Brachial plexus injury during axillary thoracotomy

SummaryBrachial plexus injury is a severe neurologic injury that results in functional impairment of the affected upper limb, and it can be difficult to diagnose and manage. We report a woman aged 51 years who developed brachial plexus injury of the right arm after axillary thoracotomy with removal of a mediastinal tumor. Aggressive rehabilitation was promptly neurologic instituted, and the impairment of her arm recovered completely 69 days after surgery

Spontaneous Migration of Central Venous Catheter to Anterior Mediastinum

Central venous devices are routinely used in delivering chemotherapy and total parenteral nutrition. Spontaneous migration of central venous catheters is a very rare complication, but the etiology of this problem is not clear. We report here a case of migration of a port catheter to the anterior mediastinum in a patient with stage IVC nasopharyngeal cancer during chemotherapy. The patient presented with pulmonary manifestations in form of shortness of breath and chest tightness caused by left massive pleural effusion. The pleural effusion was resolved by thoracocentesis and the migrated catheter was retrieved surgically

The Implementation Of Knowledge Management System In Taiwans Higher Education

Success in an increasingly competitive marketplace depends on the quality of knowledge that organizations apply to their key business processes. The concept of knowledge management (KM) is widely discussed in commercial applications. There are limited discussions as to how it applies to not-for-profit organizations and its relevant measurement issues. This paper examines the application of knowledge management systems (KMS) in a private college in Taiwan, who is facing administrative challenges and cutting-edge competition. The multi-perspective modeling approach is adopted. The college first defines vision in a SWOT analysis through faculty brainstorming sessions. Leadership is formed to ensure a culture of sharing. A knowledge road map then documents inventories of IC and core competence. After defining knowledge management strategies in academic and organizational perspective, the KM model describes steps and procedures for implementation. Finally, implications for other universities and colleges are discussed

Endoscopic Treatment of Vesicoureteral Reflux in Children with Dextranomer/Hyaluronic Acid—A Single Surgeon's 6-Year Experience

Endoscopic treatment for vesicoureteral reflux (VUR) has become an established alternative to long-term antibiotic prophylaxis and ureteral reimplantation. We present the outcome of endoscopic treatment with dextranomer/hyaluronic acid copolymer (Deflux) for VUR in children by a single surgeon at our institute from October 2003 to October 2009. We reviewed the cases of 150 patients (total 239 ureters), 56 girls (37%) and 94 boys (63%), with a mean age of 2.2 years and a median followup of 2.5 years (range 3–68 months). Among the 239 ureters treated, 67.4% (161/239) were cured with a single injection, and a second and third injection raised the cure rate to 86.6% (207/239) and 88.3% (211/239), respectively. None had postoperative ureteral obstruction

Transmission matrix of a uniaxial optically active crystal platelet

Expressions corresponding to the transmission of a uniaxial optically active crystal platelet are provided for an optical axis parallel and perpendicular to the plane of interface. The optical activity is taken into account by a consistent multipolar expansion of the crystal medium response due to the path of an electromagnetic wave. Numerical examples of the effect of the optical activity are given for quartz platelets of chosen thicknesses. The optical activity's effects on the variations of the transmission of quartz platelets as a function of the angle of incidence is also investigated.Comment: 18 pages, 12 figures. Accepted to Optics Communications Journa

Rhythm-Flexible Voice Conversion without Parallel Data Using Cycle-GAN over Phoneme Posteriorgram Sequences

Speaking rate refers to the average number of phonemes within some unit time, while the rhythmic patterns refer to duration distributions for realizations of different phonemes within different phonetic structures. Both are key components of prosody in speech, which is different for different speakers. Models like cycle-consistent adversarial network (Cycle-GAN) and variational auto-encoder (VAE) have been successfully applied to voice conversion tasks without parallel data. However, due to the neural network architectures and feature vectors chosen for these approaches, the length of the predicted utterance has to be fixed to that of the input utterance, which limits the flexibility in mimicking the speaking rates and rhythmic patterns for the target speaker. On the other hand, sequence-to-sequence learning model was used to remove the above length constraint, but parallel training data are needed. In this paper, we propose an approach utilizing sequence-to-sequence model trained with unsupervised Cycle-GAN to perform the transformation between the phoneme posteriorgram sequences for different speakers. In this way, the length constraint mentioned above is removed to offer rhythm-flexible voice conversion without requiring parallel data. Preliminary evaluation on two datasets showed very encouraging results.Comment: 8 pages, 6 figures, Submitted to SLT 201

Results of one-stage urethroplasty for hypospadias in pediatrics – single surgeon’s experience

Introduction: Hypospadias repair is a challenging technique in pediatric urology with a long learning curve. This study presents the results of urethroplasty performed by a single surgeon to repair hypospadias in children and compares the surgical outcomes at different periods. Materials and Methods: From January 2009 to February 2016, patients who were less than 18 years old and were operated for hypospadias were retrospectively reviewed and divided into two groups: group I (from January 2009 to February 2012) and group II (from March 2012 to February 2016). All operations were performed by the same pediatric surgeon, andsurgical outcomes of the two periods were compared. Results: This study considered150 patients (69 in group I/81 in group II). The Mean operative age was 30.4±32.7 months in group I and 33.6±43.3 months in group II(p=0.309). The selected procedures mainly depended on the subjective anatomical analysis in the operating room and the surgeon’s preference. The mean follow-up duration was 21.7±28.31 months in group I and 13.6±16.6 months in group II (p=0.033).The overall complication rate was 44.9% in group Iand 35.8% in group II (p=0.316). The incidence of glanular disruption significantly decreased from 21.7% to 6.2% (p=0.007) because of the wide dissection of the glanular wings and the deep incision of the urethral plate, which led to tension-free sutures for glanular reconstruction. Conclusions: One-stage repair of hypospadias may achieve satisfactory outcomes in cosmetic appearance and voiding function. Surgical outcomes could be improved by increasing practice

Investigation of morphological changes in the tamsui river estuary using an integrated coastal and estuarine processes model

© 2020 by the authors. This study is to investigate morphological changes in the Tamsui River Estuary in Taiwan driven by multiple physical processes, such as river flows, tides, waves, and storm surges, and then to study the impacts of sediment flushing operated at the Shihmen reservoir upstream on the river estuary. An integrated coastal and estuarine processes model (CCHE2D-Coast) (Center for Computational Hydroscience and Engineering Two-Dimensional-Coast) was validated by simulating these physical processes in the estuary driven by three historical typhoons in 2008. The site-specifically validated model was then applied to simulate morphological changes in the estuary in response to reservoir sediment flush scenarios from the upstream. For the impact assessment of sediment flushing, a synthetic hydrological event was designed by including a historical typhoon and a typical monsoon. It was found that during the typhoon, the sediments will be mostly deposited in the estuarine river reach of Tamsui and the Wazihwei sandy beach. During the monsoon period, most of the sediments tend to be deposited in the second fishing port of Tamsui, the northern breakwater, and the estuary, while the Wazihwei sandy beach in the river mouth would be scoured by backflow. Simulations of the complex flow fields and morphological changes will facilitate the best practice of sediment management in the coastal and estuarine regions