bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trend and survival outcome in Taiwan cervical cancer patients
Authors: Kau Yi-Chuan , Liu Fu-Chao , Kuo Chang-Fu , Huang Huei-Jean , Li Allen H. , Hsieh Mei-Yun , Yu Huang-Ping 
Published: March 2019

Abstract
Cervical cancer is one of the most common cancers in Taiwan. The aim of this study was to estimate the incidence of cervical cancer in Taiwan, the relationship between cervical cancer and previous co-morbidities, and the long-term trend of cervical cancer mortality differences in the rest of the world.
This study was based on the data of cervical cancer in the National Health Insurance Research Database from 1997 to 2013, and estimated the annual prevalence and incidence of cervical cancer. Joinpoint regression analysis was used to obtain the percentage of annual incidence of cervical cancer, morbidity and survival of patients with cervical cancer by statistical regression analysis.
The average annual percentage change (APC) was −7.2, indicating a decrease in the incidence of cervical cancer during the study period. The 1-year, 2-year, and 5-year mortality rates of cervical cancer are relatively stable. The average APC of mortality was higher in high Charlson comorbidity index (CCI) group.
This study found that both of prevalence and incidence of cervical cancer descend in Taiwan. The incidence of cervical cancer in Taiwan is increasing with age. The sample survival rate was stable in cervical cancer patients during the study period.
Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease
Authors: Liu Chi-Chu , Lu Chin-Li , Notobroto Hari Basuki , Tsai Chiang-Chin , Wen Pei-Hung , Li Chung-Yi 
Published: March 2019

Abstract
Given the fact that >80% of liver transplantations (LTs) were living donor liver transplantation (LDLT) in Taiwan, we conducted this study to assess whether patients with lower socioeconomic status are subject to a lower chance of receiving hepatic transplantation.
This was a cohort study including 197,082 liver disease patients admitted in 1997 to 2013, who were at higher risk of LT. Personal monthly income and median family income of living areas were used to indicate individual and neighborhood socioeconomic status, respectively. Cox proportional hazard model that considered death as a competing risk event was used to estimate subdistribution hazard ratio (sHR) of LT in association with socioeconomic status.
Totally 2204 patients received LT during follow-up, representing a cumulative incidence of 1.12% and an incidence rate of 20.54 per 104 person-years. After adjusting for potential confounders, including age, sex, co-morbidity, location/urbanization level of residential areas, we found that patients with < median monthly income experienced significantly lower incidence of LT (aHR = 0.802, 95% confidence interval (CI) = 0.717–0.898), but those with >- median monthly income had significantly elevated incidence of LT (aHR = 1.679, 95% CI = 1.482–1.903), as compared to those who were not actively employed. Additionally, compared to areas with the lowest quartile of median family income, the highest quartile of median family income was also associated with significantly higher incidence rate of LT (aHR = 1.248, 95% CI = 1.055–1.478).
Higher individual and neighborhood socioeconomic status were significantly associated with higher incidence of LT among patients with higher risk of LT.
Painless gouty tophus in the nasal bridge
Authors: Chen Shih-Lung , Chen Jim-Ray , Yang Shih-Wei 
Published: March 2019

Abstract

Rationale:
A gouty tophus, arising from the deposition of monosodium urate crystals (MSU), rarely occurs in the nasal bridge. There have been only 7 documented cases of a gouty tophus in the nasal bridge from 1978 to 2018 in English-language literature.

Patient concerns:
A 65-year-old male had a chief complaint of a lump in the nasal bridge that was slowly growing for over 1 year.

Diagnosis:
MSU crystals were confirmed through ultrasonography (US) and pathological examinations.

Interventions:
A cosmetically less destructive method, ultrasound-guided fine needle aspiration cytology (FNAC) was used to approach the mass lesion of nasal bridge.

Outcomes:
The diagnosis was confirmed as a gouty tophus without performing a nasal subdermal exploration.

Lessons:
This case report is the first use of US with FNAC to approach and diagnosed a gouty tophus in the nasal bridge.
Single-tunnel anatomic double-bundle anterior cruciate ligament reconstruction has the same effectiveness as double femoral, double tibial tunnel
Authors: Xiang Xianxiang , Qu Zhenan , Sun Honglin , Ma Xiaojun , Wang Weiming , Huang Lixin 
Published: March 2019

Abstract

Purpose:
To investigate whether single femoral, single tibial tunnel anatomic double-bundle anterior cruciate ligament (ACL) reconstruction is equal to or superior to double femoral, double tibial tunnel ACL double-bundle anatomic reconstruction in terms of restoring the stability and functions of the knee joint.

Methods:
A prospective clinical study was performed to compare 30 cases of single-tunnel ACL double-bundle anatomic reconstruction to 28 cases of double-tunnel ACL double-bundle anatomic reconstruction, with average follow-up of 36 months. All graft tendons were hamstring tendon autografts. Tunnel placements in all the cases were made anatomically. Clinical results were collected after reconstruction. Graft appearance, meniscus status and cartilage state under arthroscopy were compared and analyzed.

Results:
Tunnel placements were in the anatomic positions in both groups. On the lateral pivot-shift test performed at 36 months postoperatively, there was no significant difference between groups. Clinical results such as International Knee Documentation Committee score, Tegner activity scale, and range of motion showed no significant differences between the groups. The mean thickness of anteromedial graft was reduced by 10.3% and that of the posterolateral graft was reduced by 11.1% from the original graft thickness evaluated by magnetic resonance imaging. No new meniscal tears were found either group; however, cartilage damage occurred in the double-tunnel group at 39.3%, and this rate was significantly higher than that in the single-tunnel group (10.0%).

Conclusion:
Single femoral, single tibial tunnel anatomic double-bundle ACL reconstruction has the same effectiveness as the double femoral, double tibial tunnel in restoring the knee's stability and functions.
The impact of marital status on survival in patients with surgically treated colon cancer
Authors: Yang Ching-Chieh , Cheng Li-Chin , Lin Yu-Wei , Wang Shih-Chang , Ke Te-Min , Huang Chung-I. , Su Yu-Chieh , Tai Ming-Hong 
Published: March 2019

Abstract
The aim of this study was to investigate the relationship between marital status and disease outcome in patients with surgically treated colon cancer. Between June 2010 and December 2015, a total of 925 patients with newly diagnosed colon cancer receiving curative resection were enrolled. The effect of marital status on 5-year disease-specific survival (DSS) was calculated using Kaplan–Meier method, and was compared by log-rank tests. A Cox regression model was used to find significant independent variables and determine whether marriage had a survival benefit in patients with colon cancer, using stratified analysis. Among these patients, 749 (80.9%) were married, and 176 (19.1%) were unmarried, including 42 (4.5%) never-married, 42 (4.5%) divorced/separated, and 93 (10.1%) widowed. There was no significant difference between the married and unmarried groups in cancer stage or adjuvant treatment. Married patients had better 5-year DSS compared with unmarried patients (69.1% vs 55.9%, P < .001). Uni- and multivariate analyses also indicated that unmarried patients had worse 5-year DSS after adjusting for various confounders (adjusted HR [aHR], 1.66; 95% CI, 1.24–2.22). Further stratified analysis according to demographic variables revealed that unmarried status was a significant negative factor in patients with the following characteristics: age >65 years, female sex, well/moderately differentiated tumor, and advanced tumor-node-metastasis (TNM) stage disease (III–IV). Thus, marriage has a protective effect, and contributes to better survival in patients with surgically treated colon cancer. Additional social support for unmarried colon cancer patients may lead to improve outcomes.
Increased risk of central serous chorioretinopathy following end-stage renal disease
Authors: Chang Yuh-Shin , Weng Shih-Feng , Wang Jhi-Joung , Jan Ren-Long 
Published: March 2019

Abstract
This retrospective, nationwide, matched cohort study investigated the risk of central serous chorioretinopathy (CSCR) following end-stage renal disease (ESRD). The study cohort included 84722 ESRD patients who were registered between January 2000 and December 2009 at the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 84722 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. We collected information for each patient from the index date until December 2011. During the follow-up period, we found a significantly elevated risk of CSCR in the ESRD patients compared with controls (incidence rate ratio = 1.51, 95% confidence interval = 1.24–1.84). After adjustment for potential confounders, including age, sex, coronary artery disease, peptic ulcer, and obstructive sleep apnea, ESRD patients were 1.41 times more likely to develop CSCR (adjusted hazard ratio = 1.41, 95% confidence interval = 1.14–1.73). In conclusion, we found that ESRD patients showed a significantly higher risk of developing CSCR and recommend regular retina examinations and education regarding CSCR for patients with ESRD.
Observation on the curative effect of long intestinal tube in the treatment of phytobezoar intestinal obstruction
Authors: Li Liang , Xue Bing , Zhao Qiang , Xie Hong-Qiang , Luan Xue-Rong , Cui Qing 
Published: March 2019

Abstract
The aim of the study was to observe the curative effect of long intestinal tube (LT) in the treatment of phytobezoar intestinal obstruction.
We performed a retrospective study of patients with phytobezoar intestinal obstruction who underwent decompression with different tube insertion method. A total of 80 patients were collected and divided into nasogastric tube (NGT) group (n = 36) and LT group (n = 44) between August 2015 and August 2018 at our hospital. Univariate analysis was used to assess the clinical efficacy of 2 groups of patients.
There were no significant differences in the mean age, sex ratio, and previous surgical history between the 2 groups. There were statistically significant differences between the 2 groups in terms of improvement time of clinical indications (4.2 ± 1.4 vs 2.5 ± 0.6 days; P = .008), liquid decompression amount on the first day of catheterization (870.4 ± 400.8 vs 1738.4 ± 460.2 mL; P = .000), transit operation rate (4/36 vs 0/44; P = .023), clinical cure rate (25/36 vs 40/44; P = .014), total treatment efficiency (32/36 vs 44/44; P = .023), and total hospitalization cost (3.25 ± 0.39 vs 2.07 ± 0.41 ¥ ten thousand; P = .000).
The curative effect of LT in the treatment of phytobezoar intestinal obstruction is accurate and reliable, which can effectively improve the clinical symptoms of patients, comprehensively improve the non-surgical rate of intestinal obstruction treatment, reduce the total cost of hospitalization, and is worthy of promotion in clinical application.
Early enteral nutrition versus delayed enteral nutrition in patients with gastrointestinal bleeding
Authors: Zhang Hongyan , Wang Yu , Sun Shujun , Huang Xin , Tu Guangjie , Wang Jingxu , Lin Yun , Xia Haifa , Yuan Yin , Yao Shanglong 
Published: March 2019

Abstract

Background:
Controversy persists about whether early enteral nutrition administration is related to worse prognosis than delayed enteral nutrition for patients with gastrointestinal bleeding.

Objectives:
To systematically evaluate the effect of early enteral nutrition on the patient with gastrointestinal bleeding through the meta-analysis.

Methods:
Such electronic databases including PubMed, EMBASE, Cochrane Library, CNKI, and CBM were searched from 1985 to March 2018. Randomized controlled trials that compared early enteral nutrition versus delayed enteral nutrition in patients with gastrointestinal bleeding were considered eligible. Data extraction and the methodological quality assessment of the included trials were carried out according to the Cochrane Handbook. We calculated the pooled risk ratio, weighted mean difference, and the corresponding 95% confidential interval using RevMan5.3.

Result:
A total of 5 trials involving 313 patients were included. Compared with delayed enteral nutrition, there was a tendency for a decreased rebleeding rate in the early enteral nutrition group, but the trend was not statistically significant (risk ratio = 0.75, 95% confidential interval: 0.34–1.64, I
2 = 0). As for mortality within 30 days, no significant difference was found between the 2 groups (risk ratio = 0.74, 95% confidential interval: 0.23–2.39, I
2 = 0). In addition, the pooled analysis showed that early enteral nutrition was related to reduced hospitalized days (weighted mean difference = −1.69, 95% confidential interval: −2.15 to −1.23; I
2 = 27%)

Conclusion:
For patients with gastrointestinal bleeding, early enteral nutrition within 24 hours does not result in the significantly higher risk of rebleeding and mortality compared with delayed enteral nutrition, but decrease hospitalized days. Patients who are at low risk for rebleeding can be fed early and discharged early. However, larger, high-quality randomized controlled trials are needed to verify these findings, and when the gastrointestinal bleeding patient start enteral nutrition is worth studying.
Identification of a PRKAR1A mutation (c.491_492delTG) in familial cardiac myxoma
Authors: Ma Shengjun , Liu Wei , Zhang Anqi , Pan Li , Tang Wenqiang , Jiang Bo , Wang Fengju , Chen Shuangfeng , Fu Bo 
Published: March 2019

Abstract

Rationale:
Cardiac myxoma is the most common cardiac neoplasm. Currently, there are not many reports on familial cardiac myxoma. Herein, we reported 2 first-degree relatives with left atrial myxoma.

Patient concerns:
A 20-year-old female was admitted in our hospital for lapsing into a coma for 24 hours, and was diagnosed with recurrent left atrial cardiac myxoma. The patient's father also had a history of cardiac myxoma.

Diagnosis:
The patient was diagnosed with left atrial myxoma using transthoracic echocardiography (TTE). Whole exome sequencing (WES) identified a p.Val164Aspfs (c.491-492delTG) mutation in the cAMP-dependent protein kinase A (PKA) regulatory (R) subunit 1 (PRKAR1A) gene for both the proband and her father, but not in her uncle and brother, who had not shown manifestation of cardiac myxoma by the time of this report.

Interventions:
The myxoma resection was performed following the standard procedure of open chest surgery.

Outcomes:
The tumor was successfully removed along with the tuberculum. The patient recovered well and was discharged home. No recurrence occurred during 1-year follow-up.

Lessons:
Our findings suggest that PRKAR1A mutation (c.491_492delTG) may be associated with cardiac myxoma, and genetic counseling and specific locus mutation tests may contribute to assessing the risk of cardiac myxoma.
Three case reports of collagenous gastritis in children
Authors: Lee Yeoun Joo , Lee Mijeong , Kim Dae-joong , Lee Seungkoo , Hong Jeana 
Published: March 2019

Abstract

Rationale:
Collagenous gastritis (CG) is a rare form of chronic gastritis defined histologically by a thickened subepithelial collageneous band in the lamina propria. However, the clinical features and endoscopic findings of CG have not been clearly established in the pediatric population.

Presenting concerns:
We report the cases of 3 children who presented with intractable anemia and minimal or no gastrointestinal (GI) symptoms and were followed up without definitive diagnosis determination even through diagnostic endoscopic evaluations.

Diagnoses:
On repeated endoscopic examination, we determined thickened subepithelial collagen band, confirmed by Masson trichrome staining using targeted biopsies of the intervening mucosa between the prominent nodular lesions.

Interventions:
Under the diagnosis of CG, a course of steroid was administrated in 1 patient, while all patients continued oral iron replacement therapy.

Outcomes:
All 3 patients remained asymptomatic and their anemia was alleviated with continued administration of oral iron.

Main lessons:
We recommend early endoscopic evaluation for patients with unexplained anemia, emphasizing a high index of suspicion for CG, despite the absence of definitive GI symptoms. Targeted gastric biopsies should be performed in the depressed mucosa surrounding the nodules, as well as the nodules themselves, to confirm CG, when presented with nodular gastric mucosa in endoscopy.
Bacterial meningitis and cauda equina syndrome after trans-sacral epiduroscopic laser decompression
Authors: Jung Yong Jae , Chang Min Cheol 
Published: March 2019

Abstract

Rationale:
Trans-sacral epiduroscopic laser decompression (SELD) is a noninvasive pain-relieving procedure for treatment of herniated lumbar disc (HLD), and is known to have positive effects in alleviating lower back pain or radicular leg pain after HLD. However, little is known about the possible complications of SELD.

Patient concerns:
A 51-year-old woman received SELD with a holmium:yttrium-aluminum-garnet laser for controlling radicular pain due to HLD on L5-S1. However, 5 days after SELD, she complained of headache, and 9 days after the SELD, cauda equine syndrome (CES) symptoms, including motor weakness of both lower extremities (manual muscle testing—left: 3, right: 4), voiding and defecation difficulties, and neuropathic pain, were manifested.

Diagnoses:
Cerebrospinal fluid (CSF) analysis performed 15 days after the SELD revealed elevated white blood cell count 7560 cells/μL. Staphylococcus hominis sensitive to vancomycin was cultured from CSF. The gadolinium-enhanced magnetic resonance imaging showed diffuse leptomeningeal enhancement along the distal cord and cauda equina. The latency of electrically induced bulbocavernosus reflex (BCR) was delayed in the right side and no response of BCR was presented in the left side. Based on the patient's symptoms and the results of the clinical evaluation, we diagnosed the patient as having a bacterial meningitis and CES.

Interventions:
The patient received 2 g per day of intravenous vancomycin for 2 months.

Outcomes:
After treatment with intravenous vancomycin for 2 months, all the CES symptoms were completely resolved.

Lessons:
In this study, we described a patient who had bacterial meningitis after SELD. During SELD, clinicians should keep in mind the possibility of infection.
Interproximal caries and premature tooth loss in primary dentition as risk factors for loss of space in the posterior sector
Authors: Lucas-Rincón Salvador Eduardo , Robles-Bermeo Norma Leticia , Lara-Carrillo Edith , Scougall-Vilchis Rogelio José , Pontigo-Loyola América Patricia , Rueda-Ibarra Vicente , Loyola-Rodríguez Juan Pablo , Escoffié-Ramirez Mauricio , Medina-Solís Carlo Eduardo 
Published: March 2019

Abstract
Dental caries—a highly prevalent public health problem in preschoolers and school children—is the main cause of premature dental loss during childhood, and this may be related to loss of space in the posterior sector. The objective of this study was to evaluate whether interproximal caries and premature tooth loss (D and/or E) are risk factors for loss of space in the posterior sector.
A comparative cross-sectional study (split-mouth type) was performed in schoolchildren (6–8 years old). Seventeen gypsum models were evaluated. These children presented with unilateral loss of a dental organ or interproximal caries (teeth D and/or E) and without such affectations on the other side. Measurements were made with a digital Vernier caliper. The dependent variable was the difference (loss of space, mm) between the control and case sides. The independent variables were type of affectation (interproximal caries or tooth loss), sex, age, arcade, and number of interproximal surfaces affected.
The mean age was 6.82 ± 0.44 years and 64.7% were boys. The average space loss was 1.09 ± 0.18 mm (control vs case; P < .0001). A greater loss of space was observed among those who lost a dental organ than those with interproximal caries (P = .0119). A correlation was observed between the variable loss of space and the number of interproximal surfaces affected (r = 0.5712, P = .0166).
Interproximal caries and tooth loss were risk factors for loss of space in the posterior segment in this sample of Mexican schoolchildren.
Intratumoral heterogeneity as measured using the tumor-stroma ratio and PET texture analyses in females with lung adenocarcinomas differs from that of males with lung adenocarcinomas or squamous cell carcinomas
Authors: Koh Young Wha , Lee Dakeun , Lee Su Jin 
Published: March 2019

Abstract
We compared intratumoral stromal proportions and positron emission tomography (PET) textural features between females and males with lung adenocarcinoma (ADC) or squamous cell carcinoma (SCC).
We retrospectively evaluated 167 consecutive patients (male 122, female 45) who underwent pretreatment fluorodeoxyglucose PET/CT and surgical resection. The tumor-stroma ratios (TSRs) of primary tumors were estimated on hematoxylin-and-eosin-stained histological sections, and higher-order textural features were extracted on PET. We compared the histological and PET features between the sexes.
More females than males had ADC. Age and pathological tumor size did not significantly differ between females and males. Females with ADC had more stroma-rich tumors than males with ADC (P = .016) or SCC (P = .047). In addition, some PET textural features significantly differed between females with ADC and males with ADC and SCC; short run emphasis, long run emphasis, coarseness, strength, short-zone emphasis, zone percentage and high-intensity large-zone percentage were the commonly differed textural features. However, the TSRs and PET textural features did not significantly differ between males with ADC or SCC.
Intratumoral heterogeneity in females with lung ADC differs from that in males with lung ADC or SCC.
The effect of early cardiopulmonary rehabilitation on the outcomes of intensive care unit survivors
Authors: Lai Chih-Cheng , Chou Willy , Cheng Ai-Chin , Chao Chien-Ming , Cheng Kuo-Chen , Ho Chung-Han , Chen Chin-Ming 
Published: March 2019

Abstract
This study aims to compare the impact of early and late post-discharge cardiopulmonary rehabilitation on the outcomes of intensive care unit (ICU) survivors.
The retrospective, cohort study used a sub-database of the Taiwan National Health Insurance Research Database (NHIRD) that contained information of all patients had ICU admission between 2000 and 2012. Early group was defined if patients had received cardiopulmonary rehabilitation within 30 days after ICU discharge, and late group was define as if patients had received cardiopulmonary rehabilitation between 30 days and 1 year after ICU discharge. The end points were mortality and re-admission during the 3-year follow-up.
Among 2136 patients received cardiopulmonary rehabilitation after ICU discharge, 994 was classified early group and other 1142 patients were classified as late group. Overall, early group had a lower mortality rate (6.64% vs. 10.86%, P = .0006), and a lower ICU readmission rate (47.8% vs. 57.97%, P < 0.0001) than late group after 3-year follow-up. Kaplan-Meier analysis showed that early group had significantly lower mortality (P = .0009) and readmission rate (P < .0001) than late group. In multivariate analysis, the risk of ICU readmission was found to be independently associated with late group (hazard ratio, [HR], 1.28; 95% confidence intervals, [CI], 1.13–1.47).
Early post-discharge cardiopulmonary rehabilitation among ICU survivors has the long-term survival benefit and significantly decreases the readmission rate.