research on the residents working hours
Dr Chen neurologist is over-worked related cardiac incident?
1. evidence of disease
myocarditis, post-infectious? fatigue signs which may be detected by by-stander or coworkers
past history:
annual physical exams may discover the underlying causes that may play a role in hyperacute incident
uric acid elveation with episodic attacks of gouty arthritis
myocardial infaction
aneurysm rupture is less likely.
2. working hours should be collected
how to investigate the time and details, and /or course of his spending times
in the past three to six months
3. temporal relationship
4. dose-response or consistency
5. competing causes
hypertension
high uric acids
usual medications
2010年11月18日 星期四
FACEBOOK-related asthma?
FACEBOOK-related asthma?
網站恐引發氣喘 法新社更新日期:2010/11/19 09:00
(法新社巴黎18日電) 網友會讓你氣喘發作?
這項不尋常的個案研究結果今天公布在醫學期刊「刺胳針」(Lancet)。
義大利醫師表示,1名有氣喘病史的18歲少年,夏天突然好幾次呼吸困難,他在這個時期一般都不會出現氣喘症狀。 憂心忡忡的母親得知,少年因為女友與他分手而難過。這名女孩還把他從臉書(Facebook)好友名單刪除,另外加入許多新的男生朋友。
少年換了暱稱,重新成為前女友的「朋友」,終於又能在臉書上看到前女友照片。 醫師對此相當好奇,要求少年每次上臉書時,戴上呼吸面罩,測量他的呼吸流量。 每次他登入臉書,呼吸流量就驟降,有時減少超過20%。求助精神科醫師後,少年決定停用臉書,氣喘不藥而癒。
研究人員總結得出,登入臉書的壓力引發氣喘,少年對於可以看到前女友的照片,以及與她聯絡,簡直要窒息。
義大利那不勒斯(Naples)1間醫院的5名醫師對此進行研究後投稿發表。
醫師在文中指出:「臉書和一般社交網站,可能是心理壓力的新來源,成為憂鬱的氣喘患者病情惡化的誘發因子。」(譯者:中央社李威翰)
Facebook Triggers Asthma Attacks, Doctors Say
by Honey Berk (Subscribe to Honey Berk's posts)
Nov 18th 2010 6:30PM
0Comments
Filed under: Medical Conditions, In The News, Research Reveals: Teens
Facebook may be to blame for breathing problems. Credit: Corbis
If you've got asthma, you'd better think twice before you log in to Facebook.
That's right, folks. In a letter published today in The Lancet, one of the world's most prestigious medical journals, a team of Italian doctors report that Facebook can trigger asthma attacks.
This nugget of breaking scientific news is apparently based on the case history of an 18-year-old asthmatic boy in Italy whose girlfriend broke up with him, unfriended him on Facebook and then began " 'friending' many new young men," the researchers report.
Like many heartbroken teenage boy these days, the jilted Romeo created a fictitious Facebook account and succeeded in friending his ex again. But every time he accessed her Facebook profile, he became short of breath.
"The sight of (the girl's profile picture) seemed to induce dyspnea, which happened repeatedly on the patient accessing her profile," the authors write.
Since the boy's asthma symptoms had previously been controlled with medication, and the onset of his breathing problems coincided with the recent break-up and subsequent depression, the doctors concluded the two must be related.
To prove their theory, the boy's mother was told to measure his peak expiratory flow -- a measure of how fast a person can exhale, often used to help monitor asthma symptoms -- before and after he logged in to Facebook.
Sure enough, the boy's "post-Facebook" peak flow values were around 20 percent lower, which led the doctors to conclude Facebook was the trigger of his asthma flare-ups.
Here's the scientific part of the equation, according to the authors: Facebook, and social networks in general, could be a new source of psychological stress, which could trigger asthma symptoms in people who are depressed.
"Considering the high prevalence of asthma, especially among young people, we suggest that this type of trigger be considered in the assessment of asthma exacerbations," the authors conclude.
And what of the poor Italian boy? The authors note he resigned to stop logging in to Facebook, with the help of a psychiatrist, and his asthma attacks stopped.
網站恐引發氣喘 法新社更新日期:2010/11/19 09:00
(法新社巴黎18日電) 網友會讓你氣喘發作?
這項不尋常的個案研究結果今天公布在醫學期刊「刺胳針」(Lancet)。
義大利醫師表示,1名有氣喘病史的18歲少年,夏天突然好幾次呼吸困難,他在這個時期一般都不會出現氣喘症狀。 憂心忡忡的母親得知,少年因為女友與他分手而難過。這名女孩還把他從臉書(Facebook)好友名單刪除,另外加入許多新的男生朋友。
少年換了暱稱,重新成為前女友的「朋友」,終於又能在臉書上看到前女友照片。 醫師對此相當好奇,要求少年每次上臉書時,戴上呼吸面罩,測量他的呼吸流量。 每次他登入臉書,呼吸流量就驟降,有時減少超過20%。求助精神科醫師後,少年決定停用臉書,氣喘不藥而癒。
研究人員總結得出,登入臉書的壓力引發氣喘,少年對於可以看到前女友的照片,以及與她聯絡,簡直要窒息。
義大利那不勒斯(Naples)1間醫院的5名醫師對此進行研究後投稿發表。
醫師在文中指出:「臉書和一般社交網站,可能是心理壓力的新來源,成為憂鬱的氣喘患者病情惡化的誘發因子。」(譯者:中央社李威翰)
Facebook Triggers Asthma Attacks, Doctors Say
by Honey Berk (Subscribe to Honey Berk's posts)
Nov 18th 2010 6:30PM
0Comments
Filed under: Medical Conditions, In The News, Research Reveals: Teens
Facebook may be to blame for breathing problems. Credit: Corbis
If you've got asthma, you'd better think twice before you log in to Facebook.
That's right, folks. In a letter published today in The Lancet, one of the world's most prestigious medical journals, a team of Italian doctors report that Facebook can trigger asthma attacks.
This nugget of breaking scientific news is apparently based on the case history of an 18-year-old asthmatic boy in Italy whose girlfriend broke up with him, unfriended him on Facebook and then began " 'friending' many new young men," the researchers report.
Like many heartbroken teenage boy these days, the jilted Romeo created a fictitious Facebook account and succeeded in friending his ex again. But every time he accessed her Facebook profile, he became short of breath.
"The sight of (the girl's profile picture) seemed to induce dyspnea, which happened repeatedly on the patient accessing her profile," the authors write.
Since the boy's asthma symptoms had previously been controlled with medication, and the onset of his breathing problems coincided with the recent break-up and subsequent depression, the doctors concluded the two must be related.
To prove their theory, the boy's mother was told to measure his peak expiratory flow -- a measure of how fast a person can exhale, often used to help monitor asthma symptoms -- before and after he logged in to Facebook.
Sure enough, the boy's "post-Facebook" peak flow values were around 20 percent lower, which led the doctors to conclude Facebook was the trigger of his asthma flare-ups.
Here's the scientific part of the equation, according to the authors: Facebook, and social networks in general, could be a new source of psychological stress, which could trigger asthma symptoms in people who are depressed.
"Considering the high prevalence of asthma, especially among young people, we suggest that this type of trigger be considered in the assessment of asthma exacerbations," the authors conclude.
And what of the poor Italian boy? The authors note he resigned to stop logging in to Facebook, with the help of a psychiatrist, and his asthma attacks stopped.
2010年7月20日 星期二
2010 Advances in Neuroblastoma Research (ANR) 會議_兒童神經母細胞瘤
臺大跨校團隊參與國際學術組織世界兒童神經母細胞瘤研究會議大會主席Prof.PerKogner推崇為得獎效率最高團隊
文:臺大生命科學院動物學研究所李心予教授
時間:2010年6月21日至2010年6月24日
地點:瑞典、斯德哥爾摩
一、參加會議經過
Advances in Neuroblastoma Research (ANR) 會議是專門為兒童神經母細胞瘤
而開的會議,從第一次1975年在費城兒童醫院開始,大約每兩年召開一次,今
年2010年在瑞典是第14屆。兒童神經母細胞瘤目前仍是兒童癌症中最難治癒
的,因此仍有許多研究有待突破。近年來,許多知名期刊,包括NEJM、
Nature、Journal of Clinical Oncology,均有許多關於兒童神經母細胞瘤的
研究結果,而事實上這些研究成果其實先前都在本會議上先行發表。本會議可
說是全世界兒童神經母細胞瘤研究發表最重要、也是最高層級的會。
本次大會會議時間是從6月21到24日,上午8點到下午6點都有不同的會議內容,
晚上的時間,大會則是安排不同的社交活動,讓大家經驗交流。團隊成員於20
日陸續到達斯德哥爾摩後,下午即到會場註冊,團隊中外科許文明醫師因剛成
為大會advisory board的member,特別被邀請當晚先行參加大會的理監事晚
宴,席間日本的Akira Nakagawara教授,不斷替許醫師介紹大會的重要人物,
也一再強調本臺灣團隊最近在neuroblastom臨床治療及基礎研究的努力,使得
本團隊一開始就受到了大會的矚目。
大會於6月21日開始4天緊湊的會議行程。21日早上8點,團隊成員先參加了
International Neuroblastoma Tissue Bank的討論會,主要討論各國及各洲
間,tumor tissue的管理跟分享,因為neuroblastoma的病人數量不多,各國及
各個研究團隊間的合作顯得特別重要。9點後同時有neuroblastoma update
course及2個scientific workshop到下午4點半,團隊成員各自參加有興趣的議
程,其中來自臺灣中研院的陳玲津教授被大會邀請在neuroblastoma update
course中主講Anti-GD2 monoclonal antibody合併G-CSF的immunotherapy,令
人印象深刻。此時我們在會中也遇到成功大學的張玲教授,隨後大家一起與陳
玲津教授合影 (圖1)。下午4點半後,大會安排了瑞典當地的表演節目,晚上則
是到斯德哥爾摩市政廳舉辦迎賓酒會,各國學者相互交流。
6月22、23、24日大會也是安排了從上午8點到下午6點的議程。這3天,上午分
別是關於neuroblastoma在biology、translation、clinical 3個領域的口頭論
文報告,下午則是各種的workshops及scientific sessions,包括
immunotherapy、targeting therapy、ALK、MYCN、genomic sequencing and
clinical correlation、new drug development、epigenetic regulation等
等,非常豐富而精采,因為neuroblastoma目前仍是很難治癒的兒童癌症,因此
許多癌症研究最新的方法都會應用到這個疾病。團隊成員也在這3天中陸續以口
頭或壁報的方式發表研究成果,其中盧孟佑醫師以口頭報告的方式,發表臺大
醫院neuroblastoma病童在核醫科曾凱元主任率領下所做的F-18 FDOPA scan,
發現可補原來MIBG scan的不足,此研究成果受到大會極大的矚目與重視。護理
部分李雅玲老師及劉彥麟醫師發表的壁報被選為selected poster進行口頭報
告,其他團隊成員也與許多重要的學者在會場進行交流。
會議最後在6月24日下午結束,最令人高興的是在閉幕典禮上,大會主席Prof.
Per Kogner宣布本團隊的小兒部盧孟佑醫師獲頒臨床組最佳口頭論文獎且是大
會創辦人Dr. Audrey Evans的特別獎、外科部許文明醫師獲頒生物組最佳壁報
論文獎、小兒部劉彥麟醫師獲頒臨床組最佳壁報論文獎。團隊成員在與大會主
席Prof. Per Kogner、創辦人Dr. Audrey Evans、日本Prof. Akira
Nakagawara教授合影後,帶著高興又興奮的心情,於6月25日陸續啟程返國。
二、與會心得
總計本次大會一共605人、37個國家參加,論文總數為412篇。臺灣團隊在大會
中一共發表了11篇論文,在所有參與的37個國家中排行第11名,且榮獲大會3個
獎項,非常難得,大會主席Prof. Per Kogner稱讚我們是”得獎效率”最高的
團隊,也期許我們團隊持續參與這個會議,因為我們這次臺灣團隊的表現真的
令他們印象深刻。
而在本團隊這次最受矚目的核醫研究方面,這次的大會中的論文與核醫相關的
主題不多,一個是我們臺大團隊提出的利用F-18 DOPA作有關神經母細胞瘤的三
篇研究。其中一篇是口頭發表比較I-123 MIBG,F-18 FDG以及F-18 FDOPA在17
例19次的掃描中,以人為基準,F-18 FDOPA之診斷敏感度是90%,特異性是
100%,未來預計進行更大規模之測試以瞭解其真正的臨床價值。其次,有一篇
壁報論文是在重新評估I-123 MIBG加入診斷之行列後,到底還需不需要繼續進
行F-18 FDOPA掃描,也就是再次評估其臨床判斷之價值。我們發現在三分之二
的病例仍有其協助臨床判斷價值,在三分之一的例子中與I-123 MIBG或F-18
FDG並無差別。但是,問題之關鍵在於哪些病人是這三分之一或是另外三分之
二。第三篇也是壁報論文發表,回溯我們追蹤三年來比較25個病例當中,可以
利用F-18 FDOPA及早診斷6個骨髓轉移之病灶,比傳統骨掃描早7個月,比FDG
掃描早5個月,比臨床症狀則早1.5年。而這些病例當中,有5例是分化較好的腫
瘤,這也是過去用I-123或I-131 MIBG追蹤時之盲點。
另一個重要的議題是利用I-131 MIBG進行腫瘤之治療。這是我們近年來一直想
做但是又沒有藥可以用的缺憾。目前最新的進展是利用化療藥物,甚至放射照
射治療與I-131 MIBG治療等同時或分先後進行治療。在這些多重方法共同治療
之下,為提高病童之抵抗力,採用骨髓幹細胞補強的方法以為協助。由於這是
藥廠贊助的研究,只有初步結果報告,當然是相當積極的做法。另外一個是將
I-131 MIBG之治療藥劑經特殊方法處理(Ultratrace)之後減少其載體
(carrier)以達到高強度治療之效果。第一步之報告是在體重每公斤12-18mCi
之下進行治療,效果還不錯病童也還能承受副作用。相信兩年後應有更多的相
關報告會出來。國內核研所應加把勁研發I-131 MIBG之生產,否則要落後太多
了。
三、建議事項
此次國科會補助本團隊參加會議,不僅我們從中知道了neuroblastoma在治療及
研究上最新的趨勢,我們的表現也不遑多讓,使各國學者對我們臺灣團隊刮目
相看、印象深刻,是一次耗費成本極低但卻最成功的“學術外交”。
最近International Neuroblastoma Risk Group (INRG) 已制定新的疾病危險
程度分群標準,大會中許多論文也以此標準作為研究及病人治療的依據,此標
準的更新在臺灣應盡快進行,做為我國發展下一代療程的重要依據。而會議
中,歐美團隊皆有報告最新關於的neuroblastoma基因體學研究成果,發現了許
多新的neuroblastoma癌症有關基因,值得我們趕快跟進,以徹底了解臺灣
neuroblastoma病童的癌症基因體學特性,但在個案數有限的情況下,與亞洲各
國加強區域合作與交流,是必要的趨勢。最後Anti-GD2單株抗體合併細胞激素
G-CSF在neuroblastom的免疫治療成果已經很明顯可增進高危險群病人的存活
率,雖然還在美國進行第3期的臨床試驗,期待在2到3年內FDA approval後應設
法趕快引進,以提升臺灣病童的治療成績。
四、其他
臺灣此次在大會發表的11篇論文(包括成功大學張玲教授):
1.Wen-Ming Hsu, Yu-Yin Shih, Hsinyu Lee, Hsueh-Fen Juan, Yeou-Guang
Tsay, Yung-Feng Liao: The interaction between GRP75 and retenoic
acid receptor-α/retenoid X receptor-α is essential for retenoic acid-
induced neuronal differentiation of neuroblastoma cells. Advances in
Neuroblastoma Research June 21-24, 2010, Stockholm, Sweden. (臺大醫院
外科部許文明醫師,生物組最佳壁報論文獎)
2.Hsiu-Hao Chang, Wen-Ming Hsu, Hsueh-Fen Juan, Yung-Feng Liao, Min-
Chuan Huang, Hsinyu Lee, Fon-Jou Hsieh, Kai-Hsin-Lin: Microarray-
based pathway analysis leads to the identification of potential
molecularmechanisms underlying gamma-secretase inhibitor-induced
differentiation. Advances in Neuroblastoma Research June 21-24,
2010, Stockholm, Sweden. (臺大醫院小兒部張修豪醫師)
3.Wen-Ming Hsu, Pei-Yi Wu, Hsueh-Fen Juan, Hsinyu Lee: Aromatic
hydrocarbon receptor down-regulates MYCN expression and promotes
neuronal differentiation of neuroblastoma. Advances in Neuroblastoma
Research June 21-24, 2010, Stockholm, Sweden. (臺灣大學生命科學院動物
學研究所李心予教授)
4.Yen-Lin Liu, Wen-Ming Hsu, Hsiu-Hao Chang, Dong-Tsamn Lin, Kai-
Hsin Lin, Shiann-Tarng Jou, Meng-Yao Lu, Yung-Li Yang, Kai-Yuan
Tzen, Steve Hsin-Feng Peng, Shiu-Feng Huang, Ya-Ling Lee: The impact
of a mutidisciplinary team approach in the case management of
neuroblastoma. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫院小兒部劉彥麟醫師,臨床組最佳壁報論文獎)
5.Ya-Ling Lee, Tzu-Chun Chen, Wen-Ming Hsu: Illness experience and
factors that constitute resilience in families with a neuroblastoma
child. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫學院護理系李雅玲老師)
6.Kai-Yuan Tzen, Meng-Yao Lu, Hsiu-Hao Chang, Wen-Ming Hsu, Tsai-
Yueh Luo, Lie-Hang Shen: 18F-Dopa PET scan is still useful in the
presence of 123I-MIBG and 18F-FDG for neuroblastoma imaging.
Advances in Neuroblastoma Research June 21-24, 2010, Stockholm,
Sweden. (臺大醫院核醫科曾凱元主任)
7.Kai-Yuan Tzen, Meng-Yao Lu, Hsiu-Hao Chang, Wen-Ming Hsu:
Molecular imaging with 18F-Dopa PET in the early detection of new
metastatic neuroblastoma in bone marrow. Advances in Neuroblastoma
Research June 21-24, 2010, Stockholm, Sweden. (臺大醫院核醫科曾凱元主
任)
8.Yin Chen, Wen-Ming Hsu, Yeou-Guang Tsay: Identification of
proteomic changes nassociated with differentiated neuroblastoma
using an in vitro differentiation system and an optimized proteomics
platform based on 18O peptide labeling. Advances in Neuroblastoma
Research June 21-24, 2010, Stockholm, Sweden. (陽明大學蔡有光老師)
9.Kai-Yuan Tzen, Meng-Yao Lu, Hsiu-Hao Chang, Kai-Hsin Lin, Shiann-
Tarng Jou, Yung-Li Yang, Dong-Tsamn Lin, Wen-Ming Hsu:
Characterization of neuroblastoma imaging studies using 18F-Dopa
PET/CT. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫院小兒部盧孟佑醫師,臨床組最佳口頭論文獎)
10.Mei-Ieng Che; Hsiu-Hao Chang, Min-Chuan Huang: Overexpression of
Beta 1,4-N-acetylgalactosaminyltransfrase III suppresses the
malignant phenotype of neuroblastoma cells via Beta1-integrin
signaling. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫學院黃敏銓老師)
11.Christina Chang, Kai-Hui Chan, Larry Paris, Lin-Jen Ma, Renn-
Shiuan Wei, Choon-Yee Tan: Alterations of NDP kinase A/NM23-H1
deregulate c-myc transcription. (成功大學張玲教授)
文:臺大生命科學院動物學研究所李心予教授
時間:2010年6月21日至2010年6月24日
地點:瑞典、斯德哥爾摩
一、參加會議經過
Advances in Neuroblastoma Research (ANR) 會議是專門為兒童神經母細胞瘤
而開的會議,從第一次1975年在費城兒童醫院開始,大約每兩年召開一次,今
年2010年在瑞典是第14屆。兒童神經母細胞瘤目前仍是兒童癌症中最難治癒
的,因此仍有許多研究有待突破。近年來,許多知名期刊,包括NEJM、
Nature、Journal of Clinical Oncology,均有許多關於兒童神經母細胞瘤的
研究結果,而事實上這些研究成果其實先前都在本會議上先行發表。本會議可
說是全世界兒童神經母細胞瘤研究發表最重要、也是最高層級的會。
本次大會會議時間是從6月21到24日,上午8點到下午6點都有不同的會議內容,
晚上的時間,大會則是安排不同的社交活動,讓大家經驗交流。團隊成員於20
日陸續到達斯德哥爾摩後,下午即到會場註冊,團隊中外科許文明醫師因剛成
為大會advisory board的member,特別被邀請當晚先行參加大會的理監事晚
宴,席間日本的Akira Nakagawara教授,不斷替許醫師介紹大會的重要人物,
也一再強調本臺灣團隊最近在neuroblastom臨床治療及基礎研究的努力,使得
本團隊一開始就受到了大會的矚目。
大會於6月21日開始4天緊湊的會議行程。21日早上8點,團隊成員先參加了
International Neuroblastoma Tissue Bank的討論會,主要討論各國及各洲
間,tumor tissue的管理跟分享,因為neuroblastoma的病人數量不多,各國及
各個研究團隊間的合作顯得特別重要。9點後同時有neuroblastoma update
course及2個scientific workshop到下午4點半,團隊成員各自參加有興趣的議
程,其中來自臺灣中研院的陳玲津教授被大會邀請在neuroblastoma update
course中主講Anti-GD2 monoclonal antibody合併G-CSF的immunotherapy,令
人印象深刻。此時我們在會中也遇到成功大學的張玲教授,隨後大家一起與陳
玲津教授合影 (圖1)。下午4點半後,大會安排了瑞典當地的表演節目,晚上則
是到斯德哥爾摩市政廳舉辦迎賓酒會,各國學者相互交流。
6月22、23、24日大會也是安排了從上午8點到下午6點的議程。這3天,上午分
別是關於neuroblastoma在biology、translation、clinical 3個領域的口頭論
文報告,下午則是各種的workshops及scientific sessions,包括
immunotherapy、targeting therapy、ALK、MYCN、genomic sequencing and
clinical correlation、new drug development、epigenetic regulation等
等,非常豐富而精采,因為neuroblastoma目前仍是很難治癒的兒童癌症,因此
許多癌症研究最新的方法都會應用到這個疾病。團隊成員也在這3天中陸續以口
頭或壁報的方式發表研究成果,其中盧孟佑醫師以口頭報告的方式,發表臺大
醫院neuroblastoma病童在核醫科曾凱元主任率領下所做的F-18 FDOPA scan,
發現可補原來MIBG scan的不足,此研究成果受到大會極大的矚目與重視。護理
部分李雅玲老師及劉彥麟醫師發表的壁報被選為selected poster進行口頭報
告,其他團隊成員也與許多重要的學者在會場進行交流。
會議最後在6月24日下午結束,最令人高興的是在閉幕典禮上,大會主席Prof.
Per Kogner宣布本團隊的小兒部盧孟佑醫師獲頒臨床組最佳口頭論文獎且是大
會創辦人Dr. Audrey Evans的特別獎、外科部許文明醫師獲頒生物組最佳壁報
論文獎、小兒部劉彥麟醫師獲頒臨床組最佳壁報論文獎。團隊成員在與大會主
席Prof. Per Kogner、創辦人Dr. Audrey Evans、日本Prof. Akira
Nakagawara教授合影後,帶著高興又興奮的心情,於6月25日陸續啟程返國。
二、與會心得
總計本次大會一共605人、37個國家參加,論文總數為412篇。臺灣團隊在大會
中一共發表了11篇論文,在所有參與的37個國家中排行第11名,且榮獲大會3個
獎項,非常難得,大會主席Prof. Per Kogner稱讚我們是”得獎效率”最高的
團隊,也期許我們團隊持續參與這個會議,因為我們這次臺灣團隊的表現真的
令他們印象深刻。
而在本團隊這次最受矚目的核醫研究方面,這次的大會中的論文與核醫相關的
主題不多,一個是我們臺大團隊提出的利用F-18 DOPA作有關神經母細胞瘤的三
篇研究。其中一篇是口頭發表比較I-123 MIBG,F-18 FDG以及F-18 FDOPA在17
例19次的掃描中,以人為基準,F-18 FDOPA之診斷敏感度是90%,特異性是
100%,未來預計進行更大規模之測試以瞭解其真正的臨床價值。其次,有一篇
壁報論文是在重新評估I-123 MIBG加入診斷之行列後,到底還需不需要繼續進
行F-18 FDOPA掃描,也就是再次評估其臨床判斷之價值。我們發現在三分之二
的病例仍有其協助臨床判斷價值,在三分之一的例子中與I-123 MIBG或F-18
FDG並無差別。但是,問題之關鍵在於哪些病人是這三分之一或是另外三分之
二。第三篇也是壁報論文發表,回溯我們追蹤三年來比較25個病例當中,可以
利用F-18 FDOPA及早診斷6個骨髓轉移之病灶,比傳統骨掃描早7個月,比FDG
掃描早5個月,比臨床症狀則早1.5年。而這些病例當中,有5例是分化較好的腫
瘤,這也是過去用I-123或I-131 MIBG追蹤時之盲點。
另一個重要的議題是利用I-131 MIBG進行腫瘤之治療。這是我們近年來一直想
做但是又沒有藥可以用的缺憾。目前最新的進展是利用化療藥物,甚至放射照
射治療與I-131 MIBG治療等同時或分先後進行治療。在這些多重方法共同治療
之下,為提高病童之抵抗力,採用骨髓幹細胞補強的方法以為協助。由於這是
藥廠贊助的研究,只有初步結果報告,當然是相當積極的做法。另外一個是將
I-131 MIBG之治療藥劑經特殊方法處理(Ultratrace)之後減少其載體
(carrier)以達到高強度治療之效果。第一步之報告是在體重每公斤12-18mCi
之下進行治療,效果還不錯病童也還能承受副作用。相信兩年後應有更多的相
關報告會出來。國內核研所應加把勁研發I-131 MIBG之生產,否則要落後太多
了。
三、建議事項
此次國科會補助本團隊參加會議,不僅我們從中知道了neuroblastoma在治療及
研究上最新的趨勢,我們的表現也不遑多讓,使各國學者對我們臺灣團隊刮目
相看、印象深刻,是一次耗費成本極低但卻最成功的“學術外交”。
最近International Neuroblastoma Risk Group (INRG) 已制定新的疾病危險
程度分群標準,大會中許多論文也以此標準作為研究及病人治療的依據,此標
準的更新在臺灣應盡快進行,做為我國發展下一代療程的重要依據。而會議
中,歐美團隊皆有報告最新關於的neuroblastoma基因體學研究成果,發現了許
多新的neuroblastoma癌症有關基因,值得我們趕快跟進,以徹底了解臺灣
neuroblastoma病童的癌症基因體學特性,但在個案數有限的情況下,與亞洲各
國加強區域合作與交流,是必要的趨勢。最後Anti-GD2單株抗體合併細胞激素
G-CSF在neuroblastom的免疫治療成果已經很明顯可增進高危險群病人的存活
率,雖然還在美國進行第3期的臨床試驗,期待在2到3年內FDA approval後應設
法趕快引進,以提升臺灣病童的治療成績。
四、其他
臺灣此次在大會發表的11篇論文(包括成功大學張玲教授):
1.Wen-Ming Hsu, Yu-Yin Shih, Hsinyu Lee, Hsueh-Fen Juan, Yeou-Guang
Tsay, Yung-Feng Liao: The interaction between GRP75 and retenoic
acid receptor-α/retenoid X receptor-α is essential for retenoic acid-
induced neuronal differentiation of neuroblastoma cells. Advances in
Neuroblastoma Research June 21-24, 2010, Stockholm, Sweden. (臺大醫院
外科部許文明醫師,生物組最佳壁報論文獎)
2.Hsiu-Hao Chang, Wen-Ming Hsu, Hsueh-Fen Juan, Yung-Feng Liao, Min-
Chuan Huang, Hsinyu Lee, Fon-Jou Hsieh, Kai-Hsin-Lin: Microarray-
based pathway analysis leads to the identification of potential
molecularmechanisms underlying gamma-secretase inhibitor-induced
differentiation. Advances in Neuroblastoma Research June 21-24,
2010, Stockholm, Sweden. (臺大醫院小兒部張修豪醫師)
3.Wen-Ming Hsu, Pei-Yi Wu, Hsueh-Fen Juan, Hsinyu Lee: Aromatic
hydrocarbon receptor down-regulates MYCN expression and promotes
neuronal differentiation of neuroblastoma. Advances in Neuroblastoma
Research June 21-24, 2010, Stockholm, Sweden. (臺灣大學生命科學院動物
學研究所李心予教授)
4.Yen-Lin Liu, Wen-Ming Hsu, Hsiu-Hao Chang, Dong-Tsamn Lin, Kai-
Hsin Lin, Shiann-Tarng Jou, Meng-Yao Lu, Yung-Li Yang, Kai-Yuan
Tzen, Steve Hsin-Feng Peng, Shiu-Feng Huang, Ya-Ling Lee: The impact
of a mutidisciplinary team approach in the case management of
neuroblastoma. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫院小兒部劉彥麟醫師,臨床組最佳壁報論文獎)
5.Ya-Ling Lee, Tzu-Chun Chen, Wen-Ming Hsu: Illness experience and
factors that constitute resilience in families with a neuroblastoma
child. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫學院護理系李雅玲老師)
6.Kai-Yuan Tzen, Meng-Yao Lu, Hsiu-Hao Chang, Wen-Ming Hsu, Tsai-
Yueh Luo, Lie-Hang Shen: 18F-Dopa PET scan is still useful in the
presence of 123I-MIBG and 18F-FDG for neuroblastoma imaging.
Advances in Neuroblastoma Research June 21-24, 2010, Stockholm,
Sweden. (臺大醫院核醫科曾凱元主任)
7.Kai-Yuan Tzen, Meng-Yao Lu, Hsiu-Hao Chang, Wen-Ming Hsu:
Molecular imaging with 18F-Dopa PET in the early detection of new
metastatic neuroblastoma in bone marrow. Advances in Neuroblastoma
Research June 21-24, 2010, Stockholm, Sweden. (臺大醫院核醫科曾凱元主
任)
8.Yin Chen, Wen-Ming Hsu, Yeou-Guang Tsay: Identification of
proteomic changes nassociated with differentiated neuroblastoma
using an in vitro differentiation system and an optimized proteomics
platform based on 18O peptide labeling. Advances in Neuroblastoma
Research June 21-24, 2010, Stockholm, Sweden. (陽明大學蔡有光老師)
9.Kai-Yuan Tzen, Meng-Yao Lu, Hsiu-Hao Chang, Kai-Hsin Lin, Shiann-
Tarng Jou, Yung-Li Yang, Dong-Tsamn Lin, Wen-Ming Hsu:
Characterization of neuroblastoma imaging studies using 18F-Dopa
PET/CT. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫院小兒部盧孟佑醫師,臨床組最佳口頭論文獎)
10.Mei-Ieng Che; Hsiu-Hao Chang, Min-Chuan Huang: Overexpression of
Beta 1,4-N-acetylgalactosaminyltransfrase III suppresses the
malignant phenotype of neuroblastoma cells via Beta1-integrin
signaling. Advances in Neuroblastoma Research June 21-24, 2010,
Stockholm, Sweden. (臺大醫學院黃敏銓老師)
11.Christina Chang, Kai-Hui Chan, Larry Paris, Lin-Jen Ma, Renn-
Shiuan Wei, Choon-Yee Tan: Alterations of NDP kinase A/NM23-H1
deregulate c-myc transcription. (成功大學張玲教授)
2010年7月10日 星期六
GIS rescources for OEM studies
i plan to do studies using GIS to deal with spatial, temporal, demorgraphic distribution of health outcomes.
it may use NTU geographic information of UV light exposure and skin cancer incidence at town/city to test the hypothesis of sunlight exposure and skin cancer histological types.
1. malignant mesothelioma [MM] cases in Taiwan Cancer Registry, geographic locations of asbestos industries
2. NTU geographic information of UV light exposure and skin cancer incidence at town/city to test the hypothesis of sunlight exposure and skin cancer histological types.
Web references
http://taiwanarmap.moi.gov.tw/moi/
http://gisedu.tw/related_links
it may use NTU geographic information of UV light exposure and skin cancer incidence at town/city to test the hypothesis of sunlight exposure and skin cancer histological types.
1. malignant mesothelioma [MM] cases in Taiwan Cancer Registry, geographic locations of asbestos industries
2. NTU geographic information of UV light exposure and skin cancer incidence at town/city to test the hypothesis of sunlight exposure and skin cancer histological types.
Web references
http://taiwanarmap.moi.gov.tw/moi/
http://gisedu.tw/related_links
2009年10月30日 星期五
Taiwan NTU EMBA獲世界排名40名佳績
英國金融時報(Financial Times)公布2009年全球EMBA排名調查結果:
本校EMBA獲世界排名40名佳績
英國金融時報(Financial Times)最新公布的2009年全球EMBA (EXECUTIVE MASTER OF BUSINESS ADMINISTRATION)排名調查結果,全台有兩所學校進入排名,本校管理學院比去年更進一步,榮獲世界排名第40名的佳績,居全台之冠。
臺大EMBA自2007年接受英國金融時報全球EMBA評比以來,年年都獲得進步的肯定,顯見本校管理學院在國際管理教育發展上的努力,不論在國際化、學術研究成果或是最讓人關心的學生薪資評比都有明顯的進步,因此才能在今年獲得第40名的佳績。
在國際化方面,本校EMBA自2005年起,每年選派專任教師前往哈佛商學院(HBS)研習,導入國際知名商學院個案教學模式,同時邀請國際知名(MIT、美國達頓商學院等)教授定期來台授課,並與境外夥伴學校交流合班上課。在學術研究成果上,該調查資料顯示管院整體老師的研究成果在商學頂尖40個期刊的發表數量有很好的成績,與近期泰晤士報公布臺大排名第95名,擠進世界百大行列的結果一致。薪資評比部分,校友畢業三年後的平均薪資表現優異,在近百所大學中排名第15名,除此之外,臺大EMBA學生在完成學業後,薪資平均提升58%。
過去十三年來,臺大EMBA為社會培育近1800位的社會菁英,構成高價值的資源網絡,連續兩年,本校管理學院獲得天下『Cheers』雜誌EMBA調查知名度與滿意度全國第一名的殊榮,繼而榮獲《金融時報》的肯定,讓管理學院對於未來深耕高階管理終身教育更具信心,在臺大獲得百大榮譽的同時,相信也值得更多高階經理人作為終身教育的投資首選。
本校在2009年英國金融時報EMBA全球排名之重要指標排名資料
Index 2009年 2008年
Salary today (US$) $202,504 $193,732
Salary increase (%) 58% 65%
Work experience rank 21 11
International board (%) 33% 33%
FT doctoral rank 5 20
FT research rank 66 69
Rank 2009 40 43
本校EMBA獲世界排名40名佳績
英國金融時報(Financial Times)最新公布的2009年全球EMBA (EXECUTIVE MASTER OF BUSINESS ADMINISTRATION)排名調查結果,全台有兩所學校進入排名,本校管理學院比去年更進一步,榮獲世界排名第40名的佳績,居全台之冠。
臺大EMBA自2007年接受英國金融時報全球EMBA評比以來,年年都獲得進步的肯定,顯見本校管理學院在國際管理教育發展上的努力,不論在國際化、學術研究成果或是最讓人關心的學生薪資評比都有明顯的進步,因此才能在今年獲得第40名的佳績。
在國際化方面,本校EMBA自2005年起,每年選派專任教師前往哈佛商學院(HBS)研習,導入國際知名商學院個案教學模式,同時邀請國際知名(MIT、美國達頓商學院等)教授定期來台授課,並與境外夥伴學校交流合班上課。在學術研究成果上,該調查資料顯示管院整體老師的研究成果在商學頂尖40個期刊的發表數量有很好的成績,與近期泰晤士報公布臺大排名第95名,擠進世界百大行列的結果一致。薪資評比部分,校友畢業三年後的平均薪資表現優異,在近百所大學中排名第15名,除此之外,臺大EMBA學生在完成學業後,薪資平均提升58%。
過去十三年來,臺大EMBA為社會培育近1800位的社會菁英,構成高價值的資源網絡,連續兩年,本校管理學院獲得天下『Cheers』雜誌EMBA調查知名度與滿意度全國第一名的殊榮,繼而榮獲《金融時報》的肯定,讓管理學院對於未來深耕高階管理終身教育更具信心,在臺大獲得百大榮譽的同時,相信也值得更多高階經理人作為終身教育的投資首選。
本校在2009年英國金融時報EMBA全球排名之重要指標排名資料
Index 2009年 2008年
Salary today (US$) $202,504 $193,732
Salary increase (%) 58% 65%
Work experience rank 21 11
International board (%) 33% 33%
FT doctoral rank 5 20
FT research rank 66 69
Rank 2009 40 43
2009年10月20日 星期二
Dr. Raymond D. Adams, 97
Dr. Raymond D. Adams, 97; Mass. General neurology chief coauthored textbook
By Bryan Marquard, Globe Staff | October 26, 2008
Nearing the end of his long tenure as chief of neurology at Massachusetts General Hospital, Dr. Raymond D. Adams took time off and traveled to Switzerland. There, in a lakeside villa, he picked up a yellow writing pad and his fountain pen and wrote the first page of what would become his legendary textbook, "Adams and Victor's Principles of Neurology."
And then he wrote another page and another until he had a mountainous draft to give to his colleague and coauthor, Dr. Maurice Victor, who added his own insights.
"He wrote the entire book in longhand, one version that was 1,600 printed pages, and it all came from his personal experience," Dr. Allan Ropper, coauthor of recent editions of the book, said of Dr. Adams.
Chief of neurology at Mass. General for 26 years, Dr. Adams was still offering advice and editorial comments for the ninth edition of his widely-used book when he was in his mid-90s. He died Oct. 18 in Brigham and Women's Hospital of complications from congestive heart failure. Dr. Adams was 97 and had lived in the Chestnut Hill section of Brookline after many years in Milton.
"In American medicine he was viewed as really the consummate clinical neurologist," said Ropper, who is executive vice chairman of neurology at Brigham and Women's and also was the last chief resident to serve under Dr. Adams at Mass. General. "He had a longer and deeper influence on neurology than virtually anyone, but was very eager to share the credit with others. The modesty was quite something to behold."
A few years after he was appointed to head the neurology department in 1951, Dr. Adams used a Joseph P. Kennedy Jr. Foundation grant to help create at MGH Joseph P. Kennedy Jr. Laboratories, which supported children's neurology research.
Years later, he also helped found the Eunice Kennedy Shriver Center on the grounds of the Fernald School in Waltham and was its first director. Dr. Adams was the Bullard professor of neuropathology at Harvard Medical School, and retired in 1977 as chief of neurology at MGH.
His years as head of the department, beginning when he was 41, were a time of great change in the field.
"What Ray Adams did in essence was establish an American style of neurology and broke it away from the dominant European influence of the '20s, '30s, and '40s," Ropper said. "He carved out a much more modern perspective. What he did that really broke the field wide open is that he made maximum use of neuropathology to study diseases. He established neuropathology as the basic science of clinical neurology."
Under the leadership of Dr. Adams, Mass. General became "the place for neurology in the world," said Dr. J. Philip Kistler, director emeritus of the stroke unit at MGH. "It was the place that developed modern thinking about neurology."
The book, meanwhile, went on to reap acclaim from when it was first published in 1977. It "ranks first among textbooks in neurology," a review in the British medical journal The Lancet said of the seventh edition.
"Diving into a new edition of 'Adams and Victor's Principles of Neurology' is like meeting up with an old teacher after several years," began the review, which ended: "One can certainly live without this book, but medical life is far more pleasant with a copy within reach."
In addition to moving the field of neurology forward, Dr. Adams "was extremely loyal," Ropper said. "He was very, very attached to his trainees and looked out for their careers."
"He was intellectually, extraordinarily honest with himself and with others," Kistler said. "You wanted to emulate him and you wanted to strive for the best because of him."
Dr. Adams was born in Portland, Ore., and graduated from the University of Oregon, where he honed his skills as a competitive tennis player. Late into his 60s, he won matches against opponents decades his junior.
In part to impress the family of his girlfriend, Dr. Adams applied to medical school, according to his son-in-law Bud Dudley, a physician in Roanoke, Va.
Dr. Adams ended up at the Duke University School of Medicine and graduated in 1936, just six years after the school was founded. He went to Yale University on a fellowship to study psychology, but grew disenchanted, Dudley said, and moved to Boston. He had worked in the neuropathology laboratories at Boston City Hospital before he was picked to lead the neurology department at Mass. General.
At home in Milton, "he had a carved table, probably eight feet wide and long," said his son, Bill of Chicago. "It was an open table, rather than an ordinary desk, and he sat there writing hour by hour. Behind him was a bay window and he sat on the window seat. He always used a fountain pen, never erased. That mind was obviously a significant one, not only to hold the knowledge, but to modify as he went along."
Dr. Adams's first marriage, to Margaret Elinor Clark, a romance languages scholar, ended in divorce after 33 years. He then married Dr. Maria Salam-Adams, a pediatric neurologist at MGH, who died in 1991.
Though generally reserved, Dr. Adams was very good at telling jokes, said his stepdaughter, Nina Salam of Brookline, and they "would sound all the more funny coming from him, because he was so serious."
"And he loved his dark chocolates, but he was a man of strict habits, even in fun things," she said. "He'd have his cocktail in the evening and have one dark chocolate at the end of the meal. While it was a pleasurable event, there may have been some medicinal reasons, too, from relaxing the arteries with the cocktail to having the dark chocolate, which also could be beneficial."
In addition to his son and stepdaughter, Dr. Adams leaves three daughters, Mary Elinor Dudley of Roanoke, Va., Carol Still of Kalispell, Mont., and Sarah Aldrich of Heber City, Utah; six granddaughters; five grandsons; eight great-granddaughters; and eight great-grandsons.
A service will be announced.
By Bryan Marquard, Globe Staff | October 26, 2008
Nearing the end of his long tenure as chief of neurology at Massachusetts General Hospital, Dr. Raymond D. Adams took time off and traveled to Switzerland. There, in a lakeside villa, he picked up a yellow writing pad and his fountain pen and wrote the first page of what would become his legendary textbook, "Adams and Victor's Principles of Neurology."
And then he wrote another page and another until he had a mountainous draft to give to his colleague and coauthor, Dr. Maurice Victor, who added his own insights.
"He wrote the entire book in longhand, one version that was 1,600 printed pages, and it all came from his personal experience," Dr. Allan Ropper, coauthor of recent editions of the book, said of Dr. Adams.
Chief of neurology at Mass. General for 26 years, Dr. Adams was still offering advice and editorial comments for the ninth edition of his widely-used book when he was in his mid-90s. He died Oct. 18 in Brigham and Women's Hospital of complications from congestive heart failure. Dr. Adams was 97 and had lived in the Chestnut Hill section of Brookline after many years in Milton.
"In American medicine he was viewed as really the consummate clinical neurologist," said Ropper, who is executive vice chairman of neurology at Brigham and Women's and also was the last chief resident to serve under Dr. Adams at Mass. General. "He had a longer and deeper influence on neurology than virtually anyone, but was very eager to share the credit with others. The modesty was quite something to behold."
A few years after he was appointed to head the neurology department in 1951, Dr. Adams used a Joseph P. Kennedy Jr. Foundation grant to help create at MGH Joseph P. Kennedy Jr. Laboratories, which supported children's neurology research.
Years later, he also helped found the Eunice Kennedy Shriver Center on the grounds of the Fernald School in Waltham and was its first director. Dr. Adams was the Bullard professor of neuropathology at Harvard Medical School, and retired in 1977 as chief of neurology at MGH.
His years as head of the department, beginning when he was 41, were a time of great change in the field.
"What Ray Adams did in essence was establish an American style of neurology and broke it away from the dominant European influence of the '20s, '30s, and '40s," Ropper said. "He carved out a much more modern perspective. What he did that really broke the field wide open is that he made maximum use of neuropathology to study diseases. He established neuropathology as the basic science of clinical neurology."
Under the leadership of Dr. Adams, Mass. General became "the place for neurology in the world," said Dr. J. Philip Kistler, director emeritus of the stroke unit at MGH. "It was the place that developed modern thinking about neurology."
The book, meanwhile, went on to reap acclaim from when it was first published in 1977. It "ranks first among textbooks in neurology," a review in the British medical journal The Lancet said of the seventh edition.
"Diving into a new edition of 'Adams and Victor's Principles of Neurology' is like meeting up with an old teacher after several years," began the review, which ended: "One can certainly live without this book, but medical life is far more pleasant with a copy within reach."
In addition to moving the field of neurology forward, Dr. Adams "was extremely loyal," Ropper said. "He was very, very attached to his trainees and looked out for their careers."
"He was intellectually, extraordinarily honest with himself and with others," Kistler said. "You wanted to emulate him and you wanted to strive for the best because of him."
Dr. Adams was born in Portland, Ore., and graduated from the University of Oregon, where he honed his skills as a competitive tennis player. Late into his 60s, he won matches against opponents decades his junior.
In part to impress the family of his girlfriend, Dr. Adams applied to medical school, according to his son-in-law Bud Dudley, a physician in Roanoke, Va.
Dr. Adams ended up at the Duke University School of Medicine and graduated in 1936, just six years after the school was founded. He went to Yale University on a fellowship to study psychology, but grew disenchanted, Dudley said, and moved to Boston. He had worked in the neuropathology laboratories at Boston City Hospital before he was picked to lead the neurology department at Mass. General.
At home in Milton, "he had a carved table, probably eight feet wide and long," said his son, Bill of Chicago. "It was an open table, rather than an ordinary desk, and he sat there writing hour by hour. Behind him was a bay window and he sat on the window seat. He always used a fountain pen, never erased. That mind was obviously a significant one, not only to hold the knowledge, but to modify as he went along."
Dr. Adams's first marriage, to Margaret Elinor Clark, a romance languages scholar, ended in divorce after 33 years. He then married Dr. Maria Salam-Adams, a pediatric neurologist at MGH, who died in 1991.
Though generally reserved, Dr. Adams was very good at telling jokes, said his stepdaughter, Nina Salam of Brookline, and they "would sound all the more funny coming from him, because he was so serious."
"And he loved his dark chocolates, but he was a man of strict habits, even in fun things," she said. "He'd have his cocktail in the evening and have one dark chocolate at the end of the meal. While it was a pleasurable event, there may have been some medicinal reasons, too, from relaxing the arteries with the cocktail to having the dark chocolate, which also could be beneficial."
In addition to his son and stepdaughter, Dr. Adams leaves three daughters, Mary Elinor Dudley of Roanoke, Va., Carol Still of Kalispell, Mont., and Sarah Aldrich of Heber City, Utah; six granddaughters; five grandsons; eight great-granddaughters; and eight great-grandsons.
A service will be announced.
2009年10月15日 星期四
a case of asbestos exposure and bilateral upper lung fibrosis
asbestos exposure 30 years ago in an asbestos-cement factory, work duration of 1 week
temporary worker, non-regular worker in the construction sites, handle the asbestos cement roofing material, including cutting and by-stander in the past
a case of open TB.
姓名: 葉oo (5501011)十日內--檢驗結果
B4 SPUTUM (EXPECTORATED) No:0004528 ( 98.10.14 14:47登記) (98.10.14 19:59報告)
趨勢圖 項目 數值 詳細資料 單位 標準值 說明
AFS+Culture #1 Acid fast bacilli - positive( 3+) *
AFS+Culture #2 *
AFS+Culture #3 *
AFS+Culture #4 *
AFS+Culture #5 *
B4 SPUTUM (EXPECTORATED) No:0004527 ( 98.10.14 14:47登記) (98.10.14 19:59報告)
趨勢圖 項目 數值 詳細資料 單位 標準值 說明
AFS+Culture #1 Acid fast bacilli - positive( 3+) *
AFS+Culture #2 *
AFS+Culture #3 *
AFS+Culture #4 *
AFS+Culture #5 *
B4 SPUTUM (EXPECTORATED) No:0004526 ( 98.10.14 14:47登記) (98.10.14 19:59報告)
趨勢圖 項目 數值 詳細資料 單位 標準值 說明
AFS+Culture #1 Acid fast bacilli - positive(3 +) *
AFS+Culture #2 *
AFS+Culture #3 *
AFS+Culture #4 *
AFS+Culture #5 *
temporary worker, non-regular worker in the construction sites, handle the asbestos cement roofing material, including cutting and by-stander in the past
a case of open TB.
姓名: 葉oo (5501011)十日內--檢驗結果
B4 SPUTUM (EXPECTORATED) No:0004528 ( 98.10.14 14:47登記) (98.10.14 19:59報告)
趨勢圖 項目 數值 詳細資料 單位 標準值 說明
AFS+Culture #1 Acid fast bacilli - positive( 3+) *
AFS+Culture #2 *
AFS+Culture #3 *
AFS+Culture #4 *
AFS+Culture #5 *
B4 SPUTUM (EXPECTORATED) No:0004527 ( 98.10.14 14:47登記) (98.10.14 19:59報告)
趨勢圖 項目 數值 詳細資料 單位 標準值 說明
AFS+Culture #1 Acid fast bacilli - positive( 3+) *
AFS+Culture #2 *
AFS+Culture #3 *
AFS+Culture #4 *
AFS+Culture #5 *
B4 SPUTUM (EXPECTORATED) No:0004526 ( 98.10.14 14:47登記) (98.10.14 19:59報告)
趨勢圖 項目 數值 詳細資料 單位 標準值 說明
AFS+Culture #1 Acid fast bacilli - positive(3 +) *
AFS+Culture #2 *
AFS+Culture #3 *
AFS+Culture #4 *
AFS+Culture #5 *
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