responsible for the accidents. Fall from height was the major cause of fall in all four age-groups, but it was fall from bicycle or during play or sports in group C. Injuries were most common in summer and clustered at afternoon in all patients. Majority of head injuries occurred outdoors. Most children and adolescents suffered from mild head injury, but there were still 203 cases with severe head injury (24%). Eighty-one cases (9.9%) were either discharged in critical condition or died at the hospital. There were no significant differences in mortality among four age-groups.

Accidental Falls↗

PubMed1994

Epidemiology of fireworks injuries: the National Electronic Injury Surveillance System, 1980-1989.

STUDY OBJECTIVES: To estimate the annual fireworks injury rates in the United States over the past decade (1980 through 1989) and to describe the epidemiology of fireworks-related trauma. DESIGN: Retrospective analysis of fireworks-related injuries reported from the National Electronic Injury Surveillance System of the Consumer Product Safety Commission. RESULTS: During the study period, nearly 10,000 Americans were injured annually by fireworks. The rates were highest in the young, with a peak of 22.3 per 100,000 persons per year for males age 10 to 14. Males outnumbered females by 2.5:1. Half of the fireworks injuries occurred around the week of July 4. The hand was the most frequently injured body part, followed by the eyes and the face. Active participants consistently were the major victims in all "personal-use" fireworks and had more severe injuries than bystanders. Rockets were the most dangerous device among class C fireworks. CONCLUSION: Fireworks injuries are a health hazard to the public. Young persons are at the highest risk to suffer injuries, mainly due to personal-use fireworks. A majority of victims are injured during the week of July 4. Class B fireworks and rockets appear to be very dangerous.

Blast Injuries↗

PubMed1993

A priming dose of oral vitamin A given to preschool children may extend protection conferred by a subsequent large dose of vitamin A.

A randomized trial tested whether a priming dose of vitamin A would extend the protection of a subsequent 60,000-micrograms retinol equivalent (RE) oral dose. Seventy-five xerophthalmic and 74 age- and neighborhood-matched non-xerophthalmic preschool children were randomized to one of three oral regimens of vitamin A, receiving peanut oil only (Group A), 7500 micrograms RE (Group B) or 60,000 micrograms RE (Group C), followed in all instances by 60,000 micrograms RE 1 wk later. Serum retinol was measured 2, 4, 6 and 12 mo following the second dose by technicians unaware of the children's treatment status. Among xerophthalmic children, mean values differed across treatment groups at 2 mo (C > A) and tended to be different at 12 mo (C > A and B > A). Among non-xerophthalmic children mean retinol concentrations differed across treatment groups at 6 mo, but not in a consistent way (A > C > B), and at 12 mo (C > A and B > A). Xerophthalmic children reverted to biochemical deficiency faster than non-xerophthalmic children. A small or large priming dose may extend the protection conferred by a 60,000-micrograms RE dose, supporting the use of repeated, spaced doses of vitamin A for treating xerophthalmia. Similar retinol concentrations in Groups B and C at 12 mo suggest the 60,000-micrograms RE prophylactic dose currently recommended by the World Health Organization need not be increased.

Administration, Oral↗

PubMed1993

Comparison of radiotherapy and surgical results of early stage glottic cancer: a retrospective analysis.

From March 1977 to October 1989, 85 patients with early stage glottic cancer were treated with either radiotherapy or surgery at Chang Gung Memorial Hospital (CGMH). Patients were excluded from the analysis of local control if they died or remained disease-free with a follow-up period of less than two years. Of the 26 patients treated with definitive radiotherapy, initial control of the primary lesions was achieved in 100% of stage T1s, 76% of T1, and 57% of T2 patients. Surgical salvage of radiation failure was achieved in 83% of the patients, giving the ultimate local control of 100% for T1s, 94% for T1, 86% for T2 patients. Of the 44 patients treated with definitive surgery, initial control of the primary lesions was achieved in 100% for T1s, 95% for T1, and 78% for T2 patients. Salvage of the surgical failure was 50%, giving the ultimate control in this group of 100% for T1s, 95% for T1, 83% for T2. There was no difference in either initial or ultimate control of T1 and T2 lesions between patients treated with primary radiotherapy and primary surgery. Voice preservation rates were 73% and 34% in the radiotherapy and surgery group, respectively. When divided into two groups according to the times they were being treated, we found that surgery preserved a comparable number of larynges as radiotherapy did after 1988 (60% vs 77%, p = 0.33). It is concluded that radiotherapy and surgery could achieve the same good local control results and long-term survival and comparable functional results of early stage glottic cancer, if conservative surgery is carefully selected for each patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗