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Biomedical subjects

C K Mok

Publications and source records attributed to C K Mok.

85 records · Page 5Linked to original sources
PubMed1979

Y incision for median sternotomy.

Between July 1968 and June 1977, in the University of Hong Kong Department of Surgery, 1,083 patients underwent operations via a median sternotomy using a Y incision. Of these patients, 1,070 had open heart surgery, eight had total thymectomy and in five patients pericardectomy was carried out. The overall wound complication rate was 2.31%, with a wound infection rate of 1.24%. The main advantage of a Y incision is that it leaves a better cosmetic appearance than the usual vertical incision because the upper end of the scar is at a much lower level. The incidence of subcutaneous haematoma and subsequent wound infection is much lower with the Y incision, whereas the T incision is associated with a high rate of both these complications due to the large upper flap that one has to create and mobilize to expose the suprasternal area. While using the Y incision, one only requires a small V-shaped upper flap to obtain access to the suprasternal space.

Adolescent↗
PubMed1978

Coexistent bronchogenic carcinoma and active pulmonary tuberculosis.

Sixty-four cases of coexistent bronchogenic carcinoma and active pulmonary tuberculosis were diagnosed between 1969 and 1976. The majority were male chronic cigarette smokers in their fifth and sixth decades. Human bacilli were isolated in 48 patients (88.9 percent) and atypical bacilli in six patients (11.1 percent). All of the atypical bacilli and 8.3 percent of the human bacilli were found to be resistant to the first line antituberculous drugs. All patients, except two who died following resection, were given a course of antituberculous drugs with 93.8 percent successful sputum conversion. Uncontrolled or disseminated tuberculous infection was not observed. Forty-five patients (70.3 percent) underwent pulmonary resection. Median survival time of those who had curative resection was 14.3 months with a 5 year survival rate of 13.2 percent. Median survival times of those treated by palliative resection plus anticancer chemotherapy and by anticancer chemotherapy alone were 8.3 months and 11.1 months, respectively. None of these patients survived more than 30 months. It appears that, clinically, each disease runs its own course with little effect on the other.

Adenocarcinoma↗
PubMed1977

Syphilitic aortic aneurysm with spinal erosion. Treatment by aneurysm replacement and anterior spinal fusion.

Five cases of syphilitic aortic aneurysm with erosion of the spinal column are reviewed. Four patients underwent operation. When erosion of the spine was mild or moderate, the aortic lesion only was treated. Aneurysm associated with extensive vertebral erosion was treated in two cases by anterior spinal fusion combined with replacement of the disc and part of the aorta. In one of these cases the spine was later reinforced by a posterior spinal fusion. One patient so treated died a week after operation. The patient who refused operation later developed a complete paraplegia.

Adult↗
PubMedDate not supplied

Hypertrophic olivary degeneration following surgical excision of brainstem cavernous hemangioma: a case report.

Hypertrophic olivary degeneration (HOD) is a rare type of neuronal degeneration involving the dento-rubo-olivary pathway. It is distinguished from other types of neuronal degeneration in that hypertrophy, rather than atrophy, takes place in the neurons in the inferior olivary nucleus. Prior to the invention of Magnetic Resonance Imaging (MRI), HOD was difficult to be detected, and a firm diagnosis could only be made at autopsy. We present a case of bilateral HOD following surgical excision of a cavernous hemangioma in the brainstem. The literature and imaging findings of this uncommon condition are reviewed.

Adult↗
PubMedDate not supplied

Wilms' tumor with intracardiac extension: chemotherapy before surgery.

The article describes two Chinese boys ages 2 and 3 years with unilateral Wilms' tumors complicated by intracaval and intracardiac extension. In contrast to the previously recommended treatment with surgery followed by chemotherapy and radiation therapy, the children were managed primarily with combination chemotherapy before definitive operation. Reduction of tumor size on serial imaging was documented, and no viable tumor cells were found when the involved kidney and right atrium were explored. Both patients remained alive without evidence of disease more than 5 years after initial diagnosis. A literature search revealed case reports and retrospective analyses of 70 patients with Wilms' tumors and intracardiac involvement, and a tendency toward preoperative chemotherapy with or without the addition of radiation therapy was observed. The overall outcome of this group of patients parallels the outcome of those without intracardiac extension by histology and stage. Wilms' tumor presenting with extension into the inferior vena cava and right atrium is thus rare and renders the affected child with additional cardiovascular complications and operative risks. As a result of the uncommon occurrence, a consensus on management based on prospective study would be difficult. The present report and the literature are supportive of the use of preoperative chemotherapy in the initial management of advanced Wilms' tumor extending into the right atrium.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Delrin as an occluder material.

Delrin (DR) has been used in biomedical applications for more than 25 years. Because of durability concerns, it was replaced by the expensive Pyrolytic Carbon (PC) in numerous cardiac valves. However, the durability problem could be related to design rather than poor materials selection. Recent reports on brittle fracture of PC, leading to sudden deaths, have prompted a critical comparison between DR and PC in the St. Vincents Mechanical (SVM) heart valves. Three SVM-DR and SVM-PC valves were subjected to accelerated life cycle tests, and examined for wear at 400 million cycles. These results were compared to those of Björk-Shiley Delrin (BS-DR) valves. Wear in BS-DR valves in vivo for more than 17 years were also analyzed and compared. Using a linear (wear depth)-log (cycles) plot, wear rates in mm/log (million cycles) were obtained. The results showed that the wear rates for DR and PC in SVM valves are close. The double reduction in wear rate of the SVM-DR, compared to BS-DR, is probably due to the lower contact stresses of the SVM valves. SVM-DR in vivo should, therefore, have lower wear. The PC discs also showed edge chipping and hairline cracks. The authors conclude that the durability of DR can be improved by design and, since it is more impact resistant than PC, it is a safer, more inexpensive occluder material for cardiac valves.

Biomechanical Phenomena↗
PubMedDate not supplied

Effects of rheumatic mitral valvular disease and mitral valve replacement on growth and development.

The effects of rheumatic mitral valvular disease and mitral valve replacement on the growth and development of 37 Southern Chinese children were studied. The stature and body weight were measured before and after operation. All the patients had their skeletal maturity and cortical bone growth assessed after operation, but only 10 patients were similarly assessed before operation. At the time of operation the stature and body weight of all patients were generally retarded. The surgery which corrected the haemodynamic abnormality resulted in increases in the growth rates in stature and body weight but there was no evidence of a catch-up growth with subsequent return to normal dimensions. The patients who are skeletally immature had retarded bone ages and impaired growth of cortical bone. The general trend, though less marked, also showed a reduction in cortical bone in the skeletally mature patients. Surgery appears, at least partially, to alleviate the adverse effects of the disease on the growth and development of patients.

Adolescent↗
PubMedDate not supplied

The pattern of deep-vein thrombosis and clinical course of a group of Hong Kong Chinese patients following hip surgery for fracture of the proximal femur.

In a prospective study of deep-vein thrombosis following hip surgery for fractures of the proximal femur, 45 Hong Kong Chinese patients were examined by bilateral functional ascending phlebography 7 to 28 days postfracture and 5 to 15 days post-surgery. In 14 patients, the phlebography was repeated 10 to 32 days later. The patients were followed for 27 to 32 months. The phlebographic pattern of the venous thrombi were analyzed, and the clinical course of the patients was presented. Despite the fact that the overall incidence of deep-vein thrombosis in this group of Chinese patients was similar to that reported in the West, clinical pulmonary embolism was not observed. The study suggested a difference in the distribution, pattern and probably the natural history of the venous thrombi among the Chinese when compared with the Western series.

Adult↗