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Biomedical subjects

Y F Chan

Publications and source records attributed to Y F Chan.

At least 37 records · Page 2Linked to original sources

Misoprostol is as effective as gemeprost in termination of second trimester pregnancy when combined with mifepristone: a randomised comparative trial.

A prospective randomized study was conducted to compare the efficacy of misoprostol with gemeprost when combined with mifepristone for termination of second trimester pregnancy. Patients requesting termination of second trimester pregnancy were randomized into two groups. In both groups of patients, 200 mg of mifepristone was given 36 to 48 hours before the administration of prostaglandins. In Group 1, the women were given 400 micrograms of oral misoprostol every 3 hours up to 5 doses. In Group 2, patients were given 1 mg of vaginal gemeprost every 6 hours up to 4 doses. The main outcomes measured were the induction-abortion intervals (the interval between the first dose of prostaglandin and abortion) and the incidence of side effects. Altogether, 50 subjects were recruited with 25 women in each group. The mean age and parity of the women and the mean gestational age of the two groups of women were comparable. There was no significant difference in the median induction-abortion intervals (8.7 hours in Group 1 and 10.8 hours in Group 2) or the incidence of side effects between the two groups of patients. We conclude that misoprostol is as effective as gemeprost in termination of second trimester pregnancy when combined with mifepristone.

Abortifacient Agents↗

Ovarian Sertoli-Leydig cell tumor with retiform pattern.

Sertoli-Leydig cell tumors (SLCT) are sex cord-stromal tumors which exhibit testicular differentiation.1 They account for less than 0.2% of ovarian neoplasms in total but comprise 4% of ovarian tumors in females under 20 yrs of age.2 The morphological appearance of these tumors varies more widely than that of any other ovarian tumor except for the teratomas. Histologically they are now classified into 5 categories: well-differentiated, intermediately differentiated, poorly differentiated, heterologous and retiform.1 We describe the case of an ovarian Sertoli-Leydig cell tumor with retiform pattern in a 7 yr old girl.

Child↗

[Arytenoid subluxation following endotracheal intubation--a case report].

A previously healthy 39-yr-old man was scheduled for exploratory laparotomy due to acute abdomen. There was no sign of difficult intubation. After induction of anesthesia with thiopental and succinylcholine, the trachea was easily intubated with a 7.0 mm cuffed endotracheal tube. Surgery for a ruptured appendix with 2 drainage tubes lasted for 75 min was uneventful. At the end of surgery, the endotracheal tube was removed without difficulty. On the 1st postoperative day, the patient developed stridor. The symptom persisted even after conservative treatment and removal of NG tube. On the 12th postoperative day, a telescopic videolarygoscopy revealed immobile right vocal cord with anterior and medial displacement to the right. Arytenoid cartilage was moderately edematous. A diagnosis of right arytenoid subluxation was then made. On the 17th postoperative day, a closed reduction of right arytenoid cartilage using direct laryngoscope was performed successively under general anesthesia. Eight weeks after the reduction, his voice and laryngoscopic findings were normal. There has been only 18 reports with 27 cases of this complication found in the literature. However, it is generally believed that it is not so unusual. The post-intubation syndromes, such as sore throat, dysphonia, odynophagia, difficulty in swallowing or breathing which persists beyond 5 days warrant ENT consultation. Abnormal mobility of vocal cord, edema over arytenoid area found by indirect laryngoscopy should suggest the complication. Further confirmation is then needed. Although the result of our case is good, the reduction should ideally be done within 24-48 h after the incidence to avoid unfavorable long-term sequelae.

Adult↗

Prenatal sonographic detection of intra-abdominal extralobar pulmonary sequestration: report of three cases and literature review.

Three cases of intra-abdominal extralobar pulmonary sequestration detected antenatally by ultrasound are reported. One case was associated with a large left diaphragmatic hernia. Sonographically, all the cases were found in the left supra-renal region presenting as a well-defined echogenic mass with cystic hypoechoic areas. The condition should be considered in the differential diagnosis of all antenatally detected upper abdominal echogenic masses, particularly when associated with a diaphragmatic hernia. Postnatal ultrasound-guided fine needle aspiration biopsy in one case yielded respiratory type epithelium and this procedure could provide a reasonably confident diagnosis of the lesion.

Abdomen↗

Parapharyngeal teratoma in the newborn.

A parapharyngeal teratoma in a newborn was the cause of acute respiratory distress, which was relieved by tracheostomy. Subsequent investigations by soft tissue x-rays of the neck, computed tomography, and examination under anesthesia defined the anatomic location of the tumor, its extent, and its likely nature. The tumor was removed completely by the transcervical approach. Mandibulotomy was not required. Histological examination showed the presence of a large amount of mature brain tissue, a moderate amount of collagenous fibers and smooth muscle cells, and a minute amount of cartilage and epithelial structures. The postoperative course was satisfactory. No recurrence was seen 6 years after surgery. The computed tomography scan was found to be the most useful investigative method. To the authors' knowledge, this is the first comprehensive report of a teratoma occupying the parapharyngeal space in a newborn.

Female↗

Adenomyoma of the small intestine in children.

Two cases of adenomyoma of the small intestine occurring in two young children are described. One child presented with intussusception. In the other, the lesion was an incidental intraoperative finding. Underreporting is probably a major reason for the apparent rarity of this lesion in the small intestine. The condition should be considered a cause of small bowel intussusception.

Adenomyoma↗

The value of a single sensitive urine pregnancy test in prediction of pregnancy outcome.

A simple and reliable indicator for pregnancy outcome will be valuable clinically for patient management and for counselling women whose pregnancies are results of subfertility treatment. This study aimed at evaluating the ICON II test, a simple semiquantitative sensitive urine pregnancy test, in predicting pregnancy outcome in women who conceived after various forms of subfertility treatment. The ICON II test was performed on day 20 after the ovulating dose of hCG administration or spontaneous LH surge. One hundred and forty-five consecutive pregnancies were studied, 99 being viable and 46 nonviable which included subclinical abortion, clinical abortion and ectopic pregnancies. There was a significant difference in the luteal serum progesterone and hCG levels between viable and nonviable pregnancies. There was also a significant difference in the ICON II test result, i.e. either weakly positive (hCG of 25-50 IU/l) and positive (hCG > 50 IU/l) and the pregnancy outcome (p < 0.0001). The specificity of a weakly positive ICON II test in predicting poor pregnancy outcome was 98.8% whereas the sensitivity was 28.6%. In conclusion, a weakly positive ICON II test is useful in predicting poor pregnancy outcome.

Adult↗

Blood loss in termination of early pregnancy by vacuum aspiration and by combination of mifepristone and gemeprost.

Blood loss was measured in 17 subjects undergoing surgical termination of pregnancy and in 96 subjects undergoing medical termination of pregnancy with sequential mifepristone (200 mg, 400 mg, 600 mg) and 1 mg prostaglandin analogue gemeprost. The median blood loss were 53.2, 84.1, 99.9 and 101.4 ml, respectively. There was a statistically significant difference between the surgical and each of the medical termination group of subjects but there was no difference among the subgroups in the medical termination group. The pattern of bleeding was also similar, being heaviest on the day and the days shortly after prostaglandin administration. Majority of them (> 90%) experienced blood loss of < 300 ml and there was no significant drop in hemoglobin level during the 6-week follow-up period. A few women experienced heavy bleeding and, hence, strict supervision on medical termination of pregnancy is recommended.

Abortifacient Agents, Nonsteroidal↗

The value of transabdominal pelvic ultrasonography in monitoring of ovulation induction with gonadotropins.

Seventy-five patients with a total of 306 human menopausal gonadotropin treatment cycles over the period 1984-1989 were analysed retrospectively to evaluate the value of transabdominal pelvic ultrasonography in prevention of complications arising from ovulation induction with human menopausal gonadotropins. There were 60 pregnancies giving a pregnancy rate of 19.6% per cycle. There was positive correlation between the number of follicles > or = 14 mm in mean diameter and the incidence and degree of hyperstimulation (p < 0.005) as well as the incidence of multiple pregnancies (p < 0.01). Ultrasonography is a useful adjunct for monitoring in such a program.

Adult↗

Luteinizing hormone (LH) surge in patients using buserelin spray during ovarian stimulation for assisted reproduction.

The incidence of luteinizing hormone surge was studied in patients who were downregulated with a short protocol of gonadotrophin releasing hormone agonist before ovarian stimulation for assisted reproduction. Buserelin nasal spray 100 micrograms was given 5 times daily from day 2 of the cycle, followed by ovarian stimulation with human menopausal gonadotrophin and follicle stimulating hormone from day 3 onwards. Of the 159 cycles studied, luteinizing hormone surge was detected in 9 cycles (5.7%). The occurrence of LH surge was usually (67%) but not always associated with a fall in serum oestradiol level before administration of human chorionic gonadotrophin. None of the patients developed luteinizing hormone surge after day 10. Even in patients without luteinizing hormone surge the serum luteinizing hormone levels on the day of administration of hCG were significantly higher than those on day 2 before administration of buserelin. It is concluded that a short protocol with intranasal buserelin 500 micrograms per day is inadequate to suppress endogenous luteinizing hormone surge.

Administration, Intranasal↗