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Biomedical subjects

L M Tang

Publications and source records attributed to L M Tang.

At least 55 records · Page 3Linked to original sources
PubMed1994

Citrobacter meningitis in adults.

Citrobacter meningitis is an uncommon infection of neonates and young children. It is rarely seen in adults. We describe a 46-year-old man with a mixed bacterial meningitis caused by C. diversus and Klebsiella oxytoca and a 64-year-old woman with C. freundii meningitis. Review of the English-language literature revealed only 2 adult patients with C. diversus meningitis and another 2, with C. freundii meningitis. The ages of these 6 aforementioned patients ranged from 31 to 84 years. Multiple facial fractures, neurosurgical procedures, alcoholism and diabetes mellitus were predisposing conditions. Among the 5 patients whose outcome was known, antibiotic therapy was successful in 4 but failed in 1. This study emphasizes that almost any of the gram-negative bacilli can cause serious infection of the central nervous system in adults in the proper setting.

Adult↗
PubMed1994

Klebsiella pneumoniae meningitis: prognostic factors.

All 42 cases of Klebsiella pneumoniae meningitis diagnosed between 1981 and 1991 were evaluated. These accounted for 13% of patients with blood and/or cerebrospinal fluid culture-proven bacterial meningitis. There was an increased incidence of K. pneumoniae meningitis from the first 6 years of study (7%) to the last 5 years (16%). K. pneumoniae became increasingly important not only in community-acquired meningitis but also in nosocomial meningitis. 12/13 nosocomial cases were patients who had undergone neurosurgical procedures. The overall mortality rate was 43%. The mortality rate in patients with spontaneous meningitis was higher than that in patients with post-traumatic or postoperative meningitis. Factors that adversely affected mortality were age over 60, diabetes mellitus, and severe neurological deficits on admission. The use of third-generation cephalosporins did not reduce the mortality rate.

Adult↗
PubMed1994

Relapsing bacterial meningitis in adults.

Relapsing bacterial meningitis is a rare condition, diagnosed in eight patients between 1981 and 1993 at our institution. These accounted for 3.4% of 234 adult patients with blood and/or cerebrospinal fluid culture-proven bacterial meningitis. A review of the English-language literature from 1966 to the present revealed only five further adult cases of relapsing bacterial meningitis with in-depth case histories. Of these 13 total patients, nine were female and four male, aged 17-61 years. Ten were neurosurgical patients. Gram-negative bacilli, especially Klebsiella species, were the commonest micro-organisms identified for both the initial episode and the relapse of infection. Three patients died in the course of relapse. Four or more weeks of antibiotic therapy may be needed to treat post-surgical patients with Gram-negative bacillary meningitis. Even a normal cerebrospinal fluid study at the end of treatment of bacterial meningitis is not a guarantee of freedom from relapse.

Adult↗
PubMed1994

Nonsurgical treatment of spinal epidural abscess: report of a case.

Traditionally, the treatment of choice for spinal epidural abscess (SEA) is decompressive laminectomy and debridement followed by antibiotics. In recent years, nonsurgical treatment in selected cases has been reported. This report describes a 39-year-old man with lumbar SEA diagnosed by computed tomographic-myelography. In the absence of neurological deficit and the presence of infective endocarditis and a known pathogen, the patient received only antibiotic treatment and made an uneventful recovery.

Abscess↗
PubMed1993

Electrodiagnostic studies in myasthenia gravis.

Forty-three patients with myasthenia gravis (MG) were studied to compare the sensitivity of repetitive nerve stimulation (RNS) test with single fiber electromyography (SFEMG) in the diagnosis of MG. SFEMG was abnormal in 81% (35 of 43 cases), while RNS test was abnormal in 53% (23 of 43 cases). In ocular MG, SFEMG showed a much higher positive rate (70%, 16 of 23 cases) than RNS test (22%, 5 of 23 cases). Both studies had similar abnormal rates in the generalized group. In patients studied with SFEMG in the EDC muscle, the clinical severity was closely correlated with jitter abnormality. We conclude that SFEMG is more sensitive than RNS test in the diagnosis of MG, especially in the ocular group.

Adolescent↗
PubMed1990

Reevaluation of the absorption of carbenoxolone using an in situ rat intestinal technique.

The absorption of the model drug carbenoxolone was reevaluated using an in situ rat intestinal perfusion technique in which disappearance from the intestinal lumen, binding to the perfused jejunal segment, and appearance in the mesenteric (jejunal) vein were measured. The effect of the degree of ionization on these processes was examined by employing perfusion solutions of pH 4.0, 4.4, 5.0, and 6.5. Tissue binding was observed to be independent of pH. There was a rank-order correlation of the transfer rate of carbenoxolone with the degree of ionization which indicated that carbenoxolone was absorbed faster in its ionized form. This observation is in direct opposition to the pH-partition hypothesis, a finding which appears to support the previous work of Bridges et al. Ion-pairing of carbenoxolone with sodium ion present in the pH 6.5 buffer is one possible explanation for the unusually high transfer rate seen at this pH. A more likely explanation is that at the low pH values, some carbenoxolone precipitated out of solution during the perfusion experiments, thereby reducing the driving force for diffusion across the intestinal wall.

Animals↗
PubMed1990

Ventriculoperitoneal shunt in cryptococcal meningitis with hydrocephalus.

Fourteen patients with cryptococcal meningitis were reviewed. All patients had a ventriculoperitoneal shunt for hydrocephalus. Early recognitions and prompt relief of hydrocephalus were useful for eight patients who showed rapid deterioration of consciousness or signs of cerebral herniation. There was no surgical response in four patients who had had weeks of confusion or mental change. It seems, therefore, that the duration of disturbance of consciousness or change of mentality before shunting is critical in determination of the outcome of the treatment. Ventricular shunting was effective in relieving papilledema in five patients. However, the surgery did not prevent the development of papilledema to optic atrophy and subsequent blindness in two patients. Hence, in addition to hydrocephalus with increased intracranial pressure, conditions such as direct invasion of the optic pathways by Cryptococcus neoformans or optochiasmatic arachnoiditis may be responsible for the visual failure. Ventricular shunting was also helpful in restoring paraparesis in one patient. Of the cerebrospinal fluid determinations, low protein concentration was a favorable indicator for surgery. Of the seven patients who received the surgical procedure before the start of antifungal therapy, four showed a significant improvement despite active infection of the central nervous system. None of the seven patients deteriorated because of the surgical operation. Thus, active stage of cryptococcal meningitis does not contraindicate the necessity of shunting, and premedication with antifungal drugs is unnecessary. Also, no shunt-related morbidity and mortality was seen in this study.

Adolescent↗
PubMed1989

Nocardial cerebral abscess: report of a case.

Cerebral nocardiosis is an uncommon disease which has not been previously reported in Taiwan. We describe a 70-years-old man who, known to have a history of rectal cancer, developed a cerebral nocardial abscess. The patient was admitted with a week history of gradual weakness of the left limbs. There was neither fever nor headache. Neurological examination disclosed left hemiparesis. Computed tomography of the brain revealed a decreased density in the right parietal region with a ring enhancement. Biopsy of the cerebral lesion showed Nocardia asteroides.

Aged↗
PubMed1988

Postural effects on F wave parameters in lumbosacral root compression and canal stenosis.

The effects of standing, and lying with the back extended, on F wave minimal latency and F chronodispersion were studied in patients with lumbar canal stenosis, lumbosacral root compression syndromes, and low back pain. Standing for 3 min produced increased F chronodispersion in lumbar canal stenosis and root compression syndromes but had less effect on the F minimal latency. In patients with low back pain these variables were unchanged by these postural manoeuvres. These observations illustrate the value of adapting electrophysiological investigations to those clinical features that induce symptoms in these disorders.

Adult↗
PubMed1988

Intracranial phycomycosis: case reports.

Cerebral phycomycosis is a rare disease. We describe two patients with unusual features of focal intracranial phycomycosis: a diabetic patient with chronic epidural abscess and a healthy individual with an isolated intracerebral abscess. Biopsy established the diagnosis in both patients. Treatment was successful in the patient with intracerebral abscess.

Adult↗
PubMed1988

Serial lactate determinations in tuberculous meningitis.

Lactate levels in the cerebrospinal fluid (CSF) were determined in 21 patients with culture-proved tuberculous meningitis (TBM). All patients showed uniformly high lactate level (greater than or equal to 3.9 mmol/l). Neither the clinical stage of TBM nor the prognosis was related to the CSF lactate concentration. Repeated CSF studies demonstrated persistently high lactate levels in the early stage of illness despite adequate antituberculous therapy.

Adolescent↗
PubMed1986

Origin and significance of small muscle fibres in neuromuscular disease.

Small muscle fibres, defined as those of less than 40 microns diameter in the male and 30 microns in the female were encountered in muscle biopsies of patients with spinal muscular atrophy (SMA), amyotrophic lateral sclerosis (ALS), polymyositis (PM) and myopathy/dystrophy. Excessive reactivity with NADH-TR in small fibres did not discriminate between neurogenic and myopathic disorders. Quantification of perifascicular atrophic fibres, the number of nuclei in atrophic fibres, or the presence of isolated or grouped small fibres without histochemical kinship to their surrounding fibres did not aid recognition of the disease process in the groups studied. Small fibres which reacted strongly both with NADH-TR and ATPase at pH 9.4 (Type 3 fibres) constituted 38% of small fibres in the biopsies of SMA; 25% in ALS; but only 1% and 2.7% in PM and myopathy/dystrophy respectively. Thus, the presence of small Type 3 fibres in muscle biopsies may be a useful marker for neurogenic disorders in adults.

Adenosine Triphosphatases↗
PubMed1983

Syndrome of polyneuropathy, skin hyperpigmentation, oedema and hepatosplenomegaly.

Four middle-aged male Chinese with polyneuropathy, skin hyperpigmentation, oedema, hepatosplenomegaly, ascites, gynaecomastia and white nails are described. In Japan and United States this syndrome has been associated with plasma cell dyscrasia. However, neither M-protein nor skeletal lesions were demonstrated in these four patients.

Adult↗
PubMedDate not supplied

Klebsiella ozaenae meningitis: report of two cases and review of the literature.

Meningitis is rarely caused by Klebsiella ozaenae, a colonizer of the oral and nasopharyngeal mucosa. We describe two patients with K. ozaenae meningitis. Both patients suffered from a primary disease of the nasopharyngeal pathway; one had nasopharyngeal carcinoma and the other ozena. Review of the English-language literature from 1966 to the present revealed only two cases of K. ozaenae meningitis; pneumonia and hyperglycemia were noted in one patient and otitis media, sinusitis and diabetes mellitus in the other. All these four patients were over 50 years old. Of the four patients, two treated with third-generation cephalosporins recovered whereas one of the two treated with chloramphenicol died. One patient who died had a positive blood culture for K. ozaenae. Blood culture was positive in only one of the three survivors. Whether chloramphenicol should be replaced by a third-generation cephalosporin and whether blood culture indicates a poor prognosis in K. ozaenae meningitis remain to be determined.

Female↗
PubMedDate not supplied

Klebsiella oxytoca meningitis: frequent association with neurosurgical procedures.

Klebsiella oxytoca meningitis is a rare condition. Nine patients were diagnosed between 1981 and 1993 at our institution. These accounted for 2.3% of 393 patients with blood and/or cerebrospinal fluid culture-proven bacterial meningitis. K. oxytoca was noted in both community-acquired meningitis and nosocomial meningitis. Eight of the nine cases were patients who had undergone neurosurgical procedures. Four were mixed bacterial meningitis. All K. oxytoca isolates were susceptible to third-generation cephalosporins and all but one to chloramphenicol. Antibiotic therapy was successful in eight patients but failed in one.

Adult↗
PubMedDate not supplied

Primary myxoma of the cranium: CT findings.

A case of 17-year-old girl with primary myxoma of the cranium is presented. The lesion ballooned the inner and outer tables of the cranium and expanded intracranially, causing neurologic deficits. The lesion is rare and its radiographic, including CT, features are described.

Adolescent↗