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Biomedical subjects

L S Chin

Publications and source records attributed to L S Chin.

8 recordsLinked to original sources
PubMed1992

Diffuse arteriovenous malformations: a clinical, radiological, and pathological description.

In a review of our series of patients with arteriovenous malformations (AVMs), a group with atypical angiographic and histopathological characteristics was discovered. Unlike the typical AVM, these lesions contained normal cerebral tissue between the abnormal vessels. We call these lesions diffuse AVMs, and think that this AVM represents one end of the AVM spectrum from a tight nidus to a diffuse lesion. The mean age of these patients was 18.1 years. Eight patients presented with an intracerebral hemorrhage, two with seizures, one with headache without hemorrhage, and one with ischemic symptoms compatible with vascular steal. Cerebral angiography revealed three AVMs to be 2 to 4 cm in diameter, four were 4 to 6 cm in diameter, and five were > 6 cm in diameter. Characteristic angiographic features included multiple small arterial feeders, small ectatic vessels in the malformation itself, multiple small draining veins, and a diffuse, puddling appearance of the contrast dye. Despite 16 operations in 11 patients, complete resection of the AVM was accomplished in only 8. The four patients with residual disease have received radiation therapy. Histopathology of the surgical specimens found AVM vessels interspersed among normal appearing neurons and white matter. Leptomeningeal angiodysplasia was noted when the cerebral cortex was involved. Gliosis was noted in some cases. Diffuse AVMs represent a difficult surgical challenge and recognition of the lesion aids in surgical planning.

Adolescent↗
PubMed1991

The standardized assessment of argyrophilic nucleolar organizer regions in meningeal tumors.

Tissue markers of cellular proliferation have been recently utilized as prognostic indicators in tumors of the central nervous system. Nucleolar organizer regions represent transcriptionally active sites of ribosomal deoxyribonucleic acid (DNA) and can be identified by a simple argyrophilic technique. The authors describe a standardized approach to the assessment of these argyrophilic nucleolar organizer regions in meningeal tumors. Twenty-five meningiomas were classified histologically into benign, atypical, or malignant groups. In addition, two hemangiopericytomas and one leptomeningeal melanoma were examined. Appropriate sections were silver stained and argyrophilic nucleolar organizer regions were counted in 200 nuclei. The mean argyrophilic nucleolar organizer region count was statistically different (p less than 0.001) between benign tumors (245 +/- 156, 1.23/cell), atypical tumors (497 +/- 135, 2.49/cell), and malignant tumors (921 +/- 59, 4.61/cell). The count for recurrent meningiomas (544 +/- 76) was also statistically different (p less than 0.02) from non-recurrent tumors (329 +/- 183). The standardized assessment of argyrophilic nucleolar organizer regions can be easily performed by any surgical pathology laboratory without specialized equipment and, in meningeal tumors, may be useful as an independent indicator of biological behavior.

Adult↗
PubMed1990

Legg-Calve-Perthes disease: clinical analysis of 57 cases.

The rarity of the Legg-Calve-Perthes disease (LCPD) in Chinese children in Hong Kong has been reported. However, this hip disorder is not uncommon among children in Taiwan between the ages of 3 and 9. Fifty-seven patients with LCPD were observed during a 4-year period. Of these, 47 hips in 43 patients were followed up through a significant course of the disease, with an average period of 38.8 months. The mean age at onset of symptoms was 6.6 years for boys and 7.1 years for girls. Over half of the patients (67%) were older than 6 years of age at onset of the disease. The male: female ratio was 5:1, and the incidence of bilateral involvement was 10%. The majority (85%) belonged to Catterall's group 3 or 4. The skeletal maturity of 17 (68%) these children was delayed an average of 31.8 months. Fifty-three percent of the patients were from families of low socioeconomic status. Delay in diagnosis and presentation with painless limp and stiffness were common. Orthotic management was employed in 15 hips. Surgical containment, either by varus-rotation femoral osteotomy or innominate osteotomy, was achieved in 16 hips. The remaining 16 hips received no treatment. The overall results showed an increase in improvement from 19% to 47% after active treatment of the disease. The chance of satisfactory treatment was reduced considerably when the disease started after the age of 6 years, this was especially obvious in untreated hips. No significant differenced in the healing time between the nonsurgical group and the surgical group was observed.

Age Factors↗
PubMed1987

Perioperative morbidity associated with operative resection of craniopharyngioma: a review of ten years experience.

A ten-year review of perioperative morbidity after operative resection of craniopharyngioma is presented. From 1974 to 1983, 23 patients underwent a total of 34 operations. Patients were subdivided into 95% or greater resection and partial resection groups. Features compared between the two groups included sodium, glucose, temperature, diabetes insipidus, major complications, neurological deficits and death. Patients undergoing 95% or greater resection had significant fluctuations in sodium, temperature and glucose (p less than .01). Diabetes insipidus and major postoperative complications were also significantly elevated in the 95% or greater resection group (p less than .05). Therefore, the extent of surgical resection correlated well with the degree of metabolic dysfunction and major postoperative complications. Careful assessment of surgical morbidity is warranted in the management of patients with craniopharyngioma.

Body Temperature Regulation↗
PubMed1987

Multiple thoracic disc herniations. Case report.

A patient with herniated thoracic discs in tandem is reported. The previous literature is reviewed. Difficulties with the preoperative diagnosis and the surgical approach to these lesions are discussed.

Adult↗
PubMed1979

Status epilepticus controlled by althesin infusion.

Althesin will control status epilepticus when other agents fail. Its major advantage over other agents is its lack of accumulation because it is readily metabolized. Three patients are reported and relevant literature is discussed.

Adolescent↗
PubMed1978

Prolonged curarisation in the presence of renal impairment.

Prolonged curarisation in the presence of renal failure occurred in six cases where pancuronium was used, and one case where alcuronium was used. The cases are presented with a brief review of the literature. Pancuronium must be used with great caution if postoperative reversal problems are to be avoided. Greater use of adjuvants will reduce requirements and may eliminate the problems encountered in renal failure.

Adult↗