Biomedical subjects

Ching-Chia Li

Publications and source records attributed to Ching-Chia Li.

10 recordsLinked to original sources

PubMed2005

Evaluation of intrarenal blood flow by Doppler ultrasonography immediately after extracorporeal shock wave lithotripsy on hydronephrotic kidney.

Extracorporeal shock wave lithotripsy (ESWL) is an effective and relatively noninvasive mode of treatment for urinary calculi. The aim of this study was to test whether therapeutic ESWL induces changes in renal parenchymatous blood flow and to evaluate shock wave side effects on the renal parenchyma. A total of 45 patients who underwent ESWL for ureteropelvic stone between January 2002 and July 2003 were included in this prospective study. Color Doppler sonography before and 30 minutes after ESWL showed no significant morphologic change. Resistive index (RI) was used to estimate renovascular resistance. The RI significantly increased in obstructed hydronephrotic kidneys. However, no significant change was observed in both treated and untreated kidneys before and after treatment. Hydronephrotic kidneys do not have a higher risk of post-ESWL renovascular resistance interference. The measurement of changes in RI with Doppler ultrasonography may provide useful information for clinical diagnosis of renal tubulointerstitial and vascular damage.

Adult↗

PubMed2005

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↗

PubMed2005

Effect of urine specific gravity on effectiveness of shockwave lithotripsy.

PURPOSE: To determine the effect of urine specific gravity (SG) and radiographic contrast medium on the efficiency of extracorporeal shockwave lithotripsy (SWL) fragmentation using a previously published in vitro model. MATERIALS AND METHODS: Artificial kidney stones (BegoStone [BEGO USA, Smithfield, RI]) of a standard size (10 x 10 mm) and weight (mean 1.90 g; range 1.89-1.91 g) were randomly allotted to one of four test media with differing SG: group 1: synthetic urine, SG 1.003; group 2: synthetic urine, SG 1.040; group 3: 50% radiographic contrast (Cysto-Conray II, Mallinckrodt Inc., Hazelwood, MO), 50% synthetic urine, SG 1.069; and group 4: 100% contrast, SG 1.121. The stones were placed in cups made of 2.2-mm screen mesh and exposed to 500 shockwaves at 20 KV from a spark-gap lithotripter (Econolith 2000; Medispec, Germantown, MD). The stone fragmentation rate (i.e., percent fragmentation) was determined by dividing the dry residual stone weight by the prelithotripsy dry weight (X 100). RESULTS: The mean fragmentation rate for the four groups was 31.7%, 37.6%, 31.8%, and 27.2%, respectively. Statistical significance was not achieved (P = 0.1). CONCLUSION: Stone breakage tends to be more effective when urine SG is about 1.040 than at higher or lower values. Hence, the recommendation for an overnight fast prior to SWL is well founded. Introduction of contrast medium may inhibit stone breakage because it increases the specific gravity.

Humans↗

PubMed2004

Laparoscopic bladder diverticulectomy for large bladder diveticulum: a case report.

Bladder diverticula are herniations of the bladder mucosa through the bladder wall musculature. Acquired bladder diverticula are the result of outlet obstruction, mostly benign prostate enlargement, infections, or urethral stricture. Traditionally, bladder diverticulum was excised by the open method. However, the laparoscopic technique has been widely used to treat many urologic diseases, including bladder diverticulum. Laparoscopic diverticulectomy can be performed transperitoneally or extraperitoneally. We report our initial experience with laparoscopic transperitoneal diverticulectomy for a large bladder diverticulum caused by bladder outlet obstruction. The patient had satisfactory micturition and was discharged on the eighth postoperative day.

Aged↗

PubMed2003

Bladder stone in a woman after cesarean section: a case report.

Urinary bladder calculi are rarely seen in women and any history of previous pelvic surgery must, therefore, raise suspicion of an iatrogenic etiology. According to the literature, fewer than 2% of all bladder calculi occur in female subjects and, thus, their presence should provoke careful assessment of the etiology. There have been a number of reports on bladder calculi in women with a history of gynecologic procedures. We report a case of bladder calculus after cesarean section that was treated successfully by open surgery.

Adult↗

PubMed2003

Double J stent forgotten for 7 years: a case report.

Ureteral stents are an integral part of urologic practices. Nonetheless, stents that migrate, fragment, or are forgotten pose management and legal dilemmas. We report the case of a "forgotten" stent, which migrated upward into the right renal pelvis, concomitant with a ureteral stone. The "forgotten" stent was placed 7 years previously during right ureteral stone treatment. The patient finally underwent nephroscopic stent retrieval and ureteroscopic ureteral stone removal. The final plain X-ray demonstrated no stone fragment or residual double J stent fragment. The patient withstood the procedure well and was free of symptoms thereafter.

Humans↗

PubMed2002

Kallmann syndrome--a case report.

Kallmann syndrome is a very rare hereditary disease. It is characterized by hypogonadotropic hypogonadism in association with anosmia ot hyposmia, both of which occur as a result of the failure of neuronal migration of the luteinizing hormone releasing hormone (LHRH)--secreting neurons and the neurons of the vemeronasal nerve. It can be autosomal dominant, autosomal recessive, or X-linked mode of inheritance. We report a case of Kallmann syndrome that presented with delay puberty, color blindness, gynecomastia, and absence of smell. Plasma levels of LH, FSH and testosterone were very low. The patient's adrenal and thyroid hormone levels were normal. Chromosome analysis showed 46, XY karyotype without deletion in KAL gene (Xp22.3) from FISH. After 9 months of treatment by HCG and HMG, the amount of pubic hair and the volume of bilateral testes, as well as the level of testosterone had increased. Most importantly, motile sperm count be found in semen.

Adult↗

PubMed2002

Adrenal tumors: 10-year experience at Kaohsiung Medical University Hospital and literature review.

We report our 10-year experience of managing adrenal tumors at Kaohsiung Medical University Hospital (KMUH) between January 1992 and January 2002. In total, 53 patients with adrenal tumors were analyzed, including 19 men (mean age +/- standard deviation, SD, 41.8 +/- 12.9 yr; range, 24-66 yr) and 34 women (mean age +/- SD, 42.3 +/- 12.4 yr; range, 19-74 yr), with an overall mean age +/- SD of 42.6 +/- 12.5 years. All 53 adrenal tumors were confirmed by surgery and pathology. In our series, 41 (77.4%) tumors were functional, of which 39 (95%) were benign; 12 (22.6%) tumors were nonfunctional, of which two (16.7%) were malignant. Overall, women were more common than men in our series, especially in Cushing's syndrome and primary aldosteronism (female:male ratio, 4 and 1.9, respectively). Of the 41 functional adrenal tumors, 20 were primary aldosteronism, 10 were Cushing's syndrome, 10 were pheochromocytoma, and one was an androgen-producing tumor. Of the 12 nonfunctional adrenal tumors, all of which presented as adrenal incidentalomas, four were cortical adenoma, three were myelolipoma, two were ganglioneuroma, one was an adrenal cyst, one was an adrenocortical carcinoma, and one was a metastatic carcinoma. Overall, 48 patients underwent adrenalectomy, three underwent partial adrenalectomy for small and well-circumscribed tumors, and two were explored. The diagnosis and management of adrenal tumors is discussed and the literature reviewed.

Adrenal Gland Neoplasms↗

PubMed2002

Hand-assisted laparoscopic live donor nephrectomy: a case report.

Live donor renal transplantation offers significant advantages over cadaveric renal transplantation. It yields significantly better patient and graft survival on both short-term and long-term follow-up. Laparoscopic donor nephrectomy minimizes the morbidities associated with the surgical procedure and allows a speedy return to normal daily activities. The operation also provides an atraumatic kidney subjected to minimal warm ischemia time and with adequate length of artery and vein, resulting in immediate functioning of the kidney after transplantation with a low rate of ureteral complications. A 37-year-old man was referred as a kidney donor for his brother. Both donor and recipient were hepatitis-B surface antigen carriers. Cross-matching and human leukocyte antigen test showed good compatibility. Left donor nephrectomy was performed successfully by hand-assisted laparoscopy. The warm ischemic time was 4.5 minutes and the graft kidney functioned immediately after transplantation. The donor was discharged from the hospital on postoperative Day 3 with good recovery.

Adult↗

PubMedDate not supplied

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↗