From the Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Received: November 4, 2014 Accepted: May 21, 2015 Address reprint request and correspondence to: I-Ting Tsai, Department of Emergency... more
From the Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Received: November 4, 2014 Accepted: May 21, 2015 Address reprint request and correspondence to: I-Ting Tsai, Department of Emergency Medicine, E-Da Hospital, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan. Tel: +886-7-6150011 ext. 3166, Fax: +886-7-6150915, E-mail: edahospitaled@gmail.com Case Report
We describe a 49-year-old diabetic man with intermittent left arm pain and frequent episodes of chest tightness, together with elevated serum C-reactive protein and glucose levels. Three days later, he manifested fever and painful... more
We describe a 49-year-old diabetic man with intermittent left arm pain and frequent episodes of chest tightness, together with elevated serum C-reactive protein and glucose levels. Three days later, he manifested fever and painful swelling of his left elbow joint from which synovial fluid was aspirated. Both synovial fluid and blood culture subsequently revealed growth of Burkholderia Pseudomallei. Ceftazidime 1 gram every 6 hours intravenously was given for 25 days. The patient was discharged uneventfully. Melioidotic septic arthritis is uncommon but potentially fatal, especially in southern Taiwan where melioidosis is endemic. Prompt diagnosis through synovial fluid bacterial study and antibiotic coverage are crucial.
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Although peripheral blood reticulocyte enumeration reflects bone marrow functional integrity, which is important for differential diagnosis of hematological diseases, the factors affecting its accuracy have not been adequately addressed.... more
Although peripheral blood reticulocyte enumeration reflects bone marrow functional integrity, which is important for differential diagnosis of hematological diseases, the factors affecting its accuracy have not been adequately addressed. Using 100 consecutive venous blood samples being processed with four supravital staining techniques [i.e., brilliant cresyl blue (BCB), new methylene blue (NMB), and BCB/NMB with Liu’s stain] for reticulocyte enumeration, two technologists (senior vs. junior) conducted microscopic counting. The results were compared with those obtained with an automated system (Sysmex XE-5000) that served as the standard. The aims of this study were to identify (1) the technique that gave the most reliable outcome, and (2) possible human factors (i.e., seniority, repeated counting) that may affect the counting results. Analysis showed least bias (i.e., deviation from automated counting) associated with BCB staining, followed by NMB. In addition, the senior observer ...
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Background p-Cresylsulfate (PCS) is a protein-bound uremic toxin that accumulates in patients with chronic kidney disease. Previous studies have indicated that serum total PCS levels are significantly increased in the presence of abnormal... more
Background p-Cresylsulfate (PCS) is a protein-bound uremic toxin that accumulates in patients with chronic kidney disease. Previous studies have indicated that serum total PCS levels are significantly increased in the presence of abnormal corrected QT (QTc) intervals, and that they are associated with QTc prolongation. However, the QTc prolongation effect of PCS remains unclear. The current study aimed to investigate the arrhythmogenic effect of PCS using in vitro experiments and computer simulation. Methods The arrhythmogenic effect of PCS was evaluated by incubating H9c2 rat ventricular cardiomyocytes in vitro with increasing concentrations of PCS. Electrophysiological studies and mathematical computer simulations were performed. Results in vitro, the delayed rectifier potassium current (IK ) was significantly decreased in a dose-dependent manner after treatment with PCS. The modulation of PCS on IK was through regulation of the phosphorylation of the major potassium ion channel p...
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Swallowing a toothbrush is a rare event. We report a 35-year-old schizophrenic man who swallowed a toothbrush at least 3 months before the development of severe abdominal pain. He was transferred from a psychiatric institution to our... more
Swallowing a toothbrush is a rare event. We report a 35-year-old schizophrenic man who swallowed a toothbrush at least 3 months before the development of severe abdominal pain. He was transferred from a psychiatric institution to our emergency department where peritonitis was noted, Plain radiographs showed pneumoperitoneum and an intra-abdominal foreign body. During emergency laparotomy perforation in the duodenal third portion caused by a toothbrush was revealed, He had an uneventful postoperative recovery, and was transferred to the psychiatric ward eight days after surgery.
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Crepitus happened into the soft tissue is indicated subcutaneous emphysema. Subcutaneous emphysema of leg without trauma was likely to diagnose gas gangrene or gas-forming myonecrosis (GFM) at emergency department (ED). On the other hand,... more
Crepitus happened into the soft tissue is indicated subcutaneous emphysema. Subcutaneous emphysema of leg without trauma was likely to diagnose gas gangrene or gas-forming myonecrosis (GFM) at emergency department (ED). On the other hand, abdominal fatal condition with gas from the gut may spread to the leg should be considered a different diagnosis. We report a case of critically ill patient who presented to the ED with initial features suggestive of necrotizing fasciitis with gas gangrene of left leg. Assessment and further intervention revealed subcutaneous emphysema of leg secondary to a perforation of rectum associated with previous anastomosis site for rectal cancer surgery. Subcutaneous emphysema of the leg rarely happened secondary to perforation of the gastrointestinal tract and has often created serious diagnostic problems which may lead to mortality. Consequently, prompt diagnosis and aggressive treatment is imperative. Physicians and surgeons should be aware of this cond...
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Pneumoperitoneum, a common manifestation in patients with acute abdomen, is usually considered an indication for surgical intervention when combined with peritoneal signs such as in hollow viscera perforation. To date, only a few cases of... more
Pneumoperitoneum, a common manifestation in patients with acute abdomen, is usually considered an indication for surgical intervention when combined with peritoneal signs such as in hollow viscera perforation. To date, only a few cases of spontaneous pneumoperitoneum secondary to a ruptured liver abscess have been reported. We describe a rare case in an 84-year-old woman complaining of progressive abdominal pain and vomiting for 2 days. Computed tomography of the abdomen revealed a gas-containing liver abscess complicated by pneumoperitoneum. She refused surgery and pig-tail drainage and her condition rapidly deteriorated despite antibiotic treatment. She died soon after admission to the hospital.
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Camphorated oil is usually applied externally as a topical analgesic, anti-infective, rubefacient, and antipruritic agent. Although it is considered a natural product with negligible toxicity, camphor poisoning has been documented,... more
Camphorated oil is usually applied externally as a topical analgesic, anti-infective, rubefacient, and antipruritic agent. Although it is considered a natural product with negligible toxicity, camphor poisoning has been documented, especially in children. Common symptoms include headache, vomiting, agitation, hallucinations, and convulsions. We report an 84-year-old woman who ingested a large amount of camphor oil in a suicide attempt and presented to our emergency department with hypothermia, miosis, junctional bradycardia, acute pulmonary edema, and acute renal failure. She died of dysrhythmia and profound shock on the second day of hospitalization.
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This study aimed at investigating the impact of hemolysis on different coagulation parameters. A total of 216 venous blood samples without visible hemolysis were collected from adult patients at a tertiary referral center over six months.... more
This study aimed at investigating the impact of hemolysis on different coagulation parameters. A total of 216 venous blood samples without visible hemolysis were collected from adult patients at a tertiary referral center over six months. The plasma obtained was quantified for six coagulation parameters including prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, antithrombin III, and protein C. The rest of the plasma from each blood sample was aliquoted into three tubes, each containing 1 mL of plasma with three different volumes of cell-free hemoglobin (i.e., 2, 4, 8 μL) from lysed RBCs to create simulated hemolyzed blood samples with hemoglobin concentration of approximately 0.1, 0.2, and 0.4 g/dL to mimic mild (1+), moderate (2+), and severe (3+) hemolysis, respectively, before repeating the coagulation tests to determine possible correlation between the simulated degree of hemolysis and the changes in test results of the coagulation parameters. Spearm...
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Investigation of physician-related causes of unscheduled revisits to the emergency department (ED) within 72 h with subsequent admission to the intensive care unit (ICU) is an important parameter of emergency care quality. Between 2012... more
Investigation of physician-related causes of unscheduled revisits to the emergency department (ED) within 72 h with subsequent admission to the intensive care unit (ICU) is an important parameter of emergency care quality. Between 2012 and 2017, medical records of all adult patients who visited the ED and returned within 72 h with subsequent ICU admission were retrospectively reviewed by three experienced emergency physicians. Study parameters were categorized into “input” (Patient characteristics), “throughput” (Time spent on first ED visit and seniority of emergency physicians, and “output” (Charlson Comorbidity Index). Of the 147 patients reviewed for the causes of ICU admission, 35 were physician-related (23.8%). Eight belonged to more urgent categories, whereas the majority (n = 27) were less urgent. Patients who spent less time on their first ED visits before discharge (< 2 h) were significantly associated with physician-related causes of ICU admission, whereas there was no...
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To determine, in patients with coronavirus disease 2019 (COVID-19) infection, the associations of pulmonary embolism (PE) with mortality and risk factors for PE as well as the therapeutic benefit of anticoagulant prophylaxis. Embase,... more
To determine, in patients with coronavirus disease 2019 (COVID-19) infection, the associations of pulmonary embolism (PE) with mortality and risk factors for PE as well as the therapeutic benefit of anticoagulant prophylaxis. Embase, PubMed, Cochrane controlled trials register, and Web of Science databases were searched from inception to October 10, 2020. We included all published trials on PE in patients diagnosed with COVID-19 with eligibility of the trials assessed following the PRISMA guidelines. Sixteen clinical trials with 5826 patients were eligible. There were significant associations of PE with the male gender [odd ratio (OR) = 1.59, 95% CI 1.28–1.97], mechanical ventilation (OR = 3.71, 95% CI 2.57–5.36), intensive care unit admission (OR = 2.99, 95% CI 2.11–4.23), circulating D-dimer [mean difference (MD) = 5.04 µg/mL, 95% CI 3.67–6.42) and CRP (MD = 1.97 mg/dL, 95% CI 0.58– 3.35) concentrations without significant correlation between PE and mortality (OR = 1.31, 95% CI 0....
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The proliferation and migration of vascular smooth muscle cells (VSMCs) are essential in the pathogenesis of various vascular diseases, such as atherosclerosis and restenosis. Among the mediators of VSMC during atherosclerosis... more
The proliferation and migration of vascular smooth muscle cells (VSMCs) are essential in the pathogenesis of various vascular diseases, such as atherosclerosis and restenosis. Among the mediators of VSMC during atherosclerosis development, platelet-derived growth factor (PDGF)-BB is a potent mitogen for VSMCs and greatly contributes to the intimal accumulation of VSMCs. Glossogyne tenuifolia (GT, Xiang-Ru) is a traditional antipyretic and hepatoprotective herb from Penghu Island, Taiwan. This study evaluated the inhibitory effect of GT ethanol extract (GTE) and GT water extract (GTW) on proliferative and migratory activities in PDGF-BB-induced VSMCs. The experimental results demonstrated that GTE significantly inhibited the PDGF-BB-stimulated VSMC proliferation and migration, as shown by MTT, wound healing, and Boyden chamber assays. GTE was found to have a much more potent inhibitory activity than GTW. Based on the Western blot analysis, GTE significantly blocked the PDGF-BB-induce...
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Purpose: Indoxyl sulfate (IS) is linked to endothelial damage, NF-κB activation and induced development of atherosclerosis. The purpose of this study was to investigate the relationship between serum IS levels and the severity of coronary... more
Purpose: Indoxyl sulfate (IS) is linked to endothelial damage, NF-κB activation and induced development of atherosclerosis. The purpose of this study was to investigate the relationship between serum IS levels and the severity of coronary artery stenosis. In addition, the relationship among IS and various cardiovascular risk factors was also explored. Methods: Serum IS concentrations were measured using ultra performance liquid chromatography in 191 consecutive patients presenting with stable angina. The associations between serum IS levels and angiographic indexes of the number of diseased vessels, modified Gensini scores and calcium scores were determined. Results: Patients with significant coronary artery stenosis were found to have higher serum IS levels than patients with normal coronary arteries. Using multivariate analysis, serum IS levels were found to be independently associated with the presence and severity of coronary artery disease (CAD). Furthermore, statistically sign...
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BACKGROUND Total p-cresylsulfate (PCS), indoxyl sulfate (IS) and hippuric acid (HA) are harmful uremic toxins known to be elevated in patients with uremia. Serum total PCS, IS and HA levels have been associated with coronary... more
BACKGROUND Total p-cresylsulfate (PCS), indoxyl sulfate (IS) and hippuric acid (HA) are harmful uremic toxins known to be elevated in patients with uremia. Serum total PCS, IS and HA levels have been associated with coronary atherosclerosis, left ventricular hypertrophy, metabolic acidosis, neurological symptoms, and accelerated renal damage associated with chronic kidney disease; however, no study has examined the effect of total PCS, IS and HA on hemodialysis (HD) quality indicators. The aim of this study was to examine associations among total PCS, IS and HA with HD quality indicators in patients undergoing HD treatment. METHODS This study included 264 consecutive patients at a single HD center who assessed using previously demonstrated HD quality indicators including anemia, bone-mineral metabolism, dialysis dose, cardiovascular risk, and middle molecule removal area. Serum HA was measured using a capillary electrophoresis method. Serum total PCS and IS concentrations were measured using an Ultra Performance LC System. RESULTS Multiple regression analysis showed that sex, potassium, systolic blood pressure (SBP), average BP, β2-microglobulin, and creatinine were independently positively associated with IS level, and that age, total cholesterol, and estimated glomerular filtration rate (eGFR) was independently negatively associated with IS level. In addition, β2-microglobulin was independently positively associated with total PCS. Moreover, potassium, diastolic blood pressure, average BP, β2-microglobulin, dialysis vintage, and albumin were independently positively associated with HA level, and age, transferrin saturation, fasting glucose, and eGFR were independently negatively associated with HA level. When the patients were stratified by age and sex, serum IS and HA levels were still independently associated with some hemodialysis quality indicators. In addition, canonical correlation analysis also confirmed the relationship between uremic toxins (IS and HA) and HD quality indicators (potassium, β2-microglobulin, average BP, creatinine, and eGFR). CONCLUSION This study demonstrated that uremic toxins (IS and HA) and HD quality indicators (potassium, β2-microglobulin, average BP, creatinine, and eGFR) constructs were correlated with each other, and that there were sex and age differences in these associations among maintenance HD patients.
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Background: Fatty acid-binding protein 3 (FABP3) located in renal mesangial and distal tubular cells, and had been shown to be a sensitive marker of renal injury, potentially be a mediator in pathogenesis of chronic kidney disease (CKD).... more
Background: Fatty acid-binding protein 3 (FABP3) located in renal mesangial and distal tubular cells, and had been shown to be a sensitive marker of renal injury, potentially be a mediator in pathogenesis of chronic kidney disease (CKD). Our previous study revealed that plasma FABP1 and FABP2 were independently associated with CKD, however, little is known about the relationship between plasma FABP3 level and CKD. The aim of this study was therefore to evaluate the plasma levels of FABP3 at different stages of estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 334 subjects with T2DM who enrolled in a disease management program were included in this study and stratified according to eGFR. Plasma FABP3 concentrations were measured by an enzyme-linked immunosorbent assay. Results: FABP3 levels increased in parallel with the eGFR level. Increasing concentrations of FABP3 were independently and significantly associated with e...
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Objectives: Increased triglyceride glucose (TyG) index appears to be linked to carotid and coronary atherosclerosis and calcifications and possesses an elevated future risk of developing cardiovascular disease. Corrected QT (QTc) interval... more
Objectives: Increased triglyceride glucose (TyG) index appears to be linked to carotid and coronary atherosclerosis and calcifications and possesses an elevated future risk of developing cardiovascular disease. Corrected QT (QTc) interval prolongation is associated with ventricular arrhythmias and sudden cardiac death, and a high prevalence of prolonged QTc interval was previously reported in blue-collar workers. The purpose of this study was to find the possible causal inter-relationship between TyG index and QTc interval in a large population of Chinese male steelworkers. Methods: A total of 3189 male workers from two steel plants were enrolled. They responded to a cross-sectional questionnaire on basic attributes and lifestyle, including sleep patterns. All workers in the two plants underwent periodic health checkups, including twelve-lead electrocardiography. Structural equation modeling (SEM) was used to assess the direct and indirect effects of TyG index on QTc interval. Resul...
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A 60-year-old man presented to our emergency department with anal and lower right quadrant abdominal pain with occasional bloody stool for the preceding two days. An abdominal examination showed localised tenderness in the lower right... more
A 60-year-old man presented to our emergency department with anal and lower right quadrant abdominal pain with occasional bloody stool for the preceding two days. An abdominal examination showed localised tenderness in the lower right quadrant without rebound or voluntary guarding. A digital examination revealed a sharp foreign body at the left lateral position. Laboratory data showed no specific findings. A plain radiography of pelvis and abdominal sonography investigation were performed.
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The authors propose that decisions regarding the duration of cause-related marketing campaigns should depend on the combination of cause type and product type. Results from three studies show that a long duration works when a utilitarian... more
The authors propose that decisions regarding the duration of cause-related marketing campaigns should depend on the combination of cause type and product type. Results from three studies show that a long duration works when a utilitarian product is paired with a primary cause, such as life necessities, or a hedonic product with a secondary cause, such as quality of life. A short duration is advantageous for a hedonic product paired with a primary cause. Consumers favored these combinations because they attributed positive motives to the company for launching cause-related marketing campaigns. Companies can maximize the success of their cause-related marketing by choosing the duration that best suits their product–cause bundle.
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Visfatin (also known as pre-B cell colony-enhancing factor) is increased in patients with chronic kidney disease and has been linked with coronary atherosclerosis. Given that it has been reported that visfatin plays a role in endothelial... more
Visfatin (also known as pre-B cell colony-enhancing factor) is increased in patients with chronic kidney disease and has been linked with coronary atherosclerosis. Given that it has been reported that visfatin plays a role in endothelial dysfunction in chronic kidney disease patients, we examined associations between visfatin levels and several markers related to atherosclerosis. The association between visfatin and atherosclerotic risk factors was studied in 173 chronic kidney disease patients (130 men and 43 women). Serum levels of visfatin were measured by the enzyme-linked immunosorbent assay. With increasing visfatin tertiles, patients proved to have a larger number of vessels with stenosis and a higher likelihood of coronary artery disease, as well as having incrementally lower estimated glomerular filtration rate and serum albumin and higher total leukocyte, neutrophil, and monocyte counts; high-sensitivity C-reactive protein; and brain natriuretic peptide levels. Visfatin sh...
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We demonstrated that visfatin expressed in monocytes and neutrophils and increased their reactivity in male acute ST-segment elevation myocardial infarction patients. Furthermore, visfatin was strongly appeared in lipid rich coronary... more
We demonstrated that visfatin expressed in monocytes and neutrophils and increased their reactivity in male acute ST-segment elevation myocardial infarction patients. Furthermore, visfatin was strongly appeared in lipid rich coronary rupture plaques and macrophages. These results suggest another explanation about leukocytes mediated visfatin that may play a pathogenesis role in coronary vulnerable plaques rupture.
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Visfatin is a cytokine that is expressed in many tissues, including the heart, and has been proposed to play a role in plaque destabilization leading to acute myocardial injury. The present study evaluates plasma levels of visfatin in... more
Visfatin is a cytokine that is expressed in many tissues, including the heart, and has been proposed to play a role in plaque destabilization leading to acute myocardial injury. The present study evaluates plasma levels of visfatin in acute ST-elevation myocardial infarction (STEMI) patients and examines the temporal changes in visfatin levels from the acute period to the subacute period to determine a correlation with the degree of myocardial ischemia. We evaluated 54 patients with STEMI. Circulating levels of visfatin and brain natriuretic peptide (BNP) were measured by ELISA. In addition, local expression of visfatin and BNP were detected by quantitative real-time polymerase chain reaction and immunohistochemical (IHC) analysis of left ventricular myocytes in a mouse model of myocardial infarction (MI). Plasma levels of visfatin were significantly increased in patients with STEMI on admission, relative to controls (effort angina patients and individuals without coronary artery disease). The visfatin levels reached a peak 24h after percutaneous coronary intervention (PCI) and then decreased toward the control range during the first week after PCI. The basal plasma visfatin levels were found to correlate with peak troponin-I, peak creatine kinase-MB, total white blood cell count, and BNP levels. Trend analyses confirmed that visfatin levels correlated with the number of diseased coronary arteries. Further, in MI mice, mRNA levels of visfatin and BNP were found to be higher than in sham-treated mice. IHC analysis showed that visfatin and BNP immunoreactivity was diffusely observable in left ventricular myocytes of the MI mice. This study indicates that plasma visfatin levels are significantly higher in STEMI patients and that these higher visfatin levels correlate with elevated levels of cardiac enzymes, suggesting that increased plasma visfatin may be closely related to the degree of myocardial damage.
Research Interests: Cardiology, Immunology, Immunohistochemistry, Electrocardiography, Humans, and 15 moreInternal Medicine, Left Ventricular Assist Device, Hospitalization, Female, Animals, Creatine Kinase, Enzyme, Aged, Cytokine, Adult, Coronary Artery Disease, Brain Natriuretic Peptide, Coronary artery, Left Ventricular, and leukocyte Count
The significance of probability discounting (PD) among individuals with Internet gaming disorder (IGD) remains unclear. Following the PRISMA guidelines, we systematically searched the PubMed, Embase, and ScienceDirect databases for... more
The significance of probability discounting (PD) among individuals with Internet gaming disorder (IGD) remains unclear. Following the PRISMA guidelines, we systematically searched the PubMed, Embase, and ScienceDirect databases for English articles on Internet addiction that included comparison between individuals with and without IGD as well as probabilistic discounting task as the main outcome from January 1970 to July 2020 using the appropriate keyword strings. The primary outcome was the overall difference in rate of PD, while the secondary outcomes included the difference in PD with magnitude of probabilistic reward and response time of the PD task. Effect size (ES) was calculated through dividing the group means (e.g.,hvalue or AUC) by the pooled standard deviations of the two groups. A total of five studies with 300 participants (i.e., IGD group, n = 150, mean age = 20.27 ± 2.68; healthy controls, n = 150, mean age = 20.70 ± 2.81) were analyzed. The IGD group was more willing...
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Lower concentrations of serum albumin appear to be associated with an increased risk of all-cause and cardiovascular mortality, coronary heart disease, heart failure, and stroke. However, little is known about the relationship between... more
Lower concentrations of serum albumin appear to be associated with an increased risk of all-cause and cardiovascular mortality, coronary heart disease, heart failure, and stroke. However, little is known about the relationship between serum albumin level and prolonged QT interval. The aim of this study was to investigate whether lower serum albumin is associated with prolonged QT interval by recording 12-lead electrocardiography in patients with coronary artery disease (CAD) and chronic kidney disease (CKD). This study included 1,383 consecutive patients with CAD and CKD (841 with acute coronary syndrome (ACS) and 542 with elective percutaneous coronary intervention (PCI) patients) who were enrolled in a disease management program. Twelve-lead electrocardiography was recorded in each subject. We assessed the relationship between albumin levels (both as a continuous variable and stratified by tertile) at admission and corrected QT (QTc) prolongation. Patients with abnormal QTc interv...
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Alcohol-related liver disease (ALD) refers to the liver damage occurring due to excessive alcohol consumption and involves a broad spectrum of diseases that includes liver steatosis, steatohepatitis, hepatitis, cirrhosis, and... more
Alcohol-related liver disease (ALD) refers to the liver damage occurring due to excessive alcohol consumption and involves a broad spectrum of diseases that includes liver steatosis, steatohepatitis, hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). The progression of ALD is mainly associated with the amount and duration of alcohol usage; however, it is also influenced by genetic, epigenetic, and environmental factors. The definite diagnosis of ALD is based on a liver biopsy, although several non-invasive diagnostic tools and serum biomarkers have emerging roles in the early detection of ALD. While alcohol abstinence and nutritional support remain the cornerstone of ALD treatment, growing evidence has revealed that the therapeutic agents that target oxidative stress or gut-liver axis, inflammatory response inhibition, and liver regeneration enhancement also play a role in ALD management. Furthermore, microRNAs modulation and mesenchymal stem cell-based therapy have emerging ...
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Diabetic striatopathy (DS) is a rare medical condition with ambiguous nomenclature. We searched PubMed database from 1992 to 2018 for articles describing hyperglycemia associated with chorea/ballism and/or neuroimages of striatal... more
Diabetic striatopathy (DS) is a rare medical condition with ambiguous nomenclature. We searched PubMed database from 1992 to 2018 for articles describing hyperglycemia associated with chorea/ballism and/or neuroimages of striatal abnormalities. Descriptive analysis was performed on demographic/clinical characteristics, locations of striatal abnormalities on neuroimages, pathology findings, treatment strategies, and outcomes. In total, 176 patients (male:female = 1:1.7) were identified from 72 articles with mean age 67.6 ± 15.9 (range, 8–92). Among them, 96.6% had type 2 DM with 17% being newly diagnosed. Average blood glucose and glycated hemoglobin concentrations were 414 mg/dL and 13.1%, respectively. Most patients (88.1%) presented with hemichorea/hemiballism. Isolated putamen and combined putamen-caudate nucleus involvements were most common on neuroimaging studies with discrepancies between CT and MRI findings in about one-sixth of patients. Unilateral arm-leg combination was t...