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Biomedical subjects

J K Leong

Publications and source records attributed to J K Leong.

13 recordsLinked to original sources
PubMed2006

Outcome of graft free Molteno tube insertion.

AIMS: To determine the long term outcome of Molteno implants inserted using a modified surgical technique that eliminates the need for a donor scleral graft. METHODS: Retrospective case series involving a medical record analysis of 35 consecutive patients undergoing first Molteno implant surgery for refractory glaucoma. The main outcomes included life table analysis of intraocular pressure control following surgery and frequency of intraoperative and postoperative complications. RESULTS: There were no complications related specifically to the modified method of tube placement. Medium term intraocular pressure control was similar to other series. CONCLUSIONS: This simplified method for the insertion of Molteno implants eliminates the need for a donor scleral graft while maintaining the implant's ability to control intraocular pressure.

Adult↗
PubMed1985

Which hospital services are most overused? Results from a medical audit.

When we assessed the extent of unnecessary ordering of clinical services by medical house staff at a large university hospital, 21% of services were judged to be unwarranted. Most overordered were nuclear medicine services, followed by laboratory tests. Because of their large volume, clinical laboratory services accounted for 78% of all unwarranted orders. Unwarranted use of hospital services is substantial and variable among physicians and services. This study confirms the value of medical record reviews for documenting the need for and guiding the course of hospital cost-containment programs.

California↗
PubMed1984

The failure of physician education as a cost containment strategy. Report of a prospective controlled trial at a university hospital.

To test the hypothesis that physician education is an effective strategy to reduce total hospital costs, we evaluated three educational interventions at a large university hospital. This prospective controlled study spanned two academic years and involved 1,663 patients and 226 house staff. In the first year, weekly lectures on cost containment (medicine and surgery) and audit with feedback (medicine only) both failed to produce a significant change in total hospital charges. The "dose" of the intervention was increased on medicine in the second year by combining the lecture and audit strategies. Again, total charges did not change significantly. While decreased use occurred for certain selected services, the impact was not great enough to affect total hospital charges significantly. We conclude that, in the absence of other cost containing incentives, physician education alone is not an effective hospital cost containment strategy.

Adult↗
PubMed1984

Lessons for teaching cost containment.

Increasing financial restrictions on hospitals by the federal government and changing physician reimbursement procedures make it more important to control the use of medical care resources by physicians. A prospective controlled study was made of an educational program for the medical and surgical house staffs and for medical students designed to reduce unneeded orders for low cost, high volume ancillary and nursing services. The program was comprised of six mutually reinforcing components: lectures, medical record audits and reviews, group feedback in the form of cost summaries containing information on unnecessary ordering, hospital price booklets, current patient bills, and pertinent journal articles. Operating at a time of retrospective hospital cost reimbursement, the program achieved only modest reductions in the residents' and students' use of hospital services and no substantive effect upon hospital costs. However, the program participants accepted the program enthusiastically. Several factors crucial to such educational cost containment programs were identified. The authors believe that experience with the program has valuable lessons for other hospitals initiating cost-control efforts.

California↗
PubMed1978

2,3-Dimercaptosuccinic acid: a new agent for the treatment of lead poisoning.

Using minimally lead-poisoned rats, we have measured urinary and fecal lead excretion in response to 2,3-dimercaptosuccinic acid (DMS) administered i.p. or p.o. and compared it to that induced by dimercaptopropanol (BAL) (i.p.), EDTA (i.p.), D-penicillamine (p.o. and i.p.) and the combination of BAL and EDTA (i.p.). At doses of 30 mg/kg, parenterally administered DMS was as effective as i.p. BAL and these two drugs were more effective than the other treatment groups. However, p.o. DMS was only 20% less effective and was as effective as i.p. EDTA and the combination of EDTA + BAL i.p. and significantly more effective than D-penicillamine p.o. or i.p. Unlike BAL, most lead excretion in response to DMS was via the urine, undoubtedly reflecting the greater water solubility of DMS. When mice were fed a diet containing both lead and DMS, the drug prevented the accumulation of porphyrins in erythrocytes. Studies with 210Pb indicate that this prophylactic effect is not due to an inhibition of lead absorption but rather to enhanced excretion of lead. The residual tissue distribution of 210 Pb administered simultaneously with DMS was not different form that of 210Pb alone. Since DMS is orally effective and its LD50 is 30 times greater than that of BAL, we expect this compound to be clinically useful in the treatment of lead poisoning.

Animals↗
PubMed1975

Strain-specific virulence-associated antigen of Neisseria gonorrhoeae.

A strain-specific virulence-associated antigen has been found in Neisseria gonorrhoeae strain F-62. Using immunodiffusion in agar gel, it has been shown that the antigen is distinguishable from endotoxin and the virulence-associated toxic protein. It does not appear to be derived from pili. The antigen was not detected in T1 and/or T2 colony type cultures of 10 other isolates. It exhibited a possible partial immunological relationship with an antigen found in one additional strain. It was susceptible to digestion with Pronase and trypsin.

Absorption↗
PubMed1974

Involvement of the host cell nuclear envelope membranes in the replication of Japanese encephalitis virus.

The distribution of viral ribonucleic acid (RNA) on various cell membrane fractions derived from a porcine kidney cell line infected with Japanese encephalitis virus was investigated. At 40 h postinfection, after virus growth had reached its peak, three viral RNAs, 45S, 27S, and 20S, were associated with the cytoplasmic membranes and intact nuclei. The amount of each RNA associated with the nucleus was two- to fivefold greater than that present with the cytoplasmic membranes. Treatment of washed infected nuclei with 1.0% Triton X-100, which removed the outer nuclear envelope membrane, also removed the viral RNA. When the nucleus was fractionated into nuclear envelope membranes and a large particle fraction which sedimented at 600 x g, nearly all of the viral RNA remained associated with the envelope membranes. The nuclear envelope membranes contained higher viral RNA polymerase activity than the cytoplasmic membranes derived from the same cells. These data suggest that major sites for Japanese encephalitis virus RNA synthesis may be localized on or in very close association with the nuclear envelope membranes.

Animals↗
PubMed1973

System for studying uninfected and virus-infected cell cultures in hyperbaric chambers.

Equipment and techniques previously used to investigate the effect of hyperbaric gases on bacteria were modified to permit comparable investigations with uninfected and virus-infected tissue cell cultures. This report describes the modified equipment and related methodology. Use of the system is illustrated with findings on the effect of oxygen-helium mixtures at 68 atm on cell physiology and virus growth in two cell types. Our results suggested that, under those experimental conditions, several synthetic processes in chick fibroblast monolayers are inhibited but that Sindbis virus growth in the cells is increased. Growth of Japanese encephalitis virus in porcine kidney cells was found to be unaffected by oxygen-helium gas at partial pressures of oxygen between 0 and 700 mm Hg, but morphological alterations in the cells occurred at low and high pO(2) levels.

Amino Acids↗