An Emergency Psychiatric Service in a General Hospital

The same extensive range of general hospital facilities should be allocated to emergency psychiatric illness as are available for other medical conditions. During the study herein reported, for every three medical consultations in the emergency ward of a large general hospital, two psychiatric consultations were requested. Over a two-year period when 24-hour coverage by psychiatric consultants was instituted, such assessments increased from 148 to 340 (during the first four months of each year); the increase in police referrals was outstanding, rising from 16 to 105. The general wards of the hospital assumed greater responsibility for further medical treatment, while committal to the mental hospital declined. Many more psychiatric patients could have been treated in the general hospital if facilities had been available. The development of an emergency psychiatric service is not an easy process and co-ordination with other psychiatric resources is required. Residents in training face situations in the emergency ward which are not encountered in any other aspect of their clinical experience.     

Therapy of Chlorpromazine Melanosis: A Preliminary Report

Melanosis observed in association with prolonged chlorpromazine therapy has become a serious problem in mental institutions. Skin pigmentation has produced an appearance which is cosmetically undesirable. Ocular deposits have caused visual impairment. Diffuse visceral involvement has been accompanied by functional disturbances of the involved organs.Withholding chlorpromazine did not diminish the pigment deposits already present in eight patients with chlorpromazine-induced melanosis. Therefore therapy for existing cases and means of preventing this side effect were investigated. A method of blocking melanin synthesis by depressing tyrosinase activity was devised. A copperchelating agent, D-penicillamine, was administered for a period of four weeks (300 mg. three times daily for six days each week, with mineral supplement substituted on the seventh day). Four of six days patients thus treated improved markedly as evidenced by diminution of skin pigmentation. Urinary copper excretion was substantially increased during the trial period. An alternative method of treatment designed to stimulate melatonin production by the pineal gland was employed. Two patients were kept in darkness for a period of four weeks. One improved markedly, the other only slightly.     

新型生物——人工复合血管研制的初步报告

本文设计一种由胶原和高分子聚合物组成的新型生物一人工复合血管。其研制过程是将包绕有聚酯网的硅胶棒埋入羊的皮下组织,再将形成的经聚酯网为支架的胶原管经醛化处理。作者通过肉眼和SEM观察提出了研制生物——人工复合血管的要点:聚酯网网孔要合适,其与硅胶棒的间隙要恰当,理化处理方法更要选择好。     

The Low Proportion and Associated Factors of Involuntary Admission in the Psychiatric Emergency Service in Taiwan

Background

The involuntary admission regulated under the Mental Health Act has become an increasingly important issue in the developed countries in recent years. Most studies about the distribution and associated factors of involuntary admission were carried out in the western countries; however, the results may vary in different areas with different legal and socio-cultural backgrounds.

Aims

The aim of this study was to investigate the proportion and associated factors of involuntary admission in a psychiatric emergency service in Taiwan.

Methods

The study cohort included patients admitted from a psychiatric emergency service over a two-year period. Demographic, psychiatric emergency service utilization, and clinical variables were compared between those who were voluntarily and involuntarily admitted to explore the associated factors of involuntary admission.

Results

Among 2,777 admitted patients, 110 (4.0%) were involuntarily admitted. Police referrals and presenting problems as violence assessed by psychiatric nurses were found to be associated with involuntary admission. These patients were more likely to be involuntarily admitted during the night shift and stayed longer in the psychiatric emergency service.

Conclusions

The proportion of involuntary admissions in Taiwan was in the lower range when compared to Western countries. Dangerous conditions evaluated by the psychiatric nurses and police rather than diagnosis made by the psychiatrists were related factors of involuntary admission. As it spent more time to admit involuntary patients, it was suggested that multidisciplinary professionals should be included in and educated for during the process of involuntary admission.     

重庆市蚊虫初步调查

重庆地区的蚊虫调查,除过去甘怀杰(1942),周钦贤(1942—1944),张本华(1943—1944)等关于按蚊(Anopheles)的的调查外,以后尚乏人报告。1954年6月至9月,我们在沙磁区的杨公桥、石并坡、沙坪坝等地作了蚊虫的初步调查,共获蚊虫12种。其名称如下:     

A Hemodilution Technique for Open-Heart Surgery: A Preliminary Clinical Report

With the extension of open-heart procedures and the increasing success of open-heart surgery, a great strain has been placed on many hospital laboratories and on the Red Cross for the maintenance of equipment and the supply of blood. In order to decrease both of these needs, hemodilution techniques combined with disposable oxygenators have been introduced. The authors have used a disposable oxygenator with low molecular weight dextran prime, along with moderate hypothermia, in a consecutive series of 15 patients operated upon for congenital and acquired heart lesions. In this consecutive series there has been one death and this could not be attributed to the perfusion technique but to the surgical procedure carried out. It is felt that this combination not only broadens the horizons of open-heart surgery but makes the procedure more readily available and safer, as well as being economical of blood donors and time.