PubMed Health⌕ Search

Biomedical subjects

D Lam

Publications and source records attributed to D Lam.

At least 37 records · Page 2Linked to original sources
PubMed2000

Assessment of optic nerve compression in Graves' ophthalmopathy. The usefulness of a quick T1-weighted sequence.

PURPOSE: Diagnosis of optic nerve compression can be difficult in patients with equivocal clinical signs. We examined the usefulness of a quick coronal MR sequence performed at a predetermined plane as a screening tool for selecting patients at high risk of optic nerve compression. MATERIAL AND METHODS: Direct coronal images of the orbit were obtained in 37 patients with Graves' disease in a predetermined plane. The muscular indices (MI) of each orbit were calculated. Mann-Whitney U-Wilcoxon rank sum test was used to assess if there was any statistically significant difference between patients with and without signs of optic nerve compression. The ROC curve was used to identify a value useful for discriminating patients with a higher risk of developing optic nerve compression. RESULTS: There was a statistically significant difference (p<0.05) in the MI between patients with and without optic nerve compression. An MI of -0.48 had 100% sensitivity, 89% specificity and 91% accuracy in identifying patients with optic nerve compression. CONCLUSION. A quick coronal MR image obtained at the mid-orbital plane is useful in screening patients with Graves' disease for optic nerve compression.

Female↗
PubMed1999

The development and validation of the coping inventory for prodromes of mania.

This study described the construction and validation of the Coping Inventory for Prodromes of Mania (CIPM)-a newly developed instrument aimed at assessing how manic depressive sufferers dealt with their prodromes of mania. Two hundred and six subjects completed a 40-item measure of coping responses to prodromes of mania, a measure of social functioning and a mood measure. The CIPM yielded four empirically derived subscales: stimulation reduction, problem-directed coping, seeking professional help, denial or blame. All of these subscales provided good reliability and acceptably high internal consistency data. There was also some evidence of good validity of the CIPM.

Adaptation, Psychological↗
PubMed1999

Hip fracture in Hong Kong over the last decade--a comparison with the UK.

BACKGROUND: Hip fracture is a major public health problem in Asia and the UK. The objectives of this study were to describe the trends of hip fracture in Hong Kong over the last decade, and to compare the incidence in Hong Kong with that from the Wessex Health Region of the UK in 1995. METHODS: The number of hip fractures was calculated using hospital discharge records for all public hospitals in Hong Kong in 1991 and 1995. Age-specific incidence rates were then calculated using the mid-year census population for the two years. These rates were presented with previously reported age-specific rates for Hong Kong in 1966 and 1985. These age-specific rates for Hong Kong in 1995 were compared with rates for the Wessex Health Region of the UK. The total number of hip fracture expected in 2010 was calculated by applying the age-specific rates of 1995 to the projected population for 2010. RESULTS: In 1995, a total of 1138 men and 2782 women in Hong Kong fractured their hip. The age-specific rates had remained static from 1985 to 1995, after substantial rise from 1966 to 1985. In 1995, the rates of hip fracture rates were 11/1000 in women and 5/1000 in men who were 70 years and older. These rates were almost identical to those observed in the Wessex Health Region of the UK. CONCLUSION: The age-specific incidence rates of hip fracture had not risen in Hong Kong in the last decade. The incidence of hip fracture in Hong Kong was similar to that in the UK in 1995. The total number of patients with hip fracture in Hong Kong will increase substantially in the future, as a result of the ageing of the population.

Age Distribution↗
PubMed1998

Cognitive behaviour therapy approach to disputing automatic thoughts: a two-stage model.

Research shows that clients with automatic thoughts (dysfunctional thinking) often do not think of alternative explanations in relation to negative events. Furthermore, these automatic thoughts are characterized by a broad global, self-evaluative and ambiguous nature that could make disputing (or changing the ways they think) the most difficult part of the therapeutic process. This paper proposes a two-stage practise-based disputing model, guided by research, that aims to 'bring' an automatic thought to a specific, objective, quantifiable and concrete level at which not only is the particular aspect(s) of the automatic thought that causes emotional disturbances finely focused, but the disputing is also likely to be effective and manageable. Furthermore, it will also generate alternative explanations that are helpful in reducing emotional disturbances and in facilitating problem solving approach. In this paper, the authors use a case example to discuss the rationale that underpins the conceptualization of the model and to illustrate the process in which the strategies of the model are effectively used.

Cognitive Behavioral Therapy↗
PubMed1998

Impact of vision impairment on functioning.

PURPOSE: The aim of the present study was to determine the impact of vision loss on the activities of adults. METHODS: Focus groups were conducted that were either disease specific, such as for people with age-related macular degeneration, diabetic retinopathy, glaucoma or those with congenital vision impairment, or according to previous involvement in rehabilitation services. Discussions were recorded and transcribed. Because many people were retired, leisure activities and personal independence were paramount. RESULTS/CONCLUSIONS: Younger people were concerned with gaining or continuing in employment or with educational opportunities. The age at onset of vision loss and the cause and duration of vision loss influence its impact. There appears to be a greater level of handicap in people with comorbid eye disease and related disease, such as diabetes.

Activities of Daily Living↗
PubMed1998

Cadaveric liver procurement using aortic perfusion only.

BACKGROUND: To test the effectiveness of a simpler surgical technique for cadaveric liver procurement for liver transplantation, a prospective randomized study was carried out between August 1994 and December 1995, to compare aortic perfusion only (APO) for flush-preservation of the liver with the conventional combined aortic and portal perfusion (APP) technique. METHODS: Forty multiple organ donors were enrolled with 20 in each arm of the trial. Donor parameters (age, bodyweight, liver function tests), surgeons performing the operations, the involvement of other procurement teams and the total ischaemic times were similar in the two groups. The liver recipients had a wide range of native liver pathology but were of similar age, sex and bodyweight in the two groups. RESULTS: The mean procurement operation times for the APO and APP groups were 126.7+/-38.6 and 137.8+/-55.9 min, respectively (P=ns). The perfusion took longer to complete in the APO group (10.2+/-1.7 vs 7.2+/-1.4 min (APP), P < 0.001). The liver temperature fell to its lowest level (12.5+/-3.4 degrees C (APO) vs 11+/-3 degrees C (APP), P=ns) in a similar time (11.9+/-3.8 min (APO) vs 9.3+/-3.4 mins (APP), P=ns). There was no graft primary non-function or graft arterial injury in either group. There was no significant difference between the APO and APP initial graft outcomes. The 3-month patient survival rate was identical in the two groups (95%); 81% of renal grafts from the APO donors functioned well from the time of transplantation as did 76% of those from APP donors. CONCLUSIONS: It is concluded that the APO procurement technique produces equivalent results to those achieved with the APP method. The simplicity of the APO technique makes it the preferred technique.

Adult↗
PubMed1998

Family size and children's education in Vietnam.

Data from the nationally representative 1994 Inter-Censal Demographic Survey are used to examine the association between family size and children's schooling in Vietnam. The data provide information on several education measures for all children over age 10, including children no longer residing in the household. Although a clear inverse bivariate association between family size and children's school attendance and educational attainment is evident, multivariate analysis controlling for urban/rural residence, region, parents' education, household wealth, and child's age, reveals that much of this association, especially that predicting educational attainment, is attributable to these other influences. Moreover, much of the effect that remains after statistical adjustment for the other influences is seen mainly at the largest family sizes. We consider the implications of these findings for current population policy in Vietnam and the possible features of the Vietnamese context that might account for the modest association.

Adolescent↗
PubMed1997

Laparoscopic cholecystectomy as an outpatient procedure.

BACKGROUND: Laparoscopic cholecystectomy is still done mainly on an inpatient basis at hospitals or on an outpatient basis at ambulatory care departments inside hospitals. STUDY DESIGN: We reviewed 213 cases in which outpatient laparoscopic cholecystectomy was done at an ambulatory surgical center not associated with a hospital physically or administratively. Patients were selected solely on the basis of medical history and physical examination results. Patients received general anesthesia as is typical for outpatient procedures. Narcotic use was minimized to prevent postoperative nausea. The procedure did not include intraoperative cholangiography. RESULTS: Laparoscopic cholecystectomy took 1 to 2 hours in three quarters of patients. Rate of conversion to open cholecystectomy was 2.8% (6 of 213 patients). The mean recovery period was 6.6 hours, and 97% of patients were discharged on the same day (ie, were treated as outpatients). We identified no cases of retained common duct stone. Wound complications included mainly seroma, wound seepage, and wound infection; 18% of these complications were seen at trocar sites. No major complications were seen. CONCLUSIONS: Elective outpatient laparoscopic cholecystectomy can be done safely with low morbidity, high patient acceptance, and same-day discharge in > 95% of cases.

Ambulatory Surgical Procedures↗
PubMed1997

Prodromes, coping strategies, insight and social functioning in bipolar affective disorders.

BACKGROUND: Patients suffering from bipolar affective disorders are generally reported to be able to detect prodromes. Insight is also said to be desirable for a good outcome. However, very little is known about the effect of insight and patients' spontaneous strategies for coping with prodromes on their social functioning. METHOD: In a cross-sectional study 40 bipolar patients, who were not in an acute episode, were interviewed about their prodromes of depression and mania, their coping strategies for these prodromes, their levels of insight and their levels of social functioning. RESULTS: A quarter of subjects reported that they could not detect any early warnings of depression compared with only 7.5% of subjects who reported that they could not detect prodromes of mania. Subjects reported both spontaneous cognitive and behavioural strategies for coping with prodromes of depression but only behavioural strategies for prodromes of mania. Subjects' current levels of depression, how they coped with prodromes of mania and their ability to recognize early warnings for depression contributed significantly to their level of social functioning. Insight also had a weaker but significant contribution. CONCLUSION: No causal link was made in this study. However, it did show that patients' level of social functioning was related to their level of insight, and to how well they coped with the prodromes of mania and whether they could detect prodromes of depression. The results suggest that it is worth exploring ways of teaching patients to monitor their moods and to promote insight and good strategies for coping with their prodromes.

Adaptation, Psychological↗
PubMed1997

Cognitive behaviour therapy territory model: effective disputing approach.

This paper proposes a disputing model (territory model) which is particularly useful and effective for disputing clients who persistently hold on to their dysfunctional thinking and/or core irrational beliefs. Their 'stubbornness' to change is compounded by unhealthy negative emotions during sessions. The intense emotion makes it difficult to access the belief system, and therefore any attempt to dispute it often proves futile. This model advocates the shift of disputing onto a different 'territory/ground' where the client can be facilitated to acquire higher, abstract and objective thinking, and at the same time his/her emotional level is susceptible to rational and logical arguments. The new thinking would act as a catalyst for the client to reflect on his/her dysfunctional thought/irrational beliefs. In this paper, the author uses a case example to illustrate and discuss the ineffectiveness of the 'traditional' way of disputing the dysfunctional thinking/core beliefs of a difficult and emotional client. This is contrasted with the 'territory' model.

Adolescent↗
PubMed1997

Interface pressures and shear stresses at thirteen socket sites on two persons with transtibial amputation.

Residual limb/prosthetic socket interface pressures and shear stresses were measured at 13 sites on two subjects with unilateral transtibial amputation (TTA) using total-contact patellar-tendon-bearing prostheses. Maximal interface stresses during stance phase for each of 13 transducer sites were determined, then means for all steps calculated. Maximal pressure and resultant shear stress during stance phase were shown at anterior distal or mid-limb sites and the maxima occurred during the first 50% of stance phase. Anterior medial and lateral proximal sites showed their greatest pressure during the second 50%. At lateral mid-limb and popliteal fossa sites, resultant shear stress directions suggest that soft tissue was displaced toward the socket brim during weight-bearing. Results also suggest that skin across the distal tibial crest was in tension at the times of the first and second peaks in the shank axial force-time curve in all sessions. Significant difference (p < 0.05) in maximal stresses between sessions conducted > 3 weeks apart were apparent for both subjects.

Adult↗
PubMed1996

Extramedullary nasal plasmacytoma--an unusual clinical entity.

A case of extramedullary plasmacytoma with its unusual appearance is reported. This is the second reported case in world literature affecting the paranasal sinuses with intracranial extension. The role of surgery is to obtain tissue for diagnosis and to excise residual disease. Radiotherapy is the treatment of choice and long-term follow-up is necessary for monitoring disease recurrence. The overall 10-year survival is about 50%. The case is discussed with a general review of the management of this pathology.

Humans↗
PubMed1996

Uptake of sulfate conjugates by isolated rat hepatocytes.

The uptake of estrone sulfate (E1S; 1 to 400 microM), harmol sulfate (HS; 5 to 900 microM), and 4-methylumbelliferyl sulfate (4MUS; 5 to 1000 microM) was investigated in isolated rat hepatocytes in the presence or absence of inhibitors. Uptake of all of the sulfate conjugates was rapid and exhibited saturation kinetics, best characterized by saturable and nonsaturable (linear transmembrane clearance) transport systems. The KM's were: 16 +/- 6, 123 +/- 28, and 64 +/- 6 microM for E1S, HS, and 4MUS, respectively, with corresponding Vmax's of 0.85 +/- 0.56, 0.48 +/- 14, and 0.42 +/- 0.07 nmol/min/10(6) cells. The nonsaturable uptake clearances, which displayed concentration-independent uptake, were 3 +/- 2, 1 +/- 0.1, 0.5 +/- 0.1 microliter/min/10(6) cells, respectively. Uptake of E1S was inhibited by ouabain (1 mM) and replacement of sodium by choline, whereas HS was insensitive to the addition or substitution. Uptake of both E1S and HS was significantly reduced by metabolic inhibitors (antimycin A, 2.7 microM, rotenone, 30 microM, and KCN, 2 mM) and temperature reduction (from 37 to 27 degrees C). 4,4'-Diisothiocyanostilbene-2-2-'disulfonic acid (2 mM), an inhibitor of anion transport, reduced E1S and HS uptake; E1S uptake was also reduced by HS. HS uptake by both saturable and nonsaturable transport components was depressed by 4MUS (300 microM); the apparent KM was increased by 83% while the Vmax remained unaltered, and the nonsaturable component was decreased by 48%. The data strongly suggest that multiple pathways exist for the uptake of E1S, HS, and 4MUS. E1S uptake is sodium-dependent, requires energy, and is inhibited by anions such as 4,4'diisothiocyanostilbene-2-2'-disulfonic acid and other sulfate conjugates. HS uptake, while being energy dependent, is not sodium dependent, and is inhibited by 4MUS in a competitive fashion. At least one of these pathways is shared.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1995

Influence of lactobacilli on the adhesion of Staphylococcus aureus and Candida albicans to fibers and epithelial cells.

The ability of organisms to adhere to and form biofilms on fibrous materials is believed to be an important initiating step in the induction of several diseases, such as toxic shock syndrome. Using an in vitro assay, a moderately hydrophobic strain of Staphylococcus aureus (water contact angle 35 degrees) and a hydrophilic Candida albicans (shown by a hexadecane test) were highly adherent to commercial diaper fibers. The lumen side of the diaper was porous and the fibers were very hydrophobic (> 140 degrees), but the internal section was very hydrophilic (0 degrees), presumably for lus strains was present. Surfaces precoated with lactobacilli inhibited staphylococcal adhesion by 26-97%, and candida by 0-67%. When the lactobacilli were used to challenge adherent pathogens, there was 99% displacement of the S. aureus and up to 91% displacement of C. albicans. Hydrophobic L. acidophilus 76 (54 degrees) and T-13 (80 degrees) were the most effective of five Lactobacillus isolates tested at interference by precoating. The moderately hydrophilic L. casei var rhamnosus GR-1 (33 degrees) was the most effective at displacing the yeast. Experiments with uroepithelial cells also showed that the lactobacilli could significantly interfere with the adhesion of both pathogens to the cells. The results demonstrate the rapidity with which two pathogens adhered to fibers and epithelial cells, and raised the possibility that members of the normal female urogenital flora might interfere with infections caused by these organisms.

Adult↗
PubMed1995

Hip osteoarthritis and dysplasia in Chinese men.

OBJECTIVE: To estimate the prevalence of hip osteoarthritis (OA hip) and hip dysplasia in a sample of Hong Kong men who were unselected with respect to hip symptoms. METHODS: The postmicturition films of 999 men aged 60-75 years, consecutive attenders for intravenous urography between 1987 and 1990 at a regional hospital, were reviewed. OA hip was diagnosed as the occurrence of two or more features of OA using a modified version of the Kellgren and Lawrence scale, or a minimal joint space of 1.5 mm or less. Hip dysplasia was defined as a centre-edge angle of less than 25 degrees, or an acetabular depth of less than 9 mm. The results were compared with British data obtained by similar methods. RESULTS: In the Hong Kong sample, the proportion of men with two or more features of osteoarthritis in at least one hip was about 50% that of the men in the British study (5.4% and 11.0%, respectively). Severe joint space narrowing (of 1.5 mm or less) occurred in 0.7% of the hips in Hong Kong men, compared with 2% in the British men. The proportion of hips with centre-edge angles less than 25 degrees was 4.5% in Hong Kong, compared with 3.6% in Britain, and the prevalence of shallow acetabular depth was greater in Chinese (14.5%) than in the British (2.1%). Radiographic measures of hip dysplasia were not associated with minimal joint space. CONCLUSIONS: Our results have confirmed the lower prevalence of radiographic hip osteoarthritis in Hong Kong men compared with British men. However, acetabular dysplasia was as prevalent among Chinese men as in the British sample. This is evidence against the hypothesis that variations in the frequency of hip osteoarthritis are caused by differences in the occurrence of hip dysplasia.

Acetabulum↗
PubMed1994

Adhesion of lactobacilli to urinary catheters and diapers: effect of surface properties.

Thirteen strains of lactobacilli were tested for their ability to adhere to commercial devices used in the urinary tract. Although it appeared that the most hydrophilic organisms adhered in highest numbers, there was no significant correlation between water contact angle and adhesiveness to catheters. Five organisms tested were found to be highly adherent to Huggies commercial diapers. Loss in hydrophobicity upon serial culture of Lactobacillus fermentum B-54 was not due to a proteinaceous S layer, although protein involvement per se cannot be ruled out. It was evident that, not only can members of the normal female urogenital flora adhere to commonly used commercial prostheses, but their ability to attach is related to hydrophilic as well as hydrophobic surface components.

Adult↗