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Biomedical subjects

C T Lee

Publications and source records attributed to C T Lee.

At least 109 records · Page 6Linked to original sources
PubMed1991

Effects of cranial transcutaneous electrical nerve stimulation in normal subjects at rest and during psychological stress.

Some effects of sub-threshold sine-wave transcutaneous electrical nerve stimulation (TENS), passed between earlobe electrodes at a constant alternating current (AC) frequency of 100 Hertz (Hz), were investigated in 90 normal subjects after 30 minutes of treatment, and after 3 minutes of standardized mental stress (mental arithmetic) which immediately followed the 30 minute treatment. In a double-blind protocol, five groups received 1) active TENS during treatment and active TENS during stress; 2) active TENS during treatment and placebo TENS during stress; 3) placebo TENS during treatment and placebo TENS during stress; 4) placebo TENS during treatment and active TENS during stress; and 5) no treatment during both treatment and stress. Results showed significant reductions in systolic blood pressure, pulse rate and anxiety, but not in diastolic blood pressure or peripheral vascular tension, after 30 minutes of active TENS as compared to no treatment. No placebo TENS effect was observed. No significant differences were observed between active TENS; placebo TENS and no treatment in physiological or psychological response to the stress procedure. Results are discussed in terms of the applicability of this technique to the management of stress.

Adolescent↗
PubMed1991

Diagnostic and prognostic values of in vitro culture growth patterns of marrow granulocyte-macrophage progenitors in patients with myelodysplastic syndrome.

The in vitro culture growth of marrow granulocyte-macrophage progenitors (CFU-GM assay) was studied in 102 consecutive patients with newly diagnosed primary myelodysplastic syndrome (MDS) to determine its diagnostic utility and prognostic value. There were 18 patients with refractory anemia (RA), eight RA with ringed-sideroblast (RARS), 30 RA with excess of blasts (RAEB), 18 chronic myelomonocytic leukemia (CMML), and 28 RAEB in transformation (RAEB-T). Patients with MDS had a significantly lower number of GM colonies and a significantly higher cluster to colony ratio than those of normal controls and patients with cytopenias of other causes. Six in vitro growth patterns were observed; 85% of patients with MDS showed various abnormal growth patterns, and 42% of all MDS patients exhibited a leukemic growth pattern at diagnosis. None of the 40 patients with cytopenias of other causes had a leukemic type growth. A leukemic growth pattern was rarely observed in patients with RA and RARS (4%), but was common in other subgroups (57%). The distribution of various growth patterns was not statistically different among patients with RAEB, CMML, and RAEB-T. Thirty-six patients developed acute leukemia during the follow-up period. The MDS patients with leukemic type growth were at increased risk of rapid progression to acute leukemia, and they also had a shorter survival time than patients with a non-leukemic pattern. These results showed that simply scoring the number of CFU-GM is of limited value for the diagnosis and the prediction of prognosis of MDS, whereas the in vitro marrow culture growth pattern is of prognostic significance independently of the FAB classification. It is concluded that the in vitro growth pattern of marrow CFU-GM is helpful in diagnosing patients with MDS as well as in predicting their clinical outcome.

Adult↗
PubMed1990

Dermatologic surgery--its scope and some practical aspects.

Dermatologic surgery is of increasing interest to both dermatologists and other medical practitioners. It includes procedure like biopsy, excisional surgery, laser surgery, electrosurgery, curettage surgery, nail surgery, cryosurgery, minigrafting, sclerotherapy, collagen implant, punch grafting, Moh's micrographic surgery, dermabrasion and hair transplant. This article highlights the important aspects of the various procedures and some of the more important practical points.

Dermatologic Surgical Procedures↗
PubMed1990

Pyodermas: an analysis of 127 cases.

In an analysis of 127 patients with pyodermas, 38 (30%) had primary pyodermas and 89 (70%) had secondary pyodermas. Seventy-one percent (71%) of the primary pyodermas were due to Staphylococcus aureus (S. aureus). Five (5%) of the primary pyodermas were due to multiple organisms. Among the patients with secondary pyodermas, 45% were due to S. aureus, 21% Streptococci, 9% Pseudomonas and 9% Proteus species. Forty-four percent (44%) of the secondary pyodermas were due to multiple organisms. S. aureus is highly sensitive to cephalothin, cloxacillin, erythromycin, methicillin and co-trimoxazole. Streptococci are highly sensitive to cephalothin, erythromycin, ampicillin and penicillin. The gram-negative organisms are sensitive to amikacin, gentamicin, kanamycin and co-trimoxazole. Cloxacillin, or erythromycin (for patients with penicillin allergy) is the antibiotic of choice in patients with primary pyodermas. In patients with infected eczemas, first-generation cephalosporin or cloxacillin is the preferred antibiotic. In patients with infected ulcers, a combination of cloxacillin and gentamicin or a cephalosporin effective against the causative agent is most suitable.

Anti-Bacterial Agents↗
PubMed1989

Bacampicillin to treat non-gonococcal urethritis in men: pilot study.

Of 84 men with non-gonococcal urethritis (NGU), 24 yielded Chlamydia trachomatis by either cell culture or MicroTrak immunofluorescence test. All 84 were treated with bacampicillin 800 mg twice a day for seven days. Five (one chlamydia positive) defaulted from follow up 10 to 14 days after the start of treatment. Of the 23 chlamydia positive patients who attended follow up, 22 became chlamydia negative; 14 of the 23 patients also became asymptomatic and had normal urethral smears. Of the 56 chlamydia negative patients who attended follow up, 21 were cleared of their urethritis. Two patients reported side effects; one drowsiness and one mild diffuse alopecia. Bacampicillin may therefore be a safe and effective alternative to tetracycline or erythromycin in treating chlamydial urethritis in men.

Adolescent↗
PubMed1989

The effects of cranial TENS on measures of autonomic somatic and cognitive activity.

Peripheral and central nervous system effects of the cranial application of sub-threshold transcutaneous electrical nerve stimulation (TENS), of sinusoid waveform passed between earlobe electrodes at an AC frequency of 100 Hertz, were investigated. In a single-blind study, each of thirty healthy volunteer subjects was administered one 30 minute treatment of either active TENS, placebo TENS or no treatment. Pretreatment to post-treatment changes in measures of autonomic activity (blood pressure, pulse rate, peripheral vasomotor activity), somatic activity (skeletal muscle tension), and anxiety were evaluated. Significant reductions in systolic blood pressure (p less than .05), diastolic blood pressure (p less than .01), pulse rate (p less than .05), peripheral vasomotor activity (marginally significant: p less than .07) and anxiety (p less than .05) were observed subsequent to active. TENS as compared to both placebo TENS and no TENS. No significant placebo TENS effect was observed. Possible mechanisms of action of this form of cranial TENS on the peripheral and central nervous system are discussed.

Adolescent↗
PubMed1989

Epidemiology of acute epididymo-orchitis in Singapore.

A prospective study on 55 patients with acute epididymo-orchitis was studied. Their ages ranged from 15 to 65 years. Thirty-three (60%) were within the 20-29 year age group and 9 were above 35 years of age. 69% cited prostitutes as the source of sexual contact. Twenty-six patients did not receive and 29 patients received antibiotic therapy before recruitment. In the former untreated group, 6 patients (23%) had gonococcal urethritis, 3 patients (11%) had chlamydial urethritis and 2 patients (8%) had combined gonococcal and chlamydial urethritis. No pathogens were isolated from the urethra from the remaining 15 (58%) patients, 8 of whom had nonspecific urethritis. In the latter treated group, 4 patients (14%) had gonococcal urethritis and no organisms were isolated from the remaining 25 (86%) of whom 6 had non-specific urethritis. None of the 55 patients had urinary tract infections. Forty-three patients (78%) had unilateral involvement of both the testis and epididymis, and 4 patients (7%) had bilateral epididymo-orchitis. Semen analysis was performed on 13 patients of whom 8 showed pyospermia.

Acute Disease↗
PubMed1989

Endocervical chlamydial infection in female contacts of patients with nongonococcal urethritis.

Eighty-five female contacts of patients with nongonococcal urethritis attending Middle Road Hospital were examined. Chlamydia trachomatis was isolated from the cervix in 39% of them. Forty-five per cent of the chlamydia-positive patients were asymptomatic and 79% of them showed signs of a cervicitis. None of the patients developed complications. Neisseria gonorrhoeae was not isolated from any of the patients. Clinical markers other than cervicitis are not useful for detecting chlamydial infections in female contacts of NGU. Until such time when cheaper, more convenient and accurate methods of laboratory diagnosis of C. trachomatis are put to routine use, it would seem prudent to treat all female contacts of NGU patients after exclusion of other sexually transmitted diseases.

Adolescent↗
PubMed1989

Evaluation of cerebrospinal fluid in asymptomatic late syphilis.

A prospective study of the cerebrospinal fluid (CSF) of 49 previously untreated patients with asymptomatic late syphilis of more than two year's duration was conducted. The sera of all patients had reactive fluorescent treponemal antibody absorption (FTA-Abs) tests or Treponema pallidum haemagglutination tests (TPHA), and reactive or non-reactive Venereal Disease Research Laboratory (VDRL) tests. Five (10%) patients had abnormal CSF findings; these included elevated protein in four of 49 and pleocytosis in three of 49. Asymptomatic neurosyphilis, diagnosed on the basis of a reactive VDRL test of the CSF, was present in one (2%) of 49 patients.

Adult↗
PubMed1988

Single dose oral norfloxacin or intramuscular spectinomycin to treat gonorrhoea (PPNG and non-PPNG infections): analysis of efficacy and patient preference.

Norfloxacin, a new oral quinolone, was compared with intramuscular spectinomycin for treating culture proved gonorrhoea (caused by penicillinase producing strains of Neisseria gonorrhoeae (PPNG) and non-PPNG strains. A total of 547 infected men and women were randomly allocated to treatment with either single dose norfloxacin (800 mg by mouth) or spectinomycin (2 g intramuscularly). Patient preference for tablets or injections was noted at this visit. Patients returned four to eight days later for assessment of efficacy, safety, and preference. Of the 482 patients who attended follow up, all those treated with norfloxacin (94 infected with PPNG strains, 145 with non-PPNG strains) and all 82 infected with PPNG strains and treated with spectinomycin were cured. Of 161 infected with non-PPNG strains and treated with spectinomycin, 159 (99%) were cured. Side effects (headache, nausea, and sleepiness) occurred in three patients receiving norfloxacin and in 17 (16 pain at injection site, 1 giddiness) receiving spectinomycin. Most patients preferred tablets to injection both on day 1 (313 v 200) and at follow up (373 v 104). This study showed that norfloxacin was a highly effective alternative to spectinomycin, produced fewer side effects, and was the preferred mode of administration.

Administration, Oral↗
PubMed1988

Norfloxacin in the treatment of gonorrhea due to penicillinase and non-penicillinase producing Neisseria gonorrheae: a review.

In 12 recent clinical studies, norfloxacin given in various dosage regimens was shown to be highly effective in treating 1,588 gonococcal infections in 1,486 patients. A single oral dose of norfloxacin 800 mg cured 99.2% of 783 patients with penicillinase producing strains of Neisseria gonorrheae (PPNG) and non-penicillinase producing N. gonorrheae (NPPNG) causing urethritis, cervicitis and anorectal infections. A single oral dose of 800 mg of norfloxacin was found to be an effective alternative to a 2 g intramuscular dose of spectinomycin and superior to a 2.5 g oral dose of thiamphenicol for the treatment of PPNG urethritis or cervicitis. Its efficacy in treatment of NPPNG infections was shown to be similar to that of a single oral dose of 3.5 g of ampicillin plus 1 g of probenecid. Mild and transient gastrointestinal and neurological adverse events occurred in 3.3% of patients treated with norfloxacin 800 mg. Norfloxacin 800 mg as a single dose is recommended as an effective and safe single-dose treatment of urethritis, cervicitis and anorectal infections caused by PPNG or NPPNG.

Adolescent↗
PubMed1988

A case of malignant pyoderma with neurological manifestations.

A case of malignant pyoderma with a fatal course is presented. A 62-year-old Chinese man was admitted with a 8-month history of progressive ulcerative nodular skin lesions starting on the right antecubital fossa and spreading to the chest, face, arms and legs. The lesions failed to respond to many antibiotics. Examination revealed multiple large crusted foul-smelling ulcers with erythematous raised vegetative edges and tender erythematous nodules. Investigations showed an anaemia of chronic disease and an erythrocyte sedimentation rate of 135mm/1st hour. Histology showed multiple circumscribed microabscesses in the upper dermis. The skin lesions responded well to systemic corticosteroid therapy. Three months after admission, he developed multiple cranial nerve palsies, and severe progressive peripheral neuropathy. Radiographic studies revealed cavitating lesion in the right upper lobe consistent with a diagnosis of carcinoma of the lung. Five months after admission, patient was intubated for stridor but he succumbed to aspiration pneumonia. Malignant pyoderma should be considered if an ulcer fails to respond to antibiotics, and possible neurological complications should be thought of.

Anti-Bacterial Agents↗
PubMed1987

Single dose piperacillin in treating uncomplicated gonococcal urethritis in men.

A single intramuscular dose of piperacillin 2 g, with probenecid 1 g orally, was used to treat 82 men with uncomplicated gonococcal urethritis due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG) or non-PPNG. All 49 patients infected with non-PPNG strains were cured, as opposed to only 25 (76%) of 33 patients infected with PPNG strains, giving an overall success rate of 90%. No serious side effects of treatment were observed. Post gonococcal urethritis (PGU) occurred in 18% of the patients treated. Antibiotic susceptibility tests showed that 44 (96%) of the 46 non-PPNG strains tested had MICs of piperacillin of 2 mg/l or less and 26 (76%) of the 34 PPNG strains had MICs of 32 mg/l or more. This regimen is not recommended for use as first line treatment in areas where there is a high incidence of infection with PPNG strains. It is, however, highly effective against non-PPNG strains.

Drug Administration Schedule↗
PubMed1987

Genital herpes in Singapore.

As in many parts of the world, the incidence of genital herpes has increased in Singapore, the increase occurring sharply from 1982 onwards, and affecting females to a greater extent than males. Peak incidence in both sexes was found to occur in the 15-34 year age group. Changes in sexual practices, a decreasing prevalence of age-specific antibody to herpes simplex type 1 virus in sexually active adults, and greater interest in the disease following publicity in the media, are factors which have contributed to both a real and an apparent increase in incidence. However, the incidence in Malay males is very low, and neonatal herpes is extremely rare in the local population. Herpes simplex virus type 1 is responsible for about 30% of initial genital infections and an even higher proportion of primary genital herpes infections. Approximately 16% of purulent penile ulcers in Singapore are associated with genital herpes infection.

Adolescent↗
PubMed1987

Initial experience with CO2 laser in treating dermatological conditions.

CO2 laser was first used in the treatment of melanomas in animals. Since then, it has been successfully used in treating many dermatological conditions. A total of 47 patients were treated once as outpatients in Middle Road Hospital by using Model 720 Sharplan CO2 Laser System and Yoshida Opelaser-01 CO2 Laser System to determine the usefulness of CO2 laser in the treatment of various dermatological conditions. The laser was used mainly in the defocused mode at 10 watts. Local anaesthetic with 1% lignocaine HCL was employed in all cases. 3 patients defaulted follow-up. Of the 30 patients with warts, most of which were recalcitrant, 14 were cured and the remaining 16 showed marked improvement. 4 of the 5 patients with lichen simplex chronicus were cured. 1 patient each of the following conditions were also treated; prurigo nodularis, psoriasis, solar keratosis, ingrowing toe nail, Bowen's disease, infected callosity and lichen amyloidosis; cure was achieved in the former 4 conditions. The laser failed to cure 2 patients with pyogenic granuloma. Side effects included hypopigmentation (62%), mild post-operative pain (11%), scarring (11%), excess granulation tissue (11%), and infection (2%). CO2 laser is a potentially useful, effective and safe treatment modality for many dermatological conditions.

Adolescent↗