http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Delay of Surgery for Spinal Metastasis due to the COVID-19 Outbreak Affected Patient Outcomes
Chia-Jung Hsieh,Chun-Yu Wu,Yen-Heng Lin,Yu-Cheng Huang,Wen-Chi Yang,Tom Wei-Wu Chen,Wei-Li Ma,Wei-Hsin Lin,Feng-Ming Hsu,Furen Xiao,Shih-Hung Yang,Dar-Ming Lai,Chang-Mu Chen,Shin-Yi Chao,Fon-Yih Tsuan 대한척추신경외과학회 2023 Neurospine Vol.20 No.4
Objective: The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients. Methods: The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality. Results: A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours). Conclusion: The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases.
Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5
Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.
Research on Value Creativity of Taiwan`s Small and Medium-sized Enterprises
( Shiaw Wen Tien ),( Yi Chan Chung ),( Chih Hung Tsai ),( Chia Hsiang Hsieh ),( Hung Hsi Chen ) 한국품질경영학회 2007 The Asian Journal on Quality Vol.8 No.1
This research probes into the execution of small and medium-sized enterprises` value creativities by a difference analysis with different classifications, different capital, different turnover, different employees, and different established years. This study develop a questionnaire about value creativity with five dimensions and thirty-five items according to “Valuation” by McKinsey and Company, Inc. and Copeland et al., such as: “Aspiration and target,” “Portfolio management,” “Organization design,” “Process management,” and “Business and individual performance management.” The results are as follows: (1) Most small and medium-sized enterprises (SMEs) have executed value creativities; (2) There is a difference in the execution of value creativities between the livelihood industry and the chemical industry; the execution of value creativities by livelihood industry is better than the chemical industry; (3) For value creativities of the execution of different capital and turnover for SMEs, bigger entities are better than smaller ones; (4) For the value creativities of the execution of different numbers of staff in SMEs, those with more staff are better than those with fewer staff; (5) For the value creativities of the execution of different established years for SMEs, those established longer are better than those established shorter.
Pei-Wen Wu,Wen-Hung Wang,Chi-Che Huang,Ta-Jen Lee,Chien-Chia Huang 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.4
Objectives. To compare the short- and long-term hearing outcomes after successful inlay cartilage tympanoplasty between patients with small (≤25%) and large (≥50%) eardrums perforations. Methods. This is a retrospective case series study conducted in a tertiary referral center. Twenty-five patients who underwent 27 procedures were enrolled. Their mean age was 60.26 years (range, 42 to 76 years). The mean follow-up time was 18.86 months (range, 12.30 to 35.83 months). The preoperative, initial postoperative, and long-term hearing results in patients with total repair of the eardrum were analyzed. Results. In the small size group, the average (±standard deviation) air-bone gap (ABG) closure was 1.08±7.53 dB in the short-term and 2.33±11.56 dB in the long-term hearing examinations. There was no difference between short- and long-term ABG closure (P=0.689). In the large size group, the average ABG closure was 9.77±9.40 dB in the short-term and 16.25±6.01 dB in the long-term hearing examinations. There was a significant difference between short- and long-term ABG closure (P=0.029). Conclusion. Patients with large perforations have continuous hearing improvement and ABG closure for more than one year. In contrast, the short- and long-term postoperative ABGs are almost the same in patients with small perforations. More long-term postoperative follow-up of hearing results is necessary for large perforations.
Yu-Wen Tsui,Chia-Yu Tsai,Hung-Chi Chen Korean Society of Plastic and Reconstructive Surge 2024 Archives of Plastic Surgery Vol.51 No.1
A patient suffered from chronic ulcer due to recalcitrant fungal infection for 3.5 years. Five antifungal agents and 40 times of debridement—all failed. Finally, radical microscopic debridement was performed for eradication of fungal conidiospores. Since then, there was no recurrence at 2 years of follow-up. Scopulariopsis brevicaulis is one of the rarest pathogens of cutaneous fungal infections, for which multidrug resistance increased the complexity and difficulty of treatment. Radical excision, especially microscopic debridement, was the key for eradication of fungal conidiospores in this case.
Research on the Structure and Application of Fuzzy Environmental Impact Assessment Model
Tien, Shiaw-Wen,Hsneh, Chia-Hsiang,Chung, Yi-Chan,Tsai, Chih-Hung,Yu, Yih-Huei The Korean Society for Quality Management 2004 The Asian Journal on Quality Vol.5 No.2
Any business activities may have impact on environment to a certain extent. Enterprises must find appropriate approaches to measure the impact on these environmental aspects, which can be used as the basis to direct enterprises' efforts to improve the environmental impact. The method used to evaluate significant factors in life cycle assessment standards is the one most commonly used by enterprises in general to measure environmental impact. By this method, the decisive factors of each environmental aspect are given scores according to the preset scoring standard of the organization. The scores are added up for each aspect and ranked to assess major environmental aspects. The drawback of this assessment method, that is, it ignores the degree to which each of these factors affects the environment, results in poor credibility. Therefore, this study attempts to solve some qualitative problems by applying to fuzzy theory, in particular, by identifying appropriate fuzzy numbers through fuzzy sets and membership function. Moreover, the study seeks to obtain a crisp value in the process of defuzzifization in order to make up for the shortfall of the original method in dealing with relative weight of decisive factors and thus increase its applicability and credibility. The department of light production of an electronics company is used as an example in this study to measure environmental aspects by employing both the traditional significant factor method and the fuzzy environmental impact assessment model proposed in this study. Based on verification and comparison of results, the model proposed in this study is more feasible as it reduces partiality in decision-making by taking the relative weights of decisive factors into consideration.