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Andy Shau-Bin Chou

Publications and source records attributed to Andy Shau-Bin Chou.

11 recordsLinked to original sources
PubMed2006

Tracheal incision for elective tracheotomy in oral cavity cancer.

The aim of this prospective study was to compare operative procedure and postoperative complications between horizontal tracheal incision and window-type tracheal excision for elective tracheotomy in patients with oral cavity cancer. Between February 2003 and April 2004, 40 patients with advanced-stage oral cavity cancer were consecutively seen at our tumor clinic. All patients underwent elective tracheotomy before wide excision of the tumor and free flap reconstruction. Either horizontal tracheal incision (H group) or window-type tracheal excision (W group) was randomly carried out in two groups comprising 20 patients each. The post-tracheotomy tracheal stenosis was evaluated by tracheal computed tomography (CT) coupled with advantage workstation 4.0 software for reconstruction. Both groups had the following similar characteristics: age, gender, tracheotomy days, or interval between decannulation and CT scan evaluation. However, the incision time was statistically less in the H group (16.4s) compared with the W group (43.4s). Tracheal stenosis was found in five patients (25%) in the H group and four patients (20%) in the W group, with no significant differences. Nevertheless, neither dyspnea or stridor after decannulation, difficulty in tube exchange, nor accidental extrusion was reported in either groups. The horizontal incision for elective tracheotomy is simpler and faster than the window-type tracheal excision. The complication rate is not significantly different in both groups. We therefore, recommend using horizontal incision for elective tracheotomy in patients with oral cavity cancer.

Adult↗
PubMed2006

Utility of ambulatory pH monitoring and videofluoroscopy for the evaluation of patients with globus pharyngeus.

Globus pharyngeous is not an uncommon disorder. The precise pathophysiology remains unclear. The aim of this study was to assess the clinical value of videofluoroscopy and ambulatory pH monitoring in patients with globus pharyngeus. Twenty-three patients (11M/12F, age range = 21-74 yr, mean = 50 yr) with globus pharyngeus entered the study. Radiographic examination of the pharynx and esophagus included videofluoroscopy and static radiography. A dual probe to measure the proximal and distal intraesophageal pH was inserted for 24 h. The results of dual-probe pH monitoring were normal in all patients. Videofluoroscopic results were abnormal in 8 patients, with 5 patients having laryngeal aspiration, 2 having stasis of barium in the vallecula and pyriform sinuses, and 4 having poor pharyngeal elevation. Cervical osteophytes were found in 13 patients with a frequent location at the C5-6 level. Ambulatory pH monitoring seemed to be less helpful for the evaluation of globus pharyngeus without reflux-like symptoms. Pharyngeal dysfunction is detected in a substantial proportion of patients by videofluoroscopy and radiography.

Adult↗
PubMed2005

Left paraduodenal hernia presenting as recurrent small bowel obstruction.

Internal herniation of the small bowel is a relatively rare cause of intestinal obstruction. Left paraduodenal hernia resulting from abnormal rotation of the midgut during embryonic development is the most common form of congenital internal hernia. We report our experience in the diagnosis and management of a young male with left paraduodenal hernia presenting as recurrent intestinal obstruction. Correct preoperative diagnosis of left paraduodenal hernia had been difficult due to non-specific clinical presentations, but the advent of modern imaging technology makes early and correct diagnosis possible. Due to the risk of obstruction and strangulation, surgical treatment is indicated; however, timely intervention increases the likelihood of a favorable outcome.

Adult↗
PubMed2004

Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies.

BACKGROUND: The results of studies identifying the risk factors for pneumothorax and bleeding in CT-guided coaxial lung needle biopsies were inconsistent and some were even contradictory. All reported series were small with patient populations averaging about 200. STUDY OBJECTIVES: To determine the risk factors for pneumothorax and bleeding after CT-guided coaxial cutting needle biopsy of lung lesions. DESIGN: Retrospective analysis. METHODS: We reviewed 660 biopsy procedures. The risk factors for pneumothorax and bleeding were determined by multivariate analysis of variables related to patient demographics, lung lesions, biopsy procedures, and the individual radiologist. RESULTS: The main complications were pneumothorax (23%; 155 of 660 procedures), chest tube insertion (1%; 9 of 660 procedures), and hemoptysis (4%; 26 of 660 procedures), with no patient mortality. The highest pneumothorax rate correlated with a lesion size of </= 2 cm, a lesion depth of 0.1 to 2 cm, and less experienced radiologists. The highest bleeding risk correlated with a lesion size </= 2 cm, a lesion depth of >/= 2.1 cm, and the absence of pleural effusion. CONCLUSIONS: The risk factors for highest pneumothorax rate are lesion size </= 2 cm, a subpleural lesion depth of 0.1 to 2.0 cm, and a less experienced radiologist. The risk factors for highest bleeding rate are lesion size </= 2 cm, lesion depth >/= 2.1 cm, and lung lesions not associated with a pleural effusion.

Aged↗
PubMed2003

Factors affecting diagnostic accuracy of CT-guided coaxial cutting needle lung biopsy: retrospective analysis of 631 procedures.

PURPOSE: To analyze variables affecting diagnostic accuracy of computed tomography (CT)-guided percutaneous coaxial cutting needle biopsy of lung lesions. MATERIALS AND METHODS: A retrospective analysis of factors affecting diagnostic accuracy of CT-guided percutaneous coaxial cutting needle lung biopsy was performed in 631 consecutive procedures with confirmed final diagnoses. Benign and malignant needle biopsy results were cross-examined with correct and incorrect final outcomes to determine diagnostic accuracy. Factors affecting diagnostic accuracy were determined by multivariate logistic regression analysis of variables thought to affect diagnostic accuracy. A P value less than 0.05 was interpreted as statistically significant. RESULTS: The overall diagnostic accuracy of CT-guided percutaneous coaxial cutting needle biopsy of lung lesions was 95% (95% CI: 92.7%-96.2%). Sensitivity was 93%, specificity 98%, negative predictive value 6%, positive predictive value 99%, false-positive rate 0.7%, and false-negative rate 15%. The factors affecting diagnostic accuracy were final diagnoses (benign, 86%; malignant, 99%; chi(2) test, P < 0.001) and lesion size (lesions <1.5 cm, 84%; lesions 1.5-5.0 cm, 96%; lesions >5 cm, 93%; chi(2) test, P = 0.06). CONCLUSION: Benign lung lesions, lung lesions smaller than 1.5 cm (which pose technical difficulty), and lung lesions larger than 5 cm (which are associated with a higher necrosis rate) affect diagnostic accuracy of CT-guided percutaneous coaxial cutting needle biopsy of lung lesions.

Biopsy, Needle↗
PubMed2002

Pseudoaneurysm of the deep circumflex iliac artery: a rare complication at an anterior iliac bone graft donor site treated by coil embolization.

Pseudoaneurysm formation of the deep circumflex iliac artery (DCIA) after harvesting an anterior iliac bone graft for spinal fusion is reported herein. A 76-year-old man with cervical myelopathy underwent anterior cervical decompression and fusion with a left anterior iliac bone graft. A painful left inguinal mass was noted 1 month later. He was admitted to our emergency ward. Angiography of the left external iliac artery was performed which showed a pseudoaneurysm of the DCIA. Selective transarterial coil embolization of the artery was performed, and bleeding was arrested. In a review of the previous literature, only 1 pseudoaneurysm of the DCIA was reported to be associated with anterior iliac bone graft. In conclusion, vascular injury after anterior iliac bone harvesting is rare but can occur. Selective transarterial coil embolization is a prompt and effective solution.

Aged↗
PubMedDate not supplied

Diagnosis and staging of gallbladder carcinoma. Evaluation with dynamic MR imaging.

The purpose of this study is to determine the ability of dynamic magnetic resonance imaging (MRI) in the diagnosis and staging of gallbladder cancer (GBC). Images of dynamic MRI of hepatobiliary system combined with MR cholangiography (MRC) of 18 patients with pathologically proved gallbladder cancer were correlated with pathological and operative findings. Focal or diffuse wall thickening was present in 10 patients. In five patients, the tumor appeared as a fungating or intramural mass. A tumor replacing the gallbladder was found in two patients and a small cancer in cystic duct in one patient. The tumor featured early and irregular enhancement, which persisted throughout the dynamic study. Metastatic nodes were found by surgicopathology in 13 patients and were depicted by the dynamic MRI in 11 patients. Local invasion to liver was found by surgery in 12 patients and correctly detected by MRI in 11 patients. MRI detected duodenum invasion in three out of six patients and none of the three cases with omental metastasis. In conclusion, dynamic MRI is useful and reliable in staging of advanced gallbladder cancer. MRI combined with MRC is sensitive in detection of obstructive jaundice, liver invasion as well as liver and lymph nodes metastasis. It is more difficult to delineate the invasion to duodenum and omental metastasis by MRI.

Aged↗
PubMedDate not supplied

Immunophenotypic and molecular cytogenetic features of the cell line UP-LN1 established from a lymph node metastasis of a poorly-differentiated carcinoma.

A lymph node metastatic cell line (UP-LN1) was established in vitro from a poorly-differentiated epithelial tumor, and characterized for immunobiological and molecular cytogenetic profiles. The morphology of UP-LN1 cells when grown as monolayers was unique in that, apart from typical colonies of adherent epithelial cells, many loosely attached round cell colonies emerged on and around the patches of epithelial cells. By means of immunofluorescence/flow cytometric analysis, UP-LN1 cells showed selective expression of cytokeratin markers AE1 and CK20, but expressed AE3 and CK7 poorly. The expression of CEA and CK20 but not CK7 in UP-LN1 cells was also exhibited in the tumor biopsy by immunohistochemistry, suggesting a gastrointestinal origin of this tumor. Down-regulation of HLA-class I and other surface molecules including ICAM-1, CD44s, CD44v5, CD44v6 and E-cadherin were observed, which all pointed to a progressive/invasive phenotype of the tumor. Spectral karyotyping revealed a hypertriploid (approximately 3n) chromosome content with 73-76 chromosomes, including numerical alterations and translocated derivative chromosomes. Seven different translocation chromosomes were observed, four of which involved chromosome 19. Numerical imbalances were also assessed by comparative genomic hybridization. This cell line should be useful for further studies of tumor invasion and metastatic processes because of the unusual in vitro and in vivo immunobiological and genetic characteristics observed.

Aged↗