Biomedical subjects

Jung-Tsung Shen

Publications and source records attributed to Jung-Tsung Shen.

11 recordsLinked to original sources

PubMed2006

Colon perforation: a rare complication during percutaneous nephrolithotomy.

Only a few cases of colon perforation during percutaneous nephrolithotomy (PCNL) have been reported. We present here a case of colon perforation during PCNL that was managed conservatively by stenting the urinary tract, using the percutaneous catheter as the colostomy tube, and giving broad-spectrum antibiotics. This report also reviews the anatomic and technical access to the kidney and reminds the urologist about this rare but serious complication of PCNL.

Aged↗

PubMed2005

Coherent single photon transport in a one-dimensional waveguide coupled with superconducting quantum bits.

A recent theoretical analysis and experimental results show that interesting transport properties of a single microwave photon emerge when a quantum bit in a cavity is coupled to a one-dimensional waveguide. Here we adopt a real-space model Hamiltonian to give a unified approach which accounts for the experimental results, and make new predictions on the properties of single photon transport, such as the general Fano line shape, symmetric vacuum Rabi splitting for a leaky cavity at resonance, and a one-photon switching capability.

Journal Article↗

PubMed2005

Impact of lower pole anatomy on stone clearance after shock wave lithotripsy.

This study retrospectively analyzed patients treated with shock wave ithotripsy (SWL) for lower calyceal stones, to determine the influence of the lower pole anatomy and stone size in predicting the clearance of fragments. Between June 2000 and March 2002, we reviewed excretory urography (IVU) of 59 patients with isolated lower pole stones treated with SWL. A total of 44 men and 15 women, with an age ranging between 23 and 78 years (mean, 55 years), were included in the study. The patients were divided into two groups, either a stone-free group or residual-stone group. After SWL, overall stone rate was 57.6%, and clearance for stones less than 10 mm in diameter was 64.5%, whereas clearance was 50% for stones between 10 and 20 mm in diameter. Intrarenal anatomy on IVU, such as infundibular width and infundibulopelvi-ureteric angle showed no significant difference between the stone-free and residual-stone groups. Our analysis showed that three significant variables were relevant to stone clearance: infundibular length, stone size and stone burden. We conclude that SWL is the best treatment for lower pole kidney stones 10 mm or less in diameter, showing lower complication and acceptable stone-free rates.

Adult↗

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

Unusual gas pattern in emphysematous cystitis: a case report.

We present a case of emphysematous cystitis in a 43-year-old female. The gas pattern was unusual because there was only gas accumulation in the urinary bladder without bladder wall thickening or intramural gas formation. The differential diagnosis included postoperative states, enterovesical fistula, and iatrogenic instrumentation. The prognosis of emphysematous cystitis is good after early diagnosis and prompt treatment with appropriate antibiotics, blood glucose control, and adequate urinary drainage. The patient was discharged on hospital day 5 with one additional week of oral antibiotic therapy. She was quite well at the time of writing and her diabetes was controlled with an oral hypoglycemic agent.

Adult↗

PubMed2004

Foreign body stone in the urinary bladder: a case report.

Bladder calculi rarely form spontaneously and are usually a manifestation of an underlying pathologic condition of the lower urinary tract, including voiding dysfunction, urinary infection, obstruction, or foreign body retention. However, a ruptured Foley balloon-induced bladder stone is an unusual complication of an indwelling Foley catheter. We report a case of spinal cord injury with paraplegia and bladder stone induced by a fragment of a ruptured Foley balloon. The bladder stone and the Foley balloon fragment were successfully removed by cystoscopy. The stone was composed of calcium oxalate and calcium phosphate. We report this unusual case to raise awareness that it is important to check the integrity of the Foley catheter after removal of the tube.

Adult↗

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

Transitional cell carcinoma of the renal pelvis with extension into the inferior vena cava: a report of two cases.

Of all primary malignant renal tumors, 10% to 15% originate from the renal pelvis, and 90% to 92% of these tumors are transitional cell carcinomas. Nonetheless, renal pelvis transitional cell carcinoma extending into the inferior vena cava is very rare. We report one confirmed case and one highly suspicious case of renal pelvis transitional cell carcinoma with a tumor thrombus in the inferior vena cava. Both of our patients died within 6 months of initial diagnosis, indicating the poor prognosis and advanced stage of transitional cell carcinoma with an inferior vena cava thrombus. Transitional cell carcinoma should be considered in patients with obstruction of the renal vein and the inferior vena cava.

Aged↗

PubMed2003

Bilateral superselective arterial microcoil embolization in post-traumatic high-flow priapism: a case report.

Priapism is a prolonged penile erection unrelated to sexual stimulation. High-flow arteriogenic priapism is uncommon and usually occurs after genitoperineal trauma, which may damage a feeding cavernosal artery, leading to an arteriovenous fistula and, occasionally, to an associated pseudoaneurysm. The defects rarely occur bilaterally. Herein, we report successful treatment of high-flow priapism secondary to a traumatic pseudoaneurysm fed from the bilateral cavernosal artery. Diagnosis was made after cavernosal blood gas analysis, color Doppler ultrasonography, and superselective angiography. Treatment consisted of superselective arterial embolization using metallic microcoils and resulted in simultaneous detumescence of the penis with no complications. The patient regained morning erection on the second postoperative day and erectile function remained normal 8 months after treatment. This case shows that bilateral arteriocavernosal fistulae can be successfully treated with superselective arterial embolization without affecting potency and highlights the importance of warning men about the possibility of developing high-flow priapism following a perineal trauma.

Adult↗

PubMed2003

Paraganglioma of the urinary bladder: a case report.

Paragangliomas of the urinary bladder are very rare. To date, there are no reliable methods for predicting their clinical behavior, so long-term follow-up is required. We describe a paraganglioma of the urinary bladder in a 32-year-old male who presented with painless gross hematuria. Abdominal ultrasonography revealed a protruding mass with hematoma over the right lateral wall of the urinary bladder. The tumor was not completely resected by transurethral resection of bladder tumor (TURBT) due to intermingling with the bladder wall. Follow-up I131-metaiodobenzylguanidine was performed 3 weeks after surgery and suspected incomplete resection lesions were noted. Histologic examination of the tumor indicated paraganglioma of the urinary bladder. We also provide a brief review of the literature for comparison.

3-Iodobenzylguanidine↗

PubMed2002

The management strategy of renal angiomyolipoma.

The purpose of this study is to analyze the management strategy of renal angiomyolipoma. From 1990 to 2002, a total of 62 patients with renal angiomyolipoma were treated at our medical center. Angiomyolipomas were found in 44 female patients (71.0%) and 18 male patients. Of these patients the age ranged from 18 to 87 y/o (mean: 46.9 y/o). Four of 8 patients with bilateral angiomyolipomas were associated with tuberous sclerosis (TS). Nine (14.5%) of 62 patients had got spontaneous rupture. However, 54.8 per cent of patients were asymptomatic. The mean tumor size was 4.83 cm. Tumors larger than 4 cm had a greater incidence of symptoms (60.7%) and a higher nephrectomy rate (43%). Clinical management was based on tumor size and clinical presentation. Treatment consisted of conservative observation in 30 patients (group 1, 48.4%), selective embolization therapy in 2 patients with hemorrhage (group 2, 3.2%), partial nephrectomy and other surgical procedures in 14 patients (group 3, 22.6%), and total nephrectomy in 16 patients (group 4, 25.8%). Nine of 62 patients were associated with spontaneous angiomyolipoma rupture under conservative treatment in 3, TAE in 1, partial nephrectomy in 1, total nephrectomy in 3 and laparotomy to check bleeding in 1. Neither mortality no major complication was noted. Generally the outcomes were smooth and acceptable. Beyond the total nephrectomy for patients with highly suspected malignancy, we suggest conservative treatment with observation strategy for small asymptomatic tumors, selective arterial embolization as the first choice for hemorrhage or rupture and partial nephrectomy for renal sparing strategy.

Adolescent↗