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Biomedical subjects

T C Tung

Publications and source records attributed to T C Tung.

At least 37 records · Page 2Linked to original sources
PubMed1997

Massive intratumor hemorrhage in facial plexiform neurofibroma.

BACKGROUND: Plexiform neurofibromatosis is a feature of von Recklinghausen's disease. Head and neck lesions may produce varying degrees of cosmetic and functional deformity. However, life-threatening hemorrhage into facial plexiform neurofibromas has not been previously reported. METHOD: We report two patients with von Recklinghausen's disease who experienced massive hemorrhage into facial neurofibromas, one following a blunt injury and the other without a known initiating event. RESULTS: Conservative management did not stop the hemorrhage into facial neurofibromas in either instance. Surgical exploration was mandated for hemorrhage control and evacuation of blood clots. Hemostasis was attained by a combination of hypotensive anesthesia and chromic catgut suture ligatures. CONCLUSIONS: These case reports demonstrate a potentially lethal complication in patients with facial plexiform neurofibroma. Where a competent and experienced interventional neuroradiologist is not available, surgical exploration should be undertaken to control bleeding.

Adolescent↗
PubMed1997

Step-wise lengthening for delayed repair of avulsion of the flexor pollicis longus.

Repair of late avulsion of the flexor pollicis longus tendon at insertion is a rare but difficult problem. A 52-year-old female labourer presented with a 3-month history of inability to flex her right thumb at the interphalangeal joint. Avulsion of the flexor pollicis longus tendon at its insertion was noted on exploration. Because the tendon had contracted and could not be reinserted directly, a technique of step-wise lengthening was used for reinsertion. Two months after operation, the patient resumed her daily activities and went back to work with satisfactory use of her right thumb. This report highlights the possibility of using a simple technique when there is no other alternative.

Female↗
PubMed1997

Excision of subcutaneous tissue for the treatment of axillary osmidrosis.

Axillary osmidrosis is a distressing problem. Medical treatment is often inadequate. Local excision of the apocrine and eccrine glands is the most effective method available but is often accompanied by significant morbidity. We report a modified surgical technique for the treatment of this condition. From January 1994 to December 1995, 46 patients (38 females, 8 males) with axillary osmidrosis have been treated by excision of the subcutaneous tissue via two transverse incisions, without removing skin. Sutures are used to anchor the skin to the axillary fascia. There is no need for a complicated tie-over dressing and postoperative arm restriction. All patients were followed up for a minimum of 6 months (average 11.6 months). The patients were asked to complete a questionnaire. The results of malodour elimination were classified as good, fair and poor. Forty-one (89.1%) of the patients had good results, four (8.7%) had fair results, and one (2.2%) had a poor result. The average convalescent time was 9.2 days. Twenty-six patients (57%) were very satisfied and recommended this procedure. Only one patient (2%) regretted having the operation. This operation has the advantages of a high success rate, low complication rate, and rapid recovery for the treatment of axillary osmidrosis.

Adolescent↗
PubMed1997

Reverse pedicled lateral arm flap for reconstruction of posterior soft-tissue defects of the elbow.

Posterior soft-tissue defects of the elbow are difficult to reconstruct by conventional techniques such as closure by approximation or skin graft. An ideal technique should be an easy and reliable one-stage procedure that provides predictable surgical results with regard to elbow function and cosmesis. This report details our experience in 7 patients who underwent a one-stage procedure for coverage of the posterior elbow employing the reverse pedicled lateral arm flap. All flaps survived and all patients were able to resume full range of motion of the elbow joint at the 6-month follow-up. Complications included forearm paraesthesia in 3 patients and conspicuous scarring in a young female patient. We emphasize two valuable refinements in surgical technique including measuring posterior elbow defect in full flexion and postoperative elbow extension splinting. In trauma-related defects of the posterior elbow, a preoperative angiogram is important before raising this flap.

Adolescent↗
PubMed1997

Maxillary myxoma treated with wide resection and immediate reconstruction: a case report.

Myxoma of the jaw is a rare, benign bone tumor of odontogenic origin. Given the locally aggressive nature of the myxoma and the high rate of recurrence, there is a tendency to choose radical resection of the jaw segment containing the tumor mass as the treatment modality. As they appear to attain a considerable size prior to diagnosis because of their insidious growth characteristics, particularly in the maxilla, treatment requiring a hemimaxillectomy often results in a significant functional and aesthetic disability. This is particularly distressing as this condition usually affects the young. We present the case of a 16-year-old female who suffered a large maxillary myxoma with swelling of the left cheek for 2 years. Wide resection of the tumor tissue including the maxillary medial and lateral buttresses and part of the hard palate with preservation of maxillary alveolar bone and teeth was undertaken, and the maxillary buttresses were reconstructed with autogenous rib grafts. At the 3.5-year follow-up there was no local recurrence and no tooth loss. Both the functional result and aesthetic contour proved satisfactory. Wide resection with preservation of vital structures and simultaneous autogenous bone graft reconstruction is our preferred method. A long-term follow-up is needed.

Adolescent↗
PubMed1997

Full intrusion of a tooth after facial trauma.

We report two cases of fully intruded tooth after facial fracture in adults. In the first case, the lateral incisor was intruded into the nasal cavity and slipped into the pyriform sinus during operation. The second case involved full intrusion of a molar into the maxillary sinus, resulting in infection. The importance of a thorough intraoral examination for patients with facial trauma is emphasized. All missing teeth should be accounted for to ensure that they have not dislodged inside the body. When full intrusion of a tooth is suspected, facial computed tomography scan may provide assistance with definite diagnosis. If an incisor is completely intruded into the nasal cavity, removal through the floor of the nostril should be considered.

Accidents, Traffic↗
PubMed1996

Chronic volar dislocation of the metacarpophalangeal joint of the thumb: a case report and review of the literature.

A 61-year-old man sustained a chronic volar dislocation of the metacarpophalangeal joint of the thumb. He did not present for treatment until he experienced recently progressive joint pain 2 year after injury. Arthrodesis of the metacarpophalangeal joint was performed to correct the deformity of the thumb because of its extensive tissue scarring and erosion of the articular cartilage of the metacarpal head. Six weeks of splint immobilization followed by a physiotherapy program allowed the patient to resume his daily activities with his right hand.

Arthrodesis↗
PubMed1995

Polyotia.

Polyotia is an extremely rare congenital anomaly of the external ear. Only four case reports are documented in the literature. A 13-month-old child with a mirror-image duplication of the left auricle was operated on in a one-stage corrective procedure. The duplicated portion of the affected ear was positioned anteriorly and measured approximately two-thirds the size of the posterior, normally oriented portion. There were two fully developed conchae and one fully developed and one partially developed anthelix and lobule. The entire complex had a single external auditory meatus and no tragus. There were no other congenital anomalies, and the child was developmentally normal. The technique for surgical correction is described, and a review of the literature is presented.

Ear, External↗
PubMed1995

Facial plaque-type blue nevus and its reconstruction.

Blue nevi rarely appear in a plaque form. Because of their rarity and unusual clinical appearance, these nevi may present a diagnostic problem. We described a large plaque-type blue nevus measuring about 9 x 6 cm on the right cheek of a 22-year-old man. It was characterized by several dark-blue macules and papules with intervening areas of faint blue discoloration. Excision of this unusual plaque-type blue nevus with reconstruction using tissue expander was performed successfully. A 6-year postoperative follow-up revealed satisfactory results.

Adult↗
PubMed1995

Surgical complications of the Le Fort I osteotomy--a retrospective review of 146 cases.

A retrospective review of 146 cases with Le Fort I osteotomy performed between 1981 and 1990 is presented. A complication of 6.1% was recorded. These complications include intraoperative hemorrhage, trigeminal nerve injury, oronasal fistula and dental injury. Although the Le Fort I osteotomy has proven to be relatively safe, improvements in technique will further reduce the incidence and the severity of complications.

Adolescent↗
PubMed1995

Intramuscular cavernous hemangioma of the masseter muscle.

Intramuscular hemangioma is relatively uncommon and frequently misdiagnosed, and even rarer in the head and neck region. The masseter muscle is the most frequent site for such hemangioma in the head and neck. A retrospective chart-review of intramuscular hemangioma in Keelung Chang Gung Memorial Hospital from 1983 through 1992 revealed the incidence of masseter muscle hemangioma is approximately 8% of all intramuscular hemangioma. Because of the rarity of these tumors, their vague presentations, inaccurate preoperative diagnosis and inappropriate surgical planning are common problems. This paper described five hemangiomas involving the masseter muscle with a review of the current literature on masseter muscle hemangioma.

Adult↗
PubMed1994

Anatomical findings of the vanishing testis.

Inguinal exploration of 62 clinically impalpable undescended testes reveals 40 (64%) instances of absent testis. Nine (22.5%) of the 40 explorations showed complete absence of the testes along with the epididymis and vas deferens, six (15%) were associated with only vas ending blindly, and the other 25 (67.5%) were associated with blind-ending vas deferens and blood vessels: the "vanishing testis syndrome." The anatomical findings of these vanishing testes showed the presence of a vas deferens and vessels lying side by side in the inguinal canal. In Addition, two patients with bilateral vanishing testis were found to be a normal 46 xy phenotypic male. Since testicular tissue is necessary in utero to stimulate external genital development, these findings, imply that testes vanished at some point following induction of masculinization, possibly as a result of an intrauterine vascular accident or testicular torsion. Also, according to the anatomical findings of vanishing testis, it gave us the signal to terminate the exploration when we found absent testis with a blind-ending vas plus vessels on one or both side in an operation for impalpable testis.

Child↗
PubMed1985

Polychlorinated biphenyl poisoning: correlation of sensory and motor nerve conduction, neurologic symptoms, and blood levels of polychlorinated biphenyls, quaterphenyls, and dibenzofurans.

In 1979 in Taiwan, more than 2000 people were poisoned with rice cooking oil contaminated with polychlorinated biphenyls (PCB). One hundred ten patients were studied within one year of the exposure. The blood PCB levels were 39.3 +/- 16.6 ppb. The blood levels of the PCB derivatives, polychlorinated quaterphenyls (PCQ) and polychlorinated dibenzofurans (PCDF), were 8.6 +/- 4.8 and 0.076 +/- 0.038 ppb, respectively. Both the sensory and motor nerve conduction velocities (NCV) of the patients were significantly lower than the control. Abnormal slowing of sensory NCV was found in 43.6% and abnormal slowing of motor NCV was seen in 21.8%. Patients who had higher PCQ blood levels had significantly slower median nerve sensory NCV than those with lower PCQ levels. Patients with higher PCB blood levels had significantly slower peroneal nerve motor NCV than those with lower PCB levels.

Adolescent↗
PubMed1985

PCBs, PCQs and PCDFs in blood of yusho and yu-cheng patients.

Individual blood samples obtained from yusho and yu-cheng patients who had been poisoned by ingesting contaminated cooking oils, from workers occupationally exposed to polychlorinated biphenyls (PCBs) and from unexposed individuals were analyzed for PCBs, polychlorinated quaterphenyls (PCQs) and polychlorinated dibenzofurans (PCDFs) by gas chromatography and mass spectrometry. PCBs were found in the blood of all samples. PCQs were detected in the blood of 54 of 56 living yusho patients 11 years after the outbreak, and in all yu-cheng patients 6 months following poisoning. These facts indicate that the presence of PCQs in the blood was a good mark of past ingestion of the toxic oil. In the yu-cheng cases, PCDFs as well as PCBs and PCQs were detected in all blood samples. These identified isomers have been reported to be remarkably highly toxic compounds, i.e., both the 2,3,7,8-tetrachlorinated and 2,3,4,7,8-pentachlorinated compounds are toxicologically hundreds to thousands of times more toxic than PCB. In view of the high toxicity of PCDFs found in the yu-cheng patients' blood, we must deduce that they are the primary causal agents of yusho as well as of the yu-cheng incident.

Benzofurans↗
PubMed1984

A trial of fasting cure for PCB-poisoned patients in Taiwan.

Sixteen patients poisoned by ingestion of a rice oil contaminated with polychlorobiphenyls (PCBs) in Taiwan voluntarily joined a trial of fasting cure for either seven or ten days approximately 26 or 35 months after being poisoned. During fasting, mixed juice made of fresh vegetables and fruits and milk or "tohnyu," that is, boiled soybean juice, were given on a fixed schedule. All these patients showed improvements of their symptoms and signs caused by the poisoning. Some of them enjoyed a dramatic relief of their sufferings such as severe headache, lumbago, arthralgia, pain at the sole, cough, sputa, and/or acneiform eruptions. The eruptions forming abscesses or cysts were, however, hard to cure. Thus, the fasting cure was demonstrated to be effective in the treatment of the patients. PCB concentrations in blood were rather elevated during and after the fasting.

Adult↗
PubMed1984

A trial of fasting cure for PCB-poisoned patients in Taiwan.

Sixteen patients poisoned by ingestion of a rice oil contaminated with polychlorobiphenyls (PCBs) in Taiwan voluntarily joined a trial of fasting cure for either seven or ten days approximately 26 or 35 months after being poisoned. During fasting, mixed juice made of fresh vegetables and fruits and milk or " tohnyu ," that is, boiled soybean juice, were given on a fixed schedule. All these patients showed improvements of their symptoms and signs caused by the poisoning. Some of them enjoyed a dramatic relief of their sufferings such as severe headache, lumbago, arthralgia, pain at the sole, cough, sputa, and/or acneiform eruptions. The eruptions forming abscesses or cysts were, however, hard to cure. Thus, the fasting cure was demonstrated to be effective in the treatment of the patients. PCB concentrations in blood were rather elevated during and after the fasting.

Adolescent↗