Factor VIIa ; Genetic Therapy ; Hemophilia A ; drug therapy ; epidemiology ; genetics ; physiopathology ; History, 21st Century ; Humans ; Recombinant Proteins ; Singapore ; epidemiology

No abstract available.
Asphyxia* ; Phenobarbital* ; Seizures*

Sick neonates often require periodic small volume transfusion (10mg/kg) to replace blood draw for laboratory monitoring during their hospital stay. The effect of packed red cel transfudion on the hematocrit, potassium, ionized calcium, acid base status, glucose and indirect bilirubin was investigated in 25 transfusions. Analysis of transfused blood by the age of the red cells, older red cells (more than 5 days old, 13+/-7 days) showed increased potassium (27.2+/-14.1mEq/L vs 11.3+/-4.9mEq/L), decreased bicarbonate (14.4+/-2.6mEq/L) and glucose (130+/-28mg/dl vs 203+/-93mg/dl) compared with newer red cells (less than 5 days)(p<0.05). No significant changes occured in hematocrit and pH. Inspite of these results, the transfusion of the older red cells did not affect the older red cells did not affect the serum potassium, ionized calcium, pH, bicarbonate, glucose and indirect bilirubin level in neonates. The hematocrit of infants increated significantly after transfusion from 29.6%+/-4.3% to 38.3%+/-6.1%(mean+/-SD)(P<0.05). Transfusion of older red cells seemed to be as equally effective as newer ones. The valus of hematocrit obtained immediately after transfusion does not show any differences compared to those obtained 30 min, 1, 2, 4, 6 and 24 hours after transfusion. The result in the study indicate that there was no adverse effect after transfusion with packed red cell more than 5 days old and no significant difference in hematocrit observed between 0 to 24 hours following transfusion. Therfore old red cell more than 5 days can be used safely for sick neonatal transfusion and the stored donor blood can be optimzed for repeated blood transfusion.
Bilirubin ; Blood Transfusion ; Calcium ; Glucose ; Hematocrit* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Length of Stay ; Potassium ; Tissue Donors

PURPOSE: The American Joint Committee on Cancer 8th edition (AJCC8) prognostic stage (PS) was implemented January 1, 2018, but it is complex due to multiple permutations. A North American group proposed a simpler system using the anatomic stage with a risk score system (RSS) of 1 point each for grade 3 tumor and human epithelial growth factor receptor 2 (HER2) and estrogen receptor (ER) negativity. Here we aimed to evaluate this risk score system with our database of Asian breast cancer patients and compare it against the AJCC8 PS. METHODS: Patients diagnosed with breast cancer stage I–IV in 2006–2012 were identified in the SingHealth Joint Breast Cancer Registry. Five-year breast cancer-specific survival (CSS) and overall survival (OS) were calculated for each anatomic stage according to the risk score and compared with the AJCC8 PS. RESULTS: A total of 6,656 patients were analyzed. The median follow-up was 61 (interquartile range, 37–90) months. There was a high receipt of endocrine therapy (84.6% of ER+ patients), chemotherapy (84.3% of node-positive patients), and trastuzumab (86.0% of HER2+ patients). Within each anatomic stage, there were significant differences in survival in all sub-stages except IIIB. On multivariate analysis, the hazard ratio for negative ER was 1.74 (1.48–2.06), for negative HER2 was 1.49 (1.26–1.74), and for grade 3 was 1.84 (1.55–2.19). On multivariate analysis controlled for age, ethnicity, and receipt of chemotherapy, the RSS (Akaike information criterion [AIC] = 10,649.45; Harrell's Concordance Index [C] = 0.85) was not inferior to the AJCC8 PS (AIC = 10,726.65; C = 0.84) for CSS, nor was the RSS (AIC = 14,714.4; C = 0.82) inferior to the AJCC8 PS (AIC = 14,784.69; C = 0.81) for OS. CONCLUSION: The RSS is comparable to the AJCC8 PS for a patient population receiving chemotherapy as well as endocrine- and HER2-targeted therapy and further stratifies stage IV patients.
Asian Continental Ancestry Group ; Biomarkers ; Breast Neoplasms ; Breast ; Drug Therapy ; Estrogens ; Follow-Up Studies ; Humans ; Joints ; Multivariate Analysis ; Trastuzumab

No abstract available.
Phototherapy*

No abstract available.
Blood Glucose* ; Humans ; Hypoglycemia ; Infant, Newborn* ; Plasma*

Three cases of polycystic kidney were treated with conservative therapy. Of three cases one showed normal blood pressure and improved digestive disturbance after the therapy. i. e., direct aspiration of the kidney. Direct aspiration method is thought to be desirable one before the kidney operation is performed.
Blood Pressure ; Kidney ; Polycystic Kidney Diseases*

Exteriorization of the ureteral stump in nephrectomy was devised by Dr. William Mayo and was clinically applied for the treatment of renal tuberculosis by Dr. John K. Lattimer. The method was used in eighteen cases of nephrectomy with successful results at our clinic during the past two years. Ureteral Exteriorization is considered one of the most reasonable methods of preventing possible local infection at the operative wound during and after nephrectomy of a severely infected kidney. We believe that instillation or continuous irrigation of antibacterial solutions through the exteriorized ureteral stump is a simple and useful procedure for the treatment of residual infection of the urinary tract after nephrectomy.
Kidney ; Nephrectomy* ; Tuberculosis, Renal ; Ureter* ; Urinary Tract ; Wounds and Injuries

The author has observed 17 cases of the penis carcinoma is 5 years during the period from April 1954 to March 1959. 1. Their average age was 50.1 years ranging from 36 to 66 years. 2. Thirteen of 17 cases were hard workers. Average duration between the onset of the penis cancer and patients visit to hospital was about 11 months. 3. Five cases of them had suffered from venereal disease, and all of them had long prepuce or complete phimosis. 4. In 9 cases the cancer was originated at the glans penis, in 4 cases at the inner surface area of the prepuce, in 3 cases at the sulcus cornalis and one at the outer surface of the prepuce. 5. Ten cases of them had the swelling of inguinal lymphnode. Grossly, lesions were composed of 5 ulcerative form, 5 infiltrative form, 4 nodular form and 3 papillary form. 6. Microscopical findings in 9 cases showed squamous cell carcinoma in 8 cases and one case of malignant melanoma. 7. In regards to the treatment of penis cancer. the most desirable method was to prevent it. Circumcision in early age and keeping genitalia clean may contribute to the prevention.
Carcinoma, Squamous Cell ; Circumcision, Male ; Female ; Genitalia ; Humans ; Male ; Melanoma ; Penile Neoplasms ; Penis* ; Phimosis ; Sexually Transmitted Diseases ; Ulcer

Introduction: Positive oral contrast is no longer deemed necessary for abdominopelvic computed tomography (CT) scans. Studies have shown water to be an equally effective oral contrast agent. However, to our knowledge no study has compared effectiveness between gastrografin and water in the same patient, which will provide a more objective evaluation of the two oral contrast agents. We aim to make a head-to-head comparison of water as neutral oral contrast (OC) against gastrografin as positive OC for abdominopelvic CT scans in the same patient. Methods: A retrospective review of 206 abdominopelvic CT scans of 103 patients was performed. The scans were reviewed in consensus by two blinded radiologists. The ability to visualise each abdominopelvic organ, contrastassociated artefacts and small bowel wall delineation, was qualitatively scored on a 5-point scale. Each patient had two sets of scores, one with water and another with gastrografin as OC. Paired scores from the two OCs were evaluated by Wilcoxon signed rank test to determine any significant difference in performance between the two OCs for visualisation of abdominopelvic anatomy on CT. Results: There was significantly better delineation of duodenal wall (p<0.001) and overall visualisation of the duodenum (p=0.011) using water as OC compared to gastrografin. No statistically significant differences were demonstrated between water and gastrografin for visualisation of the rest of the abdominopelvic organs, walldelineation of the rest small bowel and contrast-associated artefacts. Conclusions: Water can be used in place of gastrografin as oral contrast in abdominopelvic CT without compromising visualization of abdominopelvic organs.