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Articles by H. J Chang
Total Records ( 3 ) for H. J Chang
  R. T George , A Arbab Zadeh , J. M Miller , K Kitagawa , H. J Chang , D. A Bluemke , L Becker , O Yousuf , J Texter , A. C Lardo and J. A.C. Lima
 

Background— Multidetector computed tomography coronary angiography (CTA) is a robust method for the noninvasive diagnosis of coronary artery disease. However, in its current form, CTA is limited in its prediction of myocardial ischemia. The purpose of this study was to test whether adenosine stress computed tomography myocardial perfusion imaging (CTP), when added to CTA, can predict perfusion abnormalities caused by obstructive atherosclerosis.

Methods and Results— Forty patients with a history of abnormal single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) underwent adenosine stress 64-row (n=24) or 256-row (n=16) detector CTP and CTA. A subset of 27 patients had invasive angiography available for quantitative coronary angiography. CTA and quantitative coronary angiography were evaluated for stenoses ≥50%, and SPECT-MPI was evaluated for fixed and reversible perfusion deficits using a 17-segment model. CTP images were analyzed for the transmural differences in perfusion using the transmural perfusion ratio (subendocardial attenuation density/subepicardial attenuation density). The sensitivity, specificity, positive predictive value, and negative predictive value for the combination of CTA and CTP to detect obstructive atherosclerosis causing perfusion abnormalities using the combination of quantitative coronary angiography and SPECT as the gold standard was 86%, 92%, 92%, and 85% in the per-patient analysis and 79%, 91%, 75%, and 92% in the per vessel/territory analysis, respectively.

Conclusions— The combination of CTA and CTP can detect atherosclerosis causing perfusion abnormalities when compared with the combination of quantitative coronary angiography and SPECT.

  S. G Yeo , D. Y Kim , T. H Kim , S. Y Kim , H. J Chang , J. W Park , H. S Choi and J. H. Oh
  Objective

To investigate the long-term outcomes of selected patients with cT3 distal rectal cancer treated with local excision following pre-operative chemoradiotherapy.

Methods

Between January 2003 and February 2008, 11 patients with cT3 distal rectal cancer received a local excision following pre-operative chemoradiotherapy. The median age of the patients was 61 years (range, 42–71). The median tumor size was 3 cm (range, 2–5), and the median distance of the caudal tumor edge from the anal verge was 3 cm (range, 1–4). Clinical lymph node status was positive in five patients. Pre-operative chemoradiotherapy consisted of a 50.4 Gy in 28 fractions with concurrent chemotherapy. A transanal full-thickness local excision was performed after a median of 54 days (range, 31–90) from chemoradiotherapy completion. Ten patients received post-operative chemotherapy.

Results

Pathologically complete responses occurred in eight patients, ypT1 in two and ypT2 in one. The pathologic tumor size for three ypT1–2 tumors was 0.9, 1.1 and 2.2 cm. The follow-up period was a median of 59 months (range, 24–85). One patient (ypT0) developed recurrence at the excision site 14 months after surgery, but was successfully salvaged with an abdominoperineal resection and adjuvant chemotherapy. Another patient (ypT2) developed bone metastasis after 8 months and died of the disease. The 5-year local recurrence-free, disease-free and overall survival rates were 90.9%, 81.8% and 88.9%, respectively. No Grade 3 or worse gastrointestinal toxicity was detected.

Conclusions

Full-thickness local excision following chemoradiotherapy may be an acceptable option for cT3 distal rectal cancer that responds well to chemoradiotherapy.

  C. M Chang , S. C Liao , H. C Chiang , Y. Y Chen , K. C Tseng , Y. L Chau , H. J Chang and M. B. Lee
 

All suicides (n=12 497) in Taiwan in 2001–2004 were identified from mortality records retrieved from the National Health Insurance Database. Altogether, 95.1% of females and 84.9% of males had been in contact with healthcare services in the year before their death. Females received significantly more diagnoses of psychiatric disorders (48.0% v. 30.2%) and major depression (17.8% v. 7.4%) than males. Such differences were consistent across different medical settings where contact with hospital-based non-psychiatric physicians was as common as with general practitioners (GPs). However, diagnoses of psychiatric disorders were underdiagnosed in both genders.

 
 
 
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