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Biomedical subjects

C Chee

Publications and source records attributed to C Chee.

15 recordsLinked to original sources
PubMed2002

Comparison of laparoscopic and open adrenalectomy--a Singapore experience.

OBJECTIVE: We present our experience with laparoscopic adrenalectomy for benign adrenal diseases and compare clinical outcomes with the conventional open approach. METHODS: Between 1990 and 2001, two consecutive series of patients who underwent adrenalectomy for small, benign adrenal diseases were reviewed retrospectively. Patients with large tumours(> 7 cm), cancer and phaeochromocytoma were excluded. Fifty-eight patients underwent laparoscopic adrenalectomy and 48 patients had open surgery for benign adrenal diseases. Perioperative and postoperative records of both approaches were reviewed. RESULTS: The two groups were comparable in terms of patient age, sex, weight and side of lesion.The common indications for surgery were Conn's syndrome and Cushing's syndrome. The sizes of tumour were comparable between the laparoscopic and open groups (mean, 2.1 cm vs 2.4 cm). Despite the longer operating time (mean, 128 minutes vs 87 minutes), the postoperative morbidity, parenteral analgesic requirement and length of postoperative hospital stay (3.2 days vs 7.2 days) were less inpatients undergoing laparoscopic adrenalectomy. Patients also enjoyed earlier return to oral intake and ambulation. There were fewer complications in the laparoscopic group. There was no conversion to open surgery. CONCLUSION: Laparoscopic adrenalectomy is safe and has become the treatment of choice for small, benign adrenal lesions at our institution.

Adrenal Gland Diseases↗
PubMed2002

An unusual presentation of acute scrotum after appendicitis.

Acute scrotum following perforated appendicitis is a rare complication. This usually occurs in the presence of a patent processus vaginalis in children. We report a case of acute scrotum presenting after appendectomy for perforated appendicitis in a young adult.

Abscess↗
PubMed2000

Clinics in diagnostic imaging (46). Renal cell carcinoma in acquired cystic kidney disease.

Acquired cystic disease of the kidney and renal cell carcinoma are associated with chronic renal failure. In recent years, there has been increased incidental detection of renal tumours through the liberal use of ultrasonography (US) and computed tomography (CT). A 40-year-old man suffering from chronic renal failure and who was being treated with haemodialysis for six years, was found to have a complex cystic lesion on US and CT. Nephrectomy was performed and the lesion was confirmed to be renal cell carcinoma associated with acquired cystic kidney disease. The current role of imaging in the management of affected patients are discussed.

Adult↗
PubMed1998

Laparoscopic adrenalectomy: experience with transabdominal and retroperitoneal approaches.

OBJECTIVES: To study the patient outcomes of various approaches on 14 consecutive patients who had laparoscopic adrenalectomy surgery between October 1995 and March 1997. METHODS: The patients comprised 5 men and 9 women (mean age 46.2 years, range 32 to 61) with varying diagnoses. Eleven patients had Conn's syndrome, 1 had Cushing's syndrome, 1 had a nonfunctioning adrenal adenoma, and 1 had an adrenal myelolipoma. The adenomas were confirmed by hormonal assays, biochemical tests, and computed tomography (CT) imaging. Seven adenomas were sited on the right and seven were sited on the left. We used two alternative approaches: a transabdominal approach (8 patients) and a retroperitoneal approach (6 patients). RESULTS: None of the procedures required conversion to open surgery, nor was there any procedure-related complication. Blood loss was minimal. All the lesions were benign on final histology. The mean operating time was 135 minutes (range 80 to 190). The postoperative period was without significant complications, with patients reporting minimal pain. Patients were able to achieve an early return to oral intake and preoperative activity. The postoperative hospital period ranged from 1 to 10 days. CONCLUSIONS: We believe laparoscopic adrenalectomy to be a viable option in the removal of benign adrenal lesions. It is a safe technique when performed by experienced practitioners and results in faster recovery. The key advantage to this technique is its minimally invasive approach and decreased hospital costs.

Abdomen↗
PubMed1998

A case of accelerated development of proliferative diabetic retinopathy in a woman with type 2 diabetes mellitus after pregnancy.

Whilst it is recognised that diabetic retinopathy is a consequence of prolonged elevation of blood glucose levels, recent studies suggest rapid normalisation of blood sugar as a causal factor in accelerating its development. In this case report, a non-insulin dependent diabetic with poor blood glucose control but no retinopathy in early pregnancy had normalisation of glucose control by the third trimester. However, glucose control deteriorated rapidly postnatally, and she had a sudden blurring of vision three months after delivery of her baby, at which time severe proliferative diabetic retinopathy was diagnosed. The reason for the unusually rapid development of proliferative retinopathy was uncertain, but appeared to have a temporal association with the deterioration of her glycaemic control postnatal after a period of strict diabetes control in the perinatal period.

Adult↗
PubMed1996

Trabeculectomy--success rates in a Singapore hospital.

Previously published papers on the success of trabeculectomy as a treatment for glaucoma show success rates between 67% and 84%. The success rate of trabeculectomy in Afro-Carribean patients was observed to be lower than in Caucasian patients. It has been commonly believed that the success rate of trabeculectomy in Oriental/Asian eyes would lie somewhere between these. We reviewed the records of 51 consecutive trabeculectomies performed in the National University Hospital, Singapore and found that our success rate was lower-43.1% overall and 48.7% for primary glaucomas.

Adult↗
PubMed1993

Endogenous nitrogen oxides and bronchodilator S-nitrosothiols in human airways.

Recent discoveries suggesting essential bioactivities of nitric oxide (NO.) in the lung are difficult to reconcile with the established pulmonary cytotoxicity of this common air pollutant. These conflicting observations suggest that metabolic intermediaries may exist in the lung to modulate the bioactivity and toxicity of NO.. We report that S-nitrosothiols (RS-NO), predominantly the adduct with glutathione, are present at nano- to micromolar concentrations in the airways of normal subjects and that their levels vary in different human pathophysiologic states. These endogenous RS-NO are long-lived, potent relaxants of human airways under physiological O2 concentrations. Moreover, RS-NO form in high concentrations upon administration of NO. gas. Nitrite (10-20 microM) is found in airway lining fluid in concentrations linearly proportional to leukocyte counts, suggestive of local NO. metabolism. NO. itself was not detected either free in solution or in complexes with transition metals. These observations may provide insight into the means by which NO. is packaged in biological systems to preserve its bioactivity and limit its potential O2-dependent toxicity and suggest an important role for NO. in regulation of airway luminal homeostasis.

Adolescent↗
PubMed1989

Idiopathic subretinal neovascularization.

Idiopathic subretinal neovascularization is a potentially blinding condition and often strikes patients in their prime of life. It appears to be seen in more females, at an earlier age than males. Treatment is possible by photoablation of the subretinal new vessel by Argon or Yag laser. There is a clinical impression that Argon laser is more effective than the Yag laser for this purpose.

Adult↗
PubMed1989

Implantation and diabetes: analysis of 525 cases.

This is a retrospective study of 525 posterior chamber implants in diabetics performed by A S M Lim and B C Ang of Singapore. The patients were reviewed by visiting ophthalmologists--J E Kennedy (Sydney), M Ngui (East Malaysia) and P M Hart (Belfast). This study did not show any significant difference in the complication of post-operative visual acuity between diabetics and non-diabetics. 95% obtained 6/12 vision or better when pre-existing disease was excluded. It also showed that posterior chamber implants can be inserted in eyes with maculopathy or proliferative retinopathy if laser treatment was effectively done before or after surgery.

Adult↗
PubMed1987

31P NMR studies in Duchenne muscular dystrophy: age-related metabolic changes.

To evaluate possible progressive metabolic changes in Duchenne muscular dystrophy, we used 31P nuclear magnetic resonance spectroscopy to measure high-energy phosphate compounds and phosphorylated diesters (PDE) in resting gastrocnemius muscle of 14 Duchenne patients and 10 normal boys. The patients had higher inorganic phosphate (Pi), intracellular pH, and PDE; and lower phosphocreatine (PCr) and PCr/Pi ratio; ATP was not significantly different. The patients showed significant age-related decreases in PCr and PCr/Pi, and increases in Pi and PDE, but ATP did not change. In normal boys, ATP increased with age, but PCr and Pi did not. These studies imply progressive metabolic deterioration in Duchenne dystrophy.

Adenosine Triphosphate↗
PubMed1975

Rickets associated with long-term anticonvulsant therapy in a pediatric outpatient population.

Over a 12-month period, an ambulatory pediatric population receiving long-term anticonvulsants was surveyed for the presence of biochemical and radiologic rickets. There were 74 treated children and 95 matched controls. Elevations of serum alkaline phosphatase activity occurred in 31 of the 74 (42%) treated children (23 of 47 children between 2 and 10 years and 8 of 21 children between 10 and 16 years). This frequency of abnormal values was significantly greater than that which occurred in our control population. Calcium and phosphorus abnormalities were minimal in both treated and control populations. Radiologic rickets occurred in 6 of the 74 (8%) of the treated children and in none of the control population. Neither the severity of the rickets nor the degree of hyperalkaline phosphatasemia were correlated with age of the patient, duration, and/or dose of anticonvulsant therapy.

Adolescent↗
PubMedDate not supplied

The challenge of eye disease: the patient's perspective.

An educational symposium was organized to allow patients to be instructors by encouraging them to discuss their conditions, how they perceived their eye problems and the care they received, and the effect of their experience on their lives. Patients repeatedly stressed the need they felt for more time to discuss their disorders and more communication at all levels. An increasing use of patient information material, using printed materials and video, may partially alleviate the problem of a lack of communication.

Attitude to Health↗