Sonographic diagnosis of a ureteral diverticulum.
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Adult↗
Biomedical subjects
M L Hsieh
Publications and source records attributed to M L Hsieh.
In vitro fertilization pregnancy achieved with epididymal caput sperm of a patient with obstructive azoospermia.
A successful epididymal sperm aspiration, in vitro fertilization and embryo transfer in a woman whose husband had previously undergone extensive attempts at recanalization of the spermatic ducts is reported. A twin pregnancy was achieved using sperm obtained from the husband's epididymal caput. This case demonstrates that pregnancy can be achieved by this reproductive technique in cases of obstructive azoospermia, even after extensive surgery.
Adult↗
Laparoscopic drainage for the treatment of posttransplant lymphocele.
Lymphocele following renal transplantation may be associated with ureteral obstruction, venous obstruction, venous thrombosis, infection and pain. Drainage of lymphocele is indicated when these complications arise or if the patient is symptomatic from the size and pressure of the lymphocele. Less invasive methods for the treatment of lymphocele, including simple needle aspiration, external drainage and sclerotherapy, are associated with an unacceptably high incidence of recurrence and complications. Internal drainage is the treatment of choice either via the retroperitoneal transplant incision or transperitoneally through abdominal incision. We now report a case of posttransplanted lymphocele that was successfully drained into the peritoneal cavity using laparoscopy. We believe this is an effective alternative route to provide internal drainage for lymphoceles.
Adult↗
Enhancing mediastinal mass at MR: Castleman disease.
We report a case of an enhancing middle mediastinal mass imaged by MR and CT. Repeated nondiagnostic biopsies in this 25-yr-old male patient had resulted in profuse hemorrhage. Final pathological diagnosis after thoracotomy and debulking was Castleman disease. This is a rare, benign lymphoproliferative disorder of uncertain etiology. Histological varieties include the hyaline vascular type (80-90%) and the plasma cell type (10-20%). Cure is generally accomplished via surgical excision. This entity should be included in the differential diagnosis of enhancing mediastinal lesions, prompting awareness of the potential for bleeding complications following biopsy.
Adult↗
Subcapsular hematoma of spleen--a complication following extracorporeal shock wave lithotripsy for ureteral calculus.
Splenic trauma with hematoma following extracorporeal shock wave lithotripsy (ESWL) is very rare. We reported a case of subcapsular hematoma of spleen with impending rupture following ESWL for ureteral calculus. This case was noted to have liver cirrhosis and splenomegaly, and received a total of 2000 shock waves under 18 kilovoltage. The subcapsular hematoma occurred 2 months later. Splenectomy was undertaken for a symptomatic huge subcapsular hematoma and thrombocytopenia. We reviewed the literature and concluded that portal hypertension with severe coagulopathy are contraindications for ESWL, even in case with ureteral calculus.
Female↗
The rate and topography of cell wall synthesis during the division cycle of Escherichia coli using N-acetylglucosamine as a peptidoglycan label.
The rates of synthesis of peptidoglycan and protein during the division cycle of Escherichia coli were measured by the membrane elution technique using cells differentially labelled with N-acetylglucosamine and leucine. During the first part of the division cycle the ratio of the rates of protein and peptidoglycan synthesis was constant. The rate of peptidoglycan synthesis, relative to the rate of protein synthesis, increased during the latter part of the division cycle. These results support a simple, bipartite model of cell surface increase in rod-shaped cells. Prior to the start of constriction the cell surface increases only by lateral wall extension. After cell constriction starts, the cell surface increases by both lateral wall and pole growth. The increase in surface area is partitioned between the lateral wall and the pole so that the volume of the cell increases exponentially. No variation in cell density occurs, because the increase in surface allows a continuous exponential increase in cell volume that accommodates the exponential increase in cell mass. The results are consistent with the constant density of the growing cell and the surface stress model for the regulation of cell surface synthesis. In addition, the elution pattern suggests that the membrane elution method does work by having the cells effectively bound to the membrane by their poles.
Acetylglucosamine↗
Mode of peptidoglycan synthesis in Salmonella typhimurium: single-strand insertion.
The synthesis of peptidoglycan by Salmonella typhimurium at the molecular level has been analyzed by studying the pattern of insertion of newly synthesized strands into the preexisting cell wall. We have measured the acceptor-donor radioactivity ratio during short labeling periods, and we found values between 0 and 0.2. This is less than the ratio observed by Burman and Park (Proc. Natl. Acad. Sci. USA, 81:1844-1848) for peptidoglycan synthesis in Escherichia coli. We propose that insertion of new strands occurs as single strands.
Cell Wall↗
Effects of a medical expert system on differential diagnosis of renal masses: a prospective study.
A medical expert system, RMDS, was used to prospectively evaluate patients undergoing nephrectomy for suspected renal masses. The effects of a medical expert system on differential diagnosis of renal masses were investigated. After RMDS consultation, three chief residents and one junior attending physician changed their preoperative diagnosis and significantly increased their diagnostic accuracy. The results indicate that the medical expert system may have an useful role in preoperative diagnosis of renal masses.
Bayes Theorem↗
Intractable bladder tamponade due to left internal pudendal and obturator arterial bleeding induced by erection: a superselective arteriography followed by transcatheter arterial embolization.
Bladder tamponade is an uncommon clinical symptom among men suffering during sexual intercourse. The authors report on a 46-year-old man for whom this symptom appeared 4-5 years prior to hospitalization. Angiography confirmed the presence of left pudendal and obturator arterial bleeding, and embolotherapy of the internal pudendal and obturator arteries was performed. There was no mortality, or limb loss or sexual potency loss at follow-up.
Angiography↗
Loupe-assisted modified one-layer vasovasostomy.
Several studies indicate that microsurgical modified one-layer vasovasostomy is comparable to the two-layer anastomosis with respect to patency and pregnancy rates. The objective of this study was to determine the feasibility and result of modified one-layer vasovasostomy under loupe magnification only. Thirty-two patients aged 28 to 64 years (mean 41.3 +/- 6 years) underwent vasovasostomy at CGMH from July 1997 to June 2002, with all operations being a modified on-layer anastomosis created with the aid of a 3 x loupe. The estimated duration of vasectomy ranged from 4 months to 27 years, with a mean of 9.2 +/- 4.8 years. Postoperative semen analysis and pregnancy were examined. Each patient was followed up at 1,4, and 12 weeks postoperatively. The total operation time ranged from 118 to 228 minutes (average 150 +/- 35 minutes). There was no operation-related complication such as hematoma or wound infection. The patency rate was 89% (25/28), and the pregnancy rate at 2 years or more of follow-up was 39% (11/28). The patency and pregnancy rates were similar to those obtained in most studies of microsurgical vasovasostomy. For uncomplicated vasectomy reversal, this simple loupe-assisted modified one-lyer vasovasostomy seems to provide an adequate anastomosis.
Adult↗
Evaluation of a decision-support system for preoperative staging of prostate cancer.
The usefulness and effectiveness of a decision-support system for preoperative staging of prostate cancers (PCES) were evaluated. The study population consisted of 43 consecutive patients with the preoperative diagnosis of prostate cancer who underwent surgical operation. Results obtained using the PCES were compared with staging by four urology attending physicians and five urology residents. The effect of PCES consultation on the physicians' staging of prostate cancer was also evaluated. To confirm the usefulness of the clinical findings of prostate-specific antigen, prostate-specific antigen density, prostate volume, and abnormal Gleason score in the PCES, their receiver operating characteristic (ROC) curves for diagnosis of advanced prostate cancer were plotted. The values of the areas under the curves were 0.772, 0.800, 0.531, and 0.752. The stage of prostate cancer was correctly determined by the PCES for 38 of the 43 patients, yielding 88.4% preoperative diagnostic accuracy. The PCES was significantly more accurate than two of the attending physicians and all residents. PCES consultation improved the residents' staging accuracy to approximately that of the attending physicians. The effect of PCES consultation on the residents' staging was significantly (p < 0.001) greater than the effect on the physicians' staging. The PCES may be useful in the preoperative staging of prostate cancers, especially during residency. The system's accuracy in determining the stage of advanced prostate cancer may make it possible to avoid unneccesary surgical operations.
Aged↗