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Biomedical subjects

A Leong

Publications and source records attributed to A Leong.

15 recordsLinked to original sources
PubMed1997

Randomized controlled trial of primary fistulotomy with drainage alone for perianal abscesses.

PURPOSE: Primary fistulotomy may be advantageous for perianal abscesses because unlike ischiorectal abscesses, fistulas are more commonly found and can be laid open with full preservation of the external anal sphincters. Therefore, a randomized, controlled trial was conducted to compare primary fistulotomy with incision and drainage alone, specifically for perianal abscesses. METHODS: Fifty-two consecutive patients (43 males; mean age, 40 (standard error of mean, 2) years) with perianal abscesses were randomized to treatment by either incision and drainage (controls; N = 28) or fistulotomy (N = 24). Patients were followed up clinically for a mean of 15.5 (standard error of the mean, 0.7) months. Anorectal manometry was also performed before, six weeks, and three months after surgery. RESULTS: Persistent fistulas developing after surgery were significantly more common after incision and drainage (N = 7; 25 percent) than after fistulotomy (N = 0; P = 0.009). One patient in each group was also found to have a residual abscess, which required repeat drainage. All patients remained fully continent. The anal pressures after incision and drainage and fistulotomy were not significantly different. Operative time, hospital stay, and time for the wound to heal completely were the same in both groups. CONCLUSIONS: Primary fistulotomy at the time of drainage for perianal abscesses results in fewer persistent fistulas and no added risk of fecal incontinence.

Abscess↗
PubMed1997

Laparoscopic-assisted compared with open total colectomy in treating slow transit constipation.

BACKGROUND: Total colectomy is the procedure of choice when slow transit constipation (STC) can be confidently diagnosed. A laparoscopic-assisted technique (LTC) may be potentially advantageous over traditional open technique (OTC) in the treatment of this benign condition. METHODS: A historical control (non-randomized) study was performed on patients diagnosed to have STC after clinical, anorectal physiologic and transit marker studies. All earlier consecutive patients underwent OTC and the latter consecutive patients underwent LTC. The intra-operative time, blood loss, postoperative ileus recovery, duration of hospitalization and complications were recorded. A bowel function and patient satisfaction questionnaire was administered on follow-up. RESULTS: Twenty-four of 411 patients were found to have STC; 17 (2 men, 15 women; mean age, 40 (standard error of mean [SEM] 5) years) underwent OTC and 7 (2 men, 5 women; mean age, 39.5 (SEM 6) years) underwent LTC. There were significant improvements in the stool frequency, need for assisted evacuation and abdominal distension (P < 0.05) after both procedures; 96% were fully satisfied with the resulting bowel function. However, OTC patients were less satisfied with the cosmetic outcome (P < 0.05). Intra-operative time for LTC was longer by a mean 74 min (P < 0.05). Postoperative blood loss, recovery of ileus and hospitalization time were the same in both groups. There were no deaths. The complication rates were 43% for LTC and 24% for OTC. The predominant complication was bowel obstruction for which two patients (both OTC) required adhesiolysis. CONCLUSIONS: Both OTC and LTC improve bowel function for STC;LTC gives a better cosmetic result, but takes longer to perform.

Adult↗
PubMed1996

Hepatic angiomyelolipoma and tuberous sclerosis.

A patient with angiomyelolipoma of the liver, together with radiological evidence of pancreatic, renal and bony lesions characteristic of tuberous sclerosis, is described. Although the patient had no other clinical features of tuberous sclerosis, her daughter was found to suffer from the classical triad of this syndrome and also has had hepatic lipomatous lesions and bony involvement. This is the first histologically proven case of hepatic angiomyelolipoma associated with tuberous sclerosis.

Angiolipoma↗
PubMed1993

Asthma.

Explore the source record for details and available documents.

Asthma↗
PubMed1992

The vascular supply of splenic autotransplants.

The close opposition of blood to phagocytic cells lining the pulp cords and marginal sinus has been proposed as a contributing factor in the clearance mechanism of the spleen. The vasculature of splenic autotransplants was investigated in rats using microcorrosion casts. Six-month-old splenic autotransplants and unoperated control spleens were selectively perfused and a methyl methacrylate cast was made. Scanning electron microscopy of these corroded casts was performed. In autotransplants, the marginal zone capillary network was abnormal with the fine network of capillaries replaced by dilated blood vessels. The red pulp cords were also found to be abnormal with increased diameter and loss of the fine saccular dilations found in normal spleens. The abnormally dilated capillaries and cords in the autotransplants may decrease antigen contact with these cells and hence explain previous reports of reduced phagocytic function.

Animals↗
PubMed1981

Initial psychological response to parental death.

A cohort of patients seeking help at a clinical research center providing time-limited brief therapy for posttraumatic stress disorders was assembled. The single life event experienced by each was death of a parent. A nonequivalent comparison group was gathered by review of hospital death records. Both groups received the same type of evaluation interview and completed the same measures, which were similar to those done for both groups by the clinical interviewer. These data indicated that while both groups contained persons with medium to high distress levels, the patient group was most uniformly composed of such persons; when compared with the field-study group, the patient group had significant and important elevations of distress levels.

Attitude to Death↗