Biomedical subjects

Mei-Ching Kuo

Publications and source records attributed to Mei-Ching Kuo.

3 recordsLinked to original sources

PubMed2004

Pulmonary alveolar proteinosis undergoing whole lung lavage in south Taiwan--a case report.

Pulmonary alveolar proteinosis (PAP) is rarely seen in Taiwan. According to the literature the incidence is one in two million with a male to female ratio of 3 to 1. The pathohistology of PAP is associated with the filling of the alveoli by a proteinaceous material. PAP can be divided into primary and secondary forms. PAP was once diagnosed by open lung biopsy, but since the introduction of bronchoalveolar lavage, open lung biopsy is less common now for the diagnosis of PAP. The most definite and effective therapy for PAP is whole lung lavage (WLL). Therapeutic WLL is performed under one-lung general anesthesia with a double lumen tube (DLT). This procedure is associated with three problems: 1. hypoxia. 2. circulatory disturbance. 3. difficulty in positioning the DLT. We present a case undergoing WLL in our hospital who had contracted pulmonary TB was diagnosed as a case of PAP by open lung biopsy. She was convinced to receive WLL because of intolerance of daily activity. The result of the left lung lavage was excellent, but the attempt on the other lung at a later time was cancelled because of difficulty in positioning the DLT due to tracheal stenosis. Here we would like to give an account of our management and discuss about PAP and WLL after literature review.

Female↗

PubMed2003

Fatal arrhythmia following intraoperative continuous hyperthermic peritoneal perfusion chemotherapy.

Continuous hyperthermic peritoneal perfusion chemotherapy (CHPPC) offers a safe alternative to manage peritoneal tumor seeding in advanced cancer patients. A 65-year-old male underwent exploratory laparotomy for advanced gastric cancer with intraabdominal carcinomatosis and massive ascites. Life-threatening dysrrhythmia of ventricular rhythm with a rate of 120 beats/min developed during the performance of intraoperative CHPPC following eradication of the main tumor. With timely cardiopulmonary resuscitation, appropriate fluid replacement, correction of electrolyte imbalance, and cooling of body temperature, the patient regained effective cardiopulmonary circulation without sequela.

Abdominal Neoplasms↗

PubMedDate not supplied

Does postoperative pain induce emesis?

OBJECTIVE: The aim of this prospective, controlled study was to evaluate the risk factors for postoperative emesis in patients undergoing gynecologic surgery and receiving patient-controlled analgesia for three days. METHODS: Six hundred twenty-five gynecologic patients with an American Society of Anesthesiologists physical status of I to III undergoing lower-abdominal surgeries were enrolled. A standard, general anesthetic technique was used. Postoperative pain was treated by a patient-controlled analgesia device with bolus intravenous doses of 1 mg morphine. For 3 days after surgery patients were assessed for occurrence of emesis, sedation, and pain intensity when at rest and during movement. RESULTS: The incidence of emesis was 26% on postoperative day 1, 13% on day 2, and 4% on day 3. On all 3 days, patients' pain scores when at rest and when coughing were higher for those with emesis than for those without. During the first 2 postoperative days the patients with and those without emesis consumed similar amounts of morphine daily, but on the third day the patients with emesis consumed significantly more morphine than did those without emesis ( <0.05). Further logistic regression analysis showed that incident pain was the main risk factor for postoperative emesis on all 3 days. CONCLUSIONS: The results suggested that postoperative pain was an associative risk factor to increase the incidence of emesis in these female patients.

Female↗