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Biomedical subjects

T C Chao

Publications and source records attributed to T C Chao.

At least 109 records · Page 6Linked to original sources
PubMed1991

Carcinoma of the extrahepatic bile ducts.

Thirty-seven patients with carcinoma of the extrahepatic bile ducts (EHBD), diagnosed over 14 years from 1974 to 1987, were studied retrospectively. The most common presenting complaint was jaundice, followed by abdominal pain, nausea and vomiting, and weight loss. The majority of EHBD carcinomas were located at the middle third of the bile duct (43.2%), followed by upper third bile duct (37.8%), and lower third bile duct (18.9%). The resectability of the surgically managed group was 44.4%. The most common histologic type was adenocarcinoma. The 30-day postoperative mortality was 30.6%. The mean overall survival of the patients with EHBD carcinoma was 11.2 months. Patients with distal third tumors had the best prognosis with a mean overall survival of 16.0 months. The mean overall survival of patients with upper-third and middle-third tumors were 10.9 months and 9.4 months. A high index of suspicion of the disease as well as earlier, aggressive surgery may improve patient survival.

Adenocarcinoma↗
PubMed1991

Primary carcinoma of the gallbladder.

Seventy-four patients with primary carcinoma of the gallbladder, diagnosed over 18 years from 1969 to 1987, were studied retrospectively. The most common presenting complaint was abdominal pain, followed by jaundice and weight loss. Surgery was performed in 61 patients and of these patients, only two had accurate preoperative diagnosis which was made by ultrasonography. Twelve of the 13 patients who were treated medically had the disease diagnosed at autopsy. One of the 13 patients had the diagnosis of gallbladder cancer by the findings of ultrasonography and abdominal computed tomography (CT) scanning. The resectability of the surgically managed group was 36.1%, and the majority of patients with advanced tumors (82.2%) were deemed unresectable. The most common histologic type was adenocarcinoma. Liver was the organ most commonly invaded (76.5%) by direct extension and/or metastases, followed by regional lymph nodes (52.9%). The overall 5-year survival rate was 5.4%. A high index of suspicion of the disease, intraoperative examination of gallbladder specimen, and earlier, more aggressive surgical treatment may improve patient survival.

Adenocarcinoma↗
PubMed1991

An outbreak of aflatoxicosis and boric acid poisoning in Malaysia: a clinicopathological study.

An outbreak of food poisoning resulting in 13 deaths in children occurred in Malaysia during the Chinese Festival of the Nine-Emperor Gods in 1988. The offending food was a Chinese noodle called 'Loh See Fun' (LSF). The source was traced to a factory where a banned food preservative was added to make the LSF. The food poisoning was attributable to aflatoxins and boric acid. The clinical features included vomiting, pyrexia, diarrhoea, abdominal pain, anorexia, giddiness, seizures, and eventual coma. Initially, many presented with a Reye-like syndrome. Eleven post-mortem examinations were performed. The pathological findings included extensive coagulative necrosis of the liver with proliferative 'ductal/ductular metaplasia of the hepatocytes'. Giant cell formation, central vein sclerosis, bile stasis, and steatosis were also noted. There was presence of acute tubular necrosis, superficial upper gastrointestinal erosions, and ensuing encephalopathy. The eventual cause of death is acute hepatic and renal failure.

Aflatoxins↗
PubMed1991

Localization of human sarcoma with radiolabeled monoclonal antibody--a follow-up report.

A group of 16 sarcoma patients with suspected advanced disease were studied with a radiolabeled anti-sarcoma monoclonal antibody (mAb 19-24) in an attempt to localize tumor deposits. All 16 patients received 125I-mAb 19-24 and then had external-probe analysis and imaging performed. Confirmation of tumor deposits was done at surgery or by autopsy. Tissues were studied in surgical patients when possible and analyzed for radioactivity, and tumor-to-blood ratios ranged from 0.6 to 36.8. In conjunction with the patients previously studied, probe results had an overall sensitivity of 83.3% and an overall specificity of 100%; scintigraphic results showed an overall sensitivity of 78.9% and an overall specificity of 100%. Radiolabeled mAb 19-24 may be developed into a useful tool for clinical immunodetection of sarcoma deposits.

Adolescent↗
PubMed1991

Sudden unexplained death syndrome--a new manifestation in melioidosis?

The indirect haemagglutination (IHA) test using sensitized turkey erythrocytes and the indirect immunofluorescence assay (IgM-IFA) was confirmed to be sensitive in the detection of a recent or current Pseudomonas pseudomallei infection in 19 culture-confirmed Singapore melioidosis patients. All were found to have antibody titres from 4 to 32768 in the IHA test and 10 to 320 in the IgM-IFA test. When these tests were employed on sera from 16 immigrant Thai construction workers who died of sudden unexplained death syndrome (SUDS) and 73 healthy Thai fellow workers, 93.8% and 68.8% of SUDS cases had IHA titre of greater than or equal to 4 and IgM-IFA titre of greater than or equal to 10 respectively, in contrast to 39.7% and 12.3% found among healthy Thai workers. These data indicate that at the time of death, most of the SUDS patients had an active infection with P. pseudomallei, possibly resulting from reactivation of a latent infection. The aetiological role of P. pseudomallei as the major cause of SUDS is discussed.

Adult↗
PubMed1990

Leiomyoblastoma of the jejunum.

A 35-year-old male with the symptoms of acute abdomen proved to have a jejunal leiomyoblastoma. We renew recommendations for treatment by wide excision and regional lymphadenectomy.

Abdomen, Acute↗
PubMed1990

Merkel cell tumor of the back detected during pregnancy.

Merkel cell tumor is an unusual, aggressive malignancy of skin that has been considered to be derived from cutaneous Merkel cells. We are reporting a case of Merkel cell tumor overlying the left scapula with metastases to the thoracic spine and pleura. The tumor was found incidentally in a 23-year-old pregnant black woman. The tumor recurred locally 5 months after initial wide excision. Subsequently, a second wide excision of the recurrent tumor with ipsilateral axillary dissection was performed. The course of the disease was complicated by local recurrence and formation of distant metastases to pleura and spine. At the end-stage of the disease, the patient was found to have a cardiac murmur, and echocardiography revealed a mass in the anterior wall of the right ventricle that was suspicious for a metastatic lesion. The patient expired from extensive distant metastases 23 months after diagnosis.

Adult↗
PubMed1990

Computer graphics in medical illustration.

The advent of powerful personal computers (PC) has revolutionised the production of graphic illustrations in the various disciplines of medicine. This paper reviews the current hardware devices and software programmes available in the personal computer market for the generation, processing and production of graphic output in medical illustration for the purposes of teaching and presentation. A low-cost method of generating high quality presentation slides on IBM-PC based systems is also outlined.

Computer Graphics↗
PubMed1990

Normal boron excretion levels and borates related gastroenteritis cases in Singapore.

Urinary borates calculated as boric acid were found to span 0 to 54 microgramme per ml urine for both Singaporean adults (population size: 507) and children (population size: 162). The normal dietary boron intake could account for the urinary boric acid levels observed. Of the hundred and fifty-three children who suffered from gastroenteritis in Singapore over the period from Jan to May 1989, two were found to have urinary boric acid exceeding 54 micrograms per ml urine. One of them was said to have consumed fish balls, bean curds and noodles prior to the onset of illness. These food items were among those likely to have added borates. Unfortunately, the dietary intake prior to the onset of illness of the other child was not recorded. Of the hundred and twelve adults affected by gastroenteritis in Dec 1988 in the Tiong Bahru area, one was found to have boric acid level of 117 micrograms per ml urine, indicative of added borates in the diet. The present study showed that borates related gastroenteritis incidents in Singapore over the time-period of our study at least, were few and far in between. With the on-going surveillance for the presence of added borates in both locally manufactured and imported food and the continued tight control over the importation and sale of borates, future incidents are likely to be minimal.

Adult↗
PubMed1990

Medico-legal and ethical issues in neonatology.

Very small and sick neonates are being saved with modern technology. However, the cost is high. Obstetricians and neonatologists are often faced with the difficult task of deciding who is to be saved and who is not. In the USA, virtually all infants with any chance of survival are aggressively treated and stabilized until the future outcome can be certain. In addition, Infant Bioethical Review Committees are formed. In the UK such committees do not exist. Decisions are made by doctors together with parents. The practice in Australia is similar to that in the UK. It is recommended for Singapore that decisions should be made jointly by doctors and parents after thorough discussion. The formation of an Ethics Committee would lend support to the decision making. However, it is urged that prevention of low birth weight infants and congenital abnormalities would reduce the dilemma of the doctors.

Australia↗
PubMed1990

Paper tape in the closure of abdominal wounds.

Wounds closed by adhesive tapes have less inflammatory reaction, a lower rate of wound infection, greater tensile strength and better cosmetic results than sutured or stapled wounds. Special backing tapes, such as Steri-Strip, have been reported to have satisfactory results in closing laparotomy wounds. However, they are more expensive than paper tape. Sterile paper tape had adequate adhesive and supporting strength in the closure of abdominal wounds. The wounds closed with paper tape healed well and had satisfactory cosmetic results. Paper tape is a nonexpensive and convenient alternative to close abdominal wounds.

Abdomen↗
PubMed1990

Certification of death.

In Singapore, every deceased person must have a death certificate stating the cause of death. The death certificates are prepared from certificates of cause of death signed by medical practitioners, pathologists, coroners or inspectors of death. The death certificate is a legal document and the person who certifies the cause of death is responsible for the accuracy of the facts. Singapore has a Coroner's system and all deaths due to unnatural, violent, accidental, sudden and unknown causes must be reported to the coroner. These cases are usually subjected to post-mortem examination after which pathologist will sign the certificate of cause of death. Thus only pathologists are allowed to certify unnatural causes of death. All other categories of personnel are allowed to certify natural causes only. Any deviation will result in the certificate be rejected by the Registrar of Death and the matter referred to the Coroner. The offending doctor would be reprimanded by the court. Examples of wrong certification will be given and it is hoped that medical practitioners will not make similar mistakes.

Cause of Death↗
PubMed1990

Localization of pulmonary human sarcoma xenografts in athymic nude mice with indium-111-labeled monoclonal antibodies.

In order to study localization of metastatic tumors with a radiolabeled monoclonal antibody, a pulmonary metastases model was devised in athymic mice. Metastatic pulmonary sarcoma colonies were verified by histological examination. A murine monoclonal antibody (MAb 19-24) directed against a human sarcoma antigen was labeled with indium-111 (111In) by use of the linker 1-(p-isothiocyanatobenzyl)-diethylenetriaminepentaacetic acid (SCN-Bz-DTPA). MAb P3 was similarly labeled as a negative control. In the group given MAb 19-24, the percent injected dose per gram lung tissue bearing tumor colonies (30.1%, 29.6%, and 27.7% on Days 1, 2, and 3, respectively) was significantly (p less than 0.05) higher than in those receiving MAb P3. Hepatic activities of both 111In-MAb 19-24 and 111In-MAb P3 were low. The lungs with tumor colonies demonstrated clearest images on Day 3. The specific binding of 111In-SCN-Bz-DTPA-labeled MAb 19-24 to pulmonary xenografts without appreciable liver uptake indicates that it may be useful in the clinical localization of pulmonic metastatic lesions.

Animals↗