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Biomedical subjects

A Rauff

Publications and source records attributed to A Rauff.

At least 55 records · Page 3Linked to original sources
PubMed1989

Outcome of failure in clearing the oesophageal margin in total gastrectomy for adenocarcinoma.

Failure to clear the oesophageal margin in total gastrectomy for adenocarcinoma is believed to be a major cause of mortality and morbidity. The incidence of histologically positive margin could range from 7.3 to 74%. Forty nine cases of total gastrectomy for adenocarcinoma were reviewed and nine (18%) had a positive oesophageal margin. One of the nine patients died on the second postoperative day from technical difficulty: the rest did not have anastomotic leaks. They all eventually died of metastatic disease in 3-20 months. Two had mild dysphagic symptoms which did not require active intervention. It is concluded that a histologically positive oesophageal margin in total gastrectomy does not preclude good anastomotic healing. Sound surgical judgement is required to balance the risk of leaving a positive margin and the risk of an extended operative procedure particularly when majority of the total gastrectomies are palliative rather than curative.

Adenocarcinoma↗
PubMed1988

Surgical treatment of primary tumours of the innominate bone.

9 cases of primary malignant tumours of the pelvis were treated in our department from 1981 to 1987. There was three chondro-sarcomas, one giant cell tumour and five had soft tissue tumours. One has a classical hemipelvectomy while eight had limb preservation surgery performed. In this later group., three had type I (Enneking) resection, three combined type II/III and one a type III resection. Four patients have died since and three deaths were related to surgery and its complications. As to date, no local recurrences has occurred in those living (up to 7 years' follow up). We feel that local resection with limb preservation provides adequate local control of tumour. Various reconstructive procedures to cover skin defects, and reconstruct stability of the pelvis or create hip stability were also performed. Patients with no previous irradiation has less mobidity and tend to do well.

Adolescent↗
PubMed1988

Totally implantable central venous access for cancer patients in Singapore.

Sustained venous access is assuming increasing importance in clinical medical practice for the infusion of antibiotics, cytotoxic drugs, blood products and parenteral nutrition. The limitation of peripheral venous access in patients receiving cancer chemotherapy can be a major problem. Many antineoplastic drugs are vesicant and may cause chemical ulcers when infiltrated or phlebitis and thrombosis. Recent technological advances in development of non-thrombogenic silastic catheters have facilitated in-dwelling catheters to be implanted for long periods. Port-A-Cath is a totally implantable vascular access system which allows for blood to be sampled and also infusion of drugs and blood products. Between March 1985 to October 1987, 20 devices were implanted on 19 patients (14 males and 5 females). Criteria were drawn up to select these patients. The quality of life was significantly improved for these patients who receive long term chemotherapy or blood products through this device. There were 6 episodes of transitory occlusion of catheter and 1 episode of infection. Continuous infusion of drugs given through this device does not produce chemical phlebitis. It has also facilitated new methods of delivering cytotoxic drugs and analgesia.

Adult↗
PubMed1987

Clinico-pathological prognostic factors of large bowel cancer in Singapore: a multivariate analysis.

Clinical and pathological data from 219 cases of large bowel cancer were analysed using the Cox regression model to evaluate their effects on survival. Clinical variables such as sex, change in bowel habit, bleeding per rectum, tumour site, size and duration of symptoms had no significant influence on survival. Individually, age, abdominal distension, Dukes' stage and tumour grade had significant influence on survival. When considered together, Dukes' stage was the only variable selected. Therefore Dukes' stage is the most important prognostic factor in colorectal cancer. The distribution of patients was 25, 18, 26 and 31 percent for Dukes' A, B, C and D respectively. The probabilities of survival at five years were 71, 55, 36 and 16 percent for the respective Duke's stages. These data show that the clinical and pathological variables of patients with colorectal cancer in Singapore and the factors significantly associated with survival are similar to those in western countries.

Adult↗
PubMed1987

Some aspects of breast cancer in Singapore--a review of 306 cases.

A retrospective study of 306 cases of carcinoma breast in Singaporean patients managed at the University Department of Surgery, Singapore General Hospital was made, based on all available case notes, pathology report forms, operation record books, Cancer Registry Notification Forms, and data obtained from the Registry of Births and Deaths. These cases had their initial histological diagnosis made between 1970 to 1978. Basic data like age distribution, sex distribution and racial distribution of our cases are presented. Aspects of breast cancer like stage at time of diagnosis and 5- and 10-year survival figures are also presented. The crude five-year survival for all 306 cases was 56% and the crude 10-year survival for 223 cases was 22%. Survival for small lesions (T1, or less than 2 cm) was 90% at five years and 68% at ten years, a rate comparable with most centres in the world.

Adult↗
PubMed1986

Anterior resection using the circular stapling instrument: a Singapore experience.

The circular stapler was used for colorectal anastomosis in 38 patients (rectal carcinoma 37 cases, sigmoid diverticulitis one case). In Singapore Chinese patients, the most commonly used cartridge size was the EEA 28 mm and ILS 29 mm. The incidence of clinical anastomotic leakage in patients with complete resection rings was 10% (three leaks in 32 patients), leakage occurring only amongst the 24 patients who had resection of a tumour 6-9 cm from the anal verge. Significant, though easily dilatable, stenosis occurred in three patients (8%), and was associated with rectal membrane formation in two patients. Local recurrence, occurring in seven patients in a 0.5-3 year follow-up period was associated with Dukes' C disease; two recurrences occurred in four patients in whom the distal bowel clearance was less than 1.5 cm. The circular stapler facilitates sphincter conservation in mid-rectal cancer and its use in low anterior resection is justifiable when performed with a distal bowel clearance of 2 cm and complete excision of pararectal tissue above the pelvic floor muscles.

Adult↗
PubMed1986

Adrenal phaeochromocytoma and neurofibromatosis presenting with hypotension.

We report a case of adrenal phaeochromocytoma with the stigmata of neurofibromatosis, who presented with acute hypotension. The patient later had episodes of hypertension alternating with hypotension, associated with electrocardiographic changes simulating myocardial infarction, and finally a completed stroke. The circumstances illustrate the problem of early recognition of the protean clinical effects of an excess of circulating adrenal medullary hormones. They also emphasise the need to consider phaeochromocytoma as a differential diagnosis of apparent clinical shock.

Adrenal Gland Neoplasms↗
PubMed1986

Ultrasonography in the diagnosis of cholestatic jaundice.

Fifty consecutive patients (32 males and 18 females) with cholestatic jaundice were examined by grey-scale ultrasound from June 1981 to June 1983. All patients were studied without access to case notes. All patients had a diagnosis established by subsequent liver biopsy, clinical course, surgery or autopsy. Using the presence or absence of a dilated biliary system as the criterion, intrahepatic or extrahepatic cholestasis was correctly differentiated in 48 of the 50 patients, giving an overall accuracy of 96%. All 16 patients with intrahepatic cholestasis were correctly identified. Two of the 34 patients with extrahepatic cholestasis, each of whom had biliary stones, were misdiagnosed as intrahepatic cholestasis. In the 34 patients with extra-hepatic cholestasis, site of obstruction was defined in 55.9%, and specific aetiology diagnosed in 44.1%. Ultrasound proves to be an accurate method for the evaluation of cholestatic jaundice, and would have a definite value as a screening test before proceeding to invasive studies.

Cholestasis, Extrahepatic↗
PubMed1986

Liver abscess--a clinical study.

Forty consecutive cases of liver abscess from the Department of Medicine III, Singapore General Hospital, from 1978 to July 1983 were reviewed. Nineteen (47.5%) were amoebic, 15 (37.5%) pyogenic and 6 (15%) of unknown aetiology. Of the first 20 cases from 1978 to 1980, amoebic abscesses (60%) predominated. An increased incidence of pyogenic abscess constituting 50% was seen in the next 20 cases. Though all racial groups were affected, a predilection among Indians was seen. Males outnumbered females (4:1), and peak incidence occurred in the 40 to 70 age group (62.5%). Fifty percent presented early (less than one week of symptoms) to hospital. Common physical signs were fever (97.5%) and hepatomegaly (92.5%). Investigations showed leucocytosis in excess of 10,000 WBCs/cmm (87.5%), an ESR of 80 mm/hr (80%) and an elevated alkaline phosphatase of at least twice normal (73.6%). Single abscesses (72.5%) located in the right lobe were more likely to be amoebic. Where abscesses were multiple, they were more likely to be pyogenic (63.6%). Two-thirds of the pyogenic abscesses were due to either Klebsiella species or E. coli. Medical treatment consisted of broad spectrum antibiotics, usually in combination with metronidazole. Aspiration or drainage (open or closed) was employed when indicated. These were carried out more often for pyogenic than amoebic abscesses. Amoebic abscesses responded faster to treatment compared to pyogenic abscesses. Mortality in the first 20 cases prior to 1981 was 30%, being mainly confined to pyogenic abscesses. However, after 1981, there has been no mortality in the ensuing 20 cases.

Adolescent↗
PubMed1985

Correlation of steroid receptors with histologic differentiation in mammary carcinoma. A Singapore experience.

Cancer of the breast is the most common tumor in females in Singapore, with the rate of 20.7 per 100,000 per year (1977 estimate), which is predicted to increase to 29.8 per 100,000 women per year by 1995. A detailed histopathologic review of 50 primary breast cancer tumors analyzed for estrogen receptor (ER) level was carried out and a variety of morphologic features correlated with ER results to identify any factors that will improve the management and prognosis for breast cancer. Cytosol was incubated with 3H-estradiol in the presence and absence of cold diethylstilbestrol, and bound and free hormone were separated by Dextran-coated charcoal method. Tumors binding more than 5 fmol/mg cytosol protein were classified as ER-positive. Progesterone receptor (PR) level was analyzed in some specimens with the use of a similar method. Most of the patients were Chinese (90%). Three patients were Malays, one was Indian, and one was European in this series. Results indicated that there was strong correlation between ER level, age, and histologic grade of the tumors. No correlation existed between absence or presence of lymph node metastases and ER. Although there was a trend for ER-positive tumors to have a low-grade lymphocytic infiltration, the difference was not statistically significant.

Adult↗
PubMed1984

Immunocytochemical localization of testosterone in human hepatocellular carcinoma.

A study of 10 hepatoma patients was carried out for the detection and localization of oestrogen, progesterone, testosterone, and their corresponding binding sites in liver tumour cells using immunoperoxidase and immunofluorescent techniques on histopathological sections and cultured monolayers. None of the hepatomas was positive for progesterone and its receptor; one was positive for oestrogen and its receptor; five were positive for testosterone and its receptor. Oestrogen, testosterone and their respective receptors localized predominantly to the cytoplasm of hepatoma cells. The results obtained in this investigation reveal an association between testosterone and human liver cancer which may be useful in the selection and monitoring of liver cancer patients to future hormonal therapy.

Binding Sites↗