Hawaii Medical Journal Articles For 1994

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    Blood transfusion: the risks and benefits.
    ( 1994-01) Frohlich, J A
    As greater attention is focused on medical and legal risks of the transfusion process, physicians ordering a blood transfusion must advise their patients thoroughly and clearly of the potential risks involved. Physicians must explain clearly to patients that a zero-risk blood supply is impossible to achieve; patients must understand that all necessary steps practicable have been taken to ensure the safest possible supply.
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    Ethnic differences in the recurrence of adenomatous polyps after colonoscopic polypectomy.
    ( 1994-01) Phillips, D L ; Okamura, D ; Tokumine, T
    A retrospective study was done of polyp recurrence rates following an initial clearing colonoscopy for adenomatous polyps. The intent of the study was to identify risk factors that would predict a greater risk for recurrence in Hawaii's ethnically diverse population. When the initial exam detected multiple polyps, a higher recurrence rate was found in Caucasian patients.
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    Retinopathy of prematurity: incidence and severity in Hawaii.
    ( 1994-01) Drouilhet, J H ; Pelke, S ; Sroat, D ; Ing, M ; Wong, B ; Kokame, G ; Easa, D
    Because survival of low birth-weight infants requiring intensive care has improved recently, particularly since the advent of exogenous surfactant therapy, we reviewed our experience at Kapiolani Medical Center for Women and Children (KMCWC) from 1989 to 1991 to determine if the incidence of retinopathy of prematurity (ROP), a serious long-term complication, had also increased. During this 3-year period, threshold disease, the ROP stage in which cryosurgery is recommended, occurred only in infants < or = 1000 grams. Seventy-four infants < or = 1000 grams were diagnosed with ROP of any stage. Sixteen eyes (9 infants) reached threshold; 14 were treated with cryosurgery. Six of these eyes have useful vision on follow up; 8 do not. Exogenous surfactant therapy had no significant effect on ROP incidence or severity in our series. Although ROP incidence did not increase during this review period, it remains a serious problem in high-risk premature infants in our Newborn Intensive Care Unit.
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    Persistent postoperative ventricular tachycardia treatment by using external cardiopulmonary support.
    ( 1994-01) Hamid, B A ; Azuma, S S ; Hong, R A ; Lau, J M
    Drug-resistant incessant ventricular tachycardia (DRIVT) after cardiac surgery is a rare but almost always fatal event. Antiarrhythmic therapy seems to be ineffective and electrical cardioversion is of limited value when these patients present themselves with recurrent, sustained ventricular tachycardia. A patient with DRIVT in whom external cardiopulmonary support finally succeeded in bringing about resuscitation will be described in this article. The use of external cardiopulmonary support (CPS) should be considered in patients with this kind of malignant arrhythmia.
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    The immunologic staging of chronic active hepatitis B patients in Hawaii.
    ( 1994-02) Ching, N ; Lumeng, J ; Pon, E ; Ching, C Y
    The hepatitis B antigen/antibody levels and natural killer cell activity status of chronic hepatitis B patients identified by the Hawaii State Department of Health were evaluated to select chronically infected hepatitis B patients for interferon therapy and to determine possible immunodeficiencies. The presence of hepatitis Be antigen denotes active replication of the virus. Ninety-five patients were studied: 17/95 (18%) had chronic active hepatitis B, 71/95 (75%) were hepatitis B carriers and 7/95 (7%) had seroconverted. NK activity to the erythroleukemia K562 cell and virus-infected HSV-1 cell of the chronic active and carrier population (P < .05) were lower than that of the control population and those who had spontaneously seroconverted. Of this population 18% were identified with active viral infection and would be candidates for interferon therapy.
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    A review of the radiographic manifestations of gout.
    ( 1994-02) Gagliardi, J A ; Lengyel, R J
    Hyperuricemia and gout are found in high percentages of the Pacific Island population. As local clinicians and radiologists are more likely to have patients with either the diagnosis or suspicion of gout, a pictorial review of the common radiographic manifestations is presented especially for their information.
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    The need for organ donation in Hawaii.
    ( 1994-03) Limm, W M ; Wheeler, M S ; Ishimoto, S ; O'Friel, M ; Cheung, A H
    Donor organ availability is the primary limiting factor in organ transplantation. The number of patients on the national organ waitlist has increased to more than 32,000, while the number of donors has remained fairly constant at approximately 4,500 per year. In Hawaii, there are 98 patients awaiting organ transplants, and for the past 5 years, the average number of donors per year was 15. The criteria for organ donation, brain death, approaches to donation request, and the management of the multiple organ donor are discussed.
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    Pancreas transplantation for diabetic patients in Hawaii.
    ( 1994-03) Cheung, A H ; Limm, W M ; Wong, L L
    Diabetes mellitus is a common disease affecting a large population in Hawaii. Over the past 20 years, pancreas transplantation has evolved into a viable therapeutic option for selected patients with diabetes mellitus. This report describes the first combined pancreas-kidney transplant performed in Hawaii on June 28, 1993 on a patient with juvenile-onset diabetes mellitus and diabetic nephropathy. The patient has remained off insulin and off dialysis since the transplant. The history, indications, techniques, and potential complications related to this procedure are discussed.
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    Liver transplantation in Hawaii.
    ( 1994-03) Wong, L L ; Cheung, A H ; Limm, W M ; Tsai, N C
    The first liver transplant performed in Hawaii was on May 17, 1993 in a patient with end-stage liver disease caused by autoimmune hepatitis. Liver transplantation is a well-accepted treatment for end-stage liver disease with a 1-year patient survival of 80% to 85%. Early recognition of the appropriate candidate by primary care physicians and prompt referral to a liver transplant center are essential for optimal results. The indications, contraindications, organ procurement and allocation, complications, and results of liver transplantation are described. Finally, several controversial areas will be introduced, including liver transplant for alcoholic cirrhosis and hepatitis B, and use of transjugular intrahepatic portosystemic shunts (TIPS).