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Biomedical subjects

J W Lo

Publications and source records attributed to J W Lo.

At least 19 recordsLinked to original sources
PubMed1997

Liver transplantation in children: the experience of Queen Mary Hospital, Hong Kong.

Seven living-related liver transplants (LRLT) and two reduced-size liver transplants (RSLT) were performed on eight children who suffered from end-stage liver disease, having previously undergone one to three abdominal operations. Their ages at initial transplantation ranged from 8 months to 11 years (mean 35 months, median 12 months). Excluding the two older children aged 7 and 11 years, respectively, the rest of the children weighed 6 to 9.5 kg (mean 7.3 kg) at the time of the initial transplantation. Seven left lateral segments (S2 + 3) and two left lobes (S2 + 3 + 4) were used; of these the smallest graft had a graft-to-recipient body weight ratio of 0.9%. The volunteer living donors were four mothers, two fathers and one sister who were selected after medical and psychiatric evaluations, and their suitability was confirmed by hematological, biochemical, and radiological criteria. During a follow-up period of 3 to 30 months, all eight children are alive and well with normal liver function, one of them having undergone a retransplant LRLT because of hepatitis of undetermined etiology following a RSLT 1.5 years earlier. All seven donors had an uneventful postoperative course and were discharged on day 4 to 7 postoperatively. They have all resumed normal day-to-day activities. There were no complications in the donor group. A variety of complications occurred in the recipients, all of which were overcome. Operating microscope was used to perform all the arterial anastomoses using microvascular techniques. This method has proven to be a major factor in preventing arterial thrombosis even with the smallest of arterial anastomosis where a 1.5-mm diameter recipient artery was anastomosed to a 2.5-mm diameter donor hepatic artery.

Activities of Daily Living↗
PubMed1997

Epidural infusion of bupivacaine 0.0625% plus fentanyl 3.3 micrograms/ml provides better postoperative analgesia than patient-controlled analgesia with intravenous morphine after gynaecological laparotomy.

One hundred and twenty women undergoing gynaecological abdominal operations were randomized to receive either epidural bupivacaine 0.0625% + fentanyl 3.3 micrograms/ml infusion (Group EPI, n = 57), or patient-controlled intravenous morphine analgesia (Group PCA, n = 54) for postoperative pain relief. The groups were comparable in demographic data, types and duration of operation. Group EPI achieved significantly lower verbal rating scale of pain (VRS) at rest at 0, 4, 12, 16, 20, 28 and 40th postoperative hours. The VRS during cough were also significantly lower in Group EPI at 0, 4, 8, 12, 28 and 36th postoperative hours. None of the patients had respiratory depression or hypotension. Nausea/vomiting occurred in 52.6%/33.3% of patients in Group EPI and 52.7%/37.0% in Group PCA. Most patients (84.2% in Group EPI and 72.2% in Group PCA) rated their pain management as "good". We conclude that epidural infusion of bupivacaine 0.0625% and fentanyl 3.3 micrograms/ml provide better analgesia than patient-controlled intravenous morphine after gynaecological laparotomy.

Analgesia, Epidural↗
PubMed1996

The development of hypercoagulability state, as measured by thrombelastography, associated with intraoperative surgical blood loss.

Thrombelastographic evidence of hypercoagulability, including shortening of r-time (P < 0.01); shortening of k-time (P < 0.01); and widening of trace angle (P < 0.01) were observed in a group of 21 Chinese surgical patients when (a) the amount of blood loss was at an estimated 10% of total blood volume and (b) the amount of blood loss was at an estimated 15% of blood volume. The amount of blood loss was documented by haemoglobin measurements. No evidence of hypercoagulability was observed at around one hour into the operation in the absence of bleeding. We conclude that a mild to moderate degree of surgical blood loss with haemodilution is associated with the development of hypercoagulability as measured by thrombelastography. Further studies looking at the thrombebolic outcome in such groups of patients is warranted. It is also suggested that caution should be exercised in the use of intraoperative isovolaemic haemodilution until the phenomenon is further investigated.

Adult↗
PubMed1996

Recovery from mivacurium block with or without anticholinesterase following continuous infusion in obstetric patients.

Neostigmine antagonism after suxamethonium followed by mivacurium chloride bolus and infusion was studied. Thirty ASA group I or II patients were given mivacurium 0.15 mg/kg followed by infusion during nitrous oxide-enflurane-pethidine anaesthesia. Train of four (TOF) stimuli were applied to the ulnar nerve at the wrist and TOF twitch height and ratio measured by TOF-GUARD nerve stimulator. Mivacurium infusion was titrated to give a 90% block of first twitch height. Patients were randomized into two groups. Group I patients recovered from the mivacurium block spontaneously while Group II patients were given neostigmine 0.05 mg/kg and atropine 0.02 mg/kg. Time to reach train of four ratio (TOFR) of 25%, 50% and 70% were measured. This study demonstrated a mean infusion rate of 5.1 +/- 1.8 micrograms/kg/min to maintain a 90% neuromuscular block. In the spontaneous recovery group, time to reach TOFR of 25%, 50% and 70% were 9.3 +/- 2.7 min, 13.5 +/- 3.0 min and 16.7 +/- 3.0 min respectively while the corresponding times in the neostigmine group were 5.2 +/- 1.7 min, 10.9 +/- 2.2 min and 16.1 +/- 7.4 min respectively. There were significant differences in the time taken to TOFR of 25% (P < 0.0001) and 50% (P < 0.05) but no difference in the time taken for TOFR to return to 70%. We concluded that mivacurium is suitable for use in caesarean section despite a decrease in plasma cholinesterase activity. Neostigmine antagonism is not required as a routine.

Adjuvants, Anesthesia↗
PubMed1995

Change in vascular cAMP and cGMP contents in portal hypertensive rats.

The purpose of this study was to investigate the possible changes of cyclic nucleotide contents in portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation (PVL) in Sprague-Dawley rats. Sham-operated rats served as controls. Hemodynamic and cyclic nucleotide measurements were performed at 14 days after surgery. The portal venous pressure was significantly higher, while systemic arterial pressure and heart rate were lower in PVL rats than those in controls. Basal cAMP (PVL, 10.91 +/- 0.98, vs. sham, 8.08 +/- 0.81 pmol/mg protein) and cGMP (PVL, 0.91 +/- 0.12, vs. sham, 0.59 +/- 0.05 pmol/mg protein) contents in the tail artery were significantly higher in PVL rats. Isobutyryl methylxanthine (10(-5) M), a nonspecific phosphodiesterase inhibitor, exerted similarly stimulating effects on the tissue cGMP (PVL, 158 +/- 10, vs. sham, 178 +/- 20%) and cGMP (295 +/- 28 vs. 316 +/- 71%) levels in both PVL and control rats; so did forskolin (10(-6) M) on the cAMP (184 +/- 20 vs. 197 +/- 66%) content in both groups. Our results showed that the arterial cAMP and cGMP contents were higher in PVL rats, which may contribute to the reduction of peripheral resistance in portal hypertension.

1-Methyl-3-isobutylxanthine↗
PubMed1994

Cancer pain management: a recent experience by anaesthesiologists in a teaching hospital in Hong Kong.

More than 60% of cancer patients suffers from unbearable pain, especially towards their terminal stages. Anaesthesiologists are involved in cancer pain management because of their expertise in analgesic pharmacology and neurolytic procedures. This manuscript reported on the experience of treating cancer pain in Chinese patient in Hong Kong with reference to current literature in other parts of the world. One hundred and sixty two Chinese patients were referred from other specialists to the Department of Anaesthesiology, Queen Mary Hospital for further management because of their cancer pain control were considered difficult. Upon referral, the mean visual analogue scale of pain (VAS) was 5.8 +/- 2.7. The pain caused insomnia (66.7%) and appetite loss (45%) as well. By far most (80%) patients' pain were successively controlled with oral systemic analgesics. These were prescribed in form of a combination of NSAID (72.2%), potent opioids (76.5%) and co-analgesics (21.6%). In our series, the mean oral morphine (MS Continus) requirements was 96.0 +/- 68.3 mg on discharge. Frequent nausea and constipation persisted in 16.0% and 8.0% respectively despite active treatment with anti-emetics and laxatives. Twenty eight neurolytic blocks was performed in 22 (13.6%) patients. Good pain relief was achieved in 78.6%. Overall speaking most patients (90.7%) were able to achieve adequate analgesia before death.

Adult↗
PubMed1993

Actin-positive spindle cell lymphoma.

We report an unusual case of malignant lymphoma, large noncleaved B-cell type, exhibiting sarcomatoid and myxoid patterns and strong positive staining for muscle-specific actin. Despite vigorous chemotherapy, the 64-year-old male patient, who had lymphoma involving his right inguinal area, retroperitoneum, and anterior chest wall at the time of presentation, died 3 months later.

Actins↗
PubMed1992

Postoperative spindle-cell nodule of urinary bladder with unusual intracytoplasmic inclusions.

Postoperative spindle-cell nodule of the urinary bladder (or in the absence of previous surgical procedure, inflammatory pseudotumor) is a reactive process of unknown etiology mimicking a sarcoma. Intracytoplasmic inclusion bodies were noted inside the atypical spindle cells on Diff-Quik stained smears in a recent case of this entity. Although fluorescence was noted in the inclusion bodies with monoclonal antibodies against the major outer membrane protein of the Chlamydia species, the exact nature of these inclusion bodies remains unknown.

Diagnosis, Differential↗
PubMed1981

A BASIC data management program for clinical laboratory audits.

Presented in this article is a simple computer program written in BASIC for audit purposes. Although it is developed with a DEC PDP-11 microcomputer, the program can be modified for other microcomputers. Shorter and less versatile than most commercially available data management programs, it is suitable for the type of audit functions likely to be encountered in clinical laboratories.

Computers↗
PubMed1977

Pulmonary blastoma: an ultrastructural study with a brief review of literature and a discussion of pathogenesis.

A pulmonary blastoma is reported in a 19-year-old black female. The light and electron microscopic characterics are described; they are found to be similar to those of the fetal lung prior to the fourth gestational month. Although the ultrastructural features do not favor any particular theory of histogenesis of this unique tumor, evidence for the commonly held theory that the tumor arises from pluipotential pulmonary blastema seems tenuous. A brief review of the literature disclosed 38 other similar cases. There was a male predominance with an average age of detection at 39 years. Sputum cytology was rarely positive. Among tumors larger than 5 cm in diameter, survival was usually less than 2 years. Metastases were present in approximately half of the cases.

Adolescent↗
PubMed1977

Cystadenoma of the pancreas. An ultrastructural study.

A case of cystadenoma of the pancreas was studied at the light (LM) and the ultrastructural (EM) levels. The observation made under LM that the flattened epithelial cells lining the cystic spaces were similar to the centroacinar cells of a normal pancreas was supported by EM findings. Numerous glycogen granules were demonstrated in the cells, a feature characteristic of fetal but not adult centroacinar cells. A few epithelial cells contained occasional membrane bound dense granules of unknown nature. This observation and the finding of normally appearing islets of Langerhans raise the possibility that this may be an example of a mixed insular-duct cystadenoma. However, if the islets of Langerhans were considered entrapped structures, this tumor should be labelled as a simple serous cystadenoma.

Aged↗