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Biomedical subjects

H K Ma

Publications and source records attributed to H K Ma.

At least 145 records · Page 8Linked to original sources
PubMed1983

Term breech delivery--is a high Caesarean section rate justified?

The Caesarean section rate for breech presentation has fallen from 60% in 1978 to 38% in 1980 at the University teaching hospital in Hong Kong. The number of Caesarean sections carried out for the indication of "unfavourable pelvis' in 1980 was approximately half that in 1978. No significant difference in perinatal outcome was noted in the group delivered vaginally in these 2 years. It was concluded that a high Caesarean section rate in term breech presentation may not be justified in modern obstetric practice because of the associated increase in maternal morbidity. Many patients labelled as having an "unfavourable pelvis' can in fact have a safe vaginal breech delivery.

Adult↗
PubMed1983

Partial hydatidiform mole: ultrasonographic features.

Four patients with partial hyatidiform mole managed at the Queen Mary Hospital, Hong Kong, are described. The diagnosis of blighted ovum or missed abortion was made on the sonographic findings prior to suction evacuation. The dominant features in these cases consisted of a relatively large central transonic area bearing the appearance of an empty gestational sac and surrounded by a thick rim of low-level placenta-like echoes; in contrast with the case of the blighted ovum, a well-defined echogenic sac wall is absent. In another 9 patients with molar pregnancy managed during the same period, the more typical 'snow-storm' vesicular appearance was present. It was concluded that the anembryonic appearance described should alert the sonologist and clinician to the possible diagnosis of partial hydatitiform mole. The evacuated material from the uterine cavity should be examined morphologically and if possible cytogenetically.

Adult↗
PubMed1983

Prolapse and presentation of the umbilical cord.

The outcome of pregnancies with prolapse and presentation of the umbilical cord at Tsan Yuk Hospital, Hong Kong, 1976 to 1982, was reviewed. The incidence was 0.17%, 70 of 41,939 deliveries; 98% of cases were diagnosed in hospital. Breech presentation, low birth-weight and artificial rupture of membranes were found to be significant associations; 78% of cases were discovered by vaginal examination and the diagnosis-delivery interval was less than 30 minutes in 75%. There were 8 perinatal deaths and 3 of these occurred in babies whose birth-weights were less than 1,000 g; 2 stillbirths were associated with presentation of the cord. The corrected perinatal mortality was 8.6% with a corresponding Caesarean section rate of 73.3%. 80% of the babies born by Caesarean section had 5 minutes Apgar scores of 7 or more. It was concluded that early diagnosis of umbilical cord prolapse followed by prompt treatment are effective in reducing the perinatal mortality rate. Energetic intrapartum monitoring is also essential in order that patients with occult prolapse or presentation of the umbilical cord be diagnosed early and treated promptly.

Adolescent↗
PubMed1983

Hyperprolactinaemic amenorrhoea in Hong Kong.

In a retrospective study of 595 patients attending the Menstrual Disorder Clinic from January, 1978 to December, 1981, 92 patients (15.5%) had raised serum prolactin (PRL) levels (greater than 25 ng/ml) on 2 or more separate occasions with a mean (+/- S.E.M.) value of 67.1 +/- 2.5 ng/ml. Galactorrhoea was found in 27.2% of the hyperprolactinaemic patients. Primary amenorrhoea was observed in 1 patient (1.1%) with serum PRL level of 68 ng/ml. Secondary amenorrhoea of longer than 6 months' duration occurred in 61 patients (66.3%) with mean PRL level 84.2 +/- 3.3 ng/ml. The 30 patients (32.6%) with irregular menstruation had a mean PRL level of 47.2 +/- 3.3 ng/ml. Investigations revealed that 43 patients (46.7%) had idiopathic hyperprolactinaemia, 14 patients (15.4%) had drug induced hyperprolactinaemia and 1 patient (1.1%) had hypothyroidism; 18 patients (19.5%) had suspected pituitary microadenoma and 16 patients (17.2%) had abnormal radiographic findings. Bromocriptine treatment was given to 38 patients, 13 with abnormal tomographic findings (mean serum PRL greater than 100ng/ml); 18 with suspected pituitary microadenoma (mean serum PRL 94 +/- 2.7 ng/ml) and 7 with idiopathic hyperprolactinaemia (mean serum PRL 65 +/- 4.7 ng/ml). All patients (38/38) responded to treatment with restoration of menstruation and cessation of galactorrhoea within 1 to 3 months. Mean PRL level was 21.6 +/- 5.2 ng/ml at the time of response. Thirteen patients subsequently became pregnant and all delivered healthy babies.

Adenoma↗
PubMed1983

Persistent chest opacity in trophoblastic disease: is thoracotomy justified?

From 1972 to June 1980, 138 patients were admitted into the University Gynaecological Unit, Queen Mary Hospital for persistent gestational trophoblastic tumours. Forty had pulmonary metastases, all were treated by chemotherapy and 5 died shortly after commencement of treatment. The remaining 35 patients went into biochemical remission. Five of these patients had persistent chest shadows and 2 had evidence of active disease. Thoracotomy is of doubtful value both in therapy and in predicting prognosis. These patients have an increased risk of relapse. Close and long-term follow-up HCG assay is advocated.

Adult↗
PubMed1983

Stimulation of the human spermatozoal fertilizing ability by dibutyryl 3',5'-CAMP and theophylline in vitro.

The stimulation of the human spermatozoal fertilizing ability by dibutyryl 3',5'-CAMP (diCAMP) and theophylline in suspected fertile and subfertile semen samples was demonstrated with the zona-free hamster ova penetration test. The penetration rates for the untreated (control) fertile and subfertile samples were 30% and 17%, respectively. DiCAMP increased the penetration rates to 54% and 37% (with 5 mM diCAMP) and to 46% and 36% (with 10 mM diCAMP) in the fertile and subfertile samples, respectively; theophylline increased the penetration rates to 56% and 35% (with 10 mM theophylline) and to 49% and 42% (with 20 mM theophylline) in the fertile and subfertile samples, respectively. These results indicate that diCAMP and theophylline can affect the fertilizing ability of human spermatozoa in vitro.

Animals↗
PubMed1983

Sonographic appearances of the partial hydatidiform mole.

A partial hydatidiform mole differs morphologically and cytologically from the complete mole. Correct preoperative diagnosis of the partial mole by ultrasonography is often difficult. Some partial moles have sonographic appearances indistinguishable from those of the common complete moles or missed abortions. The predominant feature in the remainder is the presence of a well-defined gestational sac, either empty or containing inappropriately small fetal echoes, surrounded by a relatively thick rim of placental echoes with intermingling cystic spaces. An echogenic rim around the sac, as is found in missed abortion or blighted ovum, is notably absent. There appeared to be no correlation between these sonographic patterns and the clinical profiles of patients.

Abortion, Missed↗
PubMed1982

The effect of oral contraceptives on coagulation and fibrinolytic parameters in the Chinese--a prospective study.

Thirty-two Chinese and 7 Caucasians were studied prospectively for 12 months for the effects of oral contraceptives (OC) on certain coagulation and fibrinolytic parameters. In both ethnic groups there was an increase in alpha 1 antitrypsin level. There was no significant change in antithrombin III concentration measured either by radioimmunoassay (At-III-RIA) or chromogenic assay (anti Xa-chromogenic) in the Chinese, but a significant decrease in anti Xa-chromogenic at 7 months and At-III-RIA at 12 months in the Caucasians. Also, alpha 2 plasmin inhibitor (alpha 2 PI) levels were unchanged in the Chinese but a significant increase occurred in the Caucasians at 12 months. Enhanced fibrinolytic response to venous occlusion was demonstrated in the Chinese at 12 months but not in the Caucasians.

Adult↗
PubMed1982

Fine needle aspiration in gynaecologic oncology.

One hundred and ten fine needle aspirations were performed on 73 patients with primary and recurrent gynaecological cancers. The sampling sites included superficial and retroperitoneal lymph nodes, soft tissue masses, liver, lungs, abdominal and pelvic masses, parametrium, thyroid and breast nodules. This relatively simple, safe and yet reliable technique can obviate the need for biopsies in most situations, and a more liberal use of aspiration cytology in gynaecological malignancies is advocated.

Biopsy, Needle↗
PubMed1981

Residual trophoblastic disease in association with partial hydatidiform mole.

A 10-year retrospective study was carried out of cases diagnosed as hydatidiform mole at the University of Hong Kong. Strict morphologic criteria established in a previous report were used to study the association of the partial mole syndrome with residual trophoblastic disease. Of the total of 138 cases available, 13 were found to be partial moles, 1 of which was followed by trophoblastic disease that required chemotherapy. This subsequently proved to be an invasive (partial) mole, the first example of its kind to be verified by pathology. The extent of the association between partial mole and subsequent trophoblastic disease and the spectrum of the pathologic lesions actually underlying the latter remain to be determined by further retrospective and prospective studies.

Adult↗
PubMed1980

Immunological parameters in gestational trophoblastic neoplasia.

Immunological function were studied in 22 patients with hydatidiform mole and 29 patients with malignant trophoblastic disease before and after treatment; normal pregnant and post-pregnant women served as controls. The only significant abnormality in hydatidiform mole was a low granulocyte chemotaxis before evacuation. In malignant trophoblastic disease the total lymphocyte counts, T-cell counts. B-cell counts, lymphocyte responses to mitogens and serum IgA levels were significantly lower than in normal women 6 wk after pregnancy. In those who responded to chemotherapy, these indices rose to the levels of post-pregnancy controls. An 'immune profile score' based on these indices was found to be a useful prognostic index. All patients with hydatidiform mole who had a score of 7 or less developed malignant trophoblastic disease, while the two patients with malignant trophoblastic disease who died had the lowest scores of the series.

Adolescent↗
PubMed1980

Deep vein thrombosis and changes in coagulation and fibrinolysis after gynaecological operations in Chinese: the effect of oral contraceptives and malignant disease.

Of 154 Chinese patients who underwent gynaecological operations, four showed a positive 125I fibrinogen leg scan for venous thrombosis, and overall incidence of 2 . 6%. In those who were on oral contraceptives and had major pelvic surgery for benign conditions, the incidence was 10 . 5%; in those who had Wertheim hysterectomy for carcinoma of cervix, it was 6 . 7%. This confirms the rarity of post-operative thromboembolism in the Chinese. Fragment E showed a biphasic rise after major operation due to tissue injury and venous thrombosis. In patients with malignancy, the postoperative 'fibrinolytic shutdown', represented by decreased plasminogen activator together with increased alpha 1 antitrypsin and C1- inhibitor levels, was more marked. In addition, alpha 2 macroglobulin level was lower and fell significantly after operation. In patients on oral contraceptives, fragment E levels were higher after surgery and there was no decrease in plasminogen activator levels. Antithrombin III levels did not fall except in three of the four patients with venous thrombosis. A marked increase in fragment E level and a decrease in antithrombin III level might be useful diagnostic markers for postoperative venous thrombosis.

Asian People↗