Biomedical subjects
Publications and source records attributed to M K Li.
Injury to the prepuce is uncommon. A total of 32 patients were treated within a 3-year period. A difference in the aetiology between boys and adults was noted. Accidental injury to the prepuce occurred in 6 boys, with zipper injuries being the commonest among children. Coital and self-inflicted injuries accounted for 85% of adult cases. In patients with coital injuries, predisposing phimosis or a short frenulum was common.
We report a case of radiolucent seed calculi in an orthotopic ureterocele. The diagnosis was based on clinical suspicion and confirmed by ultrasonography.
Four examples of multilocular cyst of the kidney occurring in adult Chinese women are reported. This uncommon lesion has distinctive sonographic and clinicopathological features. The aetiology and pathogenesis are unknown. The differential diagnosis, pre-operative evaluation, and treatment are discussed.
We report our experience of using the double valve Denver peritoneal venous shunt to palliate malignant ascites. 6 out of 7 patients achieved excellent results with no complications. Using this shunt with our selection criteria will give relief to patients in the terminal stage of their malignant disease.
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The study compared the efficacy and safety of norfloxacin to those of co-trimoxazole in the treatment of urinary tract infections (UTI). A total of 172 adults, 42 men and 130 women were recruited and randomly allocated to norfloxacin or co-trimoxazole using a double-blind study design. Patients with lower UTI received norfloxacin 200 mg or co-trimoxazole (160 mg of trimethoprim plus 800 mg of sulphamethoxazole) b.i.d. for seven days. In patients with upper UTI, the norfloxacin dose was 400 mg b.i.d. for seven days. Eleven to 14 days after treatment, the bacteriological cure rates were 96.8% and 83.3% and the clinical cure rates were 96.9% and 89.9% for norfloxacin and co-trimoxazole, respectively. A few patients complained of gastrointestinal symptoms but there were few other side-effects and the treatments were well tolerated. In conclusion, both norfloxacin and co-trimoxazole were well tolerated but norfloxacin gave higher cure rates.
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The inhibitory activity of urine on calcium oxalate crystallization was measured as an inhibitory index using a gel model modified from Schneider et al. [8]. Urine samples from 36 recurrent stone formers and 21 controls in 3 separate periods (morning, afternoon and evening) were tested. Mean inhibitory indices of greater than 0 were observed among normal controls in the 3 sampled periods and among stone formers in the morning and afternoon samples. A significantly lower (negative) value was observed in the evening samples of stone formers, indicating a higher tendency towards crystallization than normal. The gel method may be applied to identify individuals at risk of stone formation if sufficient numbers of period-defined urine samples from the individual are tested for a statistically significant mean inhibitory index but whether this is practical in a clinical laboratory will need further evaluations.
From 1970 to 1985 we treated 144 cases of malignant tumors of the kidney. Of these patients only 11 (8 per cent) had squamous cell carcinoma of the renal pelvis compared to transitional cell carcinoma of the renal pelvis in 53 per cent, renal cell carcinoma in 37 per cent and other types in 2 per cent. In all patients the squamous cell carcinoma was associated with chronically infected staghorn renal calculi of long duration. The patients usually presented late with extensive local infiltration, making surgical resection difficult. In addition, poor response to surgery, radiotherapy and chemotherapy resulted in a poor prognosis and short survival. A summary of our cases and a review of the literature are presented.
Transurethral resection of the prostate and bladder neck incision are accepted methods in the treatment of obstructive prostatic hyperplasia. Bladder neck incision is particularly useful in cases of small prostates. We have modified the method of bladder neck incision to bladder neck resection. A randomized prospective trial was done to compare the results of conventional transurethral resection of the prostate (30 patients) and the new method of bladder neck resection. Bladder neck resection was comparable to transurethral resection of the prostate with respect to postoperative hospital stay, maximal flow rates and postoperative complications. Bladder neck resection was better than transurethral resection with respect to the operating time, transfusion requirement, volume of irrigation fluid and postoperative urinary infection. We conclude that bladder neck resection is the operation of choice in patients with a prostate of 30 gm. or less.
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A case of recurrent dedifferentiated liposarcoma simulating malignant fibrous histiocytoma, with complete absence of lipoblastic differentiation, is described. The tumour cells showed strongly positive immunostaining for alpha-1-antichymotrypsin. Electron microscopy revealed a mixture of fibroblasts and histiocytes. Our findings suggest that the dedifferentiated component reflects an altered differentiation pathway of the primitive mesenchymal cells in the original liposarcoma.
The free radical mediated oxidation of proteins in stored hypothermic rat hearts has been investigated by the estimation of fluorescence (Ex 360, Em 440-460 nm) believed to result from the oxidation of tryptophan residues. Damage occurring during ischaemia results in the release of oxidised proteins. This damage is significantly attenuated by mannitol and desferrioxamine although the mechanism of action of the two compounds may be different.
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There is evidence to suggest that sucrose ingestion can cause renal parenchymal changes as well as increasing the urinary saturation index for calcium oxalate. Ten stone formers and 10 normal subjects received 250 gm of sucrose daily over a period of 7 days. Observations on the risk factors for calcium stone formation and urinary N-acetyl-B-glucosaminidase (NAG), a marker of renal tubular cell damage, were made. Oxalate excretion increased. Urinary calcium levels were unchanged but the pattern of response was different between the two groups, as with magnesium and phosphate. NAG was spontaneously higher in the patient group and increased significantly after sucrose ingestion in both groups.
We evaluated the effect of a range of physiological concentrations of magnesium on calcium oxalate crystallization from artificial urine in a continuous mixed suspension mixed product removal crystallizer at 37C. Magnesium was found to decrease both the growth and nucleation rates of calcium oxalate crystals in the simulated renal environment.
We used the restriction endonuclease HaeIII to differentiate Neisseria gonorrhoeae from other Neisseria species and Branhamella catarrhalis. A total of 16 clinical isolates and four American Type Culture Collection strains of N. gonorrhoeae were resistant to HaeIII digestion, whereas 17 isolates and four American Type Culture Collection strains from eight different bacterial species were susceptible. This resistance was not caused by an enzyme inhibitor. We propose that protection of the HaeIII recognition sequence by methylation is the mechanism of resistance since N. gonorrhoeae DNA became susceptible to digestion when passed in Escherichia coli as part of a plasmid clone.