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Biomedical subjects

W C Yip

Publications and source records attributed to W C Yip.

At least 73 records · Page 4Linked to original sources
PubMed1986

Intra-operative fibreoptic enteroscopy for bleeding lesions in the small intestine.

Twenty-five patients with gastrointestinal bleeding proved to have lesions in the small intestine. Intra-operative fibreoptic enteroscopy was performed on seven patients, in six patients through the anus and in one patient through an enterotomy and the anus. The indications for fibreoptic enteroscopy were inability to find the lesions in the 3 patients, multiple small lesions in 3 patients and to rule out suspicious pathology in the jejunum shown on a small bowel enema in a patient with ileal ulcers. In all instances, the fibreoptic enteroscopy was useful in localizing lesions, in detecting additional lesions and in ruling out the suspicious lesions. It can be performed easily and is safe. No complication developed from its use in this series.

Endoscopy↗
PubMed1986

Combined topical povidone-iodine and systemic antibiotics in postappendicectomy wound sepsis.

Three hundred and fifteen patients with appendicitis were randomized into two groups. One group received pre-operative systemic gentamicin and metronidazole while the other group received 1 per cent topical povidone-iodine solution in addition to the antibiotics. For early appendicitis including normal and acutely inflamed appendices, only one dose of antibiotics was used. The postoperative wound sepsis was very low in both groups of patients and there was no statistical difference between them. For late appendicitis including gangrenous and perforated appendices, the antibiotics were continued for 7 days. Eight out of 51 patients who had the topical agent developed wound sepsis compared with one out of 52 patients who received no topical agent. This difference is statistically significant (P = 0.03). All wound infections presented within 2 weeks of operation and were deep. Povidone-iodine, 1 per cent, adversely affects the wound infection rate in late appendicitis and should not be used.

Administration, Topical↗
PubMed1986

Cefoxitin versus gentamicin and metronidazole in prevention of post-appendicectomy sepsis: a randomized, prospective trial.

Three hundred and seven patients with appendicitis were randomized to receive cefoxitin or gentamicin and metronidazole. For early appendicitis, a single preoperative dose of antibiotics was given. For late cases, the antibiotics were continued postoperatively for seven days. Both cefoxitin and gentamicin-metronidazole were effective in the reduction of post-appendicectomy septic complications in early or late appendicitis and there was no statistically significant difference between them. Mild transient and reversible nephrotoxicity was detected in 1.9% of patients who received gentamicin-metronidazole for seven days. Nephrotoxicity was not detected in any other patients. The cost of cefoxitin is higher, but this has to be balanced against the costs of monitoring serum gentamicin and creatinine levels, and the need to adjust the gentamicin dosage in 19% of patients when gentamicin-metronidazole was used. Both cefoxitin and gentamicin-metronidazole are effective and safe when used carefully. Cefoxitin has a slight advantage in its lack of potential nephrotoxicity and ototoxicity.

Adolescent↗
PubMed1986

Emotional and social effects of congenital heart disease in Singapore.

A cohort of patients with congenital heart disease (n = 29) who had undergone corrective cardiac surgery was studied and compared with normal controls. The mean age of cardiac patients was 10.3 years with a range of 6 years to 16 years. Their emotional maladjustment as measured on a behavioural checklist was significantly higher (P less than 0.01) than controls, and their social adjustment was also similarly less satisfactory (P less than 0.05). Regression analysis indicated that emotional maladjustment in the child was related to maternal maladjustment (P less than 0.01), maternal guilt (P less than 0.01) and maternal anxiety (P less than 0.05). Social maladjustment in the child was significantly related to maternal guilt (P less than 0.05) and pampering (P less than 0.02). It was considered that the child with heart disease was perceived and 'labelled' by the mother as abnormal even after surgery and was therefore the object and focus of maternal guilt and anxiety. Hence, the child's emotional and social maladjustment is probably the result of maternal factors rather than the physical handicaps of the illness.

Adolescent↗
PubMed1985

Sonographic diagnosis of infantile hypertrophic pyloric stenosis: critical appraisal of reliability and diagnostic criteria.

Critical review of the current medical literature shows lack of complete evaluation of the parameters of "medical decision making" in the sonographic diagnosis of infantile hypertrophic pyloric stenosis (IHPS). A computer program was specially written to calculate these parameters on three published series of patients with IHPS, using originally advocated and modified sonographic criteria. The sensitivity and specificity of the sonographic tests are influenced by the chosen diagnostic criteria, while predictive values are affected by the prevalence of IHPS in the particular population studied. A change in the ventral-dorsal diameter criterion from 1.2 cm to 1.5 cm increased the sensitivity (from 0.52 to 0.97, p less than 0.0001) and negative predictive value (0.60 to 0.95, p less than 0.01) in the population of Wilson et al (9), changing the prevalence of IHPS from 0.58 to 0.12, (sensitivity, specificity and sonographic criterion kept constant) reduced the positive predictive value from 0.90 to 0.48 (p less than 0.0001). The term "accuracy" has little scientific meaning and should be discarded in comparative evaluation. These results indicate that the real contribution of sonography in decision making in patients with suspected IHPS (but without a palpable mass) has not been properly evaluated by research workers.

Evaluation Studies as Topic↗
PubMed1985

Parental age and birth order effects in children with febrile convulsions.

This is a study of the parental age and birth order of 100 Chinese children with febrile convulsions compared with 100 controls. The birth order of children with febrile convulsions (1.6 +/- 0.8) was found to be lower than that of the controls (2.1 +/- 1.0), a difference significant at P less than 0.001, whereas there was no significant difference for both paternal and maternal age. Using multiple regression analysis, it was found that the birth order effect was significant at P less than 0.0001. This finding suggests that perinatal factors may play a role in the pathogenesis of febrile convulsions.

Adult↗
PubMed1985

Estimation of glomerular filtration rate in children using 99m-technetium DTPA. A comparison with 51-chromium EDTA clearance.

The usefulness of radionuclide imaging studies with 99m-technetium diethylenetriaminepentaacetic acid (Tc-DTPA) for quantitating the glomerular filtration rate (GFR) in children was studied. This was compared to the conventional methods for measuring GFR using 51-chromium-EDTA clearance (Cr-EDTA), creatinine clearance and a height/plasma creatinine formula. In the 22 children studied, the correlation coefficient between renal uptake of DTPA and Cr-EDTA was 0.90 (p less than 0.001). In contrast, there was a poorer correlation between Cr-EDTA and creatinine clearance (r = 0.69) or the derived GFR using height/creatinine formula (r = 0.83). The regression line between Tc-DTPA uptake and Cr-EDTA clearance was used to derive a formula for calculating the predicted GFR. This was tested in 10 additional children, and the correlation between the predicted GFR and measured GFR (using Cr-EDTA clearance studies) was 0.92 (p less than 0.001). Quantitative estimation of the GFR during renal imaging studies is a feasible and convenient method of assessing renal function.

Adolescent↗
PubMed1985

Dermatoglyphs in children with mitral valve prolapse.

The dermatoglyphs of 50 Singapore school children with mitral valve prolapse (MVP) were studied, with special reference to the frequency of digital arches. The MVP was diagnosed clinically and substantiated by two dimensional echocardiography. In the study there were 35 Chinese and 15 Malay children, with ages ranging from 6 to 19 years. Four Chinese children had one or more arches on the digits but none of the Malay children was found to have arches. It was shown that the frequency of arches on the digits was not significantly higher than that among 50 controls (who were shown not to have MVP on two dimensional echocardiography) or when compared with the frequency of arches among the Chinese and Malay population in Singapore (2.0% and 2.9% respectively). No other dermatoglyphic abnormalities (including atd angle) were found.

Adolescent↗
PubMed1985

Ultrasonic systolic blood pressure gradient between upper and lower limbs in normal term Chinese neonates.

The determination of a normal pattern of systolic blood pressure (SBP) gradient between upper limbs (UL) and lower limbs (LL) in neonates is important in the diagnosis of the coarctation syndrome. The scarcity of studies of normal neonates and the conflict of opinion prompted us to evaluate this problem. The UL and LL systolic blood pressures of 100 normal term Chinese neonates were measured by the Doppler Ultrasonic method (Roche Arteriosonde 1020). Under resting condition, the majority (89%) of our neonates had a negative SBP gradient (LL greater than UL). The mean LL SBP (70.1 mmHg) was significantly higher than that of the UL (59.5 mmHg), p less than 0.001. Eleven out of 100 of our neonates had a positive (UL greater than LL) SBP gradient. Eight of these were less than 1 week old. None had a positive gradient of more than 20 mmHg. According to the results of our study, during the first week of life, normal neonates may have upper limb pressure greater than lower limb of up to 20 mmHg.

Blood Pressure↗