Publications by authors named "Chun-Ting Chen"

Pre-operative stage embolization is a valuable strategy for managing large arteriovenous malformations (AVMs). However, reflux of Onyx may be out of control and cause accidental embolization at the feeding artery's opening. We report a case of 27-year-old male suffering from right occipital AVM bleeding with left hemianopia.

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Background: Blood blister-like aneurysms (BBAs) of the internal carotid artery are rare but high risk lesions that frequently re-rupture due to their fragile structure and dissecting pathology. Treatment is particularly challenging in ruptured cases, given the risks associated with dual antiplatelet therapy. Recent advancements in flow diverter stents (FDSs) with surface modifications, and the use of single antiplatelet therapy (SAPT), offer a potential alternative strategy.

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BackgroundThrombocytopenia leads to increased postoperative complications and mortality in elective surgeries.Questions/purposesSpecific roles of thrombocytopenia on outcomes in orthopedic surgery remain relatively unexplored. This study aimed to assess the impact of chronic thrombocytopenia on outcomes of metastatic spinal tumor surgery.

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Objective: Currently, there is no optimal treatment for uremic pruritus, and traditional Chinese medicine (TCM) presents distinct theoretical perspectives and potential advantages. Bushen Qudu Formula has been reported to improve both pruritus and constipation in patients on hemodialysis who have uremia. The aim of this study is to evaluate the therapeutic efficacy of Bushen Qudu Formula on pruritus and constipation in patients undergoing hemodialysis who have uremia, as well as its impact on serum urea nitrogen, C-reactive protein, calcium, phosphorus, and potassium levels.

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This study examines the impact of hepatitis C virus (HCV) eradication through sofosbuvir/velpatasvir (SOF/VEL) treatment on glycated hemoglobin (HbA1c) levels in patients with chronic hepatitis C and type 2 diabetes mellitus (T2DM). Utilizing data from the Taiwan HCV Registry, a retrospective analysis was conducted on 2180 patients who met the inclusion criteria, 695 of whom had T2DM. HbA1c levels significantly decreased in the diabetes group from 7.

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Purpose: This study investigated whether Fibrosis-4 (FIB-4) score and its change can serve as predictors of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) infection receiving direct-acting antivirals (DAAs).

Methods: This study identified 9679 patients who completed DAA treatment and achieved sustained virologic response (SVR) from the Taiwan Nationwide Real-World HCV Registry Program, and their risk of HCC was analyzed.

Results: Multivariable Cox regression analyses identified diabetes mellitus (DM), alpha-fetoprotein (AFP) level, and FIB-4 score as independent predictors of HCC in both Model 1 (baseline) and Model 2 (SVR).

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An 8-week regimen of glecaprevir/pibrentasvir is recommended for treatment-naïve patients with chronic hepatitis C (CHC). In alignment with the Taiwanese government's objective to eliminate hepatitis C by 2025, this study aimed to provide real-world evidence on the use of this regimen in treatment-naïve patients with chronic kidney disease (CKD) by using data from the Taiwan Association for the Study of the Liver HCV Registry (TACR). CKD was defined by an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.

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Article Synopsis
  • Flap transplantation is often used for extensive wounds, relying on stable blood flow, and previous studies showed that high doses of estrogen improve flap survival but may cause side effects due to unnatural concentrations.
  • This study tested the effects of sustained-release estrogen capsules at lower, physiological levels on flap survival in ovariectomized mice, focusing on blood perfusion and wound healing indicators.
  • Results indicated that lower doses of estrogen improved blood flow and reduced necrosis while impacting specific markers related to tissue oxygen levels and cell death, suggesting that physiological estrogen levels can still be beneficial for flap survival.
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Background: Blunt cerebrovascular injury (BCVI) accounts for 1-3 % of patients with blunt trauma, which should be promptly diagnosed and managed due to risk of cerebral infarction and death. Antithrombotic therapy had been proven to reduce risk of stroke and mortality. However, due to concern of hematoma progression, treatment suggestion is still inconclusive for patients with concurrent traumatic intracranial hemorrhage.

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  • - This study explores using the C1 nerve root as a key surgical guide for identifying the shunting point of craniocervical junction spinal dural arteriovenous fistulas (CCJ-SDAVF) during surgery, based on data from 7 patients treated from January 2017 to June 2023.
  • - Of the 7 patients, most (71.4%) were male, and all showed complete obliteration of the CCJ-SDAVFs post-surgery, with follow-up assessments revealing no recurrences within two years.
  • - The findings suggest that interrupting CCJ-SDAVFs surgically yields high success rates and good functional recovery for most patients, emphasizing the importance of identifying the C1 nerve
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Background: Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition that is known to recur and that leads to unfavorable clinical outcomes. Middle meningeal artery embolization (MMAE) has emerged as an alternative treatment to prevent recurrence. This study investigated the efficacy of combined 2 therapies in a hybrid operative suite for high-risk patients.

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Background/aims: Hepatitis C virus (HCV) eradication using antiviral agents augments the metabolic profile. Changes in glycated hemoglobin (HbA1c) levels in chronic hepatitis C patients who receive glecaprevir/pibrentasvir (GLE/PIB) remain elusive.

Methods: Data from 2417 patients treated with GLE/PIB from the Taiwan HCV Registry were analyzed, and pretreatment HbA1c levels were compared with 3-months after the-end-of treatment levels.

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Objective: Incomplete occlusion of cerebral dural arteriovenous fistula (DAVF) may lead to fistula recurrence and rebleeding, which may necessitate several embolizations and lead to worse clinical outcomes. Herein, we describe a grouting technique for endovascular embolization and its outcomes in a series of patients with complex intracranial DAVF.

Methods: A total of 20 patients with aggressive type or symptomatic intracranial non-cavernous DAVF underwent endovascular transvenous embolization combining detachable coils and Onyx.

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  • * Researchers divided the sTBI patients into three groups based on disability severity using the Modified Rankin Score, analyzing the relationship between biomarker levels and patient outcomes over the week following the injury.
  • * Findings showed that elevated levels of specific cytokines, particularly IL-6, were associated with different outcomes among the patient groups, indicating their potential use in predicting recovery or decline in sTBI cases.
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  • Ethmoidal dural arteriovenous fistulas (DAVFs) are rare and serious brain lesions that can lead to bleeding and neurological issues due to their unique drainage patterns.
  • Surgical methods generally have fewer complications and better success rates in resolving DAVFs compared to endovascular treatments.
  • The supraorbital keyhole subfrontal approach is highlighted as a minimally invasive and effective surgical technique for treating these types of brain lesions, as demonstrated by two patients who achieved successful outcomes.
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Background: Chronic hepatitis C (CHC) increases the risk of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). This nationwide cohort study assessed the effectiveness of viral eradication of CHC.

Methods: The Taiwanese chronic hepatitis C cohort and Taiwan hepatitis C virus (HCV) registry are nationwide HCV registry cohorts incorporating data from 23 and 53 hospitals in Taiwan, respectively.

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Introduction: Eight-week glecaprevir/pibrentasvir (GLE/PIB) is indicated for treatment-naïve (TN) patients with chronic hepatitis C (CHC), with or without compensated cirrhosis. Given that the Taiwanese government is committed to eliminating hepatitis C virus (HCV) by 2025, this study aimed to measure real-world evidence for TN patients using 8-week GLE/PIB in the Taiwan HCV Registry (TACR).

Methods: The data of patients with CHC treated with 8-week GLE/PIB were retrieved from TACR, a nationwide registry program organized by the Taiwan Association for the Study of the Liver (TASL).

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Background: Both European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (AASLD-IDSA) guidelines recommend simplified hepatitis C virus (HCV) treatment with pan-genotypic sofosbuvir/velpatasvir or glecaprevir/pibrentasvir for eligible patients. This observational study used real-world data to assess these regimens' safety in eligible patients and develop an algorithm to identify patients suitable for simplified treatment by non-specialists.

Methods: 7,677 HCV-infected patients from Taiwan Hepatitis C Registry (TACR) who received at least one dose of sofosbuvir/velpatasvir or glecaprevir/pibrentasvir, and fulfilled the EASL/AASLD-IDSA criteria for simplified treatment were analyzed.

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Background/aims: Despite the high efficacy of direct-acting antivirals (DAAs), approximately 1-3% of hepatitis C virus (HCV) patients fail to achieve a sustained virological response. We conducted a nationwide study to investigate risk factors associated with DAA treatment failure. Machine-learning algorithms have been applied to discriminate subjects who may fail to respond to DAA therapy.

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  • A study evaluated a new portable neuroendoscopic system for minimally invasive surgery to remove spontaneous intracerebral hemorrhages, showing promising outcomes in a small group of ten patients.
  • The system allowed for improved surgical precision and efficiency, resulting in an 86% reduction in hematoma volume within 6 hours post-surgery and significant improvement in patient recovery scores.
  • No deaths or complications like rebleeding occurred in the follow-up period, indicating the device's potential, but further research is necessary to understand its long-term benefits.
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  • * Out of 112 patients analyzed, the research found that 13.4% experienced recurrence, predominantly among those treated without stents, and aneurysm rupture was a significant risk factor for recurrence.
  • * The findings revealed that aneurysms treated with stent-assisted coiling had better long-term outcomes, as no re-recurrence was noted in patients undergoing this method after an initial recurrence.
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Background: Large-scale real-world data of the 8-week glecaprevir/pibrentasvir (GLE/PIB) therapy for treatment-naïve patients of chronic hepatitis C virus (HCV) infection with compensated cirrhosis is scarce.

Methods: The TASL HCV Registry (TACR) is an ongoing nationwide registry program that aims to set up a database and biobank of patients with chronic HCV infection in Taiwan. In this study, data were analyzed as of 31 October 2021 for treatment-naïve HCV patients with compensated cirrhosis receiving 8-week GLE/PIB therapy.

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Background: This report presents the first case of intracranial cryptococcoma arising from the right frontal lobe causing right middle cerebral artery infarction. Intracranial cryptococcomas usually occur in the cerebral parenchyma, basal ganglia, cerebellum, pons, thalamus, and choroid plexus; they may mimic intracranial tumors, but seldom cause infarction. Of the 15 cases of pathology-confirmed intracranial cryptococcomas in the literature, no case has been complicated by middle cerebral artery (MCA) infarction.

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Objective: Laparoscopic ventriculoperitoneal shunt surgery has been reported to have several advantages in selected patients. However, the prognostic factors have been understudied specifically for this surgery. We sought to investigate the factors influencing the complications after the laparoscopic ventriculoperitoneal shunt placement.

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Background: Traumatic aneurysms at the superior cerebellar arteries after head injury are extremely rare and may be overlooked. Rupture of these aneurysms can cause fatal intracranial hemorrhages; thus, early identification of the entity helps prevent detrimental outcomes.

Observations: A patient suffered from sudden severe headache and decreased consciousness level several weeks after a blunt head injury.

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