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Biomedical subjects

J H Sheares

Publications and source records attributed to J H Sheares.

7 recordsLinked to original sources
PubMed1981

Primary carcinoma of the lung.

118 patients with carcinoma of the lung seen in the Department of Cardiovascular and Thoracic Surgery, Tan Tock Seng Hospital, Singapore were followed for five years. The aim was to determine the survival of these patients in relation to the stage of the disease as well as the histologic type of carcinoma. 22 patients were in stage 1, 13 in Stage II and 83 in Stage III. Thoracotomy was performed in 62 patients and the rest had biopsy of distal lymph nodes. 43.3% of the carcinoma were squamous cell, 25% adenocarcinoma, 27% large cell, anaplastic, 2.9% oat cell and 1.8% bronchoalveolar cell carcinoma. Survival of the patients were found to be closely related to stage of the disease but not with the histologic type.

Adult↗
PubMed1981

Surgical management of rheumatic heart disease in Singapore.

Over the last three decades there has been a world-wide decline in the incidence and severity of rheumatic fever and rheumatic heart disease, but the death rate in Singapore from chronic rheumatic heart disease has risen from 3.6 per 100,000 population in 1966 to 4.4 per 100,000 in 1977. Valvular lesions from rheumatic heart disease are very common, and between 1967 to 1979, 715 surgical procedures were performed for rheumatic valvular disease, and of these, 654 procedures involved the mitral valve which was most commonly affected by the disease process. Since many of the patients were female and in the child-bearing age, conservative procedures on the mitral valve were performed whenever possible. Mitral valvotomy for mitral stenosis relieved symptoms effectively; and for restenosis of the mitral valve, more than half of the patients underwent a second valvotomy with functional improvement. Mitral valve replacement was reserved for the severely distorted valve, sometimes calcified, and where there was stenosis associated with incompetence. Between 1971 to 1979, 162 mitral valves were replaced and actuarial studies showed 80% survival five years after surgery. 30 aortic and mitral valve replacements were performed in this same period with an operative mortality of 16.7%. Only 75 aortic valves were replaced for rheumatic valvular disease and 14 of these also had associated mitral and triscuspid valve disease. The prosthetic valves commonly used for replacement were the Starr-Edwards non-cloth covered valves, models 6120 and 1260. All patients that had valve replacements were treated with long-term anticoagulation with Warfarin. The incidence of thromboembolism was low, being 8% for mitral valve replacement and the majority of these episodes occurred in the first three months after surgery.

Adolescent↗
PubMed1980

Surgical management of ventricular septal defect in infancy.

Symptomatic ventricular septal defects in infants who responded poorly to intensive medical therapy require surgical intervention. This paper aims to compare the results of the two stage approach of initial pulmonary artery banding followed by debanding and ventricular septal defect closure with primary intracardiac repair in infancy. Thirty-six infants underwent pulmonary artery banding between 1968-1979 with two operative deaths (5.6%). Eighteen patients underwent pulmonary artery debanding and closure of ventricular septal defect between 1971-1979 with five operative deaths (25.6%). However during 1978-1979 ten patients underwent 2nd stage repair with no operative death. During the same period primary intracardiac repair in infancy was carried out in nine infants with three operative deaths (33.3%). There appears to be still a place for two stage treatment of symptomatic ventricular-septal defect in critically ill infants certain situation.

Cardiac Surgical Procedures↗
PubMed1980

Surgery for mitral restenosis.

Four hundred and twenty-five patients underwent mitral valvotomy between 1960 and 1979, the majority by the closed method. Thirty-two patients required another operation for mitral restenosis. There was high incidence of reoperation after the 6th and 7th years (23.3%) and after the 9th and 10th years (26.4%) postoperatively. Sixteen patients (47%) with restenosis underwent a second closed mitral valvotomy with a satisfactory result, 12 patients (35.4%) required valve replacement, and 6 patients (17.6%) had an open valvotomy. Another valvotomy for pure mitral restenosis can give satisfactory results, but where the valve is severely deformed or incompetent, valve replacement is preferred.

Adolescent↗