Bulbar palsy aggravated by metrizamide CT cisternography.
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Brain↗
Biomedical subjects
S Y So
Publications and source records attributed to S Y So.
Melioidosis: a serological survey in a tuberculosis sanatorium in Hong Kong.
A serological survey of 275 Chinese patients with underlying pulmonary diseases in a tuberculosis sanatorium in Hong Kong showed that 39 (14%) had haemagglutinating antibody (HA) against Pseudomonas pseudomallei in a titre of 1: 80 or above. Only 9 of these 39 patients had travelled to endemic areas, suggesting that at least 30 patients (11%) had been exposed to Ps. pseudomallei locally. Females are affected as often as males, and the seropositive rate is the same whether patients are immunosuppressed or not. Because subclinical melioidosis is prevalent and HA may persist for a long time, even at a high titre, after infection, determination of HA alone cannot differentiate between active melioidosis and its masquerade--active tuberculosis.
Adolescent↗
Pulmonary function in thalassemia major.
Pulmonary function tests were evaluated in 28 Chinese patients with beta-thalassemia major receiving regular transfusions and desferoxamine, and in 34 height-matched normal Chinese children. Comparison of lung function using analysis of covariance with reference to standing height showed that patients with thalassemia had a proportional decrease in forced vital capacity and forced expiratory flow volume in 1 second, whereas their expiratory flow rates, residual volume, and total lung capacity were comparable to those in normal children. The single-breath carbon monoxide diffusion capacity was normal. Our findings suggest that children with thalassemia major have mild restrictive lung disease. The previous controversy regarding the presence of restrictive or obstructive lung disease in patients with thalassemia may be related to the use of inappropriate control values.
Adolescent↗
Enzyme-linked immunosorbent assay (ELISA) of antibodies to purified protein derivative (PPD) in the diagnosis of active tuberculosis: evaluation of its potential and limitation in a high prevalence area.
Sera from patients with active tuberculosis were assayed for IgG antibodies to purified protein derivative (PPD) by an enzyme-linked immunosorbent assay (ELISA) technique. Eighty seven of the 112 patients (78%) with sputum culture-positive, and 57 of 78 patients (73%) with sputum culture-negative, pulmonary tuberculosis had positive serology. Seventeen of 19 patients (89%) with renal tuberculosis (demonstrable lesion on intravenous pyelography) had antibody to PPD, whereas only 3 of 9 patients (33%) with urinary tuberculosis (positive urine culture only, without abnormality on intravenous pyelography) and 8 of 21 patients (38%) with tuberculous cervical lymphadenitis had positive serology. Seropositivity rate in paediatric patients was also low, only 2 out of 8 patients gave positive serology. Thus, the diagnostic value of this test is limited as a positive result is obtained only when the disease is relatively long-standing or extensive.
Adult↗
A double-blind randomized study comparing ofloxacin and amoxicillin in treating infective episodes in bronchiectasis.
32 hospitalized adult patients with infective episodes of bronchiectasis were enrolled in an ongoing double-blind, placebo-controlled study comparing ofloxacin with amoxicillin. They were randomized to receive either 200 mg ofloxacin or 1 g amoxicillin, both t.i.d. orally for ten days. In the ofloxacin group (15 patients), clinical response was excellent (clinical cure) in 11 and fair (clinical improvement or early reinfection) in three patients with one failure. In the amoxicillin group (17 patients), clinical response was excellent in six, fair in five, and poor (treatment failure) in six patients. Ofloxacin levels at 2 h (day 5) were 2.3 to 8.2 mg/l (mean 3.9 mg/l) for serum and 1.3 to 15 mg/l (mean 4.5 mg/l) for sputum. Sputum: serum ratio was 1.2:1. Amoxicillin levels at 2 h were 10 to 40 mg/l (mean 19.9 mg/l) for serum and 0 to 1.5 mg/l (mean 0.3 mg/l) for sputum, with no amoxicillin detected in sputum in 10 of 17 patients. Sputum: serum ratio was 0.02:1. One patient in the ofloxacin group had nausea. In the amoxicillin group, four patients had nausea and stomach pain, one had vertigo and one had transient peripheral eosinophilia. Ofloxacin thus yielded higher sputum concentration and appeared to be more effective and better tolerated than amoxicillin in infective episodes of bronchiectasis.
Adult↗
Calcium channel blockers and asthma.
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Animals↗
No association between HLA antigens and adenocarcinoma of the lung in non-smoking Chinese women in Hong Kong.
A high incidence rate of lung cancer with preponderance of adenocarcinoma in non-smokers has been reported in women of southern Chinese ethnic origin. Thirty-three southern Chinese female patients with primary adenocarcinoma of the lung, all lifelong non-smokers, were typed for HLA-A and B antigens to study the possibility of genetically determined susceptibility factors. The antigen frequencies were compared with those of 110 healthy controls. No significant difference in antigen frequencies was found in the patients compared with controls. Studies on other possible factors determining susceptibility to lung cancer in Chinese women are necessary.
Adenocarcinoma↗
Thymectomy in myasthenia gravis during pregnancy.
A 24 year old woman with myasthenia gravis suffered an antepartum exacerbation which failed to respond to increasing dosages of pyridostigmine. Thymectomy performed in the second trimester was followed by clinical improvement and full term vaginal delivery with no puerperal deterioration.
Adult↗
An unusual cause of central cyanosis in a patient with rheumatic heart disease.
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Aortic Valve Stenosis↗
Endobronchial tuberculosis revisited.
Analysis was made of 20 patients with endobronchial tuberculosis proven by fiberoptic bronchoscopy and bronchial biopsy. Unlike prechemotherapy reports, the disease affects the older age group and more men. Only one half of the patients had fever, and the characteristic localized wheeze was found in 15 percent of cases. Chest roentgenogram showed typical collapse-consolidation in most cases; however, it was clear in 20 percent of patients. Sputum/smear was negative for AFB in 85 percent of patients. When the gelatinous granulation tissue was not found during bronchoscopy, a diagnosis of bronchogenic carcinoma was made incorrectly in 30 percent of patients. At a mean period of 27 months postchemotherapy, all 12 patients recalled for study developed bronchostenosis proven by bronchoscopy/bronchography except one. Noninvasive methods such as chest roentgenogram and flow-volume loops were insensitive for detection of stenosis. Steroid therapy probably did not influence outcome of tuberculous endobronchitis.
Adolescent↗
A young woman with apparent increase in the transverse cardiac diameter.
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Adult↗
Complete absence of serum alpha-1-antitrypsin in conjunction with an apparently normal gene structure.
A family in which a Pinull allele for alpha-1-antitrypsin (A-1-AT) segregates has been studied in detail. Two homozygous sisters have no detectable A-1-AT in their serum as measured with the most sensitive methods currently available. Both have airways obstruction, and one has bullous emphysema. Heterozygotes for Pinull and the common normal allele PiM1 have half-normal serum concentrations of A-1-AT. A restriction enzyme analysis of chromosomal DNA of the two homozygotes and one heterozygote demonstrated the presence of an apparently complete structural gene for A-1-AT. Thus, the genetic defect in Pinull is not a complete or partial deletion of the structural gene. A base pair change that cannot be detected by the restriction enzymes used here, of course, cannot be excluded. Another possibility is a mutation outside the structural gene that affects the synthesis of the protein.
Adult↗
AIDS in a Hong Kong Chinese.
A young Hong Kong Chinese male patient with fever of unknown origin is presented. The diagnosis of acquired immunodeficiency syndrome was made only 5 months after the onset of his illness. The lack of awareness of the syndrome might account for the delay in the diagnosis. The legal attitude towards homosexuality might have an adverse effect on epidemiological studies of AIDS in Hong Kong.
Acquired Immunodeficiency Syndrome↗
Twice daily administration of beclomethasone dipropionate dry-powder in the management of chronic asthma.
In a double-blind cross-over study beclomethasone dipropionate inhaled as a dry-powder in a dose of 400 micrograms twice daily was compared with a conventional aerosol in a dose of 100 micrograms four times daily in 16 outpatients with chronic asthma. Each of the 2 treatments lasted for 4 weeks. There was no significant difference with respect to daily peak expiratory flow rates, symptom scores, bronchodilator usages and other lung function measurements between the 2 treatments. Tetracosactrin tests were within normal limits and no clinical oral candidiasis was observed throughout the study. In conclusion, beclomethasone dipropionate dry-power given twice daily was effective for the control of asthma and could be recommended for patients with poor drug compliance.
Administration, Inhalation↗
Evidence that respiratory tract is major reservoir for Epstein-Barr virus.
Exfoliated cells harvested from bronchial washings of 53 patients with suspected bronchogenic carcinoma were tested by means of DNA dot hybridisation using the cloned large internal repeat (IR) sequence of Epstein-Barr virus (EBV) genome as a probe. 25 of these patients gave positive results. Since the patients had diseases that were not related to the virus, this finding suggests that the lower respiratory tract is a major reservoir for EBV. Attempts at cellular localisation of the virus revealed only an occasional cell which harboured the viral genome or expressed viral capsid antigens. These cells could not account for the quantity of the viral DNA detected in bronchial washings. Moreover, patients had similar profiles of serum EBV antibodies whether they were positive or negative for EBV DNA by dot hybridisation. These findings are compatible with a state of viral latency in which cells harbour a low copy number of the viral genome. Viral expression rarely occurs in these cells, which seem to elicit a minimum host immune response. If it is assumed that each latently infected cell harbours a maximum of approximately 30 EBV genomes (which is the lower limit of detection by the in-situ hybridisation method used in this study), the findings suggest that a considerable proportion of the exfoliative cells from the lower respiratory tract, of the order of 0.1-16%, harbour latent EBV.
Adult↗
Cyclic combination chemotherapy in advanced adenocarcinoma of the lung: comparison of two FAM schedules.
Forty patients with advanced adenocarcinoma of the lung were treated by two FAM chemotherapy schedules. Group A (20 patients) received Futraful, adriamycin, and mitomycin C, and group B (20 patients) received 5-fluorouracil, adriamycin, and mitomycin C. The response/stabilization rate was greater for group B (4 partial responses + 4 cases of stable disease) than for group A (no responders + 5 cases of stable disease), and the median survival was longer for group B (32 weeks) than for group A (22 weeks), although the differences did not reach statistical significance in either case (P greater than 0.05). Myelotoxicity was mild in both schedules. Further studies of the two FAM schemes at an escalated dose would be worthwhile.
Adenocarcinoma↗
Pulmonary scar cancer. A pathologic reappraisal.
A total of 49 consecutive specimens of lung cancer were collected prospectively at surgical resection or autopsy from 40 men and nine women, aged 40-74 years. Of the 49 tumors, the gross appearance of 22 fitted the description of a scar cancer, i.e., a tumor with pleural puckering and central pigmentation. Nineteen of the "scar cancers" were peripheral (17 adenocarcinomas and two squamous cell carcinomas); three were central (one squamous cell carcinoma and two adenocarcinomas). In the 19 peripheral "scar cancers," elastic stains demonstrated the presence of collapsed, unfibrosed lung tissue at the center with traction of the overlying pleura toward it. Elsewhere in the tumor, the elastic framework was either destroyed or expanded by tumor filling the alveolar spaces. None of the "scar cancers" had a significant desmoplastic reaction that might otherwise explain the scarred appearance. It appeared that local atelectasis was solely responsible for the pleural puckering and central pigmentation. On the other hand, atelectatic lung tissue was not seen in the 27 cancers that did not have the appearance of a scar cancer. Tuberculosis was found in 10 of the 49 lung specimens. In only one specimen was the tuberculous lesion anatomically associated with the tumor. There was no evidence of pulmonary infarct in any of the specimens. The term "scar cancer" was considered inappropriate as there was no preformed fibrous tissue. The scarred appearance was thought to be the result of localized pulmonary atelectasis owing to small airways obstruction by tumor. Association with tuberculosis was considered incidental.
Adenocarcinoma↗
Selective 5-HT2 receptor blockade in exercise-induced asthma.
Seven young extrinsic asthmatics participated in an open, pilot study to determine the protective effect of a selective 5-hydroxytryptamine (5-HT) blocking agent, ketanserin, on exercise induced asthma. Ketanserin in a dose of 10 mg given intravenously 20 min before exercise altered the basal bronchomotor tone in only 1 of 6 subjects and offered partial protection against exercise-induced bronchoconstriction in 1 of 5 asthmatics with no overall effect in the group. All patients experienced sleepiness after administration of ketanserin and one had bradycardia with hypotension. The ineffectiveness of ketanserin suggests indirectly that serotonin has a limited role in the pathogenesis of exercise-induced asthma.
Adolescent↗