235 results on '"Fu-Shan Jaw"'
Search Results
2. The FIB-4 scores in the emergency department to predict the outcomes of COVID-19 patients in taiwan
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Chia-Yu Liu, San-Fang Chou, Pei-Ying Chiang, Jen-Tang Sun, Kuang-Chau Tsai, Fu-Shan Jaw, Chung-Ta Chang, Chieh-Min Fan, Yuan-Hui Wu, Peng-Yu Lee, Chia-Ying Hsieh, Jie-Ming Chen, and Chien-Chieh Hsieh
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Critical care medicine ,Respiratory distress ,COVID-19 ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Objective: We aimed to determine the reliability of using the Fibrosis-4 (FIB-4) index in COVID-19 patients without underlying liver illness. Method: We employed multivariate logistic regression to identify variables that exhibited statistically significant influence on the ultimate outcome. Multilayer perceptron analysis was employed to develop a prediction model for the FIB-4 index concerning ICU admission and intubation rates. However, the scarcity of cases rendered the assessment of the mortality rate unfeasible. We plotted ROC curves to analyze the predictive strength of the FIB-4 index across various age groups. Result: In univariate logistic regression, only the FIB-4 index and respiratory rate demonstrated statistical significance on all poor outcomes. The FIB-4 index for mortality prediction had an ROC and AUC of 0.863 (95% CI: 0.781–0.9444). It demonstrates predictive power across age groups, particularly for age ≥65 (AUC: 0.812, 95% CI: 0.6571–0.9673) and age
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- 2024
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3. Determining patients with spinal metastases suitable for surgical intervention: A cost‐effective analysis
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Hsiang‐Chieh Hsieh, Hung‐Kuan Yen, Ting‐En Tseng, Yu‐Ting Pan, Min‐Tsun Liao, Shau‐Huai Fu, Mao‐Hsu Yen, Fu‐Shan Jaw, Wei‐Hsin Lin, Ming‐Hsiao Hu, Shu‐Hua Yang, Olivier Q. Groot, and Andrew J. Schoenfeld
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cost‐effective analysis ,neoplasm metastasis ,radiation oncology ,spine ,surgical oncology ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Both nonoperative and operative treatments for spinal metastasis are expensive interventions. Patients' expected 3‐month survival is believed to be a key factor to determine the most suitable treatment. However, to the best of our knowledge, no previous study lends support to the hypothesis. We sought to determine the cost‐effectiveness of operative and nonoperative interventions, stratified by patients' predicted probability of 3‐month survival. Methods A Markov model with four defined health states was used to estimate the quality‐adjusted life years (QALYs) and costs for operative intervention with postoperative radiotherapy and radiotherapy alone (palliative low‐dose external beam radiotherapy) of spine metastases. Transition probabilities for the model, including the risks of mortality and functional deterioration, were obtained from secondary and our institutional data. Willingness to pay thresholds were prespecified at $100,000 and $150,000. The analyses were censored after 5‐year simulation from a health system perspective and discounted outcomes at 3% per year. Sensitivity analyses were conducted to test the robustness of the study design. Results The incremental cost‐effectiveness ratios were $140,907 per QALY for patients with a 3‐month survival probability >50%, $3,178,510 per QALY for patients with a 3‐month survival probability 50%. Conclusions This study emphasizes the need to choose patients carefully and estimate preoperative survival for those with spinal metastases. In addition to reaffirming previous research regarding the influence of ambulatory status on cost‐effectiveness, our study goes a step further by highlighting that operative intervention with postoperative radiotherapy could be more cost‐effective than radiotherapy alone for patients with a better survival outlook. Accurate survival prediction tools and larger future studies could offer more detailed insights for clinical decisions.
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- 2023
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4. NKG2A and circulating extracellular vesicles are key regulators of natural killer cell activity in prostate cancer after prostatectomy
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Yu‐Chuan Lu, Chen‐Hsun Ho, Jian‐Hua Hong, Ming‐Chieh Kuo, Yi‐An Liao, Fu‐Shan Jaw, Jason Chia‐Hsien Cheng, Chao‐Yuan Huang, Ko‐Ping Chang, Chung‐Hsin Chen, Jung‐An Lin, An Hsiao, and Hsiu‐Ni Kung
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circulating EVs ,ligand alterations ,natural killer cell activity ,NKG2A ,prostate cancer ,robotic‐assisted radical prostatectomy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Extracellular vesicles (EVs) are an important regulatory factor for natural killer cell activity (NKA) in the tumor microenvironment. The relationship between circulating EVs in the peripheral blood and natural killer (NK) cells in prostate cancer (PCa) is unclear. This study aimed at investigating the key regulators in the interaction between circulating EVs and NK cells in PCa patients before and after tumor removal. NK‐cell characteristics were prospectively assessed in 79 patients treated with robot‐assisted laparoscopic radical prostatectomy preoperatively and postoperatively. Compared with healthy donors, the existence of prostate tumors increased the number of circulating EVs and altered ligand expression of EVs. Circulating EVs extracted from cancer patients significantly decreased NKA of NK cells compared with those extracted from healthy donors. Upon treatment with an inhibiting antibody or small interfering RNA, natural killer cell protein group 2A (NKG2A) was identified as the main NKA regulator in cancer patients for accepting the signal from circulating EVs. After surgery, NKA was increased and NKG2A expression on NK cells was significantly reduced. The expression of ligands for natural killer cell protein group 2D (NKG2D) on EVs and the level of circulation EVs both significantly increased. With the decrease in NKG2A levels on NK cells and the increase in total NKG2D ligands on circulating EVs, which was increased postoperatively, both NKG2A on NK cells and NKG2D ligands on circulating exosomes are main regulators of NKA restoration after prostatectomy.
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- 2023
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5. Quantitative evaluation of correlation between lumbosacral lordosis and pelvic incidence in standing position among asymptomatic Asian adults: a prospective study
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Jie-Ren Mi Le, Kuang-Ting Yeh, Chih-Wei Chen, Fu-Shan Jaw, Shu-Hua Yang, and Wen-Tien Wu
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Medicine ,Science - Abstract
Abstract The determination of lumbopelvic alignment is essential for planning adult spinal deformity surgery and for ensuring favorable surgical outcomes. This prospective study investigated the correlation between the lumbar section of lumbar spine lordosis and increasing pelvic incidence in 324 Asian adults with a mean age of 55 ± 13 years (range: 20–80 years), comprising 115 male and 209 female volunteers. Participants were divided into three groups based on pelvic incidence (G1, G2, and G3 had pelvic incidence of
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- 2022
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6. Propensity score matching analysis comparing radical prostatectomy and radiotherapy with androgen deprivation therapy in locally advanced prostate cancer
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Yu-Cheng Lu, Chao-Yuan Huang, Chia-Hsien Cheng, Kuo-How Huang, Yu-Chuan Lu, Po-Ming Chow, Yi-Kai Chang, Yeong-Shiau Pu, Chung-Hsin Chen, Shao-Lun Lu, Keng-Hsueh Lan, Fu-Shan Jaw, Pei-Ling Chen, and Jian-Hua Hong
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Medicine ,Science - Abstract
Abstract To compare clinical outcomes between the use of robotic-assisted laparoscopic radical prostatectomy (RP) and radiotherapy (RT) with long-term androgen deprivation therapy (ADT) in locally advanced prostate cancer (PC), 315 patients with locally advanced PC (clinical T-stage 3/4) were considered for analysis retrospectively. Propensity score-matching at a 1:1 ratio was performed. The median follow-up period was 59.2 months (IQR 39.8–87.4). There were 117 (37.1%) patients in the RP group and 198 (62.9%) patients in the RT group. RT patients were older and had higher PSA at diagnosis, higher Gleason score grade group and more advanced T-stage (all p
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- 2022
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7. Ultrasound-Guided Perineural Vitamin B12 Injection for Brachial Plexus Injury: A Preliminary Study
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Chien-Hua Chen, Hung-Ya Huang, Abel Po-Hao Huang, Fu-Shan Jaw, Meng-Chao Chen, Chii-Wann Lin, and Shang-Po Wang
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Medicine - Abstract
Individuals with brachial plexus injury (BPI) require upper limb function restoration, but the treatment remains controversial. Vitamin B12 may aid in pain control and nerve regeneration. We present the technical aspects of ultrasound-guided perineural vitamin B12 injection for BPI. The demonstrative case is a 50-year-old man with BPI resulting from a traffic accident. Under ultrasound guidance, vitamin B12 was injected precisely into the brachial plexus compartment around the swollen neuroma of the C6 root. Motor and sensory functions of the left upper extremity improved over 6 months. Ultrasound-guided perineural vitamin B12 injection may be an efficient and personalized intervention in cases of post-ganglionic BPI that failed to improve in the first 3 months.
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- 2023
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8. Radiological and functional assessment in patients with lumbar spinal stenosis
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Chuan-Ching Huang, Fu-Shan Jaw, and Yi-Ho Young
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Fall ,Imbalance ,Lumbar spinal stenosis ,MR imaging ,Postural control ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Although patients with lumbar spinal stenosis (LSS) may have impaired postural control, current diagnosis of LSS depends mainly on clinical manifestation and radiological assessment, while functional assessment of postural balance remains less investigated. This study thus correlated radiological assessment via MR imaging with functional assessment using foam posturography in LSS patients. Methods Forty-seven LSS patients aged 50–85 years were enrolled. All patients received subjective outcome measures first, followed by plain radiography of whole spine and lumbosacral spine, MR imaging, and foam posturography under four conditions. Then, these results were analyzed using stepwise multiple regression analysis. Another 47 age- and sex-matched healthy controls also underwent foam posturography for comparison. Results The LSS group revealed significant increases in the sway area of foam posturography than the control group regardless of various conditions. Advanced age, poor walking endurance, and neural compression at the L2/3 level on MR images were significantly correlated with the characteristic parameters of foam posturography (p 0.05). Conclusions Patients with LSS who exhibit less severe symptoms do not ensure normal postural balance. Functional assessment (foam posturography) on postural balance significantly correlated with radiological assessment (MR imaging) in LSS patients. The use of foam posturography may help assess postural control in LSS patients. It takes a short time and costs less, and would be practical to make this a routine examination in LSS patients.
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- 2022
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9. Iliopsoas abscess diagnosed by point-of-care ultrasound in a women
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Chih-Hsuan Chen, Sing-Soon Sam, Fu-Shan Jaw, and Chien-Chieh Hsieh
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Surgery ,RD1-811 - Published
- 2023
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10. A model study of resonance effect on ocular vestibular-evoked myogenic potential
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Kuei-You Lin, Fu-Shan Jaw, and Yi-Ho Young
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Acceleration ,Vibration ,Resonance effect ,Frontal sinus ,Ocular vestibular-evoked myogenic potential ,Medicine (General) ,R5-920 - Abstract
Background/Purpose: This study measured the acceleration magnitude using a dummy model filled with various air-material ratios to elucidate the mechanism of resonance effect on ocular vestibular-evoked myogenic potential (oVEMP). Methods: With the percentages of air volume altered by filling various materials (water, glycerol, or ethanol) in an acrylic-made hollow spherical model, a minishaker was utilized to deliver vibration stimuli to the model. Then, acceleration magnitude of each model was measured. Results: Since the air was most occupied at the upper part of the model (z-axis), acceleration magnitude along the z-axis was selected for comparison. An increasing trend of the z-axis acceleration magnitude ranging 0.110–0.759 g was identified in air–water model with air volume percentage ranged 40–100%. On the other hand, a significant increasing trend of acceleration magnitude along the z-axis (0.157–0.759 g) was noted in air-glycerol model with 80–100% of air volume. While in air-ethanol model, a significant increasing trend in acceleration magnitude along the z-axis ranged 0.121–0.759 g correlating with 40–100% of air volume. Conclusion: The mechanism for eliciting oVEMP is via the first-order bone vibration coupled with the second-order resonance effect. Both percentage of air volume (i.e. frontal sinus) and density of filling media (i.e. skull property) may contribute to the resonance effect, which then increases the acceleration magnitude so as to enhance the elicitation of oVEMP.
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- 2022
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11. Dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release: technical innovation and case study
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Chien-Hua Chen, Fu-Shan Jaw, Jia-Zhen Hu, Wei-Ting Wu, and Ke-Vin Chang
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Carpal tunnel syndrome ,Median nerve ,Sonography ,Surgery ,Ultrasound ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Background: Minimally invasive carpal tunnel release has recently emerged as the primary surgical approach for recalcitrant carpal tunnel syndrome. A major concern related to surgical failure with this technique is the incomplete release of the flexor retinaculum. Case presentation: We developed a technique using dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release. This novel imaging method was applied to two patients who showed significant symptom relief after the intervention. This case study also provides details of the dynamic ultrasound protocol and highlights the advantages of this technique. Conclusion: Dynamic ultrasound imaging can be used to confirm the completeness of carpal tunnel decompression. A large-scale prospective trial should be conducted to validate whether additional dynamic ultrasound examination can improve the outcome of minimally invasive carpal tunnel release.
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- 2023
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12. Corrigendum to 'Lower postoperative natural killer cell activity is associated with positive surgical margins after radical prostatectomy' [J Formosan Med Assoc 119 (11) (November 2020), 1673–1683]
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Yu-Chuan Lu, Ming-Chieh Kuo, Jian-Hua Hong, Fu-Shan Jaw, Chao-Yuan Huang, Jason Chia-Hsien Cheng, and Hsiu-Ni Kung
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Medicine (General) ,R5-920 - Published
- 2022
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13. Association between low prostate-specific antigen levels and greater disease progression in high-grade locally-advanced prostate cancer
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Yu-Cheng Lu, Chao-Yuan Huang, Yu-Chuan Lu, Kuo-How Huang, Po-Ming Chow, Yi-Kai Chang, Fan-Ching Hung, Chung-Hsin Chen, Fu-Shan Jaw, and Jian-Hua Hong
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Initial prostate-specific antigen ,Prostate cancer ,Radical prostatectomy ,Medicine (General) ,R5-920 - Abstract
Purpose: In advanced or high-grade prostate cancer (PCa), prostate-specific antigen (PSA) is usually elevated, however, some patients may present with low initial PSA (iPSA) levels. The objective of this study was to evaluate whether different iPSA levels were associated with dissimilar clinical outcomes among men with high-grade PCa and advanced disease after robot-assisted laparoscopic radical prostatectomy (RaLRP). Methods: This study enrolled 69 PCa patients with initial Gleason score ≥8 and pathologic T-stage ≥3a from April 2012 to December 2018. Patients were stratified into 3 groups based on iPSA levels at diagnosis:
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- 2021
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14. Lower postoperative natural killer cell activity is associated with positive surgical margins after radical prostatectomy
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Yu-Chuan Lu, Ming-Chieh Kuo, Jian-Hua Hong, Fu-Shan Jaw, Chao-Yuan Huang, Jason Chia-Hsien Cheng, and Hsiu-Ni Kung
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Natural killer cell activity ,Natural killer cell number ,Prostate cancer (PCa) ,Radical prostatectomy ,Medicine (General) ,R5-920 - Abstract
Background/Purpose: The inflammatory milieu has been firmly established to affect cancer progression. However, the connection between natural killer (NK) cells and prostate cancer (PCa) has not been elucidated. Methods: Prospective data on NK cell activity (NKA) and NK cell subset distribution patterns were evaluated from 51 patients treated with robot-assisted laparoscopic radical prostatectomy. Whole-blood samples were collected from patients preoperatively and 4–6 weeks postoperatively. The samples were subjected to NKA tests, NK cell number counts, determination of the NKG2D (activating receptor of NK cells), NKG2A (inhibiting receptor), and other surface markers. All the analyses were compared to the clinicopathological characteristics of patients. NKA was estimated by measuring interferon-γ (IFN-γ) levels after stimulation of the peripheral blood with PROMOCA™, which specifically stimulates the release of IFN-γ from NK cells. Results: NKA was lower in patients with PCa than in healthy participants (484.66 vs. 1550 pg/mL). A paired comparison revealed significantly higher NKA postoperatively than preoperatively (1054 vs. 484.66 pg/mL; p = 0.011). Patients with negative surgical margins exhibited significantly higher postoperative NKA and NKA ratio (postoperative NKA/preoperative NKA) than those with positive margins (557 vs. 1921 pg/mL, p
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- 2020
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15. Novel design for a dynamic ankle foot orthosis with motion feedback used for training in patients with hemiplegic gait: a pilot study
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Chih-Chao Hsu, Yin-Kai Huang, Jiunn-Horng Kang, Yi-Feng Ko, Chia-Wei Liu, Fu-Shan Jaw, and Shih-Ching Chen
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Hemiplegia ,Ankle ,Gait ,Stroke ,Orthosis ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background We designed a novel ankle foot orthosis (AFO), namely, ideal training AFO (IT-AFO), with motion feedback on the hemiparetic lower limb to improve ambulation in individuals with stroke-related hemiplegia. We, therefore sought to compare the kinematic parameters of gait between IT-AFO with and without dynamic control and conventional anterior-type AFO or no AFO. Methods Gait parameters were measured using the RehaWatch® system in seven individuals with hemiplegia (mean 51.14 years). The parameters were compared across four conditions: no AFO, conventional anterior AFO, IT-AFO without dynamic control, and IT-AFO with dynamic control, with three trials of a 10-m walk test for each. Results The dorsiflexion angle increased during the swing phase when the IT-AFO was worn, and it was larger with dynamic control. These data can confirm drop foot improvement; however, the difference between the parameters with- and without-AFO control conditions was not significant in the swing phase. The IT-AFO with or without dynamic control enhanced the loading response to a greater extent between the hemiparetic and unaffected lower limbs than conventional AFO or no AFO. The duration of the stance phase on the hemiparetic lower limb was also longer when using IT-AFO with and without dynamic control than that when using conventional AFO, which improved asymmetry. User comfort and satisfaction was greater with IT-AFO than with the other conditions. Conclusions The IT-AFO with dynamic control improved gait pattern and weight shifting to the hemiparetic lower limb, reducing gait asymmetry. The difference with and without dynamic control of IT-AFO is not statistically significant, and it is limited by sample size. However, this study shows the potential of IT-AFO in applying positive motion feedback with gait training. Trial registration Taipei Medical University-Joint Institutional Review Board. N201510010 . Registered 12 February 2015. http://ohr.tmu.edu.tw/main.php .
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- 2020
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16. Machine Learning Analysis of Heart Rate Variability for the Detection of Seizures in Comatose Cardiac Arrest Survivors
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Chih-Wei Sung, Jiann-Shing Shieh, Wei-Tien Chang, Yi-Wei Lee, Ji-Huan Lyu, Hooi-Nee Ong, Wei-Ting Chen, Chien-Hua Huang, Wen-Jone Chen, and Fu-Shan Jaw
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Heart rate variability ,seizure ,cardiac arrest ,machine learning ,electroencephalography ,Electrical engineering. Electronics. Nuclear engineering ,TK1-9971 - Abstract
Objective: Heart rate variability (HRV) reflects autonomous nervous system disturbance and is used for seizure prediction. The aim of this study was to develop a real-time, continuous physiological medical signal data acquisition system in seizure detection for intensive care unit (ICU). Methods: This prospective study was conducted in National Taiwan University Hospital from August 2018 to October 2019. This study included 20 patients who (a) had a sustained return of spontaneous circulation following out-of-hospital cardiac arrest, (b) were over 18 years old, (c) and were admitted to the emergency ICU for post-cardiac-arrest care. One-lead electrocardiography and bilateral two-channel electroencephalography recorders were synchronically used to conduct measurements for a maximum of 72 hours. The recorded data were wirelessly real-time transmitted by a proxy transmitting module through an access point and a local gateway. A system with a novel algorithm processed the signals and conducted feature extraction and supervised learning for seizure detection. Results: A total of 89 nonseizure and 83 seizure events were detected by the system. Seizure occurred in two-thirds of the patients assessed by intensivists and neurologists. Four HRV parameters, namely standard deviation of normal-to-normal R-wave intervals, high frequency, low frequency-high frequency ratio, and sample entropy, were determined as potential features for identifying seizures. The sensitivity and specificity of the developed system were 0.74 and 0.81, respectively, and the positive predictive value was 0.82. Conclusion: The developed system can be used to identify seizure events through HRV features. Significance: The current study achieved real-time seizure detection and overcame previous limitations on continuity and accessibility.
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- 2020
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17. Analysis of the clinical and radiological outcomes of percutaneous cervical nucleoplasty: A case-control study.
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Chien-Hua Chen, You-Pen Chiu, Hui-Ru Ji, Chin-Ying Wu, Jeng-Hung Guo, Fu-Shan Jaw, and Cheng-Di Chiu
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Medicine ,Science - Abstract
BackgroundPercutaneous cervical nucleoplasty (PCN) is a simple, safe, and effective treatment for contained cervical herniated intervertebral disc (CHIVD). However, few studies have compared the actual benefits of PCN against conservative treatment (CT), either clinically or radiographically.PurposeThe present study sought to analyze and to compare the outcomes of symptomatic contained CHIVD treated with PCN or CT.MethodsThe present study was designed as a case-control comparative study. Patients who indicated for PCN after a failed CT for more than 6 months were recruited. After the exclusion of some patients who did not meet the selection criteria of the study, we finally enrolled 71 patients treated with PCN. In addition, another 21 patients who indicated for PCN but finally chose to receive CT continuously were also enrolled and categorized as the control group. All patients completed the 6-month follow-up. Pain levels and functional outcomes were evaluated pre- and post-operatively by assessing the visual analog scale (VAS), Oswestry Disability Index (ODI), and Neck Disability Index (NDI). Radiographic images of 72 of 104 intervened segments were collected to measure disc height and other cervical spinal alignments, such as range of motion, C2-7 Cobb's angle, and C2-7 sagittal vertical axis.ResultsCompared with the CT group, the PCN group showed significantly better outcomes on VAS, ODI, and NDI at the 1-month post-operative follow-up, which continued through at least the 6-month follow-up (P < 0.01 for VAS and P < 0.05 for ODI and NDI). The mean disc height significantly decreased, from 6.04 ± 0.85 mm to 5.76 ± 1.02 mm, 3 months after PCN treatment (P = 0.003). However, the degree of disc height decrease did not correlate with the changes of the substantial VAS improvement.ConclusionsTo provide therapeutic benefits for symptomatic contained CHIVD patients after an invalid CT for 6 months, PCN seems to be a better option than CT. The reduced disc heights did not alter the clinical outcomes of PCN.
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- 2022
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18. Quantification Analysis of Sleep Based on Smartwatch Sensors for Parkinson’s Disease
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Yi-Feng Ko, Pei-Hsin Kuo, Ching-Fu Wang, Yu-Jen Chen, Pei-Chi Chuang, Shih-Zhang Li, Bo-Wei Chen, Fu-Chi Yang, Yu-Chun Lo, Yi Yang, Shuan-Chu Vina Ro, Fu-Shan Jaw, Sheng-Huang Lin, and You-Yin Chen
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REM sleep behavior disorder ,Parkinson’s disease ,machine learning ,smartwatch sensors ,Biotechnology ,TP248.13-248.65 - Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is associated with Parkinson’s disease (PD). In this study, a smartwatch-based sensor is utilized as a convenient tool to detect the abnormal RBD phenomenon in PD patients. Instead, a questionnaire with sleep quality assessment and sleep physiological indices, such as sleep stage, activity level, and heart rate, were measured in the smartwatch sensors. Therefore, this device can record comprehensive sleep physiological data, offering several advantages such as ubiquity, long-term monitoring, and wearable convenience. In addition, it can provide the clinical doctor with sufficient information on the patient’s sleeping patterns with individualized treatment. In this study, a three-stage sleep staging method (i.e., comprising sleep/awake detection, sleep-stage detection, and REM-stage detection) based on an accelerometer and heart-rate data is implemented using machine learning (ML) techniques. The ML-based algorithms used here for sleep/awake detection, sleep-stage detection, and REM-stage detection were a Cole–Kripke algorithm, a stepwise clustering algorithm, and a k-means clustering algorithm with predefined criteria, respectively. The sleep staging method was validated in a clinical trial. The results showed a statistically significant difference in the percentage of abnormal REM between the control group (1.6 ± 1.3; n = 18) and the PD group (3.8 ± 5.0; n = 20) (p = 0.04). The percentage of deep sleep stage in our results presented a significant difference between the control group (38.1 ± 24.3; n = 18) and PD group (22.0 ± 15.0, n = 20) (p = 0.011) as well. Further, our results suggested that the smartwatch-based sensor was able to detect the difference of an abnormal REM percentage in the control group (1.6 ± 1.3; n = 18), PD patient with clonazepam (2.0 ± 1.7; n = 10), and without clonazepam (5.7 ± 7.1; n = 10) (p = 0.007). Our results confirmed the effectiveness of our sensor in investigating the sleep stage in PD patients. The sensor also successfully determined the effect of clonazepam on reducing abnormal REM in PD patients. In conclusion, our smartwatch sensor is a convenient and effective tool for sleep quantification analysis in PD patients.
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- 2022
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19. Trends in the utilization of computed tomography and cardiac catheterization among children with congenital heart disease
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Justin Cheng-Ta Yang, Ming-Tai Lin, Fu-Shan Jaw, Shyh-Jye Chen, Jou-Kou Wang, Tiffany Ting-Fang Shih, Mei-Hwan Wu, and Yiu-Wah Li
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cardiac catheterization ,children ,congenital heart disease ,multidetector computed tomography ,utilization ,Medicine (General) ,R5-920 - Abstract
Pediatric cardiac computed tomography (CT) is a noninvasive imaging modality used to clearly demonstrate the anatomical detail of congenital heart diseases. We investigated the impact of cardiac CT on the utilization of cardiac catheterization among children with congenital heart disease. Methods: The study sample consisted of 2648 cardiac CT and 3814 cardiac catheterization from 1999 to 2009 for congenital heart diseases. Diagnoses were categorized into 11 disease groups. The numbers of examination, according to the different modalities, were compared using temporal trend analyses. The estimated effective radiation doses (mSv) of CT and catheterization were calculated and compared. Results: The number of CT scans and interventional catheterizations had a slight annual increase of 1.2% and 2.7%, respectively, whereas that of diagnostic catheterization decreased by 6.2% per year. Disease groups fell into two categories according to utilization trend differences between CT and diagnostic catheterization. The increased use of CT reduces the need for diagnostic catheterization in patients with atrioventricular connection disorder, coronary arterial disorder, great vessel disorder, septal disorder, tetralogy of Fallot, and ventriculoarterial connection disorder. Clinicians choose either catheterization or CT, or both examinations, depending on clinical conditions, in patients with semilunar valvular disorder, heterotaxy, myocardial disorder, pericardial disorder, and pulmonary vein disorder. The radiation dose of CT was lower than that of diagnostic cardiac catheterization in all age groups. Conclusion: The use of noninvasive CT in children with selected heart conditions might reduce the use of diagnostic cardiac catheterization. This may release time and facilities within the catheterization laboratory to meet the increasing demand for cardiac interventions.
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- 2015
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20. Comparing the Efficacy of OnabotulinumtoxinA, Sacral Neuromodulation, and Peripheral Tibial Nerve Stimulation as Third Line Treatment for the Management of Overactive Bladder Symptoms in Adults: Systematic Review and Network Meta-Analysis
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Chi-Wen Lo, Mei-Yi Wu, Stephen Shei-Dei Yang, Fu-Shan Jaw, and Shang-Jen Chang
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network meta-analysis ,onabotulinumtoxina ,overactive bladder ,peripheral tibial nerve stimulation ,sacral neuromodulation ,Medicine - Abstract
The American Urological Association guidelines for the management of non-neurogenic overactive bladder (OAB) recommend the use of OnabotulinumtoxinA, sacral neuromodulation (SNM), and peripheral tibial nerve stimulation (PTNS) as third line treatment options with no treatment hierarchy. The current study used network meta-analysis to compare the efficacy of these three modalities for managing adult OAB syndrome. We performed systematic literature searches of several databases from January 1995 to September 2019 with language restricted to English. All randomized control trials that compared any dose of OnabotulinumtoxinA, SNM, and PTNS with each other or a placebo for the management of adult OAB were included in the study. Overall, 17 randomized control trials, with a follow up of 3−6 months in the predominance of trials (range 1.5−24 months), were included for analysis. For each trial outcome, the results were reported as an average number of episodes of the outcome at baseline. Compared with the placebo, all three treatments were more efficacious for the selected outcome parameters. OnabotulinumtoxinA resulted in a higher number of complications, including urinary tract infection and urine retention. Compared with OnabotulinumtoxinA and PTNS, SNM resulted in the greatest reduction in urinary incontinence episodes and voiding frequency. However, comparison of their long-term efficacy was lacking. Further studies on the long-term effectiveness of the three treatment options, with standardized questionnaires and parameters are warranted.
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- 2020
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21. Decreased Power but Preserved Bursting Features of Subthalamic Neuronal Signals in Advanced Parkinson's Patients under Controlled Desflurane Inhalation Anesthesia
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Sheng-Huang Lin, Hsin-Yi Lai, Yu-Chun Lo, Chin Chou, Yi-Ting Chou, Shih-Hung Yang, I Sun, Bo-Wei Chen, Ching-Fu Wang, Guan-Tze Liu, Fu-Shan Jaw, Shin-Yuan Chen, and You-Yin Chen
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Parkinson's disease ,subthalamic nucleus ,deep brain stimulation ,microelectrode recording ,desflurane general anesthesia ,low frequency oscillation ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Deep brain stimulation (DBS) surgery of the subthalamic nucleus (STN) under general anesthesia (GA) had been used in Parkinson's disease (PD) patients who are unable tolerate awake surgery. The effect of anesthetics on intraoperative microelectrode recording (MER) remains unclear. Understanding the effect of anesthetics on MER is important in performing STN DBS surgery with general anesthesia. In this study, we retrospectively performed qualitive and quantitative analysis of STN MER in PD patients received STN DBS with controlled desflurane anesthesia or LA and compared their clinical outcome. From January 2005 to March 2006, 19 consecutive PD patients received bilateral STN DBS surgery in Hualien Tzu-Chi hospital under either desflurane GA (n = 10) or LA (n = 9). We used spike analysis (frequency and modified burst index [MBI]) and the Hilbert transform to obtain signal power measurements for background and spikes, and compared the characterizations of intraoperative microelectrode signals between the two groups. Additionally, STN firing pattern characteristics were determined using a combined approach based on the autocorrelogram and power spectral analysis, which was employed to investigate differences in the oscillatory activities between the groups. Clinical outcomes were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) before and after surgery. The results revealed burst firing was observed in both groups. The firing frequencies were greater in the LA group and MBI was comparable in both groups. Both the background and spikes were of significantly greater power in the LA group. The power spectra of the autocorrelograms were significantly higher in the GA group between 4 and 8 Hz. Clinical outcomes based on the UPDRS were comparable in both groups before and after DBS surgery. Under controlled light desflurane GA, burst features of the neuronal firing patterns are preserved in the STN, but power is reduced. Enhanced low-frequency (4–8 Hz) oscillations in the MERs for the GA group could be a characteristic signature of desflurane's effect on neurons in the STN.
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- 2017
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22. Ergonomic principles and techniques in facilitating advanced laparoendoscopic single site (LESS) urinary tract reconstruction with conventional laparoscopic instruments
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Yao-Chou Tsai, Chen-Hsun Ho, Victor Chia-Hsiang Lin, and Fu-Shan Jaw
- Subjects
laparoendoscopic single site (LESS) surgery ,laparoscopy ,suture technique ,Medicine (General) ,R5-920 - Abstract
The technical and ergonomic details of laparoendoscopic single site (LESS) reconstruction have not been reported. In this study, we explored the feasibility and safety of performing advanced LESS upper urinary tract reconstruction with conventional laparoscopic instruments. Methods: Between September 2010 and March 2011, we retrospectively reviewed prospectively collected data from five patients who underwent LESS urinary tract reconstruction. The LESS reconstruction included pyeloureterostomy (N = 1), dismembered pyeloplasty (N = 2), ureteroneocystostomy (N = 1), and ureteroplasty for bifid blind ending ureter (N = 1). The perioperative and postoperative parameters were collected for analysis. The ergonomic principles and techniques are detailed. Results: All reconstructive LESS procedures were completed successfully without open conversion or laparoscopic conversion. Ancillary ports or ancillary instruments were not applied in any of the patients. The mean patient age was 40.4 years. The mean operative time was 213 ± 69 minutes, the estimated blood loss ranged from minimal to 50 mL, and the mean hospital stay was 4.4 ± 4 days. No operation-related complication occurred. Conclusion: Based on our ergonomic principles and suturing/knotting techniques, conventional laparoscopic instruments are feasible and safe for LESS urinary reconstructive procedures.
- Published
- 2015
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23. The use of porcine small intestine submucosa implants might be associated with a high recurrence rate following laparoscopic herniorrhaphy
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Chen-Hsun Ho, Pin-Wen Liao, Stephen Shei-Dei Yang, Fu-Shan Jaw, and Yao-Chou Tsai
- Subjects
hernia ,laparoscopic ,small intestine submucosa ,total extraperitoneal ,Medicine (General) ,R5-920 - Abstract
The efficacy of porcine small intestine submucosa (SIS) implants in hernia repair has rarely been reported and remained elusive. We herein report our experience to further elucidate the efficacy of SIS mesh in herniorrhaphy. Methods: Between June 2008 and October 2009, a total of 82 patients with 125 inguinal hernias undergoing endoscopic total extraperitoneal (TEP) herniorrhaphy were included. Seventy patients (with 108 hernias) had traditional polypropylene and 12 patients (with 17 hernias) had SIS mesh repair. Postoperative complications and recurrence rates were compared between the two meshes. Results: The demographics between two groups were similar. All operations were performed smoothly with laparoscopy, and the postoperative courses were uneventful. After a median follow-up of 18 months, five (7%) in the polypropylene group and three (25%) in the SIS group had chronic pain (p = 0.09). Five of 17 (29.4%) hernia repairs in the SIS group had an ipsilateral recurrence, compared to no recurrence in the polypropylene group. In the five cases, the second laparoscopy revealed the SIS mesh had been totally degraded and there was no obvious fibrotic tissue in the previous mesh sites. Conclusion: Our data suggest that the use of SIS mesh in endoscopic TEP herniorrhaphy might be associated with a high recurrence rate. The second look laparoscopy in these recurrent cases revealed slow and inadequate integration of host tissue. More evidence is still required to further evaluate the efficacy of SIS mesh in endoscopic TEP herniorrhaphy.
- Published
- 2015
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24. Laparoendoscopic single-site (LESS) retroperitoneal partial adrenalectomy using a custom-made single-access platform and standard laparoscopic instruments: Technical considerations and surgical outcomes
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Chen-Hsun Ho, Pin-Wen Liao, Victor C. Lin, Fu-Shan Jaw, Shih-Chieh Jeff Chueh, Shiu-Dong Chung, Shih-Ping Liu, Yao-Chou Tsai, and Hong-Jeng Yu
- Subjects
laparoendoscopic single-site ,laparoscopy ,partial adrenalectomy ,Surgery ,RD1-811 - Abstract
Background: We previously reported our initial experience with laparoendoscopic single-site (LESS) retroperitoneal partial adrenalectomy using a custom-made single-port device and conventional straight laparoscopic instruments. Methods: Between December 2010 and February 2012, LESS retroperitoneal partial adrenalectomies were performed in 11 patients. Six patients had aldosterone-producing adenomas (APAs) and five patients had nonfunctioning tumors. A single-port access was created with an Alexis wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA) through an incision of 2–3 cm beneath the tip of the 12th rib. All procedures were performed with straight laparoscopic instruments. Results: All LESS procedures were successfully completed without conversion to traditional laparoscopic conversion. The tumors ranged from 1 cm to 4.7 cm (mean, 2.3 cm). The operative time was 71–257 minutes (mean, 121 minutes). Most patients (n = 8) had minimal blood loss; the other three patients had a blood loss of 150 mL, 100 mL, and 100 mL. The mean hospital stay was 3 days (range, 1–6 days). There were no perioperative or postoperative complications. Pathological examinations revealed negative surgical margins in all specimens. All patients with Conn's syndrome had an improvement in blood pressure and normalization of plasma renin activity and serum aldosterone levels; all patients were free of potassium supplementation. Conclusion: Our results clearly demonstrate that LESS retroperitoneal partial adrenalectomy can be performed safely and effectively using a custom-made single-access platform and standard laparoscopic instruments.
- Published
- 2015
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25. Ultrasound-guided Perineural Vitamin B12 Injection for Peripheral Neuropathy
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Chien-Hua Chen, Yin-Kai Huang, and Fu-Shan Jaw
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methylcobalamin ,peripheral neuropathy ,ultrasound guidance ,vitamin B12 ,Medical technology ,R855-855.5 - Abstract
The objective of this article is to present an innovative treatment for peripheral neuropathy using ultrasound-guided perineural vitamin B12 injection. A 37-year-old patient presented with a progressive dropped foot for 2 months. Preceding trauma was denied. On examination, severe weakness of ankle dorsiflexion was revealed. Ultrasound showed peroneal nerve swelling. Nerve conduction velocity and electromyography study showed results compatible with peroneal neuropathy. Under the diagnosis of peroneal neuropathy, the patient was given 500 μg of methylcobalamin around the peroneal nerve under ultrasound guidance two times, with an interval of 2 weeks. The patient showed improvement of muscle power within 2 weeks. Full muscle power was regained after 3 months. There was no adverse symptom after ultrasound-guided perineural vitamin B12 injection. Ultrasound-guided perineural vitamin B12 has the advantage of precise delivery of high-dose vitamin B12 directly around the defective nerve.
- Published
- 2015
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26. Effects of Age and Degree of Hearing Loss on the Agreement and Correlation Between Sound Field Audiometric Thresholds and Tone Burst Auditory Brainstem Response Thresholds in Infants and Young Children
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Chung-Yi Lee, Fu-Shan Jaw, Shin-Liang Pan, Tai-Hsin Hsieh, and Chuan-Jen Hsu
- Subjects
auditory brainstem response ,hearing loss ,infant ,pure-tone thresholds ,Medicine (General) ,R5-920 - Abstract
Early hearing rehabilitation programs eventually require measurement of the hearing threshold cutoff values over the whole range of speech frequencies. With tone burst auditory brainstem responses, excellent agreement and correlation between evoked-potential and behavioral thresholds have been demonstrated by previous studies. This study investigated the effects of different ages and degrees of hearing loss on the agreement and correlation in a large series of infants and young children in Taiwan. Methods: Medical records were reviewed from a large series of 1281 infants and young children aged from 3 months to 3 years who had undergone diagnostic audiometry, including sound field audiometry and tone burst auditory brainstem response measurements. The effects of age and hearing loss on the agreement and correlation between two measured thresholds were studied. Results: Significant correlations (p < 0.001) were seen between the two measured thresholds across groups of different ages and different degrees of hearing loss greater than 20 dB HL. However, the degree of correlation deteriorated at lower degrees of hearing loss. Correlations for hearing thresholds less than 20 dB HL were not significant at 1000, 2000 and 4000 Hz. Conclusion: The evoked-potentials test, properly obtained and interpreted with respect to the effects of age and degree of hearing loss, may provide a very informative hearing threshold reference to help in behavioral audiometric evaluation in infants and young children with hearing loss.
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- 2008
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27. Auditory Cortical Evoked Potentials in Tinnitus Patients with Normal Audiological Presentation
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Chung-Yi Lee, Fu-Shan Jaw, Shin-Liang Pan, Meng-Yi Lin, and Yi-Ho Young
- Subjects
auditory cortical evoked potentials ,edge frequency ,intensity dependence ,problem-tinnitus ,tinnitus ,Medicine (General) ,R5-920 - Abstract
It is widely assumed that damage to the peripheral hearing system is an essential prerequisite for the occurrence of tinnitus. However, previous studies have failed to target tinnitus patients with normal hearing. This study aims to investigate if tinnitus patients with normal audiological presentation demonstrate increased intensity dependence at the selected frequencies. Methods: This study applied auditory cortical evoked potential test to investigate nine tinnitus patients with normal audiological presentation and nine age-and sex-matched healthy subjects without tinnitus. Auditory cortical evoked potentials (N1-P2) were elicited from stimuli at four frequencies (4000, 2000, 1000 and 500 Hz) with five intensities (50, 56, 62, 68 and 74 dB nHL). Intensity dependences by latency of N1 and amplitude of N1-P2 were surveyed at midline electrodes. Results: The results showed that the intensity dependence by latency of N1 to the pooled frequencies at three midline electrodes, e.g. Fz, Cz and Pz, revealed non-significant difference. However, significant differences existed in the intensity dependence of amplitude N1-P2 to the pooled frequencies at the Fz and Cz positions. These differences suggested that tinnitus patients tended to respond less to increased sound intensity and were inclined to weaker intensity dependence. Conclusion: Increased intensity dependence of N1-P2 component at the selected frequencies cannot be demonstrated in tinnitus patients with normal hearing. Restated, the edge frequency phenomenon fails to present in tinnitus patients with normal hearing, a different characteristic from tinnitus patients with hearing loss.
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- 2007
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28. Deep-brain electrical microstimulation is an effective tool to explore functional characteristics of somatosensory neurons in the rat brain.
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Han-Jia Jiang, Kuang-Hsuan Chen, and Fu-Shan Jaw
- Subjects
Medicine ,Science - Abstract
In neurophysiology researches, peripheral stimulation is used along with recordings of neural activities to study the processing of somatosensory signals in the brain. However, limited precision of peripheral stimulation makes it difficult to activate the neuron with millisecond resolution and study its functional properties in this scale. Also, tissue/receptor damage that could occur in some experiments often limits the amount of responses that can be recorded and hence reduces data reproducibility. To overcome these limitations, electrical microstimulation (ES) of the brain could be used to directly and more precisely evoke neural responses. For this purpose, a deep-brain ES protocol for rat somatosensory relay neurons was developed in this study. Three male Wistar rats were used in the experiment. The ES was applied to the thalamic region responsive to hindpaw tactile stimulation (TS) via a theta glass microelectrode. The resulting ES-evoked cortical responses showed action potentials and thalamocortical relay latencies very similar to those evoked by TS. This result shows that the developed deep-brain ES protocol is an effective tool to bypass peripheral tissue for in vivo functional analysis of specific types of somatosensory neurons. This protocol could be readily applied in researches of nociception and other somatosensory systems to allow more extensive exploration of the neural functional networks.
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- 2015
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29. In vitro differential diagnosis of clavus and verruca by a predictive model generated from electrical impedance.
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Chien-Ya Hung, Pei-Lun Sun, Shu-Jen Chiang, and Fu-Shan Jaw
- Subjects
Medicine ,Science - Abstract
Similar clinical appearances prevent accurate diagnosis of two common skin diseases, clavus and verruca. In this study, electrical impedance is employed as a novel tool to generate a predictive model for differentiating these two diseases.We used 29 clavus and 28 verruca lesions. To obtain impedance parameters, a LCR-meter system was applied to measure capacitance (C), resistance (Re), impedance magnitude (Z), and phase angle (θ). These values were combined with lesion thickness (d) to characterize the tissue specimens. The results from clavus and verruca were then fitted to a univariate logistic regression model with the generalized estimating equations (GEE) method. In model generation, log ZSD and θSD were formulated as predictors by fitting a multiple logistic regression model with the same GEE method. The potential nonlinear effects of covariates were detected by fitting generalized additive models (GAM). Moreover, the model was validated by the goodness-of-fit (GOF) assessments.Significant mean differences of the index d, Re, Z, and θ are found between clavus and verruca (p0.7), the adjusted generalized R2 is 0.512 (>0.3), and the p value of the Hosmer-Lemeshow GOF test is 0.350 (>0.05).This technique promises to provide an approved model for differential diagnosis of clavus and verruca. It could provide a rapid, relatively low-cost, safe and non-invasive screening tool in clinic use.
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- 2014
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30. Prediabetes is associated with an increased risk of testosterone deficiency, independent of obesity and metabolic syndrome.
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Chen-Hsun Ho, Hong-Jeng Yu, Chih-Yuan Wang, Fu-Shan Jaw, Ju-Ton Hsieh, Wan-Chung Liao, Yeong-Shiau Pu, and Shih-Ping Liu
- Subjects
Medicine ,Science - Abstract
ObjectiveThe association between type 2 diabetes and low testosterone has been well recognized. However, testosterone levels in men with prediabetes have been rarely reported. We aimed to investigate whether prediabetes was associated with an increased risk of testosterone deficiency.MethodsThis study included 1,306 men whose sex hormones was measured during a medical examination. Serum total testosterone and sex hormone-binding globulin were measured; free and bioavailable testosterone concentrations were calculated by Vermeulen's formula. Prediabetes was defined by impaired fasting glucose (IFG), impaired postprandial glucose (IPG), or glycated hemoglobin (HbA1c) 5.7%-6.4%. Logistic regression was performed to obtain the odds ratios (OR) for subnormal total testosterone (ResultsNormoglycemia, prediabetes, and diabetes were diagnosed in 577 (44.2%), 543 (41.6%), and 186 (14.2%) men, respectively. Prediabetes was associated with an increased risk of subnormal total testosterone compared to normoglycemic individuals (age-adjusted OR=1.87; 95%CI=1.38-2.54). The risk remained significant in all multivariate analyses. After adjusting for MetS, the OR in prediabetic men equals that of diabetic patients (1.49 versus 1.50). IFG, IPG, and HbA1c 5.7%-6.4% were all associated with an increased risk of testosterone deficiency, with different levels of significance in multivariate analyses. However, neither prediabetes nor diabetes was associated with subnormal free testosterone in multivariate analyses.ConclusionsPrediabetes is associated with an increased risk of testosterone deficiency, independent of obesity and MetS. After adjusting for MetS, the risk equals that of diabetes. Our data suggest that testosterone should be measured routinely in men with prediabetes.
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- 2013
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31. Correction: Prediabetes Is Associated with an Increased Risk of Testosterone Deficiency, Independent of Obesity and Metabolic Syndrome.
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Chen-Hsun Ho, Hong-Jeng Yu, Chih-Yuan Wang, Fu-Shan Jaw, Ju-Ton Hsieh, Wan-Chung Liao, Yeong-Shiau Pu, and Shih-Ping Liu
- Subjects
Medicine ,Science - Published
- 2013
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32. A diagnostic model incorporating P50 sensory gating and neuropsychological tests for schizophrenia.
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Jia-Chi Shan, Chih-Min Liu, Ming-Jang Chiu, Chen-Chung Liu, Yi-Ling Chien, Tzung-Jeng Hwang, Yi-Ting Lin, Ming H Hsieh, Fu-Shan Jaw, and Hai-Gwo Hwu
- Subjects
Medicine ,Science - Abstract
OBJECTIVES: Endophenotypes in schizophrenia research is a contemporary approach to studying this heterogeneous mental illness, and several candidate neurophysiological markers (e.g. P50 sensory gating) and neuropsychological tests (e.g. Continuous Performance Test (CPT) and Wisconsin Card Sorting Test (WCST)) have been proposed. However, the clinical utility of a single marker appears to be limited. In the present study, we aimed to construct a diagnostic model incorporating P50 sensory gating with other neuropsychological tests in order to improve the clinical utility. METHODS: We recruited clinically stable outpatients meeting DSM-IV criteria of schizophrenia and age- and gender-matched healthy controls. Participants underwent P50 sensory gating experimental sessions and batteries of neuropsychological tests, including CPT, WCST and Wechsler Adult Intelligence Scale Third Edition (WAIS-III). RESULTS: A total of 106 schizophrenia patients and 74 healthy controls were enrolled. Compared with healthy controls, the patient group had significantly a larger S2 amplitude, and thus poorer P50 gating ratio (gating ratio = S2/S1). In addition, schizophrenia patients had a poorer performance on neuropsychological tests. We then developed a diagnostic model by using multivariable logistic regression analysis to differentiate patients from healthy controls. The final model included the following covariates: abnormal P50 gating (defined as P50 gating ratio >0.4), three subscales derived from the WAIS-III (Arithmetic, Block Design, and Performance IQ), sensitivity index from CPT and smoking status. This model had an adequate accuracy (concordant percentage = 90.4%; c-statistic = 0.904; Hosmer-Lemeshow Goodness-of-Fit Test, p = 0.64>0.05). CONCLUSION: To the best of our knowledge, this is the largest study to date using P50 sensory gating in subjects of Chinese ethnicity and the first to use P50 sensory gating along with other neuropsychological tests to develop a diagnostic model for schizophrenia. Further research to validate the predictive accuracy of this model by applying it on other samples is warranted.
- Published
- 2013
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33. High-resolution structural and functional assessments of cerebral microvasculature using 3D Gas ΔR2*-mMRA.
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Chien-Hsiang Huang, Chiao-Chi V Chen, Tiing-Yee Siow, Sheng-Hsiou S Hsu, Yi-Hua Hsu, Fu-Shan Jaw, and Chen Chang
- Subjects
Medicine ,Science - Abstract
The ability to evaluate the cerebral microvascular structure and function is crucial for investigating pathological processes in brain disorders. Previous angiographic methods based on blood oxygen level-dependent (BOLD) contrast offer appropriate visualization of the cerebral vasculature, but these methods remain to be optimized in order to extract more comprehensive information. This study aimed to integrate the advantages of BOLD MRI in both structural and functional vascular assessments. The BOLD contrast was manipulated by a carbogen challenge, and signal changes in gradient-echo images were computed to generate ΔR2* maps. Simultaneously, a functional index representing the regional cerebral blood volume was derived by normalizing the ΔR2* values of a given region to those of vein-filled voxels of the sinus. This method is named 3D gas ΔR2*-mMRA (microscopic MRA). The advantages of using 3D gas ΔR2*-mMRA to observe the microvasculature include the ability to distinguish air-tissue interfaces, a high vessel-to-tissue contrast, and not being affected by damage to the blood-brain barrier. A stroke model was used to demonstrate the ability of 3D gas ΔR2*-mMRA to provide information about poststroke revascularization at 3 days after reperfusion. However, this technique has some limitations that cannot be overcome and hence should be considered when it is applied, such as magnifying vessel sizes and predominantly revealing venous vessels.
- Published
- 2013
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34. Differentiation of schizophrenia patients from healthy subjects by mismatch negativity and neuropsychological tests.
- Author
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Yi-Ting Lin, Chih-Min Liu, Ming-Jang Chiu, Chen-Chung Liu, Yi-Ling Chien, Tzung-Jeng Hwang, Fu-Shan Jaw, Jia-Chi Shan, Ming H Hsieh, and Hai-Gwo Hwu
- Subjects
Medicine ,Science - Abstract
BACKGROUND: Schizophrenia is a heterogeneous disorder with diverse presentations. The current and the proposed DSM-V diagnostic system remains phenomenologically based, despite the fact that several neurobiological and neuropsychological markers have been identified. A multivariate approach has better diagnostic utility than a single marker method. In this study, the mismatch negativity (MMN) deficit of schizophrenia was first replicated in a Han Chinese population, and then the MMN was combined with several neuropsychological measurements to differentiate schizophrenia patients from healthy subjects. METHODOLOGY/PRINCIPAL FINDINGS: 120 schizophrenia patients and 76 healthy controls were recruited. Each subject received examinations for duration MMN, Continuous Performance Test, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale Third Edition (WAIS-III). The MMN was compared between cases and controls, and important covariates were investigated. Schizophrenia patients had significantly reduced MMN amplitudes, and MMN decreased with increasing age in both patient and control groups. None of the neuropsychological indices correlated with MMN. Predictive multivariate logistic regression models using the MMN and neuropsychological measurements as predictors were developed. Four predictors, including MMN at electrode FCz and three scores from the WAIS-III (Arithmetic, Block Design, and Performance IQ) were retained in the final predictive model. The model performed well in differentiating patients from healthy subjects (percentage of concordant pairs: 90.5%). CONCLUSIONS/SIGNIFICANCE: MMN deficits were found in Han Chinese schizophrenia patients. The multivariate approach combining biomarkers from different modalities such as electrophysiology and neuropsychology had a better diagnostic utility.
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- 2012
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35. Simulation of a real-time dual-loop control system for high-quality personalized cardiopulmonary resuscitation.
- Author
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Chih-Wei Sung, Wei-Tien Chang, Wei-Yu Chen, Fu-Shan Jaw, and Jiann-Shing Shieh
- Published
- 2023
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36. Pneumoretroperitoneum, pneumoperitoneum, pneumomediastinum and pneumopericardium in an elderly woman with rupture of diverticulitis
- Author
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Luo, Rong-Rong, primary, Fu-Shan, Jaw, additional, and Hsieh, Chien-Chieh, additional
- Published
- 2023
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37. Smartphone-based fall detection algorithm using feature extraction.
- Author
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Yu-Wei Hsu, Kuang-Hsuan Chen, Jing-Jung Yang, and Fu-Shan Jaw
- Published
- 2016
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38. Ultrasound Guidance for Full Endoscopic Spinal Surgery: A Technical Note
- Author
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Chien-Hua Chen, Chien-Min Chen, Fu-Shan Jaw, Jia-Zhen Hu, and Guan-Chyuan Wang
- Subjects
Endoscopes ,Humans ,Endoscopy ,Surgery ,Neurology (clinical) ,Spinal Puncture ,Neurosurgical Procedures ,Spine - Abstract
The use of intraoperative ultrasound (IOU) has proven to be useful in spinal surgery. In this study, we present the techniques of applying IOU in cervical, thoracic, and lumbar full-endoscopic spine surgery (FESS).For applying IOU in cervical FESS, first, we localize the surgical level by identifying the unique shape of C6 and C7 under ultrasound and then identify the cervical level subsequently. For the anterior approach, the endoscope passes through the cervical fascia between the carotid sheath and trachea/esophagus, which can be identified under ultrasound, and for the posterior approach, the endoscope docks on the facet joint under ultrasound. For applying IOU in thoracic FESS, we localize the surgical level by counting the ribs. The endoscope is advanced to the neural foramen under ultrasound without entering the pleural cavity. For applying IOU in lumbar FESS, we identify the surgical level by counting the interlaminar window from the sacrum. The endoscopic sheath is advanced to the neural foramen under ultrasound without entering the peritoneal cavity.The use of IOU in FESS has the potential to reduce radiation exposure, reach a higher successful puncture rate, and decrease the operation time. Furthermore, IOU prevents radiolucent organs from damage during FESS.We present the techniques of applying IOU in cervical, thoracic, and lumbar endoscopic spine surgery and hope that this will be helpful for physicians to master the IOU techniques.
- Published
- 2022
39. TEE and REBOA for non-traumatic cardiac arrest
- Author
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Chih-Hsuan, Chen, primary, Chen, Jiashan, additional, Jeng-Tang, Sun, additional, Hsieh, Chia-Ying, additional, Fu-Shan, Jaw, additional, and Hsieh, Chien-Chieh, additional
- Published
- 2023
- Full Text
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40. Data from Cigarette Smoke Containing Acrolein Contributes to Cisplatin Resistance in Human Bladder Cancers through the Regulation of HER2 Pathway or FGFR3 Pathway
- Author
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Hsiang-Tsui Wang, Hsiao-Wei Cheng, Fu-Shan Jaw, Chih-Hung Chiang, Chao-Yuan Huang, Cheng-Yu Huang, Yu-Chuan Lu, Tung-En Wei, Zhen-Jie Tong, and Jian-Hua Hong
- Abstract
Cisplatin-based chemotherapy is the first-line therapy for bladder cancer. However, cisplatin resistance has been associated with the recurrence of bladder cancer. Previous studies have shown that activation of FGFR and HER2 signaling are involved in bladder cancer cell proliferation and drug resistance. Smoking is the most common etiologic risk factor for bladder cancer, and there is emerging evidence that smoking is associated with cisplatin resistance. However, the underlying mechanism remains elusive. Acrolein, a highly reactive aldehyde, is abundant in tobacco smoke, cooking fumes, and automobile exhaust fumes. Our previous studies have shown that acrolein contributes to bladder carcinogenesis through the induction of DNA damage and inhibition of DNA repair. In this study, we found that acrolein induced cisplatin resistance and tumor progression in both non–muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC) cell lines RT4 and T24, respectively. Activation of HER2 and FGFR3 signaling contributes to acrolein-induced cisplatin resistance in RT4 and T24 cells, respectively. Furthermore, trastuzumab, an anti-HER2 antibody, and PD173074, an FGFR inhibitor, reversed cisplatin resistance in RT4 and T24 cells, respectively. Using a xenograft mouse model with acrolein-induced cisplatin-resistant T24 clones, we found that cisplatin combined with PD173074 significantly reduced tumor size compared with cisplatin alone. These results indicate that differential molecular alterations behind cisplatin resistance in NMIBC and MIBC significantly alter the effectiveness of targeted therapy combined with chemotherapy. This study provides valuable insights into therapeutic strategies for cisplatin-resistant bladder cancer.
- Published
- 2023
41. Supplementary Figure from Cigarette Smoke Containing Acrolein Contributes to Cisplatin Resistance in Human Bladder Cancers through the Regulation of HER2 Pathway or FGFR3 Pathway
- Author
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Hsiang-Tsui Wang, Hsiao-Wei Cheng, Fu-Shan Jaw, Chih-Hung Chiang, Chao-Yuan Huang, Cheng-Yu Huang, Yu-Chuan Lu, Tung-En Wei, Zhen-Jie Tong, and Jian-Hua Hong
- Abstract
Supplementary Figure from Cigarette Smoke Containing Acrolein Contributes to Cisplatin Resistance in Human Bladder Cancers through the Regulation of HER2 Pathway or FGFR3 Pathway
- Published
- 2023
42. <scp>NKG2A</scp> and circulating extracellular vesicles are key regulators of natural killer cell activity in prostate cancer after prostatectomy
- Author
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Yu‐Chuan Lu, Chen‐Hsun Ho, Jian‐Hua Hong, Ming‐Chieh Kuo, Yi‐An Liao, Fu‐Shan Jaw, Jason Chia‐Hsien Cheng, Chao‐Yuan Huang, Ko‐Ping Chang, Chung‐Hsin Chen, Jung‐An Lin, An Hsiao, and Hsiu‐Ni Kung
- Subjects
Cancer Research ,Oncology ,Genetics ,Molecular Medicine ,General Medicine - Published
- 2023
43. Author response for '<scp>NKG2A</scp> and circulating extracellular vesicles are key regulators of natural killer cell activity in prostate cancer after prostatectomy'
- Author
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null Yu‐Chuan Lu, null Chen‐Hsun Ho, null Jian‐Hua Hong, null Ming‐Chieh Kuo, null Yi‐An Liao, null Fu‐Shan Jaw, null Jason Chia‐Hsien Cheng, null Chao‐Yuan Huang, null Ko‐Ping Chang, null Chung‐Hsin Chen, null Jung‐An Lin, null An Hsiao, and null Hsiu‐Ni Kung
- Published
- 2023
44. Comparison of Support-Vector Machine and Sparse Representation Using a Modified Rule-Based Method for Automated Myocardial Ischemia Detection.
- Author
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Yi-Li Tseng, Keng-Sheng Lin, and Fu-Shan Jaw
- Published
- 2016
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45. Quantitative measurement of Parkinsonian gait from walking in monocular image sequences using a centroid tracking algorithm.
- Author
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Sheng-Huang Lin, Shih-Wei Chen, Yu-Chun Lo, Hsin-Yi Lai, Chich-Haung Yang, Shin-Yuan Chen, Yuan-Jen Chang, Chin-Hsing Chen, Wen-Tzeng Huang, Fu-Shan Jaw, You-Yin Chen, Siny Tsang, and Lun-De Liao
- Published
- 2016
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46. A model study of resonance effect on ocular vestibular-evoked myogenic potential
- Author
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Yi-Ho Young, Kuei-You Lin, and Fu-Shan Jaw
- Subjects
Medicine (General) ,Air volume ,business.industry ,Model study ,Vestibular evoked myogenic potential ,Acceleration ,Magnitude (mathematics) ,General Medicine ,Vibration ,Spherical model ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Ocular vestibular-evoked myogenic potential ,Resonance effect ,030220 oncology & carcinogenesis ,Humans ,Medicine ,030211 gastroenterology & hepatology ,business ,Frontal sinus ,Biomedical engineering - Abstract
Background/Purpose This study measured the acceleration magnitude using a dummy model filled with various air-material ratios to elucidate the mechanism of resonance effect on ocular vestibular-evoked myogenic potential (oVEMP). Methods With the percentages of air volume altered by filling various materials (water, glycerol, or ethanol) in an acrylic-made hollow spherical model, a minishaker was utilized to deliver vibration stimuli to the model. Then, acceleration magnitude of each model was measured. Results Since the air was most occupied at the upper part of the model (z-axis), acceleration magnitude along the z-axis was selected for comparison. An increasing trend of the z-axis acceleration magnitude ranging 0.110–0.759 g was identified in air–water model with air volume percentage ranged 40–100%. On the other hand, a significant increasing trend of acceleration magnitude along the z-axis (0.157–0.759 g) was noted in air-glycerol model with 80–100% of air volume. While in air-ethanol model, a significant increasing trend in acceleration magnitude along the z-axis ranged 0.121–0.759 g correlating with 40–100% of air volume. Conclusion The mechanism for eliciting oVEMP is via the first-order bone vibration coupled with the second-order resonance effect. Both percentage of air volume (i.e. frontal sinus) and density of filling media (i.e. skull property) may contribute to the resonance effect, which then increases the acceleration magnitude so as to enhance the elicitation of oVEMP.
- Published
- 2022
47. The hypoxia-age-shock index at triage to predict the outcomes of Covid-19 patients
- Author
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Chien-Chieh Hsieh, Chia-yu Liu, Kuang-Chau Tsai, Fu-Shan Jaw, and Jiashan Chen
- Subjects
Emergency Medicine ,General Medicine - Abstract
The coronavirus disease 2019 (COVID-19) outbreak has caused a severe burden on medical professionals, as the rapid disposition of patients is important. Therefore, we aimed to develop a new clinical assessment tool based on the shock index (SI) and age-shock index (ASI). We proposed the hypoxia-age-shock index (HASI) and determined the usability of triage for COVID-19 infected patients in the first scene.The predictive power for three indexes on mortality, intensive care unit (ICU) admission, and endotracheal intubation rate was evaluated using the receiver operating curve (ROC). We used DeLong's method for comparing the ROCs.The area under the curve (AUC) for ROC on mortality for SI, ASI, and HASI were 0.546, 0.771, and 0.773, respectively. The AUC on ICU admission mortality for SI, ASI, and HASI were 0.581, 0.700, and 0.743, respectively. The AUC for intubation for SI, ASI, and HASI were 0.592, 0.708, and 0.757, respectively. The AUC differences between HASI and SI showed statistically significant (P = 0.001) results on mortality, ICU admission, and intubation. Additionally, statistically significant results were found for the AUC difference between the HASI and ASI on ICU admission and intubation (P = 0.001 and P = 0.004, respectively).HASI can provide a better prediction compared to ASI on ICU admission and endotracheal intubation. HASI was more sensitive in mortality, ICU admission, and intubation prediction than the ASI.
- Published
- 2022
48. Lung abscess with chronic cough secondary to xanthogranulomatous pyelonephritis: A rare case report
- Author
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Pai-Yu Cheng, Yi-You Huang, Fu-Shan Jaw, and Shiu-Dong Chung
- Subjects
General Medicine - Published
- 2023
49. Intelligent Content-Aware Model-Free Low Power Evoked Neural Signal Compression.
- Author
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Chen-Han Chung, Yu-Chieh Kao, Liang-Gee Chen, and Fu-Shan Jaw
- Published
- 2008
- Full Text
- View/download PDF
50. The Development of Wireless Sensor Network for ECG Monitoring.
- Author
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Jun-Liang Lin, Hsien-Chieh Liu, Yu-Ting Tai, Hsin-Hsien Wu, Shuo-Jen Hsu, Fu-Shan Jaw, and You-Yin Chen
- Published
- 2006
- Full Text
- View/download PDF
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