Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure.

Background: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis.

A comparison between combined open bypass revascularization and free tissue transfer versus endovascular revascularization and free tissue transfer for lower limb preservation.

Background: Extensive defects of the lower limb as a result of diabetes and peripheral vascular disease require multidisciplinary treatment. Numerous studies with regards combining vascular bypass surgery and free tissue reconstruction of the lower limb had been published. However the trend has evolved toward a combination of endovascular revascularization and free flap reconstruction.

Endovascular revascularization and free tissue transfer for lower limb salvage.

Combined bypass surgery with free flap reconstruction is an established method for lower limb salvage. But the success of the combination of endovascular revascularization together with free tissue transfer has so far not been well established. A retrospective review of all patients who had undergone endovascular revascularization and reconstructed with free tissue transfer for lower limb salvage at Tzu Chi Dalin General Hospital between 2008 and 2012 was performed.

A comparison between proximal lateral leg flap and radial forearm flap for intraoral reconstruction.

Free flaps have become a popular option for the reconstruction of intraoral defects. The radial forearm flap used to be the workhorse flap for small and thin defects, but was associated with numerous donor-site morbidities. The proximal lateral leg flap can provide a thin and pliable tissue similar to the radial forearm flap but without the related donor-site morbidities.

Increased risk of dementia in patients with mild traumatic brain injury: a nationwide cohort study.

Background: It is known that the risk of dementia in patients with moderate to severe traumatic brain injury (TBI) is higher. However, the relationship between mild traumatic brain injury (mTBI) and dementia has never been established.

Objectives: We investigated the incidences of dementia among patients with mTBI in Taiwan to evaluate if there is higher risk compared with general population.

High risk of 'failure' among emergency physicians compared with other specialists: a nationwide cohort study.

Background: The intensive physical and psychological stress of emergency medicine has evoked concerns about whether emergency physicians could work in the emergency department for their entire careers. Results of previous studies of the attrition rates of emergency physicians are conflicting, but the study samples and designs were limited.

Objective: To use National Health Insurance claims data to track the work status and work places of emergency physicians compared with other specialists.

Dyspnea caused by atlantoaxial subluxation in a patient with rheumatoid arthritis.

Atlantoaxial subluxation is a well-known but poorly recognized disease in rheumatoid patients. We report a patient with rheumatoid arthritis whose chief complaint was dyspnea on arrival to the emergency department (ED). After further investigation, spinal cord compression caused by atlantoaxial subluxation was diagnosed.

Cryopreserved chondrocytes in porous biomaterials with surface elastin and poly-L-lysine for cartilage regeneration.

The ability of cryopreserved chondrocytes to revitalize and propagate is a key biotechnology in cartilage regeneration. This study shows the formation of neocartilage from cryopreserved chondrocytes in scaffolds grafted with elastin and poly-L-lysine. Cryopreserved chondrocytes in elastin- and poly-L-lysine-grafted constructs were cultured in a dynamic bioreactor and assessed by biochemical assay and staining.

Expanding the applications of the pedicled anterolateral thigh and vastus lateralis myocutaneous flaps.

We describe our experience in expanding the use of pedicled anterolateral thigh and vastus lateralis myocutaneous flaps. A total of 33 patients underwent 34 flaps between March 2003 and January 2012. The defects included 18 ischial, 3 trochanteric, 5 lower abdomen, 2 perineogenital, 1 groin, and 5 knee defects.

Propofol for sedation can shorten the duration of ED stay in joint reductions.

Background: For joint reductions, adequate sedation is often required. Propofol has increasingly been used for sedation in the emergency department (ED) in recent years. The benefits of propofol are the rapid onset of action and the short recovery time.

Application of albumin-grafted scaffolds to promote neocartilage formation.

This study investigates the capacity of albumin-grafted biomaterials as tissue engineering scaffolds to regenerate cartilaginous components. Porcine knee chondrocytes were seeded and cultivated in porous ternary matrix consisting of polyethylene oxide, chitin, and chitosan with surface albumin. The results revealed that the quantity of albumin did not affect the viability of porcine knee chondrocytes in the constructs.

Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation: a meta-analysis of randomised trials.

Background: Video laryngoscopes have been introduced in recent years as an alternative choice to facilitate tracheal intubation. We conducted a meta-analysis to assess their value when compared with direct laryngoscopy.

Methods: PubMed and EMBASE were searched up until 24 September 2010.

Influence of breast-feeding on weight loss, jaundice, and waste elimination in neonates.

Background: The Baby-Friendly Hospital Initiative began promoting exclusive breast-feeding in 2001 in Taiwan; however, few studies have investigated its impact. This study evaluated the influence of breast-feeding on Taiwanese neonates with regard to the frequency of jaundice, body weight loss (BWL), and elimination of both urine and stool.

Methods: The medical records of 313 healthy mother-neonate pairs admitted at our hospital were reviewed retrospectively and divided into three groups: exclusively breast-feeding (n=161), mixed (breast/formula) feeding (n=80), and exclusively formula feeding (n=72).

Validation of bidimensional measurement in nasopharyngeal carcinoma.

Background: Our previous study showed a close relationship between computed tomography (CT)-derived bidimensional measurement of primary tumor and retropharyngeal nodes (BDMprn) and gross tumor volume of primary tumor and retropharyngeal nodes (GTVprn) in nasopharyngeal carcinoma (NPC) and better prognosis for NPC patients with smaller BDMprn. In this study, we report the results on of a study to validate the use of BDM in a separate cohort of NPC patients.

Methods: We retrospectively reviewed 103 newly diagnosed NPC cases who were treated with radiotherapy/concurrent chemoradiotherapy (CCRT) or CCRT with adjuvant chemotherapy from 2002 to 2009.

Study of cryopreservation of articular chondrocytes using the Taguchi method.

This study evaluates the effect of control factors on cryopreservation of articular cartilage chondrocytes using the Taguchi method. Freeze-thaw experiments based on the L(8)(2(7)) two-level orthogonal array of the Taguchi method are conducted, and ANOVA (analysis of variables) is adopted to determine the statistically significant control factors that affect the viability of the cell. Results show that the type of cryoprotectant, freezing rate, thawing rate, and concentration of cryoprotectant (listed in the order of influence) are the statistically significant control factors that affect the post-thaw viability.

Medial plica in patients with knee osteoarthritis: a histomorphological study.

Unlabelled: The gross appearance and histological features of the medial plicae removed from 48 consecutive patients who had received total knee replacement for severe medial compartment osteoarthritis of their knees were investigated prospectively. The prevalence of the medial plica was 100%. A small branch of skeletal muscle originating from articularis genu inserting into the proximal synovial stroma of the medial plica was found in all knees.

Arthroscopic medial release for medial compartment osteoarthritis of the knee: the result of a single surgeon series with a minimum follow-up of four years.

The outcome of arthroscopic medial release of 255 knees in 173 patients for varying grades of osteoarthritis involving the medial compartment is reported. All operations were performed by a single surgeon between January 2001 and May 2003. The Knee Society score for pain and the patient's subjective satisfaction were used for the outcome evaluation.

Penile metastasis secondary to nasal NK/T-cell lymphoma.

We report on a case of recurrent nasal NK/T-cell lymphoma in a patient who presented with a penile mass. No obvious other recurrent site except the penile lesion was noted. Metastatic penile lymphoma is extremely rare.

Prognostic influence of parapharyngeal extension in nasopharyngeal carcinoma.

Conclusions: Advanced parapharyngeal tumor involvement in nasopharyngeal carcinoma (NPC) had significant predictive value associated with poorer treatment outcome. Further subclassification of parapharyngeal invasion may be considered in the TNM staging system.

Objectives: We conducted a retrospective study to elucidate the effect of parapharyngeal extension on treatment outcomes in patients with NPC who were treated with radiotherapy or concurrent chemoradiotherapy (CCRT).

Squamous cell carcinoma of the oral cavity in young patients: a matched-pair analysis.

There is an increased incidence of oral squamous cell carcinoma (SCC) in young patients. However, the literature concerning prognosis for young patients with oral SCC is conflicting. The aim of this study was to compare the survival rates of patients under 45 years of age and diagnosed with SCC of the oral cavity with those of patients older than 45 years.

Relationship of medial plica and medial femoral condyle during flexion.

Background: The goal of this study was to investigate the kinematic relationship between medial plica and medial femoral condyle during knee motion.

Methods: I prospectively selected 30 knees which had different size of medial plica from patients underwent arthroscopic surgery over a one-year-period. I located the inner margins of these plicae by inserting needles percutaneously under direct vision during arthroscopic examination.