vol. 18, no.3, september 2020cme.mc.fju.edu.tw/sites/default/files... · vol. 18, no.3, september...

Vol 18 No3 September 2020

A comparison of remifentanil and low dose fentanyl for postopera-tive recovery prole in patients undergoing minimally invasive cardiac surgery

Human factors underlying adverse medical events revisit root cause analysis cases using the hfacs

Juvenile caruncular atypical lymphoid proliferation a rare case report

Hyperacute intramembranous hemorrhage after burr hole cranios-tomy for chronic subdural hematoma

Hamartoma of the breast a case report

Issued and edited by Center of Medical Education College of Medicine Fu Jen Catholic University

Fu-Jen Journal of Medicine Vol 18 No 3 September 2020

CONTENTS

Original Research Article

A Comparison of Remifentanil and Low Dose Fentanyl for Postoperative Recovery

Profile in Patients Undergoing Minimally Invasive Cardiac Surgery

Meng-Chieh Ho Wei-Horng Jean Tzu-Yu Lin Cheng-Wei Lu 89

Human Factors Underlying Adverse Medical Events Revisit Root Cause Analysis

Cases Using the HFACS

Yu-Hsun Cheng Sheng-Hui Hung Tung-Wen Ko Pa-Chun Wang 99

Case Report

Juvenile Caruncular Atypical Lymphoid Proliferation ndash A Rare Case Report

Hua-Wei Shih Yu-Chi Lin 112

Hyperacute intramembranous hemorrhage after burr hole craniostomy for chronic

subdural hematoma

Meng-Chi Lin Jui-Ming Sun Yu-Hao Chen Cheng-Ta Hsieh 120

Hamartoma of the breast A case report

Hsuan-An Chen Cheng-Yu Lo Shih-Hung Huang Chin-Lung Lin 126

Fu-Jen Journal of Medicine Vol 3 No 1 2020

Remifentanil versus fentanyl for MICS


Submitted October 17 2019

Final version accepted November

01 2019


A Comparison of Remifentanil and Low

Dose Fentanyl for Postoperative Recovery

Profile in Patients Undergoing Minimally

Invasive Cardiac Surgery

Cite as Meng-Chieh Ho

Wei-Horng Jean Tzu-Yu Lin

Cheng-Wei Lu

A Comparison of Remifentanil

and Low Dose Fentanyl for Post-

operative Recovery Profile in

Patients Undergoing Minimally


Fu-Jen Journal of Medicine 3(1)

89-98 2020

DOI

103966181020932020091803001

Meng-Chieh Ho1 Wei-Horng Jean12 Tzu-Yu Lin12 Cheng-Wei

Lu12

1Department of Anesthesiology Far Eastern Memorial Hospital Ban-

qiao Dist New Taipei City Taiwan 220 2Department of Mechanical Engineering Yuan Ze University Taoyuan

Taiwan 320 Contributed equally

Corresponding author E-mail address

drluchengweigmailcom (Cheng-Wei Lu)

ABSTRACT

Background The concept of enhanced recovery after surgery (ERAS) is flourishing in multiple specialties including cardiac surgery Beside minimally invasive surgical ap-proach short acting anesthetic agent is one of the major components of ERAS programs Remifentanil is an ultrashort acting opioid agent The purpose of this study was to compare remifentanil and low dose fentanyl for postoperative recovery profile in patients undergoing minimally invasive cardiac surgery (MICS) Methods This study was a retrospective study We compared the recovery profile including extubation time after surgery length of hospi-tal stay postoperative morphine consumption pain scores and in hospital complication rate between patients undergoing elective MICS from May to August 2018 Results Fifty-three patients were enrolled in this study 33 of them were in group remifentanil (G remifentanil) and 20 were in group fentanyl (G fentanyl) The extubation times average hospital stay postoperative morphine consumption pain scores and in hospital complication rate were all similar between both groups Conclusion We consider remifentanil can be safely used in MICS and provides similar recovery profile as low dose fentanyl

Keywords minimally invasive cardiac surgery enhanced recovery after surgery opioids

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TRODUCconcept of en

AS) is gaininies Early traormed after operative recotay in intensivsive surgical

ance recovery urgery (MICSvery time w

h those of coor componention of a sho

mifentanil an pioid receptorspecific esteraaccumulate afpharmaceuticasidered as safey [8] Howeveng a fast-trackersial results ective study tsafety of remi

CS and to deher facilitates r

ATERIALretrospective

pt includes fis from 18 to 8MICS betweeents with a hientanyl pregnsing medical ents were moe oximetry a

metry cerebraectral index (

al echocardiopharyngeal temiratory and e

xide and sevnitored and reed with midakg of the bod

and rocuronght A doubled to provide oration The pups Patients ie induced withght and receivbody weight a

of Medicine V

Wei-Horng Je

CTION nhanced recovng popularity acheal extubat

cardiac surgovery and to

ve care unit (ICapproach is a[1] Minimal

S) is proven with recovery onventional sut of ERAS prort acting aneultra-short a

r agonist is ase [7] and fter prolongedal properties

fe and effectiver applicatiok cardiac surg[9-11] We coto investigateifentanil in paetermine wherecovery

LS AND Me study reportifty-three pat80 years) whoen May 2018 istory of allergnant women

records weronitored with

arterial and ceal near-infrar(BIS) monitorography (TEmperature re

expiratory oxyvoflurane conecorded All azolam 25 mdy weight denium 1 mge lumen endotone-lung ventatients were in group fentah fentanyl 5 μ

ved bolus doseas required du

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

very after surin multiple

tion is commgery to enhreduce the leCU) A minimanother metholly invasive cato have a shooutcomes onurgeries [2-5ograms is thesthetic agent

acting and pometabolized

therefore it d infusion Du remifentani

ve for cardiac n of remifengery yielded onducted thisthe effective

atients undergether remifen

METHODted in this mtients (rangingo underwent eand August 2gy to remifenand patients re excluded h a 5-lead Eentral venous red spectroscr and transesoE) In addiectal temperaygen and carncentrations wpatients weremg etomidatexamethasonekg of the btracheal tube tilation duringdivided into

anyl (G fentaμgkg of the bes of 1-2 μgk

uring the opera

2020

il versus fenta

n Cheng-Wei

rgery spe-

monly hance ength mally od to ardi-orter

n par ] A

e uti-[6]

otent d by does ue to il is sur-

ntanil con-

s ret-eness going ntanil

DS manu-ng in elec-

2018 ntanil

with All

EKG ma-

copy oph-ition ature arbon were e in-te 2 e 10 body was

g the two

anyl) body kg of ation

Patiwerthe of 1sia centbetwwasoid the valuteremanSimagecentnicaendlumFor tienphinsurgtientiento twaslock20 (numrecoeratencaneaccothe be tcomsurgeratcomstayposacquacquhouorderamdevcatecy Mordenusinof p

nyl for MICS

i Lu

ients in Groupre induced witbody weight

1-5 μgkgh thwas maintaintration requirween 40 and s managed bydose and gas basis of TEE

ue Inotropes ed in cases whnagement of

milarly intraopd by adjustintration folloardipine or ni

dotracheal tubmen endotrach

immediate pnts were admne thirty mingery For posnts were ant-controlled ahe ICU unders morphine 1kout time of 1ml The mormerical scaleorded every 8tion Anesthesed anesthesiosthesia Extubording to a wpatients were

transferred oumes of this stugery and mortive days 1 2

mes included hy pain scorestoperative dayuired compliuired complic

urs and the 3ed For statis

meters were dviation and weegorical paramand were comrphine consu

noted as meding Mann-Whip = 005 was s

p remifentanilth remifentanand received mhroughout thened by sevoflured to mainta

60 Intraopery fluid supplem

concentrationE findings CV

and vasopreshere other methe intraopera

perative hyperg the opioid owed by aitroglycerin T

be was replacheal tube at thpostoperative

ministered withnutes prior to toperative padministered

analgesia (PCAr sedation Re mgml and b

10 minutes anrphine consume 0-10) and 8 hours for 5 sia was adminologists specbation was perweaning protoe stabilized thut of the ICUudy were extrphine consum

2 3 and 5 Thospital stay s at rest and ys 1 2 3 anications Instacations and r30-day mortalstical analysidenoted as mere compared

meters were dmpared using Fumption and an and quartitney U test Aet for all statis

il (G remifennil 05-10 μgmaintenance d

e surgery Aneurane with aain the BIS rative hypotement and then were adjusteVC level andssor were admethods failed irative hypotenrtension was dose and gasadministrationThe double luced with a she end of suranalgesia al

h 10 mg of the conclusio

ain control alintravenous

A) and transfegimen of IV bolus 1 ml w

nd a 4-hour limmption pain

side effects days after th

nistered by excialized in carformed in theocol (Fig1) they were rea The primarytubation time mption on po

The secondarypostoperativeon movemen

nd 5 and hoances of hore-operation ility rate wereis continuous

mean and stand using t-test wdenoted as freqFisherrsquos exactpain score

iles and compA significance stical tests

90

ntanil) kg of doses esthe- con-value nsion e opi-ed on d BIS minis-in the nsion man- con-

n of umen single rgery ll pa-mor-

on of ll pa-

pa-ferred PCA

with a mit of score were

he op-xperi-ardiac e ICU Once dy to

y out-after

ostop-y out-e ICU nt on spital spital in 48 e rec-s pa-ndard while quen-t test were

pared level

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REFiftyand nyl cmeanifentfemaenteeG remonhypety-repictewas remiwas for Gmonclam796 patieμgkreceithesiclamstantextubfentaaverwas 244 avereratipitalfentathe d= 0patiere-opand tanilphinativeeratimorpdiffeG rscorespec(Figpatieifent

DISThisof re

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ESULTS y-three patienwere divided consisted of 2n age ~ 64 ytanil consistedale mean ageen patients inemifentanil u

n comorbiditieertension and elated and othed in Table 1)47 hours for

ifentanil whil355 hours f

G remifentannary bypass wmp time was 6

minutes for ents in G fekg of fentanylived 196 μgia duration o

mp duration act (Table 2) Abation was 11anyl and G rage hospital 118 days an days For page hospital sive ICU stay wl acquired coanyl and 212difference wa34) Two paent in Gperation withvascular inju

l died within ne consumptioe day 1 howeive day 5 Thphine consumerent howeveremifentanil pes were obse

ctive of the p 3) Side effeent in G fenttanil experienc

SCUSSIOs research failemifentanil ov

of Medicine V

Wei-Horng Je

nts were enrolinto the two

20 patients (1years p=0104d of 33 patiees ~ 58 yearsn G fentanyl aunderwent vales across both

diabetes meher demograp The mean anG fentanyl a

le the mean dufor G fentanynil In cases

was performed82 minutes foG remifenta

entanyl were while those kg of remifeoperation durcross the two As shown in 126 hours andremifentanil stay of patiennd postoperatiatients in G stay was 124 was 284 daysomplications in G remifs not statistictients in G

G remifentahin 48 hours ury One patie

30 days poson was the higever it decrearoughout the mption was r it was slighpatients (Fig erved across batient being a

ects of PCA wanyl and 2 pacing nausea

ON led to demonsver low dose

Vol 3 No 1 2

Remifentani

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lled in this sgroups G fe

3 male 7 fem4) while G rents (15 male p = 0104) and 25 patienve surgery C

h groups inclullitus (comorbphic data arenesthesia duraand 5 hours fouration of suryl and 375 hwhere cardio

d the mean cor G fentanylanil On averadministered

in G remifenentanil The aration and cgroups were Table 3 tim

d 1496 hours respectively

nts in G fentive ICU stay remifentanildays and pos

s The rate of was 30 in

fentanil howeally significanfentanyl and anil underw

due to bleent in G remi

st-operation Mghest on postoased up to pos

5-day periodnot significa

htly higher am2) Similar

both groups at rest or mo

were rare withatients in G r

strate the effifentanyl in sh

2020

il versus fenta

n Cheng-Wei

study enta-male rem-

e 18 Sev-

nts in Com-uded bidi-

e de-ation or G rgery hours opul-cross l and rage

d 84 ntanil anes-cross con-

me to in G The

tanyl was

the stop-hos-

n G ever nt (p

one went

eding ifen-Mor-oper-stop-

d the antly

mong pain irre-

oving h one rem-

cacy hort-

eninMICcantrecethossurgreduisteristerresustuddossionpreotivelatiosimmanwascruivenfectsugthe Thitimeremthrepatiin tHowdiscmaylizeimmafteis aologmaydonThemedresonot ICUstraICUfentto incardprogintrhightiveedutherdrai

nyl for MICS

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ng the extubatCS Previous t difference eiving remifese receiving logery [12] Othuced extubatiored remifentared sufentanults may be dy agents anding strategy mns The extubaoperative lune fluid manageon manageme

milar lung comnagement In s applied to aitment was pe

ntilation Thests of confoungested that thsubtler the d

s research ree with remife

mifentanil mayeshold level ients includedthe ICU accowever the stacretion of ICUy be prolonge Previous re

mediate extuber cardiac surgat the discretiogists [14] Thy have been ne owing to thee ERAS progdical costs anources Howeshorten the h

U Engoren etated similar lenU in patientstanyl [915] Tncreased costdiac surgery gram consistsaoperative ahlights key ce risk assessmeucation prehrapy multimoin removal an

tion time in presearch has

in extubationentanil infusiow dose fenta

her studies shoon time amonnil as oppose

nil [1013] Tattributable t

d populations may also lead ation time mayg disease smement and inent However

morbidity and paddition pro

all patients anerformed at thse measures mnding factors he longer the

difference betweports an incentanil howey have beenand thus wa

d in this researording to a wart of the weaU physicians ed to allow thesearch has

bation can be gery if the exon of the supehe extubation shortened hoe current hosp

gram was estand improve uver the use o

hospital stay ot al and Chength of stays s administereThe use of rems [9] The ERwere recentl

s of three staand postoperaomponents inent patient ophabilitation odal analgesiand ambulation

patients underg found no sig

n time in paion compare

anyl during caowed evidenceng patients aded to those adThese conflito a differen A variable oto diverse co

ay be influencemoking periontraoperative vr our patientsperioperative

otective ventilnd manual lunhe end of oneminimized thA previous

e ventilation ween groups creased extubever the effen lower thanas undetectedrch were extuweaning protaning is up t

s and the weahe patient to demonstrated

e performed sxtubation startervising anesttime in our

owever it wapital policies ablished to reutilization of of remifentanior length of steng et al dein the hospita

ed remifentanmifentanil als

RAS guidelinely publishedages preoperative Each ncluding preoptimization pagoal-direct

a early extuban [16] William

91

going gnifi-tients

ed to ardiac e of a dmin-dmin-icting ce in

opioid onclu-ed by

opera-venti-s had fluid

lation ng re-e-lung he ef-study time [13]

bation ect of n the d All bated tocol to the aning stabi-

d that safely t time thesi-study

as not

educe f ICU il did tay in emon-al and nil or so led es for The ative stage

opera-atient fluid

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RE1

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and Li et al sway with subtay in the hospid consumptonstrated a rer medical cAS protocol [1ERAS protocoutilization of a

results did erence in the ption across balso detected and in patienifentanil infusbutable to -accumulatingresults the pparable betwe

ances of hype observed thanic postopera Side effects of hospital acunrelated to r

tanil is conside fentanyl for Mre are limitatition The retritably led to s studied mayxtubation timential benefit o

her masked bAS protocol Tto all cardiac sincluded in th

ONCLUSIresearch faile

emifentanil ovarly extubatiohospital and IC

CS The postoppain score wie obtained afanyl As a resefficiently u

er scale is reqifentanil in pa

EFERENCDoenst T Levidence fosurgery A cnon-scientif

of Medicine V

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successfully absequent impropital and ICU tion [17] Leduced extub

cost upon im18] Thereforeol itself is effea specific opionot demonstrpostoperativ

both groups a higher pos

nts receiving sion [2021]

the short g property ofpostoperative een the two grralgesia wereat remifentaniative pain afte

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dered to be eqMICS ions to this srospective napotential bias

y have influenes between theof remifentanby the lack oThe results masurgeries as onhis study

ION ed to demonsver low dose n and reducedCU among paperative morpith remifentanfter administrasult remifenta

used in MICSquired to detetients undergo

CES Lamelas J Door minimallycritical reviewfic information

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applied the ERovement in leand postopera

Li et al furbation time anmplementatione we theorizeective rather oid [1019] rate a signifi

ve morphine Previous resestoperative opan intraoperaThis anomal

half-life f remifentanilpain scores wroups Further recorded Hoil does not leaer cardiac surwere rare andlications was As a result r

qually safe as

tudy that warture of our ss The numbeced the differe two groups

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strate the effifentanyl in te

d length of staatients underghine consump

nil were similaation of low anil can be saS Research ermine the roloing MICS

o we have eno-invasive car

w of scientificn The Journa

2020

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796 (336)

196 (77)

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55 (066)

82 (161)

4 (18)

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6 (179)

G fentany

(n=20)

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118 (49)

244 (114

6 (30)

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Retrospect RCA with HFACS

Yu-Hsun Cheng Sheng-Hui Hung Tung-Wen Ko Pa-Chun Wang

99


Final version accepted February

02 2020


Human Factors Underlying Adverse

Medical Events Revisit Root Cause Anal-

ysis Cases Using the HFACS

Cite as Yu-Hsun Cheng

Sheng-Hui Hung Tung-Wen Ko

Pa-Chun Wang

Human Factors Underlying Ad-

verse Medical Events Revisit

Root Cause Analysis Cases Using

the HFACS Fu-Jen Journal of

Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002

Yu-Hsun Cheng1 Sheng-Hui Hung

12 Tung-Wen Ko

3 Pa-Chun

Wang14

1Department of Quality Management Cathay General Hospital Taipei

Taiwan

2Institute of Health Policy and Management National Taiwan Universi-

ty Taipei Taiwan

3Center for Healthcare Quality Management Cheng Hsin General Hos-

pital Taipei Taiwan

4Fu Jen Catholic University School of Medicine New Taipei City Tai-

wan


drtonyseednettw (Pa-Chun Wang)

ABSTRACT Background Appropriate management of adverse medical events (AMEs) is the corner-

stone of patient safety Root cause analysis (RCA) is used to investigate serious or

high-frequency errors but is limited by its inability to explain a broader scope of factors

We re-reviewed RCA cases to understand the underlying human organizational or system-

ic factors affecting AMEs Methods A total of 40 consecutive RCA cases (2012-2016) were

retrieved from the AMEs database A panel was organized to retrospectively re-review these

cases using the Human Factor Analysis and Classification System HFACS Results For

active failures errors stemmed largely from performance-based (95) judgment and deci-

sion-making errors (875) Incorrectly followed procedures (816) and accidental

equipment operation (50) were the most common types of performance-based errors In-

adequate real-time assessment (686) and inappropriate operative actions (686) were

the most common decision-making errors For sources of latent failure teamwork problems

(275) including failure to effectively communicate (818) and communicate critical

information (727) were common Inadequate supervision (929) or command over-

sights (929) were the most common problems related to inadequate supervision (35)

Organizational programpolicy risks not adequately assessed (50) were the most common

problems related to policy and process problem (25) Conclusions The HFACS review

enhances our understanding of human factors underlying AMEs The HFACS reveals latent

supervisory organizational or systematic problems that cannot be addressed through tradi-

tional RCA Keywords patient safety adverse events root cause analysis human factors




INTRODUCTION Patient safety involves the reduction of patient

harm from potentially avoidable unintended

outcomes [1] Studies have revealed that 50ndash

80 of adverse medical events (AMEs) are pre-

ventable [2-4] to eliminate such errors the ap-

propriate management of AMEs hence repre-

sents the cornerstone of patient safety work

Through incident reporting investigation and

analysis healthcare providers can correct or

re-engineer their care processes to prevent inci-

dent recurrence [25] One of the most popular

tools for investigating AMEs is root cause anal-

ysis (RCA) RCA reconstructs a chain of errors

to identify the deviation of care from normal

processes Nonetheless with a lack of standard-

ized nomenclature and investigation procedures

RCA report conclusions are sometimes too sub-

jective and nonspecific to facilitate any actiona-

ble safety improvement plans [5-7] According

to the UK Health and Safety Executive defini-

tion human factors are environmental organiza-

tional occupational or individual human char-

acteristics which influence behavior at work

such that health and safety are affected [8] Hu-

mans and systems are prone to errors and stud-

ies have showed that nearly 70 of medical

errors involve human factors [2-4] Reasonrsquos

Swiss cheese model described the penetration of

causative human errors through layers of defen-

sive barriers leading to system collapse [9]

With much focus on the temporal sequence and

severity of departure from accepted practices in

an incident the effectiveness of RCA is often

challenged by its incapability of exploring un-

derlying human organization or even systemic

factors [5-7] Reason and others have proposed

that errors can occur at 4 levels 1) unsafe acts

(operator actions) 2) preconditions for unsafe

acts (environmental factors contributing to er-

rors) 3) inadequate supervision (management

actions affecting the operator) and 4) organiza-

tional influences (organizational culture policies

and procedures that affect the operator) [9]

Based on this theory Wiegmann and Shappell

developed the Human Factor Analysis Classifi-

cation System (HFACS) to describe human fac-

tors causing accidents from 4 tiers of categories

Each of these categories consists of nanocodes to

represent specific human behavior or system

problems leading to errors [9-10] The tier for

unsafe acts involves actual provider actions (er-

rors or rule violations) directly leading to events

The tier representing preconditions for unsafe

acts includes operational personnel and envi-

ronmental factors The supervision tier addresses

leadership problems operational planning fail-

ure or correction and supervisory ethics The

tier for organizational influences deals with re-

source management organizational climate and

operational processes (Supplement Table 1) The

HFACS provides standardized investigation

processes for the systematic analysis of common

causes of adverse events across national defense

nuclear power navy aviation and healthcare

industries Taiwan launched its nationwide

AME-reporting system the Taiwan Patient

Safety Reporting System (TPR) in 2004 RCA

methodology was subsequently introduced to the

healthcare industry by the Joint Commission of

Taiwan [11] Since 2012 appropriate manage-

ment of AMEs has been listed as a national pa-

tient safety goal [12] RCA is required by the

Ministry of Health and Welfare for major AMEs

Aside from RCA a comprehensive structural

reliable and valid framework is urgently re-

quired to further guide organizational or even

national patient safety policies In this study we

used the HFACS to review our RCA cases aim-

ing to investigate human factors underlying se-

vere or frequent AMEs

MATERIALS AND METHODS Through continuous sampling 40 consecutive

RCA cases (2012-2016) were retrieved from a

hospitalrsquos (Cathay General Hospital Taipei

Taiwan) AME-reporting system database The

database contains AMEs relating to areas such as

medication patient falls surgery transfusion

clinical care public accidents security hospital

violence tube-related complication unplanned

cardiopulmonary resuscitation laboratory testing

and examination and anesthesia The RCA cases

were sentinel or high-frequency events classified

according to severity assessment category (SAC)

[1113] The SAC is an evaluation method for

categorizing AMEs by severity of effect on pa-

tients health and risk of incident reoccurrence

The HFACS has been modified (from the US

Department of Defense version 70) and trans-

lated into Mandarin Chinese with authorization

from the original developers [10] The Chi-

nese-version HFACS for Taiwan is a valid in-

strument (content validity index 09 Cronbachrsquos

α gt07 interrater reliability Κ 04-10) equiva-

lent to the original English version [9] The

HFACS contains 4 tiers 13 subitems and 109

nanocodes (Supplement Table 1) A panel of 6

reviewers was established All reviewers were

from clinical or management (quality and patient

safety management) backgrounds Reviewers all




finished human factor education and were

trained to use the HFACS through a consensus

meeting Each RCA case was randomly assigned

to 2 reviewers Human factors leading to partic-

ular AMEs were identified and confirmed when

2 reviewers reached agreement The distribution

of errors among tiers subitems and nanocodes

are provided with descriptive statistics () The

study was approved by the Institutional Review

Board of Cathay General Hospital

(CGH-P105095)

RESULTS AMEs related to laboratory testing and examina-

tion (n = 16) clinical care (n = 9) and medica-

tion (n = 7) were the most commonly observed

in the RCA Most AMEs in this cohort are

ranked as being SAC level 3 (n = 15) or 4 (n =

17) (Table 1)

Acts (Active Failures)

This tier of errors contains 3 subitems and 13

nanocodes In the 40 RCA cases perfor-

mance-based errors for 38 (95) and judgment

and decision-making errors for 35 (875) com-

prised the most common error types with viola-

tion for 6 (15) less common Procedure fol-

lowed incorrectly for 31 out of 38 (816) was

the most common performance-based problem

Inadequate real-time risk management for 24 out

of 35 (686) was the most common judgment

or decision error All of the rule violations were

workaround types for 6 out of 6 (100) (Figure

1)

Preconditions(Latent Failures)

This tier of errors has 9 subitems and 58 nano-

codes In the 40 RCA cases teamwork for 11

(275) and environmental for 8 (20) factors

contributed to most of the errors with mental

and physical state the next most common factor

for 7 (175) Communication for 9 out of 11

(818) and information relay for 8 out of 11

(727) were the most common issues related to

teamwork Few contributors mentioned failures

related to technical errors for 4 (50) or physi-

cal for 1 (125) environment Not paying at-

tention for 4 out of 7 (571) and negative habit

transfer for 4 out of 7 (571) were common

mental contributes noted for 7 (100) Overcon-

fidence was the most common problem related

to emotional status for 4 out of 7 (571) Fa-

tigue was observed in only 2 cases for 2 out of 2

physical problems (100) (Figure 2)

Supervision(Direct Supervisory Chain of

Command)


nanocodes In the 40 RCA cases inadequate

supervision for 14 (35) and inappropriately

planned operations for 11 (275) factors con-

tributed to most of the respective errors fol-

lowed by supervisory violations for 7 (175)

Supervisory or command oversights for 13 out

of 14 (929) were the most common sources of

supervision inadequacy Authorized unnecessary

hazards for 7 out of 11 (636) were the most

common inappropriately planned operations

Failure to enforce rules for 6 out of 7 (857)

was the most common supervisory violation

(Figure 3)

Organization Influence (Upper-Level Man-

agement)


nanocodes In the 40 RCA cases policy and

process issues for 10 (25) and resources prob-

lem for 8 (20) were major concerns Few of

the respective problems are related to climate

and cultural influences for 2 (5) or to person-

nel selection and staffing for 1 (25) Poorly

assessed organizational programs or policy risks

for 5 out of 10 (50) were the most common

policy and process problems Failure to provide

adequate operational information resources for 4

out of 8 (50) and command and control re-

source deficiency for 3 out of 8 (375) were

the main resource management problems Little

was revealed regarding organizational climate

and culture (n = 1 out of 2 50) or staffing for 1

out of 1 (100) (Figure 4)

DISCUSSION Health care is a complex system comprising

many high-reliability organizations (HROs) The

vulnerability of HROs stems from the participa-

tion of multidisciplinary teams in the processes

along a variety of patient care timelines How-

ever humans and systems are inherently prone

to errors the appropriate management of AMEs

is acknowledged to be the cornerstone of patient

safety AMEs should be reported investigated

analyzed and handled appropriately[14] Theo-

retically by analyzing the pattern of key defects

providers can fix errors and re-engineer their

care processes to reduce the possibility of AME

recurrence Taiwan established its nationwide

TPR in 2004 so far 7000 health care facilities

have participated and the database has accumu-

lated more than 055 million AMEs[11] Infor-

mation generated from the TPR database can

improve patient safety at individual organiza-

tional or even national levels However despite

relentless efforts few substantial improvements

have been achieved in patient safety [15-17]

Since its introduction in Taiwan in 2006 the use

of RCA for AMEs has encountered some diffi-

culties 1) No structural and standardized




framework exists for investigation

cross-institution variability and interrater relia-

bility are often ignored 2) Conclusions are often

subjective and corrective recommendations are

less actionable relying on individual reviewersrsquo

professional backgrounds and their experiences

3) Much focus on event reconstruction and oper-

ator performance means that factors relating to

human behavior organizational culture and

system weakness are not comprehensively ad-

dressed [671718] Traditionally attempts to

improve patient safety in the health care industry

are largely reactive in nature identifying and

correcting errors in care processes [1920]

Causes of defects are not thoroughly understood

Proactive approaches must be taken to address

systematic problems within a complex system

[720] Research suggests that human error is a

causal factor in the occurrence of AMEs AME

investigation targets have moved from skill defi-

ciency toward decision-making attitudes super-

visory factors and even organizational climate

or culture HFACS methodology is based on the

Swiss cheese model that also emphasizes active

and latent failures [921] The study provides

some noteworthy findings First most AMEs as

expected involve active failures such as failure

to follow procedure accidental operation of

equipment inadequate real-time risk manage-

ment and inappropriate action These are all

sharp ends in classic RCA environment physi-

cal and mental factors are less prevalent This

proves that retrospectively determining addi-

tional causal factors is difficult when infor-

mation has not been collected during preliminary

investigation (Figure 1) Second team-

work-related problems particularly in relation to

communication and information relay are well

addressed This may be attributed to the dec-

ade-long institution-wide routine crew resource

management training in the respective research

hospital (Figure 2) Third the HFACS success-

fully reflects the importance of supervisory roles

in the occurrence of AMEs and this cannot be

overlooked (Figure 3) Fourth latent failures

especially in organizational climate or cultural

dimensions have been less frequently addressed

in incident reports a limitation of traditional

RCA However the HFACS review suggests

room for improvement in resource allocation and

policy modification within the hospital The

results of studies can make the organization

think about how to improve the patient safety

and management process from the perspective of

human factors such as improving the comfort of

the working environment and replacing and

equipment resources to prevent personnel from

affecting the medical quality and patient safety

due to the environment or equipment Need to

appropriate assessment of applicability and ade-

quate training of manpower is required The

management and control of risks should be fully

evaluate and grasp resource management and

leaders need to participate in and promote medi-

cal quality and patient safety activities to en-

hance its culture (Figure 4) No panacea exists

to ensure patient safety and improvement targets

originate largely from event investigation find-

ings Unfortunately factors identified from

AMEs are often self-explanatory with little value

for further action correction Reinforcement of

policy or processes redundant education or

repetitious training are formulaic overprescribed

RCA recommendations The use of HFACS in

this study proves that a structural prospective

AME investigation format can potentially help

with proactive patient safety management We

suggest developing an interview guideline for

the routine use of HFACS as a complement to

RCA in every AME investigation This study is a

retrospective study The underlying human fac-

tors can be under-estimated owing to the lack of

related information in the original RCA reports

CONCLUSION The HFACS review in this study enhances our

understanding of human factors in AMEs that

had previously been insufficiently scrutinized

Aside from active process and communication

errors the HFACS enables the prospective in-

vestigation of latent supervisory organizational

or systematic problems that cannot be addressed

through traditional RCA

REFERENCES 1 T Brennan L Leape N Laird et al

Incidence of adverse events and

negligence in hospitalized patients results

of the Harvard Medical Practice Study I N

Engl J Med 1991324370-376

2 Wang CH Shih CL Chen WJ et al

Epidemiology of medical adverse events

perspectives from a single institute in

Taiwan J Formos Med Assoc

2016115434-439

3 Vincent C Simon R Sutcliffe K et al

Errors Conference Executive Summary

Acad Emerg Med 200071180-1182

4 Taitz J Genn K Brooks V et al

System-wide learning from root cause

analysis A report from the New South

Wales Root Cause Analysis Review

Committee Qual Saf Health Care

2010191-5




5 Hutchinson A Young TA Cooper KL et

al Trends in healthcare incident reporting

and relationship to safety and quality data

in acute hospitals results from the

National Reporting and Learning System

Qual Saf Health Care 2009185-10

6 Mitchell RJ Williamson AM Molesworth

B et al A review of the use of human

factors classification frameworks that

identify causal factors for adverse events

in the hospital setting Ergonomics

2014571443-1472

7 Gurses AP Ozok AA Pronovost PJ Time

to accelerate integration of human factors

and ergonomics in patient safety BMJ

Qual Saf 201221347-351

8 Health and Safety Executive Introduction

to human factors

httpwwwhsegovukhumanfactorsintro

ductionhtm

9 Wiegmann DA Shappell SA A human

error approach to aviation accident

analysis The human factors analysis and

classification system Burlington VT

Ashgate Publishing Ltd 2003

10 Yu-Hsun Cheng Sheng-Hui Hung

Tung-Wen Ko et al An Analysis of the

Reliability and Validity of Human Factors

Analysis Classification System in Medical

Adverse Events Journal of Healthcare

Quality 20191370-76

11 Taiwan Joint Commission on Hospital

Accreditation Taiwan Patient-Safety

Reporting System Annual Report 2017

New Taipei City Taiwan

12 Taiwan Patient Safety Net

httpwwwpatientsafetymohwgovtwCo

ntentzMessagesslistaspxSiteID=1ampMm

mID=621273300317401756

13 Government of Western Australia

Department of Health

httpsww2healthwagovauArticlesS_T

Severity-assessment-codes

14 Farley DO Haviland A Champagne S et

al Adverse-event-reporting practices by

US hospitals results of a national survey


15 Shojania KG Thomas EJ Trends in

adverse events over time why are we not

improving BMJ Qual Saf

201322273-277

16 Levitt P Challenging the systems approach

why adverse event rates are not improving

BMJ Qual Saf 2014231051-1052

17 Kellogg KM Hettinger Z Shah M et al

Our current approach to root cause

analysis is it contributing to our failure to

improve patient safety BMJ Qual Saf

201726381-387

18 Khorsandi M Skouras C Beatson K et al

Quality review of an adverse incident

reporting system and root cause analysis of

serious adverse surgical incidents in a

teaching hospital of Scotland Patient Saf

Surg 2012621

19 Diller T Helmrich G Dunning S et al

The Human Factors Analysis

Classification System (HFACS) Applied to

Health Care Am J Med Qual

201429181-190

20 Carayon P Xie A Kianfar S Human

factors and ergonomics as a patient safety

practice BMJ Qual Saf 201423196-205

21 Reason J Human Error New York

Cambridge University Press 1990




TABLE

Table 1 Incidences by Category (N=40)

CategorySAC SAC 4 SAC 3 SAC 2 SAC 1 total

Laboratory and ex-

amination events

4 10 2 0 16 (400)

Clinical care event 6 2 1 0 9 (225)

Medication event 5 0 2 0 7 (175)

Surgery-related event 1 1 2 0 4 (100)

Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)

Public accident 0 0 1 0 1 (26)

Total 17 (425) 15 (375) 8 (200) 0 40 (100)

SAC 1113 Severity Assessment Code SAC




FIGURES

Figure 1 Active Failures (N=40)

16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40

Commits WidespreadRoutine Violation

Performs Work-Around Violation

Ignored a CautionWarning

Failure to Prioritize Tasks Adequately

Wrong Choice of Action During an Operation

Inadequate Real‐Time Risk Assessment

Rushed or Delayed a Necessary Action

Breakdown in Visual Scan

Over-ControlledUnder-Controlled AircraftVehicleSystem

Unintended Operation of Equipment

Procedure Not Followed Correctly

Performance-Based Errors

Judgment and Decision Making Errors

Violations




Figure 2 Preconditions (Latent Failures or Conditions) (N=40)

14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40

Seat and Restraint System Problems

Instrumentation amp Warning System Issues

Noise Interference

Environment

Physical Environment

Technological Environment

27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40

Technical or Procedural Knowledge Not Retained After Training

InterferenceInterruption

Task OverUnder Saturation

Distraction

Negative Habit Transfer

Not Paying Attention

Complacency

Overconfidence

Physical IllnessInjury

Fatigue

Physical and Mental State

Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40

Inadequate Task Delegation

TaskMission PlanningBriefingDebriefing Inadequate

Failure of CrewTeam Leadership

StandardProper Terminology Not Used

Critical Information Not Communicated

Failed to Effectively Communicate

Teamwork




Figure 3 Supervision (Direct Supervisory Chain of Command) (N=40)

Figure 4 Organization Influence (Upper-Level Management Command Level) (N=40)

114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40

Selected Individual with Lack of Proficiency

Improper Role‐modeling

Failed to Provide Proper Training

Failed to IdentifyCorrect Risky or Unsafe Practices

SupervisoryCommand Oversight Inadequate

Performed Inadequate Risk Assessment ‐Formal

Selected Individual with Lack of Current or Limited Experience

Authorized Unnecessary Hazard

Allowing Unwritten Policies to Become Standard

Failure to Enforce Existing Rules

Supervisory Violations

Planned Inappropriate Operations

Inadequate Supervision

12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40

Organizational Over-confidence or Under-confidence in Equipment

Organizational Culture (attitude actions) Allows for Unsafe TaskMission

Purchasing or Providing Poorly Designed or Unsuitable Equipment

Organizational ProgramPolicy Risks not Adequately Assessed

Failure to Provide Adequate Manning Staffing Resources

Failure to remove inadequate worn-out equipment in timely manner

Inadequate infrastructure

Command and control resources are deficient

Failure to provide adequate operational information resources

Resource Problems

Personnel Selection amp Staffing

Policy and Process Issues

ClimateCulture Influences




Supplement Table 1- HFACS Content of Human Factor Analysis Classifi-

cation System [9] Tier main level sub-item nano code

Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors

Unintended operation of equipment

Checklist not followed correctly

Procedure not followed correctly

Over-controlledunder-controlled aircraftvehiclesystem

Breakdown in visual scan

Rushed or delayed a necessary action

Judgment amp De-

cision-Making

Errors

Inadequate real‐time risk assessment

Failure to prioritize tasks adequately

Ignored a cautionwarning

Wrong choice of action during an operation

Violations

Performs work-around violation

Commits widespreadroutine violation

Extreme violation-lack of discipline

Tier 2 Preconditions

Environment

Physical environment

Environmental conditions affecting vision

Vibration effects vision or balance

Heatcold stress impairs performance

External force of object impeded an individualrsquos

movement

Lights of other vehiclevesselaircraft affected vision

Noise interference

Technological environment

Seat and restraint system problems

Instrumentation amp warning system issues

Visibility restrictions (not weather related)

Controls and switches are inadequate

Automated system creates unsafe situation

Workspace incompatible with operation

Personal equipment interference

Communication equipment inadequate

Physical and

Mental State

Physical problem

Substance effects (alcohol supplements medications

drugs)

Loss of consciousness (sudden or prolonged onset)

Physical illnessinjury

Fatigue

Inadequate adaptation to darkness

Dehydration

Body sizemovement limitations

Physical strength amp coordination (inappropriate for

task demands)

Nutritiondiet

State of mind

Psychological problem

Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation

Motivational exhaustion (burnout)

Sensory misperception

Motion illusion-kinesthetic

Turning illusionbalance-vestibular

Visual illusion

Misperception of changing environment

Misinterpreted misread instrument

Misinterpretation of auditorysound cues

Spatial disorientation

Temporaltime distortion

Mental awareness

Not paying attention

Fixation

Task overunder saturation

Confusion

Negative habit transfer

Distraction

Geographically lost

Interferenceinterruption

Technical or procedural knowledge not retained after

training

Inaccurate expectation

Teamwork

Failure of crewteam leadership

Inadequate task delegation

Rankposition intimidation

Lack of assertiveness

Critical information not communicated

Standardproper terminology not used

Failed to effectively communicate

Taskmission planningbriefingdebriefing inadequate

Tier 3 Supervision

Supervisory Vio-

lations

Failure to enforce existing rules

Allowing unwritten policies to become standard

Directed individual to violate existing regulations

Authorized unqualified individuals for task

Planned Inappro-

priate Operations

Directed task beyond personnel capabilities

Inappropriate team composition

Selected individual with lack of current or limited experience

Performed inadequate risk assessment ‐formal

Authorized unnecessary hazard

Inadequate Su-

pervision

Supervisorycommand oversight inadequate

Improper role‐modeling

Failed to provide proper training

Failed to provide appropriate policyguidance

Personality conflict with supervisor

Lack of supervisory responses to critical information

Failed to identifycorrect risky or unsafe practices

Selected individual with lack of proficiency

Tier 4 Organizational

Influences

Resource Prob-

lems






Failure to remove inadequate worn-out equipment in timely

manner


Fail to provide adequate funding

Personnel Selec-

tion amp Staffing

Personnel recruiting amp selection policies are inadequate

Failure to provide adequate manning staffing resources

Policy amp Process

Issues

Pace of ops-tempoworkload

Organizational programpolicy risks not adequately assessed

Provided inadequate procedural guidance or publications

Organizational (formal) training is inadequate or unavailable

Flawed doctrinephilosophy

Inadequate program management

Purchasing or providing poorly designed or unsuitable equip-

ment

ClimateCulture

Influences

Organizational culture (attitude actions) allows for unsafe

taskmission

Organizational over-confidence or under-confidence in equip-

ment

Unit missionaircraftvehicleequipment change or unit deacti-

vation

Organizational structure is unclear or inadequate






以 HFACS重新檢視根本原因分析案例挖掘造成醫療不良

事件之人為因素

鄭伃洵 1洪聖惠 12柯彤文 3王拔群 14

中文摘要

背景醫療不良事件(AMEs)的管理是促進病人安全的基石根本原因分析

(RCA)是探討重大病人安全不良事件問題但是由於無法解釋更廣泛的因素而受

到限制本研究使用人為因素分類與分析工具(HFACS)回溯審視醫療不良事件

以了解影響醫療不良事件的人為因素及各層面中錯誤原因之分佈或系統性問題

方法本研究回溯 2012-2016年間有做過根本原因分析之醫療不良事件以連續

性取樣方式(continuous sampling)收集 40例醫療不良事件以人為因素分類與分

析工具(HFACS)去系統性的挖掘每件案例發生錯誤之原因結果在行為層面中

分析結果主要為基礎技能錯誤(95)判斷和決策錯誤(875)其中在基礎技能

錯誤當中以未依程序作業執行(816)及未如預期設備操作(50)佔多數判斷和

決策錯誤中以現場風險評估不確實(686)及採取錯的步驟行為(686)佔多數

而在先決條件層面中以團隊合作(275)為主要因素包含溝通不良(818)及重

要訊息未以正確的方式即時傳達(727)佔多數在監督層面當中以監督不周

(929)或監督不妥當(929)為主要因素在組織政策和流程方面(50)以組織

系統的政策風險未充分評估(35)為主要因素結論本研究進一步了解醫療不

良事件在過去使用根本原因分析未探討到的人為因素反映出潛在的監督組織

行為或系統性的問題促進病人安全預防錯誤再發生

關鍵字病人安全醫療不良事件根本原因分析人為因素

1國泰醫療財團法人國泰綜合醫院品質管理部

2國立臺灣大學健康政策與管理研究所

3振興醫療財團法人振興醫院醫療品質管理中心

4輔仁大學醫學院

通訊作者王拔群電子信箱 drtonyseednettw


Juvenile caruncular lymphoid proliferation


Submitted January 20 2020

Final version accepted April13

2020

Case Report

Juvenile Caruncular Atypical Lymphoid

Proliferation ndash A Rare Case Report

Cite as Hua-Wei Shih Yu-Chi Lin

Juvenile Caruncular Atypical

Lymphoid Proliferation ndash A Rare

Case Report Fu-Jen Journal of

Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003

Hua-Wei Shih1 Yu-Chi Lin

1

1Department of Ophthalmology Shin Kong Wu Ho-Su Memorial Hos-

pital Taipei City Taiwan


yuchi067gmailcom (Yu-Chi Lin)

ABSTRACT

Lesions of the caruncle are very rare Most caruncular lesions are benign though there were still few reported malignant lesions Ocular adnexal lymphoproliferative disease (OALD) one of the differential diagnosis of caruncular lesion is seldom seen in young pa-tient In this article we report a 16-year-old boy with recurrent caruncular atypical lym-phoid proliferation We discuss the epidemiology clinical features images histomorpholo-gy and treatment between ocular adnexal lymphomas (OAL) and reactive lymphoid hyper-plasia (RLH)

Keywords caruncular lesion ocular adnexal lymphoproliferative disease ocular adnexal lymphoma

reactive lymphoid hyperplasia atypical lymphoid proliferation



Hua-Wei Shih Yu-Chi Lin

113

INTRODUCTION Lesions of the caruncle are very rare Differen-

tial diagnosis includes nevus myeloproliferative

disorders tumors inflammation infection cysts

vascular lesions and fibrous Biopsy is essential

for diagnosis Levy J et al reported ocular ad-

nexal lymphoproliferative disease (OALD) was

relatively uncommon diagnosis among caruncu-

lar lesions [1]

OALD was seldom described in Asian popula-

tion especially for young age C-Y Cheng re-

ported age-standardized incidence of ocular

adnexal lymphomas (OAL) in Taiwan from 1979

to 1996 was below 07 per million per year and

mean age was 531 years old [2] In 2015 five

Taiwanese cases of OAL whose age ranging

from 45 to 64 were presented [3] However

there were few cases of conjunctival OAL or

RLH in Chinese pediatric patient

Here we present a case of 16-year-old boy with a

caruncular mass at his left eye with recurrence

one month after excision We describe his clini-

cal symptoms photographs pathological results

management and follow-up clinical course in

this report

CASE REPORT A 16-year-old healthy boy presented a mass

lesion at his left eye caruncle accompanied with

the symptom of tearing for one month (Figure 1)

He had no ocular pain no itchiness no blurred

vision no night sweating no fever and no body

weight loss The patient denied systemic diseas-

es and histories of surgery His bilateral best

corrected visual acuity (BCVA) were 66 and

intraocular pressure (IOP) were both within

normal range There were no remarkable find-

ings for his cornea lens fundus and physical

examination Excision was performed and the

mass was soft with fluid inside therefore con-

junctival pyogenic cyst was our initial diagnosis

However one month after the excision a pro-

truding mass recurred at the patientrsquos nasal can-

thus of left eye (Figure 2) There were some

differences compared to previous condition At

the first time the soft mass was contained in a

well-defined cyst wall which more favored py-

ogenic granulation However after short period

of recurrence solid consistency and unclear

margin were found which favored malignancy

Besides the mass partially involved beyond the

gray line of nasal part lower eyelid whereas last

time the cyst mainly extended from conjunctiva

of caruncle The second excisional biopsy was

performed Pathologic examination demonstrat-

ed abundant atypical lymphoid proliferation

(Figure 3A 3B) Immunohistochemical studies

showed that the lymphoid aggregation was

composed predominantly of CD20-positive cells

(Figure 3C) focal positive staining of CD3

(Figure 3D) CD5 CD23 CD10 and negative

staining of cyclin-D1 Unfortunately the cellular

morphology was difficult to be evaluated due to

marked crushing artifact Thus malignant lym-

phoma cannot be excluded totally

Orbital computed tomography (CT) showed a

lesion of soft tissue density at medial canthus of

left orbit without obvious nasolacrimal duct or

bony invasion (Figure 4A) Magnetic resonance

imaging (MRI) with contrast showed strong

enhancement at left medial canthus region (Fig-

ure 4B) There was no remarkable finding in the

systemic workup including complete blood

count and differential count biochemical pro-

files and 18F-fluoro-2-deoxyglucose positron

emission tomographycomputed tomography

(18F-FDG PETCT) indicating no evidence of

systemic involvement

After the second excision we preferred con-

servative management for him due to the uncer-

tainty of malignancy and to avoid side effects

from aggressive treatment No sign of recurrence

was noted after 10 months of observation The

follow-up photo was taken at three months after

the second operation (Figure 5)

DISCUSSION Ocular adnexal lymphoproliferative disease

(OALD) consists of the spectrum of lymphoid

disease affecting the tissues surrounding the eye

including ocular adnexal lymphomas (OAL) and

lymphoid hyperplasia (LH) [4] The conjunctiva

is an important location for extranodal lympho-

ma development which comprises 25 of OAL

[5]

OAL can be grouped into two categories based

on their appearance of cells under the micro-

scope low-grade and high-grade [6] Extranodal

marginal zone lymphoma of mucosa-associated

lymphoid tissue (EMZLMALT) is the most

common subtype of OAL followed by follicular

lymphoma [7-9] Both of the above are

low-grade lymphomas

LH can be further divided by histopathology into

reactive lymphoid hyperplasia (RLH) and atypi-

cal lymphoid hyperplasia (ALH) RLH has to-

tally benign morphology and immunophenotype

whereas ALH has borderline lesions between

RLH and lymphoma [10] OAL and LH are

mostly seen in patients with age between 50-70

years old There are rare cases in pediatric group




114

[71011] In the C-Y Chengrsquos statistical report of

OAL in Taiwan only 8 patients were younger

than 15 years old among the 101 cases of ocular

lymphoma [2] According to an US study inci-

dence rates of OAL were analyzed in different

age groups the group of age over 50 had the

highest incidence rate of 574 per million per-

son-years while the 0-19 age group had the

lowest incidence rate of 009 per million per-

son-years [12] The incidence of LH was even

less than OAL [13]

Patients with OALD may be asymptomatic or

with symptoms of proptosis eyelid swelling a

palpable painless mass or conjunctival salmon

patch Diplopia visual loss pain or inflamma-

tion occurred less frequently implying more

aggressive features [714]

Orbital LH is not distinguishable from low-grade

lymphoma radiologically They both typically

present a round or lobulated mass that diffusely

moderately enhances with contrast and usually

shows homogenous hypointense or isointense to

muscle barely invasion to bone or nervous sys-

tem [10] Atypical appearances including inho-

mogeneous calcification or bony changes may

be seen in high-grade lymphoma case reports

such as ocular adnexal diffuse large B-cell lym-

phoma (DLBCL) which is one of the more ag-

gressive type of OAL [7] Whole body PET is

used for not only the evaluation of systemic

involvement but also the standard for staging

lymphoma Our patientrsquos image studies revealed

neither obvious local invasion nor systemic ma-

lignancy indicating high-grade lymphoma was

less likely Low-grade lymphoma and benign

reactive lymphoid hyperplasia were still under

consideration

Histomorphology analysis and immunohisto-

chemistry (IHC) are essential for diagnosis

Flow cytometry and polymerase chain reaction

(PCR) technique are also applied to help differ-

entiate from RLH and OAL [1016] Our case

had immunohistochemical profile of positivity

for CD20 predominantly positivity focally for

CD3 CD5 CD10 CD23 and negativity for cy-

clin-D1 BCL-6 staining was not performed in

our casersquos biopsy Thus according to the IHC

report RLH ALH and follicular lymphoma are

probable diagnosis of our patient

Radiation therapy is the standard treatment for

low-grade OAL that is classified as T1N0M0 or

T2N0M0 according to the AJCC criteria [15]

İncesoy-Ouml zdemir S et al reported a 10-year-old

boy diagnosed of MALT lymphoma who was

treated with local radiotherapy (36 Gy) and

there were no local or systemic recurrences dur-

ing his nearly four-year follow-up [17] Another

case report represented a 21-year-old man of

conjunctival follicular lymphoma treated with

surgical excision only showing no evidence of

recurrence after 8 months follow-up [18] Other

treatment options for pediatric and juvenile OAL

were performed in some case reports including

intravenous rituximab intralesional interfer-

on-α-2b topical interferon a6 systemic doxycy-

cline surgical excision and postoperative local

cryotherapy [15]

Treatment for young conjunctival RLH was less

discussed in the past In a case series article

three children (9 13 14 years old respectively)

of RLH received surgical resection without fur-

ther postoperative management and no signs of

recurrence were noted during follow-up [19]

Short-term topical and oral corticosteroids after

surgical excision were prescribed in two pediat-

ric RLH patients for their small residual mass

However poor response in both cases was nota-

ble [20]

Our patient declined to receive radiotherapy or

any further postoperative treatment mainly due

to his concerning of possible side effects (such

as dry eye and cataract)

CONCLUSION We present a rare case of caruncle mass in this

report OALD is one of the relatively uncommon

diagnosis among caruncular lesions OALD

includes benign RLH and malignant OAL

which are both mainly seen in elderly patients

even rarer in pediatric or juvenile group

The standard treatment for low-grade OAL and

RLH in young patents are still debatable How-

ever long-term follow-up is suggested for both

OAL and RLH patients Though RLH has a be-

nign and self-limited course risk of malignant

transformation is possible

REFERENCES 1 Levy J Ilsar M Deckel Y et al Lesions of

the caruncle a description of 42 cases and

a review of the literature Eye

200923(5)1004-1018

2 C-Y Cheng and W-M Hsu Incidence of

eye cancer in Taiwan an 18-year review

Eye 200418152-158

3 Chui-Lien Tsen Muh-Chiou Lin

Youn-Shen Bee et al Ocular adnexal

lymphoma Five case reports and a

literature review Taiwan Journal of

Ophthalmology 20155(2)99-102

4 Liesegang TJ Ocular adnexal

lymphoproliferative lesions Mayo Clin

Proc 199368(10)1003-1010

5 Kirkegaard MM Coupland SE Prause JU




115

et al Malignant lymphoma of the

conjunctiva Surv Ophthalmol

201560(5)444-458

6 Stacy RC Jakobiec FA Schoenfield L et

al Unifocal and multifocal reactive

lymphoid hyperplasia vs follicular

lymphoma of the ocular adnexa Am J

Ophthalmol 2010150(3)412-426

7 Sullivan TJ Ocular Adnexal

Lymphoproliferative Disease In Guthoff

RF Katowitz JA eds Oculoplastics and

Orbit Berlin Heidelberg Springer

20101-19

8 White Valerie A Understanding and

Classification of Ocular Lymphomas

Ocular Oncology and Pathology

20195379-386

9 Stefanovic A Lossos IS Extranodal

marginal zone lymphoma of the ocular

adnexa Blood 2009114(3)501-510

10 Andrew NH Coupland SE Pirbhai A et al

Lymphoid hyperplasia of the orbit and

ocular adnexa A clinical pathologic review

Surv Ophthalmol 201661(6)778-790

11 Ferry JA1 Fung CY Zukerberg L et al

Lymphoma of the ocular adnexa A study

of 353 cases Am J Surg Pathol

200731(2)170-184

12 WM Hassan MS Bakry HM Hassan et al

Incidence of orbital conjunctival and

lacrimal gland malignant tumors in USA

from Surveillance Epidemiology and End

Results 1973-2009 Int J Ophthalmol

20169(12)1808-1813

13 Ajay A Rao John H Naheedy James Y-Y

Chen et al A Clinical Update and

Radiologic Review of Pediatric Orbital

and Ocular Tumors Journal of Oncology

2013(9)975908

14 Sullivan TJ Whitehead K Williamson R

et al Lymphoproliferative disease of the

ocular adnexa a clinical and pathologic

study with statistical analysis of 69

patients Ophthal Plast Reconstr Surg

200521177-188

15 Tanenbaum RE Galor A Dubovy SR et al

Classification diagnosis and management

of conjunctival lymphoma Eye Vis (Lond)

2019622

16 Olga Klavdianou Georgios Kondylis

Vasileios Georgopoulos et al Bilateral

benign reactive lymphoid hyperplasia of

the conjunctiva a case treated with oral

doxycycline and review of the literature

Eye Vis (Lond) 2019626

17 İncesoy-Ouml zdemir S Yuumlksek N Bozkurt C

et al A rare type of cancer in children

extranodal marginal zone B-cell (MALT)

lymphoma of the ocular adnexa Turk J

Pediatr 201456(3)295-298

18 Lynn J Poole Perry Frederick A Jakobiec

Peter A D Rubin Conjunctival Pediatric

Follicular Lymphoma Arch Ophthalmol

2012130(7)941-943

19 Abdullah Al-Mujaini Upender Wali

Anuradha Ganesh1 et al Ocular Adnexal

Reactive Lymphoid Hyperplasia in

Children Middle East Afr J Ophthalmol

201219(4)406-409

20 McLeod SD Edward DP Benign

lymphoid hyperplasia of the conjunctiva in

children Arch Ophthalmol

1999117(6)832-835




116

FIGURES

Figure 1 Slit lamp image of a mass lesion at the patientrsquos left eye caruncle for one month

Figure 2 One month after the first excision a protruding mass recurred at the patientrsquos nasal canthus

of left eye It partially involved beyond the gray line of nasal part lower eyelid




117

Figure 3 Histomorphology analysis and immunohistochemistry study of the caruncular lesion Abun-

dant atypical lymphoid proliferation presented in low-power photomicrograph (A) and

high-power photomicrograph (B) under hematoxylin-eosin staining The lymphoid aggrega-

tion was composed predominantly of CD20-positive cells (C) and focal positive staining of

CD3 (D)

Figure 4 Non-contrast orbital computed tomography showed a lesion of soft tissue density at medial

canthus of left orbit without obvious nasolacrimal duct or bony invasion (A) Magnetic reso-

nance imaging with contrast showed strong enhancement at left medial canthus region (B)




118

Figure 5 The follow-up photo were taken at three months after the second excision showing no signs

of recurrence




119


罕見病例報告mdash青少年之淚阜非典型淋巴增生

施驊瑋 1林友祺 1

中文摘要

淚阜病灶相當罕見大部分為良性病灶眼睛及附屬結構淋巴增生疾病為其

鑑別診斷之一非常少見於年輕人或兒童我們報告一位 16歲的健康男性因

左眼淚阜無痛性腫塊接受切除手術卻於術後一個月復發執行第二次切除手術

後門診追蹤十個月未再復發此案例表現了部分良性與部分惡性腫瘤的特徵

我們針對反應性淋巴增生眼睛及附屬結構淋巴癌兩個疾病做討論及文獻回顧

關鍵字淚阜病灶眼睛及附屬結構淋巴增生疾病眼睛及附屬結構淋巴癌反

應性淋巴增生非典型淋巴增生

1 新光吳火獅紀念醫院眼科

通訊作者林友祺電子信箱 yuchi067gmailcom


Acute intramembranous hemorrhage


Submitted March 26 2020

Final version accepted April 16

2020

Case Report

Hyperacute intramembranous hemor-

rhage after burr hole craniostomy for

chronic subdural hematoma

Cite as Meng-Chi Lin Jui-Ming

Sun Yu-Hao Chen Cheng-Ta

Hsieh

Hyperacute intramembranous

hemorrhage after burr hole crani-

ostomy for chronic subdural he-

matoma Fu-Jen Journal of Medi-

cine 3(4) 120-125 2020

DOI

103966181020932020091803004

Meng-Chi Lin1 Jui-Ming Sun23 Yu-Hao Chen24 Cheng-Ta

Hsieh567

1Department of Surgery Zuoying Branch Kaohsiung Armed Forces

General Hospital Kaohsiung 813 Taiwan 2Section of Neurosurgery Department of Surgery Chia-Yi Christian

Hospital Chia-Yi City 600 Taiwan 3Department of Biotechnology Asia University Taichung City 41354

Taiwan 4Chung-Jen Junior College of Nursing Health Sciences and Manage-

ment Chia-Yi Country 62241 Taiwan 5Division of Neurosurgery Department of Surgery Sijhih Cathay Gen-

eral Hospital New Taipei City 22174 Taiwan 6Department of Medicine School of Medicine Fu Jen Catholic Univer-

sity New Taipei City 24205 Taiwan 7Department of Neurological Surgery Tri-Service General Hospital

National Defense Medical Center Taipei 114 Taiwan


nogormail2000comtw (Cheng-Ta Hsieh)

ABSTRACT

Burr hole craniostomy with closed-system drainage is an effective and common neurosurgical procedure to manage chronic subdural hematoma Postoperative hem-orrhage a well-known but infrequent complication may result in increased neurolog-ical deficits However hyperacute intramembranous hemorrhage within the inner and outer membrane of hematoma after burr hole craniostomy with irrigation and closed-system drainage has not been described previously Herein we report a case of postoperative spontaneous hyperacute intramembranous hemorrhage after burr hole craniostomy with closed-system drainage to manage a chronic subdural hematoma we subsequently discuss the possible pathophysiological mechanisms and review the relevant literature

Keywords Chronic subdural hematoma acute subdural hematoma bleeding burr hole craniostomy

drainage

Fu-J

Meng

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Vol 3 No 4 2

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Yu-Hao Chen

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Meng-Chi Lin Jui-Ming Sun Yu-Hao Chen Cheng-Ta Hsieh

125



慢性硬腦膜下出血進行鑽顱引流手術造成超急性夾膜內出

血

林孟楫 1孫瑞明 23陳昱豪 24謝政達 567

中文摘要

鑽顱併封閉系統引流手術是治療慢性硬腦膜下出血患者一種有效且常見的

神經外科手術方式術後出血可能導致神經功能缺損惡化是眾所周知但不常見

的併發症之一然而至今仍未有鑽孔併封閉系統引流造成原本慢性硬腦膜血

塊內膜和外膜間急性夾膜間出血案例在這裡我們報告一例慢性硬腦膜下出

血病患者接受鑽顱併封閉系統引流手術治療造成術後急性夾膜間出血我們在

本文中討論可能的致病機制並回顧相關文獻

關鍵字慢性硬腦膜下出血急性硬腦膜下出血出血鑽顱術引流

1國軍高雄總醫院左營分院外科部

2崇仁醫護管理專科學校

3亞洲大學生物科技學系

4戴德森醫療財團法人嘉義基督教醫院外科部神經外科

5汐止國泰綜合醫院神經外科

6輔仁大學醫學系

7 國防醫學院三軍總醫院神經外科

通訊作者謝政達電子信箱 nogormail2000comtw



Hsuan-An Chen Cheng-Yu Lo Shih-Hung Huang Chin-Lung Lin

126


Final version accepted July 08

2020

Case Report


Cite as Hsuan-An Chen

Cheng-Yu Lo Shih-Hung Huang

Chin-Lung Lin

Hamartoma of the breast A case

report Fu-Jen Journal of Medicine

3(5) 126-130 2020

DOI

103966181020932020091803005

Hsuan-An Chen1 Cheng-Yu Lo

3 Shih-Hung Huang

3 Chin-Lung

Lin2

1Department of Surgery Cathay General Hospital Taipei Taiwan

2Department of General Surgery Cathay General Hospital Taipei Tai-

wan

3Department of Pathology Cathay General Hospital Taipei Taiwan


lungyungmailcom (Chin-Lung Lin)

ABSTRACT

Breast hamartoma is an uncommon benign tumor rarely associated with malignancy An

excision and histological examination is necessary for the differential diagnosis We report

a case of a 49-year-old female patient presenting with a lump in the right breast Ultrasound

examination which demonstrated a 4411 cm hypoechoic lesion with lipoma Partial mas-

tectomy was arranged and the diagnosis of a hamartoma was confirmed by the histological

examination

Keywords Breast tumor Hamartoma Ultrasound




127

INTRODUCTION The hamartoma is a benign tumor-like lesion

that can affect various organs of the body in-

cluding lungs kidneys skin and more rarely the

breast In 1981 the hamartomas were recognized

in the WHO classification[1] They are defined

as well-demarcated mass of mammary ducts and

lobules containing varying amounts of fibrous

and adipose tissue and producing a distinctive

mammographic image

CASE REPORT A 49 year-old female had past history of left

breast mastitis with abscess status post partial

mastectomy This time she presented to our out

patient clinic for breast examination Physical

examination revealed a painless palpable mova-

ble and painless lump at upper outer quadrant of

right breast The risk of breast cancer was not

noted and the patient did not have any family

history of breast cancer The patient also denied

any trauma history before Ultrasound examina-

tion was arranged which demonstrated a 4411

cm hypoechoic lesion with lipoma at 3 oclock 2

cm from nipple of right breast and multiple hy-

poechoic nodules of various size in both breasts

and there was no suspicious axillary lymph

nodes noted (Figure1) Surgical treatment was

arranged partial mastectomy of right breast

harmartoma was successfully performed A 32 x

31 x 21 cm tumor was completely excised

Grossly examination showed a gray to yellow

and firm to fatty The diagnosis of a hamartoma

was confirmed by the histological examination

Microscopically sections of the breast lesion

show mammary hamartoma composed of ducts

lobules with interlobular fibrous tissue and adi-

pose tissue Fibrocystic change apocrine meta-

plastic ducts and scattered foci of adenosis are

noted The overall lobulocentric architecture and

the 2-cell pattern of the epithelium are preserved

columnar cell change and focal microcalcifica-

tion are present (Figure2) Based on submitted

biopsy specimen in-situ or invasive tumor cells

are not identified

DISCUSSION Hamartoma of the breast is a benign tumor like

nodule it was also known as fibroadenolipoma

lipofibroadenoma or adenolipoma based on its

predominant components It was composed of

varying amounts of glandular adipose and fi-

brous tissue[2] Hamartomas were first described

in 1971 by Arrigoni et al in a study of 10 patients

which breast tumors clinically and grossly re-

sembled fibroadenomas[3]

A higher predominance of tumors exists in fe-

males compared with males Hamartomas are

slowly-growing lesions with the diameter rang-

ing from 2 cm to 5 cm sometimes hamartomas

can reach giant diameter [4]

The clinical diagnosis of hamartoma is based on

the findings from mammography sonography

and histology examinations The hamartomas are

usually incidentally diagnosed by the women

older than 40 year-old starting mammography

screening

On physicial examination harmatomas are usu-

ally occult painless they may be as large mo-

bile soft to firm masses[5] Ultrasound showed

well capsulated mass with echogenic rim and

internal heterogeneity Mammography exam

showed well-circumscribed round to oval

masses containing fat and soft tissue densities

with a thin radiopaque pseudocapsule The

pseudocapsule results from displacement of

breast parenchyma by the tumor [56] In Pa-

thology finding microglandular adenosis is pre-

sent in fibroadipose stroma surrounded by a thin

fibrous capsule It composed of a combination of

epithelial and stromal elements usually with

normal ducts or lobules although variations of

normal tissue may also be seen Fibroadenoli-

poma myoid hamartoma and chondrolipoma are

histological variations of hamartomas depend-

ing on the proportion of normal breast tissue

elements[7]

Malignancy associated with hamartomas are

very rare[8] However it has been reported

hamartomas develop into carcinoma Malignant

transformation can occur as a result of cellular

atypia in the epithelial component of the mass[9]

Surgical removal is the curative method for

breast hamartomas[10] Diagnostic material such

as mammography ultrasonography or core nee-

dle biopsy may not give the definitive diagnosis

Therefore surgical excision and histological

examination is necessary for differential diagno-

sis[111213]

Although it is rare hamartoma can be seen along

with malignancy as it is formed from similar

components of breast tissue Therefore careful

diagnosis and appropriate management including

surgery are required

REFERENCES 1 World Health Organization (1981)

Histological typing of breast tumors In

International histological classification of

tumors 1981 2nd ed




128

2 Guray M and Sahin AA Benign breast

diseases classification diagnosis and

management Oncologist 11435ndash449

2006

3 ArrigoniMG DockertyMB JuddES

The identificationand treatment of

mammary hamartoma Surg Gynecol

Obstet1971 133 577-82

4 Sanal HT Ersoz N Altinel O Unal E Can

C Giant hamartoma of the breast Breast J

2006 12 84-85

5 Feder JM de Paredes ES Hogge JP

Wilken JJ Unusual breast lesions

radiologic-pathologic correlation

Radiographics 1999 19S11ndashS26

6 Murat A Ozdemir H Yildirim H Poyraz

AK Ozercan R Hamartoma of the breast

Australas Radiol 200751 Spec NoB37ndash

9

7 Fisher CJ Hanby AM Robinson L Millis

RR Mammary hamartoma-a review of 35

cases Histopathology 1992 20 99-106

8 Choi N Ko ES Invasive ductal carcinoma

in a mammary hamartoma case report and

review of the literature Korean J Radiol

2010 Nov-Dec11(6)687-91

9 Lee EH Wylie EJ Bourke AG Bastiaan

De Boer W Invasive ductal carcinoma

arising in a breast hamartoma two case

reports and a review of the literature Clin

Radiol 2003 58 80-3



management Oncologist 11 435 ‑449

2006

11 Coyne J Hobbs FM Boggis C Harland R

Lobular carcinoma in a mammary

hamartoma J Clin Pathol 199245936ndash

937

12 G M K Tse B K B Law T K F Ma A B W

Chan Hamartoma of the breast a

clinicopathological review J Clin Pathol

200255951ndash954

13 RAAmir SSheikh BreasthamartomaA

report of 14cases of an under-recognized

and under-reported entity International

Journal of Surgery Case Reports

22(2016)1ndash4




129

FIGURES

Figure 1 Ultrasound shows a 4411 cm hypoechoic lesion with lipoma at 3 oclock 2 cm from nipple

of right breast

Figure 2 Photomicrograph shows mammary hamartoma composed of ducts lobules with interlobular

fibrous tissue and adipose tissue




130


乳房錯構瘤罕見個案報告

陳宣安 1羅承裕 3黃世鴻 3林錦龍 2

中文摘要

乳房錯構瘤是一種罕見之乳房良性腫瘤切除手術及病理化驗來做鑑別診斷

我們報告一位 49歲女性以可觸摸到無痛性右側乳房腫塊為臨床表徵超音波

看到一個邊緣清楚低迴音的腫塊病患接受手術切除病灶病理診斷證實為乳

房錯構瘤

關鍵字乳房腫瘤錯構瘤超音波攝影

1國泰綜合醫院外科部

2國泰綜合醫院一般外科

3國泰綜合醫院病理科

通訊作者林錦龍電子信箱 lungyungmailcom

Fu-Jen Journal of Medicine

Mission and Goals

The Fu-Jen Journal of Medicine (FJJM) is a peer-reviewed journal which

aims to enhance research quality of staffs in the College of Medicine Fu Jen

Catholic University The journal publishes original investigations across a

wide range of medical disciplines including original research articles in basic

and clinical sciences case reports review articles brief reports and letter

to the editor FJJM is now issued by the Center of Medical Education in the

College of Medicine Fu Jen Catholic University To promote journal quality

the manuscript submitted to FJJM after August first 2015 has to be prepared

in English to meet the international standards

Issue Date

Publication Date

Institution

December 01 2003

September 30 2020

College of Medicine Fu Jen Catholic University

Honorable publisher Han-Sun Chiang

Publisher Ping-Keung Yip

Editor-in-chief Ming-Chieh Ma

Associate Editors Yu-Wen Lin

Editors

Telephone (02) 2905-3477

Address Center for Medical Education College of Medicine Fu Jen

Catholic University

No 510 Zhongzheng Rd Xinzhuang Dist New Taipei City

24205 Taiwan

Su-Jane Wang Chi-Chung Wang Chih-Ming Ho

Yih-Jing Lee Chih-Shung Wong Tze-Wah Kao

Chi-Feng Hung Rung-Fen Feng Chee-Fah Chogn

Chia-Chen Lu Zai-Ting Yeh

Dee Pei Chih-Kuang Liu

Hen-Hui Lien Chien-Hsiou Liu

Chun-Hou Liao Yi-Ju Tsai Sheng-Wen Teng

Chia-Ting Su

9月封面

9月目錄頁

2020九月刊排版NO1_完稿





版權頁(SEP)

9月封底

Fu-Jen Journal of Medicine Vol 18 No 3 September 2020

CONTENTS


A Comparison of Remifentanil and Low Dose Fentanyl for Postoperative Recovery

Profile in Patients Undergoing Minimally Invasive Cardiac Surgery





Case Report



Hyperacute intramembranous hemorrhage after burr hole craniostomy for chronic

subdural hematoma



Hsuan-An Chen Cheng-Yu Lo Shih-Hung Huang Chin-Lung Lin 126






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G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

mifentan

POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



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g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

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Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




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hemorrhage

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ON oman had a hi










f 376 patient













121


neu-

erten- She con-


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neu-


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2

3

4

5

6

7

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g-Chi Lin Ju


of Medicine V

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Surgical Drai

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Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


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hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

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122

osurg

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iew of subseq

th closed-syste

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vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

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membranous

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midline shift

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gion (white ar

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g-Chi Lin Ju

ure 3 Intraop

brane

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perative photo

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) and inner m

the previous b

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cute intramem

membrane (wh

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hemorrhage

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niostomy site

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of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底






01 2019








Cheng-Wei Lu







89-98 2020

DOI

103966181020932020091803001


Lu12






ABSTRACT



Fu-J

Meng



Jen Journal o

g-Chieh Ho W

TRODUCconcept of en












of Medicine V

Wei-Horng Je












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an Tzu-Yu Lin









uring the opera

2020

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n par ] A

e uti-[6]


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2018 ntanil

with All

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g the two



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on of ll pa-

pa-ferred PCA



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pared level

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of Medicine V

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Vol 3 No 1 2

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2020

il versus fenta

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e 18 Sev-




me to in G The

tanyl was

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oving h one rem-

cacy hort-


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as not


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of Medicine V

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3

4

5

6

7

8

9

10

11

12

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15

16

17

18

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of Medicine V

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ng J Gan TJ

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urgery Pain

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TATabl

Age

Sex

Ma

Fem

BMI

LVE

Com

DM

HT

Dy

CV

CO

CH

CK

ESR

Smo

Oper

CA

Val

Me

Jen Journal o

g-Chieh Ho W

ABLES

le 1 Patient ch

(years old)

ale

male

I (kgm2)

EF()

morbidity

M (no)

TN (no)

slipidemia (no

VA (no)

OPD (no)

HF (no)

KD (no)

RD (no)

oking (no)

ration

ABG (no)

lve (no)

ean (SD)

of Medicine V

Wei-Horng Je

haracteristics

G r

(n=

587

15

18

25 (

617

o)

14

20

7

1

3

6

7

3

4

8

25

Vol 3 No 1 2

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remifentanil

=33)

7 (108)

(36)

7 (113)

2020

il versus fenta

n Cheng-Wei

G f

(n=2

64 (

13

7

249

656

4

10

2

0

3

3

2

0

3

3

17

nyl for MICS

i Lu

fentanyl

20)

119)

9 (36)

6 (133)

p-va

0104

0941

0275

alue

4

1

5

94

Fu-J

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Tabl

Anes

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Cros

(min

Intra

(ugk

Intra

(mlk

Urin

Me

Tabl

Time

Hosp

Post

Com

Me

Jen Journal o

g-Chieh Ho W

le 2 Operation

sthesia duratio

ration duration

ss clamp

ns)

aoperative op

kg)

aoperative

kghr)

ne output (mlk

ean (SD)

le 3 Postoper

e to extubation

pital stay (day

operative ICU

mplication (no

ean (SD)

of Medicine V

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n characteristi

on (hrs)

n (hrs)

duration

pioid dose

IV fluid

kghr)

ative outcome

n (hrs)

ys)

U stay (days)

)

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

ics

G remifentan

(n=33)

50 (09)

375 (098)

796 (336)

196 (77)

1191 (625)

25 (175)

es for both gro

G re

(n=3

149

124

284

7 (21

2020

il versus fenta

n Cheng-Wei

nil G

(n=

47

35

68

84

10

26

oups

emifentanil

33)

6 (2554)

(53)

(169)

12)

nyl for MICS

i Lu

fentanyl

=20)

7 (06)

55 (066)

82 (161)

4 (18)

004 (347)

6 (179)

G fentany

(n=20)

1126 (24

118 (49)

244 (114

6 (30)

p-val

0267

0429

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0

4) 03

03

lue

7

9

1

-value

51

693

362

34

95

Fu-J

Meng

FIG

Figu

Jen Journal o

g-Chieh Ho W

GURES

ure 1 Weaning

of Medicine V

Wei-Horng Je

g protocol of

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

extubation in

2020

il versus fenta

n Cheng-Wei

ICU

nyl for MICS

i Lu

96

Fu-J

Meng

Figu

Figu

Mo

rph

ine

con

sum

pti

on

(mg

)N

RS

Jen Journal o

g-Chieh Ho W

ure 2 Postop

interqu

ure 3 Postope

rating

0

10

20

30

40M

orp

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e co

nsu

mp

tio

n (

mg

)

0

2

4

6

8

10

NR

S

of Medicine V

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erative morph

uartile range (I

erative pain s

scale POD =

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an Tzu-Yu Lin

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IQR) POD =

core for both

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PO

PO

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il versus fenta

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ption for both

postoperative

h groups Val

e day

OD2

OD2

nyl for MICS

i Lu

h groups Va

e day

lue are showe

POD3

POD3

G femovG fe

G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

mifentan

POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

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of Medicine V

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3

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5

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7

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2020

membranous

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and eurol

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midline shift

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the previous b

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of the hemato

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from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

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TRODUCconcept of en












of Medicine V

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Vol 3 No 1 2

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2020

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male

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617

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20

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196 (77)

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82 (161)

4 (18)

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extubation in

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ICU

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erical

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t

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式使

鴉片

病人

八月

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心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

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on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

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尼組結果兩

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並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

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3

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5

6

7

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membranous

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and eurol

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9

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122

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iew of subseq

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m-

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ure 3 Intraop

brane

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perative photo

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o revealing ac

) and inner m

the previous b

2020

membranous

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cute intramem

membrane (wh

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niostomy site

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of the hemato

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in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






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15

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617

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1

3

6

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3

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kg)

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kghr)

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82 (161)

4 (18)

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extubation in

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entanil and L

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臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

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共有 53 名病

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速康復鴉片

weigmailco

nyl for MICS

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ally Invasive

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陸正

要

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坦尼與低劑量

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度住院天數

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om

r Postopera

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尼

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展方向除

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數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


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Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




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to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng



RE1

Jen Journal o

g-Chieh Ho W











of Medicine V

Wei-Horng Je












Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin





qually safe as








2020

il versus fenta

n Cheng-Wei


than

ficant con-



low rem- low


dized aliza-MICS

cacy erms ay in



2

3

4

5

6

7

8

9

10

11

12

13

nyl for MICS

i Lu






Invasive s (Phila






93-903 LG Holford





WZA Turton E




adelphia



rane Database



Anesthesio





92


British

n DJ After rgery

Pa)

TT et artery

with ations

et al ardiac e Syst


et al nil in ypass

ypass 00-5





esia a heart

ner A

Fu-J

Meng

14

15

16

17

18

Jen Journal o

g-Chieh Ho W


of Medicine V

Wei-Horng Je








ng J Gan TJ

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin


wan Society 53-8





2020

il versus fenta

n Cheng-Wei

vs rgery


of



r JE first

rdiac The

cular

nced

19

20

21

22

nyl for MICS

i Lu





review and journal



Cardiac Su43-51




ndon Eng




ew Anaest


urgery Pain

93


for -7 al A unit

ardiac trial

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Val

Me

Jen Journal o

g-Chieh Ho W

ABLES

le 1 Patient ch

(years old)

ale

male

I (kgm2)

EF()

morbidity

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lve (no)

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of Medicine V

Wei-Horng Je

haracteristics

G r

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15

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617

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1

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6

7

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le 2 Operation

sthesia duratio

ration duration

ss clamp

ns)

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kg)

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of Medicine V

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)

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ics

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196 (77)

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124

284

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35

68

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(53)

(169)

12)

nyl for MICS

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7 (06)

55 (066)

82 (161)

4 (18)

004 (347)

6 (179)

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1126 (24

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244 (114

6 (30)

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0

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Vol 3 No 1 2

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extubation in

2020

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96

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g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

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人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

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Acute after


ent of 500

istics and

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FIG

Figu

Figu

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g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

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Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

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window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

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Fu-J

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g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

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Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

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cute intramem

membrane (wh

burr hole cran

hemorrhage

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hite asterisk) o

niostomy site

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of the hemato

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in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

14

15

16

17

18

Jen Journal o

g-Chieh Ho W


of Medicine V

Wei-Horng Je








ng J Gan TJ

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin


wan Society 53-8





2020

il versus fenta

n Cheng-Wei

vs rgery


of



r JE first

rdiac The

cular

nced

19

20

21

22

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i Lu





review and journal



Cardiac Su43-51




ndon Eng




ew Anaest


urgery Pain

93


for -7 al A unit

ardiac trial

gland)


ur M hesia thesia

PA et n the ntanil

hronic Pract

Fu-J

Meng

TATabl

Age

Sex

Ma

Fem

BMI

LVE

Com

DM

HT

Dy

CV

CO

CH

CK

ESR

Smo

Oper

CA

Val

Me

Jen Journal o

g-Chieh Ho W

ABLES

le 1 Patient ch

(years old)

ale

male

I (kgm2)

EF()

morbidity

M (no)

TN (no)

slipidemia (no

VA (no)

OPD (no)

HF (no)

KD (no)

RD (no)

oking (no)

ration

ABG (no)

lve (no)

ean (SD)

of Medicine V

Wei-Horng Je

haracteristics

G r

(n=

587

15

18

25 (

617

o)

14

20

7

1

3

6

7

3

4

8

25

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

remifentanil

=33)

7 (108)

(36)

7 (113)

2020

il versus fenta

n Cheng-Wei

G f

(n=2

64 (

13

7

249

656

4

10

2

0

3

3

2

0

3

3

17

nyl for MICS

i Lu

fentanyl

20)

119)

9 (36)

6 (133)

p-va

0104

0941

0275

alue

4

1

5

94

Fu-J

Meng

Tabl

Anes

Oper

Cros

(min

Intra

(ugk

Intra

(mlk

Urin

Me

Tabl

Time

Hosp

Post

Com

Me

Jen Journal o

g-Chieh Ho W

le 2 Operation

sthesia duratio

ration duration

ss clamp

ns)

aoperative op

kg)

aoperative

kghr)

ne output (mlk

ean (SD)

le 3 Postoper

e to extubation

pital stay (day

operative ICU

mplication (no

ean (SD)

of Medicine V

Wei-Horng Je

n characteristi

on (hrs)

n (hrs)

duration

pioid dose

IV fluid

kghr)

ative outcome

n (hrs)

ys)

U stay (days)

)

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

ics

G remifentan

(n=33)

50 (09)

375 (098)

796 (336)

196 (77)

1191 (625)

25 (175)

es for both gro

G re

(n=3

149

124

284

7 (21

2020

il versus fenta

n Cheng-Wei

nil G

(n=

47

35

68

84

10

26

oups

emifentanil

33)

6 (2554)

(53)

(169)

12)

nyl for MICS

i Lu

fentanyl

=20)

7 (06)

55 (066)

82 (161)

4 (18)

004 (347)

6 (179)

G fentany

(n=20)

1126 (24

118 (49)

244 (114

6 (30)

p-val

0267

0429

0231

018

087

yl p-

96) 0

0

4) 03

03

lue

7

9

1

-value

51

693

362

34

95

Fu-J

Meng

FIG

Figu

Jen Journal o

g-Chieh Ho W

GURES

ure 1 Weaning

of Medicine V

Wei-Horng Je

g protocol of

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

extubation in

2020

il versus fenta

n Cheng-Wei

ICU

nyl for MICS

i Lu

96

Fu-J

Meng

Figu

Figu

Mo

rph

ine

con

sum

pti

on

(mg

)N

RS

Jen Journal o

g-Chieh Ho W

ure 2 Postop

interqu

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rating

0

10

20

30

40M

orp

hin

e co

nsu

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tio

n (

mg

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0

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6

8

10

NR

S

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Wei-Horng Je

erative morph

uartile range (I

erative pain s

scale POD =

POD1

POD1

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

hine consump

IQR) POD =

core for both

postoperative

PO

PO

2020

il versus fenta

n Cheng-Wei

ption for both

postoperative

h groups Val

e day

OD2

OD2

nyl for MICS

i Lu

h groups Va

e day

lue are showe

POD3

POD3

G femovG fe

G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

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POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











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f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

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122

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Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

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window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

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burr hole crani

ow showed hy

123

m-

iosto-

ypera-

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Figu

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g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

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mbranous hem

hite asterisk) o

niostomy site

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of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

TATabl

Age

Sex

Ma

Fem

BMI

LVE

Com

DM

HT

Dy

CV

CO

CH

CK

ESR

Smo

Oper

CA

Val

Me

Jen Journal o

g-Chieh Ho W

ABLES

le 1 Patient ch

(years old)

ale

male

I (kgm2)

EF()

morbidity

M (no)

TN (no)

slipidemia (no

VA (no)

OPD (no)

HF (no)

KD (no)

RD (no)

oking (no)

ration

ABG (no)

lve (no)

ean (SD)

of Medicine V

Wei-Horng Je

haracteristics

G r

(n=

587

15

18

25 (

617

o)

14

20

7

1

3

6

7

3

4

8

25

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

remifentanil

=33)

7 (108)

(36)

7 (113)

2020

il versus fenta

n Cheng-Wei

G f

(n=2

64 (

13

7

249

656

4

10

2

0

3

3

2

0

3

3

17

nyl for MICS

i Lu

fentanyl

20)

119)

9 (36)

6 (133)

p-va

0104

0941

0275

alue

4

1

5

94

Fu-J

Meng

Tabl

Anes

Oper

Cros

(min

Intra

(ugk

Intra

(mlk

Urin

Me

Tabl

Time

Hosp

Post

Com

Me

Jen Journal o

g-Chieh Ho W

le 2 Operation

sthesia duratio

ration duration

ss clamp

ns)

aoperative op

kg)

aoperative

kghr)

ne output (mlk

ean (SD)

le 3 Postoper

e to extubation

pital stay (day

operative ICU

mplication (no

ean (SD)

of Medicine V

Wei-Horng Je

n characteristi

on (hrs)

n (hrs)

duration

pioid dose

IV fluid

kghr)

ative outcome

n (hrs)

ys)

U stay (days)

)

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

ics

G remifentan

(n=33)

50 (09)

375 (098)

796 (336)

196 (77)

1191 (625)

25 (175)

es for both gro

G re

(n=3

149

124

284

7 (21

2020

il versus fenta

n Cheng-Wei

nil G

(n=

47

35

68

84

10

26

oups

emifentanil

33)

6 (2554)

(53)

(169)

12)

nyl for MICS

i Lu

fentanyl

=20)

7 (06)

55 (066)

82 (161)

4 (18)

004 (347)

6 (179)

G fentany

(n=20)

1126 (24

118 (49)

244 (114

6 (30)

p-val

0267

0429

0231

018

087

yl p-

96) 0

0

4) 03

03

lue

7

9

1

-value

51

693

362

34

95

Fu-J

Meng

FIG

Figu

Jen Journal o

g-Chieh Ho W

GURES

ure 1 Weaning

of Medicine V

Wei-Horng Je

g protocol of

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

extubation in

2020

il versus fenta

n Cheng-Wei

ICU

nyl for MICS

i Lu

96

Fu-J

Meng

Figu

Figu

Mo

rph

ine

con

sum

pti

on

(mg

)N

RS

Jen Journal o

g-Chieh Ho W

ure 2 Postop

interqu

ure 3 Postope

rating

0

10

20

30

40M

orp

hin

e co

nsu

mp

tio

n (

mg

)

0

2

4

6

8

10

NR

S

of Medicine V

Wei-Horng Je

erative morph

uartile range (I

erative pain s

scale POD =

POD1

POD1

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

hine consump

IQR) POD =

core for both

postoperative

PO

PO

2020

il versus fenta

n Cheng-Wei

ption for both

postoperative

h groups Val

e day

OD2

OD2

nyl for MICS

i Lu

h groups Va

e day

lue are showe

POD3

POD3

G femovG fe

G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

mifentan

POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

Tabl

Anes

Oper

Cros

(min

Intra

(ugk

Intra

(mlk

Urin

Me

Tabl

Time

Hosp

Post

Com

Me

Jen Journal o

g-Chieh Ho W

le 2 Operation

sthesia duratio

ration duration

ss clamp

ns)

aoperative op

kg)

aoperative

kghr)

ne output (mlk

ean (SD)

le 3 Postoper

e to extubation

pital stay (day

operative ICU

mplication (no

ean (SD)

of Medicine V

Wei-Horng Je

n characteristi

on (hrs)

n (hrs)

duration

pioid dose

IV fluid

kghr)

ative outcome

n (hrs)

ys)

U stay (days)

)

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

ics

G remifentan

(n=33)

50 (09)

375 (098)

796 (336)

196 (77)

1191 (625)

25 (175)

es for both gro

G re

(n=3

149

124

284

7 (21

2020

il versus fenta

n Cheng-Wei

nil G

(n=

47

35

68

84

10

26

oups

emifentanil

33)

6 (2554)

(53)

(169)

12)

nyl for MICS

i Lu

fentanyl

=20)

7 (06)

55 (066)

82 (161)

4 (18)

004 (347)

6 (179)

G fentany

(n=20)

1126 (24

118 (49)

244 (114

6 (30)

p-val

0267

0429

0231

018

087

yl p-

96) 0

0

4) 03

03

lue

7

9

1

-value

51

693

362

34

95

Fu-J

Meng

FIG

Figu

Jen Journal o

g-Chieh Ho W

GURES

ure 1 Weaning

of Medicine V

Wei-Horng Je

g protocol of

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

extubation in

2020

il versus fenta

n Cheng-Wei

ICU

nyl for MICS

i Lu

96

Fu-J

Meng

Figu

Figu

Mo

rph

ine

con

sum

pti

on

(mg

)N

RS

Jen Journal o

g-Chieh Ho W

ure 2 Postop

interqu

ure 3 Postope

rating

0

10

20

30

40M

orp

hin

e co

nsu

mp

tio

n (

mg

)

0

2

4

6

8

10

NR

S

of Medicine V

Wei-Horng Je

erative morph

uartile range (I

erative pain s

scale POD =

POD1

POD1

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

hine consump

IQR) POD =

core for both

postoperative

PO

PO

2020

il versus fenta

n Cheng-Wei

ption for both

postoperative

h groups Val

e day

OD2

OD2

nyl for MICS

i Lu

h groups Va

e day

lue are showe

POD3

POD3

G femovG fe

G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

mifentan

POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

FIG

Figu

Jen Journal o

g-Chieh Ho W

GURES

ure 1 Weaning

of Medicine V

Wei-Horng Je

g protocol of

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

extubation in

2020

il versus fenta

n Cheng-Wei

ICU

nyl for MICS

i Lu

96

Fu-J

Meng

Figu

Figu

Mo

rph

ine

con

sum

pti

on

(mg

)N

RS

Jen Journal o

g-Chieh Ho W

ure 2 Postop

interqu

ure 3 Postope

rating

0

10

20

30

40M

orp

hin

e co

nsu

mp

tio

n (

mg

)

0

2

4

6

8

10

NR

S

of Medicine V

Wei-Horng Je

erative morph

uartile range (I

erative pain s

scale POD =

POD1

POD1

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

hine consump

IQR) POD =

core for both

postoperative

PO

PO

2020

il versus fenta

n Cheng-Wei

ption for both

postoperative

h groups Val

e day

OD2

OD2

nyl for MICS

i Lu

h groups Va

e day

lue are showe

POD3

POD3

G femovG fe

G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

mifentan

POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

Figu

Figu

Mo

rph

ine

con

sum

pti

on

(mg

)N

RS

Jen Journal o

g-Chieh Ho W

ure 2 Postop

interqu

ure 3 Postope

rating

0

10

20

30

40M

orp

hin

e co

nsu

mp

tio

n (

mg

)

0

2

4

6

8

10

NR

S

of Medicine V

Wei-Horng Je

erative morph

uartile range (I

erative pain s

scale POD =

POD1

POD1

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

hine consump

IQR) POD =

core for both

postoperative

PO

PO

2020

il versus fenta

n Cheng-Wei

ption for both

postoperative

h groups Val

e day

OD2

OD2

nyl for MICS

i Lu

h groups Va

e day

lue are showe

POD3

POD3

G femovG fe

G rmovG r

alue are show

ed as median

3 P

G fen

G rem

3 P



wed as median

NRS = num

POD5

ntanyl

mifentan

POD5

on

at rest

nil on

nil at rest

97

n and

erical

il

t

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

A

式使

鴉片

病人

八月

疼痛

20 名

疼痛

創心

關鍵

1新北

2桃園

貢獻

通訊

Jen Journal o

g-Chieh Ho W

Compariso

Profil

簡介術後

使用短效的

片類止痛藥

人恢復速度

月間進行微

痛指數與併

名為吩坦尼

痛指數與併

心臟手術並

鍵字微創

北市板橋區亞

園縣中壢市元

獻相同

訊作者陸正

of Medicine V

Wei-Horng Je

on of Remife

le in Patient

瑞

用於微創

何孟潔

後加速康復

的麻醉藥物

因此我們

度之影響方

微創心臟手術

併發症比例

尼組結果兩

併發症比例皆

並提供病人快

創心臟手術



正威電子信箱

Vol 3 No 1 2

Remifentani

an Tzu-Yu Lin

entanil and L

ts Undergoi

瑞吩坦尼

創心臟手

潔1簡維宏

復為近來心臟

物是術後加速

們比較術中使

方法此研

術的病人術

結果共

兩組病人術

皆無顯著差

快速恢復

術後加速

麻醉部

工程學系

箱 drluchengw

2020

il versus fenta

n Cheng-Wei

Low Dose F

ing Minima

尼與低劑量

手術病患術

宏12林子玉

中文摘要

臟手術病人

速康復中重

使用瑞吩坦

研究為一回溯

術後拔管速度

共有 53 名病

術後拔管時間

差異結論

速康復鴉片

weigmailco

nyl for MICS

i Lu

Fentanyl for

ally Invasive

量吩坦尼

術後恢復

玉 12

陸正

要

人照護之發展

重要的一環

坦尼與低劑量

溯性研究

度住院天數

病患納入研究

間住院天數

我們認為瑞

片類止痛藥

om

r Postopera

e Cardiac Su

尼

復之比較

正威 12

展方向除

瑞吩坦尼

量吩坦尼對

比較分析 2

數術後止

究33 名為

數術後止

瑞吩坦尼可

藥

ative Recove

urgery

較

除了微創手術

尼是一極短效

對微創心臟手

2018 年五月

止痛藥使用量

為瑞吩坦尼

止痛藥使用量

可安全地用於

98

ery

術方

效的

手術

月至

量

尼組

量

於微




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




99



02 2020







Pa-Chun Wang





Medicine 3(2) 99-111 2020

DOI

103966181020932020091803002


12 Tung-Wen Ko

3 Pa-Chun

Wang14


Taiwan


ty Taipei Taiwan


pital Taipei Taiwan


wan



















































































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底





























































































































(CGH-P105095)






17) (Table 1)














1)





















Command)














(Figure 3)


agement)













































































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底



































































































Engl J Med 1991324370-376





2016115434-439









2010191-5















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底















2014571443-1472




Qual Saf 201221347-351


to human factors


ductionhtm











Quality 20191370-76








mID=621273300317401756












201322273-277



BMJ Qual Saf 2014231051-1052





201726381-387






Surg 2012621





201429181-190









TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




TABLE



Laboratory and ex-

amination events

4 10 2 0 16 (400)




Transfusion-related

event

1 1 0 0 2 (50)

Tube event 0 1 0 0 1 (25)


Total 17 (425) 15 (375) 8 (200) 0 40 (100)





FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




FIGURES


16 (167)

66 (1000)

640 (150)

235 (57)

735 (200)

2435 (686)

2435 (686)

3540 (875)

438 (105)

438 (105)

738 (184)

1938 (500)

3138 (816)

3840 (950)

0 5 10 15 20 25 30 35 40














Violations





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底





14 (250)

24 (500)

48 (500)

11 (1000)

18 (125)

840 (200)

0 5 10 15 20 25 30 35 40



Noise Interference

Environment



27 (286)

27 (286)

27 (286)

37 (129)

47 (511)

47 (571)

77 (1000)

24 (500)

44 (1000)

47 (571)

12 (500)

22 (1000)

27 (286)

740 (175)

0 5 10 15 20 25 30 35 40




Distraction



Complacency

Overconfidence


Fatigue


Physical Problem

State of Mind

Mental Awareness

211 (182)

311 (273)

311 (273)

411 (364)

811 (7227)

911 (818)

1140 (275)

0 5 10 15 20 25 30 35 40







Teamwork






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底






114 (71)

114 (71)

214 (143)

314 (214)

1314 (929)

1440 (350)

511 (455)

511 (455)

711 (636)

1140 (275)

47 (571)

67 (857)

740 (175)

0 5 10 15 20 25 30 35 40














12 (500)

12 (500)

240 (50)

110 (100)

510 (500)

1040 (250)

11 (1000)

140 (25)

18 (125)

18 (125)

38 (35)

48 (500)

840 (200)

0 5 10 15 20 25 30 35 40










Resource Problems









Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底






Tier 1 Unsafe Acts

Perfor-

mance-Based

Errors







Judgment amp De-

cision-Making

Errors





Violations





Environment






movement


Noise interference










Physical and

Mental State

Physical problem


drugs)



Fatigue


Dehydration



task demands)

Nutritiondiet

State of mind


Life stressors

Emotional state

Personality style

Overconfidence




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




Pressing

Complacency

Motivation





Visual illusion






Mental awareness


Fixation


Confusion


Distraction

Geographically lost



training


Teamwork









Tier 3 Supervision

Supervisory Vio-

lations





Planned Inappro-

priate Operations






Inadequate Su-

pervision










Influences

Resource Prob-

lems







manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底





manner



Personnel Selec-

tion amp Staffing



Policy amp Process

Issues








ment

ClimateCulture

Influences


taskmission


ment


vation










中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底









中文摘要




























2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底






2020

Case Report







Medicine 3(3) 112-119 2020

DOI

103966181020932020091803003


1





ABSTRACT







113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




113








lar lesions [1]
















this report


































































[5]








low-grade lymphomas












114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




114











less than OAL [13]


























consideration






























cryotherapy [15]











ble [20]




















200923(5)1004-1018



Eye 200418152-158








Proc 199368(10)1003-1010





115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




115



201560(5)444-458





Ophthalmol 2010150(3)412-426





20101-19




20195379-386



adnexa Blood 2009114(3)501-510








200731(2)170-184






20169(12)1808-1813





2013(9)975908






200521177-188




2019622











Pediatr 201456(3)295-298




2012130(7)941-943





201219(4)406-409




1999117(6)832-835




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




116

FIGURES







117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




117





CD3 (D)







118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




118


of recurrence




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




119




中文摘要















2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底






2020

Case Report






Hsieh





cine 3(4) 120-125 2020

DOI

103966181020932020091803004


Hsieh567











ABSTRACT



drainage

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng



Jen Journal o

g-Chi Lin Ju















of Medicine V

i-Ming Sun Y

CTION hematoma (C






ORT man had a his






h irrigation a






brane of the

Vol 3 No 4 2

Acute intram

Yu-Hao Chen




m is discussed







previous CS

2020

membranous

Cheng-Ta Hs


y are yper-hole


d and

rten-She

con-n 10

y de-owsy



lated exci-f the


o the ency




RE1

hemorrhage

ieh











ON oman had a hi










f 376 patient













121


neu-

erten- She con-


ouncil were

iathe-(CT)


ulated exci-


in CT right


CSDH brain

nation ifera-mem-

neu-


Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

2

3

4

5

6

7

Jen Journal o

g-Chi Lin Ju


of Medicine V

i-Ming Sun Y







Surgical Drai

Vol 3 No 4 2

Acute intram

Yu-Hao Chen









2020

membranous

Cheng-Ta Hs

M dural

and eurol

et al 778

nage silia


AN dural matic 686

hole with

dural and

more)

et al tions ronic

8

9

10

11

12

13

hemorrhage

ieh








Korean Neur








122

osurg

Acute after


ent of 500

istics and

okyo)

et al bdural World

rebral hronic Scand

et al atoma cified

Clin

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

FIG

Figu

Figu

Jen Journal o

g-Chi Lin Ju

GURES

ure 1 Axial vi

poropar

ure 2 Axial v

my wit

cute sub

of Medicine V

i-Ming Sun Y

iew of CT rev

rietal region d

iew of subseq

th closed-syste

bdural hemorr

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

vealing a layer

displaying a m

quent CT scan

em drainage (

rhage in the ri

2020

membranous

Cheng-Ta Hs

red type of CS

midline shift

ns (A) Bone w

(white arrow)

ight frontal re

hemorrhage

ieh

SDH (white ar

window view

and (B) Soft

gion (white ar

rrow) in the rig

showed the b

tissue windo

rrow)

ght frontotem

burr hole crani

ow showed hy

123

m-

iosto-

ypera-

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

Fu-J

Meng

Figu

Jen Journal o

g-Chi Lin Ju

ure 3 Intraop

brane

the fro

of Medicine V

i-Ming Sun Y

perative photo

(white arrow)

ntal region to

Vol 3 No 4 2

Acute intram

Yu-Hao Chen

o revealing ac

) and inner m

the previous b

2020

membranous

Cheng-Ta Hs

cute intramem

membrane (wh

burr hole cran

hemorrhage

ieh

mbranous hem

hite asterisk) o

niostomy site

morrhage withi

of the hemato

(white triangl

in the outer m

oma situated

le)

124

mem-

from




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




125




血


中文摘要



















126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




126



2020

Case Report




Chin-Lung Lin



3(5) 126-130 2020

DOI

103966181020932020091803005


3 Shih-Hung Huang

3 Chin-Lung

Lin2



wan




ABSTRACT






examination





127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




127









mammographic image

































are not identified




















screening




















elements[7]












sis[111213]









tumors 1981 2nd ed




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




128




2006




Obstet1971 133 577-82



2006 12 84-85








9







2010 Nov-Dec11(6)687-91





Radiol 2003 58 80-3




2006




937




200255951ndash954





22(2016)1ndash4




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




129

FIGURES


of right breast






130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底




130




中文摘要




房錯構瘤







Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底


Mission and Goals










Issue Date

Publication Date

Institution

December 01 2003

September 30 2020






Editors

Telephone (02) 2905-3477


Catholic University


24205 Taiwan








Chia-Ting Su

9月封面

9月目錄頁






版權頁(SEP)

9月封底

9月封面

9月目錄頁






版權頁(SEP)

9月封底

vol. 18, no.3, september 2020cme.mc.fju.edu.tw/sites/default/files... · vol. 18, no.3, september...

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