Risk factors for imipenem-nonsusceptible Acinetobacter nosocomialis bloodstream infection.

Background: The emergence of imipenem-nonsusceptible (INS) Acinetobacter baumannii complex has had a great impact on healthcare systems worldwide. Understanding the risk factors related to INS infection is useful for infection control. The risk factors for INS A.

Dissemination of multidrug-resistant Acinetobacter baumannii carrying BlaOxA-23 from hospitals in central Taiwan.

Background: Imipenem-resistant Acinetobacter baumannii (IRAB) poses a great threat to healthcare systems. Production of carbapenem-hydrolyzing class D β-lactamases (CHDLs) is the major mechanism for imipenem resistance. In this study, we found a high prevalence of IRAB carrying a gene encoding CHDL, bla(OxA-23), in central Taiwan and elucidated the molecular characteristics and possible mechanisms of the spread of these isolates.

Outbreak of imipenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii complex harboring different carbapenemase gene-associated genetic structures in an intensive care unit.

Background And Purpose: To investigate the clinical and molecular epidemiology of the imipenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii (IRAcb) complex during an outbreak in an intensive care unit (ICU).

Methods: Forty-six clinical and 11 environmental isolates of the IRAcb complex were collected from the ICU of Taipei Veterans General Hospital, Taiwan between December 2003 and March 2004. These isolates were genotyped using pulsed-field gel electrophoresis (PFGE).

Nosocomial nasal myiasis in an intubated patient.

We report a case of nasal myiasis caused by Sarcophaga spp., noted during hospitalization. A 74-year-old man was admitted with non-ST-elevation myocardial infarction.

Preoperative positron emission tomography/computed tomography predicts advanced lymph node metastasis in esophageal squamous cell carcinoma patients.

Background: We aimed to study whether positron emission tomography/computed tomography (PET/CT) findings are associated with lymph node staging, as outlined by the 7th edition American Joint Committee on Cancer (AJCC) TNM staging system in patients with esophageal squamous cell carcinoma (ESCC).

Methods: A series of 76 ESCC patients undergoing esophagectomy were included in this study. The relation between PET/CT findings [maximum standardized uptake value (SUVmax)] and pathologic lymph node status (N stage) was studied.

The total number of resected lymph node is not a prognostic factor for recurrence in esophageal squamous cell carcinoma patients undergone transthoracic esophagectomy.

Background: The total number of resected lymph nodes (TLN) has been shown to predict survival in esophageal cancer, but its relationship with recurrence has been rarely reported. We aim to study the prognostic factors in esophageal squamous cell carcinoma (ESCC) patients, with a particular focus on the role of TLN.

Methods: Two hundred sixty-eight ESCC patients who underwent transthoracic esophagectomy were selected for the study.

Prognostic factors for post-recurrence survival in esophageal squamous cell carcinoma patients with recurrence after resection.

Objective: The survival of recurrent esophageal cancer is poor. But reports regarding prognostic factors for post-recurrence survival are limited. We analyzed the recurrence pattern and the prognostic factors for post-recurrence survival in esophageal squamous cell carcinoma with recurrence after resection.

Different efficacies of erlotinib and gefitinib in taiwanese patients with advanced non-small cell lung cancer: a retrospective multicenter study.

Introduction: Epidermal growth factor receptor-tyrosine kinase inhibitors are used as effective first-line and salvage therapy in the treatment of advanced non-small cell lung cancer (NSCLC) patients in East Asia. The objective of this study was to compare the efficacy of gefitinib and erlotinib in Taiwanese patients with advanced NSCLC.

Methods: Clinical data of NSCLC patients treated with gefitinib or erlotinib from January 2004 to December 2008 were collected retrospectively.

Esophageal metastasis from occult lung cancer.

A 66-year-old man with dysphagia was found to have a poorly differentiated esophageal carcinoma by incision biopsy. Following esophagectomy, reconstruction with a gastric tube was performed. Pathological examination and immunohisto-chemistry showed infiltration of adenocarcinoma cells with positive thyroid transcription factor 1-staining in the submucosal layer, which indicated metastatic esophageal carcinoma.

Comparison of the 6th and 7th editions of the American Joint Committee on Cancer tumor-node-metastasis staging system in patients with resected esophageal carcinoma.

Background: The 7th edition American Joint Committee on Cancer tumor-nodes-metastasis (AJCC TNM) staging system was published recently. We aim to evaluate its predictive ability and to compare the performance of the 6th and 7th editions of the AJCC TNM staging systems in esophageal cancer.

Methods: A total of 392 esophageal squamous cell carcinoma patients receiving primary surgical resection between 1995 and 2006 were included.

First identification of blaOXA-51-like in non-baumannii Acinetobacter spp.

Bla(OXA-51-like), the intrinsic carbapenemase gene in Acinetobacter baumannii previously found only in this species, was detected in a clinical isolate of Acinetobacter genomic species 13tU. this study aimed to characterize this gene in the isolate. Genomic species identification was confirmed by amplified ribosomal DNA restriction analysis and sequence analysis of 16S-23S ribosomal DNA intergenic spacer, rpoB and recA.

Primary intradural hemangiopericytoma with intramedullary invasion.

Hemangiopericytoma (HPC) is a rare tumor of the central nervous system and is usually found intracranially. Intraspinal HPCs are very rare and mostly involve the extradural bony structures. Primary intradural HPC has only been reported in 10 cases, all of which occurred in the extramedullary region.

Gene cassette arrays, antibiotic susceptibilities, and clinical characteristics of Acinetobacter baumannii bacteremic strains harboring class 1 integrons.

Background And Purpose: Acinetobacter baumannii isolates containing class 1 integrons belong to different clones, but only a few strains are successful at causing infection. This study was conducted to compare the characteristics among these clones with different epidemicity.

Methods: Eighty eight bacteremic isolates of A.

Differences in phenotypic and genotypic characteristics among imipenem-non-susceptible Acinetobacter isolates belonging to different genomic species in Taiwan.

In this study, we investigated the distribution of genes encoding various carbapenemases as well as their association with carbapenem resistance in clinical isolates of Acinetobacter genomic species from Taiwan. A total of 129 imipenem-non-susceptible and 79 imipenem-susceptible isolates were examined, of which 185 (88.9%) were Acinetobacter baumannii.

[Relationships of transactional leadership, trust, and organizational citizenship].

Under the health-care insurance system in Taiwan, hospital management has not only to challenge the impacts of the post-SARS era, but also has to conquer the system change brought about by the National Health-Insurance Bureau. By global budget and various quality-control indicators, the hospital confronts pressure on restriction measures, including, on the one hand, reducing manpower, while on the other, pushing remaining employees to achieve more. The nursing department, comprising the highest percentage of faculty in the hospital, cannot but burden itself by accepting more duties.

Pseudohypoparathyroidism: report of seven cases.

Pseudohypoparathyroidism (PHP) is a rare inherited syndrome with several types. We reviewed the cases of 7 PHP patients seen between 1990 and 2003, and analyzed their clinical, biochemical data and long-term medical outcomes. Six boys and one girl were included.

The challenge of diagnosing psoas abscess.

Diagnosing psoas abscess in patients with low back pain might be hampered by their atypical symptoms. We describe a case in which a 39-year-old retired provost marshal presented to our emergency facility with acute onset of low back pain following an episode of lumbar strain during a flight. His initial computed tomography of lumbar spine and abdominal sonography were inconclusive.

Functional characterization of the crista terminalis in patients with atrial flutter: implications for radiofrequency ablation.

Objectives: The aim of the study was to investigate the conduction properties and anisotropy of the crista terminalis (CT) in patients with atrial flutter (AFL) using non-contact mapping.

Background: The CT is a posterior barrier during typical AFL. However, the CT has transverse conduction capabilities in patients with upper loop re-entry (ULR).

High frequency of primary Sjögren's syndrome in Taiwanese patients presenting as relapsing-remitting multiple sclerosis.

Primary Sjögren's syndrome (PSS) with central nervous system involvement may mimic the manifestations of multiple sclerosis (MS). The prevalence of PSS in MS patients varies in the published literature (0-16.6%), but has not yet been investigated in Asia, having a much lower MS prevalence than Western countries.

Retinopathy of prematurity: optimal timing of the initial check and progression after discharge.

Timely detection of the threshold retinopathy of prematurity (ROP) is very important. The goal of this study was to discuss the optimal timing of the initial screening for ROP as well as ROP progression in the outpatient department (OPD) follow-up after discharge. Herein we retrospectively review the charts of 224 preterm babies with gestational ages (GAs) of less than 35 weeks or birth weights (BWs) of less than or equal to 2000 g.