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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. Source


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. Source


Wu T.-J.,Kaohsiung Municipal Min Sheng Hospital | Shiao J.S.-C.,National Taiwan University Hospital | Lu J.-Y.,Cheng Hsin Rehabilitation Medical Center
Journal of Clinical Ultrasound | Year: 2011

Purpose: It has been reported that the resistance index (RI) and pulsatility index (PI) are of limited value in differentiating lung cancers from benign lesions. We hypothesized that a vascular work index (VWI), derived from Doppler spectral waveforms, would yield better results. Methods: Forty-one patients were enrolled, 20 of them having malignancies and 21 having benign lesions. The VWI was defined as the square of peak systolic velocity times the time-velocity integral. Maximal VWI, minimal RI, and minimal PI of each tumor were used for analysis. Results: Significantly higher VWI values were found in malignant tumors compared with benign lesions (p < 0.0001). VWI was shown by analysis of the receiver operating characteristic curve to be a best predictor of lung malignancies than PI and RI (p < 0.05), with a 0.89 (95% confidence interval, 0.80-0.98) area under the receiver operating characteristic curve. Conclusions: VWI may be a useful index to help differentiate malignant from benign lung tumors. © 2011 Wiley Periodicals, Inc. Source


Chen S.-H.,Kaohsiung Medical University | Wu W.-J.,Kaohsiung Medical University | Chen H.-W.,Kaohsiung Medical University | Su C.-Y.,Kaohsiung Municipal Min Sheng Hospital | And 3 more authors.
Urological Science | Year: 2013

A postoperative ureterocolonic fistula is rare; only two cases have been reported in the past 38 years in the English medical literature. A 77-year-old female with left renal tuberculosis and staghorn stone received a nephrectomy and a 9-month course of antituberculous therapy. Twelve years later, she experienced repeated urinary tract infection and associated pneumaturia despite medical treatment. Cystoscopy revealed yellowish debris in the bladder, and a computed tomographic examination showed an air bubble in the bladder and a highly suspected fistula between the left ureteral stump and sigmoid colon. After a fistulectomy, she completely recovered, and follow-up urinalysis yielded normal results. This case report highlights this rare condition of urinary tract infection secondary to fistula formation from the ureteral stump even 12 years postoperatively. In addition, we compare different imaging techniques and hypothesize that a nephroureterectomy may be indicated for an inflammatory nonfunctioning kidney containing a staghorn stone. © 2013, Taiwan Urological Association. Source


Chen S.-M.,Fooyin University | Kuo C.-L.,Fooyin University | Lee H.-J.,Kaohsiung Municipal Min Sheng Hospital
Journal of Nursing | Year: 2014

Background: Stress and glycemic control have a significant and positive relationship. However, elderly diabetic patients who are relocated involuntarily to an institution often exhibit poor control of blood sugar . Few studies have addressed the relationship between relocation stress and diabetes control.Purpose: This study explores the relationship between relocation stress and glycemic control in seniors with diabetes in nursing homes.Result: Those participants with diabetes who relocated involuntary, had low functional independence, lived with their family prior to admission, had poor health, or were diagnosed with depression faced a significantly higher risk of poor diabetes control. The significant predictors for diabetes control were: low functional independence and relocation stress, which accounted for 45.7% of the total variance for diabetes control.Conclusion: The result of this study may be referenced to help reduce relocation stress and help improve glycemic control in recently institutionalized seniors with diabetes.Method: This study used a cross-sectional descriptive correlation design with a convenience sampling method to recruit 88 elderly diabetes patients who had relocated to a nursing home within the past 1 year. The structural questionnaires used in this study adopted a personal and disease characteristics datasheet and the modified Chinese-version Relocation Appraisal Scale (RAS). SPSS (Window 18.0 version) was used for statistical analyses. Source

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