Portable Oxygen-Sensing Device for the Improved Assessment of Compartment Syndrome and other Hypoxia-Related Conditions.

Measurement of intramuscular oxygen could play a key role in the early diagnosis of acute compartment syndrome, a common condition occurring after severe trauma leading to ischemia and long-term consequences including rhabdomyolysis, limb loss, and death. However, to date, there is no existing oxygen sensor approved for such a purpose. To address the need to improve the assessment of compartment syndrome, a portable fiber-optic device for intramuscular oxygen measurements was developed. The device is based on phosphorescence quenching, where the tip of an optical fiber was coated with a poly(propyl methacrylate) (PPMA) matrix containing a brightly emitting Pt(II)-core porphyrin. The optoelectronic circuit is highly portable and is based on a microspectrometer and a microcontroller readout with a smartphone. Results from an in vivo tourniquet porcine model show that the sensor is sensitive across the physiological oxygen partial pressure range of 0-80 mmHg and exhibits an appropriate and reproducible response to changes in intramuscular oxygen. A commercial laboratory oxygen sensor based on a lifetime measurement did not respond as expected.

Significantly increased medical expenditure on breast cancer failing to bring down its mortality and incidence rate.

BACKGROUND: The direct impact of medical expenses on breast cancer incidence and mortality rate has not been sufficiently addressed. The purpose of this study is to investigate the potential correlation between the incidence and mortality rate of breast cancer and the medical expenses in Taiwan. MATERIALS AND METHODS: Breast cancer cases were identified from the National Health Insurance Research Database (NHIRD) with corresponding to International Classification of Diseases, and the Ninth Revision (ICD-9) code 174, 1740-1749, 175, 1750 and 1759 from January 1999 to December 2006. Age-specific incidences were estimated by population data obtained from the Department of Statistics, Ministry of the Interior. Medical expenses, including outpatient and inpatient services, were also retrieved from the NHIRD. RESULTS: The incidence increased from 20.06 per 100,000 in 1999 to 30.34 per 100,000 in 2006; the total expenses increased from 1,449,333,521 in 1999 to 4,350,400,592 Taiwan dollars in 2006. The age-standardized mortality rate for female breast cancer remained essentially unchanged, while the age-standardized incidence increased steadily (except 2002-2003). Among the top 20 coexisting ICD-9 codes for expenses, four are directly on cancers, while 16 are on other diseases or symptoms, which are not necessarily caused by breast cancer. CONCLUSIONS: Significantly increased medical expenditure on breast cancer failed to bring down its mortality and incidence rate. The finding has implications for healthcare policy planners in proposing strategies for breast cancer control and allocating the resources.

Nationwide population-based epidemiologic study of Huntington's Disease in Taiwan.

BACKGROUND: The purpose of this study is to investigate the epidemiology and medical expenses of Huntington's disease (HD) in Taiwan. METHODS: Cases of HD were identified from the National Health Insurance Research Database with corresponding International Classification of Diseases, Ninth Revision (ICD-9) code 333.4 from January 2000 to December 2007. Age- and sex-specific incidences were estimated by dividing the incidence number by population data obtained from the Department of Statistics, Ministry of the Interior. RESULTS: During the study period, 182 cases were identified, including 81 males and 101 females. The average annual incidence rate was 0.1 per 100,000. The age-specific incidence peaked in the 40-49 age group in men (0.23 per 100,000 per year) and in the 50-59 age group in women (0.24 per 100,000 per year). The incidence rate was only 0.01 per 100,000 per year in those under 20 years of age. The prevalence was 0.42 per 100,000 in 2007. CONCLUSIONS: This is the first population-based epidemiologic study on HD in Taiwan. The incidence rates and prevalence were much lower than those of Caucasians although the age distribution was similar.

Results of magnetic resonance imaging assessment, acoustic analysis, phonatory function and perceptual rating of glottic insufficiency before and after fat augmentation: correlated with subjective rating.

Autogenous fat augmentation has been proven effective in the treatment of glottic insufficiency (GI) using both subjective and objective methods of evaluation. However, no information is available in published research regarding the effectiveness and predictability of value parameters with regard to patients' perceptions and concerns. This article retrospectively examines the correlation between subjective and objective examinations and subjective ratings (SRs) in patients with presbylaryngis (n = 14) and sulcus vocalis (n = 2). Acoustic analysis, phonatory function, magnetic resonance imaging (MRI) assessment, and perceptual rating data were evaluated against SRs using pre- and postoperative test results in 16 patients. The mean time over which subjective and objective examinations were performed was 10 months. Twelve patients reported excellent results, while no change was observed in 4 patients. When compared against SR, the kappa value of jitter, shimmer, harmonic to noise ratio, phonation time, grade, roughness, breathiness, and MRI were 0.25, 0, -0.08, -0.11, -0.11, 0.18, 0, and 1, respectively. The agreement between the MRI and SR values was complete, and was the only relationship shown to be significant (p < 0.001). MRI assessment is an effective and reliable examination tool which can be considered for use in assessing the progress of the post-fat injection operation in GI patients during follow-up examinations. Furthermore, due to the excellent agreement between MRI assessment and the patients' subjective feelings, the SR value may serve as a good index of fat survival.