No abstract available.
Carcinoma, Hepatocellular*

BACKGROUND/AIMS: The retrocaval dissection, with venous collaterals, is sometimes difficult, making subsequent hemostasis less easy during orthotopic liver transplantation(OLT). We have recently applied a modified technique of vena caval preservation during OLT, and undertook this study to evaluate retrospectively its effects. METHODS: Five patients with liver cirrhosis underwent a modified OLT from March 1999 through July 2001. The procedure includes a side to side anastomosis between the IVC of the donor and the recipient without vena cava occlusion during OLT. RESULTS: This technique pemitted the avoidance of vena caval occlusion in all cases. We could performed OLT without venovenous bypass in 3 patients who tolerated the temporary portal clamping test before the recipient hepatectomy. As retrocaval dissection was not performed, hemostasis was esier during anhepatic phase. We could reduce anhepatic phase into average 60 minutes from only one caval anastomosis during OLT. CONCLUSIONS: We think this alternative technique, requiring only one caval anastomosis, can reduce the duration of the anhepatic phase and the need for venous bypass.
Constriction ; Hemostasis ; Hepatectomy ; Humans ; Liver Cirrhosis ; Liver Transplantation* ; Liver* ; Retrospective Studies ; Tissue Donors

PURPOSE: The aim of this study is to explore non-steroid anti-inflammation drugs (NSAIDs) potency for pelvic floor muscle pain by measuring local concentration in a rat model. MATERIALS AND METHODS: We used nine NSAIDs, including nabumetone, naproxen, ibuprofen, meloxicam, piroxicam, diclofenac potassium, etodolac, indomethacin, and sulindac, and 9 groups of female Wister rats. Each group of rats was fed with one kind of NSAID (2 mg/mL) for three consecutive days. Thereafter, one mL of blood and one gram of pelvic floor muscle were taken to measure drug pharmacokinetics, including partition coefficient, lipophilicity, elimination of half-life (T1/2) and muscle/plasma converting ratio (Css, muscle/Css, plasma). RESULTS: Diclofenac potassium had the lowest T1/2 and the highest mean Css, muscle/Css, plasma (1.9 hours and 0.85+/-0.53, respectively). The mean Css, muscle/Css, plasma of sulindac, naproxen and ibuprofen were lower than other experimental NSAIDs. CONCLUSION: Diclofenac potassium had the highest disposition in pelvic floor muscle in a rat model. The finding implies that diclofenac potassium might be the choice for pain relief in pelvic muscle.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Butanones/therapeutic use ; Chronic Pain/*drug therapy ; Diclofenac/therapeutic use ; Female ; Muscles/drug effects ; Naproxen/therapeutic use ; Pelvic Floor/*pathology ; Pelvic Pain/*drug therapy ; Piroxicam/therapeutic use ; Rats ; Rats, Wistar ; Thiazines/therapeutic use ; Thiazoles/therapeutic use

OBJECTIVE: We intended to analyze the credibility judgment in written forensic psychiatric reports of child sexual abuse registered in Southern Taiwan. METHODS: Ninety-six cases of child sexual abuse between August 2010 and October 2017 encountered in two hospitals were analyzed. The results in these reports were categorized into credible and non-credible. We identified the factors that distinguished between the two groups in bivariate analyses using chi-square test. A binary logistic regression analysis was performed to determine whether the factors that significantly correlated in the bivariate analyses were independent predictors of credible judgments. RESULTS: Among 96 cases, 70 (73%) were judged as credible. Consistent testimonies of children (odds ratio=40.82) and multiple abuse events (odds ratio=6.05) were positive variables independently related to the sexual abuse allegations judged as credible. CONCLUSION The number of allegations judged as credible in this study was slightly higher than that reported in other studies. Our findings about predictors for credible cases are not in line with those reported previously. Due to the differences in resources of the cases and backgrounds of the evaluators among multiple studies, direct comparisons with previous studies must be treated with caution.

Adult ; Bone Neoplasms ; diagnosis ; pathology ; Chondrosarcoma ; diagnosis ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Mediastinal Neoplasms ; diagnosis ; pathology ; Neurilemmoma ; diagnosis ; pathology ; Peripheral Nervous System Neoplasms ; diagnosis ; pathology ; Phrenic Nerve ; Ribs ; Tomography, X-Ray Computed

Background: Shared decision making using patient decision aids (PtDAs) was established over a decade ago, but few studies have evaluated its efficacy in Asian countries. We therefore evaluated the application of PtDAs in a decision conflict between two muscle relaxant reversal agents, neostigmine and sugammadex, and sequentially analyzed the regional differences and operating room turnover rates. Methods: This multicenter, outcome-assessor-blind, randomized controlled trial included 3,132 surgical patients from two medical centers admitted between March 2020 and August 2020. The patients were randomly divided into the classical and PtDA groups for pre-anesthesia consultations. Their clinicodemographic characteristics were analyzed to identify variables influencing the choice of reversal agent. On the day of the pre-anesthesia consultation, the patients completed the four SURE scale (sure of myself, understand information, risk-benefit ratio, encouragement) screening items. The operating turnover rates were also evaluated using anesthesia records. Results: Compared with the classical group, the PtDA group felt more confident about receiving sufficient medical information (P < 0.001), felt better informed about the advantages and disadvantages of the medications (P < 0.001), exhibited a superior understanding of the benefits and risks of their options (P < 0.001), and felt surer about their choice (P < 0.001). Moreover, the PtDA group had a significantly greater tendency to choose sugammadex over neostigmine (P < 0.001). Conclusions PtDA interventions in pre-anesthesia consultations provided surgical patients with clear knowledge and better support. PtDAs should be made available in other medical fields to enhance shared clinical decision-making.