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Kua, Voon Fong,Ismail, Fuad,Phua, Vincent Chee Ee,Aslan, Nik Muhd Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2
Background: Palliative chemotherapy with cisplatin/5-fluorouracil (5FU) is the commonest regimen employed for metastatic and recurrent head and neck squamous cell carcinoma (SCCHN) and nasopharyngeal carcinoma (NPC). However, this regimen is cumbersome requiring 5 days of admission to hospital. Carboplatin/5FU may be an alternative regimen without compromising survival and response rates. This study aimed to compare the efficacy and toxicity of carboplatin/5FU regimen with the cisplatin/5FU regimen. Materials and Methods: This retrospective study looked at patients who had palliative chemotherapy with either cisplatin/5FU or carboplatin/5FU for metastatic and recurrent SCCHN and NPC. It included patients who were treated at UKMMC from $1^{st}$ January 2004 to $31^{st}$ December 2009 with either palliative IV cispaltin 75 $mg/m^2$ D1 only plus IV 5FU 750 $mg/m^2$ D1-5 infusion or IV Carboplatin AUC 5 D1 only plus IV 5FU 500 $mg/m^2$ D1-2 infusion plus IV 5FU 500 $mg/m^2$ D1-2 bolus. The specific objectives were to determine the efficacy of palliative chemotherapy in terms of overall response rate (ORR), median progression free survival (PFS) and median overall survival (OS) and to evaluate the toxicities of both regimens. Results: A total of 41 patients were eligible for this study. There were 17 in the cisplatin/5FU arm and 24 in the carboplatin/5FU arm. The ORR was 17.7 % for cisplatin/5FU arm and 37.5 % for carboplatin/5FU arm (p-value=0.304). The median PFS was 7 months for cisplatin/5FU and 9 months for carboplatin/5FU (p-value=1.015). The median OS was 10 months for cisplatin/5FU arm and 12 months for carboplatin/5FU arm (p-value=0.110). There were 6 treatment-related deaths (6/41=14.6%), four in the carboplatin/5FU arm (4/24=16.7%) and 2 in the cisplatin/5FU arm (2/17=11.8%). Grade 3 and 4 hematologic toxicity was also more common with carboplatin/5FU group, this difference being predominantly due to grade 3-4 granulocytopenia (41.6% vs. 0), grade 3-4 anemia (37.5% vs. 0) and grade 3-4 thrombocytopenia (16.6% vs. 0). Conclusions: Carboplatin/5FU is not inferior to cisplatin/5FU with regard to its efficacy. However, there was a high rate of treatment-related deaths with both regimens. A better alternative needs to be considered.
Cryobiopsy of the Pleura: A Local Experience at Hospital Raja Perempuan Zainab II
( Kua Han Nee ),( Suzila Che Sayuti ),( Azza Omar ),( Mat Zuki Mat Jaeb ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0
Background Medical pleuroscopy has become a popular diagnostic approach in unilateral exudative pleural effusion. Biopsy of the parietal pleura via medical pleuroscopy is usually by forcep biopsy. We hereby present our experience in cryobiopsy of the pleura during medical pleuroscopy. Method Medical records, pleuroscopy reports and histopathological Results of patients with unilateral exudative pleural effusion who underwent medical pleuroscopy with cryobiopsy of the pleura were reviewed retrospectively. Results 18 patients were included in this study, 8 men (45%) and 10 women (55%). Pleural biopsies were obtained in all patients. Median size of the pleura biopsy specimen obtained was 12mm (range, 5mm to 34mm). 12 patients (67%) were diagnosed to have malignancy and 6 patients (33%) were diagnosed to have infection. 4 patients (22%) had granulomatous inflammation in the pleura biopsy and diagnosed to have tuberculosis while 2 patients (11%) were treated as bacterial empyema evidenced by chronic inflammation of the pleura. 8 patients (45%) were diagnosed to have primary lung malignancies with pleura metastasis while 2 (11%) had pleura metastasis from other primary sites. 2 patients (11%) had no evidence of tuberculosis or malignancy seen on the pleura specimen, and were diagnosed as Meig’s Syndrome in view of Computed Tomography (CT) finding of ovarian tumour. There was no significant complication or procedure related death. Conclusion Cryobiopsy of the pleura during medical pleuroscopy is safe, able to obtain a good sample size, and has a good diagnostic yield in patients with unilateral exudative pleural effusion.
Vascularisation of Urethral Repairs with the Gracilis Muscle Flap
Kua, Ee Hsiang Jonah,Leo, Kah Woon,Ong, Yee Siang,Cheng, Christopher,Tan, Bien-Keem Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.5
Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.
Vascularisation of Urethral Repairs with the Gracilis Muscle Flap
Ee Hsiang Jonah Kua,Kah Woon Leo,Yee-Siang Ong,Christopher Cheng,Bien-Keem Tan 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.5
Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.
A New Pyranoxanthone Inophyllin B from Calophyllum inophyllum
G.C.L. Ee,A.S.M.Kua,Y.L. Cheow,C.K. Lim,V. Jong,M. Rahmani 한국생약학회 2004 Natural Product Sciences Vol.10 No.5
A new prenylated pyranoxanthone, inophyllin B (1), was isolated from the roots of Calophyllum inophyllum (Guttiferae). Together with this compound was also isolated the known pyranoxanthone brasilixanthone B (2) and two common triterpenes friedelin (3) and sitosterol (4). Structural elucidations of these compounds were achieved through 1H, 13C, DEPT, COSY, HSQC and HMBC experiments. The molecular mass was determined using MS techniques. The crude extract indicated weak toxicity to the larvae of Aedes aegypti. We report here the isolation, structural elucidation and bioassay data for Inophyllin B and brasilixanthone B.