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Fan YT, Lee JY, Cheng YC, Lin HH, Chien CH, Tu PW, Chung HW. The requirements of nucleic acid test for COVID-19 during public health emergency: Current regulatory in Taiwan, Singapore, and the United States. J Chin Med Assoc 2022; 85:1038-1043. [PMID: 36343271 DOI: 10.1097/jcma.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In mid-2022, the COVID-19 cases have reached close to 562 million, but its overall infection rate is hard to confirm. Even with effective vaccines, break-through infections with new variants occur, and safe and reliable testing still plays a critical role in isolation of infected individuals and in control of an outbreak of a COVID-19 pandemic. In response to this urgent need, the diagnostic tests for COVID-19 are rapidly evolving and improving these days. The health authorities of many countries issued requirements for detecting SARS-CoV-2 diagnosis tests during the pandemic and have timely access to these tests to ensure safety and effectiveness. In this study, we compared the requirements of EUA in Taiwan, Singapore, and the United States. For the performance evaluations of nucleic acid extraction, inclusivity, limit of detection (LoD), cross-reactivity, interference, cutoff, and stability, the requirements are similar in the three countries. The use of natural clinical specimens is needed for clinical evaluation in Taiwan and the United States. However, carry-over and cross-contamination studies can be exempted in Taiwan and the United States but are required in Singapore. This review outlines requirements and insight to guide the test developers on the development of IVDs. Considering the rapidly evolving viruses and severe pandemic of COVID-19, timely and accurate diagnostic testing is imperative to the management of diseases. As noted above, the performance requirements for SARS-CoV-2 nucleic acid tests are similar between Taiwan, Singapore and the United States. The differences are mainly in two points: the recommended microorganisms for cross-reactivity study, and the specimen requirement for clinical evaluation. This study provides an overview of current requirements of SARS-CoV-2 nucleic acid tests in Taiwan, Singapore, and the United States.
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Affiliation(s)
- Yin-Ting Fan
- Office of Medical Device Evaluation, Center for Measurement Standards, Industrial Technology Research Institute, Hsinchu, Taiwan, ROC
| | - Jin-Yu Lee
- Division of Medical Devices and Cosmetics, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan, ROC
| | - Yu-Che Cheng
- Division of Medical Devices and Cosmetics, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan, ROC
| | - Hsin-Hui Lin
- Division of Medical Devices and Cosmetics, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan, ROC
| | - Chia-Hung Chien
- Division of Medical Devices and Cosmetics, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan, ROC
| | - Pei-Weng Tu
- Division of Medical Devices and Cosmetics, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan, ROC
| | - Hui-Wen Chung
- Office of Medical Device Evaluation, Center for Measurement Standards, Industrial Technology Research Institute, Hsinchu, Taiwan, ROC
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Fan YT, Liu YQ, Yang Y. [Application of the small private online course-based blended teaching model in Human Parasitology teaching]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2022; 34:417-419. [PMID: 36116935 DOI: 10.16250/j.32.1374.2022169] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Small private online course (SPOC), an emerging network-based, student-centered blended teaching model, combines the advantages of online teaching and flipped classroom, aiming to effectively improve students' autonomous learning ability and learning efficiency. Considering a remarkable decline in the course of Human Parasitology, we built an SPOC-based blended teaching model for Human Parasitology, covering pre-course learning, intra-course leaning, post-course consolidation and evaluation, and such a model was applied among grade 2019 students with specialty of clinical medicine. Following the application of the SPOC-based blended teaching model, most students had improvements in autonomous learning ability and activity, and understanding of human parasitology knowledge, and the examination score disparity was avoided.
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Affiliation(s)
- Y T Fan
- Department of Parasitology, School of Medicine, Northwest University, Xi'an, Shaanxi 710069, China
| | - Y Q Liu
- Department of Parasitology, School of Medicine, Northwest University, Xi'an, Shaanxi 710069, China
| | - Y Yang
- Department of Parasitology, School of Medicine, Northwest University, Xi'an, Shaanxi 710069, China
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Jia Z, Ren LX, Fan YT, Tan ZM. [Observation of effective dosage of remimazolam tosilate used for moderate-to-deep sedation in fiberoptic bronchoscopy]. Zhonghua Yi Xue Za Zhi 2021; 101:813-816. [PMID: 33765724 DOI: 10.3760/cma.j.cn112137-20200901-02524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To estimate the safety and efficacy of remimazolam tosilate used for moderate-to-deep sedation in fiberoptic bronchoscopy with its 50% effective dosage (ED50) and 95% effective dosage (ED95) calculated. Methods: A total of 50 patients aged from 18 to 65 years and classified as Class Ⅰ or Ⅱ according to the American Society of Anesthesiologists (ASA) Classification who underwent fiberoptic bronchoscopy in Hainan Cancer Hospital from April to August of 2020 were included in this study. For each patient, bronchoscopy was only started when the eyelash reflex disappeared and MOAA/S score was<1 after a trial dose of remimazolam tosilate combined with 0.1 μg/kg sufentanil was intravenously given. The dosage of remimazolam tosilate for the first patient was 0.18 mg/kg, based on which the dosages for the following patients were increased or decreased by 1∶1 times for one another, forming an equal ratio sequence. A maintenance dose of remimazolam tosilate was pumped intravenously in a rate of 1 mg/(kg·h) during the bronchoscopic examination and treatment. The result of the sequential trial, the time to achieve proper sedation, the analepsia time and the adverse effects were recorded. Results: All the 50 patients went through bronchoscopy completely. The regression function of the sequential trial was Y=12.589+16.593X, the ED50 and the ED95 of remimazolam tosilate were 0.174 (95%CI: 0.162-0.186) mg/kg and 0.219 (95%CI: 0.199-0.312) mg/kg, respectively. The time to achieve proper sedation was (50±11) s and the mean analepsia time after the use of flumazenil was (56±16) s. There was one patient with respiratory inhibition, one with headache and dizziness, one with fatigue among the 50 patients. Conclusions: The strategy of moderate-to-deep sedation based on remimazolam tosilate is safe and effective in bronchoscopic examination and treatment. When combined with 0.1 μg/kg sufentanil, the ED50 and the ED95 of remimazolam tosilate are 0.174 mg/kg and 0.219 mg/kg, respectively.
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Affiliation(s)
- Z Jia
- Department of Anesthesiology, Affiliated Hainan Cancer Hospital of Hainan Medical College, Hai Kou 570100, China
| | - L X Ren
- Department of Anesthesiology, Affiliated Hainan Cancer Hospital of Hainan Medical College, Hai Kou 570100, China
| | - Y T Fan
- Department of Anesthesiology, Affiliated Hainan Cancer Hospital of Hainan Medical College, Hai Kou 570100, China
| | - Z M Tan
- Department of Anesthesiology, Affiliated Hainan Cancer Hospital of Hainan Medical College, Hai Kou 570100, China
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Abstract
Echocardiography is a key evaluation tool for the diagnosis, prognosis, and guidance of interventional management of numerous cardiovascular conditions, including ischaemia, heart failure, and structural heart diseases. Recent technological advancements have also seen the exploration of artificial intelligence, intracardiac vortex imaging, and three-dimensional printing in echocardiography. With cardiovascular diseases increasing in prevalence worldwide, it is important for clinicians including general practitioners to have updated knowledge of appropriate use of echocardiography. As such, this article reviews the current literature and summarises the latest developments and the general clinical usage of echocardiography.
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Affiliation(s)
- J S K Chan
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong
| | - G Tse
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong
| | - H Zhao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - X X Luo
- Department of Ultrasonography, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - C N Jin
- Department of Cardiology, The Second Affiliated Hospital of Zhejiang University, Zhejiang, China
| | - K Kam
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong
| | - Y T Fan
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong.,Laboratory for Cardiac Imaging and 3D Printing, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong
| | - A P W Lee
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong.,Laboratory for Cardiac Imaging and 3D Printing, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong
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Lee AP, Yang F, Fan YT, Wong MC, Wong RH. P1822Pocket-size mobile echocardiographic device screening for thoracic aortic aneurysm in asymptomatic hypertensive patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0574] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with hypertension may develop thoracic aortic aneurysm (TAA) that can be asymptomatic but potentially life-threatening. We sought to assess the prevalence of asymptomatic TAA among hypertensive patients and define the effectiveness of a TAA point-of-care screening program using pocket-size mobile echocardiographic (PME) devices.
Methods
We prospectively performed transthoracic echocardiography for TAA screening using a PME device on 1529 hypertensive patients (age, 62y [30y to 85y], 824 men) who attended our hypertension specialist clinic between June 2016 and July 2018. Measurement of the dimensions of the aortic sinus, sinotubular junction, ascending aorta, aortic arch, and descending thoracic aorta were obtained through multiple standard echo views.
Results
The prevalence of TAA (defined as maximum aortic diameter of ≥4.5cm and/or >50% diameter of the adjacent aorta) in our study population was 7.3% (111/1529), with distal ascending aorta as the most frequent location (Figure). Multiple logistic regression analysis identified male gender, older age, and presence of heart valve disease as independent factors associated with TAA (all p<0.05).
Figure 1
Conclusions
Asymptomatic TAA is common among asymptomatic hypertensive patients. Point-of-care use of PME device is effective in detecting TAA in a clinic setting. Such approach may be useful for early detection of TAA among at-risk patients allowing aggressive blood pressure control and early surgical intervention to prevent catastrophic complications such as aortic dissection or rupture.
Acknowledgement/Funding
Health and Medical Research Fund of the Hong Kong Government
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Affiliation(s)
- A P Lee
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - F Yang
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Y T Fan
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M C Wong
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - R H Wong
- The Chinese University of Hong Kong, Shatin, Hong Kong
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Tsai WW, Tu PW, Lin HH, Wang YH, Wu SI, Fan YT. A comparison study of Taiwan regulation and GHTF regulatory model on in vitro diagnostic medical devices. Expert Rev Med Devices 2017; 14:285-296. [PMID: 28298137 DOI: 10.1080/17434440.2017.1307732] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION In Taiwan, In Vitro Diagnostic Medical Device (IVD) is regulated as medical device since 1987, and the implementation of IVD registration was fully completed in 2005. The management system of IVD medical device is highly similar with a guidance 'The GHTF Regulatory Model' developed by Global Harmonization Task Force (GHTF) in 2011 for use of regulation development on medical devices. Area covered: In this study, the Regulatory Model developed by GHTF was compared with Taiwanese IVD management system and it has shown that these two regulatory frameworks are highly similar. Expert commentary: The experience of IVD management in Taiwan can serve a strong evidence to prove the feasibility and effectiveness of GHTF Regulatory Model.
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Affiliation(s)
- Wen-Wei Tsai
- a Division of Medical Devices and Cosmetics , Food and Drug Administration, Ministry of Health and Welfare , Taipei , Taiwan
| | - Pei-Weng Tu
- a Division of Medical Devices and Cosmetics , Food and Drug Administration, Ministry of Health and Welfare , Taipei , Taiwan
| | - Hsin-Hui Lin
- a Division of Medical Devices and Cosmetics , Food and Drug Administration, Ministry of Health and Welfare , Taipei , Taiwan
| | - Yin-Hsuan Wang
- b Office of Medical Device Evaluation , Center for Measurement Standards, Industrial Technology Research Institute , Hsinchu , Taiwan
| | - Shiow-Ing Wu
- c Food and Drug Administration , Ministry of Health and Welfare , Taipei , Taiwan
| | - Yin-Ting Fan
- b Office of Medical Device Evaluation , Center for Measurement Standards, Industrial Technology Research Institute , Hsinchu , Taiwan
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Abstract
INTRODUCTION With the aging of the post-war baby boomer generation, the increasing demands for healthcare are driving the growth of medical industry and development of new products in order to meet the immense needs from the aging population. However, medical devices are designed to maintain the health and safety of people, therefore, medical devices are undergoing rigorous management by competent health authorities in all countries. In recent years, Asian countries have been reforming their regulations and standards for medical devices with substantial changes. AREAS COVERED The study is a summary of the framework of medical device regulations in Asian countries, including Asian Harmonization Working Party (AHWP), Japan, China, Taiwan, South Korea, India and Singapore. Expert commentary: Asian countries are constantly reforming their medical device regulations. The emergence of brand-new technology and quality management issues arose by global manufacturing have imposed difficulties in harmonizing and reaching consensus between countries. The third-party conformity assessment system for medical devices can reduce the costs for competent health authorities and shorten the review time, which could facilitate the feasibility of harmonization of medical device regulations.
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Affiliation(s)
- Yi-Hui Wu
- a Center for Measurement Standards , Industrial Technology Research Institute , Hsinchu , Taiwan
| | - Fong-An Li
- a Center for Measurement Standards , Industrial Technology Research Institute , Hsinchu , Taiwan
| | - Yin-Ting Fan
- a Center for Measurement Standards , Industrial Technology Research Institute , Hsinchu , Taiwan
| | - Pei-Weng Tu
- b Division of Medical Devices and Cosmetics , Ministry of Health and Welfare , Taipei , Taiwan
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Pan CM, Fan YT, Xing Y, Hou HW, Zhang ML. Statistical optimization of process parameters on biohydrogen production from glucose by Clostridium sp. Fanp2. Bioresour Technol 2008; 99:3146-54. [PMID: 17644378 DOI: 10.1016/j.biortech.2007.05.055] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2006] [Revised: 05/29/2007] [Accepted: 05/30/2007] [Indexed: 05/16/2023]
Abstract
Statistically based experimental designs were applied to optimizing process parameters for hydrogen production from glucose by Clostridium sp. Fanp2 which was isolated from effluent sludge of anaerobic hydrogen-producing bioreactor. The important factors influencing hydrogen production, which identified by initial screening method of Plackett-Burman, were glucose, phosphate buffer and vitamin solution. The path of steepest ascent was undertaken to approach the optimal region of the three significant factors. Box-Behnken design and response surface analysis were adopted to further investigate the mutual interaction between the variables and identify optimal values that bring maximum hydrogen production. Experimental results showed that glucose, vitamin solution and phosphate buffer concentration all had an individual significant influence on the specific hydrogen production potential (Ps). Simultaneously, glucose and vitamin solution, glucose and phosphate buffer were interdependent. The optimal conditions for the maximal Ps were: glucose 23.75 g/l, phosphate buffer 0.159 M and vitamin solution 13.3 ml/l. Using this statistical optimization method, the hydrogen production from glucose was increased from 2248.5 to 4165.9 ml H2/l.
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Affiliation(s)
- C M Pan
- Department of Chemistry, Zhengzhou University, Zhengzhou 450052, PR China
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Beaty TH, Hetmanski JB, Zeiger JS, Fan YT, Liang KY, VanderKolk CA, McIntosh I. Testing candidate genes for non-syndromic oral clefts using a case-parent trio design. Genet Epidemiol 2002; 22:1-11. [PMID: 11754469 DOI: 10.1002/gepi.1039] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Markers in five candidate genes were examined on 269 case-parent trios ascertained through a child with an isolated, non-syndromic oral cleft (cleft lip, CL; cleft palate, CP; or cleft lip and palate, CLP). Cases and their parents were ascertained through treatment centers in Maryland. Markers at two of the five candidate genes, transforming growth factor beta3 (TGFbeta3) and MSX1, showed consistent evidence of linkage and disequilibrium due to linkage using several statistical tests (e.g., the global chi-square for TGFbeta3 was 21.1 with 12 df, P = 0.03; that for MSX1 was 8.7 with 3 df, P = 0.03). There was little evidence of heterogeneity in the role of TGFbeta3 between different types of oral clefts, but MSX1 did yield marginal evidence for such heterogeneity. MSX1 also showed evidence for interaction between infant's genotype and maternal smoking, giving a likelihood ratio test for heterogeneity between smoker and non-smoker mothers of 7.16 (2 df, P = 0.03). Using a conditional logistic model to test for gene-gene interaction showed no evidence of interaction between TGFbeta3 and MSX1, with both seeming to contribute independently to risk of isolated, non-syndromic oral clefts.
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Affiliation(s)
- Terri H Beaty
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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Beaty TH, Wang H, Hetmanski JB, Fan YT, Zeiger JS, Liang KY, Chiu YF, Vanderkolk CA, Seifert KC, Wulfsberg EA, Raymond G, Panny SR, McIntosh I. A case-control study of nonsyndromic oral clefts in Maryland. Ann Epidemiol 2001; 11:434-42. [PMID: 11454503 DOI: 10.1016/s1047-2797(01)00222-8] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE Isolated, nonsyndromic oral clefts cases (n = 171) and unaffected controls (n = 182) were used to identify both genetic and environmental risk factors. METHODS Infants born in Maryland between 1992 to 1998 with an isolated, nonsyndromic oral cleft [cleft lip (CL), cleft lip and palate (CLP), or cleft palate (CP)] were recruited and exposure plus family history data were collected. Controls were unaffected infants. DNA was collected from all cases and their parents, plus controls. RESULTS No statistically significant association was found between any of the following: maternal smoking, vitamin use, urinary tract infection, or recreational drug use in either univariate analysis or after adjusting for maternal age and education. More control mothers reported alcohol use during the critical time period of pregnancy (one month before conception through the first trimester) as compared to case mothers. There was a 10-fold increase in risk to siblings of cases as compared to siblings of controls. Markers at four candidate genes were examined: transforming growth factor alpha (TGF alpha), transforming growth factor beta 3 (TGF beta 3), MSX1, and BCL3. Only MSX1 showed significant differences in allele frequencies between CP cases and controls. MSX1 also showed significant evidence of linkage disequilibrium with a susceptibility gene controlling risk for CP. CONCLUSION Most environmental risk factors examined here gave little evidence of association with risk to isolated, nonsyndromic oral clefts, although any alcohol consumption seemed protective. MSX1 showed evidence of linkage disequilibrium in both case-control and case-parent trio analysis.
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Affiliation(s)
- T H Beaty
- The Johns Hopkins University, Baltimore, MD, USA
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Shih JC, Shyu MK, Chang CY, Lee CN, Lin GJ, Chen WH, Fan YT, Hsieh FJ. Application of the surface rendering technique of three-dimensional ultrasound in prenatal diagnosis and counselling of Klippel-Trenaunay-Weber syndrome. Prenat Diagn 1998; 18:298-302. [PMID: 9556049 DOI: 10.1002/(sici)1097-0223(199803)18:3<298::aid-pd251>3.0.co;2-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Klippel Trenaunay-Weber syndrome is a complex developmental disorder characterized by a triad of cutaneous haemangioma, varicosities of the body, and unilateral limb hypertrophy. We describe the prenatal diagnosis of Klippel-Trenaunay-Weber syndrome at 15 weeks' gestation using the surface rendering technique of three-dimensional ultrasound. The vivid three-dimensional images of the affected fetus are invaluable in prenatal diagnosis and parental counselling.
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Affiliation(s)
- J C Shih
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, Taipei
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Fan YT, Huang JS, Li SW, Li XQ, Sun ZT. [Effect of human leukocyte interferon on human hepatocellular carcinoma cells in vitro]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 1983; 5:393-5. [PMID: 6327098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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