Biomedical subjects
Publications and source records attributed to C C Changchien.
We present a case of lethal short rib-polydactyly syndrome (SRPS) that cannot be categorized into the existing classification. A nosologic discussion is presented. To our knowledge, situs inversus totalis, as in our case, has not been described before in any SRPS.
The role of copious irrigation and drainage in the treatment of tuboovarian abscess (TOA) is crucial, especially for the patients who want to remain fertile. Some have used vaginal drainage via posterior colpotomy for patients with TOA, whereas others preferred irrigation using large-bore drains. In this study, we reported 31 cases of TOA. We found that for women who want to conceive again the best method of treatment is conservative surgery plus low pressure sump tube drainage.
The amniotic band syndrome (ABS) includes intrauterine amputations, syndactyly, fetal disruption, fetal compression deformities and constriction rings associated with disruption of the amniotic membrane. The defects caused by ABS varied from simple digital band constrictions, limb defects to major visceral and craniofacial defects; fetal death may also occur. Because the ABS is a sporadic disorder that may mimic recurrent disorders, such as achondroplasia, anencephaly, Apert's syndrome, etc, it is very important to do appropriate genetic counseling and accurate diagnosis for every infant born with multiple birth defects. We report two severely damaged cases with typical features. This article also reviews the clinical features of ABS, its etiology, pathogenesis, and the status of prenatal and neonatal diagnosis are also discussed.
We attempted to determine the significant variables and to predict the probability of disease persistence after conization for microinvasive cervical carcinoma and cervical intraepithelial neoplasia grade 3 (CIN3). We analyzed 133 patients from 2001 to 2002 who had a subsequent hysterectomy after conization. The histological findings of the cone specimens, together with the clinical parameters, were correlated with the presence of residual dysplasia in the hysterectomy specimen. The probability of having residual dysplasia was calculated based on the function of the significant variables obtained by logistic regression analysis. Of the 133 patients, 42 (31.6%) had residual disease in their hysterectomy specimens. Using multivariate analysis only for the postmenopausal state, positive endocervical curettage, positive margin, and microinvasive carcinoma were predictive of residual dysplasia. The probabilities of having residual dysplasia were about 0.99, 0.84, 0.4, 0.07, and 0.01 in patients with a presence of all four, any three, any two, any one, and no risk factors, respectively. The best cutoff probability determined by the receiver operating characteristic curve was 0.32, yielding a sensitivity of 81% and a specificity of 88%. Based on these results, patients with the presence of any two or more of the risk factors mentioned above should be considered as a high-risk group for having disease persistence after conization for the treatment of CIN3 and microinvasive carcinoma.