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Biomedical subjects

E L Lee

Publications and source records attributed to E L Lee.

At least 37 records · Page 2Linked to original sources
PubMed1994

The community psychiatric nurse in Singapore.

The Community Psychiatric Nursing Service in Singapore began on 1st November 1988 in recognition of the need for continuous supervision of a group of psychiatric patients following discharge from hospital. The Community Psychiatric Nurse is able to provide mental health nursing care in a community setting. Her multiple roles are described. The various problems encountered and how she tackles them are discussed. The challenges posed and the future prospects are briefly addressed.

Combined Modality Therapy↗
PubMed1993

Platelet-activating factor-induced ischemic bowel necrosis: the effect of platelet-activating factor acetylhydrolase.

In the present investigation, the rat model of necrotizing enterocolitis (NEC) was further developed by injection of platelet-activating factor (PAF) in the descending aorta. The role of the plasma PAF-acetylhydrolase (PAF-AH) was examined in the prevention of this disease. PAF (0.35 micrograms) caused ischemic intestinal necrosis when administered intraaortically. The effects of PAF injection on the small intestine were examined histologically in samples of the duodenum, jejunum, and ileum. The administration of PAF resulted in extensive hemorrhagic damage in all regions of the small bowel and a marked hemoconcentration. Pretreatment of the rats with dexamethasone or medroxyprogesterone significantly increased plasma PAF-AH activity. Dexamethasone and medroxyprogesterone prevented the gross and histologic features of NEC as well as the hemoconcentration. In contrast, lower amounts of PAF were sufficient to cause bowel necrosis and hemoconcentration when decreased activities of plasma PAF-AH were induced by 17 alpha-ethynylestradiol or 4-aminopyrazolopyrimidine administration. We have recently reported that PAF-AH is present in human milk. The beneficial effect of breast feeding in preventing the development of NEC in the newborn is discussed and a mechanism proposed to explain this finding. It is suggested that PAF may play an important role in the pathogenesis of NEC and that the increased plasma activity of PAF-AH caused by dexamethasone and the presence of this enzyme, of milk origin, in the lumen of the small bowel may prove to be beneficial in the prevention of this disease.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1989

Esophageal achalasia secondary to mesothelioma.

Achalasia secondary to malignancy is rare, with most cases associated with gastric adenocarcinoma of the gastroesophageal junction. This report describes the clinicopathologic features of a 64-year-old man found to have mesothelioma as the cause of secondary achalasia. To our knowledge, this is the first case of secondary achalasia produced by a mesothelioma. We reviewed the English literature in regard to achalasia induced by tumors.

Esophageal Achalasia↗
PubMed1986

Morphogenesis and clinicopathologic characteristics of recurrent carotid disease.

The histopathologic characteristics of primary plaques and recurrent carotid disease were studied in 32 patients. These data were related to symptoms, recurrence interval (6 to 176 months), arteriographic anatomy, and in situ operative findings. A striking predilection was noted for recurrent lesions to be located in the internal carotid artery near the origin, but still within the confines, of the original endarterectomy site and suture line. Although recurrence was frequently associated with a long primary arteriotomy, evidence of technical faults or periarterial fibrosis was rare. Early recurrent lesions (recurrence interval less than 36 months, n = 13) had significantly more smooth muscle cells and proteoglycans (p less than 0.001) than late recurrent lesions (recurrence interval greater than 36 months, n = 19). As previously reported, features of atherosclerosis (abundant collagen, calcium deposits, and foam cells) were more pronounced in late recurrences (p less than 0.001). However, the histopathologic differentiation between early and late recurrent carotid disease was indistinct. A continuum was noted whereby characteristics of late recurrent lesions increased in proportion to recurrence interval. All recurrent lesions were easily distinguished from primary plaques in that recurrences had a less orderly arrangement of all elements and lacked the classic topographic features of advanced atherosclerosis. An important feature that differentiated primary and recurrent lesions was the presence of surface and intraplaque thrombus in 90% of recurrent lesions (p less than 0.001). In early recurrent disease, luminal surface thrombus was striking; this was frequently platelet-rich and showed organization devoid of neovascularity. Intraplaque thrombus was more common in late recurrent disease, consisted almost entirely of fibrin, and was often contiguous with luminal surface thrombus. No discernible relationships were noted between thrombus associated with recurrent lesions and the presence or absence of symptoms, treatment with antiplatelet agents, and hypertension. This finding suggests that thrombus was a continuous and intrinsic component of recurrent disease rather than a secondary, complicating feature. Recurrent carotid disease is a progressive lesion that stems from ongoing thrombogenesis occurring at the endarterectomy site. Organized thrombus and smooth muscle cell proliferation comprise the bulk of the lesion, which undergoes atherosclerotic change with time.

Aged↗
PubMed1986

Cranial nerve deficits due to amyloidosis associated with plasma cell dyscrasia.

Cranial nerve dysfunction is exceedingly rare in amyloidosis. Cranial nerve deficits have been described in the very rare form of familial amyloidosis in which there appears to be an autosomal dominant pattern of inheritance. By contrast, they are virtually unreported in the two common forms of amyloidosis, that is, secondary amyloidosis (AA), usually associated with a chronic inflammatory lesion, and primary amyloidosis (AL), resulting from light-chain immunoglobulins of plasma cell dyscrasias. Although neurologic involvement in these forms of amyloidosis has been reported in the peripheral nerves, spinal nerve roots, and autonomic ganglia, the absence of reports of cranial nerve lesions is remarkable. We report the case of a woman with multiple bilateral cranial nerve deficits involving the left trigeminal, left facial, right abducens, and hypoglossal nerves. She had nonfamilial amyloidosis associated with a plasma cell dyscrasia of the IgG kappa type with increased production of light-chain immunoglobulins. The rarity of cranial nerve involvement in this clinical setting is highlighted by three previous studies, each of which reported involvement of only a single nerve (either the facial or olfactory nerve). Since aging has been correlated with congophilic changes in the brain, the explanation for the sparing of cranial nerves can be only speculative.

Amyloidosis↗
PubMed1984

Occult papillary carcinoma of the thyroid with distant metastases.

It is well established that small clinically undetected thyroid carcinomas can produce extensive lymphatic metastases. However, occult papillary carcinoma of the thyroid presenting as a large blood-borne metastasis and occult papillary carcinoma of the thyroid leading to death are both uncommon. The authors report two unusual cases of clinically occult carcinoma of the thyroid. The first case is a 2.4 mm microscopic carcinoma presenting as a large solitary pulmonary metastasis, and is one of the smallest reported primary papillary thyroid carcinomas presenting as a distant hematogenous metastasis. The second case represents a lethal carcinoma with extensive metastases not diagnosed until autopsy. These two cases effectively illustrate that the absence of a clinically detectable thyroid abnormality does not exclude the possibility of extensive hematogenous and lymphatic metastases from a minute or undetected carcinoma of the thyroid.

Bone Marrow↗
PubMed1984

Ischemic pseudomembranous colitis with perforation due to polyarteritis nodosa.

Polyarteritis nodosa is a multisystem disease that involves the gastrointestinal tract in more than 50% of patients at some time during its course. Clinically apparent ischemic disease of the small bowel is the frequent site of involvement. The colon is less commonly involved, particularly as the initial presentation. We present a patient with polyarteritis nodosa noteworthy for prolonged nonbloody diarrhea, ischemic colitis with perforation, and pseudomembrane formation who had histological documentation of polyarteritis nodosa.

Colon↗
PubMed1983

Large hyperplastic polyps of the stomach.

Epithelial polyps of the stomach can be divided into 2 types: adenomatous and hyperplastic or regenerative. Imprecisions in terminology and histologic classification of the reported cases make it difficult to establish the true incidence of each type. The size of gastric polyps has been among the criteria for predicting malignant potential of the lesion. We present 4 patients in whom large, sometimes multiple, gastric masses represented benign hyperplastic polyps. The radiographic and pathologic features of these large gastric polyps which were not associated with carcinoma are reviewed.

Aged↗
PubMed1981

Flavobacterium meningosepticum infection: an epidemiological study in a newborn nursery.

After an outbreak of flavobacterium meningitis in the newborn nursery of the University Hospital, an investigation was carried out to determine the possible sources of this organisms in the nursery. Various serotypes of the organism were recovered from a variety of sources such as wash basins, sinks, suction apparatus, and disinfectants in the nursery as well as the neighbouring wards. Colonisation of the pharynx with this organism was demonstrated in several clinically healthy babies in the nursery. The possible role of fomites, hospital staff, newborn babies, and their mothers in the transmission of the organism is considered together with the measures taken to reduce environmental contamination.

Adult↗