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Biomedical subjects

Ming-Hsun Wu

Publications and source records attributed to Ming-Hsun Wu.

5 recordsLinked to original sources

Clinicopathological study of gastric metastases.

OBJECTIVE: The stomach is an uncommon site for metastasis, and most of the reported examples would appear to have been caused by direct invasion from primary malignancies. Metastases to the stomach are extremely rare, and few cases have been reported in the literature. This study was intended to evaluate the character of and the prognosis for metastasized tumors of the stomach. METHOD: We evaluated the medical records of patients who had presented at the National Taiwan University Hospital over a period of 10 years prior to writing who had malignancies and had developed metastasis to the stomach. We evaluated the histology, initial presentations, imaging findings, lesion locations, treatment courses, and overall patient survival. RESULT: From October 1995 to October 2004 inclusively, only 18 patients featuring known malignancies with metastases to the stomach were found. The male to female ratio was 10:8. The initial symptom for 13 study patients was bleeding from the metastasis tumors, and the remaining 5 experienced a variety of other symptoms. The site of the metastasis was the gastric body for 9 patients, the gastric antrum for 6, the cardia or fundus for 2, and the entire stomach for 1. The time period elapsing between the emergence of the primary malignancy and the gastric metastasis was less than 2 years for 3 patients and about 5-6 years for another 2 patients. The mean time elapsing from the diagnosis of gastric metastasis to patient death was quite short, namely, about 6 months. CONCLUSION: Carcinomas featuring gastric metastasis are typically very rare and reveal a rather poor prognosis. The results of this preliminary study suggest that most treatment for these patients seemed to provide only symptomatic relief but did not prove helpful for long-term survival.

Adenocarcinoma↗

The psoas muscle as an unusual site for metastasis of hepatocellular carcinoma: report of a case.

Extrahepatic metastasis of hepatocellular carcinoma (HCC) is an indicator of a poor prognosis. The most common extrahepatic sites of metastatic HCC are the lungs, intra-abdominal organs, and bone. Metastasis of carcinoma from any site to skeletal muscle is rare, and to the best of our knowledge, the hematogenous spread of HCC to skeletal muscle has never been described before. We report a case of isolated metastasis in the left side of the psoas muscle, which was found 1 year after trisegmentectomy. The lesion was successfully resected with the muscle, and no other metastatic lesions have been found in 5 months of follow-up.

Carcinoma, Hepatocellular↗

Primary intrathoracic goiter.

Nodular goiter is a common disease in Taiwan, and substernal or intrathoracic goiters are not infrequent. However, intrathoracic goiters are mainly of the secondary type and primary intrathoracic goiters are rarely seen. We report a 55-year-old woman who was incidentally found to have an ectopic goiter located in the anterior upper mediastinum with the initial presenting symptom of productive cough. Imaging studies including chest X-ray and computed tomography identified the lesion, and 131I-uptake scan showed weak uptake in the thorax. Surgical removal via thoracotomy was performed and the diagnosis was confirmed by pathology. A primary intrathoracic goiter, although rare, should also be considered in the differential diagnosis of mediastinal tumor.

Diagnosis, Differential↗

Laparoscopic Ladd's procedure for intestinal malrotation: report of three cases.

Ladd's procedure for laparoscopic repair of malrotation has many advantages over conventional surgical techniques, such as earlier feeding and discharge. However, this procedure is still not commonly used in Taiwan. This report describes the results of treatment of intestinal malrotation in three patients using laparoscopic Ladd's procedure. The patients, aged 8 days, 17 days, and 3 years, underwent laparoscopic Ladd's procedure between July 1999 and September 2000. All three patients had symptoms of intermittent vomiting and were shown to have intestinal malrotation by upper gastrointestinal series study. The procedure was performed using three trocars of 5 mm diameter placed at the infraumbilical ring and the right and left lower quadrants. All procedures were completed laparoscopically. The operative times were 4.8, 3.6, and 3.5 hours, respectively. Feeding was started on postoperative Day 2 to 5, and the hospital stay was 6 to 11 days. Our results suggest that laparoscopic Ladd's procedure can be performed safely in pediatric patients. In addition, patients are expected to benefit from the smaller incision, earlier feeding, shorter hospital stay, and fewer complications compared with traditional Ladd's procedure.

Child, Preschool↗