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C W Hsiao

Publications and source records attributed to C W Hsiao.

13 recordsLinked to original sources
PubMed2001

Carcinoid tumor of the spleen: report of a case.

Carcinoid tumors are uncommon tumors of the neuroendocrine system. They grow slowly and may remain silent for years before presenting with carcinoid syndrome. A diagnosis of asymptomatic carcinoid tumor is difficult. Wide resection of the primary tumor and metastatic lesions is the first choice of treatment. Primary carcinoid is sometimes distributed throughout the entire body, but it is rare in the spleen. We herein present a rare case of a symptomless carcinoid tumor that predominantly invaded the spleen with liver metastasis.

Aged↗
PubMed1999

Accurate assessment of tissue expansion in the lower face and anterior neck by a simple measurement technique.

A simple, precise method of clinical estimation for the accurate assessment of tissue expansion in the lower face and anterior neck is described using fixed anatomical reference points. The method makes it possible to select the most suitable size of tissue expander and to decide the optimal timing of operation. By recording the baseline data before expansion and repeating measurements as expansion proceeds, the discrepancy of the expectation between the surgeon and patient concerning the postoperative result can also be minimised.

Cicatrix↗
PubMed1998

Use of the scalp as a donor site for large burn wound coverage: review of 150 patients.

The characteristics of rapid wound healing and multiple harvest capacity make the scalp an important donor site when dealing with large and deep burn wounds. This paper reports the results of a retrospective analysis of 150 patients treated for large burn wounds. The findings indicated that bleeding during graft skin harvest could be limited to 50 ml by intradermal injection of epinephrine (1:2,000,000), high-concentration epinephrine-soaked gauze compression (1:20,000), and temporary porcine skin coverage. Use of a scalp graft also carried a low risk of complications, with only four (2.7%) major complications including three cases (2.0%) of visible alopecia and one case (0.7%) of hair transplantation. There were no hypertrophic scars, even in the patient who had the largest number (11) of repeat harvests.

Adolescent↗
PubMed1998

Necrotizing soft tissue infections. Surgical or conservative treatment?

BACKGROUND: Both surgeons and dermatologists are increasingly challenged with the prompt diagnosis and management of severe soft tissue infections. Although early surgical intervention appears to be for life-saving in many patients, especially those diagnosed as necrotizing fasciitis, some patients recover well with only conservative treatment. Because most of these infections have similar initial clinical presentations, there remains a need to find reliable clinical and/or laboratory parameters that can predict the prognosis and to accordingly judge the necessity and timing of operation. METHODS: We conducted a retrospective study of case records of patients with necrotizing soft tissue infections. The clinical presentation, laboratory findings, management, and therapeutic outcome of 34 cases with necrotizing soft tissue infections were reviewed. RESULTS: These infections were potentially life-threatening, with an overall mortality of 26.5%. Shock on admission was an extremely grave sign associated with a poor prognosis (P < 0.05). In this grave condition, most (80%) patients died regardless of the choice of treatment. Coagulation parameters, including platelet counts, prothrombin time (PT), and partial thromboplastin time (PTT), were available in 21 patients, of whom 16 had at least one abnormality at their initial presentation. In these 16 patients, those who underwent surgery had a significantly higher survival rate than those who were treated conservatively (P < 0.05). Prolonged PT was significantly associated with a higher mortality (P < 0.05). Surgery did seem to correct coagulopathies. However, in patients presenting with substantial alteration of all three coagulation parameters, there was no significant difference between medical treatment and surgical intervention in terms of mortality. In such cases, mortality was high (75%). On the other hand, the prognoses of patients who presented with normal coagulation profiles were rather good. Most of them recovered well despite the therapeutic option. Surgical treatment did not seem to increase additional benefits on chances of survival. Extent of tissue plane involvement, bacteriology, and site of infection had no significant influence on patients' survival. CONCLUSIONS: A comprehensive, well-organized, universal approach, regardless of classification, is essential for all suspected cases of necrotizing soft tissue infections. Prompt diagnostic studies are needed, and platelet counts, PT, and PTT are readily available parameters that provide substantial information on diagnosis and treatment, thus avoiding an unwarranted loss of life or unnecessary operative sequelae. Early diagnosis and, in most cases, prompt radical surgical, intervention remain the cornerstone of successful management in these infections.

Adolescent↗
PubMed1997

Continuous antegrade warm blood cardioplegia attenuates augmented coronary endothelium-dependent contraction after cardiac global ischemia and reperfusion.

BACKGROUND: Experiments were designed to evaluate the effect of warm blood cardioplegia on endothelium-dependent contraction of the coronary endothelium after cardiac global ischemia and reperfusion. METHOD: Dogs (n = 12 in each group) were exposed to extracorporeal circulation with the body temperature at 37 degrees C (group 1) or 28 degrees C (groups 2 and 3). The ascending aorta was crossclamped for 120 minutes while continuous infusion of warm blood cardioplegec solution (group 1) or intermittent infusion of cold (4 degrees C) crystalloid cardioplegic solution (group 2) was performed via the coronary arteries through the aortic root. Cardioplegic solution was not used in group 3 animals. The heart was then allowed to function for 60 minutes of reperfusion. Reperfused (groups 1, 2, and 3) and control (group 4) coronary arteries were then harvested for study. RESULTS: Perfusate hypoxia caused endothelium-dependent contraction in the arteries of all four groups that could be attenuated by NG-monomethyl-L-arginine (L-NMMA) or L-NMMA plus D-arginine, but not by L-NMMA plus L-arginine or endothelin receptor A and B antagonist PD 145065. The endothelium-dependent contraction results in groups 2 and 3 (75% +/- 4% and 80% +/- 5%, respectively) were significantly greater than those in groups 1 and 4 (15% +/- 3% and 18% +/- 5%, respectively). Scanning electron microscope studies showed that platelet adhesion and aggregation, areas of microthrombi, disruption of endothelial cells, and separation of the intercellular junction could be found in coronary segments from groups 2 and 3, but not in vessels from groups 1 and 4. CONCLUSION: These experiments suggest that global ischemia and reperfusion enhances hypoxia-mediated endothelium-dependent contraction of the coronary endothelium and damages the ultrastructure. These kinds of changes can be prevented by continuous antegrade infusion of warm blood cardioplegic solution during global ischemia.

Animals↗
PubMed1996

Chronic volar dislocation of the metacarpophalangeal joint of the thumb: a case report and review of the literature.

A 61-year-old man sustained a chronic volar dislocation of the metacarpophalangeal joint of the thumb. He did not present for treatment until he experienced recently progressive joint pain 2 year after injury. Arthrodesis of the metacarpophalangeal joint was performed to correct the deformity of the thumb because of its extensive tissue scarring and erosion of the articular cartilage of the metacarpal head. Six weeks of splint immobilization followed by a physiotherapy program allowed the patient to resume his daily activities with his right hand.

Arthrodesis↗
PubMed1995

Facial plaque-type blue nevus and its reconstruction.

Blue nevi rarely appear in a plaque form. Because of their rarity and unusual clinical appearance, these nevi may present a diagnostic problem. We described a large plaque-type blue nevus measuring about 9 x 6 cm on the right cheek of a 22-year-old man. It was characterized by several dark-blue macules and papules with intervening areas of faint blue discoloration. Excision of this unusual plaque-type blue nevus with reconstruction using tissue expander was performed successfully. A 6-year postoperative follow-up revealed satisfactory results.

Adult↗
PubMed1995

Intramuscular cavernous hemangioma of the masseter muscle.

Intramuscular hemangioma is relatively uncommon and frequently misdiagnosed, and even rarer in the head and neck region. The masseter muscle is the most frequent site for such hemangioma in the head and neck. A retrospective chart-review of intramuscular hemangioma in Keelung Chang Gung Memorial Hospital from 1983 through 1992 revealed the incidence of masseter muscle hemangioma is approximately 8% of all intramuscular hemangioma. Because of the rarity of these tumors, their vague presentations, inaccurate preoperative diagnosis and inappropriate surgical planning are common problems. This paper described five hemangiomas involving the masseter muscle with a review of the current literature on masseter muscle hemangioma.

Adult↗
PubMed1994

Plaque-type blue nevus on the face: a variant of Ota's nevus?

We describe a plaque-type blue nevus that had been present since birth on the right cheek of a 22-year-old man. It was characterized by several dark blue macules and papules with intervening areas of faint blue discoloration. Histologic examination showed a common blue nevus and a mongolian spot-like dermal melanocytosis in the dark blue and intervening faint blue pigmentary lesions, respectively.

Adult↗
PubMed1994

Midfoot replantation: case report.

The replantation of lower extremity amputations is uncommon. Foot replantation is quite rare because of the severity of the primary injury and its rare occurrence compared with lower leg and upper extremity amputations. A successful replantation in a young woman of a foot amputation at the talo-navicular-calcaneal area is reported with a 1-year postoperative follow-up revealing adequate restoration of foot function.

Adult↗
PubMed1994

Buttock augmentation with silicone prosthesis--a case report.

A 18-year-old male patient presented with small, flat buttock due to gluteus maximus contracture which caused psychological problem. Bilateral gluteal augmentation was achieved with tissue expanders followed by permanent silicone prosthesis replacement. A two year postoperative follow up revealed no capsular contracture of the prosthesis and no limitation of the patient's activities. The improved contour has improved the patient's outlook on his body image or confidence in his body image.

Adolescent↗