Biomedical subjects

Y H Chou

Publications and source records attributed to Y H Chou.

At least 163 records · Page 9Linked to original sources

PubMed1990

[Penile revascularization: report of 4 cases].

From February to June in 1989, 4 patients consulted our ward with the complaint of impotence. After each patient's history and physical examination were taken, a series of tests were administered which included hepatic and renal function, blood sugar, cholesterol, triglyceride, testosterone, prolactin level, nocturnal penile tumescence (NPT), duplex sonography, cavernosography, and internal pudendal arteriography. The results of these tests suggested vasculogenic impotence and penile revascularization was attempted. In 2 patients the Michal-II method was used. The second patient was treated with the Virag-V method. In the fourth patient, the Michal-II method was combined with the administration of the Virag-V method. After 6 months of follow-up, objective tests such as NPT and a Duplex scanning examination showed moderate improvement in the patients who received the Virag-V method, alone or in combination with the Michal-II method. Subjectively, all the patients except the one who received just the Virag-V method, felt improvement in erection angle, penetration, and satisfaction. We conclude that penile revascularization may be a more noninvasive, physiological alternative to penile prosthesis for some cases of vasculogenic impotence.

Adult↗

PubMed1990

Surgical treatment of the ruptured bladder: 22 years reviewed.

During the 22-year interval from 1964 to 1985, 36 patients with bladder injuries were treated at the Kaohsiung Medical College Hospital. Thirty-two cases were male (89%) and 4 cases were female (11%), the sex ratio of patients was 8 to 1, respectively. The average patient age was 33 years and 75% were less than 40 years of age. Hematuria was present in all of the patients and it was microscopic in 25%. Traffic accidents accounted for 55% of the injuries; penetrating trauma was responsible in only 6% of the patients. Of the 36 bladder trauma cases, 11 (30.5%) had intraperitoneal injury, 24 (66.7%) had extraperitoneal injury and 1 (2.8%) had intraperitoneal and extraperitoneal injury. Of the 28 cases with pelvic fracture and bladder trauma in this study, 18 (60%) had extraperitoneal rupture, and 9 (30%) had intraperitoneal rupture. The position of intraperitoneal rupture was mostly at the posterior wall and dome, whereas that of the extraperitoneal rupture was partly located at the anterior wall and the bladder neck. Bladder rupture was treated by operative repair of the defect, bladder drainage by suprapubic cystostomy and/or urethral catheter and drainage of the perivesical space. The mortality rate with the ruptured bladder was 17%. Multiple injuries associated with the ruptured bladder and postoperative complications especially septic shock, were the main causes of mortality.

Adolescent↗

PubMed1990

Giant hydronephrosis: report of 4 cases with review of the literature.

Giant hydronephrosis is uncommon. In 1939, Stirling defined it as the presence of more than 1,000 ml of fluid in the collecting system [1]. We herein report 4 cases of giant hydronephrosis containing 1,900 ml, 3,400 ml, 2,100 ml and 3,200 ml, respectively. Only 6 cases with a malignant tumor have been reported in the literature. Our second case with multiple foci of transitional cell carcinoma with squamous metaplasia is presented. This is the first report of this kind of pathological morphology with giant hydronephrosis. An erroneous diagnosis is often made in cases of giant hydronephrosis. For example, 3 of our 4 patients were first diagnosed as ovarian cyst, retroperitoneal hamartoma and hepatic cyst, respectively. We have found 523 cases reported in the literature. It is seen more often in males than in females (2.4:1) and more often on the left side than on the right side (1.8:1). The amount of fluid in the hydronephrotic sac is often between 1 and 2 liters. It is usually secondary to ureteropelvic junction obstruction, stones or congenital abnormality. Nephrectomy is often performed due to severe impairment of renal function. Acute renal failure and cardiopulmonary distress developed in our second case after the operation. The reason may be the sudden decompression of the huge hydronephrotic sac, which resulted in a change in the hemodynamic balance. Therefore, a two-stage procedure with slow decompression by percutaneous nephrostomy before the nephrectomy is preferred in the compromised patient.

Adolescent↗

PubMed1990

Conservative treatment for prostatorectal or urethrorectal perforation during transurethral surgical procedures.

From 7 March 1989 to 16 December 1989, we experienced 2 prostatorectal and 2 urethrorectal perforations during transurethral surgical procedures at the National Taiwan University Hospital (3 cases) and Tz'u-Chi General Hospital (1 case). All 4 patients were men. Their ages ranged from 57 to 76 years with a mean of 66 years. All 4 complications were identified immediately. Neither a transrectal/suprapubic immediate (or staged) direct suturing, nor a colostomy/cystostomy was needed in our series. Instead, we introduced a rectal tube coated with gauze soaked in Betadine and vaseline, which fit tightly into the rectum for an average of 4 days (range from 3 to 5 days). A 22-Fr three-way indwelling Foley catheter with continuous normal saline irrigation was also applied for 7 to 14 days (9.5 days on average). Nothing by mouth started immediately after the operation (range from 3 to 7 days; 5.3 days on average). All 4 patients were discharged in good condition with a mean postoperative stay of 14 days (range from 11 to 18 days). No prostatorectal or urethrorectal fistula were found during an average follow-up period of 13.5 months (range from 10 to 17 months).

Aged↗

PubMed1990

[Treatment of Wilms' tumor in children].

During the last 13 years, the Kaohsiung Medical College Hospital has treated a total of nine patients with nephroblastoma (Wilms' tumor). Among them, six were male and three were female. The age of the patients ranged from 7 months to 11 years old with an average of 3.25 years. 88.9 percent of the patients complained of abdominal mass. However, the initial symptom was gross hematuria in 33.3% of the patients. Seven out of the nine patients underwent simple nephrectomy while the remaining two were treated with the more conservative open biopsy. All patients died within three years of initial treatment except two, who never came back for follow-up treatment and whom we were unable to trace to determine whether they had survived. Nevertheless, the combination of surgery and postoperative chemotherapy helped to prolong the life of patients with Wilms' tumors.

Adolescent↗

PubMed1990

[Duplex Doppler ultrasound of internal jugular vein ectasia. Case report].

A seven-year-old boy, who complained of painless swelling mass over the right neck on exertion, was diagnosed as right internal jugular vein ectasis by the duplex Doppler ultrasound. The caliber of the right internal jugular vein was prominently dilated when Valsalva maneuver was done, the duplex Doppler ultrasound showed an essentially flat wave from that indicated the swelling mass to be a venous structure. The clinical manifestation, etiology, pathological findings and diagnostic methods of the internal jugular vein ectasia were reviewed with emphasis on the advantages of duplex Doppler ultrasound in confirming the diagnosis.

Child↗

PubMed1990

Ultrasonographic demonstration of duplication cyst of the ileum.

The enteric duplication cyst is a term applied to an anomaly of the gut which presents as a cystic structure with a mucosal lining predominantly similar to that of the adjacent alimentary tract. It may be either due to an embryologic error in normal canalization or errors in the embryologic connection between the developing gut and neural tube, as a part of the split notochord syndrome. The preoperative diagnosis of a duplication cyst is difficult to make on the basis of conventional radiologic study including barium swallowing gastrointestinal series. With the wide application of ultrasound in the detection and evaluation of pediatric abdominal masses, an intra-abdominal cystic lesion may be encountered and the differential diagnoses may be difficult or impossible. We hereby report a case of duplication cyst of the ileum in which we believe its sonographic appearance is of certain value or even diagnostic in this pathology.

Child↗

PubMed1990

[Simple testicular cyst].

High-resolution sonograms of scrotum in two hundred and ninety six patients were reviewed. Twenty six patients were found to have simple testicular cyst(s). The specific features of cyst, which included sharp clear margin, anechoic content, posterior wall enhancement and no adjacent echogenic mass, could be found in all lesions. Four cases had bilateral testicular involvement. Solitary cystic lesion was found in 14 tests. The size ranged from 2.0 mm to 1.2 cm. Clustered cystic lesions were found in six testes. The size ranged from 4.0 mm to 2.5 cm. More than one focal lesion were found in 10 testes. Twenty four of these thirty testes had tunica albuginea cyst(s) or cyst(s) abutting on testicular margins. Four patients had follow-up sonograms with the period ranging from three months to two years. No remarkable change of all lesions were noted. The sonographic pictures and its patterns were presented. The pathogenesis and the literature were briefly reviewed.

Adolescent↗

PubMed1990

Urachal anomalies: acquired patent urachus and giant urachal cyst--2 cases report.

Two cases of rare urachal anomalies in the adult are described, including one acquired patent urachus and one giant urachal cyst. The presenting symptoms and signs included pyuria, fever, lower abdominal pain and palpable abdominal mass. The correct preoperative diagnosis was made after sonography. The clinical and radiographic features and magnetic resonance imaging are presented. Stone formation and the huge capacity of the urachal cyst are first reported. Excision of the urachal tract with resection of the bladder dome and cauterization of the cystic wall with stone removal were performed in that order. When a young adult presenting with a wet umbilicus, acute abdominal pain or a lower midline abdominal mass, the possibility of an infected urachal anomaly should be considered in the differential diagnosis.

Adolescent↗

PubMed1990

[Primary tumor of the female urethra--a report of two cases].

From 1972 through 1986, 173 female patients with urinary tract tumors were treated at Kaohsiung Medical College Hospital. Only 2 (1.2%) had primary transitional cell carcinoma of the anterior urethra. These patients were treated with local excision of the tumor, one patient remained alive for more than three years while the other one was lost during the post-operative follow-up. Primary female urethral tumors are mostly malignant tumors. Prompt diagnosis and aggressive treatment is the only way to prolong the patients' survival time.

Aged↗

PubMed1989

Ischemic colitis as a cause of massive lower gastrointestinal bleeding and peritonitis. Report of five cases.

Vascular disorders of the colorectum are considered rare in Taiwan, however, recently the authors encountered five cases of ischemic colitis, all in men over 50 years of age. Cases one and five involved stricture, case two was secondary to obstructive colon cancer, and case three was of the gangrenous type presenting with peritonitis due to colonic perforation. Case four was of the transient type with acute massive lower gastrointestinal bleeding secondary to traumatic shock. All five patients were treated successfully by resection.

Aged↗

PubMed1989

Phosphorylation and disassembly of intermediate filaments in mitotic cells.

As baby hamster kidney (BHK-21) cells enter mitosis, networks of intermediate filaments (IFs) are transformed into cytoplasmic aggregates of protofilaments. Coincident with this morphological change, the phosphate content of vimentin increases from 0.3 mol of Pi per mol of protein in interphase to 1.9 mol of Pi per mol of protein in mitosis. A similar increase in phosphate content is observed with desmin, from 0.5 mol of Pi per mol of protein to 1.5 mol of Pi per mol of protein. Fractionation of mitotic cell lysates by hydroxylapatite column chromatography reveals the presence of two IF protein kinase activities, designated as IF protein kinase I and IF protein kinase II. Comparison of two-dimensional 32P-labeled phosphopeptide maps of vimentin and desmin phosphorylated in vivo in mitosis, and in vitro using partially purified kinase fractions, reveals extensive similarity in the two sets of phosphorylation sites. Phosphorylation of in vitro polymerized IFs by IF protein kinase II induces complete disassembly as determined by negative-stain electron microscopy. The results support the idea that the disassembly of IFs in mitosis is regulated by the phosphorylation of its subunit proteins.

Animals↗

PubMed1989

[Surgical treatment of ureteropelvic junction stricture].

Forty-five patients with hydronephrosis due to pelviureteric junction stricture were operated on at Kaohsiung Medical College Hospital between 1971 and 1986. In unilateral cases, the left kidney was affected more frequently than the right (24 to 13), while 8 (18%) had bilateral ureteropelvic stricture. Of the 45 cases, 24 cases (53%) underwent Anderson-Hynes pyeloplasty, 5 cases underwent Y-V plasty, 5 cases underwent ureterolysis and 11 cases underwent simple nephrectomy due to severe hydronephrosis. Except for the 11 nephrectomy cases, 11 of the remaining 34 cases had ureteral catheter placement and 9 cases had double-J ureteral catheter placement, postoperatively; another 14 cases received no ureteral stent for draining urine. The results were very encouraging with clinical improvement in 64% of the patients, and improvement in the pelviocaliceal system and early appearance of contrast medium in the ureter in 47% of the patients. The results of pyeloplasty with and without a nephrostomy or ureteral stent were compared. Patients with a nephrostomy or ureteral stent tended to have an increased incidence of urinary tract infections and longer hospital stays. In general, the results of treatment were poorer for patients with a nephrostomy or ureteral stent, than for patients without.

Adolescent↗

PubMed1989

A clinical evaluation of ultrasonography in the diagnosis of acute appendicitis.

Recently ultrasonography (US) has proven effective in the diagnosis of acute appendicitis. However, the impact of US on surgical decision-making in clinical practice remains unclear. From August 1986 to July 1987, 62 patients with clinical signs of acute appendicitis received US examinations after initial clinical evaluations. According to clinical pictures, they were classified into two groups: group I, clinically typical (Alvarado's score greater than or equal to 7) and group II, clinically dubious (Alvarado's score less than or equal to 6) cases. All group I patients (n = 34) had surgery. Group II patients (n = 28) received close in-hospital observation on an every 4-hour basis for less than 24 hours. However, surgery was performed if Alvarado's score increased up to or above 7 or surgical indications became evident during observation. The pathologic reports and operative findings were retrospectively correlated with the US diagnosis. For group I patients, clinical examination without knowledge of US findings was correct in 30 (88.9%) cases, 26 (86.7%) of which were detected by US. Four (50%) of eight patients with negative US findings had acute appendicitis. In group II, 12 of 15 patients who had surgery had acute appendicitis, and 10 (83.3%) were detected by US. Two (11%) of 18 patients with negative US findings were finally proved to have acute appendicitis. The average duration from initial clinical examination to surgical decision fpr patients with acute appendicitis was 6.8 hours. There were no false-positives in either group. For patients with typical clinical presentation, US is not superior to clinical examination, and surgery is recommended even if US findings are negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1989

[Evaluation of impotence: intracorporeal injection of papaverine by color duplex sonography].

From February 1989 to June 1989, 49 patients consulted our OPD for the complaint of impotence. The average age was 46.9 +/- 11.2 y/0. We applied intracorporeal injection of papaverine (60 mg) by color duplex sonography (Acuson 128) for evaluation. The results of the papaverine test were: good response in 6 (12%), imperfect response in 21 (43%) and impaired response in 22 (45%). So the total positive response rate was 55%; and the total negative response rate was 45%; two patients (4%) experienced priapism. Spontaneous detumescence occurred after aspiration of the corpus cavernosum and no complications ensued. We utilized duplex sonography for evaluating penile blood flow before and after papaverine injection. Diameters of the deep artery was: right artery increased from 0.42 +/- 0.13 mm to 0.76 +/- 0.26 mm, while the left artery increased from 0.43 +/- 0.19 mm to 0.64 +/- 0.31 mm. Following injection, the peak velocity and the increased change of peak velocity were higher in patients in the positive response group than in the negative response group. There was no correlation for the percent of increase in diameter of the deep arteries. This technique provides a safe method with few complications for the objective assessment of response to intracorporeal papaverine injection and the anatomic structure of the penis. Use of this technique can also avoid unnecessary examinations and influence the strategy of treatment. After normal values and parameters are established, this method should be a useful diagnostic tool.

Adult↗

PubMed1989

[Epidermoid carcinoma of the kidney].

Epidermoid carcinoma of the kidney is a rare malignant tumor, characterized by high invasiveness, poor prognosis, and the association of renal stone and renal infection. Very little reports about its sonographic appearance were mentioned in the literature. We present a case of epidermoid carcinoma of the kidney. Its ultrasonography showed a heterogeneous renal mass with perirenal and pararenal invasion, destruction of the renal pelvis, and preservation of enlarged reniform outline. Although this tumor should be differentiated with renal cell carcinoma, transitional cell carcinoma, renal metastatic tumor, renal lymphoma, renal infarction, focal bacterial nephritis, and xanthogranulomatous pyelonephritis etc., we think we should put epidermoid carcinoma of kidney into consideration when a renal tumor mass presents with perirenal and pararenal invasion, destruction of the renal pelvis, and preservation of enlarged reniform outline in sonography, and hypovascularity in angiographic study.

Adult↗

PubMed1989

[Urethral injuries: analysis of 24 cases].

Cases analysis of 24 operations for the anterior urethral injuries is presented. 7 patients were treated one-stage transperineal end-to-end anastomosis and 17 underwent an immediate urethral realignment over a fenestrated catheter. Hospital stays were generally short and the rate of complication was low as well as the number of blood transfusions needed in both groups. The operating time however was longer in patients in the anastomosis group. Postoperatively, urethral strictures occurred in 71% of the patients who underwent one-stage transperineal end-to-end anastomosis and in 65% of those treated by realignment over a fenestrated catheter. The high incidence of postoperative stricture formation caused both techniques indicated neither procedure as a valuable modality for the primary and early treatment of anterior urethral injuries. According to the authors the suprapubic cystostomy and delayed urethroplasty offer a better choice of therapy.

Adolescent↗

PubMed1989

[Clinical experience of treatment of urethral stricture].

The records of 53 patients treated for urethral stricture at Kaohsiung Medical College Hospital over a 8-year period were reviewed. Young men those affected and trauma appeared to have been the most frequent etiological cause. Of the 53 patients 12 were treated by filiform dilatation , 33 were treated by metal sound dilatation , and 8 underwent a pull-through technique. Good results were noted in 29 cases (54.7%), fair in 10 (18.9%) and poor results in 14 (26.4%). When the results were analyzed according to the method of treatment, poor results were most common among those who had underwent the pull-through technique and the metal sound dilatation as compared to filiform dilation group.

Adolescent↗