Ultrasonic detection of a single vaginal ectopic ureter inserted into an imperforate hemivagina.
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Adult↗
Biomedical subjects
Y W Li
Publications and source records attributed to Y W Li.
CT and MRI findings in a child with constrictive pericarditis.
Constrictive pericarditis is rare in children. We report computed tomography (CT) and magnetic resonance imaging (MRI) findings in a 3-year-old girl. She had a swollen abdomen that increased in two months. CT and MRI showed a thickened pericardium (5.2 mm) without calcification. Both atria were enlarged and ventricles were relatively small. The engorged inferior vena cava had 2.8x the diameter of the descending aorta at the same level. Symptoms were dramatically improved after pericardiectomy. The histopathological features confirmed chronic pericarditis.
Child, Preschool↗
The evaluation of false negative mammography from malignant and benign breast lesions.
Preoperative mammograms from 395 breast cancers and 132 benign breast lesions were enrolled for this study. The false-negative (FN) rate for breast cancers from preoperative reading was 9.6% with 38 breast cancers missed on mammograms. The statistically significant differences occurred between true-positive (TP) and FN cancers for younger age (P<.025), smaller lesion size (P<.001), denser breast (P<.05), deep retroglandular location (P<.001). None of the FN cancers exhibited calcifications. The FN rate for mammography for benign breast lesions from preoperative reading was 18.9% with 25 lesions misdiagnosed. The statistically significant difference between benign TP and FN lesions occurred for central and subareolar location (P<.025). Exploration of possible factors and imaging features in FN mammograms can help reduce the FN rate for mammography.
Adult↗
Bilateral elastofibroma dorsi. Two case reports.
Elastofibroma dorsi is a benign fibroproliferative lesion of unknown pathogenesis. It is most commonly found in the periscapular region in elderly women. The majority of patients are asymptomatic. The lesions have a characteristic location and a specific magnetic resonance imaging (MRI) appearance allowing accurate prospective diagnosis. The importance of recognizing the benign nature of this lesion to avoid an unnecessary operation is apparent. We describe two cases of bilateral elastofibroma dorsi with characteristic findings on MRI and typical histological appearances.
Bone Neoplasms↗
Three-dimensional reconstruction of abnormal ventriculoarterial relationship by electron beam CT.
PURPOSE: Assessment of the relationships of the ventricles and great vessels is critical in evaluating cardiac anomalies before surgery. We investigated the usefulness of 3D CT in their demonstration. METHOD: From July 1995 through June 1996, 20 patients with abnormal ventriculoarterial relationships were analyzed by electron beam CT. A 3D gradient shading surface rendering was done on a workstation. We focused on the morphologies of the atria, ventricles, and great vessels and particularly their spatial relationships on the 3D images. RESULTS: There were two cases of isolated ventricular inversion, three of anatomically corrected malposition, seven of congenitally corrected transposition, and eight of complete transposition. Anatomic presentations of 3D surface images in all were superior to cineangiography and echocardiography presentations and were consistent with intraoperative findings. CONCLUSION: 3D CT images provide useful information that is not available by sectional or projective imaging. Independent segmental analysis of the anomalies by this method provides a complement for surgeons to understand the spatial relationships of the vessels and chambers of the heart, which may be of value in preoperative planning.
Adolescent↗
Ultrafast fetal MR images of intracranial teratoma.
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Adult↗
Spinal fractures and pseudoarthrosis complicating ankylosing spondylitis: MRI manifestation and clinical significance.
PURPOSE: To analyze magnetic resonance (MR) patterns of fractures and pseudoarthrosis of the ankylosing spondylitic spine, and related changes in the dura and adjacent soft tissue. MATERIALS AND METHODS: Sixteen patients with radiographically evident fractures or pseudoarthrosis of the spine were included. Each underwent MR studies. Ten patients among them underwent surgical operations. RESULTS: Both transdiscal (n = 12) and transvertebral (n = 4) fractures were identified. The levels were located from T9 to L3. Five of 16 patients had pseudoarthrosis. The fractures or pseudoarthrosis had two patterns: low signal on T1-and high signal on T2-weighted images, and low signal on both T1-and T2-weighted images. Disruption of anterior longitudinal ligament (ALL) was identified in 14 patients. Seven patients had vertebral translation, all had disruption of the ALL. Dural adhesions were noted in five patients and manifested as linear epidural enhancements with triangular blunt edges. CONCLUSION: MR patterns of ankylosing spondylitis are important in evaluating complications of fractures or pseudoarthrosis, as well as changes in dura, soft tissue, and ligaments.
Adult↗
Use of c-fos functional mapping to identify the central baroreceptor reflex pathway: advantages and limitations.
Prolonged stimulation of many neurons results in the expression of the immediate early gene c-fos, which in turn cause the production of the protein Fos, whose presence in a cell can be detected by immunocytochemistry. This method has been used in both conscious and anaesthetized animals to identify central neurons involved in the baroreceptor reflex. In this paper we review the factors that can influence c-fos expression, with particular emphasis on the effects of different anaesthetic agents. We conclude that the c-fos method of functional mapping, when applied carefully and critically, is a very useful method of identifying central neurons that are activated by cardiovascular stimuli in conscious animals. Anaesthetic agents can significantly alter c-fos expression, and this effect differs greatly according to the type of anaesthetic used.
Anesthesia↗
Congenital choanal atresia: computed tomographic and clinical findings.
Congenital choanal atresia is a rare developmental anomaly characterized by failure of communication of the posterior nasal cavity with the nasopharynx. It may present as a component of the CHARGE association (C, coloboma; H, heart disease; A, atresia choanae; R, retarded growth and development; G, genital hypoplasia; and E, ear anomalies and/or deafness). The purpose of this study is to evaluate the computed tomographic (CT) appearance of membranous or bony type congenital choanal atresia. Six patients (4 females, 2 males; age range, 1 day to 8 weeks; mean, 13.8 days) with choanal atresia were included in this study and evaluated by CT scan. The CT clearly delineated the full anatomic abnormalities of choanal atresia. Among the 6 patients, three (50%) had bilateral membranous atresia, two (33%) had bilateral bony atresia, and one (17%) had unilateral (left) membranous atresia. Additionally, two (33%) patients (1 bilateral membranous atresia, 1 bilateral bony atresia) fit at least four of the six criteria in the CHARGE association. The CT plays a significant role in the diagnostic and therapeutic approach to congenital choanal atresia and should be the examination method of choice to evaluate neonates with nasal obstruction.
Choanal Atresia↗
Application of Fluid-Attenuated Inversion Recovery pulse sequence in children with tuberous sclerosis.
To evaluate the application of Fluid-Attenuated Inversion Recovery (FLAIR) pulse sequence to increase the sensitivity of detecting tubers in tuberous sclerosis patients compared with fast spin-echo T2-weighted (FSET2W) image, we obtained 12 magnetic resonance (MR) images in 10 patients (mean age = 57.7 months old). Among the 12 examinations, 114 cortical and 128 subcortical tubers were revealed on the FLAIR images, whereas 54 and 72 tubers were found respectively on the FSET2W images. This may be due to the FLAIR pulse sequences remarkably attenuated CSF signals in comparison with the FSET2W images. However, FSET2W image delineated more subependymal nodules than FLAIR imaging did. Gd-DTPA enhanced T1W image is the most suitable pulse sequence to detect giant cell astrocytoma near the foramen of Monro. The results in cases of infants and little children were similar.
Child↗
Hepatoblastoma in infancy and childhood: a clinical and pathological study of 32 cases.
During the twenty-nine-year period from June 1959 to October 1988, 32 infants and children with histology-proved hepatoblastoma were seen at the Department of Pediatrics, National Taiwan University Hospital (NTUH). The age at diagnosis ranged from four days to six years, with a mean of one year and eight months. Most of the patients (87.5%) were under the age of three. There was no sex predilection (16 males, 16 females). The most common presenting signs were an upper abdominal mass (71.9%) and/or abdominal distention (62.5%). Physically, all the patients revealed hepatomegaly, with or without mass. Laboratory abnormalities included primarily thrombocytosis (64.3%), elevated serum aspartate aminotransferase (75.0%), serum alanine aminotransferase (62.5%), cholesterol (78.3%) and alphafetoprotein (92.3%). According to the classification of Ishak and Glunz, 56.3% of these belonged to the epithelial type; the others belonged to the mixed type. During the follow-up period, 6 patients with complete resection of the tumor remained alive from 2 years to 17 years and 4 months. Twenty-two patients died from 8 days to 16 months after diagnosis. Four patients were lost to follow-up. The two-year survival rate was 21.4% (6/28). Complete resection of the tumor was the key treatment for achieving survival.
Carcinoma, Hepatocellular↗
Crisis in Gaucher disease simulating osteomyelitis: report of one case.
An 11-year-old boy with Gaucher disease developed acute bone pain of the left thigh, accompanied by fever and signs of inflammation. Initially he was treated as osteomyelitis with antibiotics. Cultures of blood and aspirate of a subperiosteal hematoma were negative for bacterial growth. Tc99m bone scan revealed relatively decreased uptake over the involved area, and the findings of magnetic resonance imaging were typical for Gaucher crisis. Although Ga 67 imaging was positive, the diagnosis of a bone pain crisis rather than an infection was made. Antibiotics were discontinued without sequelae. Differential diagnosis between Gaucher crisis and osteomyelitis is discussed.
Acute Disease↗
[Tumors detected in renal ultrasonic screening].
A program of rapid mass screening of kidneys was conducted with ultrasound for initial detection of renal and the adjacent organ abnormalities in school children and neonates in Taipei area from March 1987 to December 1990. More than a half million population were examined and the frequency of the abnormality was approximately 0.5%. Of the patients 22 had a tumor, including 13 boys and 9 girls. Age ranges were from neonate to 15 years. The tumor site for 19 patients was in the retroperitoneal space, 6 cases from the kidney, 3 cases from the adrenal gland, 1 case from the pancreas, and 9 cases from retroperitoneal tissue. The other three cases had tumor in the mediastinum, ovary or bladder. In this series, 20 cases received surgery. Pathological examination revealed 8 cases to be malignant, and 12 to be benign lesions. This experience would seem to indicate that rapid renal ultrasonic mass screening may be useful for early detection and management of tumors of the kidney and its adjacent organs.
Adolescent↗
Congenital tracheal stenosis: report of three cases.
Three infants of congenital tracheal stenosis were experienced in our hospital from 1987 to 1990. They were free from perinatal insult with the onset of symptoms at less than three months of age. Their clinical course deteriorated progressively and all died of respiratory failure in spite of the use of respirator and intensive care. One case received tracheoplasty 2 days before he died. This rare disease entity confronts neonatologist and pediatric surgeon with very high mortality. Only certain types of this disease may be corrected by advanced reconstructive surgery. Congenital tracheal stenosis is usually diagnosed by bronchoscopy, bronchography, xerography or computed tomography. The clinical characteristics and therapeutic management of our cases are discussed and literatures reviewed.
Female↗
[Congenital solitary kidney with hydronephrosis: report of five cases].
Congenital solitary kidney with hydronephrosis is a rare anomaly. Five cases including 4 boys and 1 girl were detected to have this disease in the last 3 years. Of the patients, a case had hydroureter. Ages ranged from 8 to 12 years. The intermittent abdominal pain was complained in one case. The enuresis was noted in another case. The other 3 cases were asymptomatic. The anomaly in these patients incidentally detected with ultrasound and then was confirmed by intravenous urogram and/or radionuclide scan. Diuretic radionuclide renogram T1/2 was used in these patients. A patient with UPJ obstruction was demonstrated and received surgery. Others were non-obstructive and followed up at OPD. Since sonography is a noninvasive modality, it can serve as a tool for long-term followup of such nonoperative patients for the evidence of urinary infection and stone formation, and the status of the functional solitary kidney.
Child↗
[Congenital megacalyces].
Congenital megacalyces is a calyceal anomaly characterized by nonobstructive dilatations of the calyces, associated with hypoplasia of the medullary pyramids. In the past three years, seven patients with congenital megacalyces were found incidentally during renal ultrasonic examination. There were five boys and two girls who were asymptomatic, except for a case with hematuria. Three cases presented bilateral and four unilateral, ages ranged from 7 to 14 years. In this series, all cases with dilatations of the calyces were initially detected by sonography, and then confirmed by other radiologic examinations. On intravenous urography, contrast material was visible at the normal time, but prolonged opacification. The radiological features presented widen calyces, flattened papillae, absence of papillary tips and usually no significant dilatation of the renal pelvis and ureter. The renal medulla had become thin. An ultrasound examination showed the kidneys with dilated calyces and decreased parenchyma. Renal pelvis and ureter were mostly normal in size. Diuretic radionuclide renogram T1/2 was performed in five cases, to disclose nonobstructive lesions. Radionuclide cystography, underwent in three cases, revealed no reflux phenomenon. Renal function was normal in all cases. Congenital megacalyces are a non-progressive lesions. Therefore, it is important to recognize the clinical entity and avoid unnecessary surgery. Since sonography is a noninvasive modality, it can serve as a tool for long-term follow-up of these patients and for the detection of possible future stone formation.
Adolescent↗
Spontaneous focal intestinal perforation in prematurity: report of three cases.
Three premature neonates with a localized perforation of the intestine, but not associated with necrotizing enterocolitis (NEC) or gastrointestinal anomaly are reported. The birth weight of these babies was around 1500 g and they exhibited striking similarities in the clinical course. Before laparotomy, NEC was firstly impressed. Abdominal distension, refusal of feedings, poor activity and respiratory distress were the major manifestations. Pneumoperitoneum was all detected before operation. The perforate site was terminal ileum in one and anterior cecum in the other two babies. The gastrointestinal tract was otherwise normal. The first case received segmental resection of the perforation with end to end anastomosis and the other two underwent ileostomy. Bacteria was discovered from the peritoneal fluid in the second and third cases, including E. coli, Enterobacter cloacae and Klebsiella pneumoniae respectively. The postoperative course was complicated with wound infection and adhesion ileus in two patients. Rectal suction biopsy in the second and third cases showed normal histology. Until present all three patients were uneventful. We concluded that premature or very low birth weight infants with spontaneous, localized gastrointestinal perforation and peritonitis had milder course than NEC, and if promptly diagnosed and treated, the prognosis is excellent.
Cecal Diseases↗
Mesenchymal hamartoma of the liver: report of a case.
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Celiac Artery↗