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RISS 인기검색어
- 검색키워드
- 저자 : Jacklyn Yek (검색결과 4 건)
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Yek Jia Lin Jacklyn,Kiew Sheng Chuu Anne,Ngu James Chi-Yong,Lim Jimmy Guan Cheng 대한마취통증의학회 2020 Korean Journal of Anesthesiology Vol.73 No.6
Background: As the coronavirus disease 2019 (COVID-19) pandemic spreads globally, hospitals are rushing to adapt their facilities, which were not designed to deal with infections adequately. Here, we present the management of a suspected COVID-19 patient. Case: A 66-year-old man with a recent travel history, infective symptoms, and chest X-ray was presented to our hospital. Considering his septic condition, we decided to perform an emergency surgery. The patient was given supplemental oxygen through a face mask and transported to an operating theatre on a plastic-covered trolley. An experienced anesthetist performed rapid sequence intubation using a video laryngoscope. Due to the initial presentation of respiratory distress, the patient remained intubated after surgery to avoid re-intubation. Precautions against droplet, contact, and airborne infection were instituted. Conclusions: Our objective was to facilitate surgical management of patients with known or suspected COVID-19 while minimizing the risk of nosocomial transmission to healthcare workers and other patients.
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( Jacklyn Yek ),( Lionel Cheng ),( Fazlur Jauferally ),( Chiara Chong ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Over-warfarinisation can present in the elderly with varied clinical presentations. Retrospective examination of each patient`s clinical course can highlight key learning values. We report a case of warfarin-related nephropathy (WRN) and spontaneous intramural small bowel hematoma (SISBH) in an elderly patient on warfarin therapy. Methods: An 81-year-old Chinese male on long-term warfarin therapy for atrial fi brillation presents to the emergency department (ED) with one-week of persistent dysuria, three-days of ‘smoky-brown’ hematuria, fever, vomiting and supra-pubic tenderness. Prior to ED presentation, he had been prescribed a course of antibiotics with no symptomatic relief. The subsequent clinical course was suggestive of progressive intestinal obstruction. Results: Unenhanced Computed Tomography (CT) of the abdomen revealed hyperdense mural thickening, mainly of the jejunal loops, in keeping with SISBH. Work-up of hematuria was suggestive of a glomerular origin. Follow-up investigations revealed supra- therapeutic INR that upon correction led to spontaneous resolution of symptoms. Patient was discharged well a week later. Conclusions: Spontaneous resolution of WRN and SISBH with correction of coagulopathy highlights the importance of clinching the diagnosis to limit the progression of complications. In the clinical situation of acute kidney injury, unenhanced CT is helpful to detect and prognosticate the severity of SISBH. Supportive management and avoidance of nephrotoxins is suffi cient in the management of WRN.
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Shane Tan,Jacklyn Yek,Wei Chen Ong,Chor Hoong Hing,Jane LIM,Thiam Chye LIM 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.3
Background Our objective was to compare the complication rates of two common breast reconstruction techniques performed at our hospital and the cost-effectiveness for each test group. Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selected and matched according to age and mastectomy with or without axillary clearance. Patients from each resultant group were selected, with the patients matched chronologically. The remainder were matched for by co-morbidities. Sixteen patients who underwent immediate breast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, and complications in the 2 year duration after surgery for each group were compared. Results Complications arising from both the pedicled TRAM flaps and DIEP flaps included fat necrosis (TRAM, 3/16; DIEP, 4/16) and other minor complications (TRAM, 3/16; DIEP, 1/16). The mean hospital stay was 7.13 days (range, 4 to 12 days) for the pedicled TRAM group and 7.56 (range, 5 to 10 days) for the DIEP group. Neither the difference in complication rates nor in hospital stay duration were statistically significant. The total hospitalisation cost for the DIEP group was significantly higher than that of the pedicled TRAM group (P<0.001). Conclusions Based on our study, the pedicled TRAM flap remains a cost-effective technique in breast reconstruction when compared to the newer, more expensive and tedious DIEP flap
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Tan, Shane,Lim, Jane,Yek, Jacklyn,Ong, Wei Chen,Hing, Chor Hoong,Lim, Thiam Chye Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.3
Background Our objective was to compare the complication rates of two common breast reconstruction techniques performed at our hospital and the cost-effectiveness for each test group. Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selected and matched according to age and mastectomy with or without axillary clearance. Patients from each resultant group were selected, with the patients matched chronologically. The remainder were matched for by co-morbidities. Sixteen patients who underwent immediate breast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999 to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, and complications in the 2 year duration after surgery for each group were compared. Results Complications arising from both the pedicled TRAM flaps and DIEP flaps included fat necrosis (TRAM, 3/16; DIEP, 4/16) and other minor complications (TRAM, 3/16; DIEP, 1/16). The mean hospital stay was 7.13 days (range, 4 to 12 days) for the pedicled TRAM group and 7.56 (range, 5 to 10 days) for the DIEP group. Neither the difference in complication rates nor in hospital stay duration were statistically significant. The total hospitalisation cost for the DIEP group was significantly higher than that of the pedicled TRAM group (P<0.001). Conclusions Based on our study, the pedicled TRAM flap remains a cost-effective technique in breast reconstruction when compared to the newer, more expensive and tedious DIEP flap.
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