Changgeng yi xue za zhi最新文献_第2页

Neonatal vallecular cyst: report of eleven cases. 新生儿小静脉囊肿11例报告。

Changgeng yi xue za zhi Pub Date : 1999-12-01

H C Liu, K S Lee, C H Hsu, H Y Hung

{"title":"Neonatal vallecular cyst: report of eleven cases.","authors":"H C Liu, K S Lee, C H Hsu, H Y Hung","doi":"","DOIUrl":"","url":null,"abstract":"Background: Vallecular cyst is fairly uncommon in neonates and infants. Although benign in nature, it may cause severe airway obstruction and even death. This study retrospectively analyzed the clinical manifestations of vallecular cyst in neonates and discussed its management.Methods: From June 1993 through January 1997, 11 cases of vallecular cyst were collected and reviewed retrospectively. There were 8 male infants and 3 female infants. Their clinical manifestations, age at the onset of symptoms, age at diagnosis, and surgical management were analyzed. Fibrolaryngoscopy was used for preoperative diagnosis and postoperative follow-up.Results: The infants' initial presentations were inspiratory stridor, respiratory distress, noisy breathing, feeding difficulty, and failure to thrive. There was a high incidence of patients with coexisting signs of laryngomalacia (10/11). Ten patients received laryngomicrosurgery with CO2 laser for deroofing the cyst. Additional supraglottoplasty was performed at the same time in 4 patients with laryngomalacia type A + C and in one patient with severe laryngomalacia type C. Their symptoms all resolved soon after surgery. The phenomenon of laryngomalacia also disappeared. There has been no recurrence up to the present.Conclusion: Although fairly uncommon, vallecular cyst should be included in the differential diagnosis of congenital laryngeal stridor in neonates. The use of fibroendoscopy can promptly diagnose vallecular cyst and any synchronous airway lesions. Although most of the synchronous laryngomalacia (type C) in this study was secondary to vallecular cyst, we suggest that supraglottoplasty be taken into consideration during cyst deroofing when the signs and symptoms of laryngomalacia type A are also present.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"615-20"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21548447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A huge 6.2 kilogram uterine myoma coinciding with omental leiomyosarcoma: case report. 巨大子宫肌瘤合并大网膜平滑肌肉瘤1例。

Changgeng yi xue za zhi Pub Date : 1999-12-01

C W Ruan, C L Lee, C F Yen, C J Wang, Y K Soong

{"title":"A huge 6.2 kilogram uterine myoma coinciding with omental leiomyosarcoma: case report.","authors":"C W Ruan, C L Lee, C F Yen, C J Wang, Y K Soong","doi":"","DOIUrl":"","url":null,"abstract":"Surgery for massive abdominal tumors is both interesting and challenging. We present a case involving a multiple uterine myoma weighing 6.2 Kg which coincided with omental leiomyosarcoma. To our knowledge, this is the first report of this type of condition in the English literature. A 44-year-old nulliparous woman had suffered from abdominal pain for a long time. A huge abdominal mass was palpated on physical examination. Computed tomography scanning revealed a huge pelvic-abdominal mass with the possibility of small bowel loops invaded by the mass. A 6-cm omental mass was incidentally found during the subsequent hysterectomy procedure. Perforation of the urinary bladder occurred during the dissection of adhesion. Resection of the omental mass, wide wedge resection of the invaded small bowel, primary repair of the bladder, and hysterectomy were performed. The final pathologic diagnosis was uterine leiomyomata with omental leiomyosarcoma. The patient returned home on postoperative day 14 and was well at the 18-month follow-up examination. The challenge of these tumors lies in their proper diagnosis and surgical management. More case reports and follow-up studies are needed to confirm the efficacy of their management.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"639-42"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21548451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemorrhagic gastric glomus tumor mimicks a leiomyosarcoma on both transabdominal and endoscopic ultrasonography: case report. 出血性胃球囊瘤在经腹和内镜超声检查上表现为类似平滑肌肉瘤:1例报告。

Changgeng yi xue za zhi Pub Date : 1999-12-01

T L Tsai, C M Hsiaw, C S Changchien

引用次数: 0

Renal autotransplantation for ureter stricture and renovascular disorders. 自体肾移植治疗输尿管狭窄及肾血管性疾病。

Changgeng yi xue za zhi Pub Date : 1999-12-01

C K Chuang, S H Chu, S K Liao

{"title":"Renal autotransplantation for ureter stricture and renovascular disorders.","authors":"C K Chuang, S H Chu, S K Liao","doi":"","DOIUrl":"","url":null,"abstract":"Background: Renal autotransplantation is an established therapy in cases of renal vascular lesions, tumors of the kidney and ureter, complex ureteral lesions, and kidney trauma. It has been a significant technical innovation, aiding the urologist in his great effort to preserve renal function by conserving renal tissue. We report our experience with autotransplantation in 4 patients. The indications, techniques, and results of renal autotransplantation in relation to our own experience are discussed.Methods: The patients included 3 women and one man. The average age of the patients was 35 years old, with a range from 20 to 54 years. One patient had Takayasu's arteritis, the second had Nutcracker syndrome with flank pain and hematuria, the third a complicated long ureter stricture, and the fourth patient a renal artery saccular aneurysm.Results: The average operation time was 7 hours (4.5 to 8.5 hours), and the cold ischemia time was about 88 minutes (45 to 150 minutes). Three of the autografts resumed normal renal perfusion, and in the fourth patient the renal autograft was lost due to vascular thrombosis.Conclusion: Renal autotransplantation is a feasible method for the surgical treatment of renal and ureteral lesions. To avoid postoperative ureteral sloughing and subsequent urinary fistulas, the ureter can be left intact to preserve the ureter blood supply. However, in the case of a complicated vascular reconstruction procedure, it appears to be appropriate to divide the ureter and have the kidney completely free, thus avoiding back-flow perfusion from the intrinsic and intercommunicating blood supply in the ureteral wall, which may result in vascular thrombosis and subsequent autograft failure.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"621-6"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21548448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alien hand syndrome: report of two cases. 异手综合征:附2例报告。

Changgeng yi xue za zhi Pub Date : 1999-12-01

F Y Wu, C P Leong, T L Su

引用次数: 0

Usefulness of pediatric flexible bronchoscopy in the early diagnosis and postoperation evaluation of vascular rings: report of three cases. 小儿柔性支气管镜在血管环早期诊断及术后评价中的应用:附3例报告。

Changgeng yi xue za zhi Pub Date : 1999-12-01

Y T Su, C K Niu, C D Liang, C B Huang, S F Ko

{"title":"Usefulness of pediatric flexible bronchoscopy in the early diagnosis and postoperation evaluation of vascular rings: report of three cases.","authors":"Y T Su, C K Niu, C D Liang, C B Huang, S F Ko","doi":"","DOIUrl":"","url":null,"abstract":"Vascular rings are a diagnostic and therapeutic challenge for pediatricians. Many diagnostic modalities contribute to the detection of these rare congenital vascular anomalies. The role of flexible bronchoscopy is still being debated. We present 3 cases to emphasize the usefulness of pediatric flexible bronchoscopy (PFB) in the early diagnosis and postoperative evaluation of vascular rings. In patient 1, PFB was performed before conventional techniques were available. A right aortic arch with a retroesophageal aortic diverticulum and mirror-image branching was later confirmed. In patients 2 and 3, pulmonary artery slings could not be detected clearly by imaging studies before PFB was performed. PFB was arranged again postoperatively for these 2 patients, because of difficulty weaning patient 2 from ventilator support and persistent respiratory distress in patient 3. In conclusion, we expect that more vascular rings will be diagnosed using PFB. This instrument is also useful in making a decision for surgery, and for detecting associated tracheobronchial anomalies preoperatively, assuring appropriate correction intraoperatively, and monitoring the condition of vascular rings postoperatively.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"627-32"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21548449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blunt trauma-induced internal thoracic artery injury: case report. 钝性外伤性胸内动脉损伤1例。

Changgeng yi xue za zhi Pub Date : 1999-12-01

F C Tasi, J F Fang, P J Lin, Y S Chang, C H Chang

引用次数: 0

Airway obstruction in general anesthesia--two different episodes in the same patient: case report. 全身麻醉下的气道阻塞——同一患者的两次不同发作:病例报告。

Changgeng yi xue za zhi Pub Date : 1999-12-01

Y H Lee, S C Liou, C Chen, T K Wong, P P Tan

{"title":"Airway obstruction in general anesthesia--two different episodes in the same patient: case report.","authors":"Y H Lee, S C Liou, C Chen, T K Wong, P P Tan","doi":"","DOIUrl":"","url":null,"abstract":"The case of a patient with Apert's syndrome (acrocephalosyndactyly) who had a tracheostomy tube and who encountered two different episodes of critical airway obstruction during two different general-anesthetic procedures for craniofacial surgery is reported. The first episode, at the age of four, involved occlusion of the uncuffed tracheostomy tube by a blood clot, which might have come from the surgical field of the maxillary Le-Fort III advancement procedure. The second episode was encountered during his emergence from the general anesthesia of a degloving midface osteoplasty and a maxillary Le-Fort I osteotomy procedure 3 years later. Although a cuffed armored tube had been inserted through the tracheostoma to prevent aspiration of blood from the surgical field, the armored tube was plugged by a piece of granulation tissue that might have been dislodged from the peri-stomal area. Factors that lead to tracheostomy tube obstruction, their clinical features and preventive measures are discussed. We believe that being alert to changes in the airway pressure, the ventilation pattern, and the hemodynamic status is necessary during the administration of general anesthesia. Precautions should be taken at all times, particularly for patients with a tracheostomy.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"682-6"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21547750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical implication of atypical squamous cells of undetermined significance with or without favoring high-grade squamous intraepithelial lesion on cervical smears. 宫颈涂片检查伴有或不伴有高级别鳞状上皮内病变的不典型鳞状细胞的临床意义尚不明确。

Changgeng yi xue za zhi Pub Date : 1999-12-01

C C ChangChien, H Lin, H L Eng, W K Chang

{"title":"Clinical implication of atypical squamous cells of undetermined significance with or without favoring high-grade squamous intraepithelial lesion on cervical smears.","authors":"C C ChangChien, H Lin, H L Eng, W K Chang","doi":"","DOIUrl":"","url":null,"abstract":"Background: The cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) on a cervical smear usually makes clinicians unsure of how to manage the patient and follow-up on her condition. We attempted to define the clinical implication of qualifying the cytologic diagnosis of ASCUS as either favoring a high-grade squamous intraepithelial lesion (HSIL) or not in an effort to provide management guidelines.Methods: From January through May 1997, 65 of 5792 women who had cervical/vaginal smears taken at Kaohsiung Chang Gung Memorial Hospital were diagnosed as having ASCUS. Thirteen of the 65 cases of ASCUS favored an HSIL, based on nuclear abnormalities in atypical metaplastic and parakeratotic-type squamous cells. All these 65 patients were evaluated in our outpatient clinic by a second cervical smear, colposcopy, and colposcopically directed biopsies and/or endocervical curettage. The median length of the follow-up period was 19 months (range, 16 to 21 months).Results: Of the 52 patients evaluated for ASCUS smears without favoring HSIL, 6 (11.5%) had a low-grade SIL (LSIL), 1 (1.9%) had cervical intraepithelial neoplasia grade II (CIN II), and 1 (1.9%) had invasive squamous carcinoma. Of the 13 patients with a cervical cytologic diagnosis of ASCUS favoring HSIL, 1 (7.6%) had immature metaplasia, 2 (15.4%) had LSIL, 2 (15.4%) had CIN II, 6 (46.2%) had CIN III, and 2 (15.4%) had invasive squamous carcinoma.Conclusion: For patients with a cytologic diagnosis of ASCUS favoring HSIL, more aggressive interventions, such as colposcopy-directed biopsy, endocervical curettage, or even conization, should be performed promptly. However, those without features favoring HSIL may be evaluated with regularly repeated smears.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"579-85"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21548563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laparoscopic colectomy is superior to laparotomy for reduction of disability in patients with colorectal adenoma. 腹腔镜结肠切除术在减少结直肠腺瘤患者的残疾方面优于剖腹手术。

Changgeng yi xue za zhi Pub Date : 1999-12-01

H H Chen, A J Iroatulam, O Alabaz, J S Joo, E G Weiss, J J Nogueras, S D Wexner

{"title":"Laparoscopic colectomy is superior to laparotomy for reduction of disability in patients with colorectal adenoma.","authors":"H H Chen, A J Iroatulam, O Alabaz, J S Joo, E G Weiss, J J Nogueras, S D Wexner","doi":"","DOIUrl":"","url":null,"abstract":"Background: This study was to evaluate disability after laparoscopic colectomy in patients with colorectal adenomas as compared to disability after laparotomy.Methods: Patients who underwent laparoscopic colectomy for colorectal adenoma were compared to patients who underwent laparotomy for the same problem by the same surgeons during the same time period in Cleveland Clinic Florida. A standard questionnaire was used to assess disability which included the number of days to return to partial activity, full activity, and work.Results: Twenty-nine patients who underwent laparoscopy were compared with 31 patients who underwent laparotomy. There were no significant differences in age (70.4 vs 72.5 years) (p = 0.405) or gender (M:F 13:16 vs 20:11) (p = 0.126) between the laparoscopy and laparotomy groups. The operative time was longer for the laparoscopy group than the laparotomy group: 170 vs 131 minutes (p = 0.014). However, the duration of postoperative ileus, hospitalization, time until return to partial activity, time until return to full activity, and time off of work were significantly shorter in the laparoscopy group than in the laparotomy group: 3.3 vs 5.2 days, 6.2 vs 8.7 days, 2.3 vs 4.2 weeks, 4.4 vs 9.3 weeks, and 3.7 vs 7.3 weeks, respectively (p < 0.041 for all). Although the incidence of postoperative complications was not significantly different (24% for laparoscopy vs 29% for laparotomy, p = 0.325), the incidence of postoperative prolonged ileus was statistically significantly lower in the laparoscopy group (3% vs 26%, p = 0.027).Conclusion: Laparoscopic colectomy for patients with colorectal adenoma can reduce postoperative ileus, postoperative hospitalization, and disability in terms of a quicker return to partial activity, full activity, and employment. Laparoscopic colectomy should be considered for all patients who have colorectal adenomas which require resection.","PeriodicalId":77066,"journal":{"name":"Changgeng yi xue za zhi","volume":"22 4","pages":"586-92"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21548564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0