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Biomedical subjects

K G Tan

Publications and source records attributed to K G Tan.

12 recordsLinked to original sources
PubMed2000

[Severe obstipation due to eating unshelled sunflower seeds].

In two boys aged 13 and 6 years respectively obstipation and a paradoxical diarrhoea developed four days after consumption of unshelled sunflower seeds. The cause was impaction of the unshelled sunflower seeds in the rectum. Both patients required general anaesthesia to remove the sunflower seeds via proctoscopy. It is known that eating unshelled sunflower seeds can cause impaction of the shells in the rectum (causing a bezoar). Removing the seeds under general anaesthesia is practically always necessary. Considering the serious symptoms and the invasive consequences which are not without risks, parents and children should be warned about the danger of eating unshelled sunflower seeds.

Adolescent↗
PubMed2000

Adjustable silicone gastric banding: a series with three cases of band erosion.

BACKGROUND: Among the various operations used for surgical treatment of morbid obesity, adjustable silicone gastric banding (ASGB) is the least invasive. Many good results have been described. During extended follow-up, however, serious complications may occur. We briefly describe our results with ASGB and will focus on three cases of band erosion. METHODS: From January 1996 to December 1998, 91 patients underwent laparoscopic adjustable gastric banding in our clinic. Follow-up until now is 100%. RESULTS: Body Mass Index (BMI) in this series decreased from 44.7 at time of operation to 34.8 at 18 months of follow-up (42 patients). Complications, minor and major, occurred in 27.5%. Three patients are described in which the gastric band migrated and had to be removed operatively. CONCLUSIONS: Satisfactory weight loss can be established by ASGB. However, serious and potentially lethal complications can occur. In view of the former Angelchik esophageal antireflux prosthesis, abandoned because of its notorious migration, we must be aggressive in evaluating band migration. Thus, we plead for international registration of adjustable silicone gastric banding.

Adult↗
PubMed1994

[Boerhaave syndrome. Differential diagnosis in acute chest pain].

Spontaneous perforation of the esophagus (Boerhaave syndrome) is a rare diagnosis in acute thoracic or epigastric pain. We present the case of a swiftly diagnosed and successfully treated rupture. Apart from pathophysiology, symptoms and diagnosis, the differential diagnosis and therapeutic options are discussed in more detail.

Chest Pain↗
PubMed1993

[Strengths and weaknesses of endorectal ultrasonography].

Endorectal ultrasound is the most reliable method in staging rectal cancer and is superior to computed tomography. In a prospective series of 152 consecutive patients, comparison of preoperative ultrasound staging and postoperative histopathological staging resulted in an overall accuracy of 90.1%. Overstaging was observed in 9.2%, understaging in 0.7%. Peritumoral inflammatory changes, preoperative radiotherapy and localization of the tumor in the lower rectum were the main reasons for overstaging. Understaging was seen in stenotic or only minimal invasive tumors. Accuracy in staging lymph nodes was 78.5%. Inflammatory changes in the nodes were responsible for either overstaging or understaging. Whether diagnosis will be improved with a higher frequency--mainly in lymph nodes--has yet to be proved. With knowledge of the reasons for misinterpretation, endorectal sonography is--mainly in the lower rectum--a valuable aid in evaluation of surgical procedure.

Adult↗
PubMed1993

[Surgical thoracoscopy; initial results in 13 patients].

In various diagnostic and therapeutic thoracic operations the use of thoracoscopy can replace the more radical thoracotomy. On account of the development of endoscopic video systems and specialised instrumentation, this technique is increasingly being used. Our first experiences with this new development in thoracic surgery are promising. In the period July 1991-June 1992 we performed 14 thoracoscopic operations in the Merwede Hospital in Dordrecht, for the surgical treatment of spontaneous pneumothorax (8x), for open lung biopsy (5x) and for resection of a peripheral benign tumour of the lung (Ix). No major complications occurred and patient recovery was surprisingly fast. Because of the decreased operation trauma, for several procedures already established via thoracotomy, the surgical thoracoscopy can be regarded as a great improvement in thoracic surgery.

Adult↗
PubMed1986

[Changes in diagnostic imaging of non-Hodgkin's lymphoma in recent years].

The following examinations have been carried out with various methods of diagnostic imaging: 148 CT, 69 US, 56 Ly. Data on the rate of accuracy of the various methods of examination in the individual abdominal regions. CT examinations rose from 1980 to 1985 from 83 percent to 100 percent. US examinations ranged between 50 to 25%. Lymphographies dropped from 54% to 0%. Owing to the early dissemination pattern of the NHL with frequent primary extranodal involvement, lymphography is no longer indicated. In the abdominal region including the pelvis, CT is superior to US accuracy also with those abdominal findings that have been histologically verified. CT cuts show a better reproducibility and more accurate basis for therapeutic controls. The problem of the mere characteristic of the "size of the lymph node" with non-invasive diagnostic imaging will be discussed. The costs of the various methods of examination are compared with each other. The strategy of examination has changed.

Costs and Cost Analysis↗
PubMed1985

[Stoma care].

Explore the source record for details and available documents.

Aged↗
PubMed1985

Mediastinal staging of bronchial carcinoma: can computed tomography replace mediastinoscopy?

In bronchial carcinoma the assessment of operability requires an accurate evaluation of the regional and mediastinal lymph nodes. For this, both mediastinoscopy and computed tomography are often used on a routine basis today. The present work considers the relative value of these two methods of investigation. Fifty-seven patients with bronchial carcinoma, in whom both investigations were carried out prior to surgery, were included in this prospective study. In the computed tomogram, lymph nodes with a diameter of more than 1 cm were defined as positive (i.e. suspected malignant infiltration). Sixteen of the 57 patients had histologically confirmed lymph node metastases; in 13 cases the metastases were detected by computed tomography, in 12 cases also by mediastinoscopy and in 3 cases only at thoracotomy. In 41 of the thoracotomized patients, no mediastinal metastases were found. As was to be expected, mediastinoscopy also proved negative in these cases. In 9 of these cases, however, the preoperative computed tomography findings were false-positive. For computed tomography the specificity was 78% and the sensitivity 81%; for mediastinoscopy, on the other hand, the specificity was 100% and the sensitivity 75%. The specificity of computed tomography is too low. Also, lymph nodes which are only inflamed may be considerably enlarged and cannot be differentiated in the computed tomogram from those with malignant infiltration. Mediastinal lymph nodes which appear enlarged in the computed tomogram therefore have to be further investigated by mediastinoscopy. However, in this prospective study, mediastinoscopy provided no additional information in those cases in whom the computed tomography findings were negative (lymph node diameter less than or equal to 1 cm); it did not detect the metastases in the 3 patients with false-negative computed tomography findings. Therefore, in the case of a negative computed tomogram, thoracotomy may be performed immediately, without previous mediastinoscopy.

Adult↗
PubMed1983

Towards safer colonoscopy: a report on the complications of 5000 diagnostic or therapeutic colonoscopies.

The diagnostic and therapeutic benefits of colonoscopy are well known but most large-scale surveys, especially those involving multiple centres, may underestimate the range and incidence of complications. The detailed records of 5000 colonoscopies in a specialist unit have been analysed and conclusions drawn which may help to make the procedure safer. The incidence of haemorrhage was 1% and bowel perforation 0.1%. All the major haemorrhages occurred during polypectomies over 2 cm in size. Secondary haemorrhage was an unpredictable occurrence, one to 14 days later. Three deaths followed colonoscopy: one cardiorespiratory death was related to oversedation; a second was due to mismanaged ischaemic colitis developing two days after traumatic instrumentation, and the third was due to peritonitis. Minor complications included thrombophlebitis, abdominal distension, and vasovagal episodes. Because of experience during the first half of the series and also due to improvements in instrumentation, the complication rate of the later part of the series was halved. Recommendations include the avoidance of oversedation, review of previous barium enema films so as to be aware of large polyps which are more likely to bleed, and the recognition of situations where perforation or septicaemia is likely to occur.

Adult↗
PubMed1982

The transsphincteric approach to rectal villous adenomas.

In view of the considerable risk of malignancy associated with villous rectal adenomas, treatment is aimed at their complete removal. The transsphincteric approach allows complete excision in the submucosal layer with preservation of the anal sphincter. Six patients are reported in whom this approach was used. Among them were two recurrences, one after a previous transsphincteric operation. In another patient a malignant tumor was detected, necessitating more extensive surgery. A defunctioning colostomy was performed in two cases. Apart from stenosis in one case, no complications occurred. It is concluded that the transsphincteric approach is a valuable asset in the management of rectal villous adenomas. A defunctioning colostomy is not always indicated, especially not if a bland diet is given postoperatively.

Adenoma↗
PubMedDate not supplied

Scanning electron microscopic (SEM) studies on the effect of x-ray contrast media on aortic endothelium in the rat.

A study comparing the effects of diatrizoate, ioxitalamate, metrizamide, ioxaglate, and a 22% sorbitol on aortic endothelia of the rat was performed. In each case 1 ml of the respective solution was injected in a single dose into the aorta. Endothelial damage was seen after injection of metrizamide, diatrizoate, and ioxitalamate. After injection of ioxaglate or sorbitol, only minor endothelial changes were observed.

Animals↗