19 results on '"Patricia Wanping Wu"'
Search Results
2. Diagnosis of a single gallbladder with double cystic ducts and dominant accessory duct draining into the right hepatic duct: a case report
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Cheng-Hsien Wu, Patricia Wanping Wu, Yon-Cheong Wong, and Shih-Ching Kang
- Subjects
Medicine (General) ,R5-920 - Abstract
Biliary anomalies are a high risk for biliary injury during surgery, and although a biliary anomaly is occasionally encountered, variations in cystic ducts are rare. A preoperative diagnosis is highly valuable in facilitating surgical procedures and avoiding surgical complications. Herein, the case of a 67-year-old female patient with acute cholecystitis, in which preoperative fluoroscopic cholangiography clearly demonstrated a single gallbladder with double cystic ducts, is presented. The accessory duct was found to be dominant, draining into the otherwise normal right intrahepatic bile duct, and laparoscopic cholecystectomy was performed smoothly and successfully. Fluoroscopic cholangiography is a powerful tool that may clearly depict the anomaly of a single gallbladder with double cystic ducts. Through appropriate preoperative knowledge and demonstration of this biliary anomaly in the present case, laparoscopic cholecystectomy was safely performed, and the patient was symptom-free at the 3-year follow-up assessment.
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- 2021
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3. Effects of High-Resolution CT Changes on Prognosis Predictability in Acute Respiratory Distress Syndrome with Diffuse Alveolar Damage
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Ching-Ying Huang, Patricia Wanping Wu, Yon-Cheong Wong, Kuo-Chin Kao, and Chung-Chi Huang
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acute respiratory distress syndrome ,diffuse alveolar damage ,high-resolution computed tomography ,traction bronchiectasis ,mechanical power ,Medicine - Abstract
Diffuse alveolar damage (DAD) is the pathological hallmark of acute respiratory distress syndrome (ARDS). DAD is independently correlated with higher mortality compared with the absence of DAD. Traction bronchiectasis in areas of ground-glass opacity or consolidation is associated with the late fibroproliferative or fibrotic phase of DAD. This study examined whether the 60-day mortality related to DAD could be predicted using high-resolution computed tomography (HRCT) findings and HRCT scores. A total of 34 patients with DAD who received HRCT within 7 days of ARDS diagnosis were enrolled; they were divided into a 60-day survival group and a nonsurvival group, with 17 patients in each group. Univariate and multivariate binary regression analyses and the receiver operating characteristic curve revealed that only the total percentage of the area with traction bronchiectasis or bronchiolectasis was an independent predictor of 60-day mortality (odds ratio, 1.067; 95% confidence interval (CI), 1.011–1.126) and had favorable predictive performance (area under the curve (AUC): 0.784; 95% CI, 0.621–0.946; cutoff, 21.7). Physiological variables, including age, days from ARDS to HRCT, the sequential organ failure assessment (SOFA) score, the PaO2/fraction of inspired oxygen (FiO2) ratio, dynamic driving pressure, and dynamic mechanical power, were not discriminative between 60-day survival and nonsurvival. In conclusion, the extent of fibroproliferation on HRCT in early ARDS, presented as the total percentage of area with bronchiectasis or bronchiolectasis, is an independent positive predictor with a favorable predictive ability for the 60-day mortality of DAD.
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- 2022
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4. Added Value of Computed Tomography Virtual Intravascular Endoscopy in the Evaluation of Coronary Arteries with Stents or Plaques
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Patricia Wanping Wu, Pei-Kwei Tsay, Zhonghua Sun, Syu-Jyun Peng, Chia-Yen Lee, Ming-Yi Hsu, Yu-Shien Ko, I-Chang Hsieh, Ming-Shien Wen, and Yung-Liang Wan
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coronary artery disease (CAD) ,coronary computed tomography angiography (CCTA) ,virtual intravascular endoscopy (VIE) ,coronary stent ,coronary calcification ,Medicine (General) ,R5-920 - Abstract
Coronary computed tomography angiography (CCTA) is a widely used imaging modality for diagnosing coronary artery disease (CAD) but is limited by a high false positive rate when evaluating coronary arteries with stents and heavy calcifications. Virtual intravascular endoscopy (VIE) images generated from CCTA can be used to qualitatively assess the vascular lumen and might be helpful for overcoming this challenge. In this study, one hundred subjects with coronary stents underwent both CCTA and invasive coronary angiography (ICA). A total of 902 vessel segments were analyzed using CCTA and VIE. The vessel segments were first analyzed on CCTA alone. Then, using VIE, the segments were classified qualitatively as either negative or positive for in-stent restenosis (ISR) or CAD. These results were compared, using ICA as the reference, to determine the added diagnostic value of VIE. Of the 902 analyzed vessel segments, CCTA/VIE had sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (shown in %) of 93.9/90.2, 96.2/98.2, 96.0/97.7, 70.0/83.1, and 99.4/99.0, respectively, in diagnosing ISR or CAD, with significantly improved specificity (p = 0.025), accuracy (p = 0.046), and positive predictive value (p = 0.047). VIE can be a helpful addition to CCTA when evaluating coronary arteries.
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- 2022
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5. Thymic Langerhans’ cell histiocytosis
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Hung-Hsien Liu, Yu-Jie Wu, Chao-Ping Yang, Patricia WanPing Wu, Chao-Jan Wang, and Chih-Chen Chang
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Pediatrics ,RJ1-570 - Published
- 2020
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6. The Use of Artificial Intelligence in the Differentiation of Malignant and Benign Lung Nodules on Computed Tomograms Proven by Surgical Pathology
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Yung-Liang Wan, Patricia Wanping Wu, Pei-Ching Huang, Pei-Kwei Tsay, Kuang-Tse Pan, Nguyen Ngoc Trang, Wen-Yu Chuang, Ching-Yang Wu, and ShihChung Benedict Lo
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computer-aided detection and analyzer ,artificial intelligence ,CT ,lung cancer screening ,vessel suppression ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The purpose of this work was to evaluate the performance of an existing commercially available artificial intelligence (AI) software system in differentiating malignant and benign lung nodules. The AI tool consisted of a vessel-suppression function and a deep-learning-based computer-aided-detection (VS-CAD) analyzer. Fifty patients (32 females, mean age 52 years) with 75 lung nodules (47 malignant and 28 benign) underwent low-dose computed tomography (LDCT) followed by surgical excision and the pathological analysis of their 75 nodules within a 3 month time frame. All 50 cases were then processed by the AI software to generate corresponding VS images and CAD outcomes. All 75 pathologically proven lung nodules were well delineated by vessel-suppressed images. Three (6.4%) of the 47 lung cancer cases, and 11 (39.3%) of the 28 benign nodules were ignored and not detected by the AI without showing a CAD analysis summary. The AI system/radiologists produced a sensitivity and specificity (shown in %) of 93.6/89.4 and 39.3/82.1 in distinguishing malignant from benign nodules, respectively. AI sensitivity was higher than that of radiologists, though not statistically significant (p = 0.712). Specificity obtained by the radiologists was significantly higher than that of the VS-CAD AI (p = 0.003). There was no significant difference between the malignant and benign lesions with respect to age, gender, pure ground-glass pattern, the diameter and location of the nodules, or nodules p = 0.001 and
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- 2020
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7. Subtracted Computed Tomography Angiography in the Evaluation of Coronary Arteries With Severe Calcification or Stents Using a 320-Row Computed Tomography Scanner
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Chun-Chieh Wang, Patricia Wanping Wu, Pei-Kwei Tsay, Chun-Chi Chen, Yung-Liang Wan, and Cheng-Hong Toh
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Male ,Pulmonary and Respiratory Medicine ,Tomography Scanners, X-Ray Computed ,Computed Tomography Angiography ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Sensitivity and Specificity ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Restenosis ,Predictive Value of Tests ,Computed tomography scanner ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Vascular Calcification ,Aged ,Computed tomography angiography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Significant difference ,Angiography, Digital Subtraction ,Reproducibility of Results ,Middle Aged ,equipment and supplies ,medicine.disease ,Coronary Vessels ,Invasive coronary angiography ,Coronary arteries ,medicine.anatomical_structure ,Female ,Stents ,business ,Nuclear medicine ,Calcification - Abstract
PURPOSE Coronary computed tomography angiography (CCTA) has its limitations in evaluating arteries with stents or heavy calcification. This study compares the diagnostic performance of subtracted coronary computed tomography angiography (SCCTA) and nonsubtracted coronary computed tomography angiography (NSCCTA) in evaluating coronary artery disease (CAD) and in-stent restenosis (ISR). MATERIALS AND METHODS Twelve patients with stents and 20 patients with heavy coronary calcifications (total Agatston's score >400) underwent both SCCTA and invasive coronary angiography (ICA) with an interval of
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- 2020
8. Trans-Arterial Embolization On A Catastrophic Primary Postpartum Hemorrhage Due To Arterial Aneurysm With Arteriovenous Fistula At Bilateral Lower Vagina: A Case Report
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Yon-Cheong Wong, Patricia Wanping Wu, Cheng-Hsien Wu, and Ho-Yen Chueh
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medicine.medical_specialty ,Lower vagina ,Primary postpartum hemorrhage ,business.industry ,Arterial Embolization ,medicine ,Arterial aneurysm ,Arteriovenous fistula ,medicine.disease ,business ,Surgery - Abstract
Background: Failure of the primary management at controlling the post-partum hemorrhage (PPH) is occasionally encountered. A catastrophic cause of PPH as vagina arterial aneurysms with AVF is rare and not reported in English literature.Case presentations: We present a 34-year-old woman of arterial aneurysms with arteriovenous fistulas (AVF) at bilateral lower vagina causing intractable PPH with aggressive bleeding. By trans-arterial embolization (TAE) the bleeding is successfully controlled, and patient then could recover smoothly.Conclusion: These vascular anomalies being fierce culprit of the PPH would result in primary management failure. Knowledge of the possible etiology of post-partum hemorrhage is crucial for treatment management. This case report aims to point out a pivotal role of TAE at detecting and treating this unusual cause of PPH.
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- 2021
9. Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception
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Hsiang-Ju Hsiao, Chao-Jan Wang, Chien-Chung Lee, Yi-Chen Hsin, Sze-Yuen Yau, Shih-Yen Chen, Wan-Chak Lo, Patricia-Wanping Wu, Chyi-Liang Chen, and Yi-Jung Chang
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Abdominal pain ,Pediatrics ,medicine.medical_specialty ,diagnosis ,education ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Intussusception (medical disorder) ,medicine ,point-of-care system ,Original Research ,intussusception ,child ,business.industry ,lcsh:RJ1-570 ,030208 emergency & critical care medicine ,lcsh:Pediatrics ,ultrasonography ,medicine.disease ,Bloody ,Diarrhea ,Pediatrics, Perinatology and Child Health ,Vomiting ,Observational study ,medicine.symptom ,Ultrasonography ,business ,Cohort study - Abstract
Aim: Intussusception, the most common abdominal emergency in early childhood, is frequently misdiagnosed at initial presentation. The effect of using point-of-care ultrasonography (POCUS) by emergency medicine physicians on pediatric intussusception misdiagnosis rate remains unclear. Here, we summarize outcomes and misdiagnoses before and after training junior and senior physicians on using POCUS for diagnosing intussusception and compared their performance levels.Materials and Methods: This observational cohort analysis included patients with suspected intussusception who visited a pediatric emergency department (ED) between January 2017 and December 2019. All enrolled patients were evaluated by junior (Results: Of the 167 enrolled patients, 130 were confirmed to have intussusception by air reduction. Misdiagnosis rate was significantly lower in the post-training patient group after training than in the pre-training patient group (43.7 vs. 12.7%, P < 0.001). After training, fewer misdiagnoses were made by the junior (59.1 vs. 25.9%, P = 0.003) and senior (31.7 vs. 0%, P < 0.001) physicians. In the post-training patient group, the door-to-reduction time and rate of ultrasonography consultation with an expert also decreased significantly (118.2 ± 124.5 vs. 198 ± 250.2 min, P = 0.006). Abdominal pain (80.9%) was the most common symptom of intussusception, followed by vomiting (58.3%), fever (17.8%), bloody stool (15.4%), and diarrhea (14.2%). Even after training, the presenting symptoms of intussusception often leading junior physicians to misdiagnosis were diarrhea and fever.Conclusions: A brief POCUS training leads to decreased misdiagnosis rates in both the senior and junior physicians. Junior physicians should increase their awareness regarding diarrhea and fever being the presenting symptoms of intussusception, particularly in early childhood. Combining clinical judgment and POCUS results forms the core principle of the evaluation of children with intussusception.
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- 2021
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10. Thymic Langerhans' cell histiocytosis
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Chao-Jan Wang, Patricia Wanping Wu, Chao-Ping Yang, Yu-Jie Wu, Chih-Chen Chang, and Hung-Hsien Liu
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Pathology ,medicine.medical_specialty ,Langerhans cell histiocytosis ,business.industry ,Pediatrics, Perinatology and Child Health ,lcsh:RJ1-570 ,Medicine ,lcsh:Pediatrics ,business ,medicine.disease - Published
- 2020
11. Impact of filter convolution and displayed field of view on estimation of coronary Agatston scores in low-dose lung computed tomography
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Chih-Sheng Yeh, Chung-Yin Lin, Hui-Yu Tsai, Patricia Wanping Wu, Chun Hua Wang, Pei-Kwei Tsay, Chun-Chi Chen, Yung-Liang Wan, and Yu-Hsiang Juan
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Male ,medicine.medical_specialty ,Computed tomography ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,Convolution ,Coronary artery disease ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Prospective Studies ,Vascular Calcification ,Lung ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Low dose ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Coronary artery calcification ,Female ,Radiology ,Tomography ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine - Abstract
Coronary artery calcification (CAC) may be quantified on low-dose computed tomography (CT) of the lung (LDCT). This study aims to evaluate the effects of filter convolution (FC) and displayed field of view (dFOV) in a Toshiba 320-row CT scanner in quantifying CAC, and to compare the CAC scores obtained by LDCT with standard cardiac CT.Fifty subjects (52 to 85years, mean 68.5, 36 males) with visible CAC underwent both standard cardiac CT and LDCT. CAC scores were obtained from standard cardiac CT using conventional FC12(22) (FC12 with 22-cm dFOV) and four different LDCT protocols: FC02(22), FC02(40), FC08(22), and FC08(40). CAC scores obtained by each LDCT protocol were compared with those obtained by standard cardiac CT.CAC scores obtained by all four LDCT protocols were well correlated with those by standard protocol (Pearson's coefficient=0.978 to 0.987, p0.001; kappa=0.731 to 0.836, p0.001). CAC scores obtained by FC08(22) showed the best agreement with standard cardiac CT (kappa=0.836, p0.001). Under fixed dFOV, CAC scores in FC08 were significantly higher than in FC02 (p0.001). Under fixed FC, CAC scores were significantly higher in 22-cm dFOV than in 40-cm dFOV (p≤0.006).Both FC and dFOV have significant impact on CAC scoring. To obtain reliable data, consistent parameters should be employed when quantifying CAC using LDCT. In a Toshiba 320-row CT scanner, CAC scores obtained by FC08(22) agree well with standard cardiac CT.
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- 2017
12. Congenital tuberculosis: case report and review of the literature
- Author
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Patricia Wanping Wu, Kin-Sun Wong, Chih-Chen Chang, Chao-Jan Wang, Chih-Hua Yeh, and Ching-Wen Chang
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Miliary tuberculosis ,Pediatrics ,medicine.medical_specialty ,Tuberculosis ,medicine.medical_treatment ,Antitubercular Agents ,Polymerase Chain Reaction ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Ascites ,medicine ,Humans ,030212 general & internal medicine ,Bacteriological Techniques ,Respiratory distress ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Mycobacterium tuberculosis ,medicine.disease ,Gastric lavage ,Treatment Outcome ,Pediatrics, Perinatology and Child Health ,Sputum ,Female ,Radiography, Thoracic ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Chest radiograph ,Congenital tuberculosis - Abstract
Congenital tuberculosis is rare, even where tuberculosis (TB) is endemic. A 14-day-old girl presented with a 3-day history of fever and respiratory distress. Her mother was diagnosed with a disseminated TB infection immediately after the delivery which was confirmed by a positive TB-polymerase chain reaction (TB-PCR) and subsequent culture from ascites and sputum. The infant was separated from her mother at birth. Her chest radiograph showed bilateral miliary nodules. Congenital TB was strongly suspected because of the symptoms, signs and maternal TB history, and was confirmed by TB-PCR and culture from the gastric lavage. Timely administration of standard anti-TB therapy resulted in a good outcome. The case highlights the importance of maternal TB history and typical miliary pattern on chest radiography for early diagnosis of congenital or neonatal TB which in turn facilitates prompt treatment and the prognosis.
- Published
- 2017
13. The Use of Artificial Intelligence in the Differentiation of Malignant and Benign Lung Nodules on Computed Tomograms Proven by Surgical Pathology
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Pei-Kwei Tsay, Wen-Yu Chuang, Kuang-Tse Pan, Pei-Ching Huang, Yung-Liang Wan, Ching-Yang Wu, ShihChung Benedict Lo, Nguyen Ngoc Trang, and Patricia Wanping Wu
- Subjects
Cancer Research ,lcsh:RC254-282 ,Article ,030218 nuclear medicine & medical imaging ,Surgical pathology ,03 medical and health sciences ,0302 clinical medicine ,Statistical significance ,lung cancer screening ,medicine ,Lung cancer ,Prospective cohort study ,Pathological ,computer-aided detection and analyzer ,Lung ,business.industry ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,artificial intelligence ,medicine.disease ,vessel suppression ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Tomography ,Artificial intelligence ,business ,Lung cancer screening ,CT - Abstract
The purpose of this work was to evaluate the performance of an existing commercially available artificial intelligence (AI) software system in differentiating malignant and benign lung nodules. The AI tool consisted of a vessel-suppression function and a deep-learning-based computer-aided-detection (VS-CAD) analyzer. Fifty patients (32 females, mean age 52 years) with 75 lung nodules (47 malignant and 28 benign) underwent low-dose computed tomography (LDCT) followed by surgical excision and the pathological analysis of their 75 nodules within a 3 month time frame. All 50 cases were then processed by the AI software to generate corresponding VS images and CAD outcomes. All 75 pathologically proven lung nodules were well delineated by vessel-suppressed images. Three (6.4%) of the 47 lung cancer cases, and 11 (39.3%) of the 28 benign nodules were ignored and not detected by the AI without showing a CAD analysis summary. The AI system/radiologists produced a sensitivity and specificity (shown in %) of 93.6/89.4 and 39.3/82.1 in distinguishing malignant from benign nodules, respectively. AI sensitivity was higher than that of radiologists, though not statistically significant (p = 0.712). Specificity obtained by the radiologists was significantly higher than that of the VS-CAD AI (p = 0.003). There was no significant difference between the malignant and benign lesions with respect to age, gender, pure ground-glass pattern, the diameter and location of the nodules, or nodules <, 6 vs. &ge, 6 mm. However, more part-solid nodules were proven to be malignant than benign (90.9% vs. 9.1%), and more solid nodules were proven to be benign than malignant (86.7% vs. 13.3%) with statistical significance (p = 0.001 and <, 0.001, respectively). A larger cohort and prospective study are required to validate the AI performance.
- Published
- 2020
14. Prognostic impact of peritonitis in hemodialysis patients: A national-wide longitudinal study in Taiwan
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Chee-Jen Chang, Cheng-Chia Lee, Ya-Chung Tian, Yueh-An Lu, Pao-Hsien Chu, Kun-Hua Tu, Chih-Wei Yang, and Patricia Wanping Wu
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Male ,Longitudinal study ,Cirrhosis ,medicine.medical_treatment ,030232 urology & nephrology ,lcsh:Medicine ,Pathology and Laboratory Medicine ,Geographical Locations ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Risk of mortality ,Medicine and Health Sciences ,Longitudinal Studies ,Connective Tissue Diseases ,lcsh:Science ,Multidisciplinary ,Liver Diseases ,Hazard ratio ,Middle Aged ,Nephrology ,030211 gastroenterology & hepatology ,Female ,Hemodialysis ,Research Article ,medicine.medical_specialty ,Asia ,Endocrine Disorders ,Taiwan ,Peritonitis ,Gastroenterology and Hepatology ,Peritoneal dialysis ,03 medical and health sciences ,Signs and Symptoms ,Rheumatology ,Renal Dialysis ,Diagnostic Medicine ,Internal medicine ,Diabetes mellitus ,Medical Dialysis ,medicine ,Diabetes Mellitus ,Humans ,Aged ,business.industry ,lcsh:R ,medicine.disease ,Metabolic Disorders ,People and Places ,lcsh:Q ,business - Abstract
Background Peritonitis has been independently associated with increased morbidity and mortality in peritoneal dialysis patients. However, there are few reports on peritonitis in hemodialysis patients. We aim at investigating both the risk profiles and prognostic impact of peritonitis in hemodialysis patients. Methods This nation-wide longitudinal study uses claims data obtained from the Taiwan National Health Insurance Research Database. A total of 80,733 incident hemodialysis patients of age ≥ 20 years without a history of peritonitis were identified between January 1, 1998 and December 31, 2009. Predictors of peritonitis events were estimated using Cox proportional hazard models. Time-dependent Cox proportional hazard models were used to estimate hazard ratio for mortality attributed to peritonitis exposure. Results Of 80,733 incident hemodialysis patients over a 13-year study period, peritonitis was diagnosed in 935 (1.16%), yielding an incidence rate of 2.91 per 1000 person-years. Female gender, liver cirrhosis and polycystic kidney disease were three of the most significant factors for peritonitis in both non-diabetic and diabetic hemodialysis patients. The cumulative survival rate of patients with peritonitis was 38.8% at 1 year and 10.1% at 5 years. A time-dependent Cox multivariate analysis showed that peritonitis had significantly increased hazard ratio for all cause mortality. Additionally, the risk of mortality remained significantly higher for non-diabetic hemodialysis patients that experienced peritonitis. Conclusions The risk of peritonitis in hemodialysis patients is higher in female gender, liver cirrhosis and polycystic kidney disease. Although peritonitis is a rare condition, it is associated with significantly poorer outcome in hemodialysis patients.
- Published
- 2017
15. Diagnostic Performance on Low Dose Computed Tomography For Acute Appendicitis Among Attending and Resident Radiologists
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Patricia Wanping Wu, Yu-Hsien Lee, Yon-Cheong Wong, Wei Yuan Chen, Chee-Jen Chang, Cheng-Hsien Wu, Huan-Wu Chen, Chih-Chen Chang, Wiwan Irama, and Li-Jen Wang
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medicine.medical_specialty ,Computed tomography ,Education ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Computed Tomography ,0302 clinical medicine ,medicine ,Abdominal Imaging ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Appendicitis ,medicine.disease ,Appendix ,Kowsar ,medicine.anatomical_structure ,Radiation Dose ,Acute appendicitis ,Radiology ,Emergencies ,business ,Body mass index - Abstract
Background: Low-dose computed tomography (LDCT) techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed. Objectives: To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT) and contrast-enhanced standard dose CT (CE-SDCT) for acute appendicitis among attending and resident radiologists. Patients and Methods: This retrospective study included 101 patients with suspected acute appendicitis who underwent NE-LDCT and CE-SDCT. The CT examinations were interpreted and recorded on a five-point scale independently by three attending radiologists and three residents with 4, 1 and 1 years of training. Diagnostic performance for acute appendicitis of all readers on both examinations was represented by area under receiver operating characteristic (ROC) curves. Inter-observer and intra-observer AUC values were compared using Jackknife FROC software on both modalities. The diagnostic accuracy of each reader on NE-LDCT was compared with body mass index (BMI) subgroups and noise using independent T test. Results: Diagnostic performances for acute appendicitis were not statistically different for attending radiologists at both examinations. Better performance was noted on the CE-SDCT with a borderline significant difference (P = 0.05) for senior radiology resident. No statistical difference of AUC values was observed between attending radiologists and fourth year resident on both examinations. Statistically significant differences of AUC values were observed between attending radiologists and first year residents (P = 0.001 ~ 0.018) on NE-LDCT. Diagnostic accuracies of acute appendicitis on NE-LDCT for each reader were not significantly related to BMI or noise. Conclusion: Attending radiologists could diagnose acute appendicitis accurately on NE-LDCT. Performance of senior residents on NE-LDCT is better than junior residents and comparable to attending radiologists.
- Published
- 2016
16. Dental Procedures and the Risk of Infective Endocarditis
- Author
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Lung-Sheng Wu, Pei-Chun Chen, Patricia Wanping Wu, Yu-Sheng Lin, Pao-Hsien Chu, Chee-Jen Chang, Suefang Kung, and Ying-Chang Tung
- Subjects
Adult ,Male ,medicine.medical_specialty ,Observational Study ,Risk Assessment ,Cohort Studies ,Internal medicine ,medicine ,Endocarditis ,Humans ,Antibiotic prophylaxis ,Dental Care ,Aged ,business.industry ,Incidence (epidemiology) ,General Medicine ,Odds ratio ,Antibiotic Prophylaxis ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Infective endocarditis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Dental Scaling ,Female ,business ,Risk assessment ,Cohort study ,Research Article - Abstract
Supplemental Digital Content is available in the text, Infective endocarditis (IE) is an uncommon but potentially devastating disease. Recently published data have revealed a significant increase in the incidence of IE following the restriction on indications for antibiotic prophylaxis as recommended by the revised guidelines. This study aims to reexamine the basic assumption behind the rationale of prophylaxis that dental procedures increase the risk of IE. Using the Longitudinal Health Insurance Database of Taiwan, we retrospectively analyzed a total of 739 patients hospitalized for IE between 1999 and 2012. A case-crossover design was conducted to compare the odds of exposure to dental procedures within 3 months preceding hospitalization with that during matched control periods when no IE developed. In the unadjusted model, the odds ratio (OR) was 0.93 for tooth extraction (95% confidence interval [CI] 0.54–1.59), 1.64 for surgery (95% CI 0.61–4.42), 0.92 for dental scaling (95% CI 0.59–1.42), 1.69 for periodontal treatment (95% CI 0.88–3.21), and 1.29 for endodontic treatment (95% CI 0.72–2.31). The association between dental procedures and the risk of IE remained insignificant after adjustment for antibiotic use, indicating that dental procedures did not increase the risk of IE. Therefore, this result may argue against the conventional assumption on which the recommended prophylaxis for IE is based.
- Published
- 2015
17. Intracranial migration of iophendylate four decades after conventional myelography
- Author
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Patricia Wanping Wu, Shao-Chung Wang, Ping-Sheng Lu, Chih-Chen Chang, Chih-Hua Yeh, and Chao-Jan Wang
- Subjects
medicine.medical_specialty ,Contrast Media ,Computed tomography ,Subarachnoid Space ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,Humans ,Medicine ,Myelography ,Aged, 80 and over ,Unusual case ,medicine.diagnostic_test ,business.industry ,030206 dentistry ,General Medicine ,Surgery ,Neurology (clinical) ,Radiology ,Iophendylate ,Tomography, X-Ray Computed ,business ,030217 neurology & neurosurgery ,Extravasation of Diagnostic and Therapeutic Materials - Abstract
Iophendylate is an oil-based contrast agent used in conventional myelography before the 1980s. We report an unusual case of an 82-year-old woman with iophendylate migration into the intracranial cerebrospinal fluid space after myelography 40 years ago. The patient was treated conservatively and followed up regularly.
- Published
- 2016
18. Imaging of Cardiac and Pericardial Masses
- Author
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Wan-Ching Lin, Patricia Wanping Wu, Chun-Bi Chang, Pyng-Jing Lin, Kuo-Chun Hung, Shyh-Jye Chen, Wen-Yu Chuang, Ming-Yi Hsu, Ming-Shien Wen, Yuan-Chang Liu, Jaw-Ji Chu, and Yung-Liang Wan
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Computed tomography ,Magnetic resonance imaging ,General Medicine ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Radiology ,business ,Preclinical imaging ,Cardiac Tumors - Published
- 2017
19. Congenital tuberculosis: case report and review of the literature.
- Author
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Ching-Wen Chang, Patricia Wanping Wu, Chih-Hua Yeh, Kin-Sun Wong, Chao-Jan Wang, and Chih-Chen Chang
- Subjects
- *
RESPIRATORY distress syndrome , *POLYMERASE chain reaction , *ASCITES , *NEONATAL diseases ,TUBERCULOSIS case studies - Abstract
Congenital tuberculosis is rare, even where tuberculosis (TB) is endemic. A 14-day-old girl presented with a 3-day history of fever and respiratory distress. Her mother was diagnosed with a disseminated TB infection immediately after the delivery which was confirmed by a positive TB-polymerase chain reaction (TB-PCR) and subsequent culture from ascites and sputum. The infant was separated from her mother at birth. Her chest radiograph showed bilateral miliary nodules. Congenital TB was strongly suspected because of the symptoms, signs and maternal TB history, and was confirmed by TB-PCR and culture from the gastric lavage. Timely administration of standard anti-TB therapy resulted in a good outcome. The case highlights the importance of maternal TB history and typical miliary pattern on chest radiography for early diagnosis of congenital or neonatal TB which in turn facilitates prompt treatment and the prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
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