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Biomedical subjects

K T Foo

Publications and source records attributed to K T Foo.

At least 55 records · Page 3Linked to original sources
PubMed1992

Urology.

Explore the source record for details and available documents.

Forecasting↗
PubMed1992

Preliminary experience in ileal neobladder reconstruction.

In the treatment of transitional cell carcinoma of the bladder, the recent trend is towards radiation or chemotherapy which can be either regional or systemic. There have also been good results with giving Mitomycin or Bacillus Calmette Guerin instillation into the bladder for superficial tumours. There are occasions where patients present with large bulky tumours which cannot be controlled by endoscopic measures, invasion involving multiple sites and carcinoma in-situ which progresses to invasion. In these occasions, we have to resort to surgical clearance of the tumour. If it is possible, all patients would not like to wear a urinary bag for the rest of their lives. A bladder replacement if ever possible is always welcomed because the patient can pass urine from the natural passage. Due to the magnitude of a radical cystectomy and status of the urethra, it is not always technically possible to reconstruct the bladder. With improvement of operative techniques and suture materials, there has been a recent development of a method of bladder reconstruction that uses an ileal pouch. We report our early experience with this operation.

Aged↗
PubMed1991

Comparative studies of extracorporeal shock wave lithotripsy by Dornier HM3, EDAP LT 01 and Sonolith 2000 devices.

During a 2-year period extracorporeal shock wave lithotripsy (ESWL) was done at our institution in 70 patients with the Dornier HM3, 113 with the EDAP LT 01 and 104 with the Sonolith 2000 lithotriptors. The size and location of stones were comparable in all 3 series, and all treatments were done by the same team of urologists. Complete fragmentation occurred in 79% of the patients treated by the Dornier, 82% treated by the EDAP and 79% treated by the Sonolith devices, with 3-month stone-free rates of 66, 67 and 58%, respectively. Auxiliary procedures were needed in 12% of the patients in the Dornier, 13% in the EDAP and 9% in the Sonolith groups. Repeat treatment was necessary in 4% of the Dornier group, 42% of the EDAP group and 26% of the Sonolith group. Therefore, all 3 lithotriptors are effective in stone disintegration and produce satisfactory results when selection criteria for ESWL are observed. The most significant difference among the 3 lithotriptors is the number of repeat treatments, which reflects the power and energy output of the lithotriptors. In conclusion, the Dornier HM3 device has the advantage of low repeat treatment rate and easier stone localization. The EDAP LT 01 unit has the advantage of lower treatment costs and anesthesia-free treatment with no irradiation. The Sonolith 2000 device has features of the other 2 lithotriptors with a superior ultrasound image.

Anesthesia, Conduction↗
PubMed1991

Stones in horseshoe kidneys: results of treatment by extracorporeal shock wave lithotripsy and endourology.

We report the results of 7 patients with calculi in a horseshoe kidney treated by extracorporeal shock wave lithotripsy (ESWL, 9 renal units) and percutaneous nephrolithotripsy (3 renal units) during a 3-year period. In the ESWL only group complete stone clearance was achieved in only 3 patients (50%) after an average of 3 sessions of therapy. On the other hand, complete stone clearance was achieved by percutaneous nephrolithotripsy with minimal complications. The poorer results with ESWL were due to difficulty in ultrasonographic localization of stones as well as poor drainage in these abnormal kidneys. Our experience with the Edap LT01 and the Sonolith 2000 lithotriptors suggests that while reasonable results are possible, treatment probably will require multiple sessions and the eventual outcome is less predictable than in normal kidneys. In contrast, the treatment of complicated stones in a horseshoe kidney presents no additional difficulty.

Evaluation Studies as Topic↗
PubMed1991

Intravesical chemotherapy for superficial carcinoma of the bladder.

Intravesical chemotherapy has been shown to be of value in the treatment of superficial transitional cell carcinoma of the bladder, not only in the prevention of recurrence but possibly progression of the disease to higher stage as well. At the Department of Surgery, National University of Singapore from 1980 to 1986 we had used intravesical chemotherapy for multiple or recurrent superficial carcinoma of bladder in 45 patients. Of these, 21 patients had associated carcinoma in situ. Initially, thiotepa was used as the main intravesical chemotherapeutic agent. Since 1984, mitomycin C was introduced. The schedule used is 30 mg in 30 mg of water, and left in the bladder for 2 hours weekly for 4 weeks. Intermittent courses were given when deemed necessary on follow-up cystoscopy at 3 to 6 months. Patients were deemed to have good response if there was no evidence of tumour on cytology and biopsy at follow-up cystoscopy. Eleven patients had thiotepa only, of these 4 had good response, 4 were stable and 3 had progression of disease to higher stage. Thirty-four patients had mitomycin therapy. Thirteen of them following thiotepa treatment. Twenty-one patients (64%) had good response to therapy. Three patients (9%) had progression of disease, requiring cystectomy. Of those who responded to therapy, none had developed muscle invasive disease so far with mean follow-up of 43 months. Of the group of patients treated with mitomycin, no patient developed myelosuppression.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical↗
PubMed1991

Transrectal ultrasound of the prostate: the early Singapore experience.

During a four-month-period 40 patients presenting to the Department of Urology with mainly retention of urine had their prostates scanned ultrasonically. Eight nodules were detected on the ultrasound of which five were not detected on digital rectal examination. Of the five non-palpable nodules two were diagnosed on ultrasound guided transperineal Tru-cut biopsy to be carcinomas. Of the three nodules detected both on ultrasound and digital rectal examination, two were proven to be carcinomas while the other was benign. The transrectal ultrasound was not only found to be easy to use but was also found to be a useful complement to the urologist's index finger with the added advantage of obtaining good quality biopsy material from suspicious lesions.

Aged↗
PubMed1991

Haemorrhagic papillary cystadenoma of the seminal vesicle mimicking giant seminal vesicle cyst: MRI appearances.

Papillary cystadenoma of the seminal vesicle is very rare. We describe such a case presenting in a 58 year old man with bladder outlet obstruction. Investigations included magnetic resonance imaging (MRI), the usefulness of which in pre-operative diagnosis is highlighted in this case. Seminal vesicle cysts can usually be identified by conventional radiological imaging techniques such as ultrasound and computed tomography; however, identification would be difficult if the cyst is very large, causing distortion of the adjacent anatomy. In such cases, MRI, through coronal and sagittal scanning, can be helpful in localising the lesion, as in this patient. The precise pathological nature of the cyst can only be confirmed by biopsy.

Cystadenoma↗
PubMed1990

In situ extracorporeal shock wave lithotripsy for upper ureteral stones using the EDAP LT-01 lithotriptor.

We reviewed 64 cases of upper ureteral stones treated between December 1986 and June 1988. Upper ureteral stones were defined as stones in the ureter distal to the ureteropelvic junction and proximal to the S1 vertebra. All stones were treated in situ with no invasive procedures done before treatment. The over-all success rate in rendering patients free of stones by extracorporeal shock wave lithotripsy monotherapy was 75%. Of the patients 25% required auxiliary procedures, such as percutaneous ultrasonic lithotripsy. The average duration of treatment for each stone was 88 minutes and the average storage energy used was 208 units.

Adult↗
PubMed1990

Piezoelectric extracorporeal shock wave lithotripsy by EDAP LT-01: the Singapore experience.

One hundred and eighty patients with stones in the calyces, renal pelvis, upper, middle, and lower ureter were treated by piezoelectric extracorporeal shock wave lithotripsy using the EDAP LT-01 lithotripter. The size of the stones treated ranged from 0.5 cm to 6.5 cm with the vast majority (94%) measuring less than 3.0 cm. Forty-eight patients (27%) had multiple stones in the renal collecting system. Successful fragmentation occurred in 79%, partial fragmentation in an additional 17%, and no fragmentation in 4%. Forty percent of patients required repeated treatment with an average of 2.3 sessions. Of those patients treated, none required general anesthesia, however, analgesia was needed in 121 patients (67%). Urosepsis occurred in 4% and 0.5% developed intrarenal hematoma. There was no mortality or loss of renal units in this series. The auxiliary procedure rate was 15% (percutaneous nephrolithotripsy 5%, ureteroscopic manipulation 9%, and open surgery 1%). The 3-month stone-free rate was 64%.

Humans↗
PubMed1989

Percutaneous ultrasonic lithotripsy--its role in the management of renal and upper ureteric stones.

Percutaneous ultrasonic lithotripsy (PUL), a new technique used in the treatment of renal stones has been shown to be safe and effective with low morbidity. 54 of the 57 patients (95%) were successfully treated by this method and all were done as a single stage procedure. 39 patients (68%) in this series were either unsuitable or had failed extracorporeal shock wave lithotripsy (ESWL). No mortality occurred in this series and one patient with staghorn stone required a nephrectomy due to severe secondary haemorrhage. Though PUL is technically more difficult to perform, it is a better alternative than open renal surgery and is complementary to ESWL especially in the treatment of the more complicated renal stones.

Adult↗
PubMed1989

Antegrade ureteroscopy and ultrasonic lithotripsy in the treatment of difficult upper and middle ureteric stones.

34 patients with difficult upper and middle ureteric stones were treated by antegrade ureteroscopy with ultrasonic lithotripsy over a 2-year period. 14 patients (41 percent) had failed extracorporeal wave lithotripsy and another 20 patients (59 percent) were considered unsuitable for extracorporeal shock wave lithotripsy due either to obstruction associated with urosepsis or renal failure. Thirty patients (88 percent) had large stones with a transverse diameter from 10 to 20mm in size. Thirty-three of the 34 patients (97 percent) were successfully treated by this method with minimal morbidity. Of the 7 patients with residual stones, only one needed transurethral ureteroscopic removal and another by piezoelectric extracorporeal shock wave lithotripsy. This technique is a safe and effective method in removing impacted upper and middle ureteric stones for patients who have failed or are unsuitable for extra-corporeal shock wave lithotripsy treatment.

Endoscopy↗
PubMed1988

Carcinoma in situ of the urinary bladder--the Singapore experience.

Carcinoma in situ of the urinary bladder has been described since 1952. However, it was not well recognised as a clinical entity until recently when we are more aware of its clinical significance, that a large proportion progresses to muscle invasive cancer and becomes life threatening, and therefore more aggressive management is needed. From 1980 to 1984 over a period of 5 years, we studied the records of 130 patients with transitional cell carcinoma of the urinary bladder. Eighty-two (63%) were staged as superficial carcinoma while 48 (37%) were diagnosed as muscle invasive cancer (Tables II, III & IV). Out of the 82 cases of superficial carcinoma, 12 (11%) were found to have associated carcinoma in situ of the bladder. Diagnosis depends on a high index of suspicion, urinary cytology and biopsies of not only the obvious papillary or solid tumours but also any abnormal bladder mucosa and random bladder biopsy. Management is a problem and controversial. We have been using intensive intravesical chemotherapy with thiotepa and mitomycin, and if there is evidence of deep muscle invasion, then more aggressive therapy such as cystectomy would be advised. Management of these 12 cases and the problems we encountered are discussed.

Carcinoma in Situ↗
PubMed1987

Surgical causes of haematuria--the diagnostic approach.

Gross haematuria is one of the most important symptoms in urology, as one of its causes is neoplasm of the urinary tract. The other important causes are urinary stones, urinary tract infection, which may be acute or chronic, trauma, and chronic haemorrhagic radiation cystitis. The differential diagnosis of gross haematuria depends on the age and sex of the patient, and the associated symptoms. The most important associated symptom is pain.

Hematuria↗