Browsing by Author "Chen, Jeng-Chang"

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Analysis of changes to the anterior chest wall after the Nuss procedure-an objective measurement of pectus excavatum
(2009-12-01)
Chang, Pei-Yeh
;
Chang, Chaur-Hsiang
;
Lai, Jin-Yao
;
Chen, Jeng-Chang
;
Perng, Der-Baau
Introduction: We report a noninvasive method for recording the deviation of the anterior chest wall (ACW) in patients with pectus excavatum before and after the insertion and removal of a Nuss bar. Patients and Method: All patients undergoing the Nuss procedure at our institutions between June 2008 and February 2009 were enrolled in this study. A thermal plastic strip was used to cast the ACW at the skin level along the area corresponding to the tract of the inserted bar. The height of the ACW was defined as the perpendicular length from the xiphoid process to the transverse line drawn between the 2 midaxillary points. Results: Bar insertion caused a significant increase in ACW height and width. Bar removal reduced the corrective effects in terms of a significant decrease in ACW height; at the same time, an increase in ACW width was noted. Conclusion: Feature extraction and analyses of permanent contour casts of the ACW help to understand immediate changes in the ACW after the Nuss procedure and may assist in the design of the bar at insertion. The Nuss bar in situ helped to maintain cosmetic benefits to the ACW. (C) 2009 Elsevier Inc. All rights reserved.
Diverse Presentations in Pediatric Meckel's Diverticulum: A Review of 100 Cases
(2014-10-01)
Huang, Chen-Chuan
;
Lai, Ming-Wei
;
Hwang, Fang-Ming
;
Yeh, Yu-Chen
;
Chen, Shih-Yen
Background: Our objective was to analyze demographics and characteristics of Meckel's diverticulum with different manifestations in pediatric patients. Methods: This is a retrospective study in children with symptomatic Meckel's diverticulum who underwent resection between September 1998 and October 2010. The diagnosis was confirmed by surgery and pathology. Demographic characteristics, manifestations, Meckel's scan results, surgical and histological findings were analyzed. Results: One hundred symptomatic Meckel's diverticula were identified in 74 boys and 26 girls aged from one day to 18 years old over 13 years. Depending on whether or not obstruction occurred, the patients were classified into two categories. Each category was further subdivided into two diagnostic groups: 17 intussusception and 24 non-intussusception bowel obstruction in the obstructive category and 44 gastrointestinal bleeding and 15 diverticulitis and/or perforation in the non-obstructive category. The sex discrepancy was higher in the non-obstructive category than in the obstructive category (male-to-female, 4.36 vs. 1.73, p < 0.05). Forty-one of 44 patients with gastrointestinal bleeding underwent a Meckel's scan with a high positive rate (92.7%). The ectopic tissues were identified in 73 patients and included 61 gastric type, two pancreatic type and 10 mixed type. Ectopic tissues were more prevalent in non-obstructive category (p < 0.05) with ectopic gastric tissue even more pronounced (p < 0.01). Ectopic pancreatic tissue was significantly more prevalent in intussusception (p < 0.01). Laparoscopic surgery was performed more frequently in Meckel's diverticulum with non-obstructive symptoms (p < 0.001). Conclusion: Diverse presentations in pediatric Meckel's diverticulum are affected by different ectopic tissue types and male sex. Laparoscopic surgery is widely used for children with non-obstructive symptoms. Copyright (C) 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.
Diverse Presentations in Pediatric Meckel\'s Diverticulum: A Review of 100 Cases
(2014-10-01)
Huang, Chen-Chuan
;
Lai, Ming-Wei
;
Hwang, Fang-Ming
;
Yeh, Yu-Chen
;
Chen, Shih-Yen
Background: Our objective was to analyze demographics and characteristics of Meckel\'s diverticulum with different manifestations in pediatric patients. Methods: This is a retrospective study in children with symptomatic Meckel\'s diverticulum who underwent resection between September 1998 and October 2010. The diagnosis was confirmed by surgery and pathology. Demographic characteristics, manifestations, Meckel\'s scan results, surgical and histological findings were analyzed. Results: One hundred symptomatic Meckel\'s diverticula were identified in 74 boys and 26 girls aged from one day to 18 years old over 13 years. Depending on whether or not obstruction occurred, the patients were classified into two categories. Each category was further subdivided into two diagnostic groups: 17 intussusception and 24 non-intussusception bowel obstruction in the obstructive category and 44 gastrointestinal bleeding and 15 diverticulitis and/or perforation in the non-obstructive category. The sex discrepancy was higher in the non-obstructive category than in the obstructive category (male-to-female, 4.36 vs. 1.73, p < 0.05). Forty-one of 44 patients with gastrointestinal bleeding underwent a Meckel\'s scan with a high positive rate (92.7%). The ectopic tissues were identified in 73 patients and included 61 gastric type, two pancreatic type and 10 mixed type. Ectopic tissues were more prevalent in non-obstructive category (p < 0.05) with ectopic gastric tissue even more pronounced (p < 0.01). Ectopic pancreatic tissue was significantly more prevalent in intussusception (p < 0.01). Laparoscopic surgery was performed more frequently in Meckel\'s diverticulum with non-obstructive symptoms (p < 0.001). Conclusion: Diverse presentations in pediatric Meckel\'s diverticulum are affected by different ectopic tissue types and male sex. Laparoscopic surgery is widely used for children with non-obstructive symptoms. Copyright (C) 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.