Microsatellite Instability and Altered Expressions of MLH1 and MSH2 in Gastric Cancer.

Introduction: Microsatellite instability (MSI) is a hallmark of defective DNA mismatch repair (MMR) of genes especially MLH1 and MSH2. It is frequently involved in the carcinogenesis of various tumours including gastric cancer (GC). However, MSI in GCs have not been reported in Malaysia before.

Massive dissecting intramural duodenal haematoma following endoscopic haemostasis of a bleeding duodenal ulcer.

Intramural duodenal haematoma is a rare injury of the duodenum. Most reported cases are secondary to blunt trauma to the abdomen. Such injury following endoscopic intervention is even rarer, and there are no definite guidelines for its management.

Malignant cervical teratoma in an adult presenting with impending airway obstruction.

Extragonadal teratomas and germ cell tumours are uncommon. Most teratomas of the head and neck present in the paediatric age group. Occurrence of such tumours in an adult is extremely rare and, to date, less than 40 cases have been reported in the literature.

Treatment of delayed chylothorax complicating oesophagectomy.

A patient with carcinoma of the cardia underwent Ivor-Lewis oesophagogastrectomy. He developed right chylothorax postoperatively, which is a rare complication. Attempts to treat the chylothorax by conservative means and thoracoscopic ligation failed.

Pre-ablative diagnostic whole-body scan following total thyroidectomy for well-differentiated thyroid cancer: is it necessary?

Objective: This study reviewed the incidence of positive pre-ablative diagnostic scan after total thyroidectomy and the efficacy of the current ablative dose. The predictive factors for outcome using a standard ablative dose and postoperative complications of total thyroidectomy were also examined.

Methods: This was a retrospective review of patients referred for radioiodine ablation after total thyroidectomy between September 1997 and September 2001.

Prospective study comparing scrape cytology with frozen section in the intraoperative identification of parathyroid tissue.

Objective: Intraoperative identification of parathyroid tissue is crucial during parathyroid surgery. Frozen section is the most common tool, but is time-consuming and expensive. Scrape cytology is a modification of imprint cytology that provides rapid and cheap intraoperative identification of parathyroid tissue, but its reliability remains controversial.

Inguinal hernia repair by surgical trainees at a Malaysian teaching hospital.

Objective: To assess the outcome of inguinal hernia repaired by surgical trainees at Universiti Kebangsaan Malaysia Hospital.

Methods: Retrospective review of 103 patients who underwent surgery between November 2001 and October 2002.

Results: The mean age of patients was 50 years and the male-to-female ratio was 20:1.

Thyroid carcinoma in patients with familial adenomatous polyposis.

There has been a growing awareness of the association between papillary thyroid carcinoma and familial adenomatous polyposis (FAP). The cases of four young patients with papillary thyroid carcinoma occurring with FAP are presented. Three patients underwent surgery to provide specimens for detailed histological examination.