Displaying publications 81 - 93 of 93 in total

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  1. Toh TH, Abdul Kadir KA, Tai MS, Tan KS
    Case Rep Neurol, 2020 12 14;12(Suppl 1):15-21.
    PMID: 33505267 DOI: 10.1159/000501820
    Early endovascular thrombectomy leads to improved outcomes for patients with proximal occlusions when started within 6 h from onset of symptoms. We present a case illustrating the flow of events for a patient who underwent endovascular thrombectomy in our centre after conventional imaging - a brain non-contrast computed tomography (NCCT) and CT angiogram (CTA) - achieving a door-to-groin time of 195 min. The patient is a 65-year-old who presented with signs and symptoms of a left middle cerebral artery (MCA) territory infarct. His National Institute of Health Stroke Scale (NIHSS) score was 15 on presentation and his brain NCCT showed an Alberta Stroke Programme Early CT Score (ASPECTS) of 8. His CTA showed a left MCA distal M1 occlusion with focal calcification and stenosis of the proximal left internal carotid artery. He was subsequently thrombosed and underwent thrombectomy successfully, with a door-to-groin-puncture time of 195 min. A TICI 2b reperfusion was achieved. His NIHSS score improved to 9 over the next 2 days. For cases with straightforward NCCT and CTA with no contraindications, endovascular thrombectomy should be pursued without delay. A review of the current available literature for the usage of NCCT and CTA as well as the importance of ASPECTS scoring in patient selection for endovascular thrombectomy was included.
    Matched MeSH terms: Constriction, Pathologic
  2. Prodan Z, Mroczek T, Sivalingam S, Bennink G, Asch FM, Cox M, et al.
    PMID: 33984478 DOI: 10.1053/j.semtcvs.2021.03.036
    Valved allografts and xenografts for reconstruction of the right ventricular outflow tract (RVOT) lack durability and do not grow. We report the first clinical use of a completely bioabsorbable valved conduit (Xeltis pulmonary valve - XPV) in children. Twelve children (six male), median age five (two to twelve) years and median weight 17 (10 to 43) kg, underwent RVOT reconstruction with the XPV. Diagnoses were: pulmonary atresia with ventricular septal defect (VSD) (n=4), tetralogy of Fallot (n=4), common arterial trunk (n=3), and transposition of the great arteries with VSD and pulmonary stenosis (n=1). All had had previous surgery, including prior RVOT conduit implantation in six. Two diameters of conduit 16mm (n=5) and 18mm (n=7) were used. At 24 months none of the patients has required surgical re-intervention, 9 of the 12 are in NYHA functional class I and three patients in NYHA class II. None of the conduits has shown evidence of progressive stenosis, dilation or aneurysm formation. Residual peak gradient of >40 mm Hg was observed in three patients, caused by kinking of the conduit at implantation in 1 and distal stenosis in the peripheral pulmonary arteries in 2 patients. Five patients developed severe pulmonary valve insufficiency (PI); the most common mechanism was prolapse of at least one of the valve leaflets. The XPV conduit is a promising innovation for RVOT reconstruction. Progressive PI requires however an improved design (geometry, thickness) of the valve leaflets.
    Matched MeSH terms: Constriction, Pathologic
  3. Ylmaz Ö, Temur A, Almal N, Dülger AC, Sasmaz MI
    Trop Biomed, 2018 Dec 01;35(4):1148-1153.
    PMID: 33601862
    Oesophageal strictures often occur following esophagectomy which is performed for cases of oesophageal cancer. These patients require repeated dilation procedures. The aim of this study is to investigate the effects of dietary regimens, which are changed because of stenosis, caused by Helicobacter pylori (H. pylori). In this retrospective study, 28 patients who had operation for oesophageal cancer and underwent dilation due to development of stricture were studied. 30 female and 30 male patients who were admitted to the Gastroenterology Clinic with complaints of dyspepsia and did not receive treatment for the eradication of H. pylori were randomly selected and included in this study as a control group. Patients' histopathological records on the hemogram, biochemistry, and endoscopic biopsy were analysed. There were 26 H. pylori (+) cases (92.8 %) in the stenosis group consisting of 28 patients, and 37 H. pylori (+) cases (61.6%) in the control group consisting of 60 patients. These results were found to be statistically significant (P=0.003). The albumin level in the stenosis group was reported to be statistically low (P=0.002). The incidence of H. pylori was found to be significantly higher in patients with stenosis. We ascribed this outcome due to changes in dietary regimens. Our findings showed that the dietary regimens of all patients who underwent esophagectomy should be regulated during the postoperative period considering H. pylori. The relationship between H. pylori and stenosis was significant, there is a need for further research with a larger sample size to enrich the findings.
    Matched MeSH terms: Constriction, Pathologic
  4. Lum SG, Noor Liza I, Priatharisiny V, Saraiza AB, Goh BS
    Malays Fam Physician, 2016;11(1):2-6.
    PMID: 28461841 MyJurnal
    BACKGROUND: Conditions causing stridor in paediatric patients can range from minor illnesses to life-threatening disorders. Proper evaluation and correct diagnosis are essential for timely intervention. The objective of this study was to determine the aetiological profiles and the management of paediatric patients with stridor referred to the Otorhinolaryngology Department of Hospital Serdang.

    METHODS: Medical records of all paediatric patients presenting with symptom of stridor from January 2010 to February 2015 were reviewed retrospectively. The patients' demographic data, clinical notes, laryngoscope findings, diagnosis and management were retrieved and analysed.

    RESULTS: Out of the total 137 patients referred for noisy breathing, 121 patients had stridor and were included in this study. There were 73 males and 48 females-most were of Malay ethnicity (77.7%). The age of presentation ranged from newborn to 10 years, with a mean of 4.9 months. Eighteen patients (14.9%) had associated congenital pathologies. The majority were congenital causes (90.9%), in which laryngomalacia was the commonest (78.5%), followed by subglottic stenosis (5.0%), vallecular cyst (2.5%) and congenital vocal fold paralysis (2.5%). Twelve patients (9.9%) had synchronous airway lesion. The majority of the patients were managed conservatively. Thirty-one patients (25.6%) required surgical intervention, of which only one needed tracheostomy.

    CONCLUSION: Laryngomalacia was the commonest cause of stridor among paediatric patients. A synchronous airway lesion should be considered if the child has persistent or severe symptoms. The majority of the patients were managed conservatively.

    Matched MeSH terms: Constriction, Pathologic
  5. Alsemiry RD, Sarifuddin, Mandal PK, Sayed HM, Amin N
    Biomed Res Int, 2020;2020:7609562.
    PMID: 32090110 DOI: 10.1155/2020/7609562
    The simultaneous effect of flexible wall and multiple stenoses on the flow and mass transfer of blood is investigated through numerical computation and simulations. The solution is obtained using the Marker and Cell technique on an axisymmetric model of Newtonian blood flow. The results compare favorably with physical observations where the pulsatile boundary condition and double stenoses result in a higher pressure drop across the stenoses. The streamlines, the iso-concentration lines, the Sherwood number, and the mass concentration variations along the entire wall segment provide a comprehensive analysis of the mass transport characteristics. The double stenoses and pulsatile inlet conditions increase the number of recirculation regions and effect a higher mass transfer rate at the throat, whereby more mass is expected to accumulate and cause further stenosis.
    Matched MeSH terms: Constriction, Pathologic
  6. Liew YT, Yong DJ, Somasundran M, Lum CL
    Indian J Otolaryngol Head Neck Surg, 2015 Mar;67(Suppl 1):129-33.
    PMID: 25621268 DOI: 10.1007/s12070-014-0801-8
    The aim of the study was to examine and analyze the epidemiology and outcome of treatment for paediatric acquired subglottic stenosis treated with endoscopic bougie dilatation and topical mitomycin C. There were 15 patients identified from 2008 until 2013. All of them had acquired subglottic stenosis due to history of intubation. Majority of the patients had grade III stenosis, with the total of seven. Three patients had grade IV; three were grade II and two were grade I. All of the patients with severe stenosis (grade III and IV) needed tracheostomy while only one in mild stenosis group (grade I and II) required it for prolonged ventilation rather than obstruction due to subglottic stenosis. All of them underwent direct laryngoscopy under general anesthesia followed by endoscopic dilatation with bougie and topical mitomycin C 0.4 mg/ml for 5 min. Aim of success in our study was decannulation of tracheostomy or absence of symptoms at exertion. We achieved 6 (60 %) successful decannulation out of 10 patients with tracheostomy (excluded the patient with tracheostomy in grade I stenosis due to prolonged ventilation). As for those without tracheostomy, 3 (75 %) out of 4 patients were asymptomatic even at exertion. Average number of dilatation was 3.1 times, with mean duration of 28 min. No complications were reported in our series. One patient with grade I stenosis passed away due to severe pneumonia unrelated to the stenosis or dilatation, and she did not have any dilatation before she passed away. Multiple related risk factors were identified such as intubation, prematurity, movement of endotracheal tube, respiratory infection, traumatic intubation and gastroesophageal reflux disease. Experience of open surgical method was very limited in our centre in Sabah in East Malaysia. Endoscopic technique plays an important role in treatment of subglottic stenosis with adjunct like mitomycin C possibly booster the successful rate.
    Matched MeSH terms: Constriction, Pathologic
  7. Kew TY, Abdullah A
    J Laryngol Otol, 2012 Jan;126(1):66-71.
    PMID: 21867589 DOI: 10.1017/S0022215111002258
    We report an extremely rare case of duplication of the internal auditory canal associated with dysfunction of both the facial and vestibulocochlear nerves. We also review the literature regarding the integrity of the facial and vestibulocochlear nerves in such cases.
    Matched MeSH terms: Constriction, Pathologic
  8. Beng TS, Chin LE
    J Palliat Med, 2010 Aug;13(8):1037-8.
    PMID: 20712471 DOI: 10.1089/jpm.2009.0314
    We present a case of gross lower limb edema in a 21-year-old man with an intra-abdominal malignant fibrous histiocytoma. He had a 1-month history of lower limb edema secondary to inferior vena caval obstruction. His edema failed to respond to a combination of diuretics, oral frusemide 40 mg daily and oral spironolactone 100 mg daily. Subcutaneous drainage of both lower limbs with butterfly needles was performed with minimal improvement. However, he gained significant symptomatic relief with multiple subcutaneous punctures and stoma bag drainage. A total of 12.8 L of serous fluid was drained with this simple and effective method. This is the first report of the use of this method.
    Matched MeSH terms: Constriction, Pathologic
  9. Zainol Abidin Z, Mohd Zaki F, Kew TY, Goh BS, Abdullah A
    J Laryngol Otol, 2020 Jul;134(7):603-609.
    PMID: 32713375 DOI: 10.1017/S0022215120001334
    OBJECTIVE: This study aimed to evaluate the association between cochlear nerve canal dimensions and semicircular canal abnormalities and to determine the distribution of bony labyrinth anomalies in patients with cochlear nerve canal stenosis.

    METHOD: This was a retrospective study in which high-resolution computed tomography images of paediatric patients with severe-to-profound sensorineural hearing loss were reviewed. A cochlear nerve canal diameter of 1.5 mm or less in the axial plane was classified as stenotic. Semicircular canals and other bony labyrinth morphology and abnormality were evaluated.

    RESULTS: Cochlear nerve canal stenosis was detected in 65 out of 265 ears (24 per cent). Of the 65 ears, 17 ears had abnormal semicircular canals (26 per cent). Significant correlation was demonstrated between cochlear nerve canal stenosis and semicircular canal abnormalities (p < 0.01). Incomplete partition type II was the most common accompanying abnormality of cochlear nerve canal stenosis (15 out of 65, 23 per cent).

    CONCLUSION: Cochlear nerve canal stenosis is statistically associated with semicircular canal abnormalities. Whenever a cochlear nerve canal stenosis is present in a patient with sensorineural hearing loss, the semicircular canal should be scrutinised for presence of abnormalities.

    Matched MeSH terms: Constriction, Pathologic
  10. Tan CH, Hilal S, Xu X, Vrooman H, Cheng CY, Wong TY, et al.
    J Alzheimers Dis, 2020;73(4):1501-1509.
    PMID: 31958085 DOI: 10.3233/JAD-190866
    There is a need to elucidate the combined influence of neurodegeneration and cerebrovascular disease (CeVD) on cognitive impairment, especially in diverse populations. Here, we evaluated 840 multiethnic individuals (mean age = 70.18) across the disease spectrum from the Epidemiology of Dementia in Singapore study. First, we determined whether a validated quantitative MRI score of mixed pathology is associated with clinical diagnosis and whether the score differed between ethnicities (Chinese, Malays, and Indians). We then evaluated whether the score was associated with multidomain cognitive impairment and if additional measures of CeVD were further associated with cognitive impairment. We found that lower quantitative MRI scores were associated with severity of clinical diagnosis and Chinese individuals had the highest quantitative MRI scores, followed by Indians and Malays. Lower quantitative MRI scores were also associated with lower performance in attention, language, visuoconstruction, visuomotor, visual, and verbal memory domains. Lastly, the presence of intracranial stenosis and cortical cerebral microinfarcts, but not cerebral microbleeds, were associated with memory performance beyond quantitative MRI scores. Taken together, our results demonstrate the utility of using multiple MRI markers of neurodegeneration and CeVD for identifying multiethnic Asians with the greatest cognitive impairment due to mixed pathology.
    Matched MeSH terms: Constriction, Pathologic
  11. Oteh M, Azarisman SM, Hanim NM, Noorfaizan S
    Singapore Med J, 2009 Feb;50(2):e76-8.
    PMID: 19296018
    Congenital coronary artery anomalies are rare, with an incidence of about 0.06-1.3 percent of all patients undergoing cardiac catheterisation. They are commonly asymptomatic, but potentially serious lesions may lead to myocardial ischaemia, infarction and/or sudden cardiac death. The occurrence of a concomitant stenotic lesion is exceedingly rare. We report an 80-year-old man who presented with acute anterior myocardial infarction. Coronary angiography revealed severe proximal left anterior descending (LAD) and arteriovenous malformation (AVM) from the first septal branch of the LAD. The LAD stenosis and the AVM were successfully treated with two Jomed covered stents.
    Matched MeSH terms: Constriction, Pathologic
  12. Yew KL, Anderson S, Farah R, Lim SH
    Asian Cardiovasc Thorac Ann, 2014 Oct;22(8):979-80.
    PMID: 24887840 DOI: 10.1177/0218492313491583
    Central vein stenosis is not uncommon in hemodialysis-dependent patients as a result of mechanical damage to the vessel walls from prior cannulation. It can cause ipsilateral upper limb swelling and pain, resulting in suboptimal hemodialysis. It is unfortunate for bilateral central vein stenosis to develop concomitantly, and rare in the setting of an in-situ pacemaker. This case illustrates the successful ligation of a nondependent left arteriovenous fistula and stenting of the right subclavian vein with functioning ipsilateral arteriovenous fistula, to overcome the problem of symptomatic bilateral upper limb swelling.
    Matched MeSH terms: Constriction, Pathologic
  13. Mazita A, Zabri M, Aneeza WH, Asma A, Saim L
    J Laryngol Otol, 2011 Nov;125(11):1116-20.
    PMID: 21846418 DOI: 10.1017/S0022215111002052
    To review cases of congenital external auditory canal anomaly with cholesteatoma, documenting clinical presentation, cholesteatoma site and extent, complications, and surgery.
    Matched MeSH terms: Constriction, Pathologic
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