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Biomedical subjects

P Goh

Publications and source records attributed to P Goh.

51 records · Page 3Linked to original sources
PubMed1992

Laparoscopic posterior truncal vagotomy and anterior highly selective vagotomy--a case report.

Laparoscopic vagotomy provides a viable alternative to expensive long-term treatment with H2 antagonists in patients with intractable peptic ulcer disease. The minimally invasive procedure offers reduced postoperative discomfort and improved cosmesis. Here, we report our first case of a posterior truncal vagotomy and anterior highly selective vagotomy performed laparoscopically for the first time in Asia. The surgery was uneventful. Diet was resumed on day 3 and the patient was discharged on day 4. Post-vagotomy acid secretion tests on the third week revealed a dramatic decrease in acid production. With further experience, laparoscopic vagotomy can be an attractive alternative to long term medication in peptic ulcer disease.

Humans↗
PubMed1991

Endoscopic management of bleeding peptic ulcers in Singapore: a multimodality approach.

Endoscopic haemostasis is becoming increasingly important in the management of bleeding peptic ulcers. In this study, rather than being confined to one modality of treatment, the endoscopist was allowed to customize the treatment according to the configuration of the ulcer, accessibility, and rate of bleeding in any particular patient. Fifty patients with actively bleeding peptic ulcers or stigmata of recent haemorrhage were treated endoscopically. Initial haemostasis was achieved in 48 (96%) patients. Eleven patients rebled of whom eight underwent repeat endoscopic treatment. Of these eight patients, three rebled of whom two required surgery. Permanent haemostasis was achieved in 43 of 50 patients (86%). The rate of surgery in the endoscopically treated group was 10%. There was one death due to causes not related to bleeding. The multimodality approach is a useful method of treatment in bleeding peptic ulcers, giving flexibility to the endoscopist in deciding on the best way to deal with the problem.

Adolescent↗
PubMed1991

A multimodality approach to endoscopic treatment of bleeding peptic ulcers.

The role of endoscopic haemostasis in the treatment of bleeding peptic ulcers is widely studied. Many trials to date have compared one or more modalities against a medical control with variable results. To date, no single modality has been shown conclusively to be superior to others. As such, in this study we have not confined the endoscopist to one modality of treatment but allowed him to customize the method of endoscopic haemostasis according to the configuration, accessibility and rate of bleeding in any particular patient. Seventy-three patients with non-variceal upper gastrointestinal (GI) bleeding were admitted to the National University Hospital in Singapore between May 1, 1988 and April 30, 1989. All were gastroscoped and 48 were found to have chronic peptic ulcer. Twenty-nine (60%) with actively bleeding peptic ulcer or stigmata of recent haemorrhage (SRH) were treated endoscopically. Initial haemostasis was achieved in 27 (93%) patients. Seven patients rebled (26%) of which four underwent repeat endoscopic treatment. Of these four patients only one rebled again and required surgery. Permanent haemostasis was achieved in 23 of 29 patients (79%). The multimodality approach for the treatment of bleeding peptic ulcers gives the endoscopist flexibility in deciding on the best way to deal with a bleeding gastric or duodenal ulcer. Each instrument has its strengths and weaknesses and the right choice of instrument is often a critical factor especially in treating a bleeding ulcer in a situation where access poses a problem.

Adult↗
PubMed1987

Effect of male reproductive tract fluids and proteins on the metabolism and motility of ram spermatozoa.

Cauda epididymal fluid (CEF) greatly stimulated the oxygen uptake of washed ejaculated ram spermatozoa; the effect was evident within 1 h and persisted over the 8 h of the experiment. The stimulus was comparable to that produced by 10 mM glucose and the effects were not additive, that is, CEF and CEF plus glucose elicited about the same oxygen uptake. This suggested that CEF suppressed the oxidation of added glucose and this was confirmed by measuring the amount of glucose oxidized in the presence and absence of CEF. Cauda epididymal fluid improved the motility of washed ram spermatozoa but it was somewhat less than that produced by glucose and usually only became evident after about 6 h or incubation. Electrophoretic analysis of cauda epididymal spermatozoa incubated in radioiodinated CEF showed that these cells absorb fluid components in the zone 82 to 56 kD. However, a molecular weight fraction less than 5 kD obtained by passing CEF through a Sephadex G-25 column, was not effective in stimulating the oxygen uptake of ram spermatozoa. The effects of CEF on the metabolism of ram spermatozoa could be mimicked by 2.5-4.0 mg/ml bovine serum albumin (BSA). Stimulation of oxygen uptake was apparent within 1 h and persisted over the 8 h of the experiment. As with CEF, stimulation of oxygen uptake by BAS was less than with 10 mM glucose but the effects were not additive. Like CEF, BSA reduced the amount of glucose oxidized. Bovine serum albumin also improved the motility of ram spermatozoa over 8 h. After passage through Sephadex G-25 to remove any low molecular weight contaminants (less than 5 kD), BSA was still effective in stimulating the oxygen uptake of spermatozoa over 4 h. Ram blood plasma and especially ram seminal plasma were also effective after passage through the Sephadex. Human serum albumin (HSA) was as effective as BSA in stimulating the oxygen uptake of ram spermatozoa but defatting decreases its effectiveness. The motility score of the spermatozoa was also adversely affected by this treatment. It is concluded that the stimulating effects of CEF and of the other fluids and proteins are due to substrates, at least some of which are present as or associated with macromolecules.

Animals↗
PubMed1975

Radioimmunoassay of progesterone, 17-hydroxyprogesterone, estradiol-17beta and prostaglandin F in human corpus luteum.

Radioimmunoassay procedures have been adapted for the assay of progesterone, 17-hydroxyprogesterone, estradiol-17beta, and prostaglandin F in human corpus luteum. The method utilises a single homogenisation and extraction of the tissue followed by fractionation of the steroids on alumina, and separation of the prostaglandins of the F series from the E and A series on silica gel, prior to radioimmunoassay. An attempt has been made to validate the method for the progestins by comparison with results after fractionation of the progestins on Sephadex LH-20, for estradiol-17beta by comparison with values obtained with competitive protein-binding, and for prostaglandin F by comparison with values after additional purification. The results showed that peak concentrations of the three steroids in corpora lutea from women during the luteal phase of the menstrual cycle were comparable to those found in corpora lutea from women in early pregnancy. However, in six out of fourteen corpora lutea from non-pregnant women, prostaglandin F levels were higher than those found in corpora lutea from seven women in early pregnancy, i.e. 13-46 ng/g compared with 1-7 ng/g. Of the above six corpora lutea, four were on days 23-25 of the cycle, at a time when luteolysis would be commencing. The results in this paper support the conclusion that the corpus luteum is a major site of synthesis of the three steroids examined, although the site of synthesis of prostaglandin F is still equivocal.

Adult↗
PubMedDate not supplied

Kinetic characterization of the inhibition of purified cynomolgus monkey lactate dehydrogenase isozymes by gossypol.

This report describes the results of the first step in a sequence of experiments designed to test the hypothesis that the sperm-specific isozyme of lactate dehydrogenase (LDH-C4), is a site of action of the potential male contraceptive agent gossypol. Cynomolgus monkey LDH-A4, LDH-B4 and LDH-C4 were purified and kinetically characterized. LDH-A4 and LDH-B4 exhibited "linear mixed-type" inhibition by gossypol with both lactate and pyruvate as variable substrates. LDH-C4 also exhibited "linear mixed-type" inhibition with lactate as substrate. However, the C4 isozyme exhibited "parabolic mixed-type" inhibition by gossypol and substrate inhibition with pyruvate as substrate, the latter due to abortive complex formation. Of the three isozymes, LDH-C4 exhibited the lowest apparent Km for pyruvate and the highest apparent Km for lactate. The LDH-C4 form was found to be the most sensitive isozyme to gossypol inhibition, since it had the lowest apparent Ki values for gossypol inhibition. The effect of gossypol on coenzyme binding to LDH-C4 was examined and gossypol binding was found to inhibit binding and release of NADH but not NAD+, an effect possibly due to its interaction with the more hydrophobic loop region of LDH-C4.

Animals↗
PubMedDate not supplied

Peroral tunable-dye laser lithotripsy of intrahepatic stones in oriental cholangitis.

This case report details the use of a pulsed tunable-dye laser lithotripter in the endoscopic management of recurrent intrahepatic stones in a patient with Oriental cholangitis. A 42-year-old Chinese man had a cholecystectomy and choledochoduodenostomy in 1980. Subsequently he had three episodes of recurrent cholangitis which responded to medical treatment. The patient presented in April 1989 with a fourth attack of cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) and ultrasound demonstrated a large mass of stones in the right intrahepatic ductal system. A flexible upper gastrointestinal endoscope was passed into the right hepatic duct via the choledochoduodenostomy. The stones were fragmented with a tunable-dye laser and the residual fragments were removed endoscopically.

Adult↗
PubMedDate not supplied

Endoscopic hemostasis of bleeding peptic ulcers.

Developments in therapeutic endoscopy over the last decade have made it possible to perform endoscopic hemostasis for bleeding peptic ulcers. This review traces the developments in this field in the Department of Surgery of the National University of Singapore. A recently conducted prospective randomized controlled trial using intralesional adrenaline and heater probe demonstrated that initial hemostasis could be achieved in 100% of patients with actively bleeding ulcers or stigmata of recent hemorrhage. The rebleed rate was 6.6% compared with 20.3% in a well-matched control group. The recent advent of laparoscopic vagotomy and laparoscopic Billroth II gastrectomy offers a low-morbidity surgical option to long-term medical treatment for the follow-up management of patients with bleeding ulcers.

Duodenal Ulcer↗