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Biomedical subjects

S K Tan

Publications and source records attributed to S K Tan.

At least 55 records · Page 3Linked to original sources
PubMed1994

De Quervain's tenosynovitis and ganglion over first dorsal extensor retinacular compartment.

Between 1988 to 1991, 80 cases of de Quervain's disease were managed at the Department of Orthopaedic Surgery, Singapore General Hospital. Six of them had an associated ganglion over the first dorsal retinacular compartment. Five out of 6 cases had intracompartment injections of hydrocortisone and lignocaine but the treatment was not effective in relieving the pain of de Quervain's tenosynovitis. All 6 cases had excision of the ganglion and decompression of the first extensor compartment. All the lumps were found arising from the dorsal aspect of the retinaculum and no intracompartment extension of the ganglion was found.

Female↗
PubMed1994

Reactivation of rheumatoid arthritis in knees following total knee replacement.

Between May 1985 and December 1990, 20 patients with rheumatoid arthritis had 34 total knee replacements performed. The mean follow-up period was 4.1 years and the range was 2.3 to 7.8 years. Five knees with total knee replacements (74.7%) in 4 patients were affected by activation of the rheumatoid process at an average postoperative interval of 28.6 months while the other 29 knees with total knee replacements (85.3%) remained in remission. Factors that appeared to have an influence on post total knee replacement rheumatoid activation included the activity of the disease preoperatively, and whether synovectomy was undertaken at surgery. Whether patella replacement was undertaken appeared not to have influenced postoperative reactivation of the disease. Using the Hospital for Special Surgery Knee score, total knee replacement in our cases gave excellent results. The complications included one knee with dislocation of the patella and another with infection.

Aged↗
PubMed1994

Role of arthroscopy in ankle disorder--early experience.

Eighty-four consecutive cases of ankle arthroscopy performed between 1985 and 1990 were reviewed. These patients had all undergone conservative treatment for at least six months for chronic ankle pain. This consisted of non-steroidal anti-inflammatory agents, physiotherapy and/or immobilisation. Arthroscopy was performed when there was no response to conservative treatment. Eighty-one percent (68) of the patients were between the ages 20 and 29 years. Eighty-nine percent (75) were male. The most common lesions identified were transchondral fractures, localised synovitis, osteoarthritis and loose bodies. These were treated by arthroscopic surgery which included debridement, removal of loose bodies and abrasive chondroplasty. All the patients were followed up for at least one year or until they were asymptomatic. Excellent results were observed in transchondral fracture, localised synovitis associated with chronic lateral ligament instability, loose bodies, anterior impingement syndrome, osteochondritis dissecans and meniscoid syndrome. Good to fair results were obtained in osteoarthritis and fibroarthrosis. There were no intra-operative or postoperative complications.

Adult↗
PubMed1994

Early results of total condylar knee arthroplasty.

A total of 109 consecutive total condylar knee replacements in 73 patients were assessed at one to eight years postoperatively. The average age at surgery was 66.9 years and the range was from 52 to 84 years. The primary disease was rheumatoid arthritis in 12 and degenerative osteoarthritis in 97 knees. Out of the 109 prostheses; 101 were Miller-Galante kinematic condylar type I or II prostheses, seven were Insall-Burstern type I or II and one was a Whiteside prosthesis. The fixation technique was hybrid (only the tibial prosthesis cemented) in 63, both components uncemented in two and both components cemented in 44 knees. One hundred and five (96.3%) knees showed significant improvement in the Hospital for Special Surgery score postoperatively. The average preoperative score was 48.1 and the postoperative score was 85.4. Sixty-four patients (100 knees) were satisfied or very satisfied with the result of surgery. One hundred and four (95.4%) knees had achieved either an improvement in the range of motion and/or deformity. Complications included loosening in four (3.7%) knees, infection in three (2.8%), dislocation of the patella in four (3.7%), periprosthetic fracture in one (0.9%) and severe lateral collateral ligamentous laxity in one (0.9%).

Activities of Daily Living↗
PubMed1993

Comparison of the results of spinal fusion for spondylolisthesis in patients who are instrumented with patients who are not.

Eighty-five patients who had surgery for spondylolisthesis were studied retrospectively both clinically and radiologically to determine if instrumentation lead to better fusion rates and clinical outcome. Degenerative spondylolisthesis accounted for 57 cases and patients who had instrumentation did have a better fusion rate and clinical outcome, with 60% of patients having complete relief from pain. In the group with isthmic spondylolisthesis (28 patients), there was also an improved fusion rate with instrumentation. However, these patient took a longer time before returning to work and had to be protected in a polythene brace. The improved fusion rate radiologically with instrumentation did not translate to better clinical results with regard to pain relief and disability. One patient developed ascending epidural haematoma with instrumentation and resulted in paraplegia. She had incomplete recovery during the follow-up.

Absenteeism↗
PubMed1993

Acetylcholine receptor antibody assay kit: establishment of controls in normals and non-myasthenics and evaluation of sera from patients with thyroid disease.

Immunoprecipitation assays for antibodies to the nicotinic acetylcholine receptor are a specific test for the diagnosis of myasthenia gravis. However, testing has largely been confined to reference laboratories because the preparation of the reagents is laborious, making it less accessible to practising clinicians locally. We recently acquired a test kit produced by RSR Ltd (Avenue Park, Pentwyn, Cardiff) which makes testing of serum samples practicable in smaller centres. We describe our experience in establishing normal and control values in 30 separate samples. We also assayed the sera of ten patients with thyroid disease, some of whom had ophthalmopathy and/or weakness due to periodic paralysis, and none of these tested positive. Three additional patients with thyroid disease and concurrent myasthenia gravis were also inadvertently included in the latter assay and two had high titres and one had equivocal titres. The assay is now run regularly every quarter of the year.

Adult↗
PubMed1993

Malignant granular cell tumour of the lower limb--a case report and review of the literature.

Granular cell tumour is a rare tumour of undetermined origin. Fewer than 1000 cases have been reported and less than 40 cases of malignant forms of this tumour have been described in the literature. We report a single case of the malignant form of granular cell tumour in the lower limb and review the literature regarding the possible origin of this tumour. Presently, wide surgical excision is the only modality of treatment for this lesion.

Granular Cell Tumor↗
PubMed1992

Results of total hip replacement in renal transplant recipients.

A vascular necrosis of the femoral head associated with steroid immunosuppression is a cause of significant morbidity in renal transplant recipients. We review the results of 30 total hip replacements in 20 renal transplant recipients with a mean follow-up of 6.3 years. The mean age at the time of surgery was 35 years. The average Hospital for Special Surgery Hip Score was 17 points before operation and 32 points after operation. Fourteen hips were rated excellent and 12 hips rated good. There were four failures--one hip was revised for symptomatic loosening and three prosthesis were removed for infection. Twenty-seven of the hip replacements were subjectively rated as satisfactory by the patient. There was no significant difference in post-operative hip scores between cemented and uncemented prostheses. Total hip replacement in renal transplant recipients in this study has shown good long term result with a revision rate of about 3%. Late infection was a major problem with an incidence of 13%. Prophylactic antibiotics must be used whenever there is a risk of haematogenous seeding from transient bacteremia in these immunosuppressed patients. Use of uncemented prosthesis may make future revision arthroplasty easier.

Adolescent↗
PubMed1992

Surgical treatment of metastatic long bone disease.

A retrospective study of the results of operative treatment of 60 long bones secondaries in 46 patients was carried out. The mean period of follow-up was 10 months. The most common primary in this study was carcinoma of the breast (28.2%), followed by carcinoma of the lung (21.7%) and unknown primary (10.9%). Three groups of patients were studied--pathological fracture group, prophylactic fixation group and a mixed group. In the pathological fracture group, 70% of patients achieved good to excellent pain relief and 60.9% was able to walk with or without walking aids. In the prophylactic group, all the patients achieved good to excellent pain relief and 60% were able to ambulate with or without walking aids. In the mixed group, all the patients achieved good to excellent pain relief and 66.6% of the patients were able to walk with aids. The operative mortality in both the pathological fracture group and prophylactic fixation group was 10% and 33.3% in the mixed group. Multiple internal fixation performed at one operative session was associated with high operative mortality (50%).

Adult↗
PubMed1991

Extraskeletal osteogenic sarcoma--a case report.

A rare case of extraskeletal osteogenic sarcoma of the right groin in a 50 year old Chinese lady is being presented. A wide excision of the tumour was done. The differential diagnosis are discussed. This is an extremely rare tumour and is just as malignant and aggressive, if not more so than its counterpart in the bone.

Diagnosis, Differential↗
PubMed1991

Chondrosarcoma of the spine--report of two cases.

Chondrosarcoma arising from the spine is a rare malignant tumour, associated with a poor outlook due to inadequate excision in the majority of the cases. We report two cases arising from the cervical and the thoracic spine. Both survived 15 and eight years respectively. This condition carries with it a grave prognosis because of its proximity to the vital structures, making complete extirpation of the tumour frequently difficult if not impossible. Recent developments and progress in adjuvant radiation therapy has improved the prognosis significantly.

Adult↗
PubMed1991

Clear cell chondrosarcoma--a report of 2 cases.

Clear cell chondrosarcoma is a form of chondrosarcoma that was first described by Unni in 1976. It is essentially a low-grade chondrosarcoma with many similar clinical, radiological and histological features as the more common chondrosarcomas. However, the distinguishing feature of this variant is in the presence of the characteristic clear cells histologically. We relate two such cases of clear cell chondrosarcoma in Singapore. A short discussion covering the incidence/prevalence of this tumour, its common presenting clinical, radiological and histological features follows. We also review the available world literature, highlight the salient and differentiating aspects of this particular tumour, and touch on its management and eventual prognosis.

Adult↗
PubMed1990

Impact of fine needle aspiration cytology on the management of solitary thyroid nodules.

To evaluate the impact of the routine use of fine needle aspiration cytology (FNAC) on the management of solitary thyroid nodules, 102 consecutive patients were assessed in regard to the proportion of patients being subjected to surgery and the corresponding yield of malignancy. This cohort was compared with a historical control where FNAC was not routinely applied as a diagnostic selection criterion. The percentage of patients operated on had decreased from 95% to 60% (P less than 0.001) without any significant decrease in the field of malignancy: 18.6% vs 17.6% (P = 0.97). The yield of malignancy of patients operated on had increased from 18.4% to 26.2%. Of those not subjected to surgery, 14 patients or 14% of the original cohort experienced spontaneous complete resolution of their nodules after a mean follow-up period of 5.5 months (s.d. = 3.5) (non-resected group). In the retrospective evaluation of diagnostic discriminants to maximize yield of malignancy while minimizing unnecessary surgery for thyroid nodules, the use of combined parameters of clinical suspicion, positive FNAC and age greater than or equal to 50 years detected 100% of malignancies with only 50% of patients requiring surgery. This was superior to other modalities including clinical parameters and expensive investigations of radionuclide scans and ultrasonography. In conclusion, the use of FNAC in the evaluation of solitary thyroid nodules has resulted in a decreased proportion of patients requiring surgery and cost saving while maintaining the yield of malignancy.

Adolescent↗
PubMed1990

Traumatic posterior dislocation of the hip--a local experience and review of the literature.

The results of 30 patients who sustained traumatic posterior dislocation of the hip treated in both Departments of Orthopaedic Surgery in the Singapore General Hospital from January 1980 to May 1987 were analysed. The most common cause was motorcycle accidents. Young adult males formed the majority of affected cases. 90% of the dislocations were of the Types I and II. Associated injuries were common. The primary treatment was closed reduction under anaesthesia. The subsequent period of traction and non-weight bearing was variable, but it did not seem to affect the final results. Avascular necrosis of the femoral head and secondary osteoarthritis were the major complications. The overall functional results were good.

Accidents, Traffic↗
PubMed1989

A comparative study of new cases seen at the Child Psychiatric Clinic in 1975 and 1985.

A comparative analysis of new cases seen at the Child Psychiatric Clinic in 1975 and 1985 is made in this study. There was a three and a half fold increase in the number of patients seen from 245 to 893. There was no significant change in sex ratio or ethnic groups. However, in 1985 more younger children (aged less than 6 years) were seen at the Clinic. The waiting time remained short with half the number of cases seen within one week of appointment. The commonest conditions besides Normal Variation were Adjustment Reaction, Mental Retardation, Conduct Disorder and Neurosis. Three-fifths of cases were discharged from follow-up within three months of therapy. Most cases (90%) did not require pharmacological therapy whilst family therapy was prescribed for a fifth of cases seen in 1985.

Adolescent↗
PubMed1989

Results of modified Bosworth's operation for persistent or recurrent tennis elbow.

A retrospective review was made of 28 surgically treated tennis elbows in the Department of Orthopaedics Surgery O SGH between Jan 1986 and Aug 1988. Biodata, duration of conservative treatment, postoperative results and length of recuperation were analysed. All except one patient was discharged from follow-up at the time of the study. Females outnumber males 2:1.11 cases (75%) were not associated with sports. 21 patients (24 elbows) were contacted by phone. Of these, 91.7% reported excellent or good results based on the postoperative assessment scale by Nirschl (JBJS Vol 61-A No 6, Sept 1979). Average duration of medical leave taken was 2.2 weeks. Average time before return to normal activities was 6.7 weeks.

Adult↗
PubMed1987

Three cases of partial trisomy 9q in one generation due to maternal reciprocal t(6;8;9) translocation.

A family is described in which three siblings had congenital abnormalities consistent with partial trisomy 9q syndrome. Karyotyping indicated that the mother was a carrier of two separate balanced reciprocal translocations involving three chromosomes (46,XX,t (6;8;9)(6q27;8p23;9q32;9q13] resulting from four breakpoints. The three siblings had inherited the der(8) from their mother and hence were partially trisomic for 9q32----9qter and partially monosomic for 8p23----8pter (46,XX,der(8),t(8;9)(p23;q32)mat). The clinical features of the three cases were comparable to those reported in the literature.

Chromosome Banding↗