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Biomedical subjects

S F Ko

Publications and source records attributed to S F Ko.

At least 73 records · Page 4Linked to original sources

Salmonella meningitis: clinical experience of third-generation cephalosporins.

Fifteen paediatric patients with Salmonella meningitis were retrospectively reviewed. Presenting symptoms and signs included fever, vomiting, seizures, poor activity, diarrhoea and bulging anterior fontanelle in most patients. Seven out of eight patients with prolonged fever for > 10 days had neurologic sequelae; therefore, prolonged fever is a significant prognostic factor of a poor outcome (p < 0.005). All 15 patients had a brain ultrasound or computed tomography in the acute stage and 11 patients had abnormal findings. The 14 surviving patients were treated with a third-generation cephalosporin for at least 3 weeks. Seven patients (47%) made complete recoveries; two of them were treated solely with a third-generation cephalosporin. Only one mortality (6%) occurred and there were no relapses. In conclusion, high frequencies of prolonged fever, neuroimaging abnormalities and neurologic sequelae were seen in patients with Salmonella meningitis treated with third-generation cephalosporins.

Cephalosporins↗

Right aortic arch with mirror-image branching and coarctation of the aorta.

We report a case of right aortic arch with mirror-image branching and coarctation of the aorta and left ductus arteriosus in a 6-year-old boy. He was referred to Chang Gung Children's Hospital with suspected left ventricular failure. Physical examination revealed hypertension and a pulse discrepancy between the upper and lower extremities. Echocardiography and magnetic resonance imaging revealed a right aortic arch, a long segmental aortic coarctation, and a patent ductus arteriosus. In addition, mirror-image branching of the brachiocephalic vessels was found. The coarctation was resected and the ductus arteriosus was ligated. The postoperative recovery was uneventful and the blood pressure returned to normal. He remained normotensive and had no symptoms of heart failure within the 2 years of follow-up.

Aorta, Thoracic↗

Systemic sclerosis with pulmonary involvement and right ventricular failure in a child.

We report a very rare case of systemic sclerosis in a 6-year-old girl. She presented with diffuse scleroderma, Raynaud's phenomenon, pulmonary interstitial fibrosis, pulmonary hypertension, and right ventricular failure. The diagnosis was confirmed by skin manifestations, high resolution computed tomography, cardiac catheterization, and anti-nuclear antibodies. Nifedipine, prednisolone, digoxin, and furosemide were given. There was remission of the right ventricular failure and dyspnea, and the skin showed partial improvement. The patient remained asymptomatic for a year. The symptoms of respiratory and right heart failure developed again after an episode of lower respiratory tract infection and she eventually died. We discuss the clinical manifestations, treatment, and outcome.

Child↗

Variations of the left and middle hepatic veins: application in living related hepatic transplantation.

The anatomic variations of the middle hepatic vein (MHV) and left hepatic vein (LHV) in 200 patients with normal liver function were analyzed using ultrasonography to clarify the feasibility of resecting the left lobe or left lateral segment in living subjects for living related hepatic transplantation (LRHT). The MHV and LHV form a common trunk in 70% of cases but drain independently into the inferior vena cava (IVC) in 30%. In 7% of cases, the left median vein (LMV) drains into the MHV, in 32% of cases the anterior superior segmental vein (ASSV) that drains segment 8 flows into the MHV. The distance between the two confluence points (LHV flows into MHV or IVC and LMV flows into the MHV) ranged from 0.3 cm to 2.5 cm with an average of 0.75 cm. The diameter of the LMV at the point that flows into MHV ranged from 0.3 cm to 0.9 cm. with an average of 0.61 cm. The distance from the IVC to the confluence of the MHV and LHV ranged from 0 cm to 3.5 cm with an average of 1.5 cm in those cases whose MHV and LHV presented as common trunks. Preoperative delineation of this complex venous anatomy is of paramount importance because the hepatic veins have to be transected in the cutting plane of the liver. The location of this plane is determined by the optimal graft volume required, and both the graft and the remnant liver have to retain perfect function. The venous anatomy would change the cutting plane in the living donor and the surgical method of anastomosis for the recipient.

Adult↗

Tuberculoma en plaque: CT.

A 35-year-old woman presented with a 6-month history of intermittent headaches, vomiting and dizziness. CT showed a plaque-like mass with tiny calcifications along the surface of the left frontal lobe. The mass exhibited heterogeneous enhancement with a few low-density foci. Underlying sulcal obliteration and enhancement and white matter oedema were also noted. Histopathological examination of excised material was consistent with tuberculoma. Recognition of this unusual presentation of intracranial tuberculoma may facilitate appropriate diagnosis and management.

Adult↗

Posttraumatic gluteal epidermal cyst with ischiorectal and presacral extension.

An unusual case of rapid-growing posttraumatic gluteal epidermal cyst with ischiorectal and presacral extension is reported. Pertinent clinical history and magnetic resonance imaging allowed accurate preoperative diagnosis. Cautious complete excision was important to prevent recurrence. To our knowledge, posttraumatic gluteal epidermal cyst with this unusual clinical presentation has not been described previously.

Adult↗

Acute esophageal food impaction treated by water-soluble contrast esophagography with maneuvers.

This report describes a case of acute esophageal food impaction in the lower esophagus treated by proper physical motions during esophagography using water-soluble contrast medium (WSCM). WSCM was used to avoid the complication from unexpected perforation during the examination. Relief of esophageal obstruction may be accomplished by asking the patient to jump up and down on the ground. Esophagography using WSCM combined with appropriate physical motions may be helpful in treating patients suffering from acute esophageal food impaction.

Aged↗

Primary cardiac chondrosarcoma.

A case of primary cardiac chondrosarcoma in a 41-year-old woman who presented with cardiac tamponade and cardiac intracavitary obstruction is described. The tumor originated from the right atrium and invaded the adjacent right ventricular wall and interatrial septum. Primary cardiac chondrosarcoma is extremely rare, and its clinical, computed tomographic, echocardiographic, and magnetic resonance imaging findings are described.

Adult↗

Juvenile fibromatosis of the posterior mediastinum with intraspinal extension.

Chest radiography, CT, and MR imaging were performed in a 3-year-old girl who had posterior mediastinal fibromatosis with transforaminal intraspinal and chest wall extension. Chest radiographs and CT scans showed a slow-growing, noncalcified but locally aggressive left paravertebral mass. The mass was slightly hyperintense relative to muscle on both T1-weighted and fast spin-echo T2-weighted MR images.

Child, Preschool↗

Thymic hypoplasia (DiGeorge syndrome) in a newborn with tetralogy of Fallot, detected by magnetic resonance imaging.

We report on a case of thymic hypoplasia (DiGeorge syndrome) associated with tetralogy of Fallot in a newborn. The diagnosis was established on the basis of echocardiography, magnetic resonance imaging (MRI) and surgical observations. In this paper, we emphasize that MRI may be used not only to characterize cardiovascular anomalies, but to diagnose thymic hypoplasia.

DiGeorge Syndrome↗

Mesenteric cystic lymphangioma with myxoid degeneration: unusual CT and MR manifestations.

We report an unusual case of mesenteric cystic lymphangioma presenting as a large multilocular mass with a well-enhanced solid component and a central cleft, which were were pathologically correlated to the prominent stromal myxoid degeneration interspersed with abundant capillaries and the central fibrosis, respectively. The findings of computed tomography and magnetic resonance imaging are illustrated. Recognition of the multilocular configuration of the enhanced stroma may help to make the correct preoperative diagnosis.

Child↗

Primary gas-containing mediastinal abscess in a diabetic patient.

A case of primary gas-containing mediastinal abscess is reported. Mediastinal widening was seen on the chest radiograph of a diabetic patient who presented with nonspecific symptoms of shortness of breath and abdominal pain of 3 days' duration. The diagnosis of primary gas-containing mediastinal abscess was established by the characteristic findings of computed tomography and exclusion of all the etiological possibilities. The patient was treated by closed chest tube drainage and antibiotic therapy with an uneventful outcome. Primary gas-containing mediastinal abscess should be included in the differential diagnosis when treating a diabetic patient with mediastinal widening.

Abscess↗

"Spoke wheel" sign of small intestinal volvulus.

Radiographic diagnosis of small intestinal volvulus and gangrenous change produced by an adhesive band is presented. A soft-tissue mass with radiating mucosal folds simulating a "spoke wheel" was found in the right mid-abdomen. Expansion of the mass was documented on a follow-up radiograph 3 hours later. A "spoke wheel" sign is reported as an early indication of small intestinal volvulus.

Adult↗

Mesenteric panniculitis: report of two cases.

Mesenteric panniculitis is a rare inflammatory process of the mesenteric fat with unknown etiology. We report two pathologically proven cases of mesenteric panniculitis. Both patients presented with abdominal pain and palpable masses. In one patient, computed tomography (CT) demonstrated a well-defined heterogenous mass containing fat density at the mesocolon. In the other patient, CT showed a fatty mass encompassing mesenteric vessels at the root of the mesentery. Although the definite diagnosis of mesenteric panniculitis depends on histopathology, recognition of CT features is helpful in the diagnosis and avoids unnecessary extensive operation.

Adult↗

Arachnoid cyst of the lateral ventricle manifesting positional psychosis.

A 30-year-old woman had an arachnoid cyst in the trigone of the right lateral ventricle 5 years before she developed episodic auditory and visual hallucinations as well as delusions of persecution. The psychotic episodes tended to occur after the patient had lain in bed for 1 to 2 hours. After craniotomy and wide excision of the cystic membrane, draining the cystic fluid to the lateral ventricle, the psychotic episodes subsided in a follow-up period of 6 months. We believe that when the patient was recumbent, the trigone cyst blocked the temporal horn further, caused local ischemia, and triggered the psychosis, which was a form of partial complex psychomotor seizure.

Adult↗

Retroperitoneal Castleman's disease: report of two cases.

Castleman's disease (angiofollicular lymph node hyperplasia) is a rare benign disorder characterized by hypervascular lymphoid hyperplasia. It usually manifests as an asymptomatic, solitary mediastinal tumor, and seldom presents as an isolated retroperitoneal mass. We report two cases of histologically proven Castleman's disease occurring in the retroperitoneum. Their computed tomographic and angiographic features are presented, and the characteristics of this condition are described. Recognition of Castleman's disease in the retroperitoneal area is helpful in avoiding massive intraoperative hemorrhage and an unnecessarily extensive operation.

Adolescent↗

CT findings of pediatric thoracic actinomycosis: report of four cases.

Thoracic actinomycosis is an uncommon disease, which may mimic malignancy, lymphoma or tuberculosis of the chest. In the past three years, four cases of thoracic actinomycosis have been found in children at our hospital. Their computed tomography (CT) findings included pulmonary infiltrates, a chest wall mass, pleural and pericardial effusion, mediastinum involvement and rib changes. Although the final diagnosis of Actinomyces infection depends on a bacterial culture and pathology, CT can play an important role in establishing the diagnosis and evaluating the extent of the disease.

Actinomycosis↗