The Changhua Journal of Medicine最新文献

{"title":"Immune Fecal Occult Blood Test Is Superior to Systemic Inflammatory Markers for Predicting Mucosal Healing Among Patients With Ulcerative Colitis","authors":"H. Yen, T. Hsu, May W. Chen, Ya-Huei Zeng, Yang‐Yuan Chen","doi":"10.6501/CJM.202106_19(2).0001","DOIUrl":"https://doi.org/10.6501/CJM.202106_19(2).0001","url":null,"abstract":"Ulcerative colitis (UC) has emerged in the Asia-Pacific region over the past two decades. The treatment goal for UC has shifted from symptom relief to endoscopic remission. Endoscopy is the gold standard for the diagnosis of mucosal healing; however, it is expensive and invasive. Therefore, the present study evaluated the use of the immune fecal occult blood test (iFOBT) result as a marker to predict mucosal healing among patients with UC. A total of 54 patients with UC were retrospectively enrolled from the electronic clinical database of Changhua Christian Hospital, Taiwan, from January 2019 to July 2019. Stool samples for iFOBT, blood samples for analysis (hemoglobin level, C-reactive protein [CRP] level, erythrocyte sedimentation rate [ESR], and albumin level), and Mayo disease activity scores were reviewed and analyzed. Colonic mucosa was assessed using the Mayo endoscopic subscore. The mean age of the patients was 46.67 years, and 65% of the patients were male. The disease distribution was as follows: E1 (24.07%), E2 (37.04%), and E3 (37.89%). Complete mucosal healing (CMH) occurred in 25.9% of the patients. Patients with and without mucosal healing were compared, and they were of a similar age, with a comparable white blood cell count, hemoglobin level, CRP level, ESR, and drug use. Patients with CMH exhibited a lower platelet count (226,000/μL vs. 287,000/μL, p = 0.033), iFOBT value (7.0 ng/mL vs. 105 ng/mL, p = 0.001), neutrophil-to-lymphocyte ratio (1.93 vs. 2.34, p = 0.004), and partial Mayo score (1 vs. 3, p = 0.001). Predictive cutoff values were assessed using receiver operating characteristic analysis, and the iFOBT exhibited the highest area under the curve than the other parameters examined. Using the iFOBT criterion of ≤ 30 ng/mL, the sensitivity and specificity were 100% and 69.44%, respectively, for the prediction of CMH. The iFOBT value may be a useful marker to predict endoscopic healing of colon mucosa among patients with UC in daily clinical practice.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115580994","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}

{"title":"Nonsurgical Endodontic Treatment and Surgical Periodontal Treatment for Perio-Endo Combined Lesion-A Case Report","authors":"Chien-Wei Yang, Yi-Hung Lin, Chenxu Yang","doi":"10.6501/CJM.202106_19(2).0005","DOIUrl":"https://doi.org/10.6501/CJM.202106_19(2).0005","url":null,"abstract":"Periodontal tissue and the root canal system are correlative. Periodontal and periapical lesions may be present on a single tooth either individually or simultaneously. Whether periodontal problems lead to pulpal lesions, or pulpal lesions cause periodontal damage, is sometimes unclear, making diagnosis challenging. Endodontic-periodontal lesions are classified into five categories in the most widely-used classification method. Determining whether the periodontal or endodontic lesion is the first etiology is difficult. In our case, the patient's late presentation at the clinic may have led to a true combined lesion. The endodontic pathogen must be treated first when addressing a perio-endo combined lesion, and periodontal treatment can then be performed. In conclusion, an endodontic problem must be ruled out, and periodontal treatment can then be planned. Endodontic therapy and periodontal treatment are complementary; they improve symptoms and increase the likelihood of tooth retention.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133961577","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}

{"title":"The Association Between Psychopathology and Clinical Insight in Patients With Schizophrenia","authors":"Si-Sheng Huang, Cheng-Chen Chang","doi":"10.6501/CJM.202103_19(1).0002","DOIUrl":"https://doi.org/10.6501/CJM.202103_19(1).0002","url":null,"abstract":"In Taiwan, few studies have explored the associations between insight and psychopathological dimensions in people with schizophrenia. We aimed to investigate the relationships of clinical insight with different dimensional symptoms in patients with schizophrenia, in addition to clinical variables. This cross-sectional study recruited 90 patients from an acute psychiatric ward from December 2017 to May 2019. We assessed the insight of participants using the Schedule for Assessment of Insight in Psychosis (SIP) and psychopathology using the Positive and Negative Syndrome Scale and its five-factor model. A higher SIP score indicates a poorer insight. In regression analyses, patients' age (t = 3.277, p = 0.002), family history (t = -2.773, p = 0.007), Clinical Global Impressions Scale- Improvement (t = 2.268, p = 0.026), and negative (t = 2.667, p = 0.009), disorganized (t = 2.021, p = 0.047), excited (t = 3.087, p = 0.003), and depressed symptoms (t = -3.950, p ＜ 0.001) were significantly associated with the SIP score. In conclusion, patients with greater insight in the acute phase were associated with younger age, a positive family history, greater improvement of symptoms, less-severe negative symptoms, less-severe disorganized symptoms, less-severe excited symptoms, and more-severe depressed symptoms, but not with cognitive or executive function.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129385329","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}

{"title":"Interferon-Free Anti-HCV Therapy Has a Better Treatment Response Rate and Adherence Than Interferon-Based Therapy for Patients With HCV/HIV Coinfection: A Single-Center Retrospective Study","authors":"I-Ling Liu, Theophile Liu, Yanwu Zeng, Siou-Ping Huang, Yu-Chun Hsu, P. Su, H. Yen","doi":"10.6501/CJM.202012_18(4).0002","DOIUrl":"https://doi.org/10.6501/CJM.202012_18(4).0002","url":null,"abstract":"In the last decade, the standard treatment for hepatitis C virus (HCV)-infected patients has been pegylated interferon (IFN) and daily ribavirin from 24 to 48 weeks. Many patients are unable to tolerate the treatment, or have other contraindications, especially in difficult-to-treat populations such as HCV/human immunodeficiency virus (HIV) co-infected patients. The introduction of IFN-free anti-HCV therapy has resulted in a better therapeutic response with fewer side effects and is significantly beneficial to such patients. In the present study, we aimed to compare the clinical impact of IFN-free therapy in this difficult-to-treat patient population in real-world practice. We conducted a retrospective study from November 2007 to June 2019 involving 50 HCV- and HIV-infected patients who received anti-HCV therapy in our institution. Clinical features and treatment responses were analyzed. The mean patient age was 43.3 years, and 86% were male. Twenty percent of the patients had cirrhosis. The most prevalent HCV genotype was type 1 (54%), followed by type 6 (20%), type 3 (14%), and others (12%). The overall sustained virologic response (SVR) rate was 84% in this cohort. The patients in the direct-acting antiviral agent (DAA) treatment group were older on average, and a higher proportion had cirrhosis. The patients undergoing DAA-based treatment had a higher SVR rate than those receiving IFN-based therapy (96% vs. 68%, p = 0.016). Two patients in each group demonstrated virological non-response to treatment. A high discontinuation rate was noted in the IFN-based group (27% vs. 0%, p = 0.0035) as compared with the DAA group. IFN-free therapy is associated with a significantly higher treatment response rate and better adherence than IFN-based therapy.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127974782","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}

{"title":"Abdominoscrotal Hydrocele-Induced Cellulitis: A Case Report","authors":"Po-Ke Hsu, Yangmengfan Chen","doi":"10.6501/CJM.202012_18(4).0006","DOIUrl":"https://doi.org/10.6501/CJM.202012_18(4).0006","url":null,"abstract":"A hydrocele occurs when fluid is retained in a saclike cavity surrounding a testicle. Cirrhosis often causes ascites, which leads to an increase in intra-abdominal pressure due to excessive fluid. Here, we present the case of a 52-year-old alcohol-dependent patient with cirrhosis and a giant hydrocele communicating with intra-abdominal ascites. The patient presented with fever, scrotal pain, and erythema and computed tomography of the abdomen revealed communication between the peritoneum and scrotum. Cross-fluctuation between the scrotum and abdominal swelling and abdominoscrotal hydrocele (ASH) should be considered in patients with liver cirrhosis. In this unusual case, a patient with liver cirrhosis was noted to have massive ascites secondary to a large ASH, which caused cellulitis of the scrotum, in addition to bacteremia.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133751729","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}

{"title":"Finnish Type Congenital Nephrotic Syndrome With Exon Sequencing Confirmation in Taiwan: A Case Report","authors":"Shuni Chen, M. Chao, Ching‐Yuang Lin, Ting-Yu Chane, Shao-Yen Wu, Meixia Chen, J. Chien","doi":"10.6501/CJM.202009_18(3).0003","DOIUrl":"https://doi.org/10.6501/CJM.202009_18(3).0003","url":null,"abstract":"Congenital nephrotic syndrome Finnish type (CNF) is a rare and severe kidney disorder starting soon after birth, characterized by premature birth, a small size for gestational age, and an enlarged placenta. Early-onset nephrosis with heavy proteinuria, hyperlipidemia, hypercoagulopathy, and an immunocompromised status often causes poor growth and early mortality if not treated promptly. The current treatment strategy of parenteral albumin supplementation, a hyper-caloric and protein-abundant diet, and medications to prevent and treat complications has improved patient outcomes by making curative renal transplantation possible. This report describes a female newborn diagnosed with CNF incidentally before the onset of symptoms. To the best of our knowledge, she was the first CNF case with a diagnosis confirmed by genetic testing (whole-exon sequencing) in Taiwan.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116243059","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}

{"title":"Correlations and Predictors of the Duration of Physical Therapy in Infants Diagnosed With Congenital Muscular Torticollis","authors":"H. Kuo, S. Liao, Wei-Te Wang, W. Liao","doi":"10.6501/CJM.202006_18(2).0002","DOIUrl":"https://doi.org/10.6501/CJM.202006_18(2).0002","url":null,"abstract":"Congenital muscular torticollis (CMT) is the most common musculoskeletal disorder in infancy. The aim of this study was to determine the long-term outcomes of different subtypes of CMT using ultrasonographic (US) diagnostic studies, which could affect the length of physical therapy (PT) in infants with CMT and elicit an early referral. We performed a retrospective analysis of 76 CMT infants who were referred for US investigation and PT between January 2014 and May 2017. The PT duration was 149 ± 72 days, and most infants received PT 2 times/week. The depth ratio and difference between the affected and non-affected bilateral sternocleidomastoid muscle (SCM), passive neck rotation, and lateral flexion were significantly improved after PT. The duration of PT and the number of PT sessions were found to be correlated with initial passive neck rotation (p ＜ 0.001, p ＜ 0.001) and lateral flexion (p = 0.031, p = 0.027). According to linear regression analysis, the initial passive neck rotation was the strongest predictive factor of the duration of PT (p = 0.001) and the number of PT sessions (p ＜ 0.001). Muscular torticollis can be effectively treated by traditional PT. A greater limitation in passive neck rotation requires a longer duration of PT, and attention should be paid to this issue during monitoring of the development of infants with postural torticollis.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116666857","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}

{"title":"Working Memory Capacity as a Moderator of Intrusive Memories","authors":"Ling-Jun Liu, H. Peng, Jeremy W. Newton, Ren‐hau Li, Ming-Chou Ho","doi":"10.6501/CJM.201906_17(2).0001","DOIUrl":"https://doi.org/10.6501/CJM.201906_17(2).0001","url":null,"abstract":"Intrusions can appear in different forms. The occurrence of different types of intrusion can be determined by how the traumatic information was processed. This study examined whether working memory capacity (WMC) can moderate the two peritraumatic processes (conceptual processing and data-driven processing) to affect intrusions. Participants first completed a symmetry span task, viewed traumatic film footage, and completed a processing-style questionnaire concerning the film. A week later, participants handed in a tabular diary that recorded their intrusions over the past week, and completed a free recall and recognition task about the film; they were then debriefed. WMC can moderate the effect of processing style, depending on the type of intrusion. In the prediction of intrusive thoughts (ITs), we found that higher conceptual processing scores led to more ITs in participants with a high WMC. The current study has important clinical implications, in that it recognizes the existence of less-studied ITs, and the role of WMC in trauma processing.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116833525","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}

{"title":"Lipemia Retinalis in a Patient with Type 2 Diabetes: A Case Report","authors":"Shu-yun Yang, San-Ni Chen","doi":"10.6501/CJM.1504.005","DOIUrl":"https://doi.org/10.6501/CJM.1504.005","url":null,"abstract":"脂血性視網膜是一種罕見的視網膜表徵，主要發生於高三酸甘油酯血症。本篇個案報告發表一名24歲第二型糖尿病病患合併有次發性高脂蛋白血症，病患血清三酸甘油酯高達9,100 mg/dL，同時眼底檢查發現有脂血性視網膜。經過密集的胰島素治療及降血脂藥物控制，兩週後血清三酸甘油酯降至500 mg/dL以下，且脂血性視網膜的表現伴隨血中三酸甘油酯的下降而消失。","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122283793","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}

{"title":"Severe Trachea Compression: A Rare Presentation of Giant Intrathoracic Goiter with Papillary Thyroid Cancer","authors":"Ching-Chiao Wang, Yao Lin","doi":"10.6501/CJM.1503.007","DOIUrl":"https://doi.org/10.6501/CJM.1503.007","url":null,"abstract":"甲狀腺腫是一種常見且大多無症狀的內分泌腺疾病，但是當甲狀腺過度腫大並延伸入胸腔時就可能壓迫氣管及食道，進而引起呼吸困難或吞嚥困難等臨床症狀。當病人來院時頸部外觀上無明顯異常又缺乏影像協助診斷時，病患可能會被誤認為心肺或其他內科疾病。本個案報告一49歲男性因為連續數月的高頻呼吸音及呼吸困難而來醫院就診，其頸部外觀無明顯異常，而影像顯示一個巨大的胸腔內甲狀腺腫造成氣管嚴重的壓迫。我們將甲狀腺腫經由頸部切口移除，標本大小約15.5 × 7.5 × 5.5公分，內含有一1.5公分大的甲狀腺乳突癌。術後病人的臨床症狀完全消失，且無喉返神經損傷。術後已追蹤達12個月，尚未發現復發或遠端轉移的證據。","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121535045","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}