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Biomedical subjects

Benjamin Chang

Publications and source records attributed to Benjamin Chang.

11 recordsLinked to original sources
PubMed2006

Ocular complications of autoimmune polyendocrinopathy syndrome type 1.

PURPOSE: To report the ocular complications in a series of patients with autoimmune polyendocrinopathy syndrome, type 1 (APS1). METHODS: A retrospective study of 17 patients with APS1 syndrome treated at the department of ophthalmology, Our Lady's Hospital for Sick Children in Crumlin, Dublin, Ireland. All patients had clinical manifestations of the disease in keeping with the diagnostic criteria of APS1. Each patient had a comprehensive ophthalmic history taken and examination, including ocular symptoms, best-corrected visual acuity, slit-lamp biomicroscopy, tear film evaluation, and dilated ophthalmoscopic examination. RESULTS: Six of 17 patients (35%) had corneal changes. Two patients (12%) had severe keratoconjunctivitis requiring hospitalization and intensive topical steroids and lubricants. The inflammation resulted in visual acuity reduction in one patient secondary to central corneal scarring. Other ocular findings included reduced tear production, as tested with Schirmers tear strips (63%), lens opacities (18%), hypotrichosis (12%), hypertrichosis (5.9%), anisometropic amblyopia (5.9%), and myopia (5.9%). CONCLUSIONS: The most common and clinically important ocular manifestation of APS1 was keratoconjunctivitis associated with dry eye. This can result in progressive corneal scarring and vision loss.

Adolescent↗
PubMed2006

Nerve palsies related to pediatric upper extremity fractures.

In every child who has a fracture, neurologic examination is essential at initial assessment so that early diagnosis of nerve injury can be made. Electrodiagnostic studies may be helpful in diagnosis when the examination is equivocal and in follow-up to look for signs of recovery. In a patient who has neurologic deficits associated with a fracture, nerve exploration should be considered for open fractures, fractures that require open reduction, and palsies that develop after fracture reduction. For closed fractures associated with nerve palsy at the time of initial injury, observation and serial examination after reduction is recommended. If there is no return of nerve function on examination or electrodiagnostic testing by 4 months, operative exploration is indicated.

Child↗
PubMed2006

Brachial artery aneurysms in Menkes disease.

Generalized vascular tortuosity caused by deficiency of the copper enzyme lysyl oxidase is frequently noted in Menkes disease, but reported examples of peripheral aneurysms are rare. We describe bilateral brachial artery aneurysms in a 10-month-old infant with classical Menkes disease.

Aneurysm↗
PubMed2006

Maternal cigarette smoking during pregnancy increases the risk of having a child with a congenital digital anomaly.

BACKGROUND: The U.S. Natality database from 2001 and 2002 was used to investigate the relationship between maternal cigarette smoking during pregnancy and the risk of having a child with polydactyly, syndactyly, or adactyly. METHODS: The records of 6,839,854 live births were examined to identify 5171 newborns with isolated polydactyly, syndactyly, or adactyly and 10,342 controls with no congenital anomalies. RESULTS: Maternal cigarette use during pregnancy was associated with a significantly elevated risk of having a child with a congenital digital anomaly (unadjusted odds ratio, 1.33; 95 percent confidence interval, 1.21 to 1.47; p < 0.0001). Univariate analysis indicated that maternal marital status and medical risk factors (anemia, cardiac disease, lung disease, diabetes, hydramnios/oligohydramnios, pregnancy-associated hypertension, incompetent cervix, previous preterm or small-for-gestational-age infant, and rhesus factor sensitization) were potential confounding factors. After adjustment for these variables, the odds ratio remained significant (adjusted odds ratio, 1.31; 95 percent confidence interval, 1.18 to 1.45; p < 0.0001). Cigarette consumption per day was divided into four groups: no smoking, 1 to 10 cigarettes per day, 11 to 20 cigarettes per day, and 21 or more cigarettes per day. A statistically significant dose-response relationship was found when comparing each smoking category with the no-smoking reference group: 1.29 (95 percent confidence interval, 1.15 to 1.46), 1.38 (95 percent confidence interval, 1.12 to 1.71), and 1.78 (95 percent confidence interval, 0.97 to 3.26), respectively. Increased cigarette smoking during pregnancy resulted in an elevated risk of having a child with polydactyly, syndactyly, or adactyly. CONCLUSIONS: This is the largest study to date to investigate specifically the association between maternal cigarette smoking and the risk of having a newborn with a congenital digital anomaly. The elevated odds ratio for tobacco use and the significant trend in the dose-response relationship suggests smoking during pregnancy may be an important preventable risk factor for these common congenital differences.

Abnormalities, Multiple↗
PubMed2004

A rare brachial artery pseudoaneurysm 13 years after excision of a humeral osteochondroma.

Pseudoaneurysms resulting from vascular impingement by osteochondromas are extremely rare. The authors detail the case of a 19-year-old man who represents the third known report in the English literature of a brachial artery pseudoaneurysm associated with a humeral osteochondroma. In patients presenting with a painful upper arm mass and a history of multiple hereditary exostoses, one must have a high index of suspicion for pseudoaneurysm.

Adult↗
PubMed2004

Percutaneous technique for reduction of complex metacarpophalangeal dislocations.

Historically, complex metacarpophalangeal (MCP) joint dislocations have necessitated open surgical management by either a volar or dorsal approach. The authors describe a relatively simple and reliable percutaneous technique to treat these complex MCP dislocations, with results comparable with open surgical reduction. This minimally invasive technique can be performed in the emergency room setting, thereby avoiding the cost and morbidity associated with an open procedure in the operating room. From 1996 to 2003, the percutaneous technique was performed on 4 patients with complex MCP joint dislocations. Three patients underwent percutaneous reduction in an operating room whereas the fourth patient was reduced in the emergency room. Successful reduction was attained on the first attempt in all 4 patients without complications. All dislocations were stable after reduction. Near full, painless range of motion was achieved in all 4 patients and there were no cases of recurrent instability. All patients were satisfied with their results.

Adolescent↗
PubMed2004

A simple method of designing a bilobed flap using a triangle template.

BACKGROUND: The bilobed flap is useful for the reconstruction of skin defects in which the primary closure is difficult. Proper design is paramount to achieve excellent cosmetic results, but flap design often appears unnecessarily complex and difficult. OBJECTIVE: The objective was to discuss the geometry of the bilobed flap and describe a simple and practical method for constructing such flaps using a triangle template with emphasis on the pivot point. METHODS: A detailed description with diagrams and an illustrative case are presented to demonstrate the technique. RESULTS: A patient with a scalp defect was reconstructed with a triangle-template-designed bilobed flap with excellent postoperative results. CONCLUSION: This new method using a triangle template ensures proper placement of the pivot point and will enable practitioners to achieve superior outcomes.

Aged↗
PubMed2003

Vascular malformation within the flexor tendon sheath.

We report an unusual location of a capillary vascular malformation found entirely within the flexor tendon sheath of an 8-year-old girl. Vascular malformations have been found in many locations throughout the hand but have, to our knowledge, not been reported to involve the vinculum of the flexor tendon sheath. The vascular malformation was contained completely within the sheath. Therapeutic management involved surgical excision of the vascular malformation.

Arteriovenous Malformations↗
PubMed2002

Pulsed irrigation of extremity wounds: a simple technique for splashback reduction.

Although blood and body fluid exposures are daily events often assumed to be unavoidable by operating room personnel, the potentially lethal consequences of blood-borne pathogen transmission demand preventive measures to minimize contamination risk. The authors outline a simple technique of extremity irrigation that uses a clear plastic isolation drape, pulsed lavage equipment, and surgical suction. They have found that this technique allows for thorough irrigation of wounds while providing optimal barrier protection.

Extremities↗
PubMedDate not supplied

Congenital infantile fibrosarcoma: a masquerader of ulcerated hemangioma.

Congenital infantile fibrosarcoma, a rare malignant tumor of childhood, may present as a highly vascularized mass that is clinically difficult to distinguish from a hemangioma. When ulcerated, significant hemorrhage, anemia, and thrombocytopenia may occur in children with these lesions. This report describes three infants with ulcerated congenital infantile fibrosarcomas of the hand. As appropriate medical and surgical management hinges on timely and appropriate diagnosis, we review the clinical manifestations of these lesions.

Diagnosis, Differential↗