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Biomedical subjects

J S Cheah

Publications and source records attributed to J S Cheah.

At least 73 records · Page 4Linked to original sources

Relative predispositional effects (RPEs) of marker alleles with disease: HLA-DR alleles and Graves disease.

A method is described to reveal the relative predispositional effects (RPEs) (predisposing, protective, or neutral) of the HLA alleles or of any other marker system that is associated with a disease. When the disease is associated with two or more alleles of a locus, the RPE method identifies the associations sequentially according to their strength; thus the problem that a strong association with one allele can create misleading deviations in the frequencies of other alleles is alleviated. Using this method, we have examined the relative effects of HLA-DR alleles in susceptibility to Graves disease in the Caucasian population. The well-established positive association with DR3 was confirmed as the strongest effect. In addition, a negative association was found between DR5 and Graves disease. The reduced frequency of DR5 among patients is statistically significant and is not a result of the increase in DR3. Finally, when patients were divided according to the presence or absence of eye disease, the latter showed a significant increase in the frequency of DR4. With family data, linkage to HLA of Graves disease was established in both Caucasian and Chinese families by the sib-pair method.

Alleles↗

Ischaemic heart disease and its risk factors in Singapore in comparison with other countries.

Mortality from ischaemic heart disease in Singapore is now reaching comparability with the West. For the early 1980s, rates for Indians and Malays were higher than in U.S.A. and England and Wales and while those for Chinese were lower they were considerably higher than in Japan. In keeping with this the levels of the major risk factors in Singapore are now comparable to the West. Cigarette smoking in males is virtually the same as in Britain, while the proportion of hypertensives on medication is higher than in the West. The main cause for concern is the current high levels of serum cholesterol in Singapore and strenuous health education efforts are needed to bring about dietary changes.

Adolescent↗

Hypoglycaemia misdiagnosed by capillary glucose measurement.

The diagnosis of hypoglycaemia has become much easier with the introduction of bedside capillary glucose measurements which require a single drop of blood from a finger prick. However, such a diagnosis may be wrongly made in patients with poor peripheral circulation. This case report illustrates the common circumstances where misdiagnosis occurs A drop of venous blood should be used for bedside glucose measurement if the diagnosis is in doubt.

Aged↗

Common variable immunodeficiency--a case report and review.

Common Variable Immunodeficiency is a rare primary immunodeficiency presenting usually in young adults with repeated sinopulmonary infections as a result of profound hypogammaglobulinemia. A clinical report of the first documented patient in this region is presented along with a brief review of the recent advances made especially in understanding pathogenesis and management of patients with this disorder.

Adult↗

Disseminated histiocytosis X with diabetes insipidus and diabetes mellitus in an adult female (histiocytosis with DI and DM).

We report the clinical presentations and pathologic findings in an adult female who had Disseminated Histiocytosis X associated with diabetes insipidus and diabetes mellitus. The association of these three conditions in the same subject is rare. The current knowledge on Disseminated Histiocytosis X is reviewed and the possible relationship between these three conditions discussed.

Adult↗

Abdominal tuberculosis revisited.

Four patients with abdominal tuberculosis (ATB) managed in the University Department of Medicine, Singapore General Hospital, are presented to highlight problems encountered in the diagnosis of this condition. Three patients had intestinal tuberculosis, one of whom had peritoneal involvement and another had possible hepatic disease. The fourth patient presented with peritoneal disease alone. Ages at presentation ranged from 25 years to 71 years. There were three females and one male. Two patients presented with symptoms of chronic illness for 10 months before the disease was diagnosed. Two other patients had acute presentations. Fever, abdominal pain, vomiting and diarrhoea were the main symptoms encountered. Three patients had abdominal masses at diagnosis. Radiological investigations were the most useful diagnostic aid. Bacteriological confirmation was made in only one patient. Histology helped in the diagnosis in two others. Recent literature on this condition was reviewed and the possible role of impaired immunity in the pathogenesis of this condition was discussed.

Adult↗

Wilson's disease revisited in the tropics.

The clinical features and investigations of 17 patients were analysed. Thirteen of them were Chinese and the rest Indians. Their ages at presentation ranged from 8 to 63 years (mean 18.35 years). Thirteen patients (76%) were symptomatic; 8 with predominantly hepatic manifestations and 5 with neurological features. Four were asymptomatic siblings. At diagnosis, however, 10(59%) had features of liver involvement singly, 3 (18%) had neurological involvement alone and 4 (27%) had mixed presentations. Family histories were available in 15 patients; 26.9% of siblings had Wilson's Disease. Serum ceruloplasmin was low in 82% of the patients. 24-hour urinary copper was measured in 16 patients and was raised in all of them. About half the patients (41%) had evidence of concomittant renal tubular dysfunction with hypouricaemia and aminoaciduria. Three patients (18%) had joint involvement at presentation. All 17 patients were treated with Penicillamine. Complications due to therapy included pemphigus in one and toxic epidermal necrolysis and later a lupus like syndrome in another. The features of clinical improvement included fading of K-F rings, improvement of neurological signs and the normalisation of serum transaminases. One patient developed primary hepatocellular carcinoma 5 years after presentation. Delay in diagnosis was encountered in half of the patients reviewed. Being a treatable condition, Wilson's Disease, although rare, should always be thought of in patients with haemolysis, liver diseases or extrapyramidal disorders.

Adolescent↗