Editorial
Shock index: Easy to use, but can it predict outcomes following major abdominal emergency surgery?
Major abdominal emergency surgery (MAES) is commonly performed for various potentially life-threatening intra-abdominal surgical conditions with high perioperative mortality of up to 45%.1 Certain...
Letter to the Editor
Surgical margins assessment reduces re-excision rates in breast-conserving surgery
Dear Editor,
Breast-conserving surgery (BCS) followed by radiation therapy for breast cancer offers improved cosmetic results and comparable long-term survival rates as mastectomy.1 However,...
Images in Medicine
TB or not TB? The axillary lump question
An 81-year-old woman of healthy weight presented with a 2-week history of a painless right axillary lump. Physical examination revealed a 2cm firm nodule...
Letter to the Editor
An initial experience with laser haemorrhoidoplasty in addition to mucopexy for symptomatic haemorrhoids
Dear Editor,
Symptomatic haemorrhoids is the most common anorectal disorder, where up to 75% of people experience symptoms sometime in their lives.1
The current gold standard...
Others
Mesothelial Splenic Cyst—A Case Report
Non-parasitic cystic lesions of the spleen are unusual. They are classified essentially as primary (true, epithelial) and secondary (pseudo, non-epithelial) based on the presence...
Others
A Case Report of Neutrophilic Eccrine Hidradenitis in a Patient Receiving Chemotherapy for Acute Myeloid Leukaemia
Neutrophilic eccrine hidradenitis (NEH) is a neutrophilic dermatosis primarily affecting the eccrine glands and occurs most commonly in patients undergoing chemotherapy for a malignancy.
This...
Original Article
Abdominal Surgery in Human Immunodeficiency Virus (HIV) Infected Patients—Early Local Experience
The prevalence of human immunodeficiency virus (HIV) infection is rising at an exponential rate in Singapore. The surgical experience with this disease remains limited.
This...
Others
Adjuvant Chemotherapy for Patients with Resected Dukes’ C and High-risk B2 Colon Cancer with Fluorouracil and Levamisole
Carcinoma of the large bowel is the second leading cause of cancer mortality in Singapore. Although the great majority of patients are discovered at...
Commentary
Experience with a Nine-step Policy Dealing with Requests for Medically Inappropriate Interventions for Cancer
Although great strides have been made in treating cancers, a significant number of patients still reach the point at which no curative treatment is...
Commentary
Invasive Cancer after Treatment of Cervical Intraepithelial Neoplasia
The objective of a cervical screening programme is to prevent invasive cancer of the cervix by detecting and treating pre-invasive disease of the cervix....
Commentary
The Polarprobe—Emerging Technology for Cervical Cancer Screening
Cervical cancer is a preventable disease that affects nearly half a million women worldwide. The Papanicolaou smear has been used for screening for over...
Others
Occult Virilizing Ovarian Tumours in Postmenopausal Women: Problems in Evaluation with Reference to a Case
A remarkable variety of endocrinologic disorders may cause virilization syndromes. This can pose a diagnostic dilemma to even the most experienced clinicians.
This article is...
Others
Occult Virilizing Ovarian Tumours in Postmenopausal Women: Problems in Evaluation with Reference to a Case
A remarkable variety of endocrinologic disorders may cause virilization syndromes. This can pose a diagnostic dilemma to even the most experienced clinicians.
This article is...
Others
Pelvic Spleen Masquerading as an Ovarian Neoplasm
A 53-year-old Caucasian woman, a receptionist in a general practice, was referred to the gynaecology outpatient clinic with an 18-month history of heavy, irregular...
Others
A Case Report—Delayed Vesicocutaneous Fistula After Radiation Therapy for Advanced Vulvar Cancer
To our knowledge this is the first reported case of an isolated vesicocutaneous fistula related to previous radiation therapy for recurrent vulvar cancer.
This article...
Review Article
Optimal Treatment in Gestational Trophoblastic Disease
Gestational trophoblastic diseases (GTD) encompass a spectrum of interrelated conditions:
Hydatidiform mole (HM)
Invasive mole (IM)
Choriocarcinoma (CC)
Placental site trophoblastic tumour (PSTT)
This article is available only as...
Review Article
Fallopian Tube Carcinoma—A Review
Fallopian tube cancer is the least common of gynaecological malignancies. It was first described by Renaud in 1847.
This article is available only as a...
Review Article
Current Management of Early Vulvar Cancer
Carcinoma of the vulva is an uncommon malignancy, but one that is amenable to early diagnosis if symptoms and signs are appropriately investigated. Although...
Review Article
Topoisomerase-I Inhibitors in Gynaecologic Tumours
Topoisomerases are essential nuclear enzymes with a multiplicity of cellular functions involving DNA replication, RNA transcription, mitosis, and chromosome condensation. Two classes have been...
Review Article
Screening for Ovarian Cancer
Ovarian cancer is the most common gynaecological malignancy with over 5000 new cases diagnosed every year in the UK and 22 000 in the...
Review Article
Biomarkers in Carcinoma of the Cervix: Emphasis on Tissue-related Factors and Their Potential Prognostic Factors
Accurate staging is of utmost importance in determining the prognosis of carcinoma of the cervix. Demographic features such as race and socio-economic status have...
Review Article
The Management Dilemma of the Mildly Abnormal Smear: Fact or Fiction?
Carcinoma of the cervix is still a relatively common gynaecological malignancy. However, despite being potentially preventable it still claims the lives of many women...
Review Article
Adenocarcinoma of the Cervix
It is clear from studies in Canada, Scandinavia, and more recently the United Kingdom, that routine Pap smear screening has not only reduced the...
Original Article
Malignant Ovarian Germ Cell Tumours: Experience in the National University Hospital of Singapore
One of the most remarkable advances in the management of gynaecological cancers is in malignant ovarian germ cell tumours. Before the early 70s, some...
Original Article
A Phase II Study of Combined CPT-11 and Mitomycin-C in Platinum Refractory Clear Cell and Mucinous Ovarian Carcinoma
Platinum resistance, either de novo or acquired, is a major obstacle in the treatment of advanced ovarian cancer. Platinum-resistance has been classified into the...
Original Article
Single Agent Paclitaxel in Resistant and Relapsed Epithelial Ovarian Cancer After First-line Platinum-based Chemotherapy—Experience in an Asian Population
Ovarian carcinoma ranks fourth among causes of death in women and is the leading cause of death from gynaecological malignancies in Western countries. In...
Original Article
Uterine Papillary Serous Carcinoma—The KK Hospital Experience
Endometrial carcinoma comprises a morphologically heterogeneous group of tumours. Several authors during the 1960s and 1970s described an unusual variant of endometrial cancer containing...
Original Article
Radiotherapy as Local Adjuvant Treatment for Endometrial Carcinoma—A Review of 45 Patients
Radiotherapy as an adjunct to surgery has long been used in the management of endometrial carcinoma with the intent to improve local tumour control...
Original Article
Outcome of Obstructive Uropathy After Pelvic Irradiation in Patients with Carcinoma of the Uterine Cervix
Radiotherapy is the mainstay treatment for locally advanced carcinoma of the cervix. It is also administered as an adjuvant therapy to patients deemed at...
Original Article
The Surgical Management of Colorectal Complications from Irradiation for Carcinoma of the Cervix
Radiation bowel injury is a significant clinical problem because of the technical difficulties of surgery. Among the more common causes is radiation of carcinoma...
Original Article
Adjuvant Chemotherapy in “High Risk” Patients after Wertheim Hysterectomy—10-year Survivals
Wertheim radical hysterectomy has today become an accepted method of management of stage IB and early stage IIA cervical carcinoma, particularly in young patients...
Original Article
A Review of Patients with High-risk Carcinoma of the Cervix Treated with Combined Surgery and Postoperative Radiotherapy
It is generally accepted that early stage invasive carcinoma of the cervix, stage I to stage IIA disease, can be treated with equal effectiveness...
Original Article
Outcome of Early Cervical Carcinoma Treated by Wertheim Hysterectomy with Selective Postoperative Radiotherapy
Cancer of the cervix is the fourth most common cancer in females in Singapore after breast, colorectal and lung cancers. It forms 7.8% of...
Editorial
Gynaecologic Oncology—The Next Lap
Cancer of the pelvic reproductive organs and external genitalia accounts for one in six cancers in women. It can occur in women of all...
Original Article
Ambulatory Anorectal Surgery—Is it Feasible Locally?
Economic and social pressures are compelling surgeons to modify their practice. An increasing number of procedures are being done in an outpatient setting.
This article...
Original Article
Survival after Cardiopulmonary Resuscitation in the General Wards—The Results of a Dedicated “Code” Team
Cardiopulmonary resuscitation (CPR) is widely practised for cardiopulmonary arrests with variable success. The initial intention was to defibrillate patients with ventricular fibrillation after acute...
Original Article
Phyllodes Tumour: An Update of 40 Cases
First described by Johannes Muller in 1838 as a large, benign tumour of the breast. Phyllodes tumour is a rare pathological entity, accounting for...
Original Article
The Investigation and Management of Thyroid Nodules—A Retrospective Review of 183 Cases
Thyroid nodule is a common problem in surgical practice. In 1994, more than 350 thyroid operations were performed in our department, of which 183...
Original Article
The Role for Preoperative Localisation Techniques in Surgery for Hyperparathyroidism
Hyperparathyroidism is well recognised as a clinical problem that has a myriad of presentation. The classical presenting symptoms of hypercalcaemia have been well documented...
Others
Medicine and Surgery—History, Change and Challenge
Mr Koh Yong Guan, guest-of-honour; Dr Tan Ser Kiat, Master, Academy of Medicine; Dr K C Tan, Chairman, Chapter of Surgeons; Dr Robert Jalleh...
Others
Haemorrhage into Non-functioning Adrenal Cysts—Report of Two Cases and Review of the Literature
Doran, in 1903, reported the first case of adrenal cyst described by Greiselius in 1670. It was not until 1966 that Foster reported the...
Original Article
Video-assisted Thoracoscopy: Role in the Management of Intrathoracic Pathology
Thoracoscopy was first introduced by Jacobaeus nearly a century ago. With the development of endoscopic equipment and the recent surge of interest in minimally...
Original Article
Focused Abdominal Sonography for Trauma (FAST)
The multiply injured patient presents a challenge to even the most experienced surgeon. These patients often present in shock and require a rapid diagnostic...
Others
Life-threatening Perineal Gangrene from Rectal Perforation Following Colonic Hydrotherapy: A Case Report
Alternative medicine has become widely publicised throughout the world. Alternative medicine practitioners (AMPS), which include Oriental medicine doctors, traditional Chinese medicine practitioners, naturopaths and...
Original Article
Concurrent Chemoradiotherapy in Patients with Locally Advanced Nasopharyngeal Carcinoma of the Undifferentiated Type
Nasopharyngeal carcinoma (NPC) of the undifferentiated type has a unique geographic distribution and is rather different, biologically and aetiologically, from squamous cell cancer of...
Original Article
The Outcome of Trial Off Catheter after Acute Retention of Urine
Acute retention of urine (ARU) is the commonest urological condition requiring emergency admission to hospital and is usually managed by urethral catheterisation. Previously, patients...
Review Article
Diagnosing and Managing Faecal Incontinence
Faecal incontinence is the inability to control the passage of gas, liquid or solid through the anus. Its severity varies from infrequent passage of...
Review Article
Cancer Gene Therapy—Fantasy or Foresight?
Genes define life, at least in its biological sense. The prospect of being able to manipulate human biological processes through genetic engineering understandably evokes...
Original Article
A Preliminary Study of the Immunohistochemical Detection of a Novel Tumour Marker, 22-1-1 Antigen, in Gynaecological Cancer Specimens
Monoclonal antibodies expressed against specific tumour cells can play a useful role in the study and management of such cancers. Such antibodies have been...
Others
3rd Yahya Cohen Lecture: The Role of the Myofibroblast-Like Cell in Hepatocellular Carcinoma—Host Defence?
It is indeed a great honour for me to be named the third Yahya Cohen lecturer and I would like to express my deepest...
Others
1998 Distinguished Academician Lecture: Hepatic Resection— A Western Perspective
Although debridement of portions of liver that prolapsed through war wounds was recorded from distant times, attempts at resection of a solid liver tumour...
Others
1998 Runme Shaw Memorial Lecture: Somatic Evolution of Cancer
The interpretation of cancer as a somatic evolutionary process involving genetic mutation followed by selection, goes back to the early years of this century....
Review Article
Prognostic Factors in Endometrial Carcinoma
In the United States of America, endometrial carcinoma is the most common cancer of the female genital tract and has an annual incidence of...
Original Article
Continuous Infusion 5-fluorouracil as Salvage Chemotherapy in Patients with Advanced Colorectal Cancer
Studies have shown beyond doubt that chemotherapy for metastatic colorectal cancer prolongs survival, impedes progression and stabilises disease. Compared with supportive care alone, it...
Commentary
A Practical Technique of Colour Image Analysis: Applications in Experimental Research
Colour image analysers have been extensively used in medical research since 1970 for histomorphometric studies. Image analysis gives more information and a better understanding...
Commentary
Effect of Antiangiogenic Agents on Experimental Animal Models of Hepatocellular Carcinoma
Metastatic spread is the principal reason of treatment failure in solid tumours. Surgery, radiation therapy and chemotherapy have not manifestly altered the prognosis for...
Review Article
Immunological Consequences of Trauma and Shock
Despite intensive research and intervention, trauma continues to be the leading cause of death during the first three decades of life in the USA,...
Review Article
Murine Metastatic Tumour Models for Cancer Gene Therapy Research
In the evaluation of any new cancer treatment, the use of appropriate experimental animal tumour models to bridge the gap between in vitro discovery...
Original Article
An Animal Model for the Study of Hepatic Stellate Cell and Hepatocellular Carcinoma Interaction
Hepatic stellate cells (HSC) are mesenchymal cells that are prominent in various forms of liver injury, in particular with cirrhosis or carbon tetrachloride-induced fibrosis....
Original Article
Synergistic Effect of Hepatitis B Virus and Aflatoxin B1 in Hepatocarcinogenesis in Tree Shrews
Primary hepatocellular carcinoma (HCC) is one of the commonest cancers in some parts of the world including several areas in China. The geographically distinct...
Original Article
The Expression of Insulin-like Growth Factor II, Hepatitis B Virus X Antigen and p21 in Experimental Hepatocarcinogenesis in Tree Shrews
Hepatocarcinogenesis is a multistage and multifunctional process. Epidemiological studies indicate that contamination of food with aflatoxin B, (AFB,) and chronic infection with hepatitis B...
Original Article
The Viability of Liver Graft for Transplantation After Prolonged Warm Ischaemia
Liver transplantation (LTx) is the treatment of choice for many patients with end stage liver disease. However liver allograft availability prevents its widespread application.
This...
Original Article
Extended Resection of Locally Advanced (T4) Stomach Cancer
Cancer is the most common cause of death in Singapore. Although there is a gradual decline in incidence of stomach cancer over the years,...
Others
Laparoscopic Totally Extraperitoneal Inguinal Hernioplasty: An Audit of the Early Postoperative Results of 100 Consecutive Repairs
Inguinal hernia is one of the commonest surgical pathologies in the world. Laparoscopic totally extraperitoneal repair has been gaining popularity in recent years.
This article...
Others
Design of Phase I and II Clinical Trials in Oncology and Ethical Issues Involved
Drug development is costly and time-consuming in terms of economic, patient and research resources. An integrated effort involving academia, industry, and regulatory authorities is...
Original Article
Perioperative Deaths: A Further Comparative Review of Coroner’s Autopsies with Particular Reference to the Occurrence of Fatal Iatrogenic Injury
Beginning in 1991, the Department of Forensic Medicine (DFM), which undertakes all Coroner’s casework locally, embarked on an on-going review of Coroner’s perioperative autopsies...
Original Article
Spectrum of Abnormal Mammographic Findings and Their Predictive Value for Malignancy in Singaporean Women from a Population Screening Trial
While screening mammography can detect early breast cancers, a significant proportion of asymptomatic women are subject to unnecessary workup and surgery when biopsies for...
Others
Hereditary Breast Cancer: A Brief Overview
Worldwide, breast cancer is the third most common form of cancer, after lung and stomach cancer, and it is the most common form among...
Others
Update of Genetics in Colorectal Carcinomas: Genomic Instability and Somatic Evolution
The hypothesis that carcinogenesis occurs through stepwise accumulation of mutations1 has now been generally accepted. However, there is continual dispute over how carcinogenesis can...
Original Article
Microdochectomy for Single-duct Nipple Discharge
Nipple discharge is a common disturbing symptom for many women and often leads to a surgical referral. It accounts for 3% to 5% of...
Original Article
Perioperative and Rehabilitative Outcomes after Amputation for Ischaemic Leg Gangrene
In the last century, Sir William Ferguson said: “amputation—one of the meanest and yet one of the greatest operations in surgery: mean, where resorted...
Original Article
Adverse Operative Risk Factors for Perforated Peptic Ulcer
Although there has been a significant decline in elective surgery for peptic ulcer disease with the introduction of H-2 blocker, the incidence of peptic...
Others
10th Chapter of Surgeons’ Lecture: The Challenges in Surgery—Past, Present and Future, and in Search of the 4Cs
Firstly may I thank the Academy of Medicine and the Chapter of Surgeons for giving me this great privilege and honour to deliver the...
Others
Pseudomembranous Colitis in a Patient Treated with Paclitaxel for Carcinoma of the Breast: A Case Report
Paclitaxel was discovered in 1963 as a crude extract from the bark of the pacific yew Taxus brevifolia. Since its development, a range of...
Others
Early Hepatocellular Carcinoma Presenting with Biliary Ductal Invasion—A Case Report
Hepatocellular carcinoma (HCC) is a common malignant tumour worldwide. The local incidence of HCC is 40 per 100,000 in males and 20 per 100,000...
Original Article
Survival of Colorectal Cancer Patients in Singapore by Anatomic Subsite: A Population-based Study
Colorectal cancer incidence rates rank second in most developed countries and have been rising rapidly in urban societies of East Asia. Despite much effort...
Original Article
Results of Surgical Resection of Oesophageal Carcinoma in Singapore
Although the incidence of oesophageal carcinoma is declining, it still remains a common cancer in Singapore. From 1988 to 1992, it was the ninth...
Others
Pathology of Ductal Carcinoma In situ of the Breast: A Heterogeneous Entity in Need of Greater Understanding
Breast cancer is the commonest malignancy in Singapore women, with an age-standardised rate of 46.1 per 100,000 per year and an annual increase in...
Others
Two Cases of Medullary Thyroid Carcinoma
A 44-year-old Indian man was found to have a raised carcinoembryonic antigen (CEA) (49.5 μg/L) detected on routine medical examination in February 2000....
Others
Case Report: Follicular Adenoma in a Thyroglossal Duct Remnant Arising Entirely within the Hyoid Bone
Thyroglossal duct remnant is one of the most common lesions of the anterior midline neck. It occurs in 7% of adults1 and carcinoma is...
Original Article
Digital Hand-held Sonography Utilised for the Focused Assessment with Sonography for Trauma: A Pilot Study
On a global basis, the use of ultrasonography to assist clinicians in obtaining timely diagnoses in abdominal trauma is not particularly new. The first...
Original Article
The Alvarado Score and Acute Appendicitis
Acute appendicitis is a common surgical emergency. However, it is often difficult to make an accurate preoperative diagnosis, especially during the early stage of...
Review Article
Intra-abdominal Hypertension—Implications for the Intensive Care Physician
Although the detrimental effects of raised intra-abdominal pressure have been known for over 100 years, it is only in the last two decades that...
Review Article
Quality of Life in Long-Term Survivors of Intensive Care
Intensive care has undergone rapid technological advancement in recent years enabling complex treatment of patients of advanced age and/or with advanced chronic diseases underlying...
Review Article
Limitation of Life Support in the Critically Ill: The Hong Kong Perspective
Technological advances over the last 30 years have had an enormous impact on the way in which medicine is delivered today. This is particularly...
Original Article
Perioperative Treatment with Bactericidal/Permeability-Increasing Protein (rBPI21) in Major Liver Surgery: A Concise Summary
Primary and secondary hepatic malignancies constitute a major health problem. Hepatocellular carcinoma accounts for 90% of all primary hepatic malignancies in the world. While...
Others
Mucinous Cystadenoma of the Appendix—An Unusual Cause of Intestinal Obstruction
Mucinous cystadenoma of the vermiform appendix is an uncommon entity. It is a benign lesion but may disseminate and lead to the development of...
Others
Primary Anorectal Malignant Melanoma: Clinical Features and Results of Surgical Therapy in Singapore—A Case Series
Malignant melanoma arising from the anal canal was first described in 1857. It is uncommon, comprising only about 1% of all anal canal tumours.
This...
Others
A Case of Alpha-Fetoprotein-Producing Gastric Cancer
A 57-year-old accountant presented to her doctors in a neighbouring country in early October 1998 with problems of easy bruising, bleeding gums, one single...
Others
Case Report: Acute Tumour Lysis Syndrome
Acute tumour lysis syndrome (ATLS) is one of the most urgent of all oncological treatment-related complications. It has a broad impact on organ dysfunction,...
Original Article
A Prospective Evaluation of Surgeon Performed Sonography as a Screening Test in Blunt Abdominal Trauma
Over the past decade, sonography as a screening tool in the evaluation of abdominal trauma has been thoroughly investigated. This modality was first used...
Editorial
Stapled Haemorrhoidectomy—The Evidence For and the Facts Against
Surgeons as well as patients have recently shown much interest in stapled haemorrhoidectomy. This is a new technique, which is claimed to result in...
Others
12th Chapter of Surgeons Lecture: Shifting Paradigms in the Management of Breast Cancer—A Surgical Perspective
The recorded history of breast cancer management spans four millennia. This story about breast cancer management is also one about change, about resistance to...
Others
Double Omental Hernia—Case Report on a Very Rare Cause of Intestinal Obstruction
Internal hernia is defined as the protrusion of a viscus through a normal or abnormal opening within the confines of the abdominal cavity. This...
Review Article
CerbB2 Status in Breast Cancer: Pathologic Issues
The cerbB2 gene, also known as Her2/neu, encodes a transmembrane cell receptor with tyrosine kinase activity and epidermal growth factor receptor homology. All normal...
Original Article
Cancer Incidence in Singapore, 1998 to 1999
The Singapore Cancer Registry has been monitoring the trends in cancer incidence since 1968. It publishes 5-yearly incidence figures for the periods 1968-1972, 1973-1977,...
Original Article
Efficacy and Tolerability of Irinotecan in Patients with Advanced Colorectal Cancer in Singapore
Colorectal cancer is the second most commonly encountered malignancy in the developed countries; in Singapore, it is the commonest cancer. With early detection, patients...
Original Article
A Twelve-year Review of Radical Cystectomies in Singapore General Hospital
Bladder carcinoma is the tenth most common cancer affecting men in Singapore. It is more common in men with an age-standardised incidence rate of...
Original Article
Problems Related to Epidural Analgesia for Postoperative Pain Control
Epidural analgesia has been shown to provide excellent pain relief following thoracotomy, abdominal and other surgery. Studies have shown improvement in specific variables with...
Original Article
Audit of Total Parenteral Nutrition in an Adult Surgical Intensive Care
Total parenteral nutrition (TPN) may contribute to good outcome in selected groups of patients. Parenteral nutrition is highly effective in reversing effects attributable to...
Original Article
The Mastectomy Clinical Pathway: What Has It Achieved?
In an era of increasing healthcare cost and scarce resources, the tension between the cost and quality of healthcare demands not only effective but...
Others
Agreement or Prediction: Asking and Answering the Right Question
In an article published in this journal, Chia discusses the difference between measuring association and agreement. In this paper, we extend the discussion to...
Original Article
Preliminary Experience in Radionuclide Therapy of Hepatocellular Carcinoma Using Hepatic Intra-arterial Radio-conjugates
Hepatocellular carcinoma (HCC) is a common malignancy worldwide. In Singapore, the age-standardised incidence rate is 18.9 per 100,000 per year.
This article is available only...
Review Article
Current Status in the Surgical Management of Adult Polycystic Liver Disease
Adult polycystic liver disease (APLD) is a rare benign condition that is characterised by the growth of multiple cystic lesions in the liver. More...
Original Article
Paediatric Extracranial Germ Cell Tumours: A Retrospective Review
Germ cell tumours (GCTs) in children account for 2% to 3% of childhood malignancies. They arise from primordial germ cells and constitute a heterogeneous...
Original Article
Two-year Outcome of Normal-birth-weight Infants Admitted to a Singapore Neonatal Intensive Care Unit
With the rapid advances in the field of neonatal intensive care, the focus of interest has been on the very-low-birthweight (VLBW) infant in recent...
Original Article
Emergency Laparoscopic Surgery—The Changi General Hospital Experience
Today, laparoscopic surgery has achieved widespread acceptance among surgeons as well as the general public. Emergency laparoscopic procedures (ELPs) have been performed since the...
Original Article
Surgical Management and Outcome of Carotid Body Tumours
The carotid body was first described by von Haller in 1743. It is often a small ovoid or irregular mass composed of compact pinkish...
Letter to the Editor
Re: 188Rhenium-TDD-Lipiodol in Treatment of Inoperable Primary Hepatocellular Carcinoma—A Case Report
Hepatocellular carcinoma (HCC) is a common malignancy that is best treated by surgery. However, in the vast majority, surgery is not possible and alternative...
Original Article
Hepatolithiasis —A Case Series
Intrahepatic biliary stone or hepatolithiasis is an uncommon entity worldwide, with a higher incidence in East Asia in comparison to the West. As yet,...
Others
Acute Embolic Occlusion of the Superior Mesenteric Artery: A Case Report and Discussion of Management
Acute ischaemia of the bowel is a devastating condition. Recently published figures on mortality range from 30% to 60%.
This article is available only as...
Others
Bowel Surgery for Epithelial Ovarian Cancer – An Early Case Series
Epithelial ovarian cancer is the leading cause of death in patients with gynaecological malignancies in Singapore and developed countries, the main reason being the...
Others
Carcinoma of the Cervix: Role of MR Imaging
In females with cancer, cervical carcinoma is second to breast cancer in both incidence and mortality worldwide. About 465,000 new cases are diagnosed each...
Review Article
Radionuclide Therapy of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is a common malignancy worldwide. It is a major cause of death from cancer in East Asia, especially China, Japan, Korea,...
Original Article
Non-consensual Double Reading in the Singapore Breast Screening Project: Benefits and Limitations
Double reading of mammogram is not the standard practice in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). Rather, single reading of...
Original Article
Measuring Quality of Life in Chinese Cancer Patients: A New Version of the Functional Living Index for Cancer (Chinese)
Health-related quality of life (QOL) is recognised as an important aspect of patient care. In oncology studies, it may stand as the primary end-point....
Review Article
The Molecular Biology of Peritoneal Carcinomatosis from Gastrointestinal Cancer
The term “peritoneal carcinomatosis” was first used by Sampson in 1931 to describe the intra-abdominal spread of ovarian carcinoma. Although ovarian cancers account for...
Review Article
Colorectal Hepatic Metastases: Role of Radiofrequency Ablation
Colorectal cancer is the second most common cancer in Singapore, accounting for 15.9% of all cancers registered with the Singapore Cancer Registry in the...
Review Article
Neoadjuvant Chemotherapy in the Management of Colorectal Metastases: A Review of the Literature
Colorectal cancer accounts for the most number of deaths after lung cancer, both in the West as well as locally in Singapore. Liver is...
Original Article
Computed Tomographic Appearance of Colorectal Hepatic Metastases
It is important to recognise the computed tomography (CT) appearance of hepatic metastases from colorectal primaries, as resection in a selected group may offer...
Review Article
Current Status in Imaging of Colorectal Liver Metastases
Colorectal cancer is a common primary that metastasizes to the liver. About 20% of patients with colorectal cancer will have detectable metastases at the...
Review Article
Current Concepts of Tumour Metastasis
Tumour metastasis, or the spread of cancer cells from a primary tumour to distant sites, remains the principal cause of treatment failure and poor...
Review Article
Chemoprevention of Colorectal Cancer – Experimental Approach and Clinical Applications
The age-old adage of “Prevention is Better than Cure” is still very relevant in today’s practice of medicine. Many randomised population trials have already...
Review Article
Practical Issues in Adjuvant Therapy for Rectal Cancer
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Total Mesorectal Excision (TME) – Twenty Years On
In 1982, Heald et al1 at the Basingstoke District General Hospital introduced the concept of total mesorectal excision (TME) as a means of performing...
Original Article
Flat and Depressed Lesions of the Colon and Rectum: Pathogenesis and Clinical Management
It was previously thought that the vast majority of colorectal cancers were derived from polypoid adenomas. However, several investigators have noted that most colorectal...
Others
Surgical Management of Colorectal Metastases to the Liver
Colorectal carcinoma is the second commonest cancer in both males and females in Singapore, accounting for about 15% of all cancer cases. The liver...
Editorial
Recent Advances in the Total Management of Colorectal Cancer
Considerable improvements in the survival and outcome of colorectal carcinoma have been made in recent years. These have been the result of advances in...
Others
Unusual Case of Bowel Infarction with Invasive Aspergillus in an Immunocompromised Patient
The role of neoadjuvant chemotherapy for locally advanced breast cancer has been established and there has been a growing interest in its role in...
Original Article
Adolescent Admissions to a Tertiary Paediatric Hospital: A Dynamic Pattern
The nature of paediatric practice is changing worldwide. In developing countries, infant mortality from infectious diseases continues to fall with improved immunisation, medical care...
Others
Inflammatory Fibroid Polyp of the Caecum in a Patient with Neurofibromatosis
Inflammatory fibroid polyp is an uncommon nonneoplastic lesion found in the gastrointestinal tract. It is a benign, non-encapsulated submucosal lesion, composed mainly of loose...
Others
15th Chapter of Surgeons Lecture: Surgeon of the New Millennium – Surgeon, Scientist and Scholar
Next year, we celebrate a hundred years of medical education in Singapore. We have come a long way since 1821 – from a small,...
Others
Littoral Cell Angioma of the Spleen
The littoral cells line the vascular channels of the red pulp of the spleen and have characteristics of endothelial and histiocytic cells. In 1991,...
Original Article
The HercepTest and Routine C-erbB2 Immunohistochemistry in Breast Cancer: Any Difference?
The proto-oncogene c-erbB2 (also known as HER2/neu) is located on chromosome 17q21 and encodes a 185-kD transmembrane glycoprotein. It belongs to the human epidermal...
Others
An Unusual Cause of Pulmonary Haemorrhage in a Patient with Rheumatoid Arthritis
Strongyloides stercoralis is an intestinal nematode which causes a chronic but usually asymptomatic infection in humans. However, in immunocompromised patients, parasitic larvae can develop...
Others
A Case of Metastatic Squamous Cell Carcinoma of the Hypopharynx Manifesting as Acute Abdomen
T, a 23-year-old female, was previously well until November 2000 when she presented with 1-year history of sore throat associated with neck lumps for...
Others
A Case of Maffucci’s Syndrome With Pleural Effusion: Ten-year Follow-up
A 23-year-old male patient was admitted to Ataturk Chest Disease Hospital with non-productive cough, dyspnoea, chest pain and back pain. These complaints had begun...
Others
Clinical Indications for Positron Emission Tomography (PET) Scanning
The purpose of these guidelines is to provide a broad framework for clinicians considering the use of positron emission tomography (PET) scanning for their...
Editorial
Positron Emission Tomography – A Vital Component of Molecular Imaging
Contemporary medical imaging is progressing towards quantification of tissue function in addition to merely providing anatomical information, as illustrated by the rising use of...
Others
Two Case Reports of Metastases from Colon Carcinoma to the Thyroid
Metastases to the thyroid are not as rare as previously believed and have been shown, in autopsy series, to be more common than primary...
Original Article
Trends in Cancer Incidence Among Singapore Malays: A Low-risk Population
Cancer is now one of the most common causes of death in the world. Inspection of changes in cancer incidence in ethnically or geographically...
Original Article
Image-guided Radiofrequency Ablation of Liver Malignancies: Experience at Singapore General Hospital
Radiofrequency (RF) ablation for the treatment of focal liver malignancies is a relatively new image-guided procedure that is gaining increasing acceptance in the radiologic...
Original Article
Detection and Quantification of the Abelson Tyrosine Kinase Domains of the bcr-abl Gene Translocation in Chronic Myeloid Leukaemia Using Genomic Quantitative Real-time Polymerase Chain Reaction
Chronic myeloid leukaemia (CML) is a clonal stem cell malignancy characterised by massive proliferation of mature and immature granulocytes, basophils and spleen cells, but...
Review Article
The Feminist Approach in the Decision-making Process for Treatment of Women With Breast Cancer
The ethical theories employed in healthcare today generally assume a modern Western philosophical framework, which is applied to many issues such as abortion, euthanasia,...
Others
Cutaneous and Subcutaneous Metastases of Adenocarcinoma of the Colon and Rectum
Cutaneous metastasis from colorectal adenocarcinoma is an interesting condition not only because of its rarity, it occurs in less than 4% of patients with...
Original Article
Infected Pancreatic Necrosis – An Evaluation of the Timing and Technique of Necrosectomy in a Southeast Asian Population
The management of necrotising pancreatitis has improved significantly over the last 2 decades, with a corresponding improvement in mortality rates. This improvement is largely...
Others
Complications Relating to Intravenous Buprenorphine Abuse: A Single Institution Case Series
Buprenorphine, more commonly known as Subutex (Reckitt Benckiser Pharmaceuticals), has been released in Singapore since 2002. Initially marketed as an opiate substitute to help...
Others
Postirradiation Sarcoma of the Sphenoid Bone – A Case Report
Radiation-associated tumours of the temporal and maxillary bone have been reported in patients treated with radiotherapy for nasopharyngeal carcinoma. There was no previously reported...
Original Article
Phase II Trial of Gemcitabine and Cisplatin Sequentially Administered in Asian Patients With Unresectable or Metastatic Non-small Cell Lung Cancer
Lung cancer is the most common cause of cancer-related death worldwide. It ranks first among males and third among females in the incidence of...
Others
Neuro-developmental Deficits in Early-treated Congenital Hypothyroidism
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
Neonatal Hepatic Abscess in Preterm Infants: A Rare Entity
Liver abscess has been recognised since the time of Hippocrates. The first report on liver abscess was published by Bright in 1836.1 However, reports...
Others
False Positive F-18 Fluorodeoxyglucose Combined PET/CT Scans from Suture Granuloma and Chronic Inflammation: Report of Two Cases and Review of Literature
Postoperative surveillance for recurrence after curative colorectal cancer surgery has been enhanced with the use of F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/computed...
Original Article
Implementation and Evaluation by Formal Assessments and Term End Student Feedback of a New Methodology of Clinical Teaching in Surgery in Small Group Sessions
In clinically-oriented subjects such as surgery, specific guidelines for conducting small group teachings are lacking. Different methods are being practiced and researched in different...
Images in Medicine
Putting Together Lesions in the Brain, Retina, Kidney and Pancreas
A 40-year-old Malay lady presented with a 6-month history of headache. She had a past history of a left nephrectomy 6 years ago.
This article...
Letter to the Editor
Successful Management of an Iatrogenically-ingested Sharp Foreign Body
A 37-year-old man with no significant medical history underwent dental treatment. An injection dental needle used in the course of root canal treatment came...
Letter to the Editor
Assessment of Medical Graduates Competencies
Medical professional proficiency comprises a set of skills, knowledge, and attitudes necessary to efficiently accomplish the practice of medicine. The major aim of undergraduate...
Letter to the Editor
Tuberculosis Masquerading as Recurrent Metastatic Carcinoma of the Cervix
The incidences of certain malignancies are increasing and are major causes of mortality. Diagnosis can be difficult and delayed.
This article is available only as...
Review Article
Association of Epstein-Barr Virus with Nasopharyngeal Carcinoma and Current Status of Development of Cancer-derived Cell Lines
Although nasopharyngeal carcinoma (NPC) has been reported in almost all parts of the world, most cases of NPC are found in South East Asia,...
Original Article
Laparoscopic-assisted Colon and Rectal Surgery – Lessons Learnt from Early Experience
Great strides in laparoscopic surgical techniques have been progressively made throughout the various surgical subspecialties. More procedures can be performed laparoscopically today than when...
Original Article
Contemporary Results of Endopyelotomy for Ureteropelvic Junction Obstruction
Ureteropelvic junction obstruction (UPJO) results in the gradual dilatation of the renal collecting system, and may lead to deterioration of renal function and pain....
Letter to the Editor
Massive Retroperitoneal Adrenal Haemorrhage as the First Manifestation of a Lung Cancer
A 74-year-old man was admitted with sudden onset of right upper quadrant abdominal pain radiating towards right shoulder and right thigh. Pain was aggravated...
Others
4th FY Khoo Memorial Lecture 2008: Nasopharyngeal Cancer Workgroup – The Past, The Present and The Future
Thank you Madam Chairman. First, I would like to thank the Singapore Radiological Society and the College of Radiologists, Academy of Medicine Singapore for...
Original Article
Phase II Trial of Gemcitabine in Combination with Cisplatin in Inoperable or Advanced Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) has a high incidence rate in Asia. In Singapore, it is the third most common cancer amongst males, and constituted 8%...
Letter to the Editor
Pancreas-only Metastasis from Nasopharyngeal Carcinoma
A 51-year-old Chinese man presented with a 3 month’s history of left cervical lymphadenopathy, rhinorrhoea, tinnitus and nasal congestion. On nasopharyngoscopy, a fungating mass...
Original Article
Induction Concurrent Chemoradiotherapy Using Paclitaxel and Carboplatin Combination Followed by Surgery in Locoregionally Advanced Non-Small Cell Lung Cancer – Asian Experience
Lung cancer is the leading cause of cancer mortality in Singapore. The age standardised incidence rate is 45 per 100,000/year.
This article is available only...
Original Article
Clinical Evaluation of Arthroscopic-assisted Allograft Meniscal Transplantation
The menisci of the knee are fibro-cartilaginous structures essential for the normal biomechanic of the knee joint. They play a critical role in shock...
Letter to the Editor
Advanced Burkitt’s Lymphoma Presenting With Jejunal Perforation
Burkitt’s lymphoma (BL) is a high grade B-cell neoplasm under the umbrella of non-Hodgkin’s lymphomas. It is predominantly seen in children but may also...
Letter to the Editor
Successful Surgical Treatment of Renal Cell Carcinoma With Calvarial Metastases
Renal cell cancer (RCC) accounts for 3% of all cancers. Isolated haematuria or pain is the most common form of presentation.
This article is available...
Others
Angioplasty in Critical Limb Ischaemia: One-year Limb Salvage Results
Critical limb ischaemia (CLI) is the most severe form of peripheral vascular disease where there is inadequate blood flow to a limb to maintain...
Original Article
The Toxicity and Outcomes of Continuous 5-fluorouracil/Cisplatin-based Chemotherapy Followed by Chemoradiation in Patients with Resected High-risk Gastric Cancer: Results of a Single Institute
Gastric carcinoma is the second most common cause of cancer mortality worldwide. Surgery is the only curative therapy, although 5-year survival rates remain poor...
Original Article
Charity Colonoscopy Event to Commemorate the 185th Anniversary of Singapore General Hospital
Colorectal cancer is now the cancer with the highest incidence in Singapore. Similar to many developed countries, individuals here have a moderate to high...
Original Article
Pattern and Outcome of Subsidised Referrals to Cardiology Specialist Outpatient Clinics
Singapore faces an increasing demand for public healthcare from an ageing population in need of chronic care. At our cardiology specialist outpatient clinics, the...
Original Article
Local Experience of Endorectal Magnetic Resonance Imaging of Prostate with Correlation to Radical Prostatectomy Specimens
Prostate cancer ranks among the top 10 cancers in Singapore. The incidence of prostate cancer has risen by 5% to 118% in most Asian...
Original Article
MMP-2, TIMP-2 and CD44v6 Expression in Non-small-cell Lung Carcinomas
Studies have provided data that matrix metalloproteinases (MMPs) facilitate tumour invasion, the establishment of metastases. On the other hand, matrix metalloproteinase inhibitors have been...
Original Article
Measuring the Quality of Care of Diabetic Patients at the Specialist Outpatient Clinics in Public Hospitals in Singapore
Singapore is a country with a high prevalence of diabetes mellitus, 1 8.2% amongst its population aged between 18 and 69 years,2 and is...
Others
The Role of Electrophysiology in the Diagnosis and Management of Cervical Spondylotic Myelopathy
Cervical spondylosis is an extremely common condition managed by both physicians and surgeons in daily clinical practice. Cervical spondylotic myelopathy (CSM), resulting from longstanding...
Review Article
The Role of Surgery in High-grade Glioma – Is Surgical Resection Justified? A Review of the Current Knowledge
High-grade glioma (malignant glioma) is the most common primary intra-axial tumour of the central nervous system (CNS). Despite recent therapeutic advances in glioma treatment,...
Original Article
Epidemiology, Management and Treatment Outcome of Medulloblastoma in Singapore
Medulloblastoma (MBL) is the most common type of malignant brain tumour in childhood. It belongs to the group of tumours known as primitive neuroectodermal...
Original Article
Noninvasive follicular thyroid neoplasm with papillary-like nuclear features and the risk of malignancy in thyroid cytology: Data from Singapore
As only 5–10% of thyroid nodules harbour malignancy, fine-needle aspiration (FNA) is important in triaging nodules requiring surgical excision from nodules that may be...
Original Article
Multimodal prehabilitation before major abdominal surgery: A retrospective study
Ageing is one of the biggest public health concerns of the 21st century, presenting a challenge to the practice of medicine globally. As the...
Original Article
Characteristics of unplanned hospitalisations among cancer patients in Singapore
Cancer is a pervasive global problem with growing healthcare utilisation and costs.1-3 This situation is similar in Singapore where cancer incidence is on the...
Editorial
The case for better hospitalisation selection in cancer patients
Public hospital occupancy rates and resource utilisation in Singapore are perennially high. In the last 2 years of the COVID-19 pandemic, there has been...
Original Article
The Effect of Temperature on Illness Severity in Emergency Department Congestive Heart Failure Patients
Congestive heart failure (CHF) is one of the leading causes of morbidity and mortality around the world. It is estimated that more than 5...
Original Article
Retinoblastoma: A Recent Experience at the National University Hospital, Singapore
Retinoblastoma is the most common primary intraocular malignancy in infants and children.1 Worldwide, the incidence is 1 in 18,000 to 34,000 live births with...
Original Article
Outcomes of Oral Tongue Cancer: Does Age Matter?
Oral cancer (including oral cavity and oropharynx) is the eighth most common cancer worldwide with oral cavity cancer among the 3 most common malignancies...
Original Article
Multi-disease Health Screening in an Urban Low-income Setting: A Community-based Study
With the burden of chronic disease rising amongst rapidly urbanising Asian populations, active participation in health screening would allow for early detection and management...
Review Article
Development of a Diabetes Registry to Improve Quality of Care in the National Healthcare Group in Singapore
In the last decade, the use of electronic medical records (EMR) has been widely recommended as a method for reducing errors, improving the quality...
Others
Hepatocellular Carcinoma Peritoneal Metastases: Report of Three Cases and Collective Review of the Literature
Peritoneal dissemination of hepatocellular carcinoma (HCC) is a rare presentation, with an incidence of 2% to 6% detected during autopsy or laparoscopy. Although uncommon,...
Review Article
Colorectal Cancer Liver Metastases – Understanding the Differences in the Management of Synchronous and Metachronous Disease
Colorectal cancer (CRC) is one of the commonest cancers worldwide with age standardised incidence rates of 22.8 to 64.2 and 19.0 to 46.7 per...
Original Article
Surgical Metastasectomy in AJCC Stage IV M1c Melanoma Patients with Gastrointestinal and Liver Metastases
The prognosis of patients with stage IV melanoma or recurrent melanoma is poor with an estimated median survival period of 6 months. The recent...
Letter to the Editor
Coexistence of Unicentric Castleman’s Disease and Locally Advanced Papillary Renal Cell Carcinoma: More Than a Coincidental Association?
Castleman’s disease (CD) is an enigmatic lymphoproliferative disorder due to its rarity, uncertain aetiopathogenesis and heterogeneous clinicopathologic forms. This case report presents an unusual...
Letter to the Editor
Management of Thrombotic Thrombocytopenic Purpura in Metastatic Prostate Cancer with only Endocrine Therapy
Thrombotic thrombocytopenic purpura (TTP) is a systemic disorder that presents acutely with multiple organ failure. Although defined classically as a syndrome with a pentad...
Original Article
Are New Resuscitation Guidelines Better? Experience of an Asian Metropolitan Hospital
Out-of-hospital cardiac arrest (OHCA) is a substantial public health burden that has poor prognosis. Patients who receive “good” and “high-quality” cardio-pulmonary resuscitation (CPR) have...
Original Article
Phosph-Akt1 Expression is Associated with a Favourable Prognosis in Pancreatic Cancer
Pancreatic cancer is the fourth leading cause of cancer related mortality worldwide with an estimated 34,290 deaths recorded in the United States in 2008....
Letter to the Editor
Emergency Surgery for a Ruptured Intra-abdominal Desmoid Tumour
Desmoid tumours are fibrous benign tumours that are often indolent until local symptoms evolve. We highlight a rare case of a ruptured intra-abdominal desmoid...
Original Article
Prospective Audit of Febrile Neutropenia Management at a Tertiary University Hospital in Singapore
Febrile neutropenia (FN) is considered a medical emergency and remains a major cause of morbidity and mortality in Oncology and Haematology units worldwide. A...
Original Article
An Audit Study of the Sensitivity and Specificity of Ultrasound, Fine Needle Aspiration Cytology and Frozen Section in the Evaluation of Thyroid Malignancies in a Tertiary Institution
Thyroid lesions constitute a considerable bulk of surgical practice, majority of which are thyroid nodules. A large population study revealed that clinically apparent thyroid...
Original Article
Development of Bariatric Surgery: The Effectiveness of a Multi-disciplinary Weight Management Programme in Hong Kong
Obesity is one of the most common chronic illnesses in the Western World with a frequency of 10% to 15%. It causes or exacerbates...
Original Article
Complementary and Alternative Medicine among Singapore Cancer Patients
Worldwide, the use of Complementary and Alternative Medicine (CAM) by cancer patients is highly prevalent. For cancer specialists, knowledge on CAM use in their...
Original Article
rTSβ as a Novel 5-fluorouracil Resistance Marker of Colorectal Cancer: A Preliminary Study
Although colorectal cancer is common in Western countries, in the past, it has been uncommon in Asian countries. However, its prevalence has gradually been...
Letter to the Editor
Dilemmas in Management of Brain Tumours in Pregnancy
Brain tumours in pregnancy are rare with an incidence of 15 per 100,000 and previous reports have shown variable outcomes. We present a case...
Review Article
Peritoneal-based Malignancies and Their Treatment
Peritonectomy or cytoreductive surgery has been described as the treatment of choice for selected patients with evidence of peritoneal carcinomatosis (PC) from the gastrointestinal...
Original Article
Immunophenotypic, Cytogenetic and Clinical Features of 113 Acute Lymphoblastic Leukaemia Patients in China
Acute lymphoblastic leukaemia (ALL) is a heterogeneous disease with abnormal proliferation and accumulation of immature lymphoblasts within the bone marrow (BM), peripheral blood and...
Original Article
Validation of the Paediatric Hearing Impairment Caregiver Experience (PHICE) Questionnaire
The stress experienced by parents of children with hearing impairment (HI) has been studied over the past 2 decades. Increased parenting stress is often...
Original Article
A Comparison of the Short-term Morbidity and Mortality Between Late Preterm and Term Newborns
Late preterm infants are defined as those who are born between the gestational age (GA) from 34 weeks and 0/7 days through 36 weeks...
Images in Medicine
Lower limb nodules
A 45-year-old Chinese woman with no medical history or regular medications presented with painful nodules on her left shin that progressed to involve her...
Images in Medicine
A pedunculated mass of the thigh
A 61-year-old Chinese woman presented to the general surgery clinic for a long-standing lump over her proximal medial right thigh. The painless lump was...
Letter to the Editor
Managing buccal space tumours
Dear Editor,
The buccal space is an infrequently addressed fascial space of the head and neck region. Intrinsic tumours of the buccal space are...
Letter to the Editor
Acute Marjolin’s Ulcer: A Forgotten Entity
Marjolin’s ulcers are malignancies that arise from areas of chronic irritation or injury that undergo malignant transformation after a period of many years. Such...
Original Article
Kidney Cancer and Diabetes Mellitus: A Population-Based Case-Control Study in Taiwan
Kidney cancer accounts for 3% to 4% of all cancers. In a systematic review by Mathew and et al,2 the incidence of kidney cancer...
Images in Medicine
A 22-year-old Woman Had a Lung Mass
A 22-year-old woman had an abnormal chest X-ray (Fig. 1) in her regular health examination. She was asymptomatic and a non-smoker. Chest computed tomography...
Letter to the Editor
Bilateral Polychromatic Crystalline Keratopathy as the Initial Manifestation of IgG-Lambda Multiple Myeloma
Dear Editor,
Multiple myeloma is a subgroup of plasma cell dyscrasias with neoplastic proliferation of plasma cells or their precursors. Crystalline keratopathy is a well-recognised...
Commentary
200 years of surgery at the General Hospital, Singapore
Western medicine in Singapore began with Sir Stamford Raffles’ arrival on 28 January 1819 with a sub-assistant surgeon, Dr Thomas Prendergast, providing medical care...
Letter to the Editor
Low-Grade Fibromyxoid Sarcoma of the Thyroid: A Case Report
Dear Editor,
Low-grade fibromyxoid sarcoma (LGFMS) is a rare form of neoplasm that usually occurs in the deep soft tissue of the lower limbs with...
Letter to the Editor
Five Patients with Medullary Thyroid Carcinoma Presenting as Asymptomatic Elevation of Carcinoembryonic Antigen Level
Early detection of malignancies is not easy. Few methods of health screening have been proven to be of value. The use of carcinoembryonic antigen...
Editorial
Too Much Medicine: Time to Stop Indiscriminate Cancer Screening
Like most industrialised countries in the world, cancer has now become the leading cause of mortality in Singapore. Approximately 1 in 3 deaths in...
Original Article
Assessment of Age in Ulcerative Colitis Patients with Ileal Pouch Creation—An Evaluation of Outcomes
A total proctocolectomy is considered the standard of care in patients with ulcerative colitis (UC). The indications for this operation in patients with UC...
Review Article
Does pulmonary metastasectomy of colorectal metastases translate to better survival? A systematic review
Colorectal cancer (CRC) is the one of most common cancers worldwide. Metastatic disease occurs in approximately half of all CRC patients, in either synchronous...
Original Article
Evolution and trends in the adoption of laparoscopic liver resection in Singapore: Analysis of 300 cases
Over the past few decades, the introduction of laparoscopic surgery has been the biggest game changer in abdominal surgery.1 However, although the first laparoscopic...
Editorial
Laparoscopic liver resection: Global diffusion and learning curve
Laparoscopic liver resection (LLR) is being utilised with increasing frequency worldwide, as initial concerns about the safety and feasibility of LLR, such as the...
Commentary
Prehabilitation and Its Role in Geriatric Surgery
The population in Singapore is ageing rapidly. According to statistics, by 2030, 1 in 2 adults in Singapore will be >65 years old. As...
Original Article
New-onset cardiovascular risk factors following liver transplantation: A cohort analysis in Singapore
Malnutrition is well described in liver cirrhosis. The hyperdynamic circulation and altered metabolism in cirrhosis result in a hypercatabolic state which accelerates tissue breakdown....
Original Article
Outcomes of oesophageal cancer treated with neoadjuvant compared with definitive chemoradiotherapy
Oesophageal cancer is the 7th most common cancer in the world, with 572,034 new cases diagnosed in 2018, and is the 6th most common...
Letter to the Editor
Congenital adhesion band causing recurrent subacute intestinal obstruction in a virgin abdomen
Intestinal obstruction (IO) caused by malignancy and adhesion bands from previous surgery is common among adults. However, IO caused by congenital adhesion bands (CAB)...
Review Article
Endovenous cyanoacrylate ablation for chronic venous insufficiency and varicose veins among Asians
In the past 2 decades, the management of chronic venous insufficiency (CVI) has been revolutionised by the introduction of minimally invasive endovenous techniques, which...
Editorial
Transcatheter Aortic Valve Implantation in Singapore: Reflecting on the First Decade
Transcatheter aortic valve implantation (TAVI) has markedly changed the way aortic valve stenosis is treated. It is 18 years since the first patient was...
Letter to the Editor
Circulatory collapse from rupture of splenic artery aneurysm: A case study
Splenic artery aneurysms (SAAs) are uncommon and often asymptomatic. However, ruptured SAAs can be rapidly fatal. We reviewed the literature on SAAs and highlighted...
Letter to the Editor
Penile preserving surgery in penile cancer management
Penile cancer is a condition that accounts for approximately 0.4% of cancers among Singapore males. Overall, this is an uncommon cancer with higher rates...