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Quadriplegia and Ischemic Stroke after Neck Lymph Node Dissection in a Papillary Thyroid Cancer Patient 甲状腺乳头状癌患者颈部淋巴结清扫后四肢瘫痪及缺血性中风1例
The Changhua Journal of Medicine Pub Date : 2016-03-01 DOI: 10.6501/CJM.1401.003
Yu-Kuang Chen, C. Shih
{"title":"Quadriplegia and Ischemic Stroke after Neck Lymph Node Dissection in a Papillary Thyroid Cancer Patient","authors":"Yu-Kuang Chen, C. Shih","doi":"10.6501/CJM.1401.003","DOIUrl":"https://doi.org/10.6501/CJM.1401.003","url":null,"abstract":"A 46-year-old female was scheduled for neck lymph node dissection. The patient suffered from quadriplegia and aphasia after the surgery. Acute cervical spine injury with acute ischemic stroke was indicated by MRI images. Neck extension and hypotensive episodes may together have contributed to the neurologic insult. Assessment of limitation of neck mobility and image examination should be performed at the preoperative stage. Early diagnosis and treatment of neurologic insult may not only improve patient recovery, but may also prevent further deterioration.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129121096","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
Subconjunctival Hemorrhage: A Rare Complication of Emergency Endoscopy 结膜下出血:急诊内窥镜检查的罕见并发症
The Changhua Journal of Medicine Pub Date : 2016-03-01 DOI: 10.6501/CJM.1401.004
C. Chiu, Ching-Fang Tsao, F. Siao, H. Yen
{"title":"Subconjunctival Hemorrhage: A Rare Complication of Emergency Endoscopy","authors":"C. Chiu, Ching-Fang Tsao, F. Siao, H. Yen","doi":"10.6501/CJM.1401.004","DOIUrl":"https://doi.org/10.6501/CJM.1401.004","url":null,"abstract":"Upper gastrointestinal (GI) bleeding is a common condition in the emergency department. Along with medical therapy, emergency endoscopy is usually performed to enable prompt diagnosis and treatment of such patients. However, because of the risk of aspiration, conscious sedation is not usually performed in emergency situations. Here, we report the case of a 59-year-old male patient admitted to our emergency department after vomiting fresh blood following alcohol consumption. Despite successful endoscopic therapy, the patient was found to have subconjunctival hemorrhage. The patient was admitted for observation and subsequently recovered without any complications. This case report highlights the fact that subconjunctival hemorrhage is a rare complication of emergency endoscopy, particularly when the patient complains of eye discomfort after the procedure.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132540905","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
Acute Kidney Injury in a Patient with Mantle Cell Lymphoma-Associated Hypocomplementemia 套细胞淋巴瘤相关低补体血症患者的急性肾损伤
The Changhua Journal of Medicine Pub Date : 2016-03-01 DOI: 10.6501/CJM.1401.005
Chia-Jui Wu, P. Chiu, Chin-Ye Lin, Meilee L Chen
{"title":"Acute Kidney Injury in a Patient with Mantle Cell Lymphoma-Associated Hypocomplementemia","authors":"Chia-Jui Wu, P. Chiu, Chin-Ye Lin, Meilee L Chen","doi":"10.6501/CJM.1401.005","DOIUrl":"https://doi.org/10.6501/CJM.1401.005","url":null,"abstract":"Lymphomatous infiltration of the kidney is a rare manifestation of mantle cell lymphoma (MCL). We present the case of a 54-year-old male with MCL, acute kidney injury, extremely high antinuclear antibody titers, and hypocomplementemia. The diagnosis of MCL was further confirmed by kidney, lymph node, and bone marrow biopsies and immunohistochemical analysis of cyclin D1 expression. Renal ultrasonography demonstrated bilateral renal hypertrophy, and histological examination of renal biopsy revealed lymphomatous infiltration of the tubulointerstitium, with similar antigenic profiles to those observed in bone marrow and lymph node samples. Following a thorough literature search, we believe the present case represents the first report of MCL with abnormally high antinuclear antibody titers, hypocomplementemia, and acute kidney injury.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124579636","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
Toxic Leukoencephalopathy in a Patient after Intravenous Heroin Injection Following Recovery from Septic Shock: A Case Report and Review of the Literature 脓毒性休克恢复后静脉注射海洛因致中毒性脑白质病1例报告及文献复习
The Changhua Journal of Medicine Pub Date : 2016-03-01 DOI: 10.6501/CJM.1401.006
Kun-Hong Li, I-Ching Lin, Cheng-Chen Chang
{"title":"Toxic Leukoencephalopathy in a Patient after Intravenous Heroin Injection Following Recovery from Septic Shock: A Case Report and Review of the Literature","authors":"Kun-Hong Li, I-Ching Lin, Cheng-Chen Chang","doi":"10.6501/CJM.1401.006","DOIUrl":"https://doi.org/10.6501/CJM.1401.006","url":null,"abstract":"Toxic leukoencephalopathy often involves white matter tracts connecting to higher cortical functions that cause different neuropsychiatric symptoms, such as inattention, forgetfulness, dementia, coma or even death. We present a patient who had just recovered after respiratory failure and septic shock, who then developed toxic leukoencephalopathy after intravenous heroin injection. Magnetic resonance imaging (MRI) appears to be essential for making a diagnosis, because clinical history is often unreliable and manifestations are nonspecific. Treatment is mainly supportive for toxic leukoencephalopathy. Physicians and psychiatrists should take a thorough history and be alert to the complex presentations of toxic encephalopathy.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"238 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121067754","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
Effect of Heat Shock Treatment on Endothelial Cell Integrity after Histamine Challenge 热休克处理对组胺刺激后内皮细胞完整性的影响
The Changhua Journal of Medicine Pub Date : 2016-03-01 DOI: 10.6501/CJM.1401.001
Shih-Chung Wang, Rei-Cheng Yang, Ming-Yuh Chang, T. Lu, L. Tsao
{"title":"Effect of Heat Shock Treatment on Endothelial Cell Integrity after Histamine Challenge","authors":"Shih-Chung Wang, Rei-Cheng Yang, Ming-Yuh Chang, T. Lu, L. Tsao","doi":"10.6501/CJM.1401.001","DOIUrl":"https://doi.org/10.6501/CJM.1401.001","url":null,"abstract":"Endothelial cells and endothelial cell integrity play a central role in circulatory homeostasis. Our previous study indicated that heat shock treatment reduces protein leakage and attenuates the hypotension caused by anaphylactic shock. Also, heat shock treatment maintains cerebral vascular permeability, while the blood brain barrier is opened by high osmotic stress. In this study we investigated the potential mechanism by which heat shock protein 72 (Hsp72), the major product after heat shock, maintains cellular integrity of cultured histamine-induced human umbilical vein endothelial cells (HUVECs) upon challenge by histamine. Tight junction proteins (ZO-1 and occludin) and a cytoskeleton component (F-actin) were evaluated by an immunocytochemical study. The immunochemical density of ZO-1 and occludin was clearly decreased in the non-heated cells after histamine challenge, and associated with the proportional decline of F-actin. The adverse phenomenon was prevented in the heated cells in which Hsp72 was significantly over-expressed. It was further demonstrated that Hsp72 could be exclusively coimmunoprecipitated with ZO-1 or occludin in heated cells. In conclusion, histamine-induced conformational alteration of HUVECs is attenuated by previous heat shock treatment, and the Hsp72-mediated preservation of tight junction proteins, as well as cytoskeletal structure, could be the possible mechanism of action.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126325549","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 Incidence of Venous Thromboembolism in Patients with Acute Ischemic and Hemorrhagic Stroke: A Nationwide Population-Based Study in Taiwan 急性缺血性及出血性脑卒中患者静脉血栓栓塞的发生率:台湾一项全国性人群研究
The Changhua Journal of Medicine Pub Date : 2016-03-01 DOI: 10.6501/CJM.1401.002
Kai-Ming Jhang, C. Lai, Wenfu Wang, Yen-Yu Chen
{"title":"The Incidence of Venous Thromboembolism in Patients with Acute Ischemic and Hemorrhagic Stroke: A Nationwide Population-Based Study in Taiwan","authors":"Kai-Ming Jhang, C. Lai, Wenfu Wang, Yen-Yu Chen","doi":"10.6501/CJM.1401.002","DOIUrl":"https://doi.org/10.6501/CJM.1401.002","url":null,"abstract":"Objective: To investigate the incidence of venous thromboembolism (VTE) among patients with acute ischemic or hemorrhagic stroke. Methods: Research data were collected from a subset of the National Health Insurance Research Database of Taiwan containing medical records of one million individuals randomly sampled from 25.68 million registered beneficiaries. Hospitalizations for acute ischemic and hemorrhagic stroke between 1999 and 2008, including cases of the complication of VTE, were selected according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Results: A total of 9,320 hospitalizations for acute ischemic stroke and 3,124 for hemorrhagic stroke were identified. The incidence of VTE was 0.14% (13 events) in cases of acute ischemic stroke and 0.32% (10 events) in cases of hemorrhagic stroke. The overall incidence of VTE after acute stroke was 0.18%. Multivariate logistic regression demonstrated that the female gender, a history of prior VTE, and the length of hospital stay were associated with an increased risk of post-stroke VTE. Conclusions: Compared with ischemic stroke, patients with hemorrhagic stroke tended to have a higher incidence of VTE. The risk factors for VTE during the acute stroke period included the female gender, length of hospital stay and a history of VTE. The effectiveness of VTE prophylaxis in Taiwanese patients using different methods warrants further study.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"175 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122974133","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
Clinical Utility of Next Generation Sequencing in Molecular Diagnoses of Human Genetic Disorders 下一代测序在人类遗传疾病分子诊断中的临床应用
The Changhua Journal of Medicine Pub Date : 2015-12-01 DOI: 10.6501/CJM.1304.001
L. Wong
{"title":"Clinical Utility of Next Generation Sequencing in Molecular Diagnoses of Human Genetic Disorders","authors":"L. Wong","doi":"10.6501/CJM.1304.001","DOIUrl":"https://doi.org/10.6501/CJM.1304.001","url":null,"abstract":"The next generation massively parallel sequencing has now been widely applied to clinical molecular diagnoses of human genetic disorders. This article reviews the evolution of next generation sequencing (NGS), the target sequence enrichment methods, principles and chemistry of various platforms, panel design, clinical validation, examples of clinically available panels, challenges and diagnostic yields. This review article describes how NGS can be applied to clinical diagnosis, advantages and challenges of the methodologies.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116543997","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
A Rare Complication after Arthroscopic Partial Trapeziectomy and Pinning: Rupture of the Flexor Digitorum Profundus of the Index Finger 关节镜下部分梯形切除术及钉钉后罕见的并发症:食指指深屈肌断裂
The Changhua Journal of Medicine Pub Date : 2015-12-01 DOI: 10.6501/CJM.1304.005
Jr-Kai Chen, Chung-Liang Li, G. Lin, Yin-Chih Fu, Carl C. Chen, Cheng-Chang Lu
{"title":"A Rare Complication after Arthroscopic Partial Trapeziectomy and Pinning: Rupture of the Flexor Digitorum Profundus of the Index Finger","authors":"Jr-Kai Chen, Chung-Liang Li, G. Lin, Yin-Chih Fu, Carl C. Chen, Cheng-Chang Lu","doi":"10.6501/CJM.1304.005","DOIUrl":"https://doi.org/10.6501/CJM.1304.005","url":null,"abstract":"The thumb carpometacarpal (CMC) joint is the most common site for osteoarthritis of the wrist due to its unique biomechanical anatomy. Many motion-preserving surgical treatments have been proposed. Arthroscopic-assisted motionpreserving surgical technique is popular because it produces a small wound and results in a shorter recovery time than other procedures. Migration of implants, instability, dorsal displacement of the CMC joint, radial nerve neuritis and persistent pain are common complications of this kind of surgery, but tendon rupture is rare. We present the case of a 55-year-old male with flexor digitorum profundus rupture of the index finger after arthroscopic partial trapeziectomy and pinning for CMC joint arthritis.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122438982","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
Use of Ceftazidime Resistance Pattern as a Potential Biological Marker to Predict the Presence of the bla _(TEM-1) Gene in Clinical Isolates of the Acinetobacter calcoaceticus-baumannii Complex 应用头孢他啶耐药模式作为预测钙aceticus-鲍曼不动杆菌复合体临床分离株中bla_ (TEM-1)基因存在的潜在生物标志物
The Changhua Journal of Medicine Pub Date : 2015-12-01 DOI: 10.6501/CJM.1304.002
Chang-Hua Chen, Chieh-Chen Huang
{"title":"Use of Ceftazidime Resistance Pattern as a Potential Biological Marker to Predict the Presence of the bla _(TEM-1) Gene in Clinical Isolates of the Acinetobacter calcoaceticus-baumannii Complex","authors":"Chang-Hua Chen, Chieh-Chen Huang","doi":"10.6501/CJM.1304.002","DOIUrl":"https://doi.org/10.6501/CJM.1304.002","url":null,"abstract":"The Acinetobacter calcoaceticus-baumannii complex (ABC) is considered a major infectious pathogen in Taiwan. The aim of this study was to investigate whether the ceftazidime (CAZ) resistance pattern can be used as a biological marker to predict the presence of the bla _(TEM-1) gene in clinical ABC isolates. A cross-sectional, prospective study was conducted at a hospital between April 1, 2008 and March 31, 2009. A total of 413 clinical ABC isolates were collected. The bla _(TEM-1) gene was detected using polymerase chain reactions. We divided the 413 clinical isolates into three clusters and 32 subgroups by the finite mixture method based on the antibiotics resistance patterns. In our study, 31.2% (10/32) of the ABCs carried the bla _(TEM-1) gene and 100% (10/10) of the bla _(TEM-1)-positive isolates were CAZ-resistant (p = 0.001). The performance of the CAZ phenotype in terms of predicting the presence of the bla _(TEM-1) gene was as follows: sensitivity = 90.9%, specificity = 61.9%, false positive = 9.1%, false negative = 38.1%, positive predictive value = 55.6%, and negative predictive value = 92.9%. We concluded that the CAZ resistance phenotype could be a potential biomarker for the bla _(TEM-1) gene in ABC. Further experiments are necessary to confirm this finding.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126151780","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
Simultaneous Rupture of Ulnar and Radial Collateral Ligaments of the First Metacarpophalangeal Joint: A Case Report 掌指关节尺桡副韧带同时断裂1例
The Changhua Journal of Medicine Pub Date : 2015-12-01 DOI: 10.6501/CJM.1304.006
Yueh-Hsiu Lu, Meiying Wu, Chia-Chieh Wu
{"title":"Simultaneous Rupture of Ulnar and Radial Collateral Ligaments of the First Metacarpophalangeal Joint: A Case Report","authors":"Yueh-Hsiu Lu, Meiying Wu, Chia-Chieh Wu","doi":"10.6501/CJM.1304.006","DOIUrl":"https://doi.org/10.6501/CJM.1304.006","url":null,"abstract":"Simultaneous injury to the ulnar and radial collateral ligaments of the first metacarpophalangeal joint is rare. We report an unusual case of rupture of the radial and ulnar collateral ligaments of the first metacarpophalangeal joint. We performed reconstruction with an autogenous palmaris longus graft and suture anchors. At the 18-month follow-up point after surgery, no residual instability was observed.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"136 14","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132802290","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: 2
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