Hepatitis B infection in prostitutes

The prevalence of HBV markers in prostitutes is known to be higher than that of the normal population of similar age range in previous studies. This study showed a significant correlation between the duration of prostitution and the prevalence of HBV antibodies amongst the prostitutes. The prevalence of HBV antibodies doubled after the first year of prostitution. A two-year follow-up study of these prostitutes showed that 37% of HBsAg positive prostitutes lost the HBsAg. The seroconversion rate of HBsAg negative prostitutes was 10% during this two-year period. Early immunization against HBV infection should be considered in this high risk group in view of these findings.     

新加坡亚洲人的基底细胞癌特征及完全与不完全切除肿瘤的比较

背景：大多数已报道的基底细胞癌（BCCs）的特征主要是依据高加索患者。而关于亚洲人中不完全切除BCCs的特征少见报道。目的：本研究调查了新加坡亚洲居民的BCCs特征，并对常规外科切除术后完全切除与不完全切除肿瘤进行了比较。患者和方法：收集1991--1995年间在国家皮肤病中心行肿瘤切除术的原发性BCC患者的病历进行回顾性研究。结果：166例BCC患者（男女比0．95；平均年龄70．9岁）的185个组织病检确诊的BCCs记录在案。发病最高比例（27．1％）在8l～90岁年龄组。与普查资料相比，华人BCCs患者的比例明显增高（P〈0．001）。肿瘤平均直径为12．0mm，且大多数（84．3％）位于头颈部。28处（15．1％）皮损被不完全切除，多位于鼻部及鼻唇沟。不完全切除的基底细胞癌较完全切除的基底细胞癌更多发生于面中部及躯干部（P=0．003），但与肿瘤大小、肿瘤持续时间、患者年龄、种族及性别无显著相关。平均随访74个月，     

CEREBRAL BLOOD-FLOW VELOCITY AND INTERMITTENT INTRACRANIAL PRESSURE ELEVATION DURING SLEEP IN HYDROCEPHALIC CHILDREN

The clinical importance of intermittent intracranial pressure (ICP) elevations during sleep in hydrocephalic children is unclear. Eight studies of continuous ICP monitoring with simultaneous cerebral blood-flow velocity (CBFV) measurements were recorded during sleep in seven hydrocephalic children aged between one and 10 years. ICP was measured directly through a frontal reservoir. There were two main patterns of CBFV change in response to raised ICP: a progressive decrease in mean flow velocity and increase in resistance index, suggesting impaired haemodynamic compensation to ICP elevation due to reduced circulatory reserve in patients with limited intracranial compliance; and an increase in mean flow velocity with raised ICP, suggesting that appropriate haemodynamic compensation with increased blood-flow can occur to maintain adequate cerebral perfusion in those with sufficient circulatory reserve. Simultaneous CBFV and ICP measurements may help to identify those with reduced circulatory reserve who are at greater risk of ischaemic insult from episodic increases in ICP.     

Perforation of the large bowel during colonoscopy in Singapore

The management of seven patients with colonoscopy-related perforations is described. This study demonstrates the need for an early laparotomy. A high index of suspicion is required to reach an early diagnosis. Patients with no preexisting medical problems who underwent early surgery recovered with little morbidity. In elderly patients (greater than 75 years), colonoscopic perforation can be fatal. Endoscopy should be performed with special care in such patients.     

Clinical characteristics of renal transplant recipients that underwent urologic surgery for de novo disease before and after transplantation

The pre-transplantation goal of the urologist is the optimization of urinary tract condition. Therefore, urologic surgery may be needed before or after renal transplantation. We analyzed the results of urologic surgery performed because of de novo urologic diseases. Between January 1986 and January 2001, 281 patients underwent renal transplantation, and 23 urologic surgical procedures were performed on 21 transplant recipients before or after renal transplantation because of de novo urologic diseases. By review the major reasons for urologic surgery in recipients were polycystic kidney diseases, vesicoureteral reflux, and dysfunctional voiding disorders. Nineteen surgical corrective procedures were done average 2.9 months before transplantation. The mortality rate was 10.5%. Four patients underwent urologic surgery at an average 57.5 months after transplantation. We highlight the fact that patients with uremia are vulnerable to surgical complications, and conclude that more intensive longterm urologic follow-ups should be conducted on recipients.