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Search Results: 1 - 10 of 51109 matches for " Yung-Cheng Lee "
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A Heuristic Approach for Assembly Scheduling and Transportation Problems with Parallel Machines  [PDF]
Peng-Sheng You, Yi-Chih Hsieh, Ta-Cheng Chen, Yung-Cheng Lee
iBusiness (IB) , 2013, DOI: 10.4236/ib.2013.51B006
Abstract: Many firms have to deal with the problems of scheduling and transportation allocation. The problems of assembly scheduling mainly focus on how to arrange orders in proper sequence on the assembly line with the purpose of minimizing the maximum completion time before they are flown to their destinations. Transportation allocation problems arise in how to assign processed orders to transport modes in order to minimize penalties such as earliness and tardiness. The two problems are usually separately discussed due to their complexity. This paper simultaneously deals with these two problems for firms with multiple identical parallel machines. We formulate this problem as a mixed integer programming model. The problem belongs to the class of NP-complete combinatorial optimization problems. This paper develops a hybrid genetic algorithm to obtain a compromised solution within a reasonable CPU time. We evaluate the performance of the presented heuristic with the well-known GAMS/CPLEX software. The presented approach is shown to perform well compared with well-known commercial software.
Retinoic Acid Syndrome in Patients following the Treatment of Acute Promyelocytic Leukemia with All-trans Retinoic Acid
Yung-Cheng Su,Po Dunn,Lee-Yung Shih,Ming-Chung Kuo
Chang Gung Medical Journal , 2009,
Abstract: Background: Retinoic acid syndrome (RAS) is a potentially lethal complication during alltransretinoic acid (ATRA) treatment of acute promyelocytic leukemia(APL). The incidence and risk factors have been shown to vary in differentseries. In this study we want to establish the incidence of RAS in our hospitaland try to elucidate factors that increase its risk.Methods: We retrospectively analyzed 102 patients diagnosed with APL betweenAugust 1993 and December 2007 at Chang Gung Memorial Hospital,Taiwan. All patients received ATRA as an induction regimen with or withoutconventional chemotherapy.Results: Eight of the 102 patients (7.8%) experienced RAS which developed after amedian of 9 days (range: 2 to 23 days) of ATRA treatment. Respiratory distressand fever were the most common presentations, occurring in 7 of 8patients (87.5%). Age, gender, morphological or molecular subtypes, an initialwhite blood cell (WBC) count of more than 10 x 109/L and concurrentchemotherapy did not statistically attribute to the occurrence of RAS. Onepatient developed RAS manifesting with pulmonary hemorrhage but experienceda complete recovery after administration of high-dose dexamethasone.The RAS-related mortality was 12.5% (1 out of 8 patients).Conclusion: The incidence of RAS in this study was similar to those of other series withATRA and concurrent chemotherapy. Age, gender, morphological or molecularsubtypes, an initial leukocyte count of more than 10 x 109/L or the presenceof concurrent chemotherapy is not significantly associated with theoccurrence of the RAS.
Dyspnea Caused by Atlantoaxial Subluxation in a Patient with Rheumatoid Arthritis
Hsin-Yi Lin,Chien-Chih Chen,Yi-Kung Lee,Yung-Cheng Su
Case Reports in Emergency Medicine , 2012, DOI: 10.1155/2012/170956
Abstract: Atlantoaxial subluxation is a well-known but poorly recognized disease in rheumatoid patients. We report a patient with rheumatoid arthritis whose chief complaint was dyspnea on arrival to the emergency department (ED). After further investigation, spinal cord compression caused by atlantoaxial subluxation was diagnosed. This is an uncommon but important case that ED physicians should be aware of.
Dyspnea Caused by Atlantoaxial Subluxation in a Patient with Rheumatoid Arthritis
Hsin-Yi Lin,Chien-Chih Chen,Yi-Kung Lee,Yung-Cheng Su
Case Reports in Emergency Medicine , 2012, DOI: 10.1155/2012/170956
Abstract: Atlantoaxial subluxation is a well-known but poorly recognized disease in rheumatoid patients. We report a patient with rheumatoid arthritis whose chief complaint was dyspnea on arrival to the emergency department (ED). After further investigation, spinal cord compression caused by atlantoaxial subluxation was diagnosed. This is an uncommon but important case that ED physicians should be aware of. 1. Introduction Dyspnea is a possible life-threatening condition that is encountered frequently in the emergency department (ED). We present a patient with rheumatoid arthritis who complained of intermittent shortness of breath. Atlantoaxial subluxation with cervical spinal cord compression was diagnosed after our survey. Because of the timely diagnosis and management, the adverse outcome was prevented. 2. Case Report A sixty-year-old female presented with intermittent shortness of breath happened in the morning of the day. She was a patient with chronic rheumatoid arthritis (RA) and was regularly followed in the rheumatologic clinic. During the past two weeks, she also complained of progressive numbness over bilateral hands and feet. Since the symptoms were not resolved by her daily medications and became more severe in the evening, she was brought to the ED for further evaluation. At the ED, the patient was ambulatory, cooperative, and in mild distress, complaining of shortness of breath. Her vital signs were temperature 36.8°C, pulse rate 110 beats/min, respiratory rate 24 breaths/min, blood pressure of 168/81, and pulse oximetry 97%. Breathing sounds were normal without crackles or wheeze while auscultation. Other physical examination was unremarkable. Arterial blood gas was obtained and the data were within normal range. Because of the elevated D-dimer level, computed tomography of the chest was arranged to rule out the pulmonary embolism, but there was no significant finding. The patient felt better after the use of oxygen during observation. However, reviewing of the medical records indicated the X-ray of the cervical spine was taken one week ago for the evaluation of limb numbness, and the increased distance at atlantoaxial space was noted (Figure 1). Magnetic resonance imaging of the cervical spine was arranged and atlantoaxial subluxation with acute cervical spinal cord compression over C1-C2 level was found. The neurosurgeon was consulted and surgical intervention was suggested. However, the patient refused operation and conservative treatments with neck immobilization, and steroids were initiated during hospitalization. The patient was discharged 5
Increased Risk of Acute Pancreatitis in Patients with Chronic Hemodialysis: A 4-Year Follow-Up Study
Sheng-Wen Hou, Yi-Kung Lee, Chen-Yang Hsu, Ching-Chih Lee, Yung-Cheng Su
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0071801
Abstract: Background The risk of acute pancreatitis in patients on long-term peritoneal dialysis is higher as compared to the general population. However, the relationship between long-term hemodialysis and acute pancreatitis has never been established. Objectives We investigated the incidence of acute pancreatitis among patients on long-term hemodialysis in Taiwan to evaluate if there is a higher risk of acute pancreatitis in comparison to the general population. Methods We utilized a National Health Insurance (NHI) claims data sample containing one million beneficiaries. We followed all adult beneficiaries from January 1, 2007 until December 31, 2010 to see if they had been hospitalized for acute pancreatitis during this period. We further identified patients on chronic hemodialysis and compared their risk of acute pancreatitis with the general population. Results This study included 2603 patients with long-term hemodialysis and 773,140 patients without hemodialysis. After controlling for age, gender, Charlson Comorbidity Index Score, geographic region, socioeconomic status and urbanization level, the adjusted hazard ratio was 3.44 (95% Confidence interval, 2.5–4.7). Conclusions The risk of acute pancreatitis in patients on long-term hemodialysis is significantly higher in comparison to the general population.
Antibiotic Prescriptions for Upper Respiratory Infection in the Emergency Department: A Population-Based Study
Sheng-Wen Hou,Yi-Kung Lee,Chen-Yang Hsu,Ching-Chih Lee,Yung-Cheng Su
ISRN Emergency Medicine , 2014, DOI: 10.1155/2014/461258
Abstract: Study Objective. Antibiotics prescriptions for upper respiratory infections (URI) are not uncommon, but the benefits for these groups had seldom been evaluated. We aimed to utilize a sampled National Health Insurance (NHI) claims data containing one million beneficiaries to explore if the use of antibiotics could reduce the possibility of unscheduled returns. Methods. We identified patients presented to ambulatory clinics with the discharged diagnoses of URI. The prescriptions of antibiotics were identified. We further matched each patient in the antibiotic group to the patient in the control group by selected covariates using a standard propensity score greedy-matching algorithm. The risks of unscheduled revisits were compared between the two groups. Results. A total of 6915140 visits were identified between 2005 and 2010. The proportions of antibiotics prescriptions are similar among these years, ranging from 9.99% to 13.38 %. In the propensity score assignment, 9190 patients (4595 in each group) were further selected. The odds ratio of unscheduled revisits among antibiotics group and control group was 0.92 (95% CI, 0.70–1.22) with value equal to 0.569. Conclusions. Overall, antibiotics prescriptions did not seem to decrease the unscheduled revisits in patients presented to the ED with URI. Emergency physicians should reduce the unnecessary prescriptions and save antibiotics to patients with real benefits. 1. Introduction For every clinician, whetherto treat adult patients with upper respiratory tract infections (URIs) with antibiotics was daily encountered clinical dilemma. It had been shown that oral antibiotic seldom had real therapeutic effect for acute bronchitis, since virus was the most common pathogen [1]. Overly prescribed antibiotics benefit patients little but raise the possibility of antimicrobial resistance and increase the medical cost. Recent guideline suggests that a period of observation without antibiotics use for most of URIs was reasonable and was associated with reducing the inappropriate use [2]. Nevertheless, in 2012, a study based in the emergency departments (EDs) still revealed that 74.0% of thecases of acute bronchitis in adults were discharged with antibiotics [3]. This discrepancy suggested that either there was significant gap for knowledge translation or reflected the reality that clinicians have other considerations on this issue. It has been found that, although most of time unnecessary, oral antibiotics use for URIs may fulfill patient expectations and increase satisfaction [4]. Since patient dissatisfaction was
Early Endoscopy Can Shorten the Duration of Hospitalization in Suspected Variceal Hemorrhage
Hong-Lin Guan,Hsin-Yi Lin,Yi-Kung Lee,Chen-Yang Hsu,Yung-Cheng Su
ISRN Emergency Medicine , 2013, DOI: 10.1155/2013/839126
Abstract: Background. Endoscopic treatment in patients with acute variceal hemorrhage should be performed within 12 hours, but the recommendation is based on the experts’ opinion. Objective. Our study investigated if time to endoscopy was a significant factor that could alter the outcomes of patients with suspected variceal hemorrhage. The primary outcome was the length of hospital stay and the mortality. The secondary outcomes were complications during observation periods. Methods. Patients were included if variceal hemorrhage was suspected in the emergency department. Patients were further divided into early (receiving endoscopy within 12 hours) and delayed groups (receiving endoscopy after 12 hours), and each patient was matched using a standard propensity score greedy-matching algorithm. The primary and secondary outcomes were compared accordingly. Results. 1442 patients met our inclusion criteria and therefore were enrolled for further analysis. In the Cox regression model, log time to endoscopy was not a significant factor. In the propensity score assignment, 566 patients (283 in each group) were further selected into the subcohort (P value = 0.8001). Kaplan-Meier curves showed a discharge benefit favoring the early endoscopy over the control group. The mortality rates and complications were not statistically different between the two groups (P value = 0.0045). Conclusion. Early endoscopy before 12 hours in patients with suspected variceal hemorrhage could result in shorter length of hospitalization without increasing the mortalities and complications. The results would help emergency physicians in decisions making when these patients are encountered. 1. Introduction Acute variceal hemorrhage is a life-threatening complication of liver cirrhosis [1, 2]. Unlike nonvariceal bleeding, only 50 percent of patients with variceal hemorrhage stop spontaneously, and time management is necessary in order to improve the outcome. In addition to medical therapy, endoscopic treatment is considered currently the definitive treatment of choice [3]. Theoretically, early endoscopy can achieve quicker hemostasis, prevent possible complications, and decrease transfusions and length of hospital stay [4–6]. However, the insufficient preparation time may also lead to some drawbacks such as incomplete examination and aspiration. In the guideline published by the American Association for the Study of Liver Diseases and the American College of Gastroenterology [7], endoscopic treatment should be performed within 12 hours, but the recommendation is based on the experts’ opinion [8].
Increased Risk of Dementia in Patients with Mild Traumatic Brain Injury: A Nationwide Cohort Study
Yi-Kung Lee, Sheng-Wen Hou, Ching-Chih Lee, Chen-Yang Hsu, Yung-Sung Huang, Yung-Cheng Su
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0062422
Abstract: Background It is known that the risk of dementia in patients with moderate to severe traumatic brain injury (TBI) is higher. However, the relationship between mild traumatic brain injury (mTBI) and dementia has never been established. Objectives We investigated the incidences of dementia among patients with mTBI in Taiwan to evaluate if there is higher risk compared with general population. Methods We utilized a sampled National Health Insurance (NHI) claims data containing one million beneficiaries. We followed all adult beneficiaries from January 1, 2005 till December 31, 2009 to see if they had been diagnosed with dementia. We further identify patients with mTBI and compared their risk of dementia with the general population. Results We identified 28551 patients with mTBI and 692382 without. After controlled for age, gender, urbanization level, socioeconomic status, diabetes, hypertension, coronary artery disease, hyperlipidemia, history of alcohol intoxication, history of ischemic stroke, history of intracranial hemorrhage and Charlson Comorbidity Index Score, the adjusted hazard ratio is 3.26 (95% Confidence interval, 2.69–3.94). Conclusions TBI is an independent significant risk factor of developing dementia even in the mild type.
Increased Risk of Vascular Events in Emergency Room Patients Discharged Home with Diagnosis of Dizziness or Vertigo: A 3-Year Follow-Up Study
Ching-Chih Lee, Hsu-Chueh Ho, Yu-Chieh Su, Brian C-H Chiu, Yung-Cheng Su, Yi-Da Lee, Pesus Chou, Sou-Hsin Chien, Yung-Sung Huang
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0035923
Abstract: Background Dizziness and vertigo symptoms are commonly seen in emergency room (ER). However, these patients are often discharged without a definite diagnosis. Conflicting data regarding the vascular event risk among the dizziness or vertigo patients have been reported. This study aims to determine the risk of developing stroke or cardiovascular events in ER patients discharged home with a diagnosis of dizziness or vertigo. Methodology A total of 25,757 subjects with at least one ER visit in 2004 were identified. Of those, 1,118 patients were discharged home with a diagnosis of vertigo or dizziness. A Cox proportional hazard model was performed to compare the three-year vascular event-free survival rates between the dizziness/vertigo patients and those without dizziness/vertigo after adjusting for confounding and risk factors. Results We identified 52 (4.7%) vascular events in patients with dizziness/vertigo and 454 (1.8%) vascular events in patients without dizziness/vertigo. ER patients discharged home with a diagnosis of vertigo or dizziness had 2-fold (95% confidence interval [CI], 1.35–2.96; p<0.001) higher risk of stroke or cardiovascular events after adjusting for patient characteristics, co-morbidities, urbanization level of residence, individual socio-economic status, and initially taking medications after the onset of dizziness or vertigo during the first year. Conclusions ER patients discharged home with a diagnosis of dizziness or vertigo were at a increased risk of developing subsequent vascular events than those without dizziness/vertigo after the onset of dizziness or vertigo. Further studies are warranted for developing better diagnostic and follow-up strategies in increased risk patients.
The Relationship between Brown Adipose Tissue Activity and Neoplastic Status: an 18F-FDG PET/CT Study in the Tropics
Yung-Cheng Huang, Tai-Been Chen, Chien-Chin Hsu, Shau-Hsuan Li, Pei-Wen Wang, Bi-Fang Lee, Ching-Yuan Kuo, Nan-Tsing Chiu
Lipids in Health and Disease , 2011, DOI: 10.1186/1476-511x-10-238
Abstract: 18F-FDG PET/CT scans were reviewed and the total metabolic activity (TMA) of identified activated BAT quantified. The distribution and TMA of activated BAT were compared between patients with and without a cancer history. The neoplastic status of patients was scored according to their cancer history and 18F-FDG PET/CT findings. We evaluated the relationships between the TMA of BAT and neoplastic status along with other factors: age, body mass index, fasting blood sugar, gender, and outdoor temperature.Thirty of 1740 patients had activated BAT. Those with a cancer history had wider BAT distribution (p = 0.043) and a higher TMA (p = 0.028) than those without. A higher neoplastic status score was associated with a higher average TMA. Multivariate analyses showed that neoplastic status was the only factor significantly associated with the TMA of activated BAT (p = 0.016).Neoplastic status is a critical determinant of BAT activity in patients living in the tropics. More active neoplastic status was associated with more vigorous TMA of BAT.Brown adipose tissue (BAT) is a highly specialized thermogenic tissue that is essential for non-shivering thermogenesis [1]. BAT activation helps maintain normal body temperatures in newborns. Although the amount of BAT declines with age, islets of brown adipocytes remain in the white adipose tissue of adult humans [1,2]. High levels of BAT in the adult body are associated with cancer-induced cachexia and may reflect an abnormal mechanism responsible for substantial energy expenditure and subsequent weight loss [3]. BAT has recently attracted attention because it consumes stored energy and may thereby be involved in human obesity and age-related metabolic diseases [4,5]. The two extremes in the regulation of body weight, obesity and cachexia can be considered two sides of the same coin [6,7]. Beyond the well-known influence of outdoor temperature on activated BAT, little has been published on the impact of neoplastic status. We did this
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