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Chia-Chu Liu

Publications and source records attributed to Chia-Chu Liu.

9 recordsLinked to original sources

Huge aggressive angiomyxoma: a case report and literature review.

Angiomyxoma occurs mostly in 30- to 40-year-old females and is described histologically as a mesenchymal tumor, composed of fibroblasts within a strong myxoid background. It occurs mainly in the female pelvis, vulva or perineum, and grows slowly. Treatment is surgical excision. Unfortunately, there is a relatively high rate of recurrence because the exact extent of the tumor is difficult for the surgeon to determine. We report a case of aggressive angiomyxoma combined with uterine myoma, and discuss the characteristics of its images. Surgical excision of the tumor was performed, and adjuvant treatment was given for local recurrence.

Adult↗

Adrenal leiomyoma treated by hand-assisted laparoscopic adrenalectomy: a case report.

A left adrenal incidentaloma was found by abdominal ultrasound and computed tomography (CT) in a 53-year-old woman who had a history of non-insulin dependent diabetes mellitus. Abdominal CT showed a well-circumscribed adrenal mass (5.5 x 4.5 x 3.5 cm) with low density (32HU) on precontrast scan and heterogeneous enhancement on postcontrast scan. Laboratory examinations revealed a nonfunctional adrenal tumor. As the malignant potential of the tumor could not be ruled out, the patient underwent hand-assisted laparoscopic adrenalectomy. Postoperative recovery was uneventful, and pathologic examination revealed leiomyoma.

Adrenal Gland Neoplasms↗

Are lower urinary tract symptoms associated with erectile dysfunction in aging males of Taiwan?

INTRODUCTION: This study was conducted to evaluate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging males of Taiwan. PATIENTS AND METHODS: A free health screening for aging males (>or=45 years old) was conducted in Kaohsiung Medical University Chung-Ho Memorial Hospital in August 2004. LUTS and ED were assessed by validated symptom scales: the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5 (IIEF-5). The subjects also completed a health and demographics questionnaire and underwent detailed physical examination, serum prostate-specific antigen level determination, and transrectal ultrasonography. RESULTS: The final study population consisted of 141 patients with a mean age of 59.8 years. The severity of LUTS and ED increased with age. After controlling for comorbidities, age (p<0.001) and IPSS score (p<0.001) were significantly associated with the IIEF-5 score. Furthermore, men with moderate to high IPSS scores were more likely to have ED as compared with those with mild symptoms after age adjustment (age-adjusted odds ratio 3.27, p=0.002). CONCLUSIONS: ED and LUTS are highly prevalent in our study population, and this prevalence increases with age. ED is significantly associated with the severity of LUTS after controlling for age and comorbidities. These results highlight the clinical importance of evaluating LUTS in patients with ED and the need to consider sexual issues in the management of patients with benign prostatic hyperplasia.

Age Factors↗

Spontaneous rupture of ileal neobladder: a case report.

A 63-year-old male patient suffered from diabetes, hypertension, and a bladder tumor. He had undergone radical cystectomy and ileal neobladder construction 1 year prior to this admission. He came to our emergency room complaining of abdominal pain after recent alcohol consumption. Muscle guarding and abdominal rebounding pain developed after conservative treatment for 1 day. The next day, emergency laparotomy for acute peritonitis revealed two small perforations in the neobladder and calculus formation within it. In addition, severe intraperitoneal adhesion was noted. After removing the neobladder stone and repairing the neobladder, a Foley catheter was inserted for urine drainage. The patient's postoperative recovery was excellent.

Cystectomy↗

Relationships between American Urological Association symptom index, prostate volume, and disease-specific quality of life question in patients with benign prostatic hyperplasia.

The American Urological Association (AUA) symptom index is both valid and reliable in identifying the need to treat patients with benign prostatic hyperplasia (BPH) and in monitoring their response to therapy. We evaluated the relationships between AUA symptom index, disease-specific quality of life question, and prostate volume in patients with BPH. A total of 100 patients who came to Kaohsiung Medical University Hospital, Taiwan, for help due to lower urinary tract symptoms (LUTS) and who were diagnosed with BPH between October 2002 and June 2003 were included in the study. All patients were evaluated using transrectal ultrasonography, AUA symptom index, and disease-specific quality of life question. The disease-specific quality of life question showed good correlation with AUA symptom score (r = 0.815, p < 0.01), but weak correlation with prostate volume (r = 0.225, p < 0.05) and age (r = 0.274, p < 0.05). Prostate volume had weak correlation with AUA symptom score (r = 0.251, p < 0.05) and age (r = 0.472, p < 0.01), but good correlation with prostate specific antigen (r = 0.638, p < 0.01). In addition to AUA symptom index, we suggest using the disease-specific quality of life question to evaluate the influence on quality of life and response to treatment in clinical practice. Moreover, we should assess the impact of BPH symptoms rather than the increase in prostate volume during the management of BPH.

Adult↗

Current indications for transurethral resection of the prostate and associated complications.

Transurethral resection of the prostate (TURP) is the most common surgical procedure for relieving symptoms of benign prostatic hyperplasia. Here, we report our experience of current indications for TURP and their associated outcomes at Kaohsiung Medical University Hospital (KMUH). A total of 111 patients who underwent TURP at KMUH between May 2000 and December 2001 were included in this retrospective review. For each patient, the surgical indication was categorized into acute urinary retention, chronic complications (including renal impairment, recurrent urinary infection, bladder stone/diverticulum, post-void residue, and recurrent hematuria), and symptomatic prostatism. Thirty-five patients (31%) had acute urinary retention, 28 (27%) had chronic complications, and 48 (42%) had symptomatic prostatism. Most patients chose TURP only when medical treatment had failed to relieve symptoms, no matter what category they belonged to. Patients with acute urinary retention and chronic complications had larger prostates (p = 0.002) and more tissue resected (p = 0.05) than those with symptomatic prostatism. Patients with acute urinary retention seemed to be at greater risk of postoperative complications such as recurrent urinary retention and urinary tract infection. We suggest that urodynamic study may be necessary to rule out concomitant bladder dysfunction before surgery and that adequate prophylactic antibiotic treatment be used to decrease the risk of urinary tract infection during or after TURP, especially when pyuria is noted preoperatively in patients with acute urinary retention.

Aged↗

Giant extrarenal retroperitoneal angiomyolipoma: a case report and literature review.

Extrarenal angiomyolipoma is an uncommon disease entity and is rare in the retroperitoneum. We report a case of giant extrarenal retroperitoneal angiomyolipoma mimicking liposarcoma. A 35-year-old woman presented with a history of increased abdominal circumference and urinary frequency. Abdominal computerized tomography demonstrated a 24 x 21 x 16 cm retroperitoneal fatty tumor displacing the right kidney to the left upper quadrant of the abdomen. At laparotomy, the tumor was widely excised and the right kidney was successfully preserved. Final histologic examination identified the tumor as an angiomyolipoma. At 4-month postoperative follow-up, no evidence of tumor recurrence was found and the right kidney was fully functional.

Adult↗

Spontaneous renal hemorrhage associated with idiopathic thrombocytopenic purpura--a case report.

Spontaneous renal hemorrhage is a rare and complicated clinical condition. We report a case of spontaneous renal hemorrhage associated with idiopathic thrombocytopenic purpura (ITP). To our knowledge, this is a second case associated with ITP in the literature. The main treatment of our case included absolute bed rest, platelet transfusion, steroid therapy and prevention of infection. The platelet count increased gradually and returned to the safe level greater than 50,000/microliter from the 10th day. The patient was discharged after 2 weeks due to stable condition and received further follow-up in the outpatient department. We suggest that conservative treatment for spontaneous renal hemorrhage caused by blood dyscrasias like ITP is appropriate because immediate surgical intervention may pose a higher risk due to the tendency for severe bleeding. However, long term follow-up by serial CT should be performed to rule out the possibility of concomitant diseases especially small renal cell carcinoma, which is the most common cause of spontaneous renal hemorrhage.

Female↗

Matrix stone.

Matrix stone is a rare form of renal calculi, and it is often difficult to make an exact preoperative diagnosis. To our knowledge, we reported the first case of matrix stones which received magnetic resonance imaging (MRI) for image study. They showed hypointense signal in T1-weighted images and slight hyperintense signal in T2-weighted images. No obvious contrast enhancement was found after gadolinium administration in T1-weighted images. Besides, postoperative study of computerized tomography (CT) for matrix stones also showed the characteristic of soft tissue densities by measuring the Hounsfield units. We think our experiences may provide some help for the diagnosis of matrix stones when someone encounters the same situation and may prevent overtreatment due to misdiagnosis as malignancy.

Adult↗