Search PubMed⌕ Search

Biomedical subjects

S C Chew

Publications and source records attributed to S C Chew.

At least 19 recordsLinked to original sources

Assisted reproductive techniques--promises and problems.

Assisted reproductive techniques (ART) are procedures in which the oocyte is handled before replacement, either as an oocyte or embryo. The current success rates and pregnancy outcomes of in-vitro fertilisation (IVF), gamete intra-fallopian transfer (GIFT), zygote intra-fallopian transfer (ZIFT), intra-cytoplasmic sperm injection (ICSI), donor oocyte and frozen embryo programmes are reviewed. Some problems associated with assisted reproductive procedures are also discussed.

Female↗

Amniotic fluid volume in spurious labour.

OBJECTIVE: A prospective study was undertaken to assess the amniotic fluid index (AFI) in women with spurious labour and its possible role in management. METHODS: Eight hundred and ninety-three women in early labour, who had uncomplicated pregnancy, were recruited for the study. Of these, 133 were later diagnosed to have had spurious labour, while 760 were in true labour. An admission cardiotocography and determination of AFI was done for all patients at the time of their admission to the labour ward. Labour was induced within 24 hours for those women in spurious labour who had severe oligohydramnios. RESULTS: The incidence of severe oligohydramnios (AFI < 5) was significantly higher in the patients later diagnosed to have had spurious labour (15.7%) compared with those in true labour (2.1%). With this management protocol, the obstetric and the neonatal outcome was similar in the spurious labour and the true labour groups. CONCLUSION: The assessment of AFI could be a simple and useful screening tool to avoid adverse perinatal outcome in women who experience spurious labour.

Adult↗

Clinical experience in temporomandibular joint arthroscopy.

Clinical experience of arthroscopy in 12 temporomandibular joints with a clinical diagnosis of closed lock was described. There were 10 patients and all were females with a mean age of 31.2 years (range 20 to 59 years). The antero-lateral approach was used for entry into 11 joints. The clinical findings were adhesions (64%), fibrillation (64%), anterior displacement of disc (36%) and scuffing of the articular surface of the glenoid fossa (9%). Two of the joints that had arthrocentesis prior to arthroscopy did not show any different findings from the rest. Of the 8 patients who had pre-arthroscopy pain, 7 patients (88%) had reduction of the symptom. Three patients (38%) had complete resolution of pain. The range of mouth opening (measured as maximal incisor opening) increased in all patients two weeks following arthroscopy. The average change in maximal incisor opening was 40.3% with a range of 22% to 85%. The mean follow-up was 34 months (range 4 to 68 months).

Adult↗

A cadaveric study of the potential damage in arthroscopic examination of the temporomandibular joints.

An arthroscopic study on 22 temporomandibular joints in 13 cadavers was undertaken. Dissections were carried out to correlate the arthroscopic with macroscopic findings in the joints. Iatrogenic damage to the temporomandibular joints and their surrounding tissues was also examined. Correlation between arthroscopy and macro findings was 91.0%. There was no damage to the facial nerve and superficial temporal vessels. Iatrogenic damage to the temporomandibular joint included scuffing of the articular surfaces of the glenoid fossa and articular eminence (31.8%), scuffing of the condylar articular surface (9%), one disc perforation (4.5%) and one perforation of the medial capsule (4.5%). Prevention of iatrogenic injuries is discussed.

Adult↗

Pectoralis major myocutaneous flap reconstruction in head and neck surgery--experience with 60 cases.

The aim of this paper is to evaluate the results of the use of the pectoralis major myocutaneous flap for reconstruction in 60 otolaryngology--head and neck patients over a five year period. There were 52 patients with Stage III (30%) and Stage IV (70%) untreated squamous cell carcinomas. Of the eight recurrent tumours, three patients had nasopharyngeal carcinoma with extensive post-radiation neck failures requiring extended neck dissections and flap reconstruction. The oral cavity and oropharynx were the predominant sites for reconstruction accounting for 70% of the operations performed. Twenty-eight patients had composite resections, ten with pectoralis osteo-myocutaneous flap incorporating a vascularised split sternum bone graft and titanium plate fixation for immediate mandibular reconstruction. All 52 patients underwent post-operative radiation. Major necrosis did not occur but minor tip necrosis of the skin island occurred in two cases (3%). The mean hospitalisation was 19 days for all patients and 21 days for patients with composite resections. The pectoralis major myocutaneous flap in our experience is not only a versatile flap but also a very reliable and robust flap for single stage immediate head and neck reconstruction.

Adult↗

Useful ultrasonic parameters pertaining to intra uterine fetal well being and growth retardation.

The true gestational age of the fetus is of great importance especially when there is an apparent discrepancy between the size of the fetus and the period of amenorrhoea. Various Ultrasonic measurements of the fetus have been used at different gestational periods to help arrive at the true gestation and to confirm or exclude intra uterine growth retardation. Recently, dynamic studies on the fetal blood flow through the umbilical artery and also the uterine vessels have provided an additional measurement of the internal milieu. These tests have been found to be extremely useful and of prognostic value even before changes occur in the CTG patterns.

Embryonic and Fetal Development↗

A prospective randomized comparative trial of the Gravigard, Latex Leaf, Dalkon Shield and Multiload Cu 250 IUDs.

This prospective randomized trial in 843 patients compared the effectiveness and complications of 4 intrauterine devices. At 24 months the gross accidental pregnancy rate for the Dalkon Shield was higher than for the 7Cu200 (p less than 0.05) and the ML Cu250 (p less than 0.05). The 7Cu200 had a higher expulsion rate than the Dalkon Shield (p less than 0.01), Latex Leaf (p less than 0.001) and ML Cu250 (p less than 0.001). Use-related terminations were higher for the 7Cu200 than for the ML Cu250 (p less than 0.01). Removal for pelvic inflammatory disease was necessary in 8 women (2 for the Latex Leaf and 3 each for the 7Cu200 and Dalkon Shield). There was no significant difference in termination rates between the ML Cu250 and Latex Leaf but subsequently the Leaf has given problems with removal particularly in women who have defaulted follow-up for several years.

Adult↗

A randomized comparative trial of the Lippes Loop D, Gravigard and TCu 220C IUDs.

This randomized prospective trial compared the use-effectiveness and pregnancy rates in 3 IUDs following immediate postabortal insertion in 199 women over 3107 months of use. At 24 months the Gravgard (Cu 7) was not significantly different from either of the other 2 devices. However, the Lippes Loop D when compared with the TCu 220C had a higher expulsion rate (P less than 0.05) and a higher use-related termination rate (P less than 0.001). Further details of accidental pregnancies, removal for incomplete abortion or pelvic inflammatory disease and within 48 hours after insertion are presented.

Birth Rate↗

Safety of postabortion sterilisation compared with interval sterilisation. A controlled study.

406 women--about one-fifth of those requesting an induced abortion and sterilisation over a thirty-three-month period--volunteered to be allocated randomly to either a concurrent induced-abortion/sterilisation group or a group which was sterilised six weeks after abortion. The abortion-attributable and sterilisation-attributable complication rates of 3.8% and 5.2%, respectively, for the concurrent group did not differ significantly from the 6.7% and 6.9% rates for the interval group. The estimated 2%-10% of women who would have changed their minds must be set against the 4% of women who became pregnant again before being sterilised. Efforts should be made to identify women likely to regret sterilisation.

Abortion, Induced↗

Thromboplastic and fibrinolytic activity of hydatidiform molar tissue and vesicular fluid.

We found similar levels of thromboplastic activity in molar tissue, vesicular fluid and normal placental tissue from pregnancies matched for gestational age. The fibrinolytic activity of molar tissue and vesicular fluid was, however, increased and vaginal haemorrhage tended to be heavier when fibrinolytic activity was high (p = 0.06). Subsequent choriocarcinoma occurred more frequently in patients with molar tissue which had low fibrinolytic activity (p = 0.08).

Body Fluids↗