Tainan, Taiwan
Tainan, Taiwan

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Yen C.-F.,Kaohsiung Medical University | Chou W.-J.,Chang Gung University | Liu T.-L.,Kaohsiung Medical University | Yang P.,Kaohsiung Medical University | Hu H.-F.,Tainan Municipal Hospital
Comprehensive Psychiatry | Year: 2014

Conclusions Prevention and intervention programs for Internet addiction in adolescents with ADHD should take anxiety, depression, and self-esteem into consideration.Method A total of 287 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their severity of Internet addiction symptoms was assessed using the Chen Internet Addiction Scale. Anxiety and depression symptoms and self-esteem were assessed using the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T), the Center for Epidemiological Studies Depression Scale (CES-D), and the Rosenberg Self-Esteem Scale (RSES), respectively. The association between the severity of Internet addiction symptoms and anxiety and depression symptoms and self-esteem were examined using multiple regression analyses.Background The aims of this study were to examine the associations of the severity of Internet addiction symptoms with various dimensions of anxiety (physical anxiety symptoms, harm avoidance, social anxiety, and separation/panic) and depression symptoms (depressed affect, somatic symptoms, interpersonal problems, and positive affect) and self-esteem among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan.Results The results indicated that higher physical symptoms and lower harm avoidance scores on the MASC-T, higher somatic discomfort/retarded activity scores on the CES-D, and lower self-esteem scores on the RSES were significantly associated with more severe Internet addiction symptoms. © 2014 Elsevier Inc. All rights reserved.


Huang T.-T.,Chang Gung University | Yeh C.-Y.,Health Station of Taoyuan City | Tsai Y.-C.,Tainan Municipal Hospital
Midwifery | Year: 2011

Objective: to examine the effect of individual counselling on diet and physical activity from pregnancy to six months post partum, or from birth to six months post partum, on weight retention among Taiwanese women. Design: a randomised controlled trial assigned participants to two experimental groups [from pregnancy to six months post partum (EP) and from birth to six months post partum (EPP)] and one comparison group. Setting: a 3900-bed medical centre in northern Taiwan with around 3000 births annually. Participants: a sample of 189 women who had regular check-ups during pregnancy and gave birth at the medical centre. Interventions: the comparison group received the routine outpatient department obstetric educational programme. The EP group attended regularly scheduled clinic visits with individualised dietary and physical activity education plans from 16 gestational weeks to six months post partum, and received on brochure. The EPP group received the same educational intervention as the EP group from 24-48 hours after birth to six months post partum. Measurements: body weight, body mass index, health-promoting behaviour and psycho-social variables (self-efficacy, body image, depression and social support). Findings: average gestational weight gain was 14.02, 15.27 and 16.22. kg in the three EP, EPP and comparison groups respectively, and average weight retention at six months post partum was 2.34, 4.06 and 5.08. kg in the three groups, respectively. Key conclusions: a diet and physical activity intervention from pregnancy is effective for reducing post-pregnancy weight retention. Implications for practice: the findings of the present study should be taken into consideration when incorporating significant others and weight-loss maintenance strategies with interventions for a healthier family lifestyle. © 2009 Elsevier Ltd.


Wu H.-H.,Tainan Municipal Hospital | Jao Y.T.F.N.,Tainan Municipal Hospital | Wu M.-H.,Tainan Municipal Hospital
American Journal of Case Reports | Year: 2014

Objective: Rare diseaseBackground: Glomus tumors are usually found over the dermis of the extremities, particularly over the subungual region of the fingers, and occurrence in the trachea is an extremely rare event. To date, only 29 cases of tracheal and 2 main bronchus glomus tumors have been reported in the English literature. Our patient is the first ever reported case in Taiwan that was managed by spiral tracheoplasty.Case Report: A 58-year-old woman was admitted to our hospital because of hemoptysis. Computed tomographic (CT) scan revealed a mass over the posterior wall of the trachea. Surgical resection with spiral tracheoplasty was performed due to uncontrolled bleeding and airway compromise. Histopathology and immunostaining confirmed a glomus tumor. Postoperative course was unremarkable and she was discharged in improved condition after 9 days of hospital stay.Conclusions: Although chronic symptom presentation is the rule for tracheal glomus tumors, airway obstruction and bleeding are life-threatening presentations. Histopathological examination and staining are important to differentiate it from hemangiopericytoma or carcinoid tumors. Spiral tracheoplasty after tangential resection may be tried, as this preserves more tracheal tissue, decreases tension, and prevents postoperative leakage at the anastomotic site. © Am J Case Rep, 2014.


Wu M.-H.,Tainan Municipal Hospital | Wu H.-Y.,Tainan Municipal Hospital
Surgery Today | Year: 2014

Acute esophageal necrosis, also called "black esophagus" because of its characteristic appearance on endoscopy, is a life-threatening disease; however, its temporal evolution on endoscopy is not well understood. We describe the serial changes in acute esophageal necrosis in two patients, who underwent four upper endoscopic examinations each. Serial endoscopy demonstrated progressive necrosis extending from the lower esophagus proximally to involve the middle or upper thoracic esophagus in both patients. The first patient was treated with transhiatal esophagectomy, followed by esophageal reconstruction, and medical control of repeated duodenal ulcer bleeding. The second patient died of esophageal perforation, as a complication of Sengstaken-Blakemore tube stent placement to control esophageal bleeding. We report these cases to demonstrate the importance of early detection and prompt surgical treatment of acute esophageal necrosis. © 2013 Springer Japan.


Chou D.-W.,Tainan Municipal Hospital | Chung K.-M.,Tainan Municipal Hospital | Lee C.-T.,Tainan Municipal Hospital
American Journal of Tropical Medicine and Hygiene | Year: 2014

Prototheca wickerhamii, an environmental alga, rarely causes human infections. We present a case of Prototheca wickerhamii cutaneous and systemic infections in an 85-year-old male with adrenal insufficiency. This organism was identified by morphological features and microbiological tests. The patient was successfully treated with ketoconazole. Copyright © 2014 by The American Society of Tropical Medicine and Hygiene.


Chiang J.-K.,Buddhist Dalin Tzu Chi Hospital | Kao Y.-H.,Tainan Municipal Hospital
Journal of Palliative Medicine | Year: 2016

Background: The effectiveness of home hospice care was helping patients to die at home, and reducing symptom burden. Objective: The study objective was to explore the impact of home hospice care on death at home, end-of-life (EOL) care, and health care costs among patients with advanced lung cancer in their last month of life. Methods: Using Taiwan's National Health Insurance Claims Database, we analyzed factors associated with home hospice care using logistic regression analysis. Results: We enrolled 568 patients with advanced lung cancer under hospice care who died during 1997-2011, of which 238 (41.9%) received home hospice care. Compared with the inpatient hospice (IH) group, the home hospice (HH) group had a larger portion die at home (55.5% versus 22.1%, p < 0.001), but a smaller portion stayed in hospital more than 14 days in their last month of life (67.3% versus 40.8%, p < 0.001). The mean health care cost was less in the HH group than in the IH group (US $1,385.00 ± $1,370.00 and US $2,155.00 ± $1,739.00 [p < 0.001], respectively). Female patients' (p = 0.001) decreased hospital stay in the last month of life (p < 0.001) and longer hospice care duration (p = 0.003) were predictors of receiving home hospice care in advanced lung patients. Conclusion: Home hospice care enables patients with advanced lung cancer to increase the 33.4% chance of dying at home, to spend an average of eight-days less in hospital stay, and to save 35.7% health care costs in the last month of life, compared with their counterparts with only inpatient hospice care. Female patients' decreased hospital stay and longer hospice care duration were the predictors of receiving home hospice care. © Copyright 2016, Mary Ann Liebert, Inc. 2016.


Roan J.-N.,Tainan Municipal Hospital | Wu M.-H.,E Da Hospital
Journal of Cardiothoracic Surgery | Year: 2010

Background: Esophageal perforation after external air-blast trauma is rarely presented in the emergency room. The diagnosis is often delayed more than 24 hours.Methods: We review the literature and report a case of esophageal perforation caused by external air-blast injury.Results: Including the present case, a total of 5 cases of esophageal perforation were caused by external air-blast injury in English literature. Of them, the common presentations were chest pain and dyspnea. The treatment methods varied with each case. One patient died before diagnosis of esophageal perforation and the others survived after proper surgical management.Conclusions: Early diagnosis and proper surgical management can reduce the morbidity and mortality of patients who suffered from esophageal perforation caused by external air-blast injury. © 2010 Roan and Wu; licensee BioMed Central Ltd.


Yan Y.-H.,Tainan Municipal Hospital
Studies in Health Technology and Informatics | Year: 2016

Organizational culture refers to the beliefs and values that have existed in an organization for a long time, and to the beliefs of the staff and the foreseen value of their work that will influence their attitudes and behavior. It is therefore essential to understand the relationship between organizational cultures and organizational effectiveness. Methods. A cross-sectional study was undertaken that focused on hospital nurses in Taiwan. Data was collected using a structured questionnaire; 900 questionnaires were distributed and 473 valid questionnaires were returned. Results. Organizational cultures were significantly (positively) correlated with organizational effectiveness (p<0.001). Conclusions. When the interaction between the leadership and employees is good, the latter will make a greater contribution to team communication and will also be encouraged to accomplish the mission and objectives assigned by the organization, thereby enhancing organizational effectiveness. © 2016 IMIA and IOS Press.


Yan Y.-H.,Tainan Municipal Hospital | Lu C.-L.,Tainan Municipal Hospital
Studies in Health Technology and Informatics | Year: 2016

National Health Insurance Administration established Pharma Cloud System in July 2014. The purpose is to decrease therapeutic duplications and enhance public medication safety. Comparison will be made among individual hospitals and the administering branches of National Health Insurance Bureau (NHIB) on the statistical data on the inquiry of the cloud medication history record system to understand the result of the installation and advocacy of this system. The results show (1) there were 2,329,846 entries of data collected from the branches of the NHIB from 2015 on cloud medication history record and 50,224 entries of data from individual hospitals. (2) The inquiry rate at the branches of the NHIB was 43.2% from January to April, 2015 and at individual hospitals was 18.8%. (3) The improvement rate at the branches of the NHIB was 32.5% and at the individual hospitals was 47.0% from January to April, 2015. © 2016 IMIA and IOS Press.


Wu M.H.,Tainan Municipal Hospital
Surgery today | Year: 2013

This article describes a simple pyloroplasty procedure using a linear stapler in surgery for esophageal cancer. Simple pyloroplasty was carried out using a linear stapler in a total of 22 patients, whose stomachs were used as esophageal substitutes in the surgery for esophageal cancer. Endoscopy was performed and the pyloric diameter was measured perioperatively. A barium meal study was conducted 1 month after the surgery. Stapling enlarged the diameter of the pylorus by nearly 10 %. Endoscopy revealed a smooth inner surface of the pylorus, enlargement of pyloric channel, and fewer spasms of the pylorus at the 1-month follow-up. Postoperative barium meal studies showed good patency of all of the patients' gastric outlets. Simple pyloroplasty is a time-saving and non-soiling technique used to perform the drainage of the gastric conduit for resection of esophageal cancer.

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