Biomedical subjects

B K Chong

Publications and source records attributed to B K Chong.

6 recordsLinked to original sources

PubMed1999

Predicting the size of a double-lumen endobronchial tube using computed tomographic scan measurements of the left main bronchus diameter.

UNLABELLED: We investigated the use of chest computer tomographic (CT) scan measurement of the left mainstem bronchial diameter to predict the correct left-sided double-lumen endobronchial tube (DLT) size in Asian patients who may require smaller DLT sizes. Fifty consecutive Asian adults aged 17-80 yr with preoperative chest CT scans undergoing elective thoracic surgery were entered into the study. The measurements of the left main bronchus diameter were made by using the electronic calipers of the spiral scanner to the nearest millimeter. The sizes of DLT selected were 32F, 35F, 37F, 39F, and 41F for left main bronchus diameters of <10 mm, 10 mm, 11 mm, 12 mm, and >12 mm, respectively. All DLT placements were confirmed and positioned by using fiberoptic bronchoscopy. The tracheas of all patients were successfully intubated with the predicted DLT sizes. Thirty-four patients (68%) were predicted to require smaller DLTs (37F or smaller). Six patients were correctly predicted to receive 32F DLTs. Twelve patients (24%) received an oversized DLT, but none received an undersized DLT. The overall positive predictive value for the male and female patients was 84.4% and 61.1%, respectively. Our study showed that CT scan measurements of the diameter of the left bronchus were especially useful in choosing smaller DLTs. IMPLICATIONS: We used computer tomographic scans to measure the diameter of the left mainstem bronchus, then selected the size of the left-sided double-lumen endobronchial tube (DLT) accordingly. We found that we could predict the sizes of the DLT fairly accurately, especially the smaller DLTs.

Adolescent↗

PubMed1996

Posterior element pain in a adolescent schoolgirl.

A case is presented of a transitional lumbosacral vertebra in a adolescent girl, presenting with low back pain. There was no evidence of a pars interarticularis defect. Careful assessment of children or adolescents presenting with low back pain is important since back pain in this age group is usually caused by organic disease.

Adolescent↗

PubMed1996

Spinal epidural non-Hodgkin's lymphoma: case reports of three patients presenting with spinal cord compression.

Spinal epidural non-Hodgkin's lymphoma is an uncommon lesion. In this report, we describe three patients with a clinical picture of acute spinal cord compression as the first presentation of malignant lymphoma. The diagnosis was not suspected pre-operatively, and plain radiographs of the spine were either normal or not specific. Neuroimaging showed evidence of extradural soft tissue mass crossing multiple vertebral segments. In the light of these radiological findings, non-Hodgkin's lymphoma should be a diagnostic consideration in the older patient without prior history of malignancy who presents with a prodrome of back pain followed by spinal cord compression.

Aged↗

PubMed1995

Diagnosis of deep venous thrombosis: accuracy of colour doppler ultrasound compared with venography.

Doppler ultrasound is becoming increasingly accepted as an accurate, non-invasive means of imaging in suspected deep venous thrombosis (DVT). Several studies done abroad have reported (combined) sensitivity of 95% and specificity of 98%. Locally, however, we have still been relying primarily on venography to diagnose lower limb DVT. We performed a prospective study to assess the accuracy of ultrasound compared to venography, in the local context. Forty-one limbs were studied by ultrasound within 24 hours of a venogram examination. We assessed grey-scale appearance, compressibility, presence or absence of flow, and flow characteristics. Seventeen venograms were positive for DVT, and ultrasound was positive in all seventeen cases. There were two false positive ultrasound examinations. Two cases of small localised thrombi in the superficial femoral vein only were accurately detected by ultrasound. One case of isolated calf thrombosis was also successfully diagnosed. Overall, sensitivity and specificity for detection of lower limb DVT was 100% and 91.7% respectively. Overall accuracy was 95.1%.

Adult↗

PubMed1991

Early local experience of ankle arthrography and its influence on management of patients with ankle injury.

Ankle arthrography was performed on 64 patients with a history of ankle injury from 21 January 1986 to 11 October 1988. There was a male predominance in the ratio of 15 to 1 and the mean age of our patients was 22 years. A total of 65 arthrograms were obtained as one patient had bilateral ankle arthrograms. Of these, 29 arthrograms were normal. A year after completing this study, we attempted to retrieve our patients' case-notes and reviewed their subsequent management. Our results showed that multiple factors influenced the further management of our patients and arthrogram did play a role in this respect.

Adolescent↗

PubMedDate not supplied

Local anesthesia for circumcision: which technique is most effective?

BACKGROUND AND OBJECTIVES: Circumcision is the most commonly performed surgical procedure in the United States, and it is painful. Several investigators have independently documented the reliability and safety of local anesthesia in eliminating the pain associated with circumcision. Investigations have not, however, been conducted to determine which technique is most effective in reducing the pain of the procedure. This study compares the techniques of local anesthesia for circumcision to determine which technique most safely and reliably reduces pain. METHODS: Fifty-six infants being circumcised were randomly assigned to one of three groups according to anesthesia technique: (1) distal branch block, (2) root block, and (3) subpubic block. Change in heart rate and oxygen saturation, as well as cry response, were recorded. Heart rate and oxygen saturation differences were analyzed utilizing Student's t test, whereas cry response was analyzed using the chi-square test. RESULTS: We discontinued using the distal branch block technique during the study because we were concerned about possible untoward outcomes. As a result, only data from the circumcisions of the 42 infants who were assigned to the root block and subpubic block groups were analyzed. The dorsal penile nerve root block more reliably reduced the pain of circumcision than did the subpubic technique (P = 0.05). There were no serious complications with any of the techniques in this study. CONCLUSIONS: Compared with distal branch block and subpubic block techniques, nerve block at the penile root most reliably and safely eliminated the pain of circumcision.

Anesthesia, Local↗