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Feng H.M.,Tri Service General Hospital
The New England journal of medicine | Year: 2014

A 48-year-old woman presented to the emergency department with severe otalgia of 1 day's duration. Bloody otorrhea in the left ear was noted after her hearing aid was removed. A video shows findings in the auditory canal.

Hsieh P.-S.,National Defense Medical Center | Hsieh Y.-J.,Tri Service General Hospital
World Journal of Gastroenterology | Year: 2011

The prevalence of type 2 diabetes mellitus (T2DM) is higher in patients who have liver diseases such as nonalcoholic fatty liver disease, chronic viral hepatitis, hemochromatosis, alcoholic liver disease and cirrhosis. It is suggested that there is a pathogenic link between the presence of T2DM and the severity of liver injury. However, evidence related to the impact of hepatic inflammation on the development of T2DM has not yet emerged. This article provides an overview of the evidence for an increased prevalence of diabetes in a range of liver diseases, the impact of liver diseases on insulin resistance and β cell dysfunction, and the potential mechanisms whereby coexistent liver diseases exacerbate the development of T2DM. © 2011 Baishideng. All rights reserved.

Chen S.Y.,Tri Service General Hospital
Telemedicine journal and e-health : the official journal of the American Telemedicine Association | Year: 2011

To evaluate the functionality of the telehealth system in poorly controlled type 2 diabetic (T2D) patients receiving insulin injections. Sixty-four patients with glycosylated hemoglobin (HbA(1c)) values > 7% for more than 1 year were included. All patients underwent an intensive diabetes management program, including titration of insulin, blood glucose-self monitoring, and nutritional review, and 32 participated in the telehealth system. The major outcome was to evaluate the change of the HbA(1c) and body weight, the incidence of hospitalization, and hypoglycemic events. After 1-year management, patients receiving telehealth care had significantly improved HbA(1c) levels (9.5% ± 1.8% to 8.1% ± 1.2%; p < 0.01) without significant body weight gain. In contrast, the control group patients had no significant improvement in HbA(1c) levels but showed significant increase in body weight (66.8 ± 9.8 to 67.3 ± 10.0 kg; p < 0.01). No patient in the telehealth group was hospitalized during the follow-up period, but six patients in the control group were. Intergroup differences in hypoglycemic events were absent. The intensive diabetes management program with the telehealth system is a useful education method to improve blood sugar control and prevent hospitalization in poorly controlled T2D patients receiving insulin injections.

Shen D.H.,Tri Service General Hospital
Clinical nuclear medicine | Year: 2012

A female patient aged 75 years presented with an incidental pulmonary nodule without FDG uptake when undergoing FDG PET/CT. Without obtaining histologic diagnosis, the follow-up FDG PET/CT 2 years later demonstrated intense FDG avidity within previously FDG-negative tumor. After surgery, the pathologic diagnosis is pulmonary lymphoepithelioma-like carcinoma (LELC). LELCs are unique because of histologic similarities with undifferentiated nasopharyngeal lymphoepithelioma and with a better prognosis as compared with other lung malignancies. However, the expression of FDG uptake in LELC has never been discussed. Herein, we describe a pulmonary LELC manifesting as a slowly growing tumor displaying conversion from FDG-negative to -positive avidity.

Lu D.-W.,Tri Service General Hospital
Ocular Immunology and Inflammation | Year: 2011

Purpose: To report a case of ankylosing spondylitis that initially presented as unilateral optic neuritis. Methods: Case report. Design: Clinical findings and treatment are presented. A 31-year-old woman presented with unilateral optic neuritis in her right eye. Her symptom improved following pulse steroid therapy. Unfortunately, she developed severe pain and weakness in her bilateral knee and ankle joints during follow-up. Further investigation revealed a positive finding of HLA-B27 and bilateral sacroiliitis. Ankylosing spondylitis was confirmed and was treated with Salazine and Mobic. Conclusions: Optic neuritis is rarely the first symptom of AS. Careful surveying and prompt treatment is necessary. © 2011 Informa Healthcare USA, Inc.

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