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Biomedical subjects

J Wong

Publications and source records attributed to J Wong.

At least 667 records · Page 37Linked to original sources
PubMed1983

Tuberculous lymphadenopathy: a review of results of surgical treatment.

Eighty consecutive cases of tuberculous lymphadenopathy confirmed by histological examination were reviewed. Fifty-five cases (69%) were followed up for more than two years. Excluding twelve cases with incomplete chemotherapy, the results of treatment by combined surgery and chemotherapy in the remaining 43 cases were analysed. Twelve cases had complete excision of all grossly involved lymph nodes; all did well. Twenty-one cases had only representative lymph nodes biopsied for diagnosis, five of them (24%) required a second operation--three for abscess formation and two for progressive enlargement of the residual lymph nodes. Seven cases of tuberculous abscesses were treated by a simple drainage procedure, and despite chemotherapy, all had persistent wound discharge for over one month which required a second operation to remove the underlying caseating lymph nodes. Results suggest that all easily accessible tuberculous lymph nodes should be removed and that persistent discharging sinuses should also be treated by surgery.

Adolescent↗
PubMed1983

The cytopathology of middle ear effusions (a new technique).

This article describes a simple technique for the dissolution of the mucus elements within middle ear effusions and the subsequent separation of the cells contained. After the mucus and mucopolysaccharides within middle ear effusions have been dissolved, the cells can be separated allowing for absolute cell counts with automated counters, smears for examination with light microscopy and differential cell counts, and transmission electron microscopic examination of the cell population. Transmission electron microscopy was utilized in this study to evaluate the amount of cellular distortion and artifact that resulted from the separation of these cells from the middle ear effusions and to evaluate the relative status of preservation of these cells. The ability to preserve, count, and identify the cellular component of middle ear effusions will be of value in attempting to understand the pathogenesis of otitis media with effusion.

Blood Cell Count↗
PubMed1982

Intrathoracic gastric bypass for carcinoma of oesophagus found unresectable at exploration.

Assessment of the resectability of carcinoma of the oesophagus or cardia may be inaccurate. At exploration, 8 patients in whom resection was contemplated were found to have unresectable lesions. An intrathoracic oesophagogastric bypass was performed without further change of position. Five patients were discharged from hospital and survived between 3 and 20 months before they finally succumbed to metastases. Each of them was able to take an ordinary diet. The aims of palliation were achieved.

Adenocarcinoma↗
PubMed1982

The surgical management of primary intrahepatic stones.

Primary intrahepatic stones are commonly found in association with recurrent pyogenic cholangitis. In 115 patients with this condition, the intrahepatic stones were removed by four different methods: common duct exploration (n = 74), transhepatic intubation (n = 10), hepatotomy (n = 5) and hepatic resection (n = 26). The choice of methods was guided by the location of stones and the condition of the bile ducts and the liver. These extraction procedures were combined with drainage procedures, i.e. sphincteroplasty and choledochojejunostomy, whenever the proper indications were present. The operative mortality was 4.3 per cent. Long term follow-up (median 7 years and 8 months) on 91 patients revealed that common duct exploration, transhepatic intubation and hepatotomy were associated with high incidences of recurrent symptoms requiring reoperation (23.6 per cent, 37.5 per cent and 75 per cent respectively). In most instances, failures were due to recurrent stone formation in the stenotic intrahepatic ducts. Hepatic resection had the lowest failure rate (4.2 per cent) and none of the patients had recurrent stones.

Cholelithiasis↗
PubMed1982

Survival after surgery for advanced carcinoma of the stomach other than the cardia.

The survival of 103 patients operated on for advanced carcinoma of the stomach other than the cardia was assessed. The median duration of survival for patients subjected to palliative partial gastrectomy, total gastrectomy, gastrojejunostomy, and biopsy only was 24, 22, 11, and 10 weeks, respectively. All of these patients had definite residual tumor. In the 27 patients with preoperative signs of incurable tumor, the high operative mortality rate (19 percent), the low rate of resectability (26 percent), and the short duration of survival in the patients who had resection (median 11 weeks) combined lead to the conclusion that exploration for the possibility of resection is not worthwhile.

Aged↗
PubMed1982

Bacteria and septic complications in patients with perforated duodenal ulcers.

To evaluate the clinical significance of bacterial contamination in perforated duodenal ulcers, we prospectively studied septic complications in 184 consecutive patients. All patients received parenteral antibiotics (over 90 percent preoperatively) for at least 7 days. Thirteen infections developed in eight patients (4.3 percent). Peritoneal cultures, performed in 143 unselected patients, were positive in 33.6 percent of cases. Bacterial growth occurred more often and in heavier amounts in patients who underwent exploration late (after 48 hours) and those who had gross peritoneal soilage. Candida and gram-negative organisms predominated, but there was no correlation with pathogens that produced abscesses or wound infections. Old age and late exploration significantly increased the risk of infection. Neither peritoneal soiling nor a positive culture was likely to be clinically important when explorations was performed within 2 days of perforation. We treated perforated ulcers as clean-contaminated cases, and recommend that three doses of prophylactic antibiotics be begun preoperatively in all patients.

Adult↗
PubMed1982

Salt taste sensitivity and stimulus volume: effect of stimulus residuals.

Sodium chloride (NaCl) stimulus residuals were seen to be greater after a large-volume NaCl rinse than after a small-volume rinse. Predicted changes in sensitivity dependent on adapting concentrations determined by residual levels were confirmed by signal detection R-index measures of sensitivity. R-index values were seen to be independent of the volume of the test water and NaCl stimuli used in their determination.

Adaptation, Physiological↗
PubMed1982

A prospective study of operative risk factors in perforated duodenal ulcers.

Operative risk factors for patients with perforated duodenal ulcers were examined prospectively in 213 operated patients. Nine hospital deaths (4.2%) resulted from respiratory failure, sepsis, and bleeding. Forty-five complications developed in 27 patients (12.7%). Concurrent medical illness, preoperative shock, and longstanding perforations (more than 48 hours) were significant features that increased mortality. Old age, gross peritoneal soiling, and the length of the ulcer history did not affect mortality in the absence of risk factors. No death attributable to either sepsis or abscess formation occurred when surgery was performed within two days of perforation. Bacterial contamination may not signify clinical peritonitis during this period. We conclude that simple closure of perforated ulcers is a more prudent choice when any risk factor is present, but that definitive surgery in good-risk patients merits further evaluations.

Bacterial Infections↗
PubMed1982

Pelvic exenteration for locally advanced colorectal carcinoma.

Pelvic exenteration provided worthwhile palliation and achieved a cumulative five-year survival rate of 38.8% in 49 patients who had carcinoma of the lower colon or rectum infiltrating adjoining pelvic viscera. Survival and the disease-free period were not significantly different after total or posterior exenteration. The stage of disease was the major determinant of outcome: five-year survival rates averaged 51.8% and 28.8% for Stages II and III, respectively. Hospital mortality (26.9%) after total exenteration was chiefly due to technical mishaps, and the inclusion of many high-risk but symptomatic elderly patients. Complete clearance of locally advanced colorectal cancer by pelvic exenteration is indicated in fit patients, especially those with Stage II disease.

Adenocarcinoma↗
PubMed1982

Extraperitoneal sphincteroplasty for residual stones: an update.

Sphincteroplasty was done via the extraperitoneal transduodenal approach in 42 patients. The indications were residual stones in 34 patients, stricture at Oddi's sphincter in seven patients, and relapsing pancreatitis in one patient. Seven patients suffered operative complications, with one death. Sphincteroplasty was successfully performed in all patients, and the residual stones were removed in 31. Thirty-three of the 36 patients followed up for a mean of seven years were asymptomatic. Extraperitoneal sphincteroplasty has a role in supplementing endoscopic papillotomy and percutaneous extraction through the T-tube tract in the treatment of patients with residual stones.

Adult↗
PubMed1982

Mucoepidermoid carcinoma of the bile duct.

Three patients with mucoepidermoid carcinoma of the bile duct are described. In two patients the tumor arose from the common hepatic duct. Mucoepidermoid carcinoma of the extrahepatic bile duct has not been previously reported. The clinical features and pathologic behavior of this rare type of tumor are similar to the usual biliary adenocarcinoma. The coexistence of Clonorchis sinensis infestation and primary pyogenic cholangitis raises the possibility of an etiologic association.

Adult↗
PubMed1982

Immediate definitive surgery for perforated duodenal ulcers: a prospective controlled trial.

A prospective, randomized, double-blind trial was conducted in 101 patients to evaluate the safety and benefits of immediate definitive surgery for perforated duodenal ulcers. These patients, who were judged by predefined criteria to be medically fit and to have perforations in chronic ulcers, were randomized to undergo simple closure (35 patients), truncal vagotomy and drainage (VD) (32 patients), or proximal gastric vagotomy with closure (PGV) (34 patients). Patients were followed with endoscopic assessment for up to 39 months. There was no mortality and only a few minor postoperative complications. At 39 months follow-up, the cumulative rates of recurrence were 63.3%, 11.8% and 3.8% after closure, VD, and PGV, respectively (p less than 0.001). With the exception of the one recurrence after PGV, all relapses were symptomatic, and eight of these 18 required reoperation. Relapse rates and Visick scores between VD and PGV were significantly different. Both safe as well as effective, immediate, nonresective, definitive operation is indicated for good-risk patients who have perforations in chronic duodenal ulcers.

Adult↗
PubMed1982

Problems in teaching ethnic minority nursing students.

Ethnic minority nursing students are different from the majority of white students, and approaches that nursing faculties use in teaching them must also be different. Teaching these students is sometimes viewed by many faculties as a threat. However, if difficulties are recognized early and handled efficiently, educating the ethnic minority students can instead become a challenge to the nurse educators. The authors propose some ways to deal with the existing or potential difficulties that arise from teaching these students. These suggestions are made with major emphasis on the student, the teaching process, and the curriculum. Ethnic minority students need to be helped to develop a positive self-esteem, a sense of worthiness and a feeling of equality and acceptance. Nursing faculties are charged with this responsibility and must be committed to it. Furthermore, nursing curricula need to take into account cultural diversity, to increase students' understanding of the impact of cultural diversities on health care. This paper presents a viewpoint from which important questions related to problems associated with teaching minority students, could be raised.

Adult↗
PubMed1982

Oesophagoplasty for malignant obstruction of the oesophagus following previous partial gastrectomy.

The management of 19 patients with malignant obstruction of the oesophagus who previously had undergone partial gastrectomy was reviewed. With stomach unavailable for oesophagoplasty, the jejunum was used in 12 patients, and the colon in seven patients, for reconstruction or bypass. The technique recommended is jejunal oesophagoplasty. Surgical intervention to restore swallowing in this group of patients has been associated with a 52% hospital mortality and a considerable morbidity. Because of the late stage of the disease, survival beyond two-three years after a successful operation has not been possible so far.

Aged↗
PubMed1982

Epidermoid carcinoma of the anus.

Twenty five patients with epidermoid carcinoma of the anus, representing 1.5% of all large bowel malignancies, were seen over a 33 year period. Most patients presented with an advanced lesion which gave rise to a fungating mass, bleeding or pain. Nearly all patients who received either palliative irradiation or refused treatment died within a year of diagnosis. Abdominoperineal resection in 12 patients yielded an encouraging five year survival rate of 68.5%. Therapeutic groin node dissection performed on six occasions led to only one late recurrence. The surgical literature on sphincter saving local excision and therapeutic radiotherapy is reviewed. Currently, radical resection remains the most appropriate treatment for the majority of patients with epidermoid anal cancer.

Anus Neoplasms↗