Biomedical subjects

C Kee

Publications and source records attributed to C Kee.

At least 19 recordsLinked to original sources

PubMed2003

Individual and familial characteristics of youths involved in street corner gangs in Singapore.

Thirty-six youths involved in street corner gangs in Singapore were compared with 91 age-matched controls on measures of self-esteem, aggression, dysfunctional parenting and parent-adolescent communication. Results revealed that gang youths had lower self-esteem and higher levels of aggression than controls. Of note were the findings that gang youths reported a relative absence of parental abuse and indifference, and experienced less open communication and higher levels of over-control with their mothers, but not fathers. These findings diverge from anticipated familial correlates of antisocial activity in youths and were discussed with reference to cultural factors and their implications on prevention and intervention.

Adolescent↗

PubMed2002

Pilot study to assess the viability of a rape trauma syndrome questionnaire.

INTRODUCTION: Studies have revealed that rape victims undergo a number of psychological symptoms following the attack, which constitute a specific syndrome termed the rape trauma syndrome (RTS). Evidence of the RTS has been admitted as scientific testimony in the prosecution of sexual offences and has been integral in their successful conviction. The present study aims to assess the viability of a questionnaire designed to identify the RTS in victims of alleged rape. MATERIALS AND METHOD: A 77-item rape trauma syndrome questionnaire (RTSQ) was developed and administered to 30 women who reported rape and 57 nurses who formed the control group. The data were analysed using the Statistical Package for the Social Sciences (Windows Version 6.0). RESULTS: Statistical analysis suggested that the questionnaire was internally consistent and effective in uncovering significant differences between rape victims and controls in their experience of rape trauma symptoms. Rape victims scored significantly higher than controls on the RTS scale. Those who faked rape were also found to endorse a greater number of the rape trauma symptoms than actual rape victims, as well as a greater number of fictitious and unlikely symptoms. CONCLUSION: This pilot study confirmed the viability of the RTSQ and paves the way for a more rigorous examination of its reliability and validity. In the future, the questionnaire may be of use in ascertaining the veracity of victims' claims of rape in the conviction of sexual offences where circumstances are equivocal.

Adolescent↗

PubMed2001

Prevention of early postoperative hypotony by partial ligation of silicone tube in Ahmed glaucoma valve implantation.

PURPOSE: To determine the effectiveness of the partial ligation of a silicone tube of Ahmed glaucoma valve implantation to prevent early postoperative hypotony. PATIENTS AND METHODS: Thirty-two Korean patients were divided into two groups. Ahmed glaucoma valve implantation was performed with or without partial ligation in 16 eyes. The incidence of complications and the success rate in each group were compared. RESULTS: In the partial-ligation group, 10 patients (62.5%) had successful intraocular pressure control (> 5 to < 22 mm Hg) without any additional antiglaucoma medications, whereas intraocular pressure in 12 patients (75.0%) was controlled with or without additional antiglaucoma medications. In the nonligation group, nine patients (56.3%) had successful intraocular pressure control without any additional medications, whereas intraocular pressure in 12 patients (75.0%) was controlled with or without additional antiglaucoma medications. Early postoperative hypotony occurred in 1 of 16 (6.3%) patients with partial ligation and 4 of 16 (25%) patients without ligation. CONCLUSION: The partial ligation of a tube in Ahmed glaucoma valve implantation suggested a lower rate of hypotony and surgical complications. There was no significant difference in final success rate between the partial ligation and nonligation groups.

Glaucoma↗

PubMed2001

Lens particle glaucoma occurring 15 years after cataract surgery.

A 60-year-old man visited our clinic with a sudden blurred vision and ocular pain in his right eye occurring 15 years after cataract surgery. The intraocular pressure (IOP) was 55 mmHg in the right eye and gonioscopy revealed a wide open angle with white cortical lens material in the inferior angle. Since the IOP was unable to be controlled with medical therapy, removal of the lens material was performed by irrigation and aspiration. Following surgery, the IOP was decreased to 18 mmHg without medication and the patient's vision recovered to 20/20. The pathology of the aqueous humor showed macrophages with engulfed lens particles.

Aqueous Humor↗

PubMed2001

Stromelysin gene transfer into cultured human trabecular cells and rat trabecular meshwork in vivo.

PURPOSE: To determine whether stromelysin gene can be introduced into and expressed in the cultured human trabecular cells as well as in the rat eye in vivo through means of a recombinant replication-deficient adenovirus. METHODS: Stromelysin cDNA was obtained by reverse transcription-polymerase chain reaction with mRNA extracted from the cultured human trabecular cells after induction with interleukin 1alpha. Adenovirus vector that contains stromelysin cDNA was constructed by cotransfection of pJM17 and pDeltaA.CMV-str into the 293 cells. The expression of stromelysin in the cultured human trabecular cells was assayed by Western blot and zymography. The expression of stromelysin in the trabecular meshwork of the rat eyes was detected by in situ hybridization and immunohistochemistry. RESULTS: The constructed adenovirus vector contained stromelysin cDNA, but no E1 region. Western blot and zymogram revealed that the stromelysin could be expressed and that it possessed enzymatic activity in cultured human trabecular cells. In situ hybridization and immunostaining of the stromelysin showed that the complete form of stromelysin was expressed in the trabecular meshwork, the iris, and the uveoscleral outflow pathway of the rat eye. CONCLUSIONS: Stromelysin, a functional gene, can be transferred in vivo into rat eyes and in vitro into cultured human trabecular cells using a replication-deficient adenovirus vector. This shows the possibility of gene therapy in glaucoma.

Adenoviridae↗

PubMed2000

Women's psychosocial adjustment to diabetes.

Successful adjustment to a chronic illness such as diabetes mellitus is influenced by a variety of psychosocial factors. The purpose of this study was to examine the extent to which social support, personal resources, coping styles, and psychosocial adjustment to illness differ among women with diabetes living in different types of household structure and to explore the influence of social support, personal resources, coping styles, and household structure on the psychosocial adjustment of women with diabetes. Data were collected in 1995. The convenience sample included 115 diabetic women with an average age of 48 years. Mean length of time from diagnosis was 10 years. Instruments included a demographic data form, a measure of social support, a personal resource scale, the Jalowiec Coping Scale, the Psychosocial Adjustment to Illness Scale-Self-Report, and a self-report item for assessing household structure. Multiple analysis of variance showed that women in various types of households differed in personal resources and coping. Higher levels of social support and more adequate personal resources were associated with more effective coping and better psychosocial adjustment. The effective use of confrontive, optimistic, supportant and self-reliant coping was associated with better psychosocial adjustment, while evasive and emotive coping styles were associated with more adjustment problems. Multiple regression showed that 47% of the variance in adjustment was explained by personal resources and social support. Findings indicated that women in various types of households differed in the adequacy of their resources and in the ways that they cope with diabetes. Findings further indicated that greater social support, more adequate personal resources, and more effective coping are associated with better adjustment.

Adaptation, Psychological↗

PubMed2000

Ability of a confocal scanning laser ophthalmoscope (TopSS) to detect early glaucomatous visual field defect.

AIMS: To evaluate the ability of the confocal scanning laser ophthalmoscope (TopSS) to detect early glaucomatous visual field defect using our unique discriminant criteria. METHODS: The optic discs of 110 eyes of normal Korean subjects were examined and normal values for each variable were obtained according to the size of the optic disc. The five most sensitive optic disc variables for discriminating glaucoma were then applied to one eye of 80 Korean subjects with primary open angle glaucoma or normal tension glaucoma. Only eyes with an optic disc size of 2.0-3.0 mm(2) and a contour tilt of less than 3 degrees were included. These variables were used to develop unique discriminant criteria for detecting early glaucomatous visual field defect and their sensitivity and specificity were calculated in three groups of patients with visual field loss. RESULTS: The five most sensitive variables were half the depth area, cup/disc (C/D) ratio, total area of the neuroretinal rim (NRR), volume above, and localised thinning of the NRR. The following criteria were used to diagnose glaucoma: (1) total area of the NRR decreased and one of the other four variables abnormal, and (2) total area of the NRR normal, localised thinning of the NRR, and one of the other three variables abnormal. The sensitivity of these criteria was 89.7% in patients with a mildly impaired visual field and 100% in those with a moderately or severely impaired visual field; the specificity was 89.1%. CONCLUSIONS: The discriminant criteria used had high sensitivity and specificity in the diagnosis of glaucoma and the TopSS can be useful in the early detection of changes in the glaucomatous optic disc.

Female↗

PubMed2000

Effect of cataract extraction and posterior chamber lens implantation on outflow facility and its response to pilocarpine in Korean subjects.

AIM: To investigate the effect of the lens on outflow facility in Korean patients with cataracts. METHODS: Intraocular pressure was measured by Goldmann applanation tonometry in 42 patients with cataracts and outflow facility was determined by tonography preoperatively, before and after instillation of pilocarpine. All patients received clear corneal phacoemulsification and silicone foldable intraocular lens implantation within the capsular bag by one surgeon. Two months after surgery, slit lamp examination and gonioscopy were performed and intraocular pressure and outflow facility were again determined. Statistical analysis was carried out using the Student's paired t test. RESULTS: There were no anterior chamber reactions and no visible trabecular meshwork damage 2 months after surgery. Intraocular pressure 2 months after lens extraction decreased by a mean of 2.4 (SE 0.4) mm Hg (p<0.001) compared with the preoperative value; postoperative outflow facility with and without pilocarpine increased by 0.080 (0.019) microl/min/mm Hg (p<0.001) and 0.045 (0.014) microl/min/mm Hg (p<0.001), respectively, at 2 months compared with preoperative values. The facility response to pilocarpine after lens extraction, relative to the baseline value and preoperative response, increased by 10.7 (7.1)% which was not statistically significant (p>0.1). CONCLUSION: Lens extraction causes a reduction in intraocular pressure and an increase in outflow facility in Korean subjects. Pilocarpine causes an increase in outflow facility which persists after cataract extraction and posterior chamber lens implantation.

Adult↗

PubMed2000

Nursing advocacy during a military operation.

Advocacy is an essential component of the registered nurse's professional role, yet experts provide no consistent definition of advocacy. The purpose of this study was to explore the experiences of military nurses as they engage in advocating practices and to describe their shared practices and common meanings. Heideggerian hermeneutic phenomenology, provided the framework and method for this study. Twenty-four U.S. Army nurses were individually interviewed and the researcher kept interview observational notes. The constant comparative method of analysis was used. The stories of these nurses revealed one constitutive pattern--safeguarding--and four related themes. The themes were advocating as protecting, advocating as attending the whole person, advocating as being the patient's voice, and advocating as preserving personhood. One conclusion was that military nurses must be prepared for the important safe-guarding role. They must be coached in how to deal with other members of the health team on the patient's behalf.

Attitude of Health Personnel↗

PubMed2000

Changes in gallbladder motility in gastrectomized patients.

OBJECTIVES: Gastric resection may predispose gallstone formation. However, the mechanism has not been clearly understood. To evaluate the relationship between gastric resection and gallstone formation, we compared gallbladder(GB) motility in gastrectomized patients and control subjects. METHODS: We compared the GB volume and ejection fraction of the 46 gastrectomized patients with 37 healthy controls using real time ultrasonography. RESULTS: GB volume increased significantly in the gastrectomized group in fasting (30.2 +/- 13.9 ml). The GB volume after a fatty meal was greater in the gastrectomized group (12.6 +/- 6.4 ml) than in the control group (4.3 +/- 3.3 ml) (p < 0.01). A significant reduction of ejection fraction was found in gastrectomized patients (56.9 +/- 13.0%) in comparison with the control group (75.5 +/- 16.1%) (p < 0.01). The GB ejection fraction had a poor correlation to the postoperative period (r = 0.232). CONCLUSION: A gastrectomy appears to be a risk factor of GB dysmotility, which may play a major role in gallstone formation in gastrectomized patients.

Adult↗

PubMed1999

The relationship between gelatinase A activity in aqueous humor and glaucoma.

PURPOSE: To investigate whether abnormal expression of gelatinase A in aqueous humor may be related to the development of glaucoma, the activity of gelatinase A in aqueous humor of patients with glaucoma and patients with cataract was measured and compared. METHODS: Six primary patients with open-angle glaucoma (POAG), four patients with chronic angle closure glaucoma (CACG), four patients with normal tension glaucoma (NTG), and 14 patients with cataract were enrolled. The aqueous humor of each patient was collected during surgery, and total protein concentration and gelatinase activity in the aqueous humor were measured by protein assay kit and zymography, respectively. RESULTS: In patients with POAG, total protein concentration doubled and gelatinase A activity increased by 3.9 times compared with patients with cataract. However, there were no statistically significant differences in total protein concentration and gelatinase A activity in patients with CACG or NTG compared with patients with cataract. CONCLUSION: The development of POAG may be associated with the abnormal expression of gelatinase A in aqueous humor.

Adult↗

PubMed1998

Soft contact lens care systems and corneal staining in Hong Kong-Chinese.

One hundred and ninety two patient files (for the year September 1995-September 1996) from the Contact Lens Clinic of The Department of Optometry & Radiography, The Hong Kong Polytechnic University were surveyed. A total of 117 patients mostly using three lens care systems (CIBA VISION AOSept, Allergan Oxysept 1-step and Bausch & Lomb Multipurpose solution (MPS)) were included in this retrospective study of the incidence of corneal staining in patients using different lens care systems. The incidence and severity of staining observed was significantly higher and worse respectively in patients using MPS than in patients using the peroxide systems. Corneal staining was observed in 32.3% of the patients using AOSept, in 17.8% of the patients using Oxysept 1-step, and in 70.7% of the patients using MPS system. However, these percentages did not take into account other factors (which we assumed to be affecting the three groups equally) which may have caused some of the corneal staining observed. Of the patients who had corneal staining: 31% (9/29) of the patients using MPS system changed to peroxide system, and 38% (11/29) of the patients were re-educated on proper lens care; 77% (14/18) of the patients using the peroxide systems did not use proper care procedures. The tear stability and volume of HK-Chinese have been reported to be low compared to those reported for Caucasians, which may render Hong Kong-Chinese soft contact lens wearers more prone to adverse reactions to preservatives and to rapid deposit formation. The majority of the patients with corneal staining did not complain of any ocular discomfort even when severe staining was observed.

Journal Article↗

PubMed1998

Changing practice patterns in the management of acute myocardial infarction complicated by cardiogenic shock: elderly compared with younger patients.

BACKGROUND: Cardiogenic shock continues to be an ominous complication of acute myocardial infarction (AMI). Evidence from retrospective analyses, registries and observational studies suggests that aggressive management using emergent revascularization strategies can bring about significant improvement in survival in this setting. Several studies have identified age as an independent predictor of survival. OBJECTIVE: To study retrospectively the possible changes in practice patterns in the management of patients with AMI complicated by cardiogenic shock in a tertiary care referral centre, and to determine what effect these changes may have had on survival of the patients, stratified by age. METHODS: From 1989 to 1995, 115 patients fulfilled the study criteria of cardiogenic shock based on pump failure and of presenting within 48 h of onset of shock. Prespecified data were extracted from medical records. All available coronary angiograms (n = 72) were analyzed by two experienced angiographers and consensus of findings was obtained. RESULTS: The study revealed a significant increase in the use of cardiac catheterization, interventional procedures and intra-aortic balloon pump (IABP) support in patients in the age groups 65 years or less, 66 to 75 years, and older than 75 years in 1989 to 1990, through 1991 to 1992, to 1993 to 1995. Significantly fewer patients aged older than 75 years received cardiac catheterization, coronary intervention and IABP support throughout the study period and even in the final period analyzed. In-hospital survival improved from 4% in 1989-90 to 33% in 1991-92, and 44% in 1993-95 (P = 0.001). Patients aged 65 years or less improved from 10% in 1989-90 to 59% in 1993-95 (P = 0.032). Only 20% of patients aged older than 75 years survived in the 1993-95 period. By univariate analysis, use of coronary angiography (catheterization 46% versus no catheterization 5%; P < 0.0001), coronary intervention procedures (percutaneous transluminal coronary angioplasty or coronary artery bypass grafting) (intervention 48% versus no intervention 9%; P < 0.0001) and IABP support (IABP 41% versus no IABP 18%; P = 0.0096) were all associated with improved in-hospital survival. Use of thrombolytic therapy showed possible survival benefit only in patients aged older than 75 years (thrombolysis 33% versus no thrombolysis 5%; P = 0.10). Patients who underwent coronary intervention were younger (P = 0.002), had a lower incidence of previous myocardial infarction (P = 0.0002), lower heart rate (P = 0.04), higher peak creatine phosphokinase (P = 0.04) and fewer vessels with at least 70% stenosis (P < 0.0001). On multivariate analysis only lower age, lower heart rate and presence of coronary intervention procedures were found to have an independent effect on survival. CONCLUSIONS: Use of invasive treatment strategies has increased significantly since 1989-90 in the management of patients with AMI complicated by cardiogenic shock. This increase has been associated with improved in-hospital survival in all age groups except possibly the very elderly. Patients undergoing coronary interventional procedures are significantly different in baseline clinical characteristics from patients not undergoing these procedures. These observations underscore the need for randomized trials to define the optimal treatment strategies in these patients. Efficacy of invasive treatment strategies in elderly patients aged older than 75 years-deserves special attention.

Age Factors↗

PubMed1997

A sensitive ocular perfusion apparatus measuring outflow facility.

PURPOSE: To build an improved apparatus for measuring outflow facility by one- and two-level, constant pressure perfusion. METHODS: A computer-controlled and -monitored tower adjusts the height of a fluid reservoir by a stepper motor every 5 min, to keep intraocular pressure (IOP) constant at one or two desired pressure levels (e.g. 2.5 and 12.0 mm Hg above the spontaneous IOP). The fluid flow rate is calculated by the equation Q = (Pres - IOP)/R, where Pres is the pressure of the reservoir as calculated by the term "pgh," h being the height of the reservoir, measured by the rotation of stepper motor, g, the gravity constant, and p, the fluid density. IOP is measured by the transducer, and R is the resistance of 180 microns tubing. Outflow facility is calculated by delta Q/ delta P. delta Q is the difference between flow rate at the two pressure levels, and delta P is the intraocular pressure difference. Perfusion was performed on live albino rat eyes by the two-level constant pressure technique, and on artificial steel eyes at a single constant pressure perfusion (20 mm Hg). RESULTS: Outflow facility of albino rat eyes and artificial steel eyes perfused for 40 and 30 min, respectively was 0.0507 +/- 0.0039 microliter/min/mm Hg and 0.3546 +/- 0.0034 microliter/min/mm Hg (mean +/- SD), respectively. CONCLUSIONS: Our perfusion apparatus is highly stable, sensitive, and capable of measuring subtle changes in outflow facility in vivo and in vitro.

Animals↗

PubMed1997

Effect of optic disc size or age on evaluation of optic disc variables.

AIMS/BACKGROUND: It has been reported that the number of optic nerve fibres decrease with age, and the cup/disc (C/D) ratio increases as the optic disc size increases. Consequently, the normal value of the optic disc variables measured by an optic disc analyser may change according to the optic disc size or age. The effect of individual variations in optic disc size or age on interpretation of optic disc variables was investigated. METHODS: Topographic optic disc variables of 104 normal Asian adults of both sexes aged 40 to 68 were measured using a confocal scanning laser ophthalmoscope (TopSS, Laser Diagnostic Technologies, Inc). Fourteen variables were evaluated according to the optic disc size or age. Statistical analysis was done by regression analysis. RESULTS: With an increase in optic disc size, the increase in cup shape, effective area, 1/2 depth area, C/D ratio, neuroretinal rim area, volume above, volume below, and 1/2 depth volume were statistically significant (p < 0.05). However, contour variation, mean contour depth, average depth, maximum depth, average slope, and maximum slope were not affected (p > 0.1). Age did not have any significant influence on optic disc variables (p > 0.1). CONCLUSION: Optic disc size, but not age, should be considered in the interpretation of optic disc variables.

Adult↗

PubMed1997

TIGR gene in primary open-angle glaucoma and steroid-induced glaucoma.

To identify TIGR gene mutation in two Korean pedigrees of primary open-angle glaucoma (POAG), and in 25 steroid-induced glaucoma patients, TIGR gene assay was performed. Genomic DNA was extracted from peripheral blood and the TIGR gene was amplified by polymerase chain reaction (PCR). The PCR amplification products were evaluated by single-stranded conformation polymorphism and direct DNA sequencing. In POAG families, not only those patients clinically diagnosed as glaucoma, but also most of their siblings, in whom glaucoma had not yet been detected, had a proline-to-serine (TCC-to-CCC) mutation in codon 334. However, no steroid-induced glaucoma patients showed TIGR gene mutation. TIGR gene mutation, in familial POAG, was found in a different codon from that previously reported. The TIGR gene does not, however, seem to be related to steroid-induced glaucoma.

Cytoskeletal Proteins↗

PubMed1997

The effect of interleukin-1alpha on outflow facility in rat eyes.

PURPOSE: The authors investigated whether regulation of the trabecular extracellular matrix turnover rate and remodeling plays an important role in decreasing outflow resistance by determining the effect of intracamerally given interleukin-1alpha, a known stimulator of the expression of trabecular matrix metalloproteinases, on outflow facility of albino rat eyes. MATERIALS AND METHODS: Forty normal albino rats (Sprague-Dawley), weighing 250 to 300 g, were studied. Rats were anesthetized by intraperitoneal pentobarbital sodium (30 mg/kg) injection. The rats were separated into four groups and given 5, 10, 25, or 50 units of interleukin-1alpha injected intracamerally in one eye. Bovine serum albumin in phosphate-buffered saline, which was used to dissolve the interleukin-1alpha, was injected in the fellow eye as a control. Outflow facility was measured by two-level constant pressure perfusion 1, 3, and 7 days after injection. RESULTS: The eyes treated with 50 units of interleukin-1alpha showed a statistically significant increase of outflow facility by 37% compared with the contralateral control eyes 3 days after injection, but returned to normal levels in 7 days. The eyes treated with 5, 10, 25, or 50 units of interleukin-1alpha showed outflow facility increases of 12%, 20%, 39%, and 37%, respectively, 3 days after injection. CONCLUSION: Interleukin-1alpha increased the outflow facility, supporting the hypothesis that regulation of trabecular meshwork extracellular matrix plays a role in trabecular outflow resistance.

Animals↗

PubMed1996

Aceclidine effects on outflow facility after ciliary muscle disinsertion.

Aceclidine increases outflow facility with little accommodative effect. To determine whether this dissociation resides in the ciliary muscle (CM) or trabecular meshwork (TM), we measured aceclidine effects on perfusion outflow facility in both eyes of 8 rhesus monkeys after unilateral disinsertion of the CM from the TM. Facility in the control eyes increased by approximately 250% following intravenous pilocarpine and by an additional approximately 250% following intracameral pilocarpine, relative to baseline and uncorrected for washout. In CM-disinserted eyes, the facility response to intravenous and intracameral pilocarpine averaged approximately 25% of that in contralateral controls. Cytochalasin B, which acts directly on the TM to increase facility but is not additive to maximal pilocarpine doses in normal eyes, had no additional effect beyond that of pilocarpine in control eyes but induced an additional 100% facility increase relative to baseline in CM-disinserted eyes. The accommodative response to carbachol in CM-disinserted eyes was approximately 80% of that in contralateral controls, consistent with retention of CM contractility and the gonioscopic appearance of shallow CM disinsertion. Intracameral aceclidine HCl doses of 5 and 50 micrograms increased outflow facility by approximately 80 and 250%, respectively, in control eyes, and by approximately 0 and 80% in CM-disinserted eyes. Either the low aceclidine dose affected facility via the CM, while the high dose exerted an additional effect on the TM, or aceclidine acted only via the CM, with the low dose being ineffective and the high dose modestly effective in CM-disinserted eyes because only a few CM-TM attachments remained.

Accommodation, Ocular↗