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Biomedical subjects

Y L Wan

Publications and source records attributed to Y L Wan.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Congenital cystic adenomatoid malformation of the lung--a case report].

Congenital cystic adenomatoid malformation of the lung is a rare but potentially lethal variety of congenital pulmonary defect. This is a multicystic mass of dysplastic pulmonary tissue in which there is proliferation of bronchial structure at the expense of alveoli. We report a newborn infant with respiratory distress. The chest X-ray showed multicystic lesions with air-fluid level and shift of mediastinum. The patient was successfully treated with segmentectomy. The clinical manifestations, radiographic and pathologic features were summarized and the literature reviewed.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1989

Salmonella cholerasuis bacteremia and mycotic aneurysm of abdominal aorta--report of five cases.

From August 1986 to October 1987, there were 5 cases of primary mycotic aneurysm of the lower abdominal aorta in Chang Gung Memorial Hospital at Kaoshiung. All patients were proved to have Salmonella cholerasuis (Sal. chol.) septicemia by blood culture. The ages ranged from 60 to 80 years old, the mean age was 71.6 years old. The male to female ratio was 4 to 1, 3 patients had diabetes mellitus (DM) and 3 had hypertension. The duration of symptoms lasted from 1 week to 2 months before diagnosis. Clinically, all patients had sepsis with fever, chills, leucocytosis, and complained of pain in the lower abdomen (80%), at flank (20%) or low back (20%). Abdominal tenderness was present in 3 (60%). Two patients underwent surgery, 1 expired during the operation, the other expired 1 month after operation because of retroperitoneal abscess and sepsis. Three were discharged in septic shock and expired within 1 day. The mortality rate was 100%. The diagnosis of complicated aneurysm of the lower abdominal aorta was established in all by computed tomography (CT). In conclusion, when there are clinical manifestations of sepsis, positive blood culture for Sal. chol., and pain or tenderness in the lower abdomen, flank area or back, one should consider the possibility of mycotic aneurysm of the lower abdominal aorta. Although the prognosis is poor, early surgical intervention may improve the outcome. And the diagnosis is best established by CT.

Aged↗
PubMed1989

Actinomycosis of the greater omentum.

A case of histologically proven actinomycosis of the greater omentum is reported. Computed tomography (CT) showed a mass at the greater omentum near the left flank area; it was hypervascular on angiograms and was supplied by the omental artery originating from the splenic artery. Sonography showed that the echogenecity of the lesion was complex. Actinomycosis of the greater omentum, although rare, should be included in the differential diagnosis of omental mass.

Actinomycosis↗
PubMed1989

[Polypoid lesions of the gallbladder].

26 cases of polypoid lesions of the gallbladder are reported. 19 were benign lesions, among them, there were 12 (63%) cholesterol polyp, 4 adenoma, 1 inflammatory polyp, and 2 others. 95% of benign lesions were less than 1 cm in diameter, 63% of which were less than 0.5 cm in diameter, 15 cases were multiple lesions; all cases were not associated with gallstones. 7 cases were carcinoma of the gallbladder, of which, 5 were more than 1 cm in diameter, 2 were less than 1 cm which were carcinoma in situs; 3 were associated with gallstones. The accuracy of preoperative diagnosis of polypoid lesions of the gallbladder made by B-mode ultrasonography, cholecystography, CT, endoscopic ultrasonography were 84%, 53%, 80% and 75% respectively. It is concluded that preoperative diagnosis of polypoid lesions on the gallbladder mainly depends on the B-mode ultrasonography; the lesions less than 0.5 cm in diameter should not be treated by operation for the time being; the lesions between 0.5-1 cm should be followed up by B-mode ultrasonography; the operation may be considered if stones present; the lesions more than 1 cm should be resected since malignancy could not be excluded.

Adenocarcinoma, Papillary↗
PubMed1987

Endoscopic measurements of canine colonic mucosal blood flow using hydrogen gas clearance.

We have examined the feasibility of hydrogen (H2) clearance for endoscopic measurements of colonic mucosal blood flow in anesthetized dogs. In 6 animals, measurements of H2 clearance did not differ significantly in different regions of the sigmoid colon and they were highly reproducible (p less than 0.001) on different days. In a total of 12 dogs, measurements of H2 clearance correlated closely with those obtained using radioactive microspheres under resting conditions and, in 4 dogs, during infusion of vasopressin (slope = 0.94, p less than 0.001). In 8 dogs, ligation of the major arteries supplying the sigmoid colon resulted in an acute 60% decrease in sigmoid mucosal blood flow (p less than 0.001); however, in 5 animals that survived the procedure, mucosal blood flow returned nearly to control levels as early as 3 days after operation. Endoscopic H2 clearance thus appears to be feasible for measuring mucosal blood flow in the colon. Serial measurements of H2 clearance may prove useful in characterizing the role of mucosal blood flow in the pathogenesis of various forms of human colonic disease.

Animals↗
PubMedDate not supplied

Sonographically guided core-needle biopsy in the diagnosis of superficial lymphadenopathy.

PURPOSE: This study was designed to evaluate the efficacy of ultrasound-guided percutaneous core-needle biopsy for establishing histopathologic diagnoses of palpable enlarged lymph nodes. METHODS: Thirty patients without a history of malignancy or recent infection underwent ultrasound-guided core-needle lymph node biopsies. Only patients with enlarged lymph nodes ranging from 1.5 to 3.5 cm in greatest diameter that had been present for more than 2 months were included in this study. Two cores from each lymph node were obtained by a freehand core-needle biopsy technique using a 7-MHz ultrasound transducer and an automatic spring-loaded biopsy gun with an 18-gauge cutting needle. RESULTS: The histologic diagnoses were conclusive in 24 cases (80%) and inconclusive in 6 cases (20%). In the 24 conclusive cases, the lymph node enlargement was due to benign causes in 12 cases and malignancy in 12 cases. All specimens in the conclusive cases were sufficient for histologic diagnosis, but there was insufficient material for a diagnosis in 3 of the inconclusive cases. No complications were seen in this series. CONCLUSIONS: Ultrasound-guided core-needle biopsy of enlarged lymph nodes is a safe, minimally invasive alternative to surgical biopsy, enabling a histologic diagnosis for treatment planning in most cases.

Adolescent↗
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

Gas-containing liver abscess: radiological findings and clinical significance.

Sixty-two cases of verified gas-containing pyogenic liver abscess were reviewed to study the radiological and clinical prognostic factors. A mortality rate of 37.1% (23 cases) was observed. Among these patients, the survival time of 13 patients with alveolar gas pattern or pneumoperitoneum (6.15 +/- 7.36 days) was significantly shorter than that of the other 10 patients (17.70 +/- 13.32 days) despite immediate diagnosis and aggressive treatment. The poor radiological prognostic signs were: (1) alveolar gas pattern and pneumoperitoneum as viewed on radiographs; and (2) globular configuration, shaggy margin, alveolar internal structure, and total gas content on computed tomographic (CT) scans. High serum creatinine and glucose levels and a short time to diagnosis were the poor clinical prognostic factors. The aggressive treatment did not change the outcome. We conclude that, in addition to the clinical evaluation, meticulous radiological study of the abscess morphology should be done in cases of gas-containing liver abscess in an effort to provide further aggressive treatment for those patients with poor radiological prognostic signs.

Aged↗
PubMedDate not supplied

Icteric-type hepatoma: magnetic resonance imaging and magnetic resonance cholangiographic features.

BACKGROUND: We evaluated the imaging features of magnetic resonance imaging (MRI) and magnetic resonance cholangiography (MRC) of icteric-type hepatoma and correlated these with the findings of endoscopic retrograde cholangiography (ERC), percutaneous cholangiography, and surgery. METHODS: Thirteen patients with viral hepatitis complicated by cirrhosis of the liver and obstructive jaundice underwent MRC and dynamic MRI. Five patients received percutaneous transhepatic cholangiography and drainage; one of these patients also underwent resection of the left hepatic lobe. Another patient received MRC followed by thrombectomy and T-tube insertion. ERC and endoscopic nasobiliary drainage were performed in another patient for bile diversion. RESULTS: Primary liver tumors and dilatation of biliary system were demonstrated in all patients. No capsule formation could be found in any primary liver tumors. MRI showed the simultaneous presence of an intraluminal tumor in the portal trunk and common hepatic duct in eight patients. Three different MRC features were found: (a) an oval defect in the hilar bile duct(s) with dilated intrahepatic ducts (n = 9), (b) dilated intrahepatic ducts with missing major bile ducts (n = 2), and (c) localized stricture of the hilar bile duct(s) (n = 2). CONCLUSION: The presence of one or more of the following features in multiplanar MRI and MRC help to identify this rare, specific type of hepatocellular carcinoma: (a) the presence of an intraluminal tumor in both the portal trunk and the common hepatic duct, (b) enhancement of the intraluminal tumor in the common hepatic duct on the arterial phase, (c) type I MRC feature, and (d) hemobilia, blood clot within the gallbladder, and/or type II MRC feature.

Adult↗
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

Biliary ascariasis: CT, MR cholangiopancreatography, and navigator endoscopic appearance--report of a case of acute biliary obstruction.

A case of acute common bile duct obstruction caused by a roundworm in a 6-year-old girl is reported. Computed tomography (CT) and magnetic resonance imaging (MRI) showed "bull's-eye" and "eye-glass" appearances of the ascaris in the common bile duct. On reformation of the transverse CT and coronal MR images, the tubular Ascaris was better depicted. MRI and navigator endoscopic demonstrations of the common bile duct ascaris have not been described previously in the literature. These CT and MRI findings may be helpful in the diagnosis of Ascaris.

Acute Disease↗