Search PubMed⌕ Search

Biomedical subjects

C Yeung

Publications and source records attributed to C Yeung.

45 records · Page 3Linked to original sources
PubMed1988

Limitations and dangers of gastrografin swallow after esophageal and upper gastric operations.

In a series of 135 patients who underwent esophageal and upper stomach surgery, the incidence of anastomotic leakage was 20.4 percent. One hundred four patients had either Gastrografin swallow or the methylene blue test to evaluate anastomotic integrity before resumption of oral feeding. Both tests were disappointing in that methylene blue failed to detect any case of leakage and Gastrografin swallow could only detect three cases of subclinical leakage. The high false-negative detection rate of Gastrografin swallow might be related to the inferior radiographic detail provided by this contrast medium. Aspiration of Gastrografin is potentially dangerous and could be fatal. We believe that barium sulfate, which provides better radiographic detail and is not so hazardous when aspirated, should be the contrast medium of choice.

Anastomosis, Surgical↗
PubMed1988

Infection rate for single lumen v triple lumen subclavian catheters.

An infection rate was calculated for all subclavian catheters inserted during a 12-month period. The overall, single lumen, and triple lumen infection rates were 1.7% (42/2,431), 0.4% (8/1,936), and 6.9% (34/495), respectively. After excluding single lumen catheters in patients in a surgical cardiovascular unit who appeared to have a decreased risk of infection, the overall, single lumen, and triple lumen rates were 3.7% (42/1,140), 1.2% (8/645), and 6.9% (34/495), respectively. Within this group, 11.8% (28/237) of the catheters used for total parenteral nutrition (TPN) were infected, whereas 1.6% (14/903) of the non-TPN catheters were infected. Of patients receiving total parental nutrition through a triple lumen catheter, 14.5% (25/172) became infected, whereas 4.6% (3/65) of the patients receiving total parental nutrition through a single lumen catheter became infected. Single and triple lumen patient groups appeared comparable based on average age, death rate, immunosuppression, underlying disease, and duration of catheterization, but the risk of infection was approximately three times greater for patients receiving total parental nutrition through a triple lumen catheter.

Aged↗
PubMed1988

Healing of esophageal fistulas after surgical treatment for carcinoma of the esophagus and the upper part of the stomach.

In a series of 132 patients who had undergone surgical treatment for carcinoma of the esophagus and upper part of the stomach, anastomotic leakage occurred in 29. We retrospectively studied the factors that could influence the healing of the fistulas in the management of this condition. Despite adequate supportive treatment, including total parenteral nutrition, five patients died from unrelenting infection. Fifteen fistulas closed spontaneously after an average of about four weeks of conservative treatment and full nutritional therapy. Those patients who had persistent fistulas after similar treatment were found to have either residual tumor after palliative operation or preoperative serum albumin levels that were lower than those of the other group. Prolonged conservative treatment for persistent fistulas may not be warranted if such risk factors are identified, and surgical repair should be considered.

Carcinoma↗
PubMed1987

Prediction of postoperative pulmonary complications in oesophagogastric cancer surgery.

In a series of 102 patients with cancer of the oesophagus or gastric cardia in whom surgery had been performed, postoperative respiratory infection, respiratory failure and mortality secondary to respiratory complication occurred in 55.8, 34.3 and 21.6 per cent respectively. The incidence of complications correlated well with the pre-operative peak expiratory flow rate when it was less than 65 per cent of the predicted normal value. However, the predictive ability of peak expiratory flow rate was much less than the patient's age, pre-operative serum albumin level, pre-operative Pa,O2 and number of surgical wounds when all risk factors were considered. Significantly more complications occurred when the patient was greater than 65 years old, Pa,O2 was less than 10 kPa, serum albumin was less than 39 g/l and when the operation required three incisions. These findings may serve as guidelines for identification of high-risk patients in the future.

Adult↗
PubMed1987

Acute appendicitis in children.

A prospective study was conducted on 344 children aged from 3 months to 16 years with acute appendicitis. Most children presented with typical features of acute appendicitis (70%) or peritonitis (28%). Atypical presentation was uncommon and occurred only in seven young children, masquerading as intestinal obstruction, gastroenteritis or urinary tract infection. Prolonged delay in surgery was associated with a rise in incidence of late appendicitis (gangrenous and perforated appendicitis). This rise was especially marked 37 h after onset of symptoms. The main causes of delay were inability of the parents and primary care medical practitioners to recognize the disease early. Surgeons contributed very little to the delay. High risk factors for postappendectomy sepsis were young children under 6 years old, late appendicitis, obese patients, inferior systemic antibiotic regimes and inexperienced surgeons. Young children had high postoperative sepsis mainly because of the high incidence of late appendicitis due to their inability to express their symptoms properly. They were not especially prone to postappendectomy sepsis; they had the same degree of appendicitis compared with older children. Measures to decrease the postappendectomy morbidity are suggested.

Acute Disease↗
PubMed1986

Conventional vs. triple rubber band ligation for hemorrhoids. A prospective, randomized trial.

Two hundred five patients with symptomatic first- and second-degree hemorrhoids were randomized to receive either conventional rubber band ligation or triple rubber band ligation. In conventional rubber band ligation, the hemorrhoids were ligated at one primary site per session at intervals of four weeks until symptoms were relieved or when all three hemorrhoids were ligated. In triple rubber band ligation, all three primary hemorrhoids were ligated in a single session. After completion of treatment, the patients were examined every three months, or earlier if symptoms recurred. Both methods were effective in the treatment of early hemorrhoids and the incidence of postligation pain and complications was similar. The advantages of having the treatment completed at the initial visit in triple rubber band ligation are obvious. Furthermore, less treatment sessions were required for triple rubber band ligation to control symptoms than for conventional rubber band ligation. Triple rubber band ligation is more cost-effective and therefore is recommended.

Clinical Trials as Topic↗
PubMed1986

Cefoxitin versus gentamicin and metronidazole in prevention of post-appendicectomy sepsis: a randomized, prospective trial.

Three hundred and seven patients with appendicitis were randomized to receive cefoxitin or gentamicin and metronidazole. For early appendicitis, a single preoperative dose of antibiotics was given. For late cases, the antibiotics were continued postoperatively for seven days. Both cefoxitin and gentamicin-metronidazole were effective in the reduction of post-appendicectomy septic complications in early or late appendicitis and there was no statistically significant difference between them. Mild transient and reversible nephrotoxicity was detected in 1.9% of patients who received gentamicin-metronidazole for seven days. Nephrotoxicity was not detected in any other patients. The cost of cefoxitin is higher, but this has to be balanced against the costs of monitoring serum gentamicin and creatinine levels, and the need to adjust the gentamicin dosage in 19% of patients when gentamicin-metronidazole was used. Both cefoxitin and gentamicin-metronidazole are effective and safe when used carefully. Cefoxitin has a slight advantage in its lack of potential nephrotoxicity and ototoxicity.

Adolescent↗
PubMed1984

Activated charcoal adsorption of diphenhydramine.

The adsorption of the antihistamine diphenhydramine (D) by activated charcoal (AC) was assessed in vitro and in vivo in six healthy volunteers in order to assess the utility of AC as an adjunct in the treatment of antihistamine overdose. Results of greater than 85% adsorption with AC:D weight ratios of 10:1 or greater in the in vitro studies led to a three-way crossover trial in six volunteers. Fifty mg D was administered alone (control), with 50 g AC within 5 minutes of D (D + C5) and with 50 g AC 60 minutes after D (D + C60). Mean reductions in peak serum D concentrations of 94.8% (D + C5) and 12.3% (D + C60), AUC 0-24 h of 96.9% (D + C5) and 20.4% (D + C60), and AUC 0-omega of greater than 90% (D + C5) and 24.0% (D + C60) were noted, although only the comparison of D with D + C5 reached statistical significance due to wide interpatient variation. A positive correlation of time to peak concentration of drug in serum in the control group with percentage reduction in AUC in the D + C60 group further indicate the potential for positive therapeutic benefit of AC in antihistamine overdose. This is because lag time and time to peak concentration may be excessively prolonged in overdose due to anticholinergic-induced alterations in G.I. motility. Maximal and multiple doses of AC are recommended for adjunctive treatment of antihistamine overdose.

Adsorption↗