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Huang YY, Ng YT, Chiu CH, Chuang CA, Sheu H, Yang CP, Tang HC. Addition of preoperative ultrasound-guided suprascapular nerve block and axillary nerve block to parecoxib is more effective in early postoperative pain control following arthroscopic rotator cuff repair: a prospective randomized controlled study. Arthroscopy 2024:S0749-8063(24)00166-X. [PMID: 38447626 DOI: 10.1016/j.arthro.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/18/2024] [Accepted: 02/24/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE The purpose of the study was to prospectively compare the pain intensity and patient-reported outcomes (PROs) following arthroscopic rotator cuff repair (ARCR) between patients who received ultrasound-guided suprascapular nerve block (SSNB) and axillary nerve block (ANB) as well as preincisional parecoxib and patients who received preincisional parecoxib only. METHODS Sixty-one patients receiving ARCR between March 2020 and March 2021 were prospectively enrolled. They were randomly assigned to the peripheral nerve block group (group N, n=30) or control group (group C, n=31). Two patients from group C were excluded because of miscommunication. All patients were administered parecoxib 40 mg intravenously prior to induction of anesthesia. In group N, SSNB/ANB were performed after general anesthesia while no nerve block was performed in group C. The pain intensity was compared before the surgery, as well as immediately, 24 hours and 2 weeks after the surgery. PROs, including Oxford shoulder score, University of California-Los Angeles shoulder score and Single Assessment Numeric Evaluation score, were compared before and 6 months after the surgery. RESULTS The resting pain numerical rating scale (NRS) was significantly lower in group N (4.9 ± 3.1 vs. 7.6 ± 2.5, p<0.001) immediately after the surgery, but no difference was noted 24 hours after the surgery. The resting pain NRS 2 weeks after the surgery was significantly lower in group N (1.4 ± 1.6 vs. 2.7 ± 2.7, p=0.03), but the movement-evoked pain and night pain were similar. All PROs significantly improved 6 months after the surgery in both groups, but there was no difference between the 2 groups. CONCLUSION Addition of preoperative ultrasound-guided SSNB and ANB to parecoxib offered better resting pain control immediately and 2 weeks after ARCR, but there was no benefit for PROs 6 months after the surgery. LEVEL OF EVIDENCE Level 2 prospective randomized controlled trial.
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Affiliation(s)
- Yu-Yi Huang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, No.222, Maijin Rd., Anle Dist., Keelung City 204, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan, No.259, Wunhua 1(st) Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Yuet-Tong Ng
- Department of Anesthesiology, Chang Gung Memorial Hospital, Keelung, Taiwan, No.222, Maijin Rd., Anle Dist., Keelung City 204, Taiwan
| | - Chih-Hao Chiu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, No.259, Wunhua 1(st) Rd., Guishan Dist., Taoyuan City 333, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, No. 5, Fusing St., Gueishan, Taoyuan City 333, Taiwan
| | - Chieh-An Chuang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, No.259, Wunhua 1(st) Rd., Guishan Dist., Taoyuan City 333, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, No. 5, Fusing St., Gueishan, Taoyuan City 333, Taiwan
| | - Huan Sheu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, No.259, Wunhua 1(st) Rd., Guishan Dist., Taoyuan City 333, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, No. 5, Fusing St., Gueishan, Taoyuan City 333, Taiwan
| | - Cheng-Pang Yang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, No.259, Wunhua 1(st) Rd., Guishan Dist., Taoyuan City 333, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, No. 5, Fusing St., Gueishan, Taoyuan City 333, Taiwan
| | - Hao-Che Tang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, No.222, Maijin Rd., Anle Dist., Keelung City 204, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan, No.259, Wunhua 1(st) Rd., Guishan Dist., Taoyuan City 333, Taiwan.
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Loren J, Lu CY(J, Yang CP, Hsu KY, Cheng YH, Sheu H, Chen CY, Tang HC, Chuang CA, Chiu CH(J. Arthroscopic Lower Trapezius Tendon Transfer for a Patient with Axillary Nerve Injury and Concomitant Rotator Cuff Tear: A Case Report and Technical Notes. Medicina (Kaunas) 2023; 59:1817. [PMID: 37893536 PMCID: PMC10608587 DOI: 10.3390/medicina59101817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Introduction: Concomitant nerve injuries with musculoskeletal injuries present a challenging problem. The goals of nerve reconstruction for the shoulder include shoulder abduction and external rotation. When patients fail to achieve acceptable shoulder external rotation and shoulder abduction, tendon transfers such as trapezius transfer offer a reliable option in the subsequent stage. Case Presentation: A 32-year-old male presented with weak external rotation in his left shoulder, after previous axillary nerve reconstruction. He received the ipsilateral lower trapezius transfer with the aim of improving the external rotation. Discussion: The lower trapezius restores a better joint reaction force in both the compressive-distractive and anterior-posterior balancing and provides a centering force through the restoration of the anterior-posterior force couple. Conclusion: We believe that the ipsilateral lower trapezius transfer to the infraspinatus is a good outcome and is effective in improving overall shoulder stability and the shoulder external rotation moment arm or at least maintaining in neutral position with the arm fully adducted in patients with post axillary nerve injuries post unsatisfactory nerve reconstruction to increase the quality of life and activities of daily living.
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Affiliation(s)
- Jeff Loren
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (J.L.); (C.-P.Y.); (C.-Y.C.)
- Department of Orthopedics & Traumatology, Royal Prima General Hospital, Medan 20118, Indonesia
| | - Chuieng-Yi (Johnny) Lu
- Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Cheng-Pang Yang
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (J.L.); (C.-P.Y.); (C.-Y.C.)
| | - Kuo-Yao Hsu
- Department of Orthopedic Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan; (K.-Y.H.); (Y.-H.C.)
| | - You-Hung Cheng
- Department of Orthopedic Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan; (K.-Y.H.); (Y.-H.C.)
| | - Huan Sheu
- Department of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
| | - Chao-Yu Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (J.L.); (C.-P.Y.); (C.-Y.C.)
| | - Hao-Che Tang
- Department of Orthopedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan; (H.-C.T.); (C.-A.C.)
| | - Chieh-An Chuang
- Department of Orthopedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan; (H.-C.T.); (C.-A.C.)
| | - Chih-Hao (Joe) Chiu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (J.L.); (C.-P.Y.); (C.-Y.C.)
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Cheng CF, Lan TY, Kao JH, Lu CH, Chang YC, Huang YM, Yang FJ, Chen JH, Lin YC, Chuang CA, Chang CH, Li KJ, Shen CY, Hsieh SC. The significance of dense fine speckled pattern in antinuclear antibody-associated rheumatic disease and coexisting autoantibodies: A propensity score-matched cohort study. Int J Rheum Dis 2023; 26:1667-1675. [PMID: 37338084 DOI: 10.1111/1756-185x.14789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
AIM To investigate the relationship between the prevalence of antinuclear antibody (ANA) -associated rheumatic diseases (AARD) and the presence of dense fine speckled (DFS) and homogeneous patterns in ANA tests. METHODS This retrospective study enrolled adult patients with either a DFS or homogeneous pattern in their ANA test. A mixed pattern was defined as the presence of more than one pattern reported in the test. The presence of anti-DFS70 antibodies and other common autoantibodies were detected using EUROLINE ANA Profile 23. A 1:2 propensity score matching was applied to control for demographic and other interfering factors. RESULTS A total of 59 patients with a DFS pattern were enrolled and compared with a matched homogeneous group. The DFS group had a significantly lower prevalence of AARD (3.4% vs. 16.9%, p = .008) and the subgroup with anti-DFS70 antibodies showed an even lower prevalence (2% vs. 20%, p = .002). Among the 33 patients with monospecific anti-DFS70 antibodies, five had a mixed pattern, and all patients with common autoantibodies had an isolated DFS pattern. CONCLUSIONS The findings of this study suggest that patients with a DFS pattern in their ANA test may have a lower prevalence of AARD compared with those with a homogeneous pattern. However, an isolated DFS pattern in ANA testing does not necessarily indicate the presence of monospecific anti-DFS70 antibodies or AARD. Confirmatory testing for the monospecific anti-DFS70 antibody is mandatory to exclude AARD.
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Affiliation(s)
- Chiao-Feng Cheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Yuan Lan
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Jui-Hung Kao
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Cheng-Hsun Lu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Cheng Chang
- Department of Laboratory Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Yi-Min Huang
- Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Feng-Jung Yang
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Jen-Hao Chen
- Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Yen-Chun Lin
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chieh-An Chuang
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Chih-Hui Chang
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ko-Jen Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chieh-Yu Shen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Song-Chou Hsieh
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Yang L, Chiu CH, Hsu KY, Chuang CA, Chen ACY, Chan YS, Yang CP. Using Single Peroneal Longus Tendon Graft for Segmental Meniscus Transplantation and Revision Anterior Cruciate Ligament Combined Anterolateral Reconstruction. Medicina (Kaunas) 2023; 59:1497. [PMID: 37629787 PMCID: PMC10456414 DOI: 10.3390/medicina59081497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
This case report describes a new approach to segmental meniscal reconstruction using a peroneal longus autograft in a patient with recurrent traumatic medial meniscus tear and anterior cruciate ligament reconstruction (ACLR) failure. While allograft meniscal transplantation is the preferred method for treating meniscal deficiency, its high cost and various legal regulations have limited its widespread use. Autologous tendon grafts have been proposed as a substitute for allograft meniscus transplantation, but their initial results were poor, leading to little progress in this area. However, recent animal experiments and clinical studies have demonstrated promising results in using autologous tendon grafts for meniscal transplantation, including improvements in pain and quality of life for patients. Further research is needed to evaluate the effectiveness of segmental meniscal reconstruction using autologous tendon grafts, but it could potentially lead to more accessible and cost-effective treatment options for patients with meniscal deficiency.
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Affiliation(s)
- Ling Yang
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taoyuan 333, Taiwan; (L.Y.); (C.-H.C.); (K.-Y.H.); (C.-A.C.); (A.C.-Y.C.)
| | - Chih-Hao Chiu
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taoyuan 333, Taiwan; (L.Y.); (C.-H.C.); (K.-Y.H.); (C.-A.C.); (A.C.-Y.C.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan
| | - Kuo-Yao Hsu
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taoyuan 333, Taiwan; (L.Y.); (C.-H.C.); (K.-Y.H.); (C.-A.C.); (A.C.-Y.C.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan
| | - Chieh-An Chuang
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taoyuan 333, Taiwan; (L.Y.); (C.-H.C.); (K.-Y.H.); (C.-A.C.); (A.C.-Y.C.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan
| | - Alvin Chao-Yu Chen
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taoyuan 333, Taiwan; (L.Y.); (C.-H.C.); (K.-Y.H.); (C.-A.C.); (A.C.-Y.C.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan
| | - Yi-Sheng Chan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Keelung 204, Taiwan
| | - Cheng-Pang Yang
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taoyuan 333, Taiwan; (L.Y.); (C.-H.C.); (K.-Y.H.); (C.-A.C.); (A.C.-Y.C.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333423, Taiwan
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Chuang CA, Sheu H, Yang CP, Tang HC, Wu CT, Fu CJ, Chan YS. Combined 3-Dimensional CT and Multidirectional CT Arthrography for Femoroacetabular Impingement and Hip Lesions: A Cross-sectional Study Comparing Imaging and Hip Arthroscopic Surgery Findings. Orthop J Sports Med 2023; 11:23259671221143459. [PMID: 36644778 PMCID: PMC9834784 DOI: 10.1177/23259671221143459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 01/11/2023] Open
Abstract
Background There is limited research investigating the diagnostic strength of 3-dimensional computed tomography (3D-CT) and multidirectional CT arthrography (CTA) for femoroacetabular impingement (FAI) and related hip lesions. Purpose To evaluate the diagnostic strength of combined 3D-CT and CTA in patients with FAI and related hip lesions by comparing it with hip arthroscopic surgery findings. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods This study included patients who were suspected of having FAI and related hip lesions and who underwent a combination of 3D-CT and CTA and subsequent hip arthroscopic surgery between December 2013 and December 2017. The CT and intraoperative arthroscopic findings were recorded and compared. The sensitivity, specificity, and accuracy of 3D-CT for FAI and those of CTA for related hip lesions were calculated. Results A total of 114 patients with 114 hips were included in our study. There were 101 patients with positive findings and 13 patients with negative findings for FAI (including cam, pincer, and combined morphology) according to 3D-CT. The sensitivity, specificity, and accuracy of 3D-CT for FAI were 91.58%, 57.14%, and 89.47%, respectively. The sensitivity, specificity, and accuracy of CTA for labral tears were 94.64%, 100.00%, and 94.73%, respectively. For acetabular cartilage defects, the sensitivity, specificity, and accuracy of CTA were 60.71%, 91.37%, and 76.31%, respectively. For femoral cartilage defects, the sensitivity, specificity, and accuracy of CTA were 82.22%, 76.81%, and 78.94%, respectively. Conclusion The study results indicated that 3D-CT was able to provide excellent accuracy for FAI compared with hip arthroscopic surgery findings. In addition, multidirectional CTA demonstrated promising diagnostic strength for hip lesions such as labral tears and chondral defects.
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Affiliation(s)
- Chieh-An Chuang
- Division of Sports Medicine, Department of Orthopaedic Surgery,
Linkou Chang Gung Memorial Hospital, Taoyuan.,Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital,
Taoyuan.,Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial
Hospital, Taoyuan
| | - Huan Sheu
- Division of Sports Medicine, Department of Orthopaedic Surgery,
Linkou Chang Gung Memorial Hospital, Taoyuan.,Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital,
Taoyuan.,Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial
Hospital, Taoyuan
| | - Cheng-Pang Yang
- Division of Sports Medicine, Department of Orthopaedic Surgery,
Linkou Chang Gung Memorial Hospital, Taoyuan.,Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital,
Taoyuan.,Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial
Hospital, Taoyuan
| | - Hao-Che Tang
- Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial
Hospital, Taoyuan.,Department of Orthopaedic Surgery, Keelung Chang Gung Memorial
Hospital, Keelung
| | - Chen-Te Wu
- Department of Medical Imaging and Intervention, Linkou Chang Gung
Memorial Hospital, Taoyuan
| | - Chen-Ju Fu
- Department of Medical Imaging and Intervention, Linkou Chang Gung
Memorial Hospital, Taoyuan
| | - Yi-Sheng Chan
- Division of Sports Medicine, Department of Orthopaedic Surgery,
Linkou Chang Gung Memorial Hospital, Taoyuan.,Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital,
Taoyuan.,Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial
Hospital, Taoyuan.,Department of Orthopaedic Surgery, Keelung Chang Gung Memorial
Hospital, Keelung.,Yi-Sheng Chan, MD, Department of Orthopaedic Surgery, Linkou
Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan
City, 333 ()
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Cho SL, Lin WC, Chuang CA, Liao WY, Lai CF. Tubulointerstitial nephritis associated with erlotinib therapy for lung cancer. Nephrology (Carlton) 2020; 25:730. [PMID: 32364270 DOI: 10.1111/nep.13721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/22/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Sheng-Li Cho
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Chou Lin
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chieh-An Chuang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Yu Liao
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chun-Fu Lai
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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