Singap Med J
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Case Reports
Giant cell arteritis causing bilateral sequential anterior ischaemic optic neuropathy--a case report.
Giant cell arteritis is a chronic granulomatous inflammation of unknown aetiology involving large and medium size arteries in the elderly. It causes acute visual loss from ischaemia to the optic nerves or central retinal artery occlusion. ⋯ She was treated with intravenous steroids immediately. Diagnosis was based on histopathological studies of temporal artery biopsies.
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This paper attempts to determine the appropriate surgical procedure in relation to the pathological types of adenocarcinoma of the gastro-oesophageal junction in Singapore. ⋯ Although gastro-oesophageal cancer presents late, it can be resected safely by extended total gastrectomy for Types II and III disease and oesophagectomy for Type I disease, taking precautions to minimise anastomotic leakage. Although usually palliative, Stages I and II and to a lesser extent Stage III, are curable by these surgical procedures which ensure a tumour free surgical margin and adequate lymphadenectomy.
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The development of a pleural effusion in a patient with a known malignancy often raises the possibility that the effusion is due to malignant involvement of the pleura. Accurate diagnosis of the cause of the pleural effusion in such a patient is essential as the treatment and prognosis may vary. Currently, thoracentesis and cytologic analysis of pleural fluid cytology is usually the initial diagnostic step. ⋯ Pleural fluid cytologic examination is a useful initial step in the diagnostic work-up of patients with suspected malignant pleural effusions. The diagnostic yield of such examination is improved with repeated pleural fluid cytologic specimens and when combined with a percutaneous pleural biopsy. Clinical presentation and pleural fluid characteristics were inadequate in differentiating between malignant and paramalignant effusions.