Biomedical subjects

Hon-Man Chan

Publications and source records attributed to Hon-Man Chan.

9 recordsLinked to original sources

PubMed2006

Intestinal obstruction during pregnancy.

Intestinal obstruction is a rare cause of acute abdominal pain during pregnancy. We reviewed and analyzed the medical records of four pregnant women with intestinal obstruction, treated at the Department of Surgery in the Kaohsiung Medical University Hospital during a period of 19 years, between June 1984 and December 2002. Their ages ranged from 22 to 35 years (mean, 28 yrs). Three cases had had prior lower abdominal surgery. Adhesion was the unique finding in all four patients during the operation. Enterolysis was needed to release the intestinal obstruction in three of the patients; the fourth required resection and anastomosis of the ileum as a result of volvulus. Premature labor was prevented with tocolysis in two patients. The results of this study lead us to emphasize the importance of close observation and early surgery to avoid intestinal strangulation if a pregnant woman who develops intestinal obstruction has an old surgical scar on her abdomen. Premature labor may be avoided with tocolysis.

Adult↗

PubMed2006

Successful localization and surgical removal of ingested sewing needles under mini C-arm fluoroscopy: a case report.

Foreign body ingestion is common, but ingestion of multiple sewing needles is rare. Most ingested sharp metallic bodies pass through the digestive tract spontaneously and patients can be managed conservatively. Sometimes, however, perforation develops and surgical treatment is necessary. It is hard to localize ingested sewing needles because they tend to scatter widely in the digestive tract and are impalpable manually. We report a psychiatric patient who ingested six sewing needles: one intact needle was found at the larynx, one had penetrated into the stomach, one was in the duodenum, one was in the cecum, one was broken into two pieces, and the final needle was broken into three pieces. All of the broken fragments were in the colon. The needle at the larynx was removed by a laryngoscope. Subsequently, we used mini C-arm fluoroscopy to localize the remaining needles and successfully removed all of them intraoperatively.

Aged↗

PubMed2006

Subcutaneous emphysema and pneumomediastinum secondary to dental extraction: a case report and literature review.

Here, we present the case of a woman who suffered from acute dyspnea and right cheek and neck swelling during molar extraction. The use of a high-speed dental drill may introduce air into the soft tissue and lead to subcutaneous emphysema and pneumomediastinum. After a review of the literature, we found that subcutaneous emphysema and pneumomediastinum are rare complications secondary to dental extraction. We report this case because physicians in the emergency department may misdiagnose the symptoms as an allergic reaction. Dentists should be more aware of air leak during dental extraction.

Adult↗

PubMed2005

Encapsulated columnar-cell carcinoma of the thyroid: a case report.

Columnar-cell carcinoma is a rare form of papillary thyroid carcinoma. It is a biologically aggressive variant, according to the World Health Organization classification, due to its rapid growth, high local recurrence rate, and frequent lung, brain, and bone metastases. However, recent reports indicate encapsulated tumors confined to the thyroid gland are associated with a more favorable prognosis. We report a case of encapsulated columnar-cell carcinoma occurring in the right lobe of the thyroid in a 25-year-old female and discuss the histopathologic features, differential diagnosis, and prognostic factors.

Adult↗

PubMed2005

Compurerized morphometric study of thyroid follicular carcinoma in correlation with known prognostic factors.

This study investigates the correlation between computer-assisted nuclear morphometry and known prognostic factors in thyroid follicular carcinoma. Thirty-six patients with thyroid follicular carcinoma who underwent surgery between 1991 and 2001 were grouped according to sex, age, size of the primary lesion, the presence of vascular invasion, and metastases. Four nuclear parameters were measured and analyzed: mean nuclear area, mean nuclear perimeter, largest to smallest diameter ratio of the nuclei, and coefficient of variation of the nuclear area. Our results indicated that none of the chosen nuclear variables were significantly correlated with the prognostic factors studied. In conclusion, nuclear morphometry does not seem to correlate with known prognostic factors and cannot serve as an additional predicting factor for biologic behavior.

Adenocarcinoma, Follicular↗

PubMed2005

Computerized nuclear morphometry in thyroid follicular neoplasms.

Differential diagnosis of follicular adenoma (FA) and follicular carcinoma (FC) of the thyroid can be challenging in the routine practice of surgical pathology because the diagnosis of FC is strictly defined and identification depends on the presence of invasion of the capsule or blood vessels. These features may be equivocally presented in the histological sections and interpreted subjectively by different pathologists, so an objective approach to solve this problem is essential. Computerized morphometry is a scientific tool to evaluate cellular changes and it can enhance the interpretation of morphological features by the transformation of pathological changes in cells to a qualitative form. The present study investigated the diagnostic role of objective computerized nuclear morphometry in follicular neoplasms. Thirty-six cases of thyroid FC and 36 cases of FA from patients who were matched by age and sex were studied. Four nuclear parameters were selected and analyzed: mean nuclear area, mean nuclear perimeter, largest to smallest diameter ratio of the nuclei, and coefficient of variation of the nuclear area. The results indicate that all the chosen nuclear variables were significantly correlated with the FA and FC studied. In conclusion, computerized nuclear morphometry can be considered a helpful ancillary tool for differential diagnosis of FA and FC.

Adenocarcinoma, Follicular↗

PubMed2005

Expression of human telomerase reverse transcriptase in thyroid follicular neoplasms: an immunohistochemical study.

Differential diagnosis of follicular adenoma (FA) and follicular carcinoma (FC) of the thyroid can be difficult in the routine practice of surgical pathology because the diagnosis of FC is strictly defined and determined by the presence of capsular and/or vascular invasion by the tumor. These features may be equivocal in the histologic sections. On the other hand, telomerase is expressed in many human cancers and is thought to contribute to their immortality. Human telomerase reverse transcriptase (hTERT) is the major determinant of human telomerase activity, and its expression is suggestive of capacity for unlimited replication. This case-control study examined the expression of hTERT using immunohistochemistry in 36 thyroid FC and 36 FA from patients who were matched by age and sex. The aim was to investigate the value of immunohistochemical staining for hTERT in the differential diagnosis of follicular neoplasms. The results revealed 23 cases of FC and 14 cases of FA that showed high expression of hTERT, with moderate to strong immunoreactivity. The remaining cases showed weak or negative staining. The difference between FA and FC was statistically significant (p < 0.05). In conclusion, immunohistochemical staining for hTERT can be considered an ancillary marker for differential diagnosis of FA and FC.

Adenocarcinoma, Follicular↗

PubMed2002

Emergency one-stage surgery for obstructing left-sided colorectal carcinomas.

A one-stage operation for obstructing left-sided colorectal carcinoma remains controversial. This study was performed to compare our surgical management of patients with left-sided colorectal cancer (at or distal to splenic flexure) obstruction presenting to the Kaohsiung Medical University Hospital from January 1995 to December 2000. Ninety-six patients underwent immediate operation within 24 hours of admission. Of these, 73 patients (76%) who underwent immediate tumor resection and anastomosis in one stage after appropriate resuscitation were enrolled into our study. In one-stage operation subtotal coloectomy with ileocolic or ileorectal anastomosis (group 1) was performed in 46 patients (63%), and intraoperative bowel preparation followed by immediate resection (group 2) was undertaken in 27 patients (37%). In comparing the two groups, there was no significant difference in the postoperative mortality (8.7% in group 1 vs. 7.4% in group 2) or cumulative 5-year survival rate (36.7% in group 1 vs. 35.7% in group 2) (all p > 0.05). However, mean operation time (178 +/- 12 min in group 1 vs. 238 +/- 12 min in group 2) and postoperative wound infection rate were significantly lower (10.9% in group 1 vs. 29.6% in group 2). The incidence of postoperative diarrhea was more prominent in the group 1 than group 2 (32.6% in group 1 vs. 11.1% in group 2) (all p < 0.05). The results of our current study showed that primary resection and anastomosis by subtotal colectomy is an acceptable means for the treatment of patients with obstructing left-sided colorectal carcinomas when the patient's condition is feasible.

Adult↗

PubMedDate not supplied

Laparoscopic assisted placement of peritoneal dialysis catheters for selected patients with previous abdominal operation.

Peritoneal dialysis is an established alternative method for the management of patients with end-stage renal disease. Recently, laparoscopy has been utilized in assisting the insertion of catheters under direct vision. The efficacy of the laparoscopic approach for patients with a history of abdominal surgery remains largely unknown. The purpose of this study is to evaluate laparoscopy in the placement of peritoneal dialysis catheters for selected patients with previous abdominal operation. Laparoscopic assisted placement of peritoneal dialysis catheters was performed in 20 patients, who were carefully selected preoperatively and who also underwent previous abdominal operation between April 1999 and July 2001. Previous abdominal operation included appendectomy, ovarian resection, hysterectomy, cesarean section, open cholecystectomy, segmental resection of the small intestine, and truncal vagotomy with pyloroplasty. The procedure was performed using two 10-mm and one 5-mm abdominal trocar. All of the patients tolerated this procedure without significant surgical complications. However, 3 patients developed temporary hemoperitoneum, and 1 patient developed dialysate leakage. The overall success rate of catheter function (> 30 days after laparoscopy) was 90%, except in 2 cases where the catheter functioned poorly due to severe intra-abdominal adhesions. Simultaneous laparoscopic adhesiolysis was successfully performed in 5 cases. Laparoscopic implantation of peritoneal dialysis catheters appears to be a straightforward procedure, even for patients with previous abdominal operation. We believe that this technique may extend the application of peritoneal dialysis treatment in patients with previous abdominal surgery after discreet evaluation preoperatively.

Abdomen↗