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Hong-Ming Tsai

Publications and source records attributed to Hong-Ming Tsai.

11 recordsLinked to original sources
PubMed2006

Clinical analysis of the predictive factors for recurrent appendicitis after initial nonoperative treatment of perforated appendicitis.

BACKGROUND: The purpose of this study was to study the clinical symptoms, laboratory data, and the characteristics of computed tomography (CT) imaging of nonoperated perforated appendicitis for predicting the recurrence of appendicitis. METHODS: Thirty-five patients with nonoperated perforated appendicitis were retrospectively reviewed for this study. During a median follow-up period of 1155 days, 7 patients had to receive an appendectomy owing to recurrent appendicitis. Accordingly, the patients were divided into 2 groups: the recurrence and the nonrecurrence group. The clinical characteristics between these 2 groups were compared. RESULTS: Both of the 2 patients who had a past history of appendicitis suffered recurrent appendicitis (the recurrence versus the nonrecurrence group, P<.05). The only CT imaging relating to the recurrence of appendicitis is the presence of calcified appendicolith (the recurrence versus the nonrecurrence group, P<.001). CONCLUSIONS: It is most likely that appendicitis will recur if a calcified appendicolith on CT imaging or a past history of appendicitis is presented. Interval appendectomy may be reserved only for those patients who possess one of these risk factors of recurrent appendicitis.

Adult↗
PubMed2005

Application of technetium-99m-labeled human serum albumin scan to assist surgical treatment of protein-losing enteropathy in Cronkhite-Canada syndrome: report of a case.

Cronkhite-Canada syndrome is a rare form of nonhereditary gastrointestinal polyposis associated with ectodermal change and protein-losing enteropathy. Here we report a 63-year-old male presenting with diffuse gastrointestinal polyposis, onychodystrophy, cutaneous pigmentation, alopecia, diarrhea, hypoalbuminemia and lower leg edema. Technetium-99m-labeled human serum albumin scan confirmed the patient to have protein-losing enteropathy, which originated from the transverse and descending colon. Subtotal colectomy was performed. Albumin level and ectodermal change were gradually improved during three years of outpatient clinic follow-up. Based on our finding, Technetium-99m-labeled human serum albumin scintigraphy is helpful to localize the protein-losing origins and surgery is an effective treatment for Cronkhite-Canada syndrome with protein-losing enteropathy.

Colectomy↗
PubMed2005

Evaluation of predictive value of CLIP, Okuda, TNM and JIS staging systems for hepatocellular carcinoma patients undergoing surgery.

BACKGROUND: An accurate staging system is required to assess hepatocellular carcinoma (HCC) patients in order to benefit from hepatic resection before surgery. Cancer of the Liver Italian Program (CLIP) score was considered to be better than the Okuda staging system to predict survival. Japan Integrated Staging Score (JIS score) includes tumor, nodes, metastases (TNM) stage and Child-Pugh grade as a new staging system for HCC. The purpose of the present paper was to compare the CLIP, Okuda, TNM and JIS staging systems for HCC patients undergoing surgery. METHODS: From 1991 to 1995, 599 patients undergoing hepatic resection for HCC from four medical centers in Taiwan were evaluated. All patients were classified by Okuda, CLIP, TNM and JIS systems. Factors associated survivals were analyzed. RESULTS: There was no statistical difference in survival between CLIP 0 and 1 patients, or among CLIP 2-4 patients. The prognostic validation of the Okuda and CLIP scoring systems in discriminating survival in HCC patients undergoing surgery was not satisfied. The TNM system was successful in predicting survival for HCC patients undergoing surgery. The JIS score could also differentiate survivals for those patients except for JIS 3. By multivariate analysis, age > or =60 years old, serum albumin <3.5 g/dL, tumor size >5 cm and TNM stage were associated with survival. CONCLUSION: Both the Okuda and CLIP systems are not superior to TNM staging for HCC patients who undergo surgical resection. Whether JIS score is feasible for those patients with advanced HCC needs further evaluation.

Adult↗
PubMed2005

Quantitatively characterizing the textural features of sonographic images for breast cancer with histopathologic correlation.

OBJECTIVE: In this study, quantitative characterization of sonographic image texture and its correlation with histopathologic findings was developed for facilitating clinical diagnosis. A statistical feature matrix was applied to quantify the texture difference (ie, the dissimilarity) of the sonographic images for malignant and benign breast tumors. METHODS: Thirty-three patients were recruited for this study. Imaging was performed on a commercially available sonographic imaging system in clinical use. The parameters used for image acquisition were kept the same during clinical examination. RESULTS: On the basis of dissimilarity values, 3 phenomena were noted in the relatively large malignancies studied. First, stellate carcinoma showed the least dissimilarity on sonographic images; second, circumscribed carcinoma showed the most dissimilarity; and third, malignant tissue mixed with fibrous and cellular parts (dense lymphocyte infiltration and prominent intraductal tumors) had dissimilarity values in between. Image textures with smaller dissimilarity values (especially for those values <4.4 in our study) are likely to be stellate carcinoma. CONCLUSIONS: From the experimental results, it is shown that the cellular and fibrous content with spatial distribution of breast masses determine the dissimilarity values on sonographic images. The dissimilarity may be used to quantitatively represent the image texture and is well correlated with the histopathologic description.

Adolescent↗
PubMed2004

The role of transcatheter arterial embolization in patients with resectable hepatocellular carcinoma: a nation-wide, multicenter study.

PURPOSE: The role of transcatheter arterial embolization (TAE) for patients with resectable hepatocellular carcinoma (HCC) is controversial. Analyzing a cohort of nation-wide data can delineate the beneficial effect of TAE for those patients. METHODS: From 1991 to 1995, 818 patients who had potentially resectable HCC from four medical centers in Taiwan were enrolled. Among them, 599 underwent curative resection, 157 received TAE and 62 received supportive treatment alone. The survivals among the three groups were compared. RESULTS: The 5-year survival rates for patients who underwent surgery, TAE and supportive treatment were 43.6%, 25.6% and 3.7%, respectively. Surgery offered the best survival for those patients. TAE could also prolong survival as compared with supportive treatment (P=0.0001). However, among patients who were in advanced tumor stage (Cancer and the Liver Italian Program (CLIP) score > or =2), no statistical difference in survival was noted between patients who underwent TAE or supportive treatment. In multivariate analysis, single tumor, serum albumin > or =3.5 g/dl, tumor size less than 5 cm, early-stage tumor (CLIP score=0-1) and aggressive treatment including surgery and TAE were independent factors associated with a better survival. CONCLUSIONS: Surgery is superior to TAE for patients with resectable HCC. In patients who refuse surgery, TAE can be considered for selected patients whose tumors are in early stage.

Aged↗
PubMed2004

MRI of gallstones with different compositions.

OBJECTIVE: Gallstones are usually recognized on MRI as filling defects of hypointensity. However, they sometimes may appear as hyperintensities on T1-weighted imaging. This study investigated how gallstones appear on MRI and how their appearance influences the detection of gallstones. MATERIALS AND METHODS: Gallstones from 24 patients who had MRI performed before the removal of the gallstones were collected for study. The gallstones were classified either as cholesterol gallstone (n = 4) or as pigment gallstone (n = 20) according to their gross appearance and based on analysis by Fourier transform infrared spectroscopy. MRI included three sequences: single-shot fast spin-echo T2-weighted imaging, 3D fast spoiled gradient-echo T1-weighted imaging, and in-phase fast spoiled gradient-echo T1-weighted imaging. The signal intensity and the detection rate of gallstones on MRI were further correlated with the character of the gallstones. RESULTS: On T1-weighted 3D fast spoiled gradient-echo images, most of the pigment gallstones (18/20) were hyperintense and all the cholesterol gallstones (4/4) were hypointense. The mean ratio of the signal intensity of gallstone to bile was (+/- standard deviation) 3.36 +/- 1.88 for pigment gallstone and 0.24 +/- 0.10 for cholesterol gallstone on the 3D fast spoiled gradient-echo sequence (p < 0.001). Combining the 3D fast spoiled gradient-echo and single-shot fast spin-echo sequences achieved the highest gallstone detection rate (96.4%). CONCLUSION: Based on the differences of signal intensity of gallstones, the 3D fast spoiled gradient-echo T1-weighted imaging was able to diagnose the composition of gallstones. Adding the 3D fast spoiled gradient-echo imaging to the single-shot fast spin-echo T2-weighted sequence can further improve the detection rate of gallstones.

Adult↗
PubMed2003

Identifying multiple abdominal organs from CT image series using a multimodule contextual neural network and spatial fuzzy rules.

Identifying abdominal organs is one of the essential steps in visualizing organ structure to assist in teaching, clinical training, diagnosis, and medical image retrieval. However, due to partial volume effects, gray-level similarities of adjacent organs, contrast media affect, and the relatively high variations of organ position and shape, automatically identifying abdominal organs has always been a high challenging task. To conquer these difficulties, this paper proposes combining a multimodule contextual neural network and spatial fuzzy rules and fuzzy descriptors for automatically identifying abdominal organs from a series of CT image slices. The multimodule contextual neural network segments each image slice through a divide-and-conquer concept, embedded within multiple neural network modules, where the results obtained from each module are forwarded to other modules for integration, in which contextual constraints are enforced. With this approach, the difficulties arising from partial volume effects, gray-level similarities of adjacent organs, and contrast media affect can be reduced to the extreme. To address the issue of high variations in organ position and shape, spatial fuzzy rules and fuzzy descriptors are adopted, along with a contour modification scheme implementing consecutive organ region overlap constraints. This approach has been tested on 40 sets of abdominal CT images, where each set consists of about 40 image slices. We have found that 99% of the organ regions in the test images are correctly identified as its belonging organs, implying the high promise of the proposed method.

Algorithms↗
PubMed2002

Transnasal sphenopalatine artery electrocautery for posterior epistaxis.

BACKGROUND: To evaluate the effects of sphenopalatine artery electrocautery for the treatment of recurrent posterior epistaxis. METHODS: Nine patients were enrolled in the study. Seven patients had hypertension, two had diabetes, two received irradiation for nasopharyngeal carcinoma, one had congestive heart failure and one was a heavy drinker. Three patients needed blood transfusion for profound blood loss. The sphenopalatine artery electrocautery was performed transnasally with endoscope. After the sphenopalatine foramen was identified through dissecting the mucosa of middle meatus posteriorly one centimeter from the choana, the neurovascular bundle in the sphenopalatine foramen was cauterized. RESULTS: Most operations can be performed within fifty minutes with minimal blood loss under local anesthesia. One patient developed minor epistaxis 2 months after surgery, and the bleeding was controlled with medical treatment. The other patients had no recurrent epistaxis after surgery. Thus, epistaxis was well controlled in all patients without complications. The follow-up duration was 2 to 14 months after surgery, with a mean duration of 10 months. CONCLUSIONS: Transnasal sphenopalatine artery electrocautery is a simple, effective and safe method for the treatment of posterior epistaxis.

Adult↗
PubMedDate not supplied

Computed tomography demonstration of immediate and delayed complications of computed tomography-guided transthoracic percutaneous ethanol injection of hepatocellular carcinoma at the liver dome.

OBJECTIVE: We conducted this study to correlate computed tomography (CT) images with the complications induced by CT-guided percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC). METHODS: Twenty-two patients with ultrasonographically unreachable HCC were treated with CT-guided transthoracic PEI. The procedures and the CT findings were recorded to correlate with the various complications of PEI. RESULTS: After the ethanol injection, 3 patterns of CT images were identified according to the distribution of ethanol (ie, intratumoral, extrahepatic, and intrahepatic patterns). The intrahepatic pattern was further classified as the branch, tubular, and infiltrative types. During the follow-up period, 3 patients developed biliary stricture, portal vein thrombosis, or tumor seeding. The tubular type was associated with the development of biliary stricture, whereas the branch type was related to the occurrence of portal vein thrombosis. These complications were considered to be caused by a greater amount of ethanol leakage into bile ducts or portal veins than in cases without complications (median = 17 mL vs. 0 mL, P = 0.002). CONCLUSIONS: Ethanol leakage is not uncommon when performing PEI; however, it seems to be safe when the leakage is less than 15 mL. Injection of a small amount of ethanol or monitoring by CT may be helpful in preventing the development of these complications.

Administration, Cutaneous↗