Biomedical subjects
Publications and source records attributed to L L Ooi.
Isolated splenic abscess is an uncommon condition. Seven cases seen between 1980 and 1990 are reviewed. The clinical presentation is non-specific and diagnosis is usually delayed. Computerized tomography allowed for accurate diagnosis in all cases. Pseudomonas species as a causative organism is reported to be rare, but were present in three of the present cases. Antibiotic therapy alone is insufficient and splenectomy remains the treatment of choice.
Gall-bladder conservation therapy has been evolving during the past decade. Popular techniques of conservative therapy are extracorporeal shock wave lithotripsy (ESWL) and medical dissolution therapy. The limitations of these procedures have prompted a search for alternative techniques, particularly in relation to percutaneous stone extraction. The cases of four patients with symptomatic gallstones who underwent percutaneous cholecystolithotomy under laparoscopic guidance are reported. The gall-bladder was punctured with a long needle and the tract dilated so that a nephroscope could be introduced. Three cases required stone fragmentation by an ultrasonic lithotripter before removal. Postoperative recovery was uneventful in all cases.
Papillary carcinoma of the thyroid has a propensity for spread to the regional lymph nodes, in particular those along the recurrent laryngeal nerve. Twenty cases of papillary carcinoma of the thyroid had prophylactic clearance of the lymph nodes along the tracheo-oesophageal groove, and one patient had removal of recurrent disease in the groove. Eleven of the twenty patients had, in addition, some form of cervical lymph node clearance for clinically palpable ipsilateral cervical lymph nodes. Metastases to the tracheo-oesophageal groove lymph nodes was seen in seven of the twenty patients (35%). Tumour size, age, sex, race and cervical lymph node involvement did not appear to predict involvement of the tracheo-oesophageal groove lymph nodes. Clearance of the lymph nodes along the tracheo-oesophageal groove at the time of resection of primary disease is worthwhile for thyroid papillary carcinoma, because of the high incidence rate (35%) and also clearance for subsequent recurrence will be more difficult with a higher risk of damage to the recurrent laryngeal nerve and parathyroids.
Calcifying epithelioma of Malherbe (pilomatrixoma) is a relatively uncommon benign skin tumour of hair follicle origin. It usually presents in the face and upper extremities of young adults as an asymptomatic subcutaneous or dermal tumour. Treatment is surgical excision. This paper presents a case of a large tumour in the preauricular region with difficulty in diagnosis preoperatively and required a superficial parotidectomy to clear the tumour from the facial nerve.
B-mode real-time ultrasound was used to assess vocal cord function in six patients with recurrent laryngeal nerve palsy. The thyroid cartilage acted as an acoustic window through which the true cords appear as hypoechoic structures. Vocal cord palsy detected on ultrasound was compared with fibreoptic direct laryngoscopy and indirect laryngoscopy mirror examination. Good correlation was seen in all the cases.