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Biomedical subjects

Peng-Hui Wang

Publications and source records attributed to Peng-Hui Wang.

46 records · Page 3Linked to original sources
PubMed2002

Advantages of open laparoscopic surgery over exploratory laparotomy in patients with tubo-ovarian abscess.

STUDY OBJECTIVE: To compare laparoscopic surgery and conventional laparotomy in managing patients with tubo-ovarian abscess (TOA). DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: Regional hospital. PATIENTS: Sixty-nine women with clinically suspicious TOA. INTERVENTION: Operative laparoscopy or laparotomy. MEASUREMENTS AND MAIN RESULTS: Laparoscopic surgery in 19 women had significant advantages over laparotomy in 37 women. It decreased hospital stay (5.37 +/-1.38 days vs 8.92 +/- 2.59 days, p = 0.0001), had a lower percentage of wound infections, and had a shorter time for fever to subside (25.79 +/- 11.45 vs 39.46 +/- 17.47 hrs, p = 0.003). CONCLUSION: Although management of TOA consists of conservative medical treatment with antibiotics, it is now widely accepted that surgical intervention should be pursued early after the diagnosis. Open laparoscopy seems to be a good alternative to traditional laparotomy in managing these patients.

Abdominal Abscess↗
PubMed2002

Laparoscopic bipolar coagulation of uterine vessels to manage delayed postpartum hemorrhage.

Postpartum hemorrhage (PPH) is a big challenge for obstetricians. Fertility-preserving procedures are encouraged, especially in young women. Bilateral hypogastric (internal iliac) artery ligation, bilateral uterine artery ligation after vaginal delivery or after cesarean delivery, and uterine artery embolization are well documented vascular occlusive methods for treating PPH. To our knowledge, the laparoscopic approach to uterine artery ligation has not been reported. A 29-year-old woman experienced delayed PPH. Although curettage of the uterine cavity to remove retained placenta was performed, bleeding did not stop. We successfully performed a relatively new method--laparoscopic bipolar coagulation of uterine vessels--to stop bleeding and preserve the uterus.

Arteries↗
PubMed2002

Analysis of genetic aberrations in uterine adenomyosis using comparative genomic hybridization.

OBJECTIVE: To use comparative genomic hybridization (CGH) to analyzefrozen tissuesfrom adenomyosis cases to discover and map genomic regions for chromosomal gains and losses. STUDY DESIGN: In a retrospective study, upper and lower threshold values of 1.20 and 0.80, respectively, were used to define positive findings. RESULTS: No positive recurrent gene copy number alterations were detected in the 25 cases of pathologically proven adenomyosis. CONCLUSION: Although CGH is extremely useful in investigating candidate genes in the development of adenomyosis, CGH was not useful in this study. Genetic changes might be indeed extremely rare in adenomyosis, or CGH was not sensitive enough to detect candidate genes.

Chromosome Aberrations↗
PubMed2002

New strategies and advances in the management of cervical carcinoma.

BACKGROUND: Carcinoma of the cervix is still common female cancer in Taiwan. A large portion of patients die of the disease in spite of various kinds of therapies and even the combination of multi-modality treatment. METHODS: The current review includes a comprehensive review of the literature. Many new strategies and advanced in the management of cervical carcinoma have been the subject of this intense study and include assisted systems to improve sensitivity and specificity of Pap smear, human papillomavirus (HPV), and its vaccination, operation, radiation, chemotherapy, and combination of these strategies. Because of the constant failure rate, a systemic and critical review of the disease and management should be considered. RESULTS: With improvement of detection rate of pre-invasive cancer and popularity of screening protocol, the prevalence rate of cervical carcinoma decreases progressively. However, although new strategies in managing cervical carcinoma focus on combination therapy, the life quality and survival rate of these patients with cervical carcinoma only show beneficial in certain group patients. CONCLUSION: As to the complexity of both disease nature and various combinations in the diagnosis and treatment of cervical cancer, comprehensive quality control programs and large prospective multicenter trials are mandatory for establishing the "standard of care" adhered to the principles of evidence-based medicine.

Combined Modality Therapy↗
PubMed2002

Ovarian stone. A case report.

BACKGROUND: To our knowledge, ovarian calcification and ossification involving the whole ovary with images that mimic stone formations have not been reported before. CASE REPORT: A 42-year-old woman presented with severe abdominal pain. Plain abdominal radiography showed a well-defined, calcified mass, 4 x 5 cm, located in the pelvis. Physical examination showed a right adnexal mass accompanied by severe pain and tenderness while lifting. Transvaginal ultrasound showed an ill-defined mass with acoustic comet tail. Computed tomography demonstrated a well-defined mass on the right adnexa, 4 x 5 cm, with an extensively calcified shell. Surgical exploration revealed an enlarged, ovoid, pale brown ovary, which looked exactly like an ovary made of stone. The pathologic findings were compatible with a benign chocolate cyst with extensive calcification and ossification. The pelvic pain resolved completely after the surgery. CONCLUSION: Though the cause of this unique case remains unknown, torsion with subsequent infarction of an ovarian endometrioma was suggested. Complete excision was the treatment of choice.

Adult↗
PubMed2002

Successful conservative treatment for advanced interstitial pregnancy. A case report.

BACKGROUND: Interstitial pregnancy is a relatively rare and life-threatening disease, occurring in 2-4% of all extrauterine pregnancies, and the maternal mortality rate is 2-2.5%. Laparoscopic surgery and, less commonly, methotrexate are the treatments of choice for interstitial pregnancy. However, there is another treatment, ultrasound-guided direct injection of etoposide, the effect and safety of which are unclear. CASE REPORT: In a 32-year-old woman with interstitial pregnancy at 12 weeks of gestation, ultrasound-guided direct injection of etoposide (100 mg) was used successfully after intravenous high-dose methotrexate, 300 mg (200 mg/m2), therapy failed to produce a response. The patient's posttherapeutic course was smooth. Twelve months after treatment, she conceived and later delivered a healthy infant vaginally without adverse events. CONCLUSION: Ultrasound-guided direct injection of etoposide offers another choice for treating advanced interstitial pregnancy, but further study is needed to define its efficacy and safety.

Abortifacient Agents, Nonsteroidal↗
PubMed2002

Uterus didelphys with cervical agenesis associated with adenomyosis, a leiomyoma and ovarian endometriosis. A case report.

BACKGROUND: Elevated level of serum CA-125 was detected in a 48-year-old woman who was diagnosed with a lateral fusion defect in association with congenital agenesis of the uterine cervix. This unusual case combined two developmental anomalies of the müllerian duct. CASE REPORT: A 48-year-old woman consulted our outpatient department due to persistent abdominal pain for six months. Bimanual pelvic examination showed absence of the cervix, an anteverted uterus and a 6-cm, left adnexal mass. Ultrasound and computed tomography revealed a uterus didelphys with a 3-cm cystic mass over the right ovary. Serum level of CA-125 was 641.4 U/mL. The patient underwent exploratory laparotomy, and total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology confirmed adenomyosis and a leiomyoma of the uterus with functional endometrium in conjunction with endometriosis of the right ovary. CONCLUSION: Multiple müllerian anomalies associated with adenomyosis and endometriosis should be considered in patients presenting with primary amenorrhea. Thorough evaluation, careful planning, fertility preservation and postoperative outcomes should be reviewed.

Abdominal Pain↗
PubMed2002

Fetal meconium peritonitis in the infant of a woman with fulminant hepatitis B. A case report.

BACKGROUND: Simultaneous fulminant maternal hepatitis B infection and fetal meconium peritonitis has never been reported before in the English-language literature. CASE REPORT: Fetal meconium peritonitis was detected at 32 weeks' gestation in a 21-year-old woman suffering from fulminant hepatitis. Fulminant hepatitis B was confirmed by clinical observation and serologic examination results. The course was also complicated with preterm labor. The fetus was diagnosed with meconium peritonitis prenatally. Because of failed tocolytic treatment, the fetus was delivered vaginally. Both the mother and fetus received intensive care, and the mother recovered. In contrast, the fetus's course worsened due to progressive abdominal distension. Although exploratory laparotomy was attempted, the operation was not successful. The infant died five days after birth. CONCLUSION: Recognition of the predisposing factors in fetal meconium peritonitis and immediate referral to a tertiary medical center, where specialists are available, could help physicians determine an accurate diagnosis and might improve prognosis.

Adult↗
PubMedDate not supplied

Initial experience using magnetic resonance imaging in prenatal diagnosis of osteogenesis imperfecta type II: a case report.

We report a fetus with osteogenesis imperfecta (OI) first diagnosed by ultrasound in routine prenatal examination and further evaluated by magnetic resonance imaging (MRI). Fetal MRI was undertaken with a 1.5-T magnet using a body-phased array coil and an ultrafast imaging technique, half-Fourier single-shot turbo spin-echo (HASTE). Radiological examination shortly after birth and postmortem examination confirmed the prenatal diagnosis. In this case, fetal MRI provided excellent spatial and tissue resolution with multiplanar display. It revealed additional diagnostic information and improved imaging conspicuity. MRI complemented sonography for further differentiating clinical and sonographic findings.

Adult↗