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Report of gossypiboma from the standpoint in medicine and law

World Journal of Gastroenterology 2005年第8期11卷 1248-1249页

作者： li-rung shyung Wen-Hsiung Chang Shee-Chan lin Shou-Chuan Shih Chin-Roa Kao Sun-Yen Chou Division of Gastroenterology L.L.B. Department of LawNational Taiwan UniversityChina

We report on a case of gossypiboma. A 78-year-old man was admitted to our hospital with acute abdomen. He had undergone an operation for colon cancer 4 mo *** ultrasonography revealed an echogenic lesion with a hypoechoic rim and strong posterior acoustic shadowing in the lower abdomen. Diagnosis of gossypiboma can be made by ultrasonography to avoid loss-of-chance of survival. We reviewed the English literature briefly of gossypiboma from the medical and juridical view. According to the theory of loss-of-chance, the damage of plaintiff is the loss of the chance of survival or recovery, rather than the final harm. The victim would allow recovery for the loss of the chance from the defendant. But the plaintiff would show by a preponderance that he was deprived of a betterchance of a cure. Under the proposed rule, the compensable value of the victim would be the plaintiff's compensation for the loss of the victim's chance of survival.

关键词： Gossypiboma Loss-of-chance Preponderance

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Decision making in right-sided diverticulitis

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World Journal of Gastroenterology 2003年第3期9卷 606-608页

作者： li-rung shyung Shee-Chan lin Shou-Chuan Shih Chin-Roa Kao Sun-Yen Chou Division of Gastroenterology Department of Internal MedicineMackay Memorial HospitalTaipeiTaiwanChina

AIM: To evaluate systematically our nine-year experience in treating right-sided diverticulitis of the colon, and to explore its clinical and radiological ***: The clinical and radiological data of 40 patients with colonic diverticulitis treated in Mackay Memorial Hospital,Taipei, from 1993 through 2002 were reviewed ***: The average age of the patients with right-sided diverticulitis was 53.1 years, which was 11.6 years younger than that of the patients with left-sided diverticulitis. The preoperative diagnosis of appendicitis was made in 8 of 13 right-sided diverticulitis patients. Nine (69 %) had right lower quadrant abdominal pain for more than 48 hours, and ten patients (77 %) presented with fever. CT findings suggesting acute right-sided diverticulitis including thickening of the intestinal wall and pericolonic inflammation were present in five ***: Right-sided diverticulitis is easily confused with acute appendicitis because it occurs at a somewhat younger age than that in left-sided diverticulitis. Barium enema and CT are helpful for the early diagnosis of rightsided diverticulitis. While clearly not required in the majority of patients with right lower quadrant abdominal pain, barium enema and CT may be helpful in making the decision with a clinical history or physical examinations atypical of acute appendicitis.

关键词：右结肠憩室炎放射影像学临床特点 CT表现诊断

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Are gap junction gene connexins 26,32 and 43 of prognostic values in hepatocellular carcinoma?A prospective study

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World Journal of Gastroenterology 2004年第19期10卷 2785-2790页

作者： I-Shyan Sheen Kuo-Shyang Jeng Po-Chuan Wang Shou-Chuan Shih Wen-Hsing Chang Horng-Yuan Wang Chung-Chu Chen li-rung shyung Division of Hepatogastroenterology Chang Gung Memorial HospitalTaipeiTaiwanChina Departments of Surgery Mackay Memorial HospitalTaipeiTaiwanChina Mackay Junior School of NursingTaipeiTaiwanChina M.D.F.A.C.S. Department of Internal Medicine Mackay Memorial HospitalTaipeiTaiwanChina

AIM: To investigate the prognostic value of the expression of connexin (Cx) 26, 32 and 43 messenger RNA (mRNA) in hepatocellular carcinoma (HCC) tissues. METHODS: Using a reverse-transcriptase polymerase chain reaction (RT-PCR), Cx 26, Cx 32 and Cx 43 mRNAs were determined in the liver tissues of 15 controls and in HCC tissues of 25 patients undergoing curative hepatic resection. The patients were followed up ***: Cx 26 and Cx 32 mRNAs were significantly lower in HCC tissues compared with controls (both Plity (P = 0.031,P= 0.031). Cx 43 mRNA was higher in HCC tissues compared with controls but did not correlate with postoperative recurrence or recurrence-related mortality. Other significant predictors of HCC recurrence included cellular dedifferentiation (P = 0.033), less encapsulation (P = 0.050), vascular permeation (P= 0.046), and daughter nodules (P= 0.046). Significant variables related to recurrence-related mortality consisted of cell dedifferentiation (P = 0.031), vascular permeation (P = 0.048), and daughter nodules (P = 0.048).The levels of Cx 26 and Cx 32 mRNAs correlated significantly with cell differentiation (P= 0.031). CONCLUSION: A low expression of Cx 26 and Cx 32 mRNAs in HCC tissues is predictive of postoperative recurrence of HCCs.

关键词：缺口联合基因接合素肝细胞癌肿瘤 mRNA HCC RT-PCR

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Peer reviewing of screening mammography in Taiwan： its reliability and the improvement

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Chinese Medical Journal 2013年第1期126卷 68-71页

作者： PAN Huay-ben HSU Giu-cheng YANG Tsung-lung HUANG Jer-shyung CHOU Chen-pin liANG Huei-lung LEE San-kan CHOU Yi-hong li Hung-ju WONG Kam-fai Department of Radiology Kaohsiung Veterans General HospitalKaohsiung Taiwan China National Yang-Ming University Taipei Taiwan China Department of Radiology Tri-Service General Hospital TaipeiTaiwan China Department of Radiology Taichung Veterans General HospitalTaichung Taiwan China Department of Radiology Yaipei Veterans General HospitalTaipei Taiwan China Institute of Statistics National University of KaohsiungKaohsiung Taiwan China

Background Early detection with screening mammography can potentially reduce breast cancer mortality rates. To achieve an efficient screening, a peer review system provides a compensatory double-check reviewing, will hopefully to prevent the omission of detectable lesions and reduce unnecessary recall. Methods In 2009, 4643 initial mammographic screenings reported by 74 screening radiologists had negative results with a recall rate of less than 5%. In the same year, 2538 initial positives screened by 18 screening radiologists had a recall rate higher than 15%. Those 7181 randomized screenings were evenly distributed for reassessment by 39 reviewing radiologists. The disagreement of assessments between the reviewers and screening radiologists was recorded. The differential rate was defined as the number of the disagreements divided by the number of audited films reviewed by a screening radiologist. The equality of the differential rates for each screening radiologists with negative and positive assessments was compared by a Chi-square test. The performance of the 39 auditors was measured by the Kendalrs tau statistic. P values less than 0.05 were considered statistically significant. Results The mean differential rate for screening radiologists of negative assessments was 6.7% （P=0.588）, while 35.0% for positive assessments were significant （P 〈0.001）. The result indicated that most of the initial negative assessments reported by the screening radiologists were generally accepted by the reviewers but not the positive assessments. With respect to the 39 reviewers, there was no significant evidence for the association of the difference rates between negative and positive assessments. Nine reviewers were found to have their differential rate for negative and positive assessments larger than the average of the population. Eleven reviewers were found to have their differential rates smaller than the average for both. Thirteen reviewers had their differential rates smaller

关键词： breast cancer mammography screening peer reviewing

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