輔仁醫學期刊/Fu-Jen Journal of Medicine
輔仁大學醫學院,正常發行
選擇卷期
- 期刊
Background and purpose: With advancements in technology, computer use is becoming ubiquitous. The present study developed a computer-based short-term memory (CBSTM) test for screening for mild cognitive impairment (MCI). The study was designed to assess the psychometric properties of the CB-STM test, including temporal reliability and concurrent validity. Methods: The study sample comprised 69 elderly participants (age: 60- 94 years), including 17 patients with mild possible dementia, 22 patients with MCI, and 30 normal controls (NCs). Results: The CB-STM test demonstrated adequate test-retest reliability (.75) and high internal consistency (.83-.85), as well as adequate sensitivity and specificity for differentiating between the NC, MCI, and mild possible dementia groups. Conclusions: Twenty points in the CB-STM test is suggested to generate sufficient balance sensitivity (76%) and specificity (73%) for differentiating between NCs and patients with MCI, and 13 points is suggested to generate sufficient sensitivity (77%) and specificity (77%) for distinguishing between patients with MCI and those with Alzheimer disease.
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Back ground and purpose: The existence of the septum within the first compartment of wrists may be a risk factor of developing de Quervain's disorder. In order to figure out the relationship between the variations in the first compartment and de Quervain's disease, the prime question is the prevalence of normal variations in normal population. Previous studies of the prevalence were mostly based on the studies of cadava anatomy. Furthermore, few studies have been conducted to compare bilateral wrist variations. This study aims to investigate the anatomic variations and bilateral wrist first compartments variation by ultrasonography. Methods: A cross-sectional study was conducted by using the ultrasound to identify the existence of the septum within the first extensor compartment in the wrists. To ensure all kinds of wrist anatomic variations, 24 participants (12 male, 12 female) with and without DQ was recruited. We used the criteria of Kwon's research to detect the presence of a septum in the first extensor compartment. Results: Among the 24 participants, the prevalence of the septum within the first extensor compartment was 70.8% and the prevalence of bilateral septum was 54.2%. There was a discrepancy in the first extensor compartment between the bilateral wrists in 4 participants; the prevalence rate was 16.7%. Conclusions: Ultrasonographic examination is a good way to detect the existence of septum between APL and EPB. The prevalence rate of septum was high in this study. Compared with previous research, the existence of septum was the risk factor of de Duervain's disease and further evaluating the anatomic variations was warranted among those patients due to the variation of bilateral wrists. Furthermore, due to the high prevalence of bilateral septum, home education of reducing the work loading of affected wrist with subsequently increasing the burden of the unaffected wrist might be a risk factor of subsequent DQ attack in the unaffected wrists. Therefore we suggested that bilateral wrists ultrasonographic examination of DQ patients should be taken subsequent DQ attack of the unaffected wrists.
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Traditionally, up to six incisions are required for video-assisted thoracoscopic surgery (VATS) for bilateral lung tumor resection. Besides, change posture was required during operation. In this case report, a single-incision subxiphoid approach was used for VATS to shorten operation time and reduce postoperative pain; this approach may also lead to better cosmetic results. However, in the described case, after a right-side tumor was removed, an episode of desaturation due to right-side tension pneumothorax was observed during one-lung ventilation for left lung tumor resection. CO2 insufflation was ceased, and the patient's condition improved. A literature review and suggestions for future similar surgeries are discussed.
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A 58-year-old woman suffered from odynophagia with left shoulder pain 1 day after swallowing a piece of fish bone. Neck computed tomography (CT) revealed a linear calcific obstacle anterior to the C2 and C3 vertebral bodies, buried near the left transverse foramen and vertebral artery. Foreign body impaction in uncommon sites cannot be detected by a routine physical examination or plain radiography. In this case report, we discuss the value of using CT to diagnose foreign body impactions with atypical clinical presentation.
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Metastases to the spine are a common manifestation of breast cancer considerably reducting the quality of life. Surgeon must consider various available approaches for decreasing pain, reducing tumor burden, ensuring spinal stability and treating neurological disorders. Intradural lesions are rare, accounting for only 5% of spinal metastases. This case was a 57-year-old female with a history of breast cancer and an intradural extramedullary lesion at the T3-4 level of the thoracic spine. She had suffered from left hip numbness and lower left limb weakness for 2 weeks. After completion of T2-3-4 decompressive laminectomy with complete removal of the tumor, her left hip numbness was relieved and lower left limb muscle strength improved. Intradural metastases are rare and often associated with limited survival time and focal neurological deficits. In this case, the patient experienced marked improvement to her neurological deficit through decompression surgery and resection of the tumor.
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Solitary fibrous tumors were previously referred to as localized mesotheliomas or pleural fibromas but were later defined as a submesothelial mesenchymal rather than a mesothelial neoplasm. These tumors are rare neoplasms that most frequently occur in the pleura but can be encountered in many other parts of the body. We describe a case of a 54-year-old man with dyspnea on exertion who underwent surgical resection of a solitary fibrous tumor from the right anterior mediastinum. Computed tomography and angiography imaging studies were used in presurgical survey and tumor embolization. We provided a valuable experirence for the image features of solitary fibous tumor were rarely discussed.
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Airway mucus secretion from submucosal gland cells (SMGC) plays an important role in protecting the respiratory system from pathogens and particles. However, mucus hypersecretion is a common pathophysiological characteristic of many chronic inflammatory pulmonary diseases such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, and asthma that can lead to airway obstruction and impaired gas exchange, and if serious enough even plug the airways, possibly leading to death. Both hyperplasias of submucusosal glands and increased sensitivity of SMGC to various secretagogues such as neurotransmitters and hormones play roles in mucus hypersecretion. Acute increases in mucus release are the result of sensitization of SMGC. Therefore, understanding the mechanisms of mucus secretion and its sensitization will provide potential targets for therapies that would be beneficial in the treatment of chronic inflammatory lung diseases. The submucosal gland is comprised of serous cell and mucous cell ascini. Serous cells secrete water, electrolytes and some mucin, while mucous cells secrete mainly mucin but also some fluid. Mucin, a highly glycosylated protein, is the main macromolecular component of airway-secreted mucus. It forms high molecular weight chains that are packaged within SMGC in vesicles that are released by exocytosis upon activation of the SMGC by a stimulus. An increase in intracellular Ca^(2+) is required for ion movement and evoked mucin release stimulated by secretagogues such as acetylcholine (Ach), histamine, or ATP. In SMGC, membrane receptor activation induces Ca^(2+) release from internal stores and subsequent Ca^(2+) influx through store-operated Ca^(2+) channels (SOC) or receptor- operated channels (ROC).