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Biomedical subjects

S M Lim

Publications and source records attributed to S M Lim.

88 records · Page 5Linked to original sources
PubMed1986

Surgery in transsexuals.

A review was made of transsexual patients who presented at a clinic for treatment. A total of 154 patients were seen over 6 years. There were 16 female to male transsexuals and 138 male to female transsexuals. Psychiatric screening was a mandatory prerequisite. Hormonal treatment for the transsexual had been started with no exception, prior to consultation. The scope of surgery and its limitations were described to the patient. The female to male transsexual had to undergo a multistaged procedure that included mastectomy, hysterectomy, raising of the penile pedicle, mobilising of the pedicle, insertion of silicone stiffener, and use of testicular prosthesis. Urethral diversion was not attempted. The surgical technique for the male transsexual utilised an inverted U flap on the perineum. Bilateral orchidectomy was performed. The penile skin flap was filletted. The vaginal tunnel was created by sharp and blunt dissection. The urethra was mobilised and translocated. The excess scrotal skin formed the labia. The most serious complication that occurred was that of rectovaginal fistula. Other complications included vaginal stenosis, urethral stenosis and labial abscess.

Adolescent↗
PubMed1982

The pattern and management of traumatic soft tissue injuries of the lower limb.

38 cases of soft tissue injuries of the lower limb seen in the Department of Plastic Surgery, Singapore General Hospital are reviewed. The pattern of soft tissue trauma reveals that the incidence is highest in the young male population between the ages of 20-30 years. Road traffic accidents are the commonest cause of trauma and the pedestrian is the most frequent victim. The commonest site of lower limb involvement is the leg and the majority of the cases of bone exposure following trauma are due to degloving injuries. The reconstructive procedures used include split-skin grafts, cross-leg flap, local transposition flap, muscle transposition flap, dorsalis pedis island flap and free groin flap. Split-skin graft and cross-leg flap procedures accounted for the management of 75% of the cases in this series.

Accidents, Traffic↗
PubMed1982

Induction of labour with prostaglandin E2 and amniotomy--a multicentre, three dose schedule study in 1533 patients.

Prostaglandin E2 administered orally and combined with amniotomy was used for induction of labour at or near term in 1533 patients. The study was carried out as a collaborative project between the University Departments of Obstetrics and Gynaecology in Singapore, Medan (Indonesia) and Kuala Lumpur (Malaysia). The overall success rates for Medan, Kuala Lumpur and Singapore were 95.6%, 88.1% and 84.7% respectively.

Drug Administration Schedule↗
PubMedDate not supplied

Falope ring application via culdoscopy.

This report describes a series of 122 women who were sterilized with Falope ring application via culdoscopy and demonstrates the feasibility of the procedure.

Adult↗
PubMedDate not supplied

Pleural and pulmonary staining at inferior phrenic arteriography mimicking a tumor staining of hepatocellular carcinoma.

PURPOSE: To describe the findings of pleural and pulmonary staining of the inferior phrenic artery, which can be confused with tumor staining during transarterial chemoembolization (TACE) of hepatoma. METHODS: Fifteen patients who showed pleural and pulmonary staining without relationship to hepatic masses at inferior phrenic arteriography were enrolled. The staining was noted at initial TACE (n = 8), at successive TACE (n = 5), and after hepatic surgery (n = 2). The angiographic pattern, the presence of pleural change on computed tomography (CT), and clinical history were evaluated. RESULTS: Draining pulmonary veins were seen in all cases. The lower margin of the staining corresponded to the lower margin of the pleura in 10 patients. CT showed pleural and/or pulmonary abnormalities in all cases. After embolization of the inferior phrenic artery, the accumulation of iodized oil in the lung was noted. CONCLUSION: Understanding the CT and angiographic findings of pleural and pulmonary staining during TACE may help differentiate benign staining from tumor staining.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Preoperative transarterial embolization of spinal tumor: embolization techniques and results.

BACKGROUND AND PURPOSE: The techniques of preoperative embolization of hypervascular spinal tumors, which has been known to be helpful for completing tumor resection, have not been described in detail. The purpose of this study was to analyze the technique and to evaluate the safety and value of preoperative transarterial embolization of hypervascular spinal tumors. METHODS: Eighteen patients with hypervascular spinal tumors underwent transarterial embolization before surgery. The lesions were located between the upper cervical and lower lumbar spine: C1-T1 (n = 6), T5-L3 (n = 11), and L5 (n = 1); they arose intradurally in six patients and extradurally in 12. Thirty-one arteries were embolized with polyvinyl alcohol (PVA) particles (150-500 microm), and, in 18 of these, pieces of gelatin sponge were added for proximal pedicular embolization. The criteria for judging the effectiveness of embolization were completeness of tumor removal and estimated blood loss during surgery. RESULTS: Tumor embolization was total in eight patients, nearly total in seven, subtotal in one, and partial in two. There were no symptomatic complications associated with embolization. Tumors were totally removed in 17 patients and nearly totally removed in one. The average estimated blood loss during surgery was 1100 mL (range, 200-6000 mL) for all 18 patients, and 1540 mL in patients with extradural tumors. CONCLUSION: Preoperative embolization of hypervascular spinal tumors is safe and effective. It can make complete resection of a tumor possible and can make an unresectable tumor resectable. Superselection or flow control is necessary to achieve effective devascularization and to avoid complications.

Adolescent↗
PubMedDate not supplied

Pituitary atrophy in Korean (epidemic) hemorrhagic fever: CT correlation with pituitary function and visual field.

Eleven patients with Korean (epidemic) hemorrhagic fever were each studied three times with high-resolution CT in order to demonstrate necrosis of the pituitary gland and to correlate the CT findings with the patients' pituitary function and visual fields. Seven of the 11 patients showed varying degrees of progressive decrease in the height of the pituitary gland: one severe, two moderate, and four mild. The visual fields of all the patients were checked at the time of the third (last) follow-up CT. Six of the 11 patients had bitemporal superior quadrantanopsia. In five patients, the decreased height (atrophic change) of the pituitary gland and the visual-field defect were coincidental. The visual-field defects in those patients were not improved on follow-up examination 5 weeks later. Two patients in whom a 1-year follow-up examination was performed showed no interval changes in the defects. Pituitary function tests were performed in nine of the 11 patients (six with atrophic pituitary glands and three without atrophic changes) at the time of the third CT. Five of the six patients with atrophy showed decreased pituitary reserve function for follicle-stimulating hormone, cortisol, or human growth hormone, while only one patient showed decreased reserve function for cortisol among the three patients without atrophic change. The pituitary atrophic changes observed on follow-up sellar CT are thought to be the result of the ischemic necrosis of the gland. The high probability (five of seven) of visual-field defects in those patients with atrophic glands suggests optochiasmatic and pituitary ischemia as the basic pathogenesis.

Adult↗