Human papillomavirus in cervical cancers of Malaysians.

Aim: With cervical carcinoma remaining the second leading cancer among Malaysian women, it is imperative to clarify the prevalence of human papillomavirus (HPV) in this respect, considering the dearth of local information.

Material And Methods: Formalin-fixed, paraffin-embedded (FP) tissues of 29 invasive cervical carcinoma cases, diagnosed between 1 January 1991 and 31 December 1992, fresh, frozen (FF) and paired FP tissues of 43 cases diagnosed between 1 January 1995 and 31 December 2000, and 21 FF normal control cervices were subjected to polymerase chain amplification (PCR) for HPV following successful amplification of a 268 bp β-globin fragment using primers specific for HPV types 6, 11, 16 and 18 and consensus L1 ORF (MY09/11).

Results: HPV was detected in 69.

Third S. S. Ratnam memorial lecture 2007. Ovarian cancer: Is there hope for women?

Ovarian cancer is today the most lethal female cancer with an overall survival of only 49.9%. The currently available screening modalities are disappointing in detecting highly curable early stage ovarian cancer.

Clinical usefulness of tumour markers.

Tumour markers are substances related to the presence or progress of a tumour. An ideal tumour marker is (1) detectable only when malignancy is present, (2) specific for the type and site of malignancy, (3) correlates with the amount of malignant tissue present and (4) responds rapidly to a change in tumour size. At present, no tumour marker fulfills all of the above criteria.

Management of gestational trophoblastic disease in developing countries.

In Malaysia, the incidence of molar pregnancy and gestational trophoblastic neoplasia is 2.8 and 1.59 per 1000 deliveries, respectively; the disease is more common among the Chinese compared to the Malays and Indians.

Telomerase activation and human papillomavirus infection in invasive uterine cervical carcinoma in a set of Malaysian patients.

Aim: Telomerase activity was studied in invasive uterine cervical carcinoma to assess whether it was activated during cervical malignant transformation and to look for a possible association with human papillomavirus (HPV) infection in a set of Malaysian patients.

Methods: Histologically confirmed invasive cervical carcinoma and benign cervices were assayed for telomerase activity using a commercial telomerase polymerase chain reaction (PCR) enzyme linked immunosorbent assay kit. The same cases were subjected to PCR detection of HPV using type specific (HPV types 6b, 11, 16, and 18) followed by L1 open reading frame (ORF) consensus primers.

Chien-Tien Hsu Memorial Lecture. Fertility and gynaecologic malignancies.

Fertility and gynaecological malignancies have an important relationship. A clear inverse relationship exists between family size and the incidence of ovarian and endometrial cancer. Current methods of fertility control have an influence on subsequent development of various gynaecological malignancies.

Management of the pregnant mother with malignant conditions.

A malignancy discovered in pregnancy is often difficult to manage; the optimal maternal therapy has to be balanced with the fetal well-being. Generally, the cancer is managed as though the patient is not pregnant. For the various site-specific cancers, surgery is the main modality of treatment; this should be individualized.

Epidural analgesia in primigravidae in spontaneous labour at term: a prospective study.

Objectives: To prospectively study the intervention rate, duration of labour, malpositions, fetal outcome, maternal satisfaction, voiding complications and adverse events in healthy primigravidae in spontaneous labour at term following epidural analgesia.

Methods: A prospective randomized study involving 55 patients in the epidural group and 68 in the control pethidine--inhalational entonox group.

Results: There were significantly more obstetric interventions (instrumental deliveries) in the epidural group (p < 0.

The acute abdomen and the obstetrician.

An acute abdomen in pregnancy can be caused by pregnancy itself, be predisposed to by pregnancy or be the result of a purely incidental cause. These various conditions are discussed. The obstetrician often has a difficult task in diagnosing and managing the acute abdomen in pregnancy.

Recent trends in histological pattern of cervical carcinoma among three ethnic groups in Malaysia.

Objective: To study the trend of different histological types of cervical carcinoma among the 3 major ethnic groups in Malaysia.

Methods: All invasive cervical carcinoma histologically diagnosed for the first time in 1991-1992 and 1996-1997 at the University Hospital, Kuala Lumpur (UHKL) were reviewed for the following parameters; age, ethnic group, histological category.

Results: One hundred and twenty-one and 145 cases were diagnosed in 1991-1992 and 1996-1997, respectively.

Large lower segment myoma--myomectomy at lower segment caesarean section--a report of two cases.

Uterine leiomyoma is found in approximately 2% of pregnant women. One in ten women will have complications related to myoma in pregnancy. Myomectomy during pregnancy especially at Caesarean section is much discouraged in the literature.

Adjuvant chemotherapy in "high risk" patients after Wertheim hysterectomy--10-year survivals.

Although the primary operative mortality following radical hysterectomy for stage IB and early stage IIA cervical carcinoma is less than 1%, survival is poor in those patients with histological evidence of "risk" features--lymph node metastases, lymphatic vascular tumour permeation and clinically undetected parametrial metastases. In the 7-year period 1983 to 1989, 239 patients with stage IB and early IIA disease had radical hysterectomy and pelvic lymphadenectomy. One hundred and eight patients (45.

The management of gestational trophoblastic disease in developing countries such as Malaysia.

Gestational trophoblastic disease is a common gynaecological problem in Malaysia. The incidence of molar pregnancy is 2.8 per 1000 deliveries, being more common amongst the Chinese.

The management of gestational trophoblastic disease in developing countries such as malaysia.

Gestational trophablastic disease is a common gynaecological problem in Malaysia. The incidence of molar pregnancy is 2.8 per 1000 deliveries, being more common amongst the Chinese.

Early congenital syphilis--a continuing problem in Malaysia.

Between February 1990 and May 1993, 13 cases of early congenital syphilis (ECS) were managed in the Paediatrics Unit, University Hospital, Kuala Lumpur. Twelve mothers were unbooked with 10 inborn babies. Only one mother had antenatal booking at this hospital but she defaulted antenatal follow-up.

Aggressive angiomyxoma of the vulva with an unusual vascular finding.

We report the first documented Malaysian case of aggressive angiomyxoma (AAM) of the vulva. A 56-yr-old woman of Indian ethnic origin presented with a vulval lesion which was clinically mistaken for a Bartholin's cyst. The lesion was surgically excised and a diagnosis of AAM was made histologically.

Hydatidiform molar pregnancy in Malaysian women: a histopathological study from the University Hospital, Kuala Lumpur.

A review of gestational trophoblastic disease diagnosed at the Department of Pathology, University Hospital, Kuala Lumpur from January 1989 to December 1990 using established histological criteria showed 25 complete hydatidiform moles (CHM), 11 partial hydatidiform moles (PHM), 1 invasive mole and 2 choriocarcinoma. The ages of the patients with CHM ranged from 21 to 43 years (mean = 28.5 years) and PHM 20 to 33 years (mean = 27.

Surgical management of early invasive cancer of the cervix associated with pregnancy.

The simultaneous occurrence of carcinoma of the cervix in pregnancy is uncommon. In a prospective study of 397 patients undergoing type III radical hysterectomy for early invasive cancer of the cervix, 18 were pregnant at the time of surgery; 4 of these were operated after delivery elsewhere. Two others had a type I extrafascial hysterectomy.

Bilateral ovarian cysts in a newborn: a case report.

Large ovarian cysts in the fetus are uncommon. Ultrasonography has helped in the detection of these cysts antenatally and in the newborn female infant. A case of bilateral ovarian cysts in a newborn is presented.

Total perineal reconstruction after major obstetrical injuries with extensive tissue loss: a report of 2 cases.

Major perineal injuries following obstetrical complications represent difficult problems of reconstruction. We describe 2 such patients with perineal injuries simulating infantile cloacas. Surgical repair using an abdominoperineal pullthrough procedure in 1 patient, and a Bricker loop type of repair in another resulted in successful restoration of function in both.

Depressed skull fracture in a newborn successfully managed conservatively: a case report.

A preterm baby was born to a multiparous mother by emergency caesarean section at 36 weeks of gestation. Apart from a depression on the right temporo-parietal region measuring 3 cm x 3 cm x 0.5 cm, no other abnormality was noted.