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1.
IEEE Trans Biomed Eng ; 59(6): 1593-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22410954

RESUMO

Radio-frequency ablation (RFA) has been used in liver surgery to minimize blood loss during tissue division. However, the current RFA tissue division method lacks an effective way of determining the stoppage of blood flow. There is limitation on the current state-of-the-art laser Doppler flow sensor due to its small sensing area. A new technique was proposed to use bioimpedance for blood flow sensing. This paper discusses a new geometrical multiscale model of the liver bioimpedance incorporating blood flow impedance. This model establishes correlation between the physical tissue structure and bioimpedance measurement. The basic Debye structure within a multilevel framework is used in the model to account for bioimpedance dispersion. This dispersion is often explained by the Cole-Cole model that includes a constant phase element without physical explanation. Our model is able to account for reduced blood flow in its output with changes in permittivity in gamma dispersion that is mainly due to the polarization of water molecules. This study demonstrates the potential of a multiscale model in determining the stoppage of blood flow during surgery.


Assuntos
Fígado/fisiologia , Modelos Biológicos , Pletismografia de Impedância/métodos , Animais , Simulação por Computador , Humanos
2.
Singapore Med J ; 50(3): e100-1, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19352550

RESUMO

Carcinoid tumours of the gastrointestinal tract are uncommon, generally slow-growing and associated with a good prognosis. We present a 52-year-old Chinese woman with a carcinoid at the ampulla of Vater, a site far less common than other areas of the gastrointestinal tract. Preoperative imaging showed a pancreatic mass with displacement and possible invasion of the portal vein associated with peripancreatic nodal enlargement. A radical pancreaticoduodenectomy with portal vein wedge excision was performed. An intraoperative biopsy of the enlarged nodes was negative for malignancy and postoperative histology of the large pancreatic mass yielded a surprising finding of a carcinoid tumour at the ampulla of Vater with a large inflammatory pancreatic mass adherent to the portal vein. This is an uncommon case associated with "pseudotumour pancreatitis", causing biliary and pancreatic duct obstruction mimicking a large tumour in the head of the pancreas.


Assuntos
Ampola Hepatopancreática/patologia , Tumor Carcinoide/complicações , Neoplasias da Vesícula Biliar/complicações , Granuloma de Células Plasmáticas/etiologia , Tumor Carcinoide/fisiopatologia , Tumor Carcinoide/cirurgia , Feminino , Neoplasias da Vesícula Biliar/fisiopatologia , Neoplasias da Vesícula Biliar/cirurgia , Granuloma de Células Plasmáticas/patologia , Granuloma de Células Plasmáticas/cirurgia , Humanos , Pessoa de Meia-Idade , Pancreaticoduodenectomia , Prognóstico
3.
Singapore Med J ; 50(3): e102-4, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19352551

RESUMO

We present a 33-year-old Chinese woman with Wilson's disease in whom ultrasonography and computed tomography showed gallbladder features suggestive of acute cholecystitis. Incongruence in liver function prompted further investigations with the final diagnosis of Wilson's disease, complicated by oedema of the gallbladder mimicking acute cholecystitis. The patient was subsequently treated nonoperatively, and is well on follow-up.


Assuntos
Colecistite Aguda/etiologia , Degeneração Hepatolenticular/diagnóstico , Adulto , Colecistite Aguda/diagnóstico , Colecistite Aguda/diagnóstico por imagem , Colecistite Aguda/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Vesícula Biliar/patologia , Doenças da Vesícula Biliar , Degeneração Hepatolenticular/complicações , Degeneração Hepatolenticular/diagnóstico por imagem , Degeneração Hepatolenticular/tratamento farmacológico , Humanos , Penicilinas/uso terapêutico , Tomografia Computadorizada por Raios X , Ultrassonografia , Compostos de Zinco/uso terapêutico
4.
Singapore Med J ; 48(8): e224-6, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17657371

RESUMO

We describe a 43-year-old man who had a difficult endoscopic retrograde cholangiopancreatography, allowing only placement of a stent without removal of the common bile duct stone. He subsequently underwent laparoscopic cholecystectomy with laparoscopic common bile duct exploration and primary closure after laparoscopic choledochotomy.


Assuntos
Colecistectomia Laparoscópica/métodos , Ducto Colédoco/cirurgia , Cálculos Biliares/cirurgia , Stents , Adulto , Humanos , Masculino
5.
Singapore Med J ; 46(2): 90-2, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15678292

RESUMO

Focal nodular hyperplasia (FNH) is a benign liver tumour with an asymptomatic course, rarely causing complications. When the diagnosis is certain, only watchful observation is necessary. We highlight an interesting case of a 42-year-old woman with a FNH that ruptured and became haemorrhagic, thus presenting as an acute surgical abdomen. The diagnosis was only established after surgical resection with histopathological confirmation. Although haemorrhage of hepatic FNH is extremely rare, this case highlights the small risk of rupture in large lesions.


Assuntos
Abdome Agudo/etiologia , Hiperplasia Nodular Focal do Fígado/complicações , Abdome Agudo/diagnóstico por imagem , Adulto , Feminino , Hiperplasia Nodular Focal do Fígado/diagnóstico por imagem , Humanos , Ruptura Espontânea/diagnóstico por imagem , Tomografia Computadorizada por Raios X
6.
Singapore Med J ; 45(1): 6-8, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14976575

RESUMO

Recurrent appendicitis is defined when patients with recurring similar right iliac fossa pain had acute appendicitis confirmed at the time of operation and the pain completely subsided after surgery. We conducted a retrospective study on our patients with appendicitis. There were 290 patients with appendicitis over a two-year period and 33 patients (11%) had reported recurring pain prior to the presentation. Majority had one prior episode but 15% had multiple episodes of right iliac fossa pain. Fifty-eight percent of the episode occur within six months of the presentation. We conclude that recurrent appendicitis should be considered as a differential diagnosis in patients with recurrent right iliac fossa pain.


Assuntos
Dor Abdominal/epidemiologia , Apendicite/diagnóstico , Apendicite/epidemiologia , Dor Abdominal/fisiopatologia , Adulto , Comorbidade , Feminino , Humanos , Íleo/fisiopatologia , Incidência , Masculino , Recidiva , Estudos Retrospectivos , Distribuição por Sexo , Singapura/epidemiologia
7.
Arch Dis Child ; 86(6): 407-10, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12023168

RESUMO

AIMS: To evaluate effects of a low energy diet, with or without strength training, on blood lipid profile in obese children. METHODS: Eighty two obese children were enrolled into a six week dietary programme, and were randomly allocated to a training group or a non-training group. The training group underwent regular exercise sessions with emphasis on strength training. RESULTS: Height increased significantly, with a non-significant reduction in body mass index. Fat free mass increased significantly in the training group. Serum total cholesterol was significantly reduced in both groups. The LDL:HDL ratio significantly decreased in the training group. CONCLUSION: Results support the potentially beneficial effects of both diet and physical training. Further and longer term evaluation of such programmes is required.


Assuntos
Terapia por Exercício/métodos , Lipídeos/sangue , Obesidade/terapia , Adulto , Índice de Massa Corporal , Criança , Terapia Combinada/métodos , Ingestão de Energia , Feminino , Humanos , Masculino , Obesidade/sangue , Obesidade/dietoterapia , Aptidão Física
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