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  1. Intracranial suppuration caused by Micrococcus luteus
    Selladurai BM, Sivakumaran S, Aiyar S, Mohamad AR
    Br J Neurosurg, 1993;7(2):205-7.
    PMID: 8098607
    Micrococcus spp. are commensal organisms colonizing the body surfaces of humans. In a few instances these organisms have been reported to colonize ventricular shunts. We report a patient, with no overt evidence of immunosuppression, in whom Micrococcus luteus was responsible for intracranial suppuration at multiple sites.
    Matched MeSH terms: Tomography, X-Ray Computed
  2. Biloma and biliary fistula associated with hepatorrhaphy for liver injury
    Shahrudin MD, Noori SM
    Hepatogastroenterology, 1997 Mar-Apr;44(14):519-21.
    PMID: 9164529
    To review our experience in managing post-hepatorrhaphy complications in liver trauma.
    Matched MeSH terms: Tomography, X-Ray Computed
  3. Fulltext A review of the management of 107 dizzy patients at the university hospital
    Krishnan G
    Med J Malaysia, 1994 Mar;49(1):44-8.
    PMID: 8057990
    The common investigations done were pure tone audiometry, electronystagmography, X-ray of the internal auditory meatus, CT-scan of the internal auditory meatus and X-ray of the cervical spine. After the examinations and investigations only 52 patients out of the 107 could be given any diagnosis. The most common diagnosis for the vertigo was Meniere's disease.
    Matched MeSH terms: Tomography, X-Ray Computed
  4. Coagulopathy in acute head injury--a study of its role as a prognostic indicator
    Selladurai BM, Vickneswaran M, Duraisamy S, Atan M
    Br J Neurosurg, 1997 Oct;11(5):398-404.
    PMID: 9474270
    The aim of this investigation was to determine the prognostic value of coagulation abnormalities in a defined subset of patients with acute head injury. Prothrombin time, accelerated partial thromboplastin time (APTT), thrombin clotting time, fibrinogen assay, platelet count, fibrin degradation products (FDP) were assayed in 204 patients with acute closed head injury. Their values were graded on a score 0-3 and the sum score for each patient regarded as the disseminated intravascular coagulation (DIC) score. Moderate to severe DIC scores were evident in 38% of the cohort. At least one parameter was abnormal in 71% of patients. The DIC score correlated inversely with the Glasgow coma score (GCS) (p < 0.0001). In the GCS 13-15 subset, FDP scores were significant predictors of poor outcome (p < 0.001). In the GCS 6-12 subset, the APTT score (p < 0.001), and DIC score (p < 0.0001) predicted an adverse outcome. The DIC scores were significantly abnormal in most patients who had a poor outcome, without evidence of adverse predictors on CT. Logistic regression analysis confirmed the independent predictive capacity of APTT, FDP and DIC scores when values for GCS were fixed. Abnormal haemostatic parameters may enhance the predictive ability in subsets of patients with acute head injury defined by clinical or CT predictors.
    Matched MeSH terms: Tomography, X-Ray Computed
  5. Syringomyelia associated with a cauda equina meningioma involving the conus medullaris
    Chee CP, Tan CT, Nuruddin R
    Br J Neurosurg, 1990;4(6):529-33.
    PMID: 2076215
    An unusual case of syringomyelia secondary to a cauda equina meningioma involving the conus medullaris is described. The tumour was totally removed with decompression of an adjacent cyst and syrinx resulting in resolution of the symptoms and radiological appearance.
    Matched MeSH terms: Tomography, X-Ray Computed
  6. Incidental magnetic resonance image sinus abnormalities in asymptomatic Australian children
    Lim WK, Ram B, Fasulakis S, Kane KJ
    J Laryngol Otol, 2003 Dec;117(12):969-72.
    PMID: 14738607
    Plain X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) scans performed for non-ENT reasons often reveal incidental sinus mucosal changes. These changes need to be correlated clinically before diagnosing rhinosinusitis. This study examined the prevalence of such changes in MRI scans in children up to age 16. Scans were scored using an adapted Lund-Mackay classification and were positive when one or more sinuses showed abnormalities. Randomly selected scans in the retrospective arm revealed a prevalence of 20 of 62 (32.3 per cent). In the prospective arm 45 of 60 children were defined as truly asymptomatic, of which 14 scans (31 per cent) were positive. Other studies in adults and children using CT and MRI report a prevalence range of roughly 30 to 45 per cent. This variability may be attributed to differences of study design, definitions of population age, definitions of asymptomatic and definition of abnormal sinus. Other plausible factors to explain regional differences are climate and frequency of upper respiratory tract infections.
    Matched MeSH terms: Tomography, X-Ray Computed
  7. Fulltext Thyroid hormones and coronary artery calcification in euthyroid men and women
    Zhang Y, Kim BK, Chang Y, Ryu S, Cho J, Lee WY, et al.
    Arterioscler Thromb Vasc Biol, 2014 Sep;34(9):2128-34.
    PMID: 25060795 DOI: 10.1161/ATVBAHA.114.303889
    OBJECTIVE: Overt and subclinical hypothyroidism are risk factors for atherosclerosis. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC).
    APPROACH AND RESULTS: We conducted a cross-sectional study of 41 403 apparently healthy young and middle-aged men and women with normal thyroid hormone levels. Free thyroxin, free triiodothyronine, and thyroid-stimulating hormone levels were measured by electrochemiluminescent immunoassay. CAC score was measured by multidetector computed tomography. The multivariable adjusted CAC ratios comparing the highest versus the lowest quartile of thyroid hormones were 0.74 (95% confidence interval, 0.60-0.91; P for trend <0.001) for free thyroxin, 0.81 (0.66-1.00; P for trend=0.05) for free triiodothyronine, and 0.78 (0.64-0.95; P for trend=0.01) for thyroid-stimulating hormone. Similarly, the odds ratios for detectable CAC (CAC >0) comparing the highest versus the lowest quartiles of thyroid hormones were 0.87 (0.79-0.96; P for linear trend <0.001) for free thyroxin, 0.90 (0.82-0.99; P for linear trend=0.02) for free triiodothyronine, and 0.91 (0.83-1.00; P for linear trend=0.03) for thyroid-stimulating hormone.
    CONCLUSIONS: In a large cohort of apparently healthy young and middle-aged euthyroid men and women, low-normal free thyroxin and thyroid-stimulating hormone were associated with a higher prevalence of subclinical coronary artery disease and with a greater degree of coronary calcification.
    KEYWORDS: thyroid hormones; thyrotropin; thyroxine; triiodothyronine
    Matched MeSH terms: Multidetector Computed Tomography
  8. Fulltext Effects of calcium supplements on fracture healing in a rat osteoporotic model
    Shuid AN, Mohamad S, Mohamed N, Fadzilah FM, Mokhtar SA, Abdullah S, et al.
    J Orthop Res, 2010 Dec;28(12):1651-6.
    PMID: 20572125 DOI: 10.1002/jor.21180
    Fracture healing is a complex process, which is further complicated if the bone is osteoporotic. Calcium is one of the important minerals in bone and has been found to prevent osteoporosis but its role in fracture healing of osteoporotic bone is still unclear. We carried out a study on the effects of calcium supplementation on the late phase healing of fractured osteoporotic bone using an ovariectomized rat model. Twenty-four female Sprague-Dawley rats were divided into three groups: sham-operated (SO), ovariectomized-control (OVXC), and ovariectomized + calcium supplements (Ca). The right femurs of all the rats were fractured at mid-epiphysis and a K-wire was inserted for internal fixation. After 2 months of treatment, the rats were sacrificed and the femora were dissected out for radiological and biomechanical assessment. As expected, osteoporosis resulted in impaired healing as shown by the poor radiological and biomechanical properties of the OVXC group. CT scans showed significantly lower callus volumes in the SO and Ca groups compared to the OVXC group. Radiological scoring of fracture healing and callus staging of the SO and Ca groups were better than the OVXC group. However, the biomechanical parameters of the Ca group were significantly lower than the SO group and similar to the OVXC group. Therefore, calcium supplements may appear to improve fracture healing of osteoporotic bone but failed to improve strength.
    Matched MeSH terms: Tomography, X-Ray Computed
  9. Dengue Maculopathy Associated with Choroidopathy and Pseudohypopyon: A Case Series
    Ng CWK, Tai PY, Oli Mohamed S
    Ocul Immunol Inflamm, 2018;26(5):666-670.
    PMID: 27929712 DOI: 10.1080/09273948.2016.1254804
    Matched MeSH terms: Tomography, Optical Coherence
  10. Fulltext Transient Cortical Blindness After Coronary Angiography, Bypass Graft Angiography, and Coronary Angioplasty
    Lee ZV, Arjan Singh RS
    Cureus, 2021 Jan 07;13(1):e12542.
    PMID: 33425567 DOI: 10.7759/cureus.12542
    Transient cortical blindness after coronary angiography has long been reported in the literature; however, this condition remains rare until today. We report a case of transient cortical blindness after coronary angiography, bypass graft angiography, and coronary angioplasty, which was deemed to be secondary to contrast agent. A 60-year-old man who underwent prior coronary artery bypass grafting (CABG) started to experience recurrence of exertional and resting chest pain one year after CABG. In addition to coronary artery disease, he has underlying type 2 diabetes mellitus, hypertension, and dyslipidemia. Due to technical reasons, he was unable to undergo a computed tomography (CT) angiography of the coronary arteries and bypass grafts. Invasive coronary and bypass graft angiography were done, followed by stenting of the left circumflex artery. Thirty minutes after completion of the procedure, the patient had bilateral blurring of vision, which worsened drastically to only being able to perceive light bilaterally. The patient otherwise did not have any other neurological deficits. Binocular indirect ophthalmoscopy revealed no significant abnormalities apart from mild non-proliferative diabetic retinopathy of the left eye. A non-contrasted CT scan of the brain revealed acute subarachnoid bleed in both occipital lobes, but a subsequent magnetic resonance imaging scan of the brain revealed no evidence of intracranial bleed. The patient's vision gradually improved eight hours after the index event, and his vision completely normalized 12 hours later. The patient was discharged well two days later, and at one-month, three-month, and six-month follow-up, the patient remained angina-free, and his vision had remained stable bilaterally.
    Matched MeSH terms: Tomography, X-Ray Computed
  11. Intraoperative ultrasound with palpation is still superior to intra-arterial calcium stimulation test in localising insulinoma
    Wong M, Isa SH, Zahiah M, Azmi KN
    World J Surg, 2007 Mar;31(3):586-92.
    PMID: 17322973
    This study assessed the sensitivities of preoperative localisation modalities such as computed tomography (CT), magnetic resonance imaging (MRI), arteriography and arterial stimulation venous sampling (ASVS) using serum insulin and C-peptide gradients to intraoperative techniques in localising insulin-secreting tumours in our institution.
    Matched MeSH terms: Tomography, Spiral Computed
  12. Dermoid cyst simulating recurrent dacryocystitis in a toddler
    Tengku-Fatishah A, Abdullah B, Sanjeevan N, Nurul-Shuhada AH, Sharifah-Emilia TS, Haron J, et al.
    Can J Ophthalmol, 2019 08;54(4):e196-e199.
    PMID: 31358169 DOI: 10.1016/j.jcjo.2018.10.006
    Matched MeSH terms: Tomography, X-Ray Computed
  13. Fulltext Different vascular healing process between bioabsorbable polymer-coated everolimus-eluting stents versus bioresorbable vascular scaffolds via optical coherence tomography and coronary angioscopy (the ENHANCE study: ENdothelial Healing Assessment with Novel Coronary tEchnology)
    Wan Ahmad WA, Nakayoshi T, Mahmood Zuhdi AS, Ismail MD, Zainal Abidin I, Ino Y, et al.
    Heart Vessels, 2020 Apr;35(4):463-473.
    PMID: 31587103 DOI: 10.1007/s00380-019-01516-9
    Recent clinical trials have raised concerns about the safety and efficacy of ABSORB™ bioresorbable vascular scaffolds (BVS). The difference in the vascular healing process between SYNERGY™ bioabsorbable polymer-coated everolimus-eluting stents (BP-EES) and BVS remains unclear. The aim of the ENHANCE study was to compare vascular healing on BP-EES versus BVS by optical coherence tomography (OCT) and coronary angioscopy (CAS) at 4- and 12-month follow-ups. This is a prospective, non-randomized, single center clinical trial. Thirteen eligible patients with multivessel disease were enrolled. BP-EES and BVS were simultaneously implanted in the same patients, but in different coronary vessels. Imaging follow-up with both OCT and CAS was completed in 11 patients at 12 months. Neointimal coverage rates were similar between the two groups based on OCT measurements. The neointimal thickness of BP-EES was significantly thicker at the 12th month than at the 4th month, whereas the neointimal thickness of BVS did not change between the measurements taken at the 4th and 12th month. Existence of intra-stent thrombus was significantly higher in the BVS group, compared to the BP-EES group. On the other hand, CAS revealed that red-thrombi and yellow-plaque were more frequently observed in BVS at 4 months and up to 12-month follow-ups than in BP-EES. These findings suggested that the evidence of instability remained up to 12 months in the vascular healing with BVS, compared to that with BP-EES. Vascular healing of the stented wall was recognized at the very early phase after BP-EES implantation. However, vascular healing with BVS was still incomplete after 12 months.
    Matched MeSH terms: Tomography, Optical Coherence
  14. Mediastinal melioidosis masquerading as malignancy of the lung
    Kho SS, Ho YF, Chan SK, Tie ST
    Lancet, 2021 03 13;397(10278):e8.
    PMID: 33714391 DOI: 10.1016/S0140-6736(21)00200-2
    Matched MeSH terms: Tomography, X-Ray Computed
  15. Fulltext Massive, spontaneous ruptured renal subcapsular haematoma following thrombolytic therapy in acute ST-elevation myocardial infarction
    Raja Ezman Faridz Raja Shariff, Sazzli Shahlan Kasim
    Journal of Clinical and Health Sciences, 2019;4(2):82-85.
    MyJurnal
    Thrombolytic therapy remains widely used in majority of developing countries, where delivery
    of primary percutaneous coronary intervention (PCI) remains a challenge. Unfortunately,
    complications following such therapy remains prominent, predominantly bleeding-related
    problems. We present a rare case of massive renal subcapsular haemorrhage and hematoma
    following thrombolytic therapy. A 61-year old gentleman presented following an episode of
    chest pain due to acute ST-elevation myocardial infarction. Due to potential delays in obtaining
    PCI, the patient was counselled for thrombolysis using streptokinase which he had consented
    to. Unfortunately, within 36 hours of admission, he developed abdominal pain, haematuria,
    hypotension and altered mental status, associated with acute drops in haemoglobin levels.
    Following initial resuscitation efforts, a Computed Tomography scan of the abdomen was
    performed revealing a massive renal subcapsular hematoma, likely secondary to previous
    thrombolysis. Renal subcapsular hematoma can either be spontaneous or iatrogenic, the latter
    often due to coexisting renal-based neoplasm or vasculitidies. Iatrogenic causes include
    trauma, following renal biopsies or anticoagulation therapy amongst a few others. Iatrogenic
    renal subcapsular haemorrhage and hematoma formation are rare following thrombolysis. Our
    literature search revealed only one other similar case, although this was following
    administration of recombinant Tissue Plasminogen Activator in a case of acute ischaemic
    cerebrovascular accident. This case highlights the complexity in management, following the
    findings in terms of need for cessation of dual antiplatelet therapy and timing for PCI and stent
    selection.
    Matched MeSH terms: Tomography
  16. Cochlear nerve canal stenosis and associated semicircular canal abnormalities in paediatric sensorineural hearing loss: a single centre study
    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: Tomography, X-Ray Computed
  17. Fulltext Scedosporium apiospermum: A Rare Cause of Aggressive Orbital Apex Syndrome
    Loh UL, Tai PY, Hussein A, A Qamarruddin F
    Cureus, 2018 Dec 17;10(12):e3743.
    PMID: 30800553 DOI: 10.7759/cureus.3743
    Orbital apex syndrome (OAS) is a localized orbital cellulitis at the orbital apex that can cause vision loss from optic neuropathy and ophthalmoplegia involving multiple cranial nerves. Herein, we report a rare and rapidly progressive case of OAS secondary to fungal pansinusitis caused by Scedosporiumapiospermum in an immunocompromised patient following the extraction of abscessed teeth. A 48-year-old man with diabetes mellitus who had failed to adhere to his treatment presented with complaints of a right-sided headache and toothache for two weeks, with nausea and vomiting for two days prior to presentation. The patient was treated for septic shock secondary to the dental abscesses. Non-contrast brain computed tomography (CT) showed no significant intracranial abnormalities other than pansinusitis. Four days later, dental extraction was performed. The patient reported progressive painless blurring of the vision in his right eye following the dental extractions and was referred to the ophthalmology department. Subsequent examinations revealed decreased optic nerve function and ophthalmoplegia in his right eye and dental caries in the upper molars, with a mucopurulent discharge from the right sphenoid region. The clinical diagnosis was OAS. Pus near the orbital apex was drained surgically. Methicillin-resistant Staphylococcus aureus was isolated from the pus and a nasal swab. Tissue culture from the septal wall yielded S.apiospermum. The patient's condition deteriorated, despite intensive antibiotic and antifungal treatment and repeated surgical debridement. The disease progressed rapidly to his left eye. Sixty-seven days after the inital presentation, his visual acuity (VA) of both eyes was classified as no perception of light (NPL). The patient discharged himself from the hospital (at own risk discharge) and subsequently failed to attend a scheduled appointment in the ophthalmology clinic. If immunocompromised patients present with OAS, fungal infections should be ruled out. Prompt and aggressive treatment using a multidisciplinary approach is mandatory in cases of potentially life-threatening and vision-threatening fungal infections.
    Matched MeSH terms: Tomography, X-Ray Computed
  18. Recurrent occipital dermatofibrosarcoma protuberans tackled with wide local excision: A case report and current management
    Kho JPY, Ng BHK, John R
    Med J Malaysia, 2019 02;74(1):82-84.
    PMID: 30846668
    Dermatofibrosarcoma protuberans (DFSP) is a slowgrowing, locally invasive tumour of the dermis. It commonly presents in the trunks and proximal extremities but is seen to a lesser extent in the head and neck regions. We present a case report of a recurrent DFSP in a 48-year-old Iban woman at the occipital region. The patient underwent wide local excision and removal of outer table of cranium, dressing followed by split thickness skin graft. Histopathological examination confirmed dermatofibrosarcoma protuberans with clear lateral surgical margins and a deep margin of 0.5mm. She is currently undergoing radiotherapy and is planned for 50Grey 25cycles.
    Matched MeSH terms: Tomography, X-Ray Computed
  19. The great masquerade: Empyema thoracis as an unusual presentation of primary lung malignancy
    Nyanti LE, Kho SS, Tie ST
    Med J Malaysia, 2019 02;74(1):79-81.
    PMID: 30846667
    Primary lung malignancy presenting as empyema is rare, with a reported incidence of 0.3%. We report a case of a 60- year-old man presenting with unilateral pleural effusion; diagnostic thoracocentesis confirmed Salmonella empyema. Post-drainage, chest radiograph showed persisting right hemithorax opacity; subsequent computed tomography revealed a right lung mass with right upper lobe bronchus obliteration. Percutaneous biopsy confirmed advanced stage lung adenocarcinoma. We discuss the mechanism of post-obstructive pneumonia in lung cancerassociated empyema and the utility of bedside ultrasound in diagnosis of lung masses. Clinicians are alerted to the possibility of lung malignancy in elderly patients presenting with empyema.
    Matched MeSH terms: Tomography, X-Ray Computed
  20. Fulltext C1-C2 fusion with absence of C1 posterior arch and presence of C2 high-riding vertebral artery: Is it possible?
    Wong TS, Abdul Rashid ML, Hasan MS, Chiu CK, Chan CYW, Kwan MK
    J Orthop Surg (Hong Kong), 2019 4 9;27(2):2309499019840763.
    PMID: 30955474 DOI: 10.1177/2309499019840763
    The presence of anatomical anomalies such as absence of C1 posterior arch and presence of C2 high-riding vertebral artery may not allow a conventional C1-C2 fusion, and this patient will require occipitocervical fusion. A 62-year-old lady presented with cervical myelopathy. CT scan demonstrated an os odontoideum with C1-C2 dislocation. The posterior arch of atlas on right C1 vertebra was absent, and there was high-riding vertebral artery on left C2. MRI revealed severe cord compression with cord oedema. The chronic atlantoaxial dislocation was reduced successfully with skeletal traction. Hybrid C1-C2 fusion augmented with autogenous local bone graft with corticocancellous iliac crest bone graft was performed to avoid an unnecessary occipitocervical fusion. She was stable throughout surgery and discharged 6 days later. CT scan 6 months post-operation showed a solid posterior fusion mass. Hybrid C1-C2 fusion can be performed to avoid occipitocervical fusion despite presence of abnormal anatomy at C1 and C2 vertebrae.
    Matched MeSH terms: Tomography, X-Ray Computed
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