The Changhua Journal of Medicine最新文献

{"title":"The Factor Structure of the Center for Epidemiologic Studies Depression Scale (CES-D) for Depression in Dementia Caregivers","authors":"Si-Sheng Huang, Wenfu Wang, Y. Liao","doi":"10.6501/CJM.1304.007","DOIUrl":"https://doi.org/10.6501/CJM.1304.007","url":null,"abstract":"The aim of the present study was to investigate thefactor structure of the Center for Epidemiologic Studiesdepression scale (CES-D) used for evaluating depression indementia caregivers and to examine the relationships betweeneach factor and the variables. We used principle componentfactor analysis with oblique oblimin rotation for extractionof factors. The results revealed a three-factor model thatincluded depressed affect (factor 1), positive affect (factor2) and interpersonal relations (factor 3), which differs fromthe original version. Unlike the depressive and positive affectfactors, the interpersonal relations factor was statisticallysignificantly positively correlated with the educational level ofthe caregiver rather than functional and cognitive impairment(as according to the Mini-Mental State Examination andInstrumental Activities of Daily Living). When we evaluatepatients with dementia, we should consider the 3 psychometricproperties and keep in mind that different dimensions ofdepressive symptomatology indicate different concerns forpatients and their caregivers in clinical practice.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"7 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":"115947104","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":"Ultrasound Computed Tomography Image Fusion- Guided Radiofrequency Ablation for Difficult Hepatocellular Carcinoma: A Case Report","authors":"Lisa Wu, Shun-Shen Wu, M. Soon, H. Yen","doi":"10.6501/CJM.1304.004","DOIUrl":"https://doi.org/10.6501/CJM.1304.004","url":null,"abstract":"Ultrasound is a widely used tool for screening and treating hepatocellular carcinoma (HCC) to prolong patient survival, particularly for those who are unable to undergo surgery. Although ultrasound is less expensive and highly accessible, the use of ultrasound alone is sometimes limited in terms of detecting tumors with isoechogenicity, thus hampering further ultrasound-guided therapy. Here, we report a 64-year-old man with chronic hepatitis C-related cirrhosis. A 1-cm HCC was detected during an abdominal computed tomography assessment. Two attempts at ultrasound-guided radiofrequency ablation failed to target the lesion because of the inaccurate localization of the lesion using ultrasound alone. After the introduction of an ultrasound image fusion system in the hospital, the third attempt at radiofrequency ablation of the tumor was successful. Therefore, this case study suggests the use of an ultrasound image fusion system to improve treatment outcomes in complicated HCC cases.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"80 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":"116673530","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":"Amenorrhea as the Initial Presentation in a Patient with Setpto-Optic Dysplasia","authors":"Yu-Mei Wang, Chia-Yu Sung, Rei-Cheng Yang","doi":"10.6501/CJM.1303.004","DOIUrl":"https://doi.org/10.6501/CJM.1303.004","url":null,"abstract":"A 16-year-old girl presented with primary amenorrhea and no pubertal hair development. She had normal onset of breast development but experienced failure to progress through puberty. Growth hormone, cortisol and gonadotropin deficiencies were detected. Brain magnetic resonance imaging examination revealed the absence of the septum pellucidum, hypoplastic anterior pituitary gland and ectopic posterior pituitary gland. Septo-optic dysplasia (SOD) with multiple pituitary hormone deficiency may be related to abnormality of the hypothalamic-pituitary axis. Long-term follow-up of endocrine dysfunction in this patient is necessary. The etiology of SOD and incomplete puberty are discussed.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131917253","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":"A Rare Congenital Fused Kidney Anomaly in a 3-Year-Old Boy","authors":"Shao-Yen Wu, A. Yang, J. Chien, Rei-Cheng Yang","doi":"10.6501/CJM.1303.005","DOIUrl":"https://doi.org/10.6501/CJM.1303.005","url":null,"abstract":"Renal fusion is the second most common congenital anomaly of the kidney and the urinary tract, the first being duplication of the renal collecting system. Most patients are incidentally diagnosed during abdominal examination such as ultrasound, computed tomography, or magnetic resonance imaging. Renal fusion can accompany other anomalies and increases the incidence of urinary tract or systemic diseases. We report a 3-year-old boy who was initially diagnosed with a solitary kidney, which was then proved to be a rarelyseen variation of fused kidneys. We also discuss the further evaluation and prognosis of such a congenital anomaly.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134428340","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":"A Half-Day Training Workshop for Nurse Practitioners to Improve Their Knowledge of Insulin and Inpatient Diabetes Management","authors":"J. Kuo, Shi‐Dou Lin, Mei-Jung Lin, Ya-Leng Jhang","doi":"10.6501/CJM.1303.002","DOIUrl":"https://doi.org/10.6501/CJM.1303.002","url":null,"abstract":"Nurse practitioners (NPs) nowadays often have primary responsibility for diabetes management in hospitals. Evaluation of the insulin knowledge of NPs is especially important. A half-day workshop was designed and delivered by two senior endocrinologists. NPs from general adult ward units were invited to attend. Participants completed a 20-item multiplechoice questionnaire before and after the workshop to evaluate their erudition of insulin nomenclature, characteristics and clinical use in hospitalized patients. Their scores before and after the workshop and among subgroups categorized by work location and experience were analyzed. Seventy-seven NPs attended the workshop and completed the questionnaire. Their median scores were 56 and 88 before and after the workshop, respectively (p ＜ 0.001). The pre-test score differed according to work location (medical, surgical or obstetric ward), but not by work experience. Their learning sources were mainly educational presentations. Instruction in insulin formulations and inpatient glycemic control is required for NPs working in all departments. Attendance at a half-day workshop can increase the knowledge of insulin of NPs which may serve to improve inpatient diabetes management.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133707289","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":"Superior Mesenteric Artery Syndrome: An Atypical Case with a Severe Complication","authors":"Cheng-Tsung Yang, Jui-Ju Tseng, Ming-Sheng Lee, Chien-Hsing Lee, Liang-Yo Yang, Fu-Huan Huang, Han-Yiaw Chiu","doi":"10.6501/CJM.1303.007","DOIUrl":"https://doi.org/10.6501/CJM.1303.007","url":null,"abstract":"Superior mesenteric artery syndrome (SMAS) is an uncommon disease involving upper gastrointestinal obstruction. It has been postulated that a decrease in the angle between the superior mesenteric artery and the aorta results in occlusion of the third portion of the duodenum, especially in patients who lose body weight rapidly. We present a case of SMAS in a well-nourished, risk-free boy who was admitted owing to abdominal pain and vomiting after eating a large meal and suffered subsequent gastric perforation several hours later. Diagnostic evaluation revealed compression over the third portion of the duodenum by the SMA.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129964605","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":"Food Protein-Induced Protocolitis: A Case Report of a Two-Day-Old Boy","authors":"Shun-Cheng Yang, Cheng-Sheng Hsu, Rei-Cheng Yang, J. Shieh, Ming-Sheng Lee, Jun-Kai Kao","doi":"10.6501/CJM.1303.006","DOIUrl":"https://doi.org/10.6501/CJM.1303.006","url":null,"abstract":"Bloody stools from rectal bleeding in healthy newborns are rare, and swallowing of maternal blood is a more common cause. Here, we present a two-day-old newborn who swallowed maternal blood and presented with a bloody stool who was later diagnosed with food protein-induced protocolitis. A diagnosis of food hypersensitivity in a newborn is obtained by examining the responses to food elimination and performing sigmoidoscopy, rectal mucosal biopsy or even an oral challenge test. Extensively-hydrolyzed formula, rather than partiallyhydrolyzed formula, should be the first choice for the treatment of rectal bleeding caused by food hypersensitivity in a newborn.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127023372","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":"Effect of Quercetin Inhalation on Experimental Sepsis-Induced Lung Injury","authors":"Ming-Sheng Lee, T. Su, Chung-Wei Chen, Jun-Kai Kao, Cheng-Han Lee, Jui-Ju Tseng, Yu-Ching Tseng, Rei-Cheng Yang","doi":"10.6501/CJM.1303.003","DOIUrl":"https://doi.org/10.6501/CJM.1303.003","url":null,"abstract":"Background: Sepsis-induced lung injury is caused by recruitment of neutrophils and activated cytokines in alveoli, leading to plasma extravasation and inflammation. Quercetin was reported to have a significant anti-inflammatory activity owing to its direct inhibition of several initial processes of inflammation. This study investigated the effect of local administration of quercetin in adult SD rats with sepsisinduced lung injury. Materials and Methods: Sepsis-induced lung injury was induced by cecal ligation and puncture (CLP) in adult SD rats. Three doses of quercetin inhalation were given at 1-hr intervals in differing doses of 20, 40 and 60 mg/Kg of BW after the CLP procedure, divided into early (3 hrs after CLP) and late (6 hrs after CLP) treatment. Serum and bronchoalveolar lavage fluids (BALF) were collected after sacrifice of the animals, and neutrophils and pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) were analyzed by ELISA. Lung tissues were stained with hematoxylin and eosin and the severity of lung injury was evaluated under a microscope. Results: Neutrophil counts in the blood increased with the passage of time and became significant during the 9 ~ 18th hr in septic rats. However, a delayed increase in neutrophils in BALF was observed from the 12th to the 24th hr after CLP. Following treatment with quercetin inhalation, the levels of IL-1β and TNF-α in the BALF decreased significantly in both the early and late treatment groups, and early treatment with 40 mg/Kg BW showed the best efficacy. However, the abovedescribed changes in the IL-1β and TNF-α levels were not present in peripheral blood. Pathological results revealed that lung injury was less severe in the quercetin-treated groups than in the control group. Conclusions: We concluded that local administration of quercetin is effective in reducing lung injury in septic rats, especially following early treatment, with little systemic influence. It was suggested that quercetin inhalation may play a therapeutic role for the treatment of infectious lung diseases.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"10 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129222567","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":"Optical Coherence Tomography Findings in a Patient with Foster Kennedy Syndrome","authors":"Ya-Chi Huang, Jiunn-Feng Hwang, Shin-Lin Chiu","doi":"10.6501/CJM.1302.004","DOIUrl":"https://doi.org/10.6501/CJM.1302.004","url":null,"abstract":"Introduction: The aim of this report is to describe the optical coherence tomography findings in a case of Foster Kennedy syndrome. Method: Case report. Results: A 35-year-old man presented with a one-month history of headache and gradually progressive blurred vision in the left eye. His best corrected visual acuity was 20/20 in the right eye and 20/40 in the left eye. Fundoscopy revealed a swollen disc in the right eye and a pale disc in the left eye. Optical coherence tomography showed diffuse asymmetrical thickening of the peripapillary retinal nerve fiber layer in both eyes. Magnetic resonance imaging of the brain revealed a meningioma in the left sphenoid wing with optic nerve compression and cavernous sinus invasion. One year after surgery, the patient's visual acuity had improved to 20/20 in both eyes and his visual field had returned to normal. Conclusions: Optical coherence tomography enables structural evaluation and can be used as an adjuvant tool for the early detection of a brain tumor involving the optic nerve.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"86 1-2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116656967","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":"Trigeminal Neuralgia Caused by Compression of a Tortuous Internal Carotid Artery and Associated Congenital Agenesis of the Contralateral Internal Carotid Artery in a 4-Year-Old Boy","authors":"Chi‐Kuang Liu, A. Yang, Ming-Yuh Chang, Kwo-whei Lee, Yi-Ru Chen, Chih-Wei Lee","doi":"10.6501/CJM.1302.005","DOIUrl":"https://doi.org/10.6501/CJM.1302.005","url":null,"abstract":"We report a 4-year-old patient with trigeminal neuralgia. Magnetic resonance (MR) imaging and computed tomography (CT) studies demonstrated congenital absence of the right internal carotid artery (ICA) with compensatory dilatation and tortuosity of the left carotid siphon, presumably compressing the maxillary branch of the left trigeminal nerve, resulting in trigeminal neuralgia.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129133505","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}