Search PubMed⌕ Search

Biomedical subjects

L L Ooi

Publications and source records attributed to L L Ooi.

28 records · Page 2Linked to original sources

Thoracoscopic vagotomy for peptic ulcer disease--report of two cases.

Thoracoscopic vagotomy is a well-established technique in the management of recurrent peptic ulceration after previous abdominal vagotomy. The procedure allows an easy approach to the vagus nerves without having to dissect through dense adhesions from previous surgery. With thoracic vagotomy, the main morbidity is postoperative pain from the thoracotomy incision and rib spreading. Advances in endoscopic camera systems and instrumentation allow thoracic vagotomy to be safely and effectively accomplished by thoracoscopic surgery techniques, with reduced postoperative pain. We describe our experiences with thoracoscopic vagotomy in two cases of recurrent peptic ulceration.

Adult↗

Primary papillary carcinoma in a thyroglossal cyst--a case report.

A benign thyroglossal cyst is a common clinical condition and is second only to a cervical lymph node as the most common cause of a solitary neck swelling. Primary carcinoma of a thyroglossal cyst, however, is rare and has been described in only 115 cases in the literature. The malignant cysts are clinically difficult to differentiate from benign lesions and the diagnosis often rests on histopathological examination. Before initiating treatment, primary papillary carcinoma of the thyroid gland must be excluded. The treatment options range from simple excision to a Sistrunk operation with concurrent cervical lymph node dissection. We describe here a case of papillary carcinoma of a thyroglossal cyst and review the 115 reported cases.

Adult↗

Splenic abscess.

Isolated splenic abscess is an uncommon condition. Seven cases seen between 1980 and 1990 are reviewed. The clinical presentation is non-specific and diagnosis is usually delayed. Computerized tomography allowed for accurate diagnosis in all cases. Pseudomonas species as a causative organism is reported to be rare, but were present in three of the present cases. Antibiotic therapy alone is insufficient and splenectomy remains the treatment of choice.

Abscess↗

Laparoscopy-guided percutaneous cholecystolithotomy: an evolving technique.

Gall-bladder conservation therapy has been evolving during the past decade. Popular techniques of conservative therapy are extracorporeal shock wave lithotripsy (ESWL) and medical dissolution therapy. The limitations of these procedures have prompted a search for alternative techniques, particularly in relation to percutaneous stone extraction. The cases of four patients with symptomatic gallstones who underwent percutaneous cholecystolithotomy under laparoscopic guidance are reported. The gall-bladder was punctured with a long needle and the tract dilated so that a nephroscope could be introduced. Three cases required stone fragmentation by an ultrasonic lithotripter before removal. Postoperative recovery was uneventful in all cases.

Adult↗

Tracheo-oesophageal groove clearance in well differentiated thyroid carcinoma.

Papillary carcinoma of the thyroid has a propensity for spread to the regional lymph nodes, in particular those along the recurrent laryngeal nerve. Twenty cases of papillary carcinoma of the thyroid had prophylactic clearance of the lymph nodes along the tracheo-oesophageal groove, and one patient had removal of recurrent disease in the groove. Eleven of the twenty patients had, in addition, some form of cervical lymph node clearance for clinically palpable ipsilateral cervical lymph nodes. Metastases to the tracheo-oesophageal groove lymph nodes was seen in seven of the twenty patients (35%). Tumour size, age, sex, race and cervical lymph node involvement did not appear to predict involvement of the tracheo-oesophageal groove lymph nodes. Clearance of the lymph nodes along the tracheo-oesophageal groove at the time of resection of primary disease is worthwhile for thyroid papillary carcinoma, because of the high incidence rate (35%) and also clearance for subsequent recurrence will be more difficult with a higher risk of damage to the recurrent laryngeal nerve and parathyroids.

Adult↗

Calcifying epithelioma of Malherbe--a case report of a large preauricular tumour.

Calcifying epithelioma of Malherbe (pilomatrixoma) is a relatively uncommon benign skin tumour of hair follicle origin. It usually presents in the face and upper extremities of young adults as an asymptomatic subcutaneous or dermal tumour. Treatment is surgical excision. This paper presents a case of a large tumour in the preauricular region with difficulty in diagnosis preoperatively and required a superficial parotidectomy to clear the tumour from the facial nerve.

Adult↗

B-mode real-time ultrasound assessment of vocal cord function in recurrent laryngeal nerve palsy.

B-mode real-time ultrasound was used to assess vocal cord function in six patients with recurrent laryngeal nerve palsy. The thyroid cartilage acted as an acoustic window through which the true cords appear as hypoechoic structures. Vocal cord palsy detected on ultrasound was compared with fibreoptic direct laryngoscopy and indirect laryngoscopy mirror examination. Good correlation was seen in all the cases.

Adult↗

Benign retroperitoneal neurilemmoma--a case report.

Retroperitoneal neurilemmomas are the rarest of all retroperitoneal tumours. A rare case of a very large benign retroperitoneal neurilemmoma is presented. Pre-operative diagnosis of these tumours is difficult and the majority are asymptomatic. They are usually detected as an abdominal mass on routine examination as in this case. Despite severe displacement and distortion of the inferior vena cava in this patient, there were no clinical abnormalities detected. The predominantly cystic nature of the tumour was well demonstrated by ultrasound and CT scan examination but the true nature of the tumour could not be diagnosed. It is very rare for these tumours to be malignant and recurrence after surgical excision is rare.

Angiography↗

Non-functioning cyst of the adrenal gland--a case report.

Adrenal cysts are a rare entity. Only about 300 cases have been reported throughout the world. A case of an asymptomatic, benign, non-functioning adrenal cyst of the left adrenal gland is presented. Pre-operative diagnosis is usually by incidental imaging findings as the majority of adrenal cysts are asymptomatic. The adrenal cyst in this case was detected on an abdominal ultrasound for the investigation of jaundice, and confirmed by a CT scan examination. Selective biochemical studies are needed to assess adrenal function, and here they were normal. Simple surgical enucleation of the cyst, with preservation of remaining adrenal tissue is the treatment of choice.

Adrenal Gland Neoplasms↗

Color Doppler imaging for vocal cord palsy.

BACKGROUND: Conventional techniques of laryngoscopy for vocal cord palsy can sometimes be difficult or impossible to perform, and B-mode real-time ultrasonography has been previously reported by the authors to be helpful in these situations. In some cases, however, B-mode ultrasonography can be inconclusive. We investigated whether color Doppler imaging can significantly improve vocal cord examination in these cases. METHOD: Ten normal volunteers were examined using the Acuson 128XP/5 with a 7-MHz L7384 linear transducer. The thyroid cartilage was used as an acoustic window. Several distinct color flow patterns were observed with the subjects breathing quietly at rest, at the start of vocalization, and in prolonged phonation. Eight patients with hoarseness of voice were then examined by two separate observers in a double-blinded fashion. The first observer performed B-mode ultrasonography and color Doppler imaging, while the second observer performed indirect laryngoscopy and direct fiberoptic laryngoscopy. RESULTS: Laryngoscopy was used as the standard for comparison. B-mode real-time ultrasonography correctly identified vocal cord palsy in three patients and normal vocal cords in one. The remaining four patients were reported as equivocal or normal. Color Doppler imaging correctly identified the problem in all eight patients. CONCLUSION: Color Doppler imaging for vocal cord examination is more sensitive than B-mode real-time ultrasonography, and seems to be as accurate as laryngoscopy in determining vocal cord palsy or paresis.

Adult↗