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( Meng Chieh Wu ),( Hsin Kai Huang ),( Chun Cheng Zhang ),( Li Sheng Chang ),( Yung Ze Cheng ),( Chien Chin Hsu ),( Kao Chang Lin ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Emergency department (ED) overcrowding is a problem in many countries including Taiwan. Access block refers to a situation where patients in the emergency department requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame (more than 8 hours total time in the emergency department). Access block is one major reason of ED overcrowding. Methods: A new holistic care unit was established in our medical center in Taiwan in July 2012, with the attending physicians including internal medicine physicians and a neurologist. The patients who required hospitalized treatment were referred to internal medicine physicians in the emergency department. The new department was comprised of seven experienced medical attending physician to take care of the patients directly, with 8-hour duty work shifts within 24 hours, in collaboration with emergency physicians, radiologists, nurses, social workers and case managers to form a team. This team had similar three-shift work duty, education and training programs, and they shared medical devices and resources. If beds in the intensive care unit or ward are not available immediately, procedures and treatment can be performed in the holistic care unit. The pediatric patients were excluded from this study. Results: In total, 26,623 patients were admitting to ward from our emergency department from August 2011 to July 2012, and 23,790 patients from August 2012 to July 2013. The rate of access block decreased from 55.29% to 50.01% ( p < 0.01) after holistic care unit was established. The mean time of ED length of stay was also improved from 18.04 hours to 15.43 hours ( p < 0.01). Conclusions: The newly established holistic care unit in our hospital improved the quality of medical care, not only physiologically but also psychologically.
Coronary Stent Infection Presented as Recurrent Stent Thrombosis
Chih-Hung Lai,Wei-Chun Chang,Yung-Kai Lin,Wen-Lieng Lee 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.2
Percutaneous transluminal coronary angioplasty with metal stent placement has become a well-developed treatment modality for coronary stenotic lesions. Although infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. We describe herein a case of an inserted coronary stent that was infected and complicated with recurrent stent thrombosis, pseudoaneurysm formation and severe sepsis. Despite repeated intervention and bypass surgery, the patient died from severe sepsis.
Congo Tak Shing Ching,Pei-Yuan Lee,Nguyen Van Hieu,Hsin-Hung Chou,Fiona Yan-Dong Yao,Cheng Sha-Yen,Lin Yung-Kai,Thien Luan Phan 한국생물공학회 2023 Biotechnology and Bioprocess Engineering Vol.28 No.3
Microplastic, being a direct carrier of many pollutants, has caused grave concern and become a public issue. This gives rise to the need of a quick method for quantifying and identifying microplastics in the environment. This study uses impedance spectroscopy, particularly the imaginary part of impedance, for detection and identification of sample microplastics. Two type of common microplastic contaminants, Polyethylene and Polystyrene, diameter 20 m and 150 m, were chosen for this study. The results confirm accurate identification of microplastic material in question, by using self-normalized ratio between two characteristic frequencies of 7MHz and 8.9 MHz, Zf = 7 MHz / Zf = 8.9 MHz. 3-kNN classifier built with the ratio Zf = 7 MHz / Zf = 8.9 MHz, and Zf = 8 MHz /Zf = 8.9 MHz, demonstrates accuracy upto 90% for the identification of single or both microplastic types in samples. These results confirm impedance spectroscopy, permitting rapid identification of microplastic without labeling and skillful techniques, as a potential rapid sensor.