[Surgery of hyperthyroidism prepared with telepaque (author's transl)].
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Adolescent↗
Biomedical subjects
F F Chou
Publications and source records attributed to F F Chou.
[Removal of retained biliary stone by choledochofiberscope (author's transl)].
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Cholelithiasis↗
Computed tomography of an exophytic gastric hemangioma with torsion and intratumoral hemorrhage.
A case of exophytic gastric hemangioma with intratumoral bleeding due to torsion of the tumor pedicle is reported. A radiograph showed a mass without phleboliths. Computed tomography (CT) demonstrated a 14-cm mass with high densities due to hemorrhage, which was contiguous to the stomach and extended to the pelvis. The tumor showed no remarkable enhancement on post-enhanced CT due to torsion of the tumor pedicle.
Aged↗
The management of complicated hepatolithiasis with intrahepatic biliary stricture by the combination of T-tube tract dilation and endoscopic electrohydraulic lithotripsy.
Hepatolithiasis with intrahepatic biliary strictures, more common in Southeast Asia than elsewhere, remains a difficult problem to manage. Retention of stones behind strictures after surgery is a frequent and troublesome complication. Post-operative duct dilation with percutaneous transhepatic cholangioscopy tube stenting through a matured T-tube tract was performed in 15 patients. Choledochoscopic electrohydraulic lithotripsy was applied in six patients when impacted or large stones were encountered. Complete clearance of stones was achieved in 12 patients (80%). Two patients had fevers develop after ductal dilation and recovered after conservative treatment. These 12 successfully treated patients remain well, with a mean follow-up of 18 months. Post-operative T-tube tract dilation, selectively combined with endoscopic electrohydraulic lithotripsy, is an effective and safe method for complicated hepatolithiasis with biliary strictures.
Adult↗
Serum level of angiogenin in breast cancer.
OBJECTIVE: Angiogenin (ANG), a potent inducer of neovascularization, is secreted by some types of human tumor cells and appears crucial for their growth. This study was designed with the aim to investigate any correlation between the serum angiogenin and the clinicopathological variables and furthermore evaluate the prognostic value of serum angiogenin in patients with breast cancer. MATERIAL AND METHODS: Sixty-four consecutive patients with invasive breast cancer undergoing surgery were prospectively included and evaluated. Venous blood samples were collected before surgery. Sera were obtained by centrifugation and stored at -70 degrees C until assayed. The control group consisted of 16 patients with benign breast tumor (8 with fibrocystic disease and 8 with fibroadenoma). Serum concentration of angiogenin was measured by the quantitative sandwich enzyme immunoassay technique. The data on primary tumor staging, age, estrogen receptor, lymph node status, distant metastases and TNM staging were reviewed and recorded. RESULTS: The mean value of serum angiogenin in patients with invasive breast cancer was 2123.95 +/- 324.34 pg/ml and that of control group were 2108.16 +/- 398.20 pg/ml (fibrocystic disease) and 2010.27 +/- 318.40 pg/ml (fibroadenoma). The difference was not significant (p = 0.66). Furthermore, with univariate analysis, there were no significant differences in serum angiogenin levels between the subgroups of the above-mentioned clinicopathological variables. CONCLUSION: Serum angiogenin levels did not appear as a meaningful prognostic parameter for invasive breast cancer.
Adult↗
Cystosarcoma phylloides of the breast: a review of clinical, pathological and therapeutic option in 18 cases.
The clinical and pathological findings and therapeutic options in 18 patients with cystosarcoma phylloides were retrospectively studied and analysed. Painless breast lump was the most common clinical penetration. An accurate pre-operative diagnosis was obtained in only six patients (33.3%). Intraoperative frozen section examination was performed in nine patients and the diagnosis was cystosarcoma phylloides in five patients, benign breast tumor in four patients with a 55.5% yield. The final pathological results revealed benign form cystosarcoma phylloides in 17 patients and malignant form in one patient. Seven patients, including the one with malignant form tumor, underwent wide excision with an adequate margin of normal breast tissue. One patient underwent subcutaneous mastectomy due to the huge size of tumor. The remaining 11 patients with presumed diagnosis of fibroadenoma or breast cancer underwent simple excision. There was no local recurrence or distant metastasis in any of the 18 patients, with a mean follow-up time of 31.5 months. On the basis of this data, wide excision with an adequate margin of normal breast tissue may be the preferred initial therapy for cystosarcoma phylloides. For those patients undergoing simple excision, the follow-up option may be acceptable if microscopic examination reveals no unrecognised amputation of tumor.
Adolescent↗
Hyperthyroidism and concurrent thyroid cancer.
A total of 14 patients had hyperthyroidism coexisting with thyroid malignancy. Twelve patients had papillary cancer, 1 follicular cancer and 1 anaplastic cancer. Patients with Graves' disease had a low rate of associated malignancy 1.5% (10/674) and toxic nodular goiter had an incidence of 3.1% (4/27). Subtotal thyroidectomy was performed in 11 patients, total thyroidectomy in 2 and biopsy only in 1. Two of the subtotal thyroidectomy groups had to be operated on again due to their size being over 1 cm. In the follow-up period, only one patient died of anaplastic cancer in the second month. One patient who had multiple foci of the papillary cancer had local recurrence and lymph node metastasis 27 months later, and needed another radical neck dissection. All the other 12 patients were doing well without cancer recurrence. In conclusion, hyperthyroidism may have a malignancy of 1.75% (14/801). Subtotal thyroidectomy is adequate for occult cancer. Those patients with multiple foci, cancer size over 1 cm and capsule invasion should have a second operation with total thyroidectomy.
Adult↗
Ultrasonic dissection in resection of hepatocellular carcinoma.
An ultrasonic dissector has been used in the resection of liver tumors and was found to be safe and efficient in noncirrhotic patients. Thirty-one (cirrhosis, 61%) liver resections for hepatoma treated with ultrasonic dissector were compared to 39 (cirrhosis, 74%) resections treated with finger fracture. We found that patients treated with an ultrasonic dissector versus those treated by finger fracture, had less blood loss (especially in cirrhotic liver), 836 +/- 593 cc vs 1348 +/- 1226 cc, more operative time, 337.6 +/- 100.5 min vs 197 +/- 92.8 min, more days of hospital stay 19.1 +/- 12.8 days vs 11.5 +/- 5.6 days and more days of removal of drains, 14.9 +/- 11.7 days vs 10.2 +/- 6.4 days. The morbidity, mortality, amount of blood transfusion and amount of drainage were quite similar between two groups.
Adult↗
Surgical treatment of cholangiocarcinoma.
BACKGROUND/AIMS: To report the results of surgical treatment of intrahepatic cholangiocarcinoma with different procedures and to find the factors that may affect the long-term survival. MATERIALS AND METHODS: From 1987 to 1994, 57 patients with intrahepatic cholangiocarcinoma underwent laparotomy. Among them, resection was performed in 27 patients, operative drainage in 14 patients and biopsy only in 14 patients. The liver resections included 9 right lobectomies, 14 left lobectomies and 4 hilar resections. All specimens were stained with carcinoembryonic antigen (CEA) and HLA-DR monoclonal antibodies. RESULTS: There were 7 postoperative mortalities, one in the resection group (1/27), two in the drainage group (2/14) and 4 in the biopsy group (4/14). Patients undergoing resection survived significantly longer (median, 8 months) (mean, 19 +/- 4 months) than patients undergoing drainage (median, 4 months) (mean, 6 +/- 2 months) and biopsy (median, 2 months) (mean, 3 +/- 1 months) (p < 0.01). After resection, univariate analysis showed that positive hiliar lymphnode was a poor prognostic sign and mucobilia was a good prognostic sign. Age, sex, size of tumors cell differentiation, clear margin, and positive HLA-DR and CEA had no effect on prognosis. CONCLUSION: The results support the surgical resection of intrahepatic cholangiocarcinoma. Tumor free margin should be aggressively achieved but may not be necessary. Mucobilia is a good prognostic sign and positive hilar lymphnode is a grave sign.
Adult↗
Serum levels of circulating intercellular adhesion molecule-1 in patients with breast cancer.
BACKGROUND: The outcome of breast cancer is usually determined by multiple factors. Circulating intercellular adhesion molecule-1 has been found to be increased in the circulation of patients with malignancy. This study was designed with the aim of evaluating the prognostic significance of circulating intercellular adhesion molecule-1 in breast cancer. METHODS AND MATERIAL: From December 1994 to May 1995, 50 patients with invasive breast carcinoma were included. Venous blood samples were collected before surgery and the serum levels of circulating intercellular adhesion molecule-1 were measured with an enzyme immunoassay method. The data of maximum tumor size, age, estrogen receptor status, lymph node status and TNM staging were collected and evaluated simultaneously with the serum levels of circulating intercellular adhesion molecule-1. Fifteen healthy subjects were used as control group. RESULTS: The mean value of circulating intercellular adhesion molecule-1 in patient group was 463 +/- 92 ng/ml and that of the control group was 346 +/- 68 ng/ml and the difference was significant (p < 0.01). In univariable analysis, patients with maximum tumor size of 5 cm or greater (p < 0.01), more advanced lymph node status (p < 0.01) and more advanced TNM staging (p < 0.01) were shown to have significantly higher serum levels of circulating intercellular adhesion molecule-1. However, in multivariable analysis, TNM staging was demonstrated to be the only independent factor (p < 0.01) related to significant, higher serum level of circulating intercellular adhesion molecule-1. CONCLUSION: Preoperative serum levels of circulating intercellular adhesion molecule-1 may reflect the severity of staging for invasive breast cancer and may be a promising, additive predictor which deserves further investigation.
Adult↗
Serum-soluble interleukin-2 receptor in patients with hepatolithiasis: a preliminary report.
BACKGROUND/AIMS: Hepatolithiasis is prevalent in Southeast Asia and remains a difficult problem to manage. Recent studies in immunology have provided evidence for the provocative roles of cytokines in many diseases. This study was designed to explore the possible relationship between the serum-soluble interleukin-2 receptor and the pathogenesis of hepatolithiasis. METHODOLOGY: In this pilot study, 34 patients with hepatolithiasis were included. All of the patients met the following criteria: (1) presence of hepatolithiasis; (2) no obvious clinical evidence of associated intrahepatic cholangiocarcinoma; (3) no clinical manifestation of cholangitis for at least 72 hours; (4) no intake of immunomodulatory agents in the previous 3 weeks; and (5) no blood transfusions in the previous 3 weeks. Venous blood samples were collected before surgery, and the concentrations of serum soluble interleukin-2 receptor were measured with an enzyme immunoassay method. Fifteen healthy subjects were used as the control group. Bile specimens routinely obtained during surgery were cultured for aerobes and anaerobes. The cholangiography films were reviewed in detail. RESULTS: The mean value of soluble interleukin-2 receptor in patients with hepatolithiasis was 706 +/- 294 units/ml, and that of the control group was 326 +/- 62 units/ml. The difference was significant (p < 0.01). Bacteria were present in the bile of all patients. The total number of bacterial species in the 34 patients was 119, and there was an average of 3.5 bacterial species cultured per patient. Intrahepatic bile duct strictures were present in 30 patients (88%). CONCLUSIONS: In addition to a high incidence of intrahepatic bile duct strictures and bacterial infection of the bile, significantly high levels of the serum soluble interleukin-2 receptor were also found in the patients with hepatolithiasis. The preliminary results in the present study seem to be promising, and the specific role of the soluble interleukin-2 receptor in patients with hepatolithiasis deserves further investigation and elucidation.
Adult↗