Correction: Hsu et al. Effect of Early Pelvic Binder Use in the Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study. 2017, , 1217.

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Comparison of Long-Term Pneumonia Risk between Spleen Injury and Non-Spleen Injury after Total Splenectomy-A Population-Based Study.

Patients who undergo splenectomy are at a high risk of infection. We aimed to investigate the rate of pneumonia in patients who underwent splenectomy, specifically comparing those who had splenectomy due to spleen injury and those who had it for other reasons. A population-based cohort study was conducted.

Association between Electronic Medical Records and Healthcare Quality.

The implementation of electronic medical records (EMRs) has generally been thought to improve medical efficiency and safety, but consistent evidence of improved healthcare quality due to EMRs in population-based studies is lacking. We assessed the relationship between the degree of EMR adoption and patient outcomes.We performed an observational study using discharge data from Tri-service General Hospital from 2013 to 2018.

The crowd-out effect of a mass casualty incident: Experience from a dust explosion with multiple burn injuries.

A mass casualty incident (MCI) can have an enormous impact on an already crowded emergency department (ED), affecting the quality of health care provided to non-MCI ED patients. On June 26, 2015, a burn MCI (BMCI) occurred due to a cornstarch explosion at a party at a water park. The competing needs of the BMCI patients might have crowded out the needs of the non-BMCI patients.

Experienced trauma team leaders save the lives of multiple-trauma patients with severe head injuries.

The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan.

A Novel Strategy of Laparoscopic Insufflation Rate Improving Shoulder Pain: Prospective Randomized Study.

Background: Laparoscopic surgery is the main trend method in a variety of surgical fields. Post-operative shoulder pain remains a bothersome issue although many surgical techniques have been applied to minimize it. A simple novel approach to reduce shoulder pain without adverse effects during and after laparoscopic surgery is desired.

The Risk of Erectile Dysfunction Following Pelvic Angiographic Embolization in Pelvic Fracture Patients: A Nationwide Population-Based Cohort Study in Taiwan.

Background: Pelvic fracture with hypovolemic shock is a known crucial injury in trauma patients. Pelvic fracture with vessel injury often leads to hemodynamic complications; in a trauma scenario, evidence of other systems being affected is often absent. Bleeding cessation and resuscitation are important for these types of trauma patients.

Long-term outcomes in elderly patients with resectable large hepatocellular carcinoma undergoing hepatectomy.

Background: In contrast to the feasibility of hepatectomy for resectable large hepatocellular carcinoma (HCC, >5 cm) in the younger patients, the concerns of benefits for the elderly patients remain in practice. This study aimed to evaluate the long-term outcomes and safety after hepatectomy in elderly patients with resectable large HCC compared with younger patients.

Methods: Between 2003 and 2014, a total of 2211 HCC patients were reviewed using a prospective database and 257 patients with resectable large HCC undergoing hepatectomy were included: 79 elderly patients with age ≥70 years and 178 younger patients with age <70 years.

Risk of infertility following pelvic angiographic embolization in female patients with pelvic fractures: A nationwide population-based cohort study in Taiwan.

Pelvic angiographic embolization is an effective procedure to provide haemostasis in patients with pelvic fractures. However, management with repeated follow-up radiographs may result in infertility. The study aimed to evaluate the risk of infertility following pelvic fracture treated with pelvic angiographic embolization in female patients.

Effect of Early Pelvic Binder Use in the Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study.

Background: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach.

Methods: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: a loss of consciousness or a Glasgow coma score (GCS) of <13; systolic blood pressure of <90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury.

Senior general surgery residents can be trained to perform focused assessment with sonography for trauma patients accurately.

Purposes: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments.

An Investigation of the Outcomes of PGY Students' Cognition of and Persistent Behavior in Learning through the Intervention of the Flipped Classroom in Taiwan.

The Postgraduate Year (PGY) Program allows doctors-in-training to learn about the diagnosis, treatment and nursing of various common, general diseases. These items form the core curriculum and are mostly learned through caring for patients and clinical teaching. Doctors-in-training are evaluated for their knowledge through written tests or assignments, based on which the effectiveness of their training is also assessed; however, this generally produces a negative learning attitude among them.

The evolution of computed tomography from organ-selective to whole-body scanning in managing unconscious patients with multiple trauma: A retrospective cohort study.

We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT.Totally, 144 unconscious patients with high-energy multiple trauma from single level I trauma center in North Taiwan were enrolled from January 2009 to December 2013. All patients were managed by a well-trained trauma team and were suitable for CT examination.

Increased matriptase zymogen activation by UV irradiation protects keratinocyte from cell death.

Background: Overexposure to ultraviolet (UV) derived from solar light causes skin damage by causing DNA lesions and the generation of reactive oxygen species (ROS) in keratinocytes and other epidermal cells. The type 2 transmembrane serine protease matriptase has characteristics that allow keratinocytes to respond to/recover from, environmental insults to the skin. This response may depend on its roles in epidermal proliferation and early differentiation, and its rapid activation in response to changes in the cellular chemical milieu, including increased oxidative stress.

SLC6A2 variants may predict remission from major depression after venlafaxine treatment in Han Chinese population.

Objective: Venlafaxine, an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) type, is used to treat patients with major depressive disorder (MDD). Much evidence suggests that genetic polymorphisms may modulate serotonergic and noradrenergic function, thereby affecting the treatment efficacy of venlafaxine. The aim of this study was to examine whether polymorphisms in the norepinephrine transporter gene (SLC6A2) associate with remission after venlafaxine treatment for MDD.

Thyroid storm following trauma: a pitfall in the emergency department.

We present a case of a patient with thyroid storm exhibiting symptoms similar to those of traumatic injury. This patient presented multiple traumatic wounds on his limbs and face, loss of consciousness, and tachycardia. Diagnosis was initially confounded by the similarity between the symptoms of traumatic hypovolemic shock and trauma-induced thyroid storm.

CDH1 polymorphisms and haplotypes in sporadic diffuse and intestinal gastric cancer: a case-control study based on direct sequencing analysis.

Background: Findings related to the influence of the -160C → A promoter polymorphism and haplotypes of the E-cadherin (CDH1) gene have not been consistent in previous studies regarding the risk for sporadic gastric cancer. Investigators in most previous studies detected those genotypes using restriction fragment length polymorphism analysis. Therefore, we conducted a case-control study to investigate the association of the CDH1 - 160C → A promoter polymorphism and haplotypes for cancer risk related to sporadic diffuse and intestinal gastric cancer by direct sequencing analysis.

Distilled water peritoneal lavage in patients with rupture hepatocellular carcinoma.

Background/aims: Intra-peritoneal lavage is well known and used in intra-peritoneal malignancy However, the clinical role for patients with rupture of HCC has not yet been established. The aim of this study was to evaluate the clinical value of intraoperative peritoneal lavage for patients with rupture of HCC.

Methodology: A retrospective study of operative findings, other factors, and outcome was performed in 66 patients with rupture of HCC who underwent distilled water peritoneal lavage (DWPL) during hepatectomy.

Potential Therapeutic Role of Z-Isochaihulactone in Lung Cancer through Induction of Apoptosis via Notch Signaling.

Lung cancer is one of the leading causes of cancer death in worldwide and required for novel therapeutic strategy. Our previous research demonstrated that the crude acetone extract of Bupleurum scorzonerifolium (BS-AE) and its component isochaihulactone induce antiproliferative and apoptotic effects on the lung adenocarcinoma cell line. Structural analysis has identified isochaihulactone as a lignan, with a chiral center and two racemic forms (Z-isochaihulactone and E-isochaihulactone).

Application of marionette technique for 3-port laparoscopic liver resection.

Background: Laparoscopic liver resection has become a feasible and safe procedure for liver tumor, but it requires experienced surgeons in the case of hepatobiliary and laparoscopic surgeries. More minimally invasive laparoscopic techniques of liver surgery are developed. We here report our experience of using a marionette technique for 3-port laparoscopic liver resection.

Malignant perivascular epithelioid cell tumor of the mesentery: a case report and literature review.

Background: Perivascular epithelioid cell tumors (PEComas) are very rare mesenchymal neoplasms, and have been found in various organs such as the liver, kidney, falciform ligament, uterus, uterine cervix, and both the small and large bowel. However, only 3 cases of mesenteric PEComa have been described in the literature so far. The treatment and prognosis of malignant mesenteric PEComas are discussed.

Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy.

Aim: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery.

Methods: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth II (BII) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression.

Synergistic anti-tumor activity of isochaihulactone and paclitaxel on human lung cancer cells.

Drug resistance frequently develops in tumors during chemotherapy. Therefore, to improve the clinical outcome, more effective and tolerable combination treatment strategies are needed. Here, we show that isochaihulactone (K8) enhanced paclitaxel-induced apoptotic death in human lung cancer cells, and the enhancing effect was related to increased NSAID-activated gene-1 (NAG-1) expression.