Continuous brachial plexus block in six patients undergoing reimplantation of severed fingers or hand is described. The technique involved placement of a catheter within the neurovascular sheath enclosing the brachial plexus. This enabled us to give the local anaesthetic as required to last the whole duration of surgery.
This paper discusses the feasibility of using a free pericardial patch in repairing defects of the esophagus. The experimental model used is the dog. A piece of the side wall of the esophagus is first excised. This defect in the esophagus is then covered
with a free patch of pericardium. The animals are then sacrificed at sequential dates and the grafted site submitted for microscopic examination. The results show that a free graft of pericardium when used as a patch can prevent leakage of esophageal contents and allow healing of the defect without gross narrowing of the lumen.
The effects of ethanol on gastric thromboxane B2 was studied in man. A single dose of 20 ml 15% ethanol significantly inhibited the gastric secretion of thromboxane B2 whereas 20 mls of 5% ethanol were without effect. It was concluded that ethanol can suppress gastric secretion of thromboxane B2 psychosis.
A double-antibody radioimmunoassay technique has been used to investigate the serum prolactin (hPRL) level in Malay females from premenarche to the postmenopause. The results showed that the hPRL level (mena ± SEM) in the premenarchal, postmenarchal and late pubertal/reproductive subjects were 23.6 ± 2.3, 19.1 ± 2.0 and 22.7 ± 1.9 ng/ml respectively. In premenopausal women, hPRL level (11.8 ± 2.4 ng/ml) was significantly reduced (p < 0.01) compared to that of late pubertal group; the level declined even further after menopause (9.5 ± 1.7 ng/ml). Although the difference in the mean prolactin levels between premenopause and postmenopause were not significant, 73% of the postmenopausal women had serum prolactin concentrations below 10 ng/ml compared to 44% of the premenopausal and 10% in late pubertal group.
A retrospective study of the indications for temporary transvenous pacing in the University Hospital, Kuala Lumpur, from 1971 to 1979 is reviewed. There were 111 patients. The main indications for temporary transvenous pacing were, namely,complete heart block (57%), sick sinus syndrome (24%), Mobitz type 11 block (5%) and bifascicularblock (3%).
A survey of a total of 1,157 Indian primary school children from eight schools from urban and rural areas in and around Kuala Lumpur showed an overall
prevalence of infection with soil-transmitted helminthiasis of 89.02%. The prevalence and intensity of infection were consistently high among both school boys and girls throughout the six years of primary school. The predominant helminth was Trichuris trichiura - both as single and mixed infections. The commonest type of helminthic infection among urban primary school children was mixed infections with Trichuris trichiura and Ascaris lumbricoides. Hookworm infections, both as single or mixed infections, were more common among school children from rubber and oil palm estates in the rural areas.
In general, psychotic symptomatology falls within the major categories of mental disorders such as schizophrenia, affective disorder and organic mental
disorder. Those that do not fit the proposed diagnostic criteria for the aforementioned disorders are usually classified under the DSM-IV diagnosis of atypical psychosis. In the eastern culture, such symptoms are accepted as part of the cultural beliefs rather than being regarded as illness. Several such cases were seen at -the University Hospital, Kuala Lumpur and two such casesare reported in this paper. Cultural influences in determining symptomatology are also discussed.
A case of paranoid psychosis in myxoedema is described. Though depression is commonly encountered in myxoedema, the disorder can also manifest itself with schizophrenic features; this can lead to problems in diagnosis and management.
A case of Tracheoesophageal Fistula (TOF) was presented where the blind upper esophageal pouch was mistakenly intubated; in spite of this, adequate lung ventilation was possible for more than one hour. This was only noticed by the surgeon upon incision of the lower end of the pouch.
An uncommon problem that can present as a surgical emergency is described and the aetiology of priapism and its management is alluded to in the light of simpler surgical measures that are presently available.
The common chromosome abnormalities that are encountered in the various types of leukemia are discussed here. Chromosome abnormalities in leukemia are non-random and certain chromosomal changes are now becoming recognised as being rather specific for certain leukemia types.
A high frequency of nonhemolytic hereditary ovalocytosis in Malayan aborigines is thought to result from reduced susceptibility of affected individuals to malaria. Indeed, Kidson et al. recently showed that ovalocytes from Melanesians in Papua New Guinea are resistant to infection in culture by the malarial parasite Plasmodium falciparum. In order to determine if protection against parasitic invasion in these ovalocytes might be the result of some altered membrane material property in these unusual cells, we measured their membrane and cellular deformability characteristics using an ektacytometer . Ovalocytic red cells were found to be much less deformable in comparison to normal discoid red cells. Similar measurements on isolated membrane preparations revealed a marked reduction in ovalocytic membrane deformability. To produce equal deformation of ovalocytic and normal membranes, ovalocytes required an 8-10-fold increase in applied shear stress, indicating that their membrane was capable of deforming under sufficient stress. To test the possibility that this increased membrane rigidity might confer resistance to parasitic invasion, we performed an in vitro invasion assay using Plasmodium falciparum merozoites and Malayan ovalocytes of varying deformability from seven different donors. The level of infection of the ovalocytes ranged from 1% to 35% of that in control cells, and the extent of inhibition appeared to be closely related to the reduction in membrane deformability. Moreover, we were able to induce similar resistance to parasitic invasion in nonovalocytic normal red cells by increasing their membrane rigidity with graded exposure to a protein crosslinking agent. Our findings suggest that resistance to parasite invasion of Malayan ovalocytes is the result of a genetic mutation that causes increased membrane rigidity.
This study has analyzed 260 patients with multiple injuries sustained in road accidents admitted to the University Hospital during the period July 1967 to July 1976, in relation to age, sex, and ethnic distribution. The types of injuries sustained have been discussed to highlight their effects on the community in a developing country. The extremities have been most frequently involved, while head injuries followed closely. The causative factors of multiple injury-producing accidents have been evaluated. The categories of victims most liable to multiple injuries have been discussed. The significance of understanding the mechanism of these accidents and the effect of such knowledge in minimizing diagnostic errors, thus enabling management and the urgent need for regional accident services in developing countries, have been stressed.