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Yang C.Y.,Hsin chu Mackay Memorial Hospital | Yang C.-C.,Mackay Memorial Hospital | Yang C.-C.,Mackay Medical College
Acta Oto-Laryngologica | Year: 2015

Conclusion: The location of the foreign body did not correspond well to the location of pain reported by patients. When patients present with foreign bodies in the pharynx, in addition to recording the location of pain and foreign body sensation, clinicians should perform a comprehensive and thorough oropharyngeal examination to avoid misdiagnosis. Objectives: Physicians are often guided by patient-indicated locations of pharyngeal foreign bodies. In this study, we aimed to determine the correlation between the location of the subjective neck pain or foreign body sensation and the true location of the foreign body. Methods: We prospectively studied 90 patients who had pharyngeal foreign bodies removed at MacKay Memorial Hospital. We divided the head and neck into 10 zones according to the superficial anatomy. Subjective location, examination findings, and actual foreign body location were recorded and compared. Results: The overall subjective and true locations of the foreign body were poorly correlated (kappa 0.27, p = 0.003). The positive predictive value (PPV) for the midline neck was 68%, which was higher than that on either lateral side of the neck. PPV above cricoid cartilage level was 66%. © 2015 Informa Healthcare.


Yang C.Y.,Hsin chu Mackay Memorial Hospital | Wang C.-P.,National TaiwanUniversity | Wang C.-P.,National Taiwan University Hospital
Journal of Medical Ultrasound | Year: 2014

Temporomandibular joint (TMJ) tumors may initially present with symptoms similar to TMJ internal derangements and myositis of masticatory muscles. However, malignant tumors and specific types of benign tumors, such as giant cell tumors, may need aggressive surgical intervention. The current case is a 41-year-old man who initially presented with right preauricular pain. Computed tomography (CT) revealed a destructive bone lesion over the right TMJ with temporal bone destruction. A biopsy conducted with an ultrasound-guided core needle confirmed that the lesion was a giant cell tumor. Giant cell tumors can eventually destroy the surrounding tissue. Magnetic resonance imaging and CT have been traditionally used to evaluate TMJ disorders, whereas ultrasonography provides real-time imaging for evaluating the joint structure, movement, and biopsy guidance. For a TMJ tumor, a precise diagnosis is necessary for adequate planning of treatment. Ultrasound-guided core needle biopsy is a safe and effective method for confirming a diagnosis. © 2014.


Hsieh J.-Y.,National Yang Ming University | Wang H.-W.,National Yang Ming University | Wang H.-W.,Taipei Medical University Hospital | Chang S.-J.,Hsin chu Mackay Memorial Hospital | And 8 more authors.
PLoS ONE | Year: 2013

Mesenchymal stem cells (MSCs) are promising tools for the treatment of diseases such as infarcted myocardia and strokes because of their ability to promote endogenous angiogenesis and neurogenesis via a variety of secreted factors. MSCs found in the Wharton's jelly of the human umbilical cord are easily obtained and are capable of transplantation without rejection. We isolated MSCs from Wharton's jelly and bone marrow (WJ-MSCs and BM-MSCs, respectively) and compared their secretomes. It was found that WJ-MSCs expressed more genes, especially secreted factors, involved in angiogenesis and neurogenesis. Functional validation showed that WJ-MSCs induced better neural differentiation and neural cell migration via a paracrine mechanism. Moreover, WJ-MSCs afforded better neuroprotection efficacy because they preferentially enhanced neuronal growth and reduced cell apoptotic death of primary cortical cells in an oxygen-glucose deprivation (OGD) culture model that mimics the acute ischemic stroke situation in humans. In terms of angiogenesis, WJ-MSCs induced better microvasculature formation and cell migration on co-cultured endothelial cells. Our results suggest that WJ-MSC, because of a unique secretome, is a better MSC source to promote in vivo neurorestoration and endothelium repair. This study provides a basis for the development of cell-based therapy and carrying out of follow-up mechanistic studies related to MSC biology. © 2013 Hsieh et al.


Liao Y.-Y.,National Tsing Hua University | Liao Y.-Y.,Hungkuang University | Lee W.-N.,University of Hong Kong | Lee M.-R.,National Tsing Hua University | And 5 more authors.
Radiology | Year: 2015

Purpose: To determine the feasibility of two-dimensional (2D) ultrasonographic (US) strain imaging for quantifying and mapping mechanical behaviors of the median nerve, flexor retinaculum, and flexor tendons within the carpal tunnel in normal and carpal tunnel syndrome (CTS) disease states during active finger motion. Materials and Methods: This prospective study was approved by the institutional review board; all subjects gave written informed consent and had both of their hands examined. Ten wrists in 10 healthy volunteers (age range, 35-51 years) and 16 wrists in 12 patients with CTS (age range, 37-55 years) were examined. In the patients, CTS had been confirmed on the basis of clinical symptoms and results of electrophysiologic studies. Raw US signals were acquired and were cross correlated to enable estimation of 2D incremental displacements, from which 2D strains were computed. The median nerve was characterized by the axial normal strain, while the flexor tendons and the flexor retinaculum were characterized by the shear strain. Temporal mean values (mean cumulative strain [MCS] values) and standard deviations (standard deviations of the cumulative strain [SDCS]) of the spatially averaged cumulative strains in each tissue region over the entire cycle of finger motion were compared by using an unpaired two-tailed Student t test. Results: MCS for patients with CTS and volunteers was similar. The SDCS for the shear strain of the flexor retinaculum was significantly lower (P <.001) in patients with CTS than in healthy volunteers, while that for the axial strain of the median nerve was higher in healthy volunteers than in patients with CTS (P =.0065). Conclusion: US strain imaging can be used to quantify and map tissue kinematics in the carpal tunnel and to differentiate abnormal from normal median nerves in the wrist. © RSNA, 2015.


Yang C.Y.,Hsin chu Mackay Memorial Hospital | Wang C.P.,National Taiwan University | Wang C.P.,National Taiwan University Hospital
Journal of Medical Ultrasound | Year: 2014

Temporomandibular joint (TMJ) tumors may initially present with symptoms similar to TMJ internal derangements and myositis of masticatory muscles. However, malignant tumors and specific types of benign tumors, such as giant cell tumors, may need aggressive surgical intervention. The current case is a 41-year-old man who initially presented with right preauricular pain. Computed tomography (CT) revealed a destructive bone lesion over the right TMJ with temporal bone destruction. A biopsy conducted with an ultrasound-guided core needle confirmed that the lesion was a giant cell tumor. Giant cell tumors can eventually destroy the surrounding tissue. Magnetic resonance imaging and CT have been traditionally used to evaluate TMJ disorders, whereas ultrasonography provides real-time imaging for evaluating the joint structure, movement, and biopsy guidance. For a TMJ tumor, a precise diagnosis is necessary for adequate planning of treatment. Ultrasound-guided core needle biopsy is a safe and effective method for confirming a diagnosis. © 2014.

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