1.Computed tomography analysis of primary bone tumors : the significance in the evaluation of destructive lesionsof pelvic bone.
Journal of the Korean Radiological Society 1988;24(4):648-655
In a study of 20 primary tumors of osseous pelvis proven pathologically, computed tomographic appearance wasanalysed and correlated with the conventional radiographic appearance in terms of destructive patterns, tumor-bonemargins, internal architectures, periosteal reaction and extents of the tumors. CT was invaluable for theassessment of the extent of tumors/associated extraosseous soft tissue masses and the detection of the internalmatrix within the tumor. We found the additional information about the extent of soft tissue mase in 4 cases (20%)and about the internal matrix in 5 cases (25%). According to the analysis of the patterns of corticaltransgression, grade III was absent in benignancy, but in 6 cases of malignant tumors. CT is less useful in theevaluation of the periosteal reaction and tumor-bone margin in flat bony lesions, not tumor-soft tissue margins.Certain types of tumor behavior characterizing the lesions under discussion may be helpful in diagnosis.
Diagnosis
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Pelvic Bones*
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Pelvis
2.A Rare Infection Following Snakebite.
Malaysian Orthopaedic Journal 2010;4(1):53-55
Snakebite is very common especially in Asia. We report a rare case of Providencia rettgeri infection following snakebite on the foot. This patient was treated with early and aggressive wound debridement, daily wound dressing during hospitalization and then skin coverage with split skin graft. No anti venom was given administered. Appropriate intravenous antibiotics were given to the patient while hospitalized and oral antibiotic were prescribed upon discharge. The outcome of this treatment was successful.
Orthopaedic
3.Cyclopiazonic acid enhanced the Ca~(2+)-dependent outward K~+ currents in cultural aortic smooth muscle cells from SHR and WKY
Yongyuan GUAN ; Zhang JOHN ; Rkw LEE ; Cy KWAN ; Ee DANIEL
Chinese Pharmacological Bulletin 1986;0(04):-
ABSTRACT The effects of cyclopiazonic acid (CPA) on the Ca2+ -dependent ourward K+-cur-rent [IK(ca)] were studied using whole-cell and single-channel patch-clamp techniques. Depolarization (pipette potential range from - 20 to - 120 mV)induced a outward Ik(ca) with a conductance of about 40 pS in the cultural aortic smooth muscle cells from SHR and WKY. 10 ?mol ? L-1 CPA significantly enhanced these currents and prolonged the mean open time of the channels. This effect of CPA was completely blocked by glybenclamide, a K+-channel block-er. In the whole cell recording experiments, CPA increased the amplitude of outward K+-current. This effect of CPA was Ca2+-dependent and completely blocked by glybenclamide. There was no any significant difference between the effects of CPA in SHR and in WKY. These results suggest that the functional change of vascular smooth muscle in SHR doesn't appear to be related to Ik(ca).
4.Surgical Fixation of a Comminuted Inter-Trochanteric Fracture in a Patient with Bilateral Below Knee Amputation
Malaysian Orthopaedic Journal 2018;12(1):54-56
Surgical fixation of hip fractures in patients with below kneeamputation is challenging due to the difficulty in obtainingoptimal traction for reduction of the fracture. Surgeons mayface difficulty in positioning such patients on the tractiontable due to the absence of the foot and distal lower limb.There are several techniques described to overcome thistechnical difficulty. In this case report, we present a case ofa 64-year old gentleman with bilateral below kneeamputation presenting with a comminuted rightintertrochanteric fracture. We highlight a simple andeffective method of applying skin traction to obtain adequatereduction for hip fracture fixation.
5.Five-Year Review of Patients Presenting with Non-Accidental Injury to a Children's Emergency Unit in Singapore.
Yi Rong CHEW ; Michaela Hl CHENG ; Mei Ching GOH ; Liang SHEN ; Peter Cy WONG ; Sashikumar GANAPATHY
Annals of the Academy of Medicine, Singapore 2018;47(10):413-419
INTRODUCTION:
There is an increasing trend of physical child abuse cases reported in Singapore. Children presenting to the Emergency Department with injuries require a high index of suspicion for clinicians to distinguish those that are abusive in nature.
MATERIALS AND METHODS:
A retrospective study of children with diagnosis of NAI presenting to KK Women's and Children's Hospital (KKH) from June 2011 to May 2016 was conducted.
RESULTS:
There were 1917 cases reported from 1730 subjects, of which: 8.8% of subjects had repeat visits; 55.2% of cases were male; and mean age was 7.69 years. Racial demographics were: Chinese 45.5%, Malay 33.4%, Indian 15.4% and Others 5.9%. The most frequent injuries sustained were head and neck (50.8%), limbs (32.2%), and chest (5.7%). Of the type of injuries, 55% had contusions, 21% had cane marks, 16% had lacerations, 4.4% had burn marks and 1% sustained fractures. Males were more likely to be caned ( <0.001); 54.9% of cases were admitted and 38.9% were discharged. Cases that presented without a parent ( <0.001), were known to Child Protective Service ( <0.001), or had a history of parental substance abuse ( = 0.038), mental illness in caregiver ( = 0.021), or domestic violence ( <0.001) were more likely to require admission.
CONCLUSION
Analysing these factors provide a better understanding of the presentation of NAI cases, including 'red flags' and vulnerable groups who should have better protection.
Age Factors
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Child
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Child Abuse
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prevention & control
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statistics & numerical data
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Child, Preschool
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Cohort Studies
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Emergency Service, Hospital
;
statistics & numerical data
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Ethnic Groups
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statistics & numerical data
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Female
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Hospitalization
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statistics & numerical data
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Humans
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Injury Severity Score
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Male
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Mandatory Reporting
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Needs Assessment
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Physical Abuse
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prevention & control
;
statistics & numerical data
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Prevalence
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Retrospective Studies
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Risk Assessment
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Sex Factors
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Singapore
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Vulnerable Populations
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statistics & numerical data
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Wounds and Injuries
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diagnosis
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epidemiology
6.Comparison of Outcomes of Intra-operative Neuromonitoring of Recurrent Laryngeal Nerve Versus Visualisation Alone during Thyroidectomies: A Singapore Experience.
Yao Guang LEOW ; Caroline Cy LEE ; Jereme Y GAN ; Lilleen M HUANG
Annals of the Academy of Medicine, Singapore 2020;49(11):870-875
INTRODUCTION:
Although intra-operative neuromonitoring (IONM) has become commonly used to identify the recurrent laryngeal nerve (RLN) during thyroid surgeries, its value is still debatable. This study aimed to evaluate the outcomes of thyroid surgery using IONM versus visualisation alone (VA).
METHODS:
We conducted a retrospective analysis of all the open thyroidectomies performed by the otolaryngology department in a tertiary institution in Singapore (Khoo Teck Puat Hospital) from 1 January 2014 to 31 December 2018. There were 301 nerves-at-risk (NAR), 139 in the IONM group and 162 in the VA group. The primary outcome measure was the incidence of RLN injury and the secondary outcome measure was operative duration.
RESULTS:
There were 33 NAR with immediate post-operative RLN injury, of which 7 had permanent (>6 months) injury. There were minor improvements in the respective rates of immediate and permanent injury in the IONM group (7.9%, 0.7%) compared to the VA group (13.6%, 3.8%), but these were not statistically significant (
CONCLUSION
The current study shows that the use of intra-operative neuromonitoring shows a tendency towards better RLN outcome and operative duration for total thyroidectomies, but the study may be too small to demonstrate a statistical difference.
8.Asian Consensus Report on Functional Dyspepsia.
Hiroto MIWA ; Uday C GHOSHAL ; Sutep GONLACHANVIT ; Kok Ann GWEE ; Tiing Leong ANG ; Full Young CHANG ; Kwong Ming FOCK ; Michio HONGO ; Xiaohua HOU ; Udom KACHINTORN ; Meiyun KE ; Kwok Hung LAI ; Kwang Jae LEE ; Ching Liang LU ; Sanjiv MAHADEVA ; Soichiro MIURA ; Hyojin PARK ; Poong Lyul RHEE ; Kentaro SUGANO ; Ratha korn VILAICHONE ; Benjamin CY WONG ; Young Tae BAK
Journal of Neurogastroenterology and Motility 2012;18(2):150-168
BACKGROUND/AIMS: Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. METHODS: Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group. RESULTS: Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added. CONCLUSIONS: This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians.
Asia
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Asian Continental Ancestry Group
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Consensus
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Dyspepsia
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Electronic Mail
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Helicobacter pylori
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Humans
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Life Style
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Physicians, Primary Care
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Politics
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Prevalence
9.The Singapore Myeloma Study Group Consensus Guidelines for the management of patients with multiple myeloma.
Sanjay de MEL ; Yunxin CHEN ; Sathish Kumar GOPALAKRISHNAN ; Melissa OOI ; Constance TEO ; Daryl TAN ; Min Li Claire TEO ; Allison Cy TSO ; Lian King LEE ; Chandramouli NAGARAJAN ; Yeow Tee GOH ; Wee Joo CHNG
Singapore medical journal 2017;58(2):55-71
Multiple myeloma (MM) is an incurable plasma cell neoplasm with an incidence of 100 patients per year in Singapore. Major advances have been made in the diagnosis, risk stratification and treatment of MM in the recent past. The reclassification of a subset of patients with smouldering MM, based on high-risk biomarkers, and the development of the revised international staging system are among the key new developments in diagnosis and staging. The use of novel agent-based treatment has resulted in significant improvements in the survival and quality of life of many patients with MM. Determining the optimal use of proteasome inhibitors, immunomodulators and, more recently, monoclonal antibodies is an area of ongoing investigation. In this guideline, we aim to provide an overview of the management of MM, incorporating the latest developments in diagnosis and treatment.
Aged
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Antibodies, Monoclonal
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chemistry
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Biomarkers, Tumor
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Female
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Humans
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Male
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Medical Oncology
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standards
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Middle Aged
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Multiple Myeloma
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diagnosis
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therapy
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Practice Guidelines as Topic
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Proteasome Endopeptidase Complex
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Quality of Life
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Risk
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Singapore
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Societies, Medical
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Stem Cell Transplantation
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Transplantation Conditioning