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Biomedical subjects

T K Lim

Publications and source records attributed to T K Lim.

At least 109 records · Page 6Linked to original sources
PubMed1987

Effects of volume history during spontaneous and acutely induced air-flow obstruction in asthma.

We examined the volume history effect on maximal expiratory flow (Vmax) in patients with asthma by comparing Vmax at 60% of VC from forced exhalation maneuvers begun just above FRC (partial, P) with those begun from TLC (maximal, M) and expressed the results as M-P ratios. In a clinic population with varying degrees of obstruction, we found that M-P ratios varied inversely with the severity of the obstructive process, i.e., the more severely obstructed patients had a fall in Vmax after a deep inhalation (DI). By contrast, equally severe obstruction acutely induced in subjects with mild asthma was associated with an increase in Vmax after a DI. There was no difference between the spontaneous versus the induced groups in degree of nonhomogeneity as assessed by single-breath nitrogen tests. Changes in specific airway conductance after a DI during spontaneous obstruction were in the same direction as the changes in Vmax, and the time course for restitution of airway caliber in subjects who showed bronchoconstriction after a DI was significantly longer than for those subjects who showed bronchodilatation. We conclude that in severe bronchial asthma with spontaneous obstruction, a DI produces an increase in severity that is opposite to the results found in acutely induced obstruction, and the time course for reestablishing baseline airway caliber is more prolonged. We suggest that mechanisms for and sites of obstruction vary between the 2 groups.

Acute Disease↗
PubMed1987

The role of the fibreoptic bronchoscope in the diagnosis of bronchial neoplasm.

We report our experience from January 1980 to December 1985 with the fibreoptic bronchoscope in the evaluation of bronchial disease, particularly bronchial neoplasm. Bronchoscopy was performed in 456 patients (329 men, 127 women) and the pathological results were analysed retrospectively. The main indications for bronchoscopy were the radiological findings of a central mass (22%), a peripheral mass (18%), lobar or segmental collapse (14%), unresolved pneumonia (13%), and haemoptysis as a symptom (15%). Abnormal bronchoscopic findings were noted in 167 patients. This was supported by histological examination in 136 patients (81%). In 43 patients (32%) the diagnosis was only made on cytology. The clinical predictive values of common indications were: central mass 0.53, lobar or segmental collapse 0.51, and superior vena cava obstruction 0.36. The fibreoptic bronchoscope is a highly efficient method for diagnosing bronchial malignancy. Bronchial brushing and aspiration should be performed in all cases to maximise the yield.

Adult↗
PubMed1985

The obstructive sleep apnoea syndrome: case studies.

We describe the upper airway abnormalities and sleep observations of cardiorespiratory function in six patients with the obstructive sleep apnoea syndrome. They were all men, the youngest had evident upper airway obstruction from enlarged tonsils while the rest had no gross mechanical obstruction on direct laryngoscopy but had demonstrable abnormalities of flow-volume loop recordings. Sleep studies demonstrated marked cyclical variation of heart rate and arterial oxygen desaturation. These were associated with loud snoring and cyclical hyper-ventilation and hypo-ventilation. These features were characteristic of the obstructive sleep apnoea syndrome. This paper documents the classic features of the obstructive sleep apnoea syndrome in an Oriental population.

Adult↗
PubMed1985

Acute carbon dioxide narcosis during inhalational therapy with oxygen powered nebulizers in patients with chronic airflow limitation.

Six patients with acute carbon dioxide narcosis following nebulised salbutamol therapy were described. They had chronic obstructive airflow disease and were admitted in acute respiratory failure. The patients were treated with aerosolized salbutamol delivered from oxygen powered nebulizers. They developed severe acute hypercapnia. Five of the six patients died. The hazards of indiscriminate oxygen use in this clinical situation was discussed.

Aerosols↗
PubMed1981

Late result of sphincteroplasty in the treatment of primary cholangitis.

Sphincteroplasty is one of the surgical procedures used in the treatment of primary cholangitis. We performed this operation on 342 patients over a 13-year period, with an operative mortality of 4.7%. Postoperative examination of 271 patients (average follow-up, seven years four months) showed that a good result was achieved in 226 patients, a fair result in 23 patients, and a poor result in 22 patients. Analysis of the reoperations in 17 patients showed that stone reformation is the most common finding, followed by sphincteroplasty stricture, liver abscess, and empyema of the gallbladder. When performed with proper indications in the management of primary cholangitis, sphincteroplasty is a safe procedure, and the majority of patients can expect good results.

Adult↗
PubMed1979

Acute pancreatitis in Hong Kong.

A series of 311 Chinese patients with acute pancreatitis admitted to Queen Mary Hospital, Hong Kong, over a 10-year period is reviewed. Biliary tract disease was associated with pancreatitis in 52.4 per cent of patients and 77.9 per cent of them had stones, mud or parasites in the common bile duct. Fever and jaundice were present in 55 per cent and 41.2 per cent of patients respectively. Because of the prevalence of recurrent pyogenic cholangitis among the indigenous population, emergency operation, with the aim of common duct decompression, was conducted in 54.3 per cent of patients during the acute episode, with a mortality rate of 14.8 per cent. Five of 142 patients (3.5 per cent) died whilst on conservative treatment and all 5 had haemorrhagic pancreatitis. The overall mortality rate was 9.6 per cent. Exploration of the common bile duct, which was carried out in 57.4 per cent of patients in the acute phase, was not associated with a higher mortality than when laparotomy alone was performed, and 19 patients had sphincteroplasty without any death. Subtotal pancreatectomy was performed in 2 patients with haemorrhagic pancreatitis with 1 death.

Acute Disease↗