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Biomedical subjects

W K Luk

Publications and source records attributed to W K Luk.

26 records · Page 2Linked to original sources
PubMed1996

An outbreak of pseudobacteraemia caused by Burkholderia pickettii: the critical role of an epidemiological link.

A protracted outbreak of pseudobacteraemia caused by Burkholderia pickettii is reported. Initial investigation did not reveal the source of the outbreak. Subsequently, careful examination of patient records provided an insight to the probable source, which was further confirmed by a case control study. It was found that 48% of cases had either hepatobiliary diseases or haematological malignancies, whereas only 15% of the controls had similar problems. Furthermore, a coagulation study was performed on all of the cases on the day the blood culture was taken, but was performed on only 17% of the controls. With the establishment of this epidemiological link, a breakdown in aseptic blood culture technique was suspected. B. pickettii was isolated from citrated bottles used in the wards and from the citrate solution stocked in the haematology laboratory. The clonality of these strains was established by the pulsed-field gel electrophoresis (PFGE) and the arbitrary primed-polymerase chain reaction (AP-PCR). The phlebotomists were notified of the findings of the outbreak investigation, and the importance of strict adherence to the aseptic blood culture technique was re-emphasized.

Adult↗
PubMed1996

The epidemiology of acinetobacter infections in Hong Kong.

A retrospective survey was conducted of the characteristics of acinetobacter infections in Hong Kong--seasonal and geographic distributions, frequency of isolation from various body sites, antimicrobial susceptibility and molecular epidemiology. Most (80%) isolates of Acinetobacter spp. belonged to DNA groups 2 (A. baumannii) or 13, as defined by growth at 44 degrees C. An increased isolation rate in summer was related to higher ambient temperatures. The notion that acinetobacters are opportunist nosocomial pathogens was supported by the body site- and ward-specific distributions, which were similar to those of Pseudomonas aeruginosa and in marked contrast to those of coagulase-negative staphylococci and Escherichia coli. Typing of Acinetobacter isolates by arbitrary-primed polymerase chain reaction revealed extensive genotypic polymorphism, suggesting that numerous unrelated strains were circulating between patients. In view of the association with a high incidence of polymicrobial bacteraemia and multiresistance to antibiotics, a careful selection of appropriate antibiotics in combination is necessary for empirical therapy of infections caused by Acinetobacter spp.

Acinetobacter↗
PubMed1995

Contamination of titanium castings by aluminium oxide blasting.

OBJECTIVES: It is desirable that the surfaces of surgical implants be uncontaminated by foreign materials to avoid untoward tissue reactions, and grit blasting is widely assumed to leave clean metal surfaces. SEM examination and X-ray microanalysis of a recovered 'pure' titanium implant casting that was associated with tissue breakdown revealed embedded particles of alumina. The casting had been cleaned of investment by blasting with alumina grit. METHODS: A variety of treatments of cast titanium plates was used: (a) to establish that the observed aluminium was due to the blasting grit, and (b) to determine whether removal of investment could be achieved effectively by other means. SEM examination and X-ray microanalysis were used. RESULTS: The detected aluminium was associated with embedded fragments identified as coming from the blasting grit. Acid-pickling and mechanical (rotary instrument) trimming produced minimally contaminated surfaces. CONCLUSIONS: Whilst unproven, the presence of the alumina is viewed with great concern as a possible causative agent in the observed tissue breakdown and procedures avoiding alumina blasting are recommended as a precautionary measure.

Aluminum Oxide↗
PubMed1994

[Roentgen findings in bronchial tuberculosis].

To determine the value of chest roentgenographic findings in the diagnosis and therapy of endobronchial tuberculosis we analysed roentgenograms of 41 patients with endoscopically confirmed tuberculous involvement of the intrathoracic airways. 40 patients had infiltrates typical for pulmonary tuberculosis predominantly in the upper lobes. Signs of diminished air entry in form of collapse or consolidations were found in 52%. 10 patients had cavities and two had a destroyed lung. In only one patient the chest roentgenogram was completely normal demonstrating a case of isolated endobronchial tuberculosis. During antituberculosis drug therapy radiological signs improved in 38 of 41 patients, but in more than half of the cases stenoses persisted as verified by bronchoscopy. We conclude that endobronchial tuberculosis is usually accompanied by lung parenchyma involvement and that roentgenological findings are characterised by signs of pulmonary tuberculosis in most cases. A normal chest roentgenogram does not exclude endobronchial tuberculosis. Despite roentgenographic improvement during therapy tracheobronchial stenoses may persist. These findings justify to perform early fibreoptic bronchoscopy. Sputum conversion during the clinical course may indicate the most appropriate time for this examination.

Adolescent↗
PubMed1993

Posthysteroscopy fungal peritonitis in a patient on continuous ambulatory peritoneal dialysis.

We report the first case of posthysteroscopy fungal peritonitis, which developed in a woman 11 days after she had a hysteroscopy for menorrhagia. A high vaginal swab grew Candida albicans and the same organism was cultured from the peritoneal dialysate effluent. A vaginoperitoneal communication was suspected to allow the distension medium to carry the fungus into the peritoneum. The potential use of a prophylactic local antifungal agent before hysteroscopy is discussed.

Adult↗
PubMed1991

[Involvement of the central nervous system in disseminated tuberculosis].

Four weeks after starting tuberculostatic treatment (with isoniazid, rifampicin, streptomycin and pyrazinamide) a 21-year-old man with pulmonary tuberculosis developed symptoms of a radiculomyelopathy as well as mild renal failure. After isoniazid and streptomycin had been discontinued and ethambutol and high doses of vitamin B6 had been added all signs and symptoms improved. However, 4 weeks later tuberculous meningitis occurred which at first seemed to respond to administration of 5 antituberculosis drugs and dexamethasone. But 3 weeks later the patient sustained a partial hemiparesis. Its cause was proven to be a tuberculoma in the region of the brainstem. During further administration of tuberculostatic drugs and glucocorticoids the symptoms gradually receded over 8 months. A 54-year-old man with pulmonary tuberculosis developed cranial nerve pareses and symptoms of cerebellar involvement (trunk ataxia, intention tremor, dysdiadochokinesia) 3 weeks after starting tuberculostatic treatment. Computed tomography revealed multiple intracerebral tuberculomas which gradually shrank with continuation of the tuberculostatic treatment plus glucocorticoids. These two case reports illustrate that in tuberculosis involvement of the CNS can express itself clinically through complex symptoms, sometimes even after the start of tuberculostatic treatment.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Oral rehabilitation of a patient with scleroderma associated with systematic lupus erythematosus: a case report.

This case report presents a patient who had a limited oral opening due to systematic lupus erythematosus (SLE) and describes how oral rehabilitation was achieved with a removable partial denture. Various techniques for the delivery of oral health care have been reported for patients who have limited mouth openings as a result of SLE and scleroderma. After a review of the literature, a new approach was required for this patient with SLE who had a very limited mouth opening. The retention for the removable partial denture (RPD) used the undercut in the abutment teeth and a magnet-retained sectional RPD. A set of tweezers was modified to help with the insertion and removal of the sectional RPD by the patient. This paper reports a new clinical and laboratory technique of fabricating a sectional RPD using magnets and customized tweezers for this patient.

Adult↗