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Biomedical subjects

T J Yu

Publications and source records attributed to T J Yu.

At least 37 records · Page 2Linked to original sources
PubMed1995

Early repair of traumatic ventricular septal defect and mitral valve regurgitation.

Traumatic ventricular septal defect with valvular injury is an uncommon blunt trauma. It may develop either immediately or be delayed, but it should be corrected electively. With hemodynamic instability and cardiopulmonary deterioration, however, early repair is necessary as a lifesaving procedure. Two-dimensional echocardiography and Doppler color flow mapping are very important for rapid detection in patients who are critically injured. This is a case report of the successful repair of ventricular septal defect and posterior leaflet disruption of mitral valve right after blunt trauma.

Adult↗
PubMed1995

Use of laparoscopy in intersex patients.

PURPOSE: Management of impalpable gonads in intersex patients remains a challenging problem. Since laparoscopic gonadectomy or gonadal preservation has been used in the management of impalpable gonads in the normal male population, laparoscopy can be an alternative method in the treatment of intersex patients. MATERIALS AND METHODS: Laparoscopic operations were performed on 6 patients with intersex conditions, including the testicular feminization syndrome in 2, 17 beta-hydroxysteroid dehydrogenase deficiency in 1, 5 alpha-reductase deficiency in 1 and mixed gonadal dysgenesis in 2. RESULTS: Laparoscopic gonadal biopsy, gonadectomy and hysterosalpingectomy were done in select patients. CONCLUSIONS: Although the initial diagnoses were made by phenotypic presentation, and biochemical and cytogenetic studies, laparoscopy had an important role in defining the internal ductal and gonadal structures to confirm the diagnosis, and served as an efficient method for gonadectomy and removing structures contrary to the assigned gender.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1994

Radiolucent ureterocele calculus. Case report.

In a 30-year-old man a radiolucent stone in an orthoptic, nonobstructing ureterocele was detected by ultrasonography of the bladder. The stone was impacted in the ureteral orifice. Endoscopic ureteral meatotomy was performed in preference to endoscopic incision of the ureterocele, and the stone was disintegrated at ureterorenoscopy via the enlarged orifice.

Adult↗
PubMed1994

[Use of pediatric laparoscopy for nonpalpable testis].

Children with nonpalpable testes create a clinical dilemma because it is difficult to determine the location or absence of the testis by clinical examination. Twenty-two children with unilateral nonpalpable tests underwent successful laparoscopic management under general anesthesia. In 11 (50%) of the patients, the vas deferens and the spermatic vessels exited the internal inguinal ring via the normal anatomy. Either hypoplastic testes or inguinal vanishing testes were found during inguinal exploration in 8 children with normal anatomy but smaller spermatic vessels exiting the internal inguinal ring. Four patients (18%) with blind end of vas and vessels terminating proximal to the internal inguinal ring were considered to be cases of intra-abdominal vanishing testis and no further surgery was necessary. Laparoscopy revealed 7 intra-abdominal testes (32%) which were managed by laparoscopic orchiectomy, simple orchiopexy, trans-abdominal orchiopexy or laparoscopic staged orchiopexy depending on the patient's age and the gonadal intra-abdominal location.

Adolescent↗
PubMed1994

Urethral prolapse--a case report.

Urethral prolapse is an uncommon anomaly that involves primarily the distal female urethra. It occurs most commonly in black girls and in post-menopausal white patients. We report a case of urethral prolapse in an 8-year-old girl. She was treated by total excision of prolapsed mucosa. Postoperative course was smooth. No urinary incontinence or recurrence was found.

Child↗
PubMed1994

Synchronous carotid endarterectomy and myocardial revascularization.

BACKGROUND: The management of the coexisting extracranial carotid and coronary disease is still controversial. We reviewed our experience in synchronous operation for both diseases in Veterans General Hospital-Taipei. METHODS: From Jan. 1988 to Nov. 1992, the synchronous carotid endarterectomy and myocardial revascularization were performed in nine patients with the mean age of 66.6 +/- 11 years. Five had symptomatic extracranial vascular disease or stabilized neurological deficits, and four had asymptomatic carotid bruits. Four had bilateral hemodynamically significant carotid stenosis. NYHA functional class III-IV was noted in three patients. Triple-vessel coronary disease was documented in 6 patients including one with left main lesion more than 50%. Eight had previous or recent myocardial infarction and four had moderate to severe left ventricular dysfunction noted on left ventriculography. RESULTS: All nine patients received unilateral carotid endarterectomy and a mean number of 2.8 distal anastomosis. Operative number of 2.8 distal anastomosis. Operative mortality within 30 days was zero and morbidity was noted in two patients. One patient was CVA and the other one was perioperative myocardial infarction. Late mortality occurred in previous two patients with morbidity. Late morbidity was mainly due to cardiac rather than neurological problems. CONCLUSIONS: If long-term natural history of coronary or carotid artery disease could be actually altered by surgery, a systemic evaluation for possible multifocal atherosclerosis is mandatory. By following a proposed guideline, synchronous operation is appropriate for a subgroup of patients with coexisting carotid and coronary artery disease.

Aged↗
PubMed1993

Bicomponent vascular grafts consisting of synthetic absorbable fibers. I. In vitro study.

The objective of this study is to determine the effects of the location and concentration of synthetic absorbable yarn components in bicomponent vascular graft fabrics on their structure and properties in a controlled in vitro hydrolytic environment. Bicomponent vascular fabrics were made from Dacron and polyglycolic acid (PGA) yarns with a range of composition ratios of PGA to Dacron and a range of locations of PGA. Both woven and single jersey knit fabrics were made. These fabrics were characterized by standard textile methods and subject to in vitro hydrolytic degradation study. In vitro hydrolytic degradation study showed that the most dramatic changes in the bicomponent fabric characteristics and properties occurred 30 and 60 days of hydrolysis. This schedule coincided with the hydrolytic degradation rate of PGA absorbable sutures. In the woven (W) group, the incorporation of absorbable yarns in the weft direction (W3) of the bicomponent fabrics resulted in the velour-like, loose, and porous surface morphology of the fabric for potential subsequent tissue ingrowth, while those woven fabrics with absorbable yarns in the warp direction (W1) did not have this unique velour-like surface. In the knitted (K) group, the concentration of absorbable yarns appeared to be closely related to the observed changes in fabric properties and structure. The incorporation of absorbable yarns into knitted fabrics did not result in the same level change in fabric structure and property as woven fabrics. In both W and K groups, a minimal level of mechanical strength of the fabrics was maintained due to the remaining Dacron yarns. Structural integrity of these fabrics was retained at the end of hydrolytic degradation study. The data obtained could be used to correlate with the subsequent in vivo performance of these bicomponent vascular grafts. If correlations exist, they could be used to improve the design of future bicomponent vascular grafts for improved performance.

Absorption↗
PubMed1993

Intrapelvic Wilms tumor: report of 2 cases and review of the literature.

Wilms tumor arising from the renal parenchyma usually presents initially as an abdominal mass. A review of the literature revealed fewer than 10 cases manifesting as a renal pelvic mass occupying primarily the collecting system. We have treated 2 patients with this unusual presentation: 1) a 4-month-old male infant whose initial radiological investigation demonstrated a left renal neoplasm measuring 10 x 7 x 5 cm.; bisection of the kidney showed a tumor completely filling the collecting system to the proximal ureter with extreme attenuation of the renal parenchyma, and 2) a 9-year-old boy who was hospitalized due to hematuria; ultrasonography, computerized tomography and magnetic resonance imaging showed a mass in the right renal pelvis; gross pathology displayed a 7 x 6 x 5 cm. polypoid mass occupying the renal pelvis without parenchymal involvement. Microscopically, both lesions were typical Wilms tumors. We discuss the characteristic clinical manifestations, diagnosis and treatment, and review the literature.

Child↗
PubMed1993

Acute urinary retention in two patients with imperforate hymen.

Acute urinary retention in two adolescent girls with hematometrocolpos caused by imperforate hymen are reported. The accumulation of the menstrual blood in the vagina and uterus may form a mechanical effect on the urethra and bladder and lead to the obstructive urinary symptoms. Hymenotomy created individually by CO2 laser and cruciate incision was performed. The two patients were discharged on the same day after operation and made an uneventful recovery.

Acute Disease↗
PubMed1993

Single unilateral vaginal ectopic ureter.

Three cases of girls, aged three, four and five years, with a single unilateral ectopic ureter draining into the vagina are discussed. All of the children had urinary incontinence. Vaginoscopy demonstrated different findings of the ectopic ureteral orifice within the vaginal mucosal fold in each child. Of the three patients, two underwent nephroureterectomy and one underwent ureteral reimplantation. Complete cure of urinary incontinence was obtained in all three children after surgery.

Child, Preschool↗
PubMed1992

Idiopathic portal hypertension: a case report.

Clinically, idiopathic portal hypertension (IPH) is characterized by overt splenomegaly with pancytopenia, portal hypertension and relatively mild abnormalities in liver function tests. Although its etiology is still undetermined, the liver pathology is characterized by occlusive changes of the intrahepatic portal radicles, portal and periportal fibrosis, irregularly distributed parenchyma atrophies and absent of regeneration nodules. The disease is relatively benign and does not progress to cirrhosis. Differential diagnosis between IPH and liver cirrhosis is mandatory. We now report a case with histologically proven IPH, including clinical course, laboratory data, roentgenographic findings of hepatic venogram and celiac angiogram, hepatic hemodynamic features and intravariceal pressure of esophageal varix which has never been reported in Taiwan.

Adult↗
PubMed1992

A new autoperfusion technique for aortic reconstruction of suprarenal aortic aneurysm.

Visceral ischemia is a serious factor in the postoperative morbidity and mortality of suprarenal aortic reconstruction. We reported two patients of suprarenal aortic aneurysm involving visceral arteries, who received successful Dacron graft replacement by using Pruitt-Inahara balloon catheters as an autoperfusion for preservation of the visceral organs. No visceral organ ischemia occurred postoperatively except in patient 2 who had preoperative chronic renal failure and persistent renal failure after the operation. The renal function recovered gradually during the follow-up period. Both patients are doing well at the present time. The new autoperfusion technique can directly deliver normothermic blood from the arterial cannula at proximal aorta to the individual visceral arteries by using the balloon perfusion catheters. It is simple, safe, easily instituted and the used products are readily obtainable. It allows the surgeon to provide an effective protection of visceral organs for the suprarenal aortic reconstruction.

Aged↗
PubMed1992

Methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) for advanced TCC of urothelium.

After the introduction of methotrexate, vinblastine, adriamycin and cisplatin combination (M-VAC) chemotherapy for transitional cell carcinoma (TCC) of the urothelium, the reported response and survival rates improved when compared with the previous regimens. From July 1989 to March 1991, 43 consecutive cases of invasive or metastatic TCC that had received at least one course of M-VAC treatment were collected by a computer-assisted search and analyzed. The overall response rate, including complete response (CR) and partial response (PR), was 44% (CR, 16%; PR, 28%). Tumors originating from the renal pelvis or bladder responded better than those from the ureter (kidney, 57%; bladder, 42%; and ureter 30%). Lymph node, soft tissue, lung metastases and local recurrent tumors had a greater chance of response than bone or liver metastases. Although patients from the blackfoot disease endemic area seemed to respond better than those from the nonendemic area, there was no statistically significant survival benefit. The duration of follow-up ranged from nine to 38 months. The length of survival of nonresponders ranged from one month to 19 months (median, eight months; mean, seven months). Ten of the 19 responders relapsed, and the others were still responding. Three patients (7%) survived two years, disease-free. Although the response rate improved, the chance of long-term survival was still unsatisfactory in our study.

Adult↗
PubMed1991

Initial results of laser angioplasty under angioscopic guidance for salvage of an ischemic lower limb: preliminary report.

From March to July 1989, nine patients at risk for peripheral artery disease underwent intraoperative Nd:YAG laser angioplasty using angioscopy at the Veterans General Hospital (Taipei, Taiwan, Republic of China). Following the laser angioplasty, balloon dilatation was performed in all cases. Eight men and one woman at an average age of 68 were included in the study (range: 58 to 78 years old). Ischemic symptoms included five patients with disabling claudication, four with pain at rest and one with gangrene on the toes. Eight of the nine patients had complete occlusions ranging from 2 to 19 cm in length. Two patients had high degree multiple segmental stenosis of the superficial femoral artery from 1 to 2 cm in length. Initial clinical success (indicated by relief of symptoms and increase in Doppler ankle pressure and index) and improvement in the angiographic luminal diameter was noted in 9 of 10 occluded vessels (90%) that underwent Nd:YAG laser treatment which was delivered at 10 to 12 watts through laser probes. Prelaser intraluminal diameter increased from 0.05 +/- 0.07 to 0.53 +/- 0.07 mm, Doppler ankle pressure index rose from 0.51 +/- 0.12 to 0.81 +/- 0.12, Doppler ankle pressure increased from 62.44 +/- 16.10 to 104 +/- 21.21 mmHg and the amplitude of pulse volume recorder at ankle level rose from 5.77 +/- 2.80 to 12.11 +/- 2.77 mm as compared with prelaser therapy (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Unusual presentations of angiomyolipoma].

Angiomyolipoma is an uncommon benign tumor of the kidney. The tumor is composed of fat, smooth muscle, and blood vessels. The same pathological entity can appear in two clinically different forms, with or without tuberous sclerosis. We present two cases of renal angiomyolipomas with unusual manifestations. One was associated with tuberous sclerosis and both had the presentation of acute abdomen. Case one presented with epilepsy, angiofibroma, subungual fibroma, periventricular calcification, and bilateral renal angiomyolipomas. Tuberous sclerosis is characterized by these findings. Both cases had spontaneous hemorrhage with hypovolemic shock. Massive hemorrhage resulting in shock is uncommon and the incidence has been estimated to be about 10 per cent. In fact, many angiomyolipomas are clinically occult. The size of the tumor correlates well with the presence or absence of symptoms which include microhematuria, flank pain, hypertension and urinary tract infection. Abdominal CT is the preferred modality for diagnosis of angiomyolipoma. The most important finding is the presence of an intrarenal tumor with fat component which is recognized as a relative low density on CT. Our patients were hospitalized under the impression of angiomyolipoma after the CT study. In addition, the CT defined either the size of the tumor or the extension of the hemorrhage. Although many believe that renal angiography is not sufficient by itself to establish the diagnosis of angiomyolipoma, occasionally it is mandatory in the management of the tumor. The management is decided by two factors, the size of tumor and the clinical presentation. The attitude of management should include conservative treatment with regular follow-up, selective arterial embolization, enucleation, and partial or total nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Experimental implantation of human umbilical vein grafts in dogs.

Locally produced human umbilical vein grafts (HUVG), using glutaraldehyde as a stabilizing agent, were implanted into 24 mongrel dogs. Different arterial bypass procedures, using HUVG, were carried out in three experimental groups. In Group I, 2 dogs underwent femorofemoral crossover bypass procedures and 6 dogs received aortoiliac bypass procedures. Thrombus formation was found in all HUVG implants of Group I. In Group II, 8 dogs received abdominal aorta HUVG interposition. In Group III, 8 dogs received abdominal aorta HUVG bypass procedures. Patent HUVG implants without thrombus formation, demonstrated by postoperative angiogram, were found in 6 dogs of Group II and 5 dogs of Group III. Morphological and histological studies of the patent HUVG implants retrieved after sacrifice showed on sign of rejection, biodegeneration, or aneurysmal formation. Our preliminary experience with this cost-effective locally produced human umbilical vein graft material was promising and may pave the way to further clinical applications.

Animals↗
PubMed1990

Radionuclide transit studies for esophageal function before and after esophageal transection and devascularization.

Nonobstructive swallowing disturbance is a common complication following esophageal transection and devascularization to control bleeding from esophageal varices. From July 1983 to July 1984, 12 patients underwent both a radionuclide esophageal transit study (RETS) and a barium swallowing fluoroscopic study (BSFS) before and after surgery to evaluate esophageal function. Before surgery, 9 of the 12 patients had no swallowing disturbance and the RETS was normal in 8 cases, and the BSFS was normal in all cases. Three patients who received sclerotherapy on more than 3 occasions suffered from swallowing disturbances and both the RETS and BSFS detected their defective passage. The average distal 1/3 segmental and total esophagus transit times were 11.5 +/- 9.9 seconds and 13.0 +/- 10.6 seconds among symptom-free patients; and 24.8 +/- 11.8 seconds and 30.1 +/- 14.6 seconds among swallowing-disturbance patients. The time prolongation was significant (p less than 0.005). After surgery, 5 of 9 preoperative symptom-free patients suffered from swallowing disturbances for 10 days and then became symptom free. Their serial follow-up RETS and BSFS at 1 month, 3 months and 6 months all showed normal results. One preoperative symptom-free patient suffered from a mild swallowing disturbance for 2 months. However, only RETS, but not BSFS, demonstrated the prolonged proximal segmental esophageal transit time at 1 month postoperatively. The remaining 6 patients suffered from prominent swallowing disturbances and their initial postoperative RETS demonstrated prolonged defective transit or the presence of gastroesophageal (GE) reflux. All these events were confirmed by both tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗