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Biomedical subjects

C Y Lo

Publications and source records attributed to C Y Lo.

At least 91 records · Page 5Linked to original sources
PubMed1996

Lymphoepithelioma-like carcinoma of the thyroid gland: lack of evidence of association with Epstein-Barr virus.

Lymphoepithelioma-like carcinomas (LELC) occurring in sites derived from the primitive pharynx and foregut have been reported to show a strong association with Epstein-Barr virus (EBV), especially in the Oriental population. Primary lymphoepithelioma-like carcinoma of the thyroid is an extremely rare neoplasm which has been known under many different names, such as intrathyroidal epithelial thymoma, primary thyroid thymoma, carcinoma of the thyroid showing thymoma-like features, and carcinoma showing thymus-like differentiation (CASTLE). We report one such case in a Chinese woman, whose tumor was negative for EBV by in situ hybridization technique. This finding suggests that LELC of the thyroid may be biologically different from other LELCs, and that detection of EBV may aid in diagnosis when the LELC presents initially in lymph nodes or other metastatic sites.

Adult↗
PubMed1996

Optimal treatment and long-term outcome of tuberculous peritonitis complicating continuous ambulatory peritoneal dialysis.

A retrospective study of the treatment and short- and long-term outcomes of tuberculous peritonitis (TBP) complicating continuous ambulatory peritoneal dialysis (CAPD) among our dialysis patients over a 6-year period was performed. Ten cases of TBP complicating CAPD were identified among 601 dialysis patients between January 1988 and December 1994. There were four male and six female patients. The most common clinical features were abdominal pain, fever, and cloudy peritoneal fluid (PDF). Two patients had concurrent bacterial peritonitis. Extraperitoneal tuberculosis was not observed. The majority of the patients showed neutrophil predominance in the PDF. Only one patient had a positive acid-fast bacilli smear of the PDF. The acid-fast bacilli culture of the PDF was positive in all patients. The patients were treated with isoniazid, rifampicin, and pyrazinamide for 9 to 12 months (mean, 11 months). Continuous ambulatory peritoneal dialysis was continued in all patients. Two patients died, one from multiorgan failure at 2 months and the other from sudden cardiac death at 9 months. Two patients were converted to hemodialysis at 3 months. Six patients continued to receive CAPD after completion of the antituberculous treatment. Four of these six patients were still alive 5 years after the TBP. Three patients were still undergoing CAPD with satisfactory ultrafiltration and solute clearance. None of the patients developed relapse of TBP. We concluded that (1) TBP is a rare but important complication of CAPD, (2) removal of the Tenckhoff catheter is not mandatory in the management of TBP complicating CAPD, and (3) long-term continuation of CAPD is possible after TBP.

Antitubercular Agents↗
PubMed1996

Primary aldosteronism. Results of surgical treatment.

SUMMARY BACKGROUND DATA: Management of primary hyperaldosteronism has undergone dramatic changes in the past 40 years. This retrospective study was carried out to review our recent surgical experience and to identify potential factors associated with postoperative persistent hypertension. METHODS: Forty-six patients who had adrenal surgery for primary hyperaldosteronism from 1983 to 1994 were included in the study. RESULTS: Periodic paralysis occurred in 12 (26%) patients. Hypertension and hypokalemia (mean serum potassium, 2.2 + 0.5 [+ standard deviation (SD) mmol/L) were present in all patients. Postural study was diagnostic in 85% (23 of 27). Computed tomography scan correctly localized the tumor in all except 1 patient, and venous sampling was performed in 11 patients. There was no operative mortality, and complications developed in six patients (13%), including one patient requiring re-exploration for hemostasis. All patients had a histologically documented adenoma. During a mean follow-up of 51 months, 34 (77%) of the 44 patients required no further antihypertensive treatment. Two patients were lost to follow-up. Age, response to spironolactone treatment, and blood pressure on discharge were risk factors identified for persistent hypertension. CONCLUSION: Primary hyperaldosteronism due to aldosterone-producing adenoma can be diagnosed and localized expeditiously, whereas surgical treatment can be performed safely. Hypokalemia may be cured by surgical treatment, although persistent hypertension, usually of a mild degree, still occurs in selected patients.

Adrenalectomy↗
PubMed1996

Xanthogranulomatous inflammation of the sigmoid colon: a case report.

A rare case of xanthogranulomatous inflammation of the sigmoid colon presenting as intestinal obstruction is reported. This is the first report of this lesion involving the large bowel which demonstrated the characteristic macroscopic and microscopic features. Though rare, xanthogranulomatous inflammation should be considered in patients presenting with large bowel obstruction.

Adipose Tissue↗
PubMed1995

Follicular carcinoma of the thyroid gland in Hong Kong Chinese.

A total of 64 Chinese patients (eight men, 56 women) undergoing primary treatment for follicular thyroid cancer between 1961 and 1986 were studied retrospectively to report the local experience in treatment of this condition and to identify the risk factors for mortality. The minimum follow-up was 7 (median 14) years. The mean tumour size was 3.0 (range 0.1-11.0) cm. The majority of patients (91 per cent) underwent total or near-total thyroidectomy. Distant metastases were detected in ten patients at the time of initial diagnosis and in three during follow-up. Locoregional recurrence had developed in six patients at follow-up. There were 13 deaths, with a median survival of 45 months. The 5- and 10-year survival rates were 87 and 80 per cent respectively. Six risk factors for mortality were selected for multivariate analysis using logistic regression; the presence of distant metastasis was the only significant risk factor for survival.

Adenocarcinoma, Follicular↗
PubMed1995

The role of one-stage surgery in acute left-sided colonic obstruction.

BACKGROUND: One-stage surgery with primary anastomosis is not widely accepted for acute left-sided colonic obstruction. PATIENTS AND METHODS: Forty-four patients representing our total admission for acute left-sided colonic obstruction over a 3-year period were evaluated with regard to their suitability for one-stage surgery and primary anastomosis. RESULTS: Thirty-five patients (80%) were found to be suitable for this approach and the failures were mainly due to either the advanced nature of the malignant lesions or to their distal location, which precluded an anastomosis. The overall in-hospital mortality was 11%, but only 2 patients (6%) died in the one-stage surgery group, and these deaths were unrelated to anastomotic leakage. This latter complication occurred in 1 patient representing a leak rate of 3%. CONCLUSIONS: We recommend, based on our results, the one-stage approach as an alternative to the more conventional primary resection and staged anastomosis.

Acute Disease↗
PubMed1995

Mouse monoclonal antibodies to human immunodeficiency virus glycoprotein 120 generated by repeated immunization with glycoprotein 120 from a single isolate, or by sequential immunization with glycoprotein 120 from three isolates.

Mouse hybridomas were isolated that produce monoclonal antibodies (MAbs) to several regions of the HIV envelope, gp120, which may be used to map immunogenic regions in animal and human immunity. One series of MAbs was generated by repeated immunization with recombinant gp120 (rgp120) from a single isolate, and a second series by sequential immunization with rgp120 from three isolates. All MAbs bound to rgp120IIIB, but only one bound well to cell surface-expressed gp160. Synthetic peptides spanning much of the length of gp120 were used to map MAb reactivity. Two MAbs were mapped to the C1 region, one to the C2 region, and three to the C5 region by this approach. Six distinct epitopes were detected by competitive binding analysis. One MAb binding the C1 region blocks binding of CD4 to rgp120IIIB, binds by ELISA to rgp120MN (an isolate not used during immunization), and binds to cell surface-expressed gp160. These hybridomas will be made available to the scientific community through a hybridoma culture facility.

AIDS Vaccines↗
PubMed1995

Penicillium marneffei infection in a patient with SLE.

We describe a patient with SLE who was infected by the fungus Penicillium marneffei. She was initially misdiagnosed as having disseminated tuberculosis. The correct diagnosis was finally made by bone marrow culture and she responded to a prolonged course of amphotericin B, flucytosine and itraconazole. The clinical presentation and histology of penicilliosis are very similar to those of Mycobacterium tuberculosis. In Southeast Asia, penicilliosis should be considered as a differential diagnosis in patients with SLE who present with fever and lymphadenopathy.

Adult↗
PubMed1994

Obturator hernia presenting as small bowel obstruction.

Obturator hernia is a rare but important cause of small bowel obstruction that is associated with difficult diagnosis and high mortality. In the past 7 years, 16 patients with small bowel obstruction due to obturator hernia diagnosed at operation were seen at the Department of Surgery, the University of Hong Kong, Queen Mary Hospital. They represented 1% (16 of 1,554) of all hernia repair performed and 1.6% (16 of 1,000) of mechanical intestinal obstruction encountered during the same period. Elderly emaciated women with chronic disease were commonly affected. All patients presented with partial or complete mechanical small bowel obstruction. Right-sided obturator hernia outnumbered left-sided hernia, and bilateral hernia was found in only one patient. The majority of patients required resection of their strangulated small bowel. Most of the hernial orifices were closed with interrupted nonabsorbable sutures. Morbidity and mortality rates were significantly high for this group of debilitated patients with chronic disease who underwent late operation for this elusive diagnosis.

Age Factors↗
PubMed1994

Treatment of fungal peritonitis complicating continuous ambulatory peritoneal dialysis with oral fluconazole: a series of 21 patients.

Twenty-one episodes of fungal peritonitis occurred over 35 months among 290 patients on CAPD, accounting for 6.3% of all peritonitis episodes. Patients with more frequent bacterial peritonitis were at higher risk of developing fungal peritonitis, and 28.6% of cases followed antimicrobial therapy. Candida species accounted for 85.7% of cases. Oral fluconazole was used as initial therapy in all patients, which was followed by catheter removal if peritonitis failed to improve. The cure rate with fluconazole therapy alone without catheter removal was 9.5%. Fluconazole plus catheter removal, the latter necessitated in 85.7% of cases, resulted in a cure rate of 66.7%. The remaining 3 (14.3%) patients responded to intravenous amphotericin given as salvage therapy. Disease-related mortality was 14.3%. Reinsertion of dialysis catheter was attempted in 15 patients and CAPD was successfully resumed in 13 (86.7%). We conclude that oral fluconazole can be safely used as initial therapy in patients with fungal peritonitis complicating CAPD. Although catheter removal was necessary in the majority of patients, this sequential approach resulted in a relatively low prevalence of peritoneal adhesions and subsequent CAPD failure.

Administration, Oral↗
PubMed1994

Small bowel phytobezoars: an uncommon cause of small bowel obstruction.

Phytobezoars are an uncommon but important cause of mechanical small bowel obstruction. Seventeen Chinese patients with small bowel obstruction due to phytobezoars underwent 19 operations at the Department of Surgery, The University of Hong Kong at Queen Mary Hospital, accounting for 2% of mechanical small bowel obstruction treated in the past decade. There were ten men and seven women with an average age of 58 years. All except five patients had previous gastric outlet surgery. The diagnosis depends on a high index of suspicion in patients with partial or complete intestinal obstruction. The bezoars were broken down and milked through the ileocaecal valve in seven cases, whereas enterotomy to retrieve the bezoars or resection of small bowel together with the bezoars was performed on ten and two patient, respectively. There was no postoperative mortality but pneumonia and wound infection occurred in four patients. Because of its potential mortality and associated morbidity, patients with previous gastric surgery should be warned about this preventable complication and be given dietary advice. Phytobezoars should be considered in the differential diagnosis of all patients presenting with mechanical small bowel obstruction.

Adolescent↗
PubMed1994

Delayed recurrent thromboembolism of the allograft kidney.

Renal artery thromboembolism is a rare event in native kidneys and has never been reported to occur in allograft kidney. We report a case of allograft kidney infarction secondary to embolisation from thrombus in the hypogastric artery supplying the allograft on two separate occasions 1 and 2 years after transplant. Anticoagulation therapy alone was given and the patient responded well with partial recovery of renal function.

Adult↗
PubMed1994

Palliation for extrahepatic biliary obstruction by metastatic colorectal carcinoma.

OBJECTIVES: Extrahepatic biliary obstruction due to metastatic colorectal carcinoma, though rare, can account for the occurrence of obstructive jaundice even in the presence of hepatic metastases. The present report aims at reviewing our experience with the palliative treatment of these patients. METHODS: During a 5-yr period, 11 patients with obstructive jaundice had documented extrahepatic biliary obstruction secondary to metastatic colorectal carcinoma. Their clinical records were retrospectively analyzed. RESULTS: Nonoperative drainage was performed in eight patients by either the endoscopic (n = 5) or percutaneous (n = 3) route. Palliation was achieved in six patients with a mean hospital stay of 24.5 days (14% of survival). Three patients died of hepatorenal failure before a drainage procedure could be performed. Blocked stent and cholangitis were noted in two patients. The mean survival was 5 months in the drainage group. CONCLUSIONS: The occurrence of obstructive jaundice in patients with metastatic colorectal carcinoma deserves routine investigation to exclude extrahepatic biliary obstruction. Endoprosthesis insertion by nonoperative means should be considered for palliation.

Aged↗
PubMed1994

[Care of visual impairment in children and adolescents].

Visual impairment refers to a loss of visual acuity or one or more functions of the eye and visual system. It is not necessarily a disability or a handicap for the individual. The majority of visually impaired children are multihandicapped. Diagnostic and treatment centers have been introduced in an attempt to resolve present difficulties in providing health care to the multihandicapped. Pseudoretardation can occur in blind children if adequate opportunities are not provided for learning. Early diagnosis of visual impairment is important for obvious medical reasons. Early referral of blind children and their families to agencies for help is crucial. Almost invariably, mothers are the first to suspect that something is wrong with their infants' eyes. An ophthalmological examination, rather than simple reassurance, is needed. How an ophthalmologist leads parents through the period after diagnosis and the following next few weeks will affect the child's life much more than is generally realized. There is a need for a multidisciplinary team approach to evaluation and treatment of blind children. Cerebral palsy and profound visual impairment are a bad combination. Visual impairment alone does not predispose to a specific learning disability. Partially sighted students can be helped in various ways to function in their class.

Adolescent↗