Biomedical subjects
Publications and source records attributed to Y Y Ong.
Clear cell carcinoma of the lung is a rare entity. We report the first case seen locally. The patient is symptomatic, presenting with a large pulmonary tumour. Histologically, there were clusters of large tumour cells with ample clear cytoplasm and absence of mucin, glandular and squamous differentiation. Urine analysis, blood carcinoembryonic antigen level and abdominal CT scan were normal.
To ascertain the profile of medical intensive care unit (MICU) utilization in the Singapore General Hospital, a prospective survey studying 162 consecutive patients admitted to MICU was conducted over a four-month-period spanning September through December 1990. While there was no racial predilection, male admissions (n = 98) outnumbered female (n = 64) by a ratio of 3:2. Male admissions averaged 56.7 +/- 1.9 years (mean +/- SEM) vs 56.4 +/- 2.69 years in female (p = 0.98). Sepsis comprised 25.3% (n = 41) of admissions during this period of which chest infection (n = 26) made up 63%. The superinfection rate was 3% comprising colonization of endotracheal and peritoneal dialysis tubes by Candida and Acinetobacter. There was a surprisingly high number of culture negative infections. These amounted to 43.9% (n = 18) out of 41 admissions for sepsis as the primary indication and 57.1% of admissions in which sepsis was an accompaniment of the main indication. The mean duration of ICU stay was 7.17 +/- 1.5 days for sepsis vs 4.7 +/- 0.5 days for admissions other than sepsis. Although this did not reach statistical significance (p = 0.79) it corroborates the prevalent impression that patients with sepsis tend to require longer intensive care. The overall mortality was 37% (n = 60). The mortality for septic patients (42.5%) is alarmingly high. This contrasts with a mortality rate of 34.7% for non-septic patients. The issue of culture negative sepsis needs to be addressed. As it stands, septic patients stay longer than non-septic ones.(ABSTRACT TRUNCATED AT 250 WORDS)
Cough is a recognised side effect of angiotensin converting enzyme (ACE) inhibitors although its exact mechanism is still unknown. Reports on the side effect of ACE inhibitors on asthma have been conflicting. These drugs either had no effect on bronchial reactivity or resulted in an increase in pre-existing hyperreactivity. We report a case of a non-asthmatic patient who had lisinopril-induced cough and bronchial hyperreactivity.
Pulmonary alveolar proteinosis is a relatively rare disease. Its etiology is unknown but it has been found associated with various opportunistic infections as well as immunological conditions. The clinical and radiological features may be indistinguishable from other respiratory disorders and diagnosis is often dependent on histology. Its course can vary from progressive deterioration to spontaneous improvement and treatment with bronchopulmonary lavage may not always be necessary. Many theories regarding pathogenesis have been put forward and most of these centre upon the roles of alveolar macrophages. We describe a case of Pulmonary Alveolar Proteinosis in a local Oriental male and reviewed the current understanding of its pathogenesis.
The authors performed a comparative study of the values of 18 serum constituents of blood specimens taken simultaneously from the arm into which an intravenous solution was flowing, using a site distal to the intravenous needle, and from the other arm. Subjects of the study were 15 patients at the Norwalk Hospital. Statistical analysis showed no clinically significant difference between the levels in the two arms except for elevation of glucose in the "iv arm" when the intravenous solution contained glucose.
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