Kaohsiung Municipal Min Sheng Hospital

Kaohsiung, Taiwan

Kaohsiung Municipal Min Sheng Hospital

Kaohsiung, Taiwan

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Wu T.-J.,National Taiwan University | Wu T.-J.,Kaohsiung Municipal Min Sheng Hospital | Wu C.-F.,National Taiwan University | Lee Y.L.,National Taiwan University | And 3 more authors.
Respiratory Research | Year: 2014

Background: In western countries, late-onset asthmatics are more severe than early-onset asthmatics in clinic-based studies. However, whether asthma occurrence rates were higher in late ages than in younger ages was inconclusive. This information is essentially lacking in Asian population. Methods: The participants were schoolchildren's parents recruited from 94 elementary and middle schools in 2004. A cross-sectional self-administered questionnaire was sent through the children to their parents to survey their respiratory health. We investigated typical asthma symptoms occurring at different ages and subsequent remission or relapse after the first asthma event. Person-years of the participants from birth to the time of survey were used as the denominator. Results: Among the 25,377 participants consisting of 949,807 total person-years, 860 reported ever having asthma. Highest incidences occurred at ages 0-12 and 36-40 years. The incidence of asthma was higher in males before puberty, and higher in females after puberty, with overall incidences 1.00 and 0.77 per 1000 person-years for females and males, respectively. Participants with late-onset asthma (onset age >12 years) comprised a large portion of adult current asthmatics. More than 52% of persistence or relapse was observed in early-onset asthma (onset age ≤12 years). The younger birth cohort had a more prominent later peak of asthma incidence than the older one. Conclusions: In Asian population, asthma occurrence showed a U-shape age distribution with a prominent second peak in the thirties. A high proportion of early-onset asthma relapsed and most of late-onset asthma persisted or relapsed in adulthood.

PubMed | Kaohsiung Municipal Min Sheng Hospital, National Yang Ming University and Taipei Veterans General Hospital
Type: Journal Article | Journal: Journal of the Chinese Medical Association : JCMA | Year: 2015

Publications on digital amputation and replantation have been mostly derived from case series in high-volume hand surgery practices, and epidemiological studies are few. This study used a population-based dataset to illustrate the incidence of digital amputation, patient and hospital characteristics, and their relationships with replantation.A claim for reimbursement dataset (2008) was provided as a research database by the Bureau of National Health Insurance, Taiwan. Patients with ICD-9-CM coded as digital amputation (885 and 886) were included. These were cross-referenced with procedure codes for replantation procedures (84.21 and 84.22). We defined the patients who underwent thumb replantation (84.21) and thumb amputation (84.01) during a single hospitalization as replantation failure. Patient and hospital characteristics were studied with statistical analysis.In total, 2358 patients with digital amputation were admitted (1859 male, 499 female), mean age 39.215.5 years. The incidence was 10.2/100,000 person-years. The highest incidence was 14.7/100,000 person-years in the age group 45-54 years. Machinery and powered hand tools caused 68.8% of digital amputations. Thumb amputation [odds ratio (OR): 1.35, p=0.01], private hospital (OR: 1.40, p=0.01), medical center (OR: 2.38, p<0.001), regional hospital (OR: 2.41, p<0.001) and hospitals with an annual volume >20 digital amputations (OR: 4.23, p<0.001) were associated with higher attempt rates for replantation. Elderly patients (age >65 years) had higher risk of thumb replantation failure (OR: 32.30, p=0.045), while hospitals with >20 annual replantations had lower risk (OR: 0.11, p=0.02).Our study of the National Health Insurance database characterized the epidemiology of digital amputation patients undergoing replantation and the facilities in Taiwan where these procedures are performed. The hospitals treating more digital amputation patients had higher attempt rates and lower thumb failure rates.

Lee M.-Y.,Kaohsiung Medical University | Lee M.-Y.,Kaohsiung Municipal Min Sheng Hospital | Lai W.-T.,Kaohsiung Medical University
JRAAS - Journal of the Renin-Angiotensin-Aldosterone System | Year: 2015

Introduction: We aimed to determine the association between plasma aldosterone and renin levels as well as their ratios with carotid plaques in patients with coronary artery disease (CAD). Materials and methods: Carotid intima-media thickness (IMT) and plaque score were evaluated in 111 patients with stable CAD. Plasma renin and aldosterone levels were measured in all patients. Aldosterone to renin ratio (ARR) was calculated. All patients were categorized into: Group 1 (normal coronary angiography), Group 2 (patients had CAD but without carotid plaque) and Group 3 (patients had CAD and at least one carotid plaque). Results: Renin levels are significantly higher in Group 3 than in Group 1 and 2. ARR was significantly lower in Group 3 than in Group 1 and 2. Renin levels were found to be positively correlated with carotid IMT and plaque score but ARR was inversely associated with carotid IMT and plaque score. Renin levels and ARR are independently associated with presence of carotid plaque in CAD patients (OR 1.124, CI 1.021-1.237, p = 0.017 and OR 0.906, CI 0.839-0.978, p = 0.011, adjusted for age, respectively). Conclusions: Plasma renin and ARR but not aldosterone are independently associated with presence of carotid plaques in CAD patients. Hence, the linkage between aldosterone and renin plays a more important role than aldosterone alone in carotid atherosclerosis. © The Author(s) 2014.

Wu C.-W.,Kaohsiung Medical University | Lu I.-C.,Kaohsiung Medical University | Randolph G.W.,Massachusetts Eye and Ear Infirmary | Kuo W.-R.,Kaohsiung Medical University | And 3 more authors.
Head and Neck | Year: 2010

Background Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has recently been more frequently applied in thyroid surgery. However, concerns have been raised regarding the safety and optimal intensity of electrical nerve stimulation. Methods Eight piglets were enrolled, and electrically evoked electromyography (EMG) was recorded from the vocalis muscles via endotracheal surface electrodes. The baseline EMG was measured and continuous pulsatile stimulations were performed on the vagus nerve and RLN for 10 minutes. Changes of EMG waveform and cardiopulmonary status were analyzed. Results A dose-response curve existed with increasing EMG amplitude as stimulating current was increased, with maximum amplitude elicited on vagal and RLN stimulation at <1 mA. No obvious EMG changes and untoward cardiopulmonary effects were observed after the stimulation. Conclusions Electrical stimulation is safe during IONM in this porcine model. Minimal current that required generating the maximal evoked EMG, approximately 1 mA in this study, can be selected to minimize the risk of nerve damage and cardiopulmonary effects. © 2010 Wiley Periodicals, Inc.

Huang Y.-H.,Chang Gung University | Huang Y.-H.,Kaohsiung Municipal Min Sheng Hospital | Ou C.-Y.,Chang Gung University | Ou C.-Y.,Kaohsiung Armed Forces General Hospital
World Neurosurgery | Year: 2015

Objective Lumbar fusion is a widely used procedure for degenerative spine diseases but frequently is accompanied with substantial surgical blood loss. We aimed to investigate the risk factors for significant intraoperative blood loss and the influence of excessive bleeding on postoperative complications in patients undergoing fusion for degenerative lumbar spines. Methods For this retrospective study, we enrolled 199 patients who had undergone lumbar fusion surgery for degeneration. The definition of significant blood loss at operation was 500 mL or more in blood volume. The patients were subdivided into 2 groups on the basis of whether significant blood loss was present (n = 107) or not (n = 92). Results The incidence of significant blood loss during lumbar fusion was 53.8%. In the multivariate logistic regression model, the independent risk factors for significant blood loss included body mass index (P = 0.027), extreme spinal canal narrowing (P = 0.023), spine fusion segments >1 level (P = 0.008), and transforaminal lumbar interbody fusion (P = 0.006). Significant blood loss in lumbar fusion was associated with a greater incidence of postoperative complications (P = 0.002). The length of hospital stay for patents with excessive bleeding was prolonged significantly (P = 0.045). Conclusions Because substantial bleeding in lumbar fusion is associated with a greater incidence of morbidities and prolonged length of hospital stay, attention to the risk factors for significant blood loss is important in the preoperative assessment and postoperative guidance for the level of care. © 2015 Elsevier Inc.

Wang T.-C.,Asia University, Taiwan | Wang T.-C.,Tzu Hui Institute of Technology | Tsai A.C.,Asia University, Taiwan | Tsai A.C.,China Medical University at Taichung | And 6 more authors.
Neurorehabilitation and Neural Repair | Year: 2015

Background and Purpose. Patients with chronic stroke may benefit from continuing rehabilitation training after hospital discharge. This study examined whether caregiver-mediated, home-based intervention (CHI) could improve physical functioning and social participation in these patients. Methods. A single-blind, randomized, controlled 12-week trial conducted with 51 patients from 3 hospitals in Taiwan who had chronic stroke (>6 months; Brunnstrom recovery stages III-V). Patients and their caregivers in the intervention arm (n = 25) were given weekly personalized CHI trainings designed by a physical therapist. Patients in the control arm (n = 26) received visits from the therapist without intervention. All were evaluated for physical recovery through the Stroke Impact Scale, Berg Balance Scale, 10-Meter Walk Test, 6-Minute Walk Test, and Barthel Index at baseline and endpoint. Caregivers were evaluated with the Caregiver Burden Scale. Results were analyzed through Mann-Whitney U test. Results. CHI significantly improved scores of the Stroke Impact Scale: strength (control vs intervention, respectively: 1.4 vs 15.5; P = .002), mobility (-0.5 vs 13.7; P < .001), composite physical (-0.7 vs 11.2; P < .001), and general recovery domain (0.2 vs 17.4; P < .001). CHI also significantly improved free-walking velocity (-1.4 vs 7.5 cm/s; P = .006), 6-minute walk distance (-10.5 vs 15.8 m; P = .003), Berg Balance Scale score (-0.8 vs 4.5; P = .006), and Barthel Index score (0.6 vs 7.2; P = .008). CHI did not significantly increase caregiver burden at endpoint. Conclusion. CHI can improve physical functional recovery and, possibly, social participation in patients with chronic stroke. © The Author(s) 2014.

Lin S.-Y.,Kaohsiung Veteran General Hospital | Lin W.-C.,Kaohsiung Municipal Min Sheng Hospital | Lin W.-C.,National Kaohsiung University of Applied Sciences | Wang J.-W.,National Kaohsiung University of Applied Sciences
Journal of the Chinese Medical Association | Year: 2011

Patella sleeve fracture is a rare fracture that only occurs in children. Diagnosis is difficult both clinically and radiologically. A high-riding patella and hemarthrosis are important signs when diagnosing this fracture. We report a case of an 11-year-old boy who suffered from patella sleeve fracture without visible bony fragments on a lateral radiograph. Open reduction with transosseous tunneling and patellotibial cerclage wiring for anastomosis protection was performed. Early weight bearing was achieved together with a satisfactory range of knee motion. Premature anterior physeal arrest was noted because of insertion of cerclage wire in the open physis. However, no genu recurvatum was present 2 years after the initial operation. An awareness of sleeve fracture, together with its characteristic clinical and radiological features, is important to avoid misdiagnosis and treatment delay. If the cerclage wire technique is used, care should be taken not to disturb the proximal tibial apophysis. © 2011.

Lin W.-C.,Kaohsiung Municipal Min Sheng Hospital | Wang J.-W.,National Kaohsiung University of Applied Sciences | Lin S.-Y.,Kaohsiung Municipal Min Sheng Hospital
Optical Engineering | Year: 2010

Low-contrast profile images are frequently encountered in medical practice, and the correct interpretation of these images is of vital importance. This study introduces a contrast enhancement technique based on singular value decomposition (SVD) to enhance low-contrast fracture x-ray images. We propose a development of the traditional singular value solution by applying a feature selection process on the extracted singular values. The proposal calls for the establishment of a feature space in which the interpretability or perception of information in images for human viewers is enhanced, while noise and blurring are reduced. In this approach, the area of interest is manually cropped, and histogram equalization (HE) and singular value selection procedures are then conducted for comparative study. This approach exploits the spectral property of SVD, and the singular value selection algorithm is developed based on the corresponding Fourier domain technique for high frequency enhancement. The proposed method can generate more enhanced views of the target images than HE processing. Ten physicians confirm the performance of the proposed model using the visual analog scale (VAS). The average VAS score improves from 2.5 with HE to 8.3 using the proposed method. Experimental results indicate that the proposed method is helpful in fracture x-ray image processing. © 2010 Society of Photo-Optical Instrumentation Engineers.

Lin W.-C.,Kaohsiung Municipal Min Sheng Hospital | Lin W.-C.,National Kaohsiung University of Applied Sciences | Wang H.-Y.,National Kaohsiung University of Applied Sciences | Liu C.-Y.,National Kaohsiung University of Applied Sciences | Lee T.-F.,National Kaohsiung University of Applied Sciences
Microelectronics Journal | Year: 2013

The behavioral modeling of active devices using pathological nullor-mirror elements has shown advantages comparing with their representations using nullor elements only. In order to model the terminal characteristic of active devices containing current or voltage differencing properties, the pathological representations of current and voltage differencing cells are presented. Each proposed model includes the non-ideal effects of input and output parasitics and transfer characteristics. They are used to model some active devices with the consideration of their non-ideal effects. Symbolic nodal analyses (NA) using the non-ideal models of active devices are given to demonstrate the usefulness of the proposed models. © 2013 Elsevier Ltd. All rights reserved.

PubMed | I - Shou University, China Medical University at Taichung and Kaohsiung Municipal Min Sheng Hospital
Type: | Journal: The American journal of medicine | Year: 2016

The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk.From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups.The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P=.001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher inthe BE cohort (adjusted hazard ratio= 1.46, 95% confidence interval= 1.23-1.73) compared with the non-BEcohort, especially in the first 2 months (adjusted hazard ratio= 9.72, 95% confidence interval= 4.65-20.3).BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.

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