Journal of the Chinese Medical Association : JCMA
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Without well recognizing the vascular territories of the perforator, it might damage the pedicle and diminish the survival of the flap. This study described a transillumination method for intraoperative mapping of subfascial plexus of the perforator in radial forearm flap and also compared the perioperative outcomes and complications of the method with the standard folded, bipaddled forearm flap in head and neck reconstruction. ⋯ The transillumination method can allow plastic surgeons to easily identify the perforator vascular plexus of the radial forearm flap, which facilitates intraoperative flap design in head and neck reconstruction without increasing harvesting time and risk of postoperative complications.
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Pancreas transplantation is currently the most effective and curative treatment for complicated type 1 diabetes mellitus, providing durable and physiological insulin-independent euglycemia, preventing worsening or ameliorating of diabetic complications, and improving quality of life. Currently, more than 31 000 pancreas transplantation procedures have been performed, mainly in the United States. ⋯ The first pancreas (simultaneous pancreas and kidney transplantation) transplantation was successfully initiated at Taipei Veterans General Hospital on September 19, 2003, and we are the first team to be qualified to perform human pancreas procurement and transplantation by Taiwan Department of Health on August 31, 2007. The technique success rate in our pancreas transplantation is 97%, with 1-year pancreas graft survival rate of 95.8%, 5-year pancreas graft survival rate of 89.9%, and 10-year pancreas graft survival rate of 65.9%.
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This study aimed to investigate the impact of changes in the serum levels of trace elements and heavy metals in threatened abortion, which is a common complication in early pregnancy. Earlier studies have shown that changes in the serum levels of some trace elements and increased serum concentrations of heavy metals are associated with spontaneous abortion; however, this relationship has not been fully clarified. ⋯ Changes in the balance of some essential trace elements (especially decreases in Fe and Zn) and elevated concentrations of some toxic heavy metals in the blood may be important diagnostic and prognostic parameters for threatened abortion.
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The implantation of the Argus II retinal prosthesis system in a 54-year-old woman with retinitis pigmentosa who presented with an eye of long axial length at 26.82 mm was successful. Postoperative examination revealed a gap of 700 µm between the electrode array and the retina, which caused decreased visual perception. A modified strategy with quad and quinary electrode stimulation was introduced to generate higher perceptual thresholds. ⋯ Schisis of the retina developed and filled the gap, resulting in decreased threshold, and the strategy was then shifted back to single electrode stimulation mode. Rehabilitation program is an evolving process that depends on the distance between the array and the retina in the eye with staphyloma. This study first showed the implantation in a patient with high myopia who presented with long axial length after surgery and rehabilitation program in Taiwan.
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To evaluate a single surgeon's experience with minimally invasive total knee arthroplasty (MIS-TKA) and report the 9-year learning curve and trends in clinical outcomes based on assessment of surgical skills, radiographic alignments, and patient's function scores. ⋯ Although a surgeon may become competent with MIS-TKA and achieved the preliminary learning curve within one year, experience accumulation continuously improved technical proficiency in MIS-TKA. This study confirmed significant improvements in surgical skills, postoperative alignment, and patients' function over time.