Formosan Journal of Surgery RSS feed: Articles in Press. The Formosan Journal of Surgery (FJS) is the official international peer-reviewed publication of the Taiwan Surgical Association . The Journal began life in January 1968, when it was called the Taiwan Journal of Surgery , which dealt with all surgical subspecialties, including thoracic surgery, cardiovascular surgery, digestive surgery, neurosurgery, endocrine surgery, pediatric surgery, plastic surgery, and orthopedic surgery. The Journal welcomes clinical as well as basic research papers on both medical and surgical aspects of various diseases (mainly surgical) from all over the world. It is published every 2 months by Elsevier, with a circulation of about 5400 copies per issue, and is indexed in the ScienceDirect, SCOPUS, Academic Citation Index (ACI) and Taiwan Academic Online (TAO). http://www.e-fjs.com//inpress?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. Formosan Journal of Surgery1682-606X2012-05-07 © 2012 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.e-fjs.com/article/PIIS1682606X12000266/abstract?rss=yesSummary: Background: Dysfunctional voiding is an abnormality of bladder emptying in neurologically normal individuals where the external sphincter activity increases during voiding, and it is difficult to diagnose by symptoms alone. Videourodynamic study could provide great help in differentiating dysfunctional voiding and other voiding disorder. In this retrospective study, we analyze the videourodynamic parameters of the patients with dysfunctional voiding.Purpose: To investigate the clinical presentations and videourodynamic characteristics of adult women with dysfunctional voiding (DV).Methods: A total of 1605 women with lower urinary tract symptoms (LUTS) were investigated with videourodynamic (VUD) studies from 1997 to 2010. The clinical urinary symptoms and VUD characteristics of DV were compared with a group of urodynamically normal controls. Antimuscarinic or alpha-blocker treatment, with or without a skeletal muscle relaxant according to the chief complaint was given.Results: There were 168 women diagnosed with DV. Detrusor overactivity (DO) occurred in 69% of women with DV. Patients with DV had significantly lower cystometric bladder capacity, higher detrusor pressure, lower maximum flow rate, and larger post-void residual volume than the controls. A total of 114 (67.9%) patients had storage symptoms and 54 (32.1%) had voiding symptoms as their chief complaints among those with DV. Among them, urinary frequency (n = 69, 41.1%) was the most common chief complaint, followed by dysuria (n = 54, 32.1%), and urgency incontinence (n = 26, 15.5%). The incidence of urgency incontinence and dysuria were significantly greater than that in the control group, however, the incidence of frequency, urgency, or nocturia showed no significant difference between DV and control groups. Recurrent UTI was a common adverse event, and happened in 20 patients (12%) with DV. The medication, alpha-blocker or antimuscarinic agent, was prescribed to the patients with DV according to their symptoms. The success rates were 41.2% (n = 47) for antimuscarinic therapy and 51.9% (n = 28) for alpha-blocker therapy in patients with storage and voiding LUTS, respectively (p = 0.366).Conclusion: DO and storage LUTS commonly occurred in women with DV, suggesting DO could be one of the etiology in the pathophysiology of DV. VUD studies yielded a high diagnostic rate for DV in women with LUTS.Therapeutic effects of transurethral incision of the bladder neck on primary bladder neck dysfunction refractory to alpha-adrenergic blockade in men - Corrected ProofYih-Chou Chen, Chung-Cheng Wang, Hann-Chorng Kuo10.1016/j.fjs.2012.03.001Formosan Journal of Surgery (2012)2012-05-07Formosan Journal of Surgery2012-05-07ORIGINAL ARTICLEhttp://www.e-fjs.com/article/PIIS1682606X12000308/abstract?rss=yesSummary: Tumor with bone metastases to the periacetabulum is rare, and its surgical management is challenging. Instead of wide excision with reconstruction of the hip joint, we used a relatively noninvasive method to manage periacetabular metastasis. Such a procedure for this condition has the benefits of short surgical time, less bleeding, and fewer complications during surgery. Our surgical management of the case reported here included curettage, phenol cauterization and filling of cisplatin-loaded cement in order to reduce local recurrence. After following-up for 2 years, there was no local recurrence and disease progression.Minimal invasive strategy for gynecologic cancer with solitary periacetabular metastasis - Corrected ProofYi-Chou Chen, Po-Kuei Wu, Cheng-Fong Chen, Chien-Lin Liu, Wei-Ming Chen10.1016/j.fjs.2012.03.005Formosan Journal of Surgery (2012)2012-05-07Formosan Journal of Surgery2012-05-07CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X1200028X/abstract?rss=yesSummary: Blunt abdominal injuries are not uncommon; however, ileal perforation caused by blunt trauma, especially when associated with an inguinal hernia, is a very rare event, and a difficult diagnosis. We present the case of a 63-year-old male who had sustained a blunt abdominal injury on his left inguinal hernia in a bicycle versus motorcycle accident. Computed tomography (CT) scans on arrival at hospital showed the left inguinal hernia with partial protrusion of the small intestine, without categorical inflammatory changes of the mesenteric tissue or intraperitoneal fluid. During observation, he sustained intermittent lower abdominal pain. About 8 hours later, hypotension and fever ensued. The repeated CT scans showed adjacent bowel edema with free air, and a hernia sac, in the left lower quadrant of the abdomen. Emergency laparotomy revealed ileal perforation. Segmental resection with end-to-end anastomosis was performed. The patient made an uneventful recovery and was discharged 2 weeks later. Although the CT scan has become the gold standard in evaluating abdominal trauma, delayed perforation of the intestine with blunt injuries may escape early detection. Serial physical examinations with a high index of suspicion are mandatory in susceptible patients to avoid time-related complications. The imaging findings from a single examination should not be depended upon solely.Delayed presentation of herniated ileal perforation after blunt abdominal injury - Corrected ProofKwan Ming Soo, Hsing-Lin Lin, Chao-Wen Chen, Yuan-Chia Cheng, Wei-Che Lee10.1016/j.fjs.2012.03.003Formosan Journal of Surgery (2012)2012-04-30Formosan Journal of Surgery2012-04-30CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000291/abstract?rss=yesSummary: We report a case of acute subdural hematoma as the first manifestation of colon cancer and emphasize the need for careful assessment and consideration of clinical and radiological data for patients with nontraumatic subdural hematoma.Intracranial metastasis of colon cancer with acute subdural hematoma - Corrected ProofFu-Yuan Shih, Tao-Chen Lee, Jui-Wei Lin, Tsung-Ming Su, Hsiang-Lin Lee, Tsung-Han Lee10.1016/j.fjs.2012.03.004Formosan Journal of Surgery (2012)2012-04-30Formosan Journal of Surgery2012-04-30CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000084/abstract?rss=yesSummary: Primary breast neuroendocrine carcinoma (BNEC) is rare. High-grade BNEC, such as small cell carcinoma and large cell carcinoma, sometimes exhibits specific histological features, and is easily diagnosed. Low-grade solid BNEC, however, may demonstrate no specific neuroendocrine features on histological examination, which serve to distinguish it from conventional invasive carcinoma. Here, we present the case of a 46-year-old woman who was suspected of having BNEC. Suspicion was initially aroused by crush artifact during the time of frozen section. Subsequent immunohistochemistry established the diagnosis of solid BNEC according to the criteria of the WHO definition.Neuroendocrine carcinoma of the breast - Corrected ProofPing-Hung Huang, Yi-You Chan, Qi-Xuan Lin10.1016/j.fjs.2012.01.007Formosan Journal of Surgery (2012)2012-04-27Formosan Journal of Surgery2012-04-27CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000278/abstract?rss=yesSummary: Esthesioneuroblastoma is a rare neoplasm arising from the olfactory epithelium, and shows intracranial extension in the advanced disease. We report here a 40-year-old female, who had initially been diagnosed to have a Kadish stage C esthesioneuroblastoma. Recurrence presented about 10 months after the first operation, radiotherapy and chemotherapy, with pure bilateral subdural extension but without local signs. Although recurrence is common in advanced esthesioneuroblastoma, such a pattern of presentation is rare, with only three similar cases reported previously. We discuss the possible pathophysiology of such an event and propose possible means of prevention.Recurrent pure subdural extension of esthesioneuroblastoma - Corrected ProofBoon-Kee Lua, Ann-Shung Lieu, Shiuh-Lin Hwang, Shen-Long Hong10.1016/j.fjs.2012.03.002Formosan Journal of Surgery (2012)2012-04-26Formosan Journal of Surgery2012-04-26CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000059/abstract?rss=yesSummary: Mesenchymal chondrosarcomas are very rare central nervous system (CNS) tumors consisting of undifferentiated mesenchymal cells plus islets of cartilage. We report a case of giant intracranial mesenchymal chondrosarcomas presenting with acute neurologic deterioration. A 22-year-old woman presented with right facial and hand numbness and ocular torsion for about 2 weeks. Magnetic resonance imaging (MRI) disclosed a mass in the right middle cranial fossa with a mass effect. Two days before scheduled surgery, the patient suddenly lost consciousness and was found to have uncal herniation. At emergency surgery, the tumor was totally excised. Pathologically, there was a dimorphic pattern of undifferentiated cells and islets of cartilage, consistent with mesenchymal chondrosarcoma. Although the patient survived surgery, she remained in a vegetative state. The tumor recurred 3 years after surgery. Intracranial mesenchymal chondrosarcoma is rare and should be considered when evaluating a tumor with dural involvement, particularly in younger adults. Differential diagnoses include intracranial meningioma and schwannoma. An aggressive surgical resection is highly recommended because of the high risk of recurrence.Giant intracranial mesenchymal chondrosarcoma with uncal herniation - Corrected ProofHung-Shih Lin, Cheng-Chia Tsai, Cheng-Kuei Chang, Shiu-Jau Chen10.1016/j.fjs.2012.01.004Formosan Journal of Surgery (2012)2012-03-19Formosan Journal of Surgery2012-03-19CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000072/abstract?rss=yesSummary: Amputation of facial tissue presents difficult management problems, including cosmetic, functional, and psychological effects for the patient. A case of successful microsurgical replantation of a bitten-off vermilion of the lower lip is hereby reported. The outcome in this case was both functionally and cosmetically acceptable. A comprehensive review of the literature on the subject of lip replantation is also made in this communication.Successful replantation of a bitten-off vermilion of the lower lip - Corrected ProofChing-Yueh Wei10.1016/j.fjs.2012.01.006Formosan Journal of Surgery (2012)2012-03-14Formosan Journal of Surgery2012-03-14CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000060/abstract?rss=yesSummary: Exostosis, also known as osteochondroma, results from a disorder of the growth-plate in which bone grows from the growth axis to form an irregular projection. This abnormality most commonly occurs around the femur, scapula, humerus, and ribs. Hemothorax and diaphragmatic rupture are known complications of exostotic growth, but they are rarely reported. Here we present a case, possibly the first one in Taiwan, with pin-like inward-facing exostosis in a 20-year-old man with hereditary multiple exostosis that caused hemothorax and required surgical intervention. Exostosis is asymptomatic in most cases and requires no treatment. However, when it causes bursitis or local entrapment of vessels, or when tendons or nerves are involved, surgical resection becomes necessary.Thorn-like costal osteochondroma presenting as hemothorax in an adult - Corrected ProofPen-Gang Cheng, Chang-Chin Chen, Shyi-Kuen Wu, Soa-Min Hsu, Matthew N. Wang10.1016/j.fjs.2012.01.005Formosan Journal of Surgery (2012)2012-03-05Formosan Journal of Surgery2012-03-05CASE REPORThttp://www.e-fjs.com/article/PIIS1682606X12000047/abstract?rss=yesSummary: Aneurysms arising from the posterior inferior cerebellar artery (PICA) are uncommon, accounting for 0.5–3% of all intracranial aneurysms. Symptoms and signs usually include subarachnoid hemorrhage, neck pain, dizziness, and coma. We describe a patient who presented with cervical myeloradiculopathy (manifested by neck, shoulder, and arm pain) and an unsteady gait whose symptoms persisted after surgery on the cervical spine. A PICA aneurysm was diagnosed incidentally when we performed computed tomography (CT) of the brain and angiography after he fell into a coma. The patient was successfully treated with endovascular therapy. We emphasize that the symptoms of a PICA aneurysm may clinically mimic cervical myeloradiculopathy, and that PICA aneurysms may thus be overlooked.Posterior inferior cerebellar artery aneurysm mimicking cervical myeloradiculopathy - Corrected ProofChe-Wei Hung, Cheng-Hsing Kao, Chao-Hung Yeh10.1016/j.fjs.2012.01.003Formosan Journal of Surgery (2012)2012-02-27Formosan Journal of Surgery2012-02-27CASE REPORT