Biomedical subjects

S F Ko

Publications and source records attributed to S F Ko.

89 records · Page 5Linked to original sources

PubMed1992

Circumaortic left renal vein: report of a case.

Circumaortic left renal vein is an uncommon anomaly which has not been previously reported in Taiwan. We describe a case of circumaortic left renal vein in a 15-year-old girl who presented with intermittent hematuria. Angiogram revealed double left renal veins in the form of a venous collar. Computed tomography depicted the preaortic and retroaortic left renal veins clearly. In a survey of hematuria, circumaortic renal vein should be taken into consideration in a differential diagnosis, and an appreciation of the specific radiologic findings can help to establish the diagnosis easily. In addition, preoperative recognition of this uncommon anomaly is of supreme importance in a retroperitoneal operation in order to avoid massive bleeding.

Adolescent↗

PubMed1991

Mammography of breast carcinoma: experience of 108 cases.

Mammography is the radiographic imaging of the breast and includes screen-film mammography and xeromammography. From September 1987 to March 1990, 108 patients with breast carcinoma received mammographic examinations at Chang Gung Memorial Hospital. The spectrum of mammographic appearance included mass abnormalities (50.9%), calcifications (10.2%), a combination of mass abnormalities and calcifications (25%), asymmetrical increased density (4.6%), and parenchymal distortion (1.9%). The remaining 7.4% of the lesions lacked any radiologic sign of malignancy and primarily appeared as dense breast on the mammogram. In this series, mammography had a sensitivity of 86.1%, a specificity of 77.3% and a positive predictive value of 67.4%. Recognition of these mammographic appearances is beneficial in detecting breast carcinoma and in establishing a correct diagnosis. In addition, knowing the abilities, as well as limitations, of mammography will optimize the efficacy of this examining modality.

Adult↗

PubMedDate not supplied

Meckel's diverticulum mimicking infantile colic: sonographic detection.

We report a case of Meckel's diverticulum in a 6-month-old girl who presented with a 5-month history of chronic screaming but no symptoms or signs of intestinal obstruction. Infantile colic was the presumptive diagnosis. Abdominal sonography at 6 months of age demonstrated an abdominal mass with an anechoic center and a double-layered wall, surrounded by bowel loops. Abdominal CT and barium enema x-ray studies demonstrated nonspecific findings of a cystic mass with compression of adjacent bowel loops. Histologic examination of the resected mass revealed a Meckel's diverticulum with a perforation sealed off by the neighboring bowel and mesentery to form an inflammatory mass.

Colic↗

PubMedDate not supplied

MRI of nasopharyngeal carcinoma with emphasis on relationship to radiotherapy.

MRI has been used increasingly in the evaluation of nasopharyngeal carcinoma (NPC) because of its good tissue contrast and multiplanar capacity. Although there are some controversies in assessing skull base invasion and cervical metastatic adenopathy, recent reports demonstrate that MRI is currently better than or as good as CT in defining the extent of NPC. During follow-up of patients with NPC after radiotherapy, MRI is also more effective than CT in demonstrating tumor recurrence and in detecting postradiation complications. However, the difficulty of using MRI to detect early mucosal recurrence and to differentiate postradiation tissue changes from local tumor recurrence should be recognized. This paper reviews the literature regarding MRI of NPC related to radiotherapy, with special emphasis on treatment planning, recurrence assessment, and complication detection.

Carcinoma↗

PubMedDate not supplied

Cortical renal leiomyoma with extension to renal pelvis.

We describe a case of renal leiomyoma in a 21-year-old woman who presented with flank pain and hematuria. Urographic and computed tomographic (CT) studies revealed a large right renal mass with polypoid outgrowth protruding into the renal pelvis. Cortical renal leiomyoma with this radiographic manifestation is extremely rare.

Adult↗

PubMedDate not supplied

Dissection of retroesophageal aortic diverticulum and descending aorta in a patient with right aortic arch: magnetic resonance demonstration.

An acute aortic dissection involved the retroesophageal aortic diverticulum (RAD) and descending thoracic aorta in a patient with right aortic arch. The RAD, which was separated into false and true lumens by an intimal flap-the classic diagnostic sign of aortic dissection-was overlooked on transesophageal echocardiography and computed tomography but was clearly depicted on magnetic resonance imaging (MRI). It was found that MRI can delineate the anatomy of a congenital arch anomaly complicated by great vessels disease.

Aortic Dissection↗

PubMedDate not supplied

Treatment of postoperative residual hepatolithiasis after progressive stenting of associated bile duct strictures through the T-tube tract.

PURPOSE: The authors report their experience with the treatment of intrahepatic bile duct strictures associated with hepatolithiasis. METHODS: Eighty patients had multiple postoperative retained intrahepatic duct stones trapped behind intrahepatic biliary strictures. Before stone extraction, the strictures were opened gradually by semirigid dilators, followed by stent placement to create enough patency for stone removal. All procedures were carried out through the T-tube tracts and were aided by cholangioscopy and electrohydraulic lithotripsy. RESULTS: Complete clearance of stones was achieved in 69 patients. Failure to dilate the strictures was due to acute and multiple ductal angulations. These included the right posterior inferior intrahepatic duct at its junction with the left intrahepatic ducts when it was more than 2 cm distal to the hepatic bifurcation, when the angle between the T-tube tract and the common bile duct was smaller than 90 degrees, and when stones were located in peripheral intrahepatic ducts with more than five angulations. CONCLUSION: This technique is considered safe and effective for complicated hepatolithiasis with intrahepatic biliary strictures.

Adult↗

PubMedDate not supplied

Mucin-hypersecreting papillary cholangiocarcinoma presenting as abdominal wall abscess: CT and spiral CT cholangiography.

We describe CT findings of a case of mucin-hypersecreting papillary cholangiocarcinoma (MHPC), with extrahepatic bile leakage to the rectus abdominis muscle via the ligamentum teres hepatis forming an abdominal wall abscess. Endoscopic retrograde cholangiography was unsatisfactory. Spiral three-dimensional CT cholangiography was helpful in assessing the resectability of MHPC by offering anatomic details of the uninvolved biliary tree.

Abdominal Abscess↗

PubMedDate not supplied

Renal squamous cell carcinoma: CT findings and clinical significance.

BACKGROUND: To study the biological behavior of renal squamous cell carcinoma (RSCC). METHODS: Fifteen cases of RSCC were retrospectively studied. These cases were classified as central (eight cases) and peripheral (seven cases) types by the tumor location. The clinical data and computed tomographic findings were analyzed and compared. RESULTS: High incidence (87%) of urolithiasis was observed. The prognosis of RSCC was very poor, with a median survival time of 3.5 months. The infectious symptoms, central location, and modified stage IV of the tumor were the poor prognostic factors of RSCC. Two types of RSCC were different in the presenting symptoms, lymph node metastasis, modified tumor staging, and survival time. CONCLUSION: The central and peripheral types of RSCC were different biologically. High index of suspicion should be maintained when identifying the subtle clues of malignancy in patients with urolithiasis.

Adult↗

PubMedDate not supplied

Retroperitoneal actinomycosis with intraperitoneal spread. Stellate pattern on CT.

We report a case of pathologically proved actinomycosis that presented unusual computed tomographic (CT) features: a soft-tissue retroperitoneal mass encasing the adjacent ureter resulting in hydronephrosis and spreading into the intraperitoneal space with a stellate pattern. The role of CT in monitoring the response to antibiotic treatment is also discussed.

Actinomycosis↗

PubMedDate not supplied

Superior mesenteric artery aneurysm in systemic lupus erythematosus.

We present a case of giant superior mesenteric artery (SMA) aneurysm in a patient with systemic lupus erythematosus (SLE). The ultrasound, computed tomography, magnetic resonance, and angiographic findings are discussed. To our knowledge, SLE associated with a giant SMA aneurysm as a late complication of previous lupus mesenteric arteritis has not been reported previously.

Adult↗

PubMedDate not supplied

Giant bronchogenic cyst masquerading as tension pneumothorax. Radiographic and CT findings.

Pulmonary bronchogenic cysts with tracheobronchial communication may occasionally mimic tension pneumothorax leading to unnecessary thoracostomy. We describe such a case to emphasize that cautious identification of the direction of displacement of the collapsed lung tissue on chest radiograph or computed tomography (CT) may help in differentiating these two diseases. Tension pneumothorax should lead to centripetal compression of the ipsilateral lung toward the hilum while giant bronchogenic cysts result in centrifugal displacement of the adjacent lung away from the hilum.

Bronchogenic Cyst↗

PubMedDate not supplied

CT features of calcifications in abdominal malignant fibrous histiocytoma.

The purpose of this study was to describe the computed tomographic (CT) features of intralesional calcifications in abdominal malignant fibrous histiocytomas (MFH). Forty-three pathologically proven abdominal MFH with preoperative CT were retrospectively reviewed, of which seven tumors with intralesional calcifications were studied with pathohistologic correlation. All seven calcified abdominal MFH belonged to the storiform-pleomorphic subtype with peripherally located calcifications that appeared as either lumpy (three cases) or ringlike (four cases), which were due to the presence of variable amounts of osseous (six cases) and chondroid metaplasia (two cases). About 16% of abdominal MFH, especially the storiform-pleomorphic subtype, exhibited metaplastic calcifications which were characteristically located at the periphery of the tumor and appeared as either lumpy or ringlike on CT.

Abdominal Neoplasms↗

PubMedDate not supplied

Neurocutaneous melanosis associated with inferior vermian hypoplasia: MR findings.

OBJECTIVE: We describe the MR findings of two cases of neurocutaneous melanosis (NCM) associated with inferior vermian hypoplasia (IVH). MATERIALS AND METHODS: Two cases of NCM associated with IVH are presented. Both patients had congenital giant hairy nevi and multiple satellite lesions. RESULTS: Magnetic resonance imaging revealed IVH as well as hyperintensities in the pons and the cerebellar leptomeninges on T1-weighted images. The hyperintensities may be ascribed to the T1-shortening effect of melanin. A right parietal tumor in one patient and unilateral ventriculomegaly in another patient were also depicted. CONCLUSIONS: Magnetic resonance demonstration of the T1-shortening leptomeningeal infiltrations adds weight to the diagnosis of NCM. The implication of the concurrence of NCM and IVH is discussed.

Brain Neoplasms↗

PubMedDate not supplied

Anomalous systemic arterialization to normal basal segments of the left lower lobe: helical CT and CTA findings.

PURPOSE: The purpose of this work was to evaluate the helical CT and CT angiography (CTA) findings of anomalous systemic artery (ASA) to the basal segments of the left lower lobe (LLL). METHOD: Three patients (two had hemoptysis, one was asymptomatic) with blotchy nodular density in the LLL revealed on chest radiographs underwent helical CT and CTA. Bronchoscopy was performed in two of these patients. Angiography and surgery were performed in one patient. RESULTS: All three patients demonstrated characteristic helical CT and CTA findings including 1) a sigmoid-shaped ASA originating from the lower descending thoracic aorta, with a distal bulbous configuration and four arterial branches supplying the basal segments of the LLL; 2) absence of an interlobar pulmonary artery or presence of a small artery lateral to the truncus basalis; 3) engorged vascular markings in the basal segments of the LLL; and 4) normal tracheobronchial tree and lung parenchyma. CONCLUSION: The findings in the present three cases suggest that the use of invasive studies such as angiography or bronchoscopy may be obviated in the diagnosis of ASA to the LLL because diagnosis can be provided through a clear set of criteria on helical CT and CTA.

Adult↗

PubMedDate not supplied

Clinical experience in the treatment of ulcer-induced gastric outlet obstruction in seven children.

Peptic ulcer disease complicated with gastric outlet obstruction is rare in children. The experience in the treatment in children is limited. From 1987 to 1998, 7 children with gastric outlet obstruction due to peptic ulcer disease were encountered in our hospital. The 5 patients treated from October 1987 to May 1997 underwent truncal vagotomy, combined with pyloroplasty in 4 patients and antrectomy in 1. The indications for operation were failure of treatment with a histamine 2 (H2)-receptor antagonist. The remaining 2 patients, treated from June 1997 to October 1998, were successfully treated with oral omeprazole with or without the addition of antibiotics. These 2 patients had shorter hospital stays and could tolerate feeding earlier than those treated with truncal vagotomy. Although surgical treatment has merits in the management of children with peptic ulcer disease complicated with gastric outlet obstruction, in light of our cases we disclosed the trend toward intensive medical treatment.

Child, Preschool↗

PubMedDate not supplied

Hypoplastic right hepatic lobe with retrohepatic gallbladder complicated by hepatolithiasis and liver abscess: a case report.

A 37-year-old man with fever, jaundice, severe right upper quadrant abdominal pain and impending septic shock was pre-operatively diagnosed to have hypoplastic right lobe liver with retrohepatic gallbladder, left hepatolithiasis and liver abscess by computed tomography. An urgent operation with cholecystectomy, choledocholithotomy, operative choledochoscopy and T-tube drainage was performed. Postoperative cholangiograms depicted multiple residual stones behind the sharply angulated biliary strictures in the medial branches of the left intrahepatic duct, which could not be eradicated by biliary dilatation via the T-tube tract. The left hepatolithiasis might be coincidental, or secondary to the congenital anomaly of the liver, because of the distorted biliary architecture, and the hypoplastic right lobe liver was associated not only with the retrohepatic gallbladder, but also with the much more complicated left biliary strictures and the hepatolithiasis behind them.

Adult↗