Browsing by Author "Lin, Shih-Wen"

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Cardiac Autonomic Modulation during on-Call Duty under Working Hours Restriction
(2020-02-01)
Chien, Jien-Wen
;
Chen, Chung-Yen
;
Lin, Sheng-Hsuan
;
Lin, Shih-Wen
;
Lin, Yu-Hsuan
Background: Medical residency is a time of high stress and long working hours, which increase the risk of cardiovascular disease. This study aimed to investigate the autonomic modulation of resident physicians throughout the on-call duty cycle. Methods: Spectral analysis of heart rate variability (HRV) was used to compute cardiac parasympathetic modulation (high-frequency power, HF) and cardiac sympathetic modulation (normalized low-frequency power, LF%, and the ratio of LF and HF, LF/HF) of 18 residents for a consecutive 4-day cycle. Results: Male residents show reduced cardiac sympathetic modulation (i.e., higher LF/HF and LF%) than the female interns. Medical residents' cardiac parasympathetic modulation (i.e., HF) significantly increased on the first and the second post-call day compared with the pre-call day. In contrast, LF% was significantly decreased on the first and the second post-call day compared with the pre-call day. Similarly, LF/HF was significantly decreased on the second post-call day compared with the pre-call day. LF/HF significantly decreased on the first post-call day and on the second post-call day from on-call duty. Conclusion: The guideline that limits workweeks to 80 h and shifts to 28 h resulted in reduced sympathetic modulation and increased parasympathetic modulation during the two days following on-call duty.
Yolk sac tumor of endometrium: A case report and literature review
(2019-11-01)
Lin, Shih-Wen
;
Hsieh, Shu-Wei
;
Huang, Shih-Hung
;
Liang, Hung-Shuo
;
Huang, Chia-Yen
Objective: To report a rare case of endometrial yolk sac tumor (YST) and review published cases of YST of the endometrium. Case report: A 68-year-old female presented with intermittent vaginal spotting for nine months. An endometrial biopsy showed adenocarcinoma. Complete surgical staging operation was performed and the final pathology revealed stage II endometrial yolk sac tumor. The post-operative a-fetoprotein (AFP) level was 133.4 ng/mL. Post-operative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin (BEP) regimen was prescribed for 6 cycles. AFP levels were normal before the fourth cycle of chemotherapy. She is disease free 6 months after completion of therapy. Conclusion: Primary YSTs arising in the endometrium is an extremely rare disease especially in postmenopausal women. Complete surgical staging operation with adjuvant chemotherapy will lead to good outcome in this disease. (C) 2019 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.