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Biomedical subjects

S T Lim

Publications and source records attributed to S T Lim.

At least 73 records · Page 4Linked to original sources
PubMed1985

Evaluation of the posterior approach for subfascial ligation of perforating veins.

A posterior midline incision was used for subfascial ligation of incompetent medial and lateral perforating veins in 32 patients. The indications for surgery were recurrent ulceration in 31 limbs and stasis dermatitis in six limbs. Incompetent perforating veins were found on the medial aspect of the leg in all cases and lateral aspect of the leg in 69% of cases. Postoperative mild skin edge necrosis and wound infection each occurred in seven limbs. Follow-up of these patients from 5 months to 4 years showed that there were 11 recurrent ulceration, 10 mild leg oedema and three recurrent varices. This operation was successful in preventing further leg ulceration in 70% of patients, and a further 21.6% had benefited from the operation in that ulcers which recurred in the follow-up period were small in size compared to the original ones, and healed quickly.

Adult↗
PubMed1984

Micturition after cystoplasty.

In patients with advanced carcinoma of the bladder not involving the trigone, radical total cystectomy with bladder replacement (replacement cystoplasty) using either the colon, ileum or stomach can be performed. In male patients, the prostatic urethra is always included in the resection so that the extent of radical surgery is not compromised. Thus the neobladder is anastomosed to the membranous urethra in these patients. In patients with contracted tuberculous bladder, the neobladder is anastomosed to the trigone after subtotal cystectomy (augmentation cystoplasty). The pattern of micturition is studied in 32 patients with cystoplasty after cystectomy. Emptying of the neobladder is achieved and completed mainly by abdominal straining rather than by the spontaneous contraction of the gastrointestinal segment, as evidenced by cystometric studies. The stomach generates high pressures during its peristaltic contractions but this could be a disadvantage during the early postoperative period particularly in the females, as urinary incontinence may result. In the majority of patients, micturition takes place every 2 to 3 hours with full urinary continence during the waking hours. However, in patients after radical total cystectomy, incontinence of urine during deep sleep is inevitable. No differences of voiding pattern, bladder capacity and residual urine volume are noted when either the colon, ileum or stomach is used for cystoplasty.

Adult↗
PubMed1983

Effects of gastrocystoplasty on serum gastrin levels and gastric acid secretion.

Hypersecretion of gastric acid and hypergastrinaemia occur when the antrum of the stomach is transposed as a diverticulum to the colon. Thus, when an antral pouch is transposed to increase bladder capacity or to replace the bladder as a gastrocystoplasty, similar pathophysiological disturbances can be anticipated. However, previous studies in our laboratories in dogs have shown that acid overproduction and stomal ulcerations do not occur. This paper reports the results of gastrocystoplasty in 13 patients followed up from 1 to 6 years. Gastric acid hypersecretion and hypergastrinaemia did not occur.

Adult↗
PubMed1983

Disseminated tuberculosis in a renal transplant recipient.

A case of disseminated tuberculosis in a renal transplant recipient is presented. Tuberculosis can occur in the early postoperative period and is potentially curable. It should be vigilantly looked for in every case of post-transplant infection.

Humans↗
PubMed1982

Intrathoracic gastric bypass for carcinoma of oesophagus found unresectable at exploration.

Assessment of the resectability of carcinoma of the oesophagus or cardia may be inaccurate. At exploration, 8 patients in whom resection was contemplated were found to have unresectable lesions. An intrathoracic oesophagogastric bypass was performed without further change of position. Five patients were discharged from hospital and survived between 3 and 20 months before they finally succumbed to metastases. Each of them was able to take an ordinary diet. The aims of palliation were achieved.

Adenocarcinoma↗
PubMed1982

Jejunal loop bypass and fundoplication for malignant esophagobronchial fistula.

A new operation was designed to supplement the Kirschner operation for patients with locally advanced carcinoma of the esophagus and who, in addition, had had a gastrectomy for peptic ulcer disease. Bypass of the esophageal obstruction was by jejunal loop, and gastroesophageal reflux was prevented by fundoplication. Eighteen patients underwent this operation with a mortality of 27.8 per cent. Death occurred in one of the three patients with leakage of the esophagojejunal anastomosis. One patient had gangrene of the jejunal loop develop. Severe bronchopneumonia was the cause of death in all five. The functional result in the surviving patients was satisfactory and they lived for a mean period of 3.6 months postoperatively. It is not advocated that this operation replace the Kirschner operation, which we consider the operation of choice for locally advanced carcinoma of the esophagus, but as an alternative procedure in those patients in whom a previous gastric resection precluded a Kirschner operation.

Aged↗
PubMed1981

Total parenteral nutrition versus gastrostomy in the preoperative preparation of patients with carcinoma of the oesophagus.

Gastrostomy feeding has been a well established form of nutritional support for patients presenting with total dysphagia for carcinoma of the oesophagus. More recently, total parenteral nutrition has proved to be efficient and safe, offering an alternative to gastrostomy feeding. Twenty-four patients were randomly selected into two groups to compare the efficacy of total parenteral nutrition and gastrostomy feeding with respect to nitrogen balance and weight gain. Total parenteral nutrition was found to be superior to gastrostomy feeding in achieving an earlier positive nitrogen balance and greater weight gain during a 4-week period. However, gastrostomy feeding is still preferred as it is cheap, simple and safe, and allows patients to be active, mobile and self dependent. Total parenteral nutrition is reserved for those patients in whom an earlier operation is advisable.

Adult↗
PubMed1981

Monocyte function in ageing humans.

Peripheral blood monocytes from hospitalised patients greater than 60 years of age and less than 35 years, and those from healthy normal controls less than 35 years, were tested for a range of functional and physiological properties, comprising chemotaxis under agarose, the ability to phagocytose and kill Candida albicans, adhesion to glass and spreading on glass. No significant difference was found between young and old groups, nor between hospitalized and non-hospitalized groups in respect of any parameter. There was some decline in phagocytosis and in spreading in a very old subgroup (greater than 75 years), but this was not statistically significant. This study showed that phagocytic cell function in the elderly does not decline at the same rate as the specific immune response and thus cannot directly account for the increased incidence of infection in the aged.

Adhesiveness↗
PubMed1981

Leakage of lymph through scrotal skin.

We report a case of scrotal dermal chylorrhea associated with chyluria. This is an uncommon complication of chyluria and the only case recorded in our series of 206 patients. Lymphograms showed the presence of abnormal reflux from the inguinal lymphatics into the scrotum.

Chyle↗
PubMed1980

Carcinoma of the tongue: factors affecting the results of surgical treatment.

Sixty-five cases of carcinoma of the tongue treated by surgery were reviewed. The types of operation included hemiglossectomy, subtotal and total glossectomy with or without hemimandibulectomy and laryngectomy. Simultaneous neck dissection was usually performed except for patients who had radiotherapy and did not have clinical lymph node involvement. The hospital mortality and five-year survival rates were analysed for individual subgroups of patients classified according to clinical and pathological features. The overall hospital mortality rate was 21.5 per cent. The size of the tumour and the presence of extension posteriorly, to the opposite side and to the floor of the mouth increased the mortality. Lesions situated on the dorsum fared worse than those at the edge or undersurface. Clinically and pathologically involved lymph nodes adversely affected the mortality. The more extensive the resection, the higher the mortality. Old age and previous failed radiotherapy also increased mortality. The overall five-year survival rate was 46 per cent. Long term survival was not so much affected by the size of the primary tumour and degree of local extension as was the hospital mortality. Clinical as well as pathological staging of regional lymph nodes were more important in influencing long term survival. Recurrence after radiotherapy had a worse prognosis than previously untreated tumours.

Female↗
PubMed1980

Surgical treatment of cervical lymph nodes in carcinoma of the tongue.

A series of 56 cases of carcinoma of the anterior two-thirds of the tongue treated surgically was reviewed. Lymph node metastasis occurred in 50% of cases. There was 22% false-negative clinical assessments of lymph node status for the ipsilateral side of the neck. Because of these and the difficulty in ensuring early treatment of subsequent node metastasis, concurrent ipsilateral radical neck dissection is recommended. When the ipsilateral side of the neck was involved the contralateral side has 22% false-negative assessments. Elective radical neck dissection for the contralateral side is recommended in this situation. The overall five-year survival was 50.6%, and was greatly affected by the status of the neck lymph nodes.

Carcinoma, Squamous Cell↗
PubMed1980

Surgical treatment of carcinoma of the hypopharynx and cervical oesophagus.

From 1964 to 1979 a total of 1,702 patients with carcinoma of the oesophagus were admitted into the University Department of Surgery, Queen Mary Hospital, Hong Kong. Among these the tumour was situated at the hypopharynx in 112 cases and at the cervical oesophagus in 36 cases. The treatment of choice for resectable tumours of these sites was pharyngo-laryngo-oesophagectomy (81 cases). Reconstruction with pharyngo-gastric anastomosis was preferred (76 cases). Other methods of reconstruction were indicated only when the stomach had been resected previously. Although the hospital mortality after pharyngo-laryngo-oesophagectomy was 31% this was the only means by which a long term survival could be achieved. Occasionally even when the trachea was infiltrated by tumour, salvage could be attempted by including the posterior wall of the trachea in the resection and repairing with an in-turned delto-pectoral flap. Although the actuarial survival of patients after pharyngo-laryngo-oesophagectomy was only 9%, all the patients who survived the operation were relieved of their distressing symptom of dysphagia.

Adult↗