Zhonghua yi xue za zhi = Chinese medical journal; Free China ed最新文献

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Minimally invasive cardiac surgery for resection of right atrial hepatic tumor in an octogenarian. 微创心脏手术切除八旬老人右房肝肿瘤1例。
Tsung-Po Tsai, Jung-Min Yu
{"title":"Minimally invasive cardiac surgery for resection of right atrial hepatic tumor in an octogenarian.","authors":"Tsung-Po Tsai,&nbsp;Jung-Min Yu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Removal of right atrial hepatic tumor with caval involvement requires control of bleeding, avoidance of tumor embolization, and adequate resection. We reported an octogenarian having hepatocellular carcinoma with caval and right atrial involvements who underwent successful resection using cardiopulmonary bypass and intraoperative transesophageal echocardiography.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22054794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stroke registry in Kaohsiung Veterans General Hospital. 高雄退伍军人总医院脑卒中登记处。
Yuh-Te Lin, Yuk-Keung Lo, Hun-Chang Kuo, Yun-Te Chang, Ming-Hong Chang, Jieh-Yuan Li
{"title":"Stroke registry in Kaohsiung Veterans General Hospital.","authors":"Yuh-Te Lin,&nbsp;Yuk-Keung Lo,&nbsp;Hun-Chang Kuo,&nbsp;Yun-Te Chang,&nbsp;Ming-Hong Chang,&nbsp;Jieh-Yuan Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Stroke ranks as the second major cause of death in Taiwan. For better understanding of stroke characteristics in southern Taiwan and to provide further information to other studies of stroke, we reviewed the clinical data of our in-patients with acute stroke.</p><p><strong>Methods: </strong>Patients who were admitted to our hospital due to acute stroke between January 1999 and December 1999 were enrolled in our study. We used a stroke registration form to collect clinical data, including laboratory data, stroke subtype, risk factors, neurosonographic result, treatment, related complications, and Rankin Scale. Chi-square test was used to compare clinical parameters among the stroke patients.</p><p><strong>Results: </strong>A total of 578 patients with acute stroke were enrolled in our study. Among 578 patients, 408 (71%) patients were of ischemic stroke and 170 (29%) patients were of hemorrhagic stroke type. In the ischemic stroke group, the prevalence rate of risk factors were hypertension (71%), intracranial arterial stenosis (41%), diabetes mellitus (37%), current smoking (30%), hyperlipidemia (30%), atrial fibrillation (15%) and extracranial carotid stenosis (15%). Hypertension (79%) and diabetes (17%) were also major risk factors in hemorrhagic stroke patients. The in-hospital case-fatality rate for ischemic stroke (8.8%) was less than that for hemorrhagic stroke (20.6%).</p><p><strong>Conclusions: </strong>The proportion of hemorrhagic stroke in our acute stroke patients was higher in comparison to western countries. Hypertension, diabetes, smoking and hyperlipidemia were major modifiable risk factors in ischemic stroke. Better control of such risk factors is an important issue in either primary or secondary prevention of stroke. In our study, intracranial arterial stenosis (41%) was more common than extracranial carotid stenosis (15%). The result was different from western stroke registration. The cause is worth further study.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22053709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intra-extracranial hemangiopericytoma: clinical manifestations, histopathological features, diagnosis, treatment, and outcomes. 颅内外血管外皮细胞瘤:临床表现、组织病理特征、诊断、治疗及预后。
Hsi-Kai Tso, Yeou-Chih Wang, Dar-Yu Yang, Shan-Hua Wei
{"title":"Intra-extracranial hemangiopericytoma: clinical manifestations, histopathological features, diagnosis, treatment, and outcomes.","authors":"Hsi-Kai Tso,&nbsp;Yeou-Chih Wang,&nbsp;Dar-Yu Yang,&nbsp;Shan-Hua Wei","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Intra-extracranial hemangiopericytomas (HPCs) are rare vascular neoplasms. This paper reports the clinical manifestations, histopathological features, diagnosis, treatment, and outcomes of HPCs.</p><p><strong>Methods: </strong>We reviewed three patients with intracranial HPC and one patient with HPC of the scalp who were surgically treated at Taichung Veterans General Hospital between 1989 and 1999.</p><p><strong>Results: </strong>All four patients underwent surgery and postoperative radiotherapy. After surgery, three patients showed improvement compared with their preoperative neurological function. Two patients had recurrent tumors, one patient was well and free from tumor recurrence, and one patient was lost during follow-up.</p><p><strong>Conclusions: </strong>Clinical presentation and radiographic appearance of intracranial HPC can be indistinguishable from meningioma. Intracranial HPC is an aggressive neoplasm with malignant potential. Both benign and malignant variations of HPC of the scalp exist. The principal treatment is surgical excision. Survival is influenced by more aggressive primary resection and by postoperative radiotherapy. Recurrences are common. Metastases may be multiple and can develop in many organs and systems.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22053710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The in vitro inhibitory effect of flavonoid astilbin on 3-hydroxy-3-methylglutaryl coenzyme A reductase on Vero cells. 黄酮类乙酰胆碱对Vero细胞3-羟基-3-甲基戊二酰辅酶A还原酶的体外抑制作用。
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed Pub Date : 2000-12-01 DOI: 10.1046/J.1443-9506.2000.06978.X
T. H. Chen, J. C. Liu, J. Chang, M. Tsai, M. Hsieh, P. Chan
{"title":"The in vitro inhibitory effect of flavonoid astilbin on 3-hydroxy-3-methylglutaryl coenzyme A reductase on Vero cells.","authors":"T. H. Chen, J. C. Liu, J. Chang, M. Tsai, M. Hsieh, P. Chan","doi":"10.1046/J.1443-9506.2000.06978.X","DOIUrl":"https://doi.org/10.1046/J.1443-9506.2000.06978.X","url":null,"abstract":"BACKGROUND\u0000Epidemiological studies have shown that hypercholesterolemia is a major risk factor for coronary heart disease. In clinical trials of lipid lowering therapy, 3-hydroxy-3-methylglutaryl Coenzyme A (HMG-CoA) reductase inhibitor has been shown to decrease cardiac events and mortality. Flavonoids are polyphenolic natural antioxidants existing in vegetables, fruits and beverages such as tea and wine. Previous studies have shown that some antioxidants had hypocholesterolemic effect, and flavonoid intake was associated with the decrease of mortality from coronary artery disease. The aim of this study was to evaluate the inhibitory effect of flavonoids on HMG-CoA reductase.\u0000\u0000\u0000METHODS\u0000The methods for analysis of specific inhibitors of mevalonate biosynthesis have been well-established, using Vero cells, a cell line obtained from kidneys of African green monkeys. Flavonoids isolated from different traditional Chinese herbs were dissolved in DMSO and incubated with Vero cells with or without the addition of 1 mM mevalonate or 5 mM sodium acetate in order to observe cell growth for 24 h.\u0000\u0000\u0000RESULTS\u0000Concentrations of 1 mM mevalonate or 5 mM sodium acetate were added into culture medium in order to observe the effect on cell growth. Different concentrations of pravastatin to inhibit cell growth were used as a positive control. About 40 flavonoid compounds were used for study, only one compound, astilbin (belonging to the flavonol group), showed significant inhibition of Vero cell growth.\u0000\u0000\u0000CONCLUSIONS\u0000This study shows that one flavonoid compound, isolated from traditional medicinal herbs, may be an effective HMG-CoA reductase inhibitor which might be developed into a new hypocholesterolemic agent.","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87567452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 28
Assessment of nutritional status in continuous ambulatory peritoneal dialysis patients: a comparison of bioelectric impedance and conventional methods. 评估连续非卧床腹膜透析患者的营养状况:生物电阻抗与常规方法的比较。
C H Cheng, M Y Chen, Y J Lee, M C Lee, K H Shu, M Y Wu, J D Lian
{"title":"Assessment of nutritional status in continuous ambulatory peritoneal dialysis patients: a comparison of bioelectric impedance and conventional methods.","authors":"C H Cheng,&nbsp;M Y Chen,&nbsp;Y J Lee,&nbsp;M C Lee,&nbsp;K H Shu,&nbsp;M Y Wu,&nbsp;J D Lian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Nutritional status is an important factor in long term continuous ambulatory peritoneal dialysis (CAPD) prognoses. Conventionally, serum albumin is an indicator of nutritional status. More recently, protein catabolic rate and lean body mass have been calculated during peritoneal equilibrium testing to assess nutritional status. These have the advantage of providing an early indication of malnutrition before the serum albumin decreases. Bioelectric impedance analysis (BIA) of nutrition has the advantage of being the simplest procedure among all nutritional assessments. Standard nutritional assessments was compared with the BIA method.</p><p><strong>Methods: </strong>The protein catabolic rate and lean body mass was measured by the Keshaviah method. At the same time BIA was used to assess lean body mass, fat mass and fixed percentage of fat in 27 long-term CAPD patients, with and without peritoneal fluids.</p><p><strong>Results: </strong>Among the 27 patients, the protein catabolic rate was 0.95+/-0.5 g/kg/day and lean body mass was 37.4+/-0.5 kg measured by the conventional method. Using BIA, the lean body mass was 37.8+/-11.0 kg with peritoneal dialysate, which was strongly correlated with the conventional method (p<0.001). BIA of lean body mass was 37.4+/-9.2 kg without peritoneal dialysate, which was also significantly correlated to the conventional method (p<0.001).</p><p><strong>Conclusions: </strong>BIA nutritional assessment of lean body mass was comparable to the conventional method of nutritional assessment. The presence or absence of peritoneal dialysate did not influence the BIA method for detection of lean body mass. BIA has the advantage of being a more simple procedure and can be used for the long-term assessment of nutritional status in CAPD patients.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of the efficacy and safety of oral granisetron plus dexamethasone with intravenous ondansetron plus dexamethasone to control nausea and vomiting induced by moderate/severe emetogenic chemotherapy. 口服格拉司琼加地塞米松与静脉注射昂丹司琼加地塞米松控制中/重度致吐性化疗引起的恶心呕吐的疗效和安全性比较
T J Chiou, W F Tzeng, W S Wang, C C Yen, F S Fan, J H Liu, P M Chen
{"title":"Comparison of the efficacy and safety of oral granisetron plus dexamethasone with intravenous ondansetron plus dexamethasone to control nausea and vomiting induced by moderate/severe emetogenic chemotherapy.","authors":"T J Chiou,&nbsp;W F Tzeng,&nbsp;W S Wang,&nbsp;C C Yen,&nbsp;F S Fan,&nbsp;J H Liu,&nbsp;P M Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced nausea and vomiting can affect cancer patients' compliance with cytotoxic chemotherapy. Currently, there are some new antiemetic therapies for the treatment of chemotherapy-induced emesis. A single institution, randomized, open, parallel trial was done to compare oral granisetron plus intravenous (i.v.) dexamethasone with intravenous ondansetron for the prevention of moderate or severe emetogenic chemotherapy-induced acute and delayed emesis.</p><p><strong>Methods: </strong>Fifty-one cancer patients were treated with moderate/severe emetogenic chemotherapy and randomized to receive either oral granisetron 1 mg twice daily or i.v. ondansetron 8 mg every 8 hours combined with i.v. dexamethasone 10 mg on the day of chemotherapy. The efficacy and safety of the two antiemetic regimens were compared.</p><p><strong>Results: </strong>Oral granisetron plus i.v. dexamethasone had comparable antiemetic efficacy for the prevention of nausea in the first 24-hour period after initiation of chemotherapy compared with intravenous ondansetron plus i.v. dexamethasone. The complete response of antiemesis in the first 24-hour period after initiation of antiemetic therapy between granisetron and ondansetron were 84.0% (95% CI, 62.9%-95.6%) and 84.6 (95% CI, 64.0%-97.5%). The complete response for delayed emesis after initiation of antiemetic therapy between granisetron and ondansetron were 16.0% (95% CI, 4.5%-36.1%) and 19.2% (95% CI, 6.8%-40.7%0. There was diarrhea in 12% of patients receiving granisetron therapy and constipation in 23.1% of the ondansetron group.</p><p><strong>Conclusions: </strong>Oral granisetron plus i.v. dexamethasone and i.v. ondansetron plus i.v. dexamethasone are potentially equally effective antiemetic agents in the prevention of moderate or severe emetogenic chemotherapy-induced acute or delayed emesis. Oral granisetron with dexamethasone appears to be a suitable alternative antiemetic agent in cancer patients who receive moderately or severely emetogenic chemotherapy.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative study of timolol gel versus timolol solution for patients with glaucoma. 替洛尔凝胶与替洛尔溶液治疗青光眼的比较研究。
S H Chiou, W M Hsu, J H Liu, J L Liu, M R Chen, D C Tsai, C K Chou
{"title":"Comparative study of timolol gel versus timolol solution for patients with glaucoma.","authors":"S H Chiou,&nbsp;W M Hsu,&nbsp;J H Liu,&nbsp;J L Liu,&nbsp;M R Chen,&nbsp;D C Tsai,&nbsp;C K Chou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The timolol gel was developed for the simplification of multi-dose medications for glaucoma patients. This gel can be used once per day instead of twice per day of the aqueous form. It is necessary to understand the clinical effects of intraocular pressure maintained in glaucoma by there two forms of timolol.</p><p><strong>Methods: </strong>Fifty-two eligible patients were included and completed the 12-week study. In this randomized, open-label, two-period crossover study design, patients received either the gel form of 0.5% timolol once daily or the aqueous form of 0.5% timolol twice daily for the first 6 weeks, then crossed over to the other treatment form for the remaining 6 weeks. Intraocular pressure was measured at baseline, week 6 and week 12 at the end of the treatment period. The incidences of all the adverse events were recorded and summarized in each follow-up visit.</p><p><strong>Results: </strong>No statistically significant difference in intraocular pressure was observed between the two different control treatment groups (p>0.05). However, stickiness and transient blurred vision was reported more often by patients using the gel form than the aqueous form of timolol.</p><p><strong>Conclusions: </strong>The gel form of 0.5% timolol used once daily offers a new alternative that is probably more convenient than the aqueous form of 0.5% timolol given twice daily in maintaining the intraocular pressure of patients with glaucoma.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Histopathologic analysis of sentinel lymph nodes in breast carcinoma. 乳腺癌前哨淋巴结的组织病理学分析。
P P Hsieh, W L Ho, D C Yeh, T J Liu, C C Wu, J H Lin, S J Wang
{"title":"Histopathologic analysis of sentinel lymph nodes in breast carcinoma.","authors":"P P Hsieh,&nbsp;W L Ho,&nbsp;D C Yeh,&nbsp;T J Liu,&nbsp;C C Wu,&nbsp;J H Lin,&nbsp;S J Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative lymphatic mapping and identification of the first draining lymph node (the sentinel lymph node) may allow some patients with breast cancer to avoid the morbidity of formal axillary clearance. The aim of this study was to determine the accuracy of sentinel lymph node (SLN) biopsy in predicting axillary nodal involvement.</p><p><strong>Methods: </strong>From August, 1998 until July, 1999, 41 patients with clinically node-negative breast cancer underwent SLN biopsy that was immediately followed by axillary lymph node dissection. If the SLN section was found free of metastasis by routine hematoxylin and eosin staining (H&E), then an additional four sections of the SLN were cut and examined for the presence of tumor cells by H&E staining (three sections) and by cytokeratin immunohistochemical staining (IHC) (one section). If the SLN had metastatic cells and the other remaining nonsentinel axillary lymph nodes were free of metastases by routine H&E staining, then an additional three sections of the nonsentinel axillary lymph nodes were cut and examined for the presence of tumor cells by H&E staining.</p><p><strong>Results: </strong>The 41 patients had a mean of 2.2 sentinel (range, 1-7) and 14.6 nonsentinel (range, 5-32) lymph nodes excised per patient. Routine H&E staining identified 13 patients (31.7%) with SLN metastases and 28 patients (68.3%) with tumor-free SLNs. Applying IHC and the additional three sections stained with H&E to these tumor-free SLNs showed one additional patient with sentinel node metastasis. The conversion rate from being a sentinel node-negative patient to a sentinel node-positive patient was 3.6% (1/28). Overall, SLN metastases were detected in 14 (34.1%) of the 41 patients. The SLNs were negative in 27 patients (65.9%), two of whom had at least one positive nonsentinel lymph node each (7.4% \"skip\" metastasis). Biopsy of SLNs was 92.6% accurate in predicting the absence of nonsentinel nodal metastasis (p=0.001).</p><p><strong>Conclusions: </strong>Our results suggest that formal axillary lymph node dissection may need only be performed in SLN-positive patients. Nonetheless, further experience and refinement are needed to perfect this technique.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Calcified schwannoma of the orbit and differential diagnosis of orbital calcification. 眼眶钙化神经鞘瘤与眼眶钙化的鉴别诊断。
S C Kao, C Y Tsai, C C Tsai, W M Hsu
{"title":"Calcified schwannoma of the orbit and differential diagnosis of orbital calcification.","authors":"S C Kao,&nbsp;C Y Tsai,&nbsp;C C Tsai,&nbsp;W M Hsu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Calcified schwannoma of the orbit is rarely reported in the world literature. A 38-year-old Chinese male presented with a 5-year history of slow progressive left-sided axial proptosis. A smooth, retrobulbar and intracornal mass with central calcification and high internal reflectivity was found on computed tomography and sonographic study. From the clinical and radiologic features, the presumptive diagnosis of orbital cavernous hemangioma or meningioma was made and orbitotomy with tumor exicision was performed. Tumor excision revealed the rare diagnosis of calcified schwannoma. The differential diagnoses of a calcified orbital mass and the radiologic and clinical findings of the calcified schwannoma are described and discussed.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21901390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Klebsiella pneumoniae renal abscess. 肺炎克雷伯菌肾脓肿。
S W Chang, D H Yen, C P Fung, C Y Liu, K K Chen, C M Tiu, L M Wang, C H Lee
{"title":"Klebsiella pneumoniae renal abscess.","authors":"S W Chang,&nbsp;D H Yen,&nbsp;C P Fung,&nbsp;C Y Liu,&nbsp;K K Chen,&nbsp;C M Tiu,&nbsp;L M Wang,&nbsp;C H Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The clinical characteristics of renal abscess caused by Klebsiella pneumoniae have not been previously reported in case-series studies. The purpose of this study is to demonstrate the clinical characteristics of K pneumoniae renal abscess for early diagnosis and to identify the clinical risk factors associating with poor prognosis.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 24 patients with K pneumoniae renal abscess, from April, 1982 through February, 1998. The clinical presentations, including the demographic characteristics, predisposing disorders, initial signs and symptoms, laboratory test results, diagnostic radiology studies, therapeutic modalities and risk factors associated with mortality were studied.</p><p><strong>Results: </strong>The mean age was 58.7 years and the male to female ratio was 10:14. The most common predisposing factors were diabetes mellitus (58%), urolithiasis (25%) and immunosuppression (17%). Fever, chills and flank pain were the most common symptoms and signs, whereas pyuria, elevation of leukocyte count, glucose, blood urea nitrogen and creatinine were the common laboratory features. The distinct complications of K pneumoniae renal abscess were bacteremia in 13 (54%), emphysematous pyelonephritis in five (21%), and metastatic septic infection in three (12.5%). The cure rate was 52% (11/21) in patients treated with a combination of antibiotics and percutaneous drainage; however, six (35%) patients who survived required another surgical procedure for complete recovery. The overall mortality rate was 25%. The clinical factors of elderly age (>65 years) at presentation, lethargy, elevation of serum blood urea nitrogen and pulmonary complications were associated with poor prognoses.</p><p><strong>Conclusions: </strong>Focusing on the early diagnosis of K pneumoniae renal abscess and recognition of the prognostic factors for a poor prognosis, we highlight the specific clinical characteristics that include elderly age, lethargy, impairment of renal function, metastatic septic lesions and pulmonary complications. All patients with K pneumoniae renal abscesses should receive empiric antibiotics and percutaneous drainage or aspiration, and surgical intervention as necessary for patients with intractable disease.</p>","PeriodicalId":24073,"journal":{"name":"Zhonghua yi xue za zhi = Chinese medical journal; Free China ed","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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