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Biomedical subjects

J See

Publications and source records attributed to J See.

13 recordsLinked to original sources
PubMed2004

Randomised controlled trial comparing the effect of brimonidine and timolol on visual field loss after acute primary angle closure.

AIM: To compare the effect of brimonidine and timolol in reducing visual field loss in patients with acute primary angle closure (APAC). METHODS: In addition to standard acute medical treatment, patients presenting with APAC were randomised to either brimonidine 0.2% or timolol 0.5% upon diagnosis, then twice daily for 4 weeks. After laser peripheral iridotomy (LPI), subjects underwent three baseline perimetry tests during the first week, and then at weeks 4, 8, 12, and 16. Pointwise linear regression analysis was applied to the field series of each of these subjects starting with the third test (total of five tests per subject). Progression was defined as a significant regression slope (p<0.05) showing 1 dB per year or more of sensitivity loss at the same test location in the series. Patients were also compared for prevalence of abnormal fields at 16 weeks, which was defined as an abnormal glaucoma hemifield test result and/or corrected pattern standard deviation outside the 95% confidence limits. RESULTS: 59 subjects (31 in the brimonidine group; 28 in the timolol group) completed the study. There were 47 females (79.7%), the majority of subjects (94.9%) were Chinese and the mean age was 59.2 (SD 7.2) years. There were no significant differences between the two groups with respect to demographic features, presenting intraocular pressure (IOP), duration of symptoms, time from presentation to LPI, or mean IOP at each study visit. Over the 16 week study period, despite adequate statistical power, no difference was found between groups in terms of the number of patients with progressing locations, the mean number of progressing locations per subject, or the mean slope of the progressing locations. Nine (29%) subjects in the brimonidine group and 10 (35.7%) in the timolol group were found to have significant visual field defects at 16 weeks (p = 0.58). 15 out of these 19 subjects (78.9%) already had these visual field defects in the first week. CONCLUSIONS: In the first 16 weeks after APAC, there was no difference in the prevalence of visual field defects or rate of visual field progression between brimonidine and timolol treated groups.

Acute Disease↗
PubMed2001

The epidemiology of ocular trauma in Singapore: perspective from the emergency service of a large tertiary hospital.

PURPOSE: To describe the epidemiology of ocular trauma from the perspective of the emergency service of a large tertiary hospital in Singapore. METHODS: A prospective survey was conducted over a 3 month period (August to October 1997) on all patients seen at the ophthalmic unit at the Singapore General Hospital's emergency service. Data on clinical presentation, type and cause of injury and use of eye protective devices (EPD) were collected via a standardised interview and examination. RESULTS: A total of 870 persons presented with a diagnosis of ocular trauma, out of the 1,631 patients seen during the study period. Compared with non-trauma cases, trauma cases were more likely to be male (odds ratio (OR): 4.2, 95% confidence interval (95% CI): 3.2, 5.4), non-residents (OR: 6.2, 95% CI: 3.7, 10.5), younger than 40 years of age (OR: 3.2, 95% CI: 2.7, 4.1) and less likely to require follow-up or hospital admission (OR: 0.2, 95% CI: 0.2, 0.3). The three most common types of injuries were superficial foreign body (58.2%), corneal abrasion (24.9%) and blunt trauma (12.6%), while open globe injury occurred in only 17 cases (2%). Comparison with a 10% random sample of all cases seen in the previous 9 months (n = 284) revealed no significant time variation in the types of injuries (p = 0.63). Work-related injuries accounted for 590 (71.4%) cases, where grinding, cutting metal and drilling were the specific activities in more than 90% of the cases. In appropriate settings, only 21.7% of patients with work-related injuries used EPD; 43.7% were provided with EPD, but did not use them at the time of injury; and the remaining 34.6% reported that EPD were not provided. CONCLUSIONS: Ocular trauma at the emergency service level in Singapore involved mainly young non-resident men, were work-related and associated with well-defined activities, and were generally minor. The low prevalence of EPD use reinforces the need for a review of the design and implementation of occupational eye safety programmes, especially among non-resident workers.

Accidents, Occupational↗
PubMed1998

The capacity of a combined liposomal hepatitis B and C vaccine to stimulate humoral and cellular responses in mice.

Combined hepatitis B surface antigen and hepatitis C antigen were encapsulated into 1, 2, and 5 microm discrete liposomes and then lyophilized. Groups of adolescent CD-1 mice were given a single 0.3 mL oral dose of these liposomes containing 50 microg/mL hepatitis B surface antigen and hepatitis C antigen, 50 microg/mL of the same antigens or liposomes alone. Animals in each group were sacrificed every 2 weeks for 10 weeks and the humoral response investigated by enzyme-linked immunosorbent assay (ELISA) and the cellular response by splenic lymphocyte proliferation to 10 microg of either antigen. Seroconversion to both antigens in the mice receiving liposomal antigens occurred in 87.5% of animals sacrificed at 4 weeks and later. One animal (12.5%) receiving antigen alone seroconverted to hepatitis B virus at 6 weeks, but all animals receiving liposomes alone remained negative. Proliferation indexes (PI) greater than 3 were observed in all animals receiving liposomal antigens, with the greatest response seen at 10 weeks. PI was less than 2 for all animals in the other two groups. Thus, a single oral dose of liposomes of three sizes containing both hepatitis B and C antigens given to mice resulted in rapid seroconversion and a progressive robust cellular immune response, whereas the antigens alone or liposomes without antigen did not.

Animals↗
PubMed1997

Hypopigmented common blue nevus.

Blue nevus is a benign pigmented lesion of dermal melanocytes with a number of histologic and clinical variants, of which the major types are the common blue nevus, cellular blue nevus and combined nevus. This study describes 9 cases of hypopigmented blue nevus (HBN), a variant of common blue nevus in which there is minimal identifiable melanin pigment. We also discuss the usefulness of the immunoperoxidase stain HMB-45 in relation to the diagnosis of HBN and the lesions with which it may be histologically confused, namely common intradermal nevus, dermatofibroma, neurofibroma, dermal scar and desmoplastic malignant melanoma. The HMB-45 stain was found to be uniformly positive in all 9 cases of HBN, in contrast to the other dermal lesions which have been reported as either negative or showing only focal positivity. The physical distribution and age range of the patients in this study was similar to the age and sites for common BN, supporting the relationship between the 2 lesions. The occurrence of HBN in predominantly young adults indicates that this lesion is not a phenomenon due to ageing or degenerative change, and should be regarded as a variant of common blue nevus.

Adolescent↗
PubMed1996

Phase II trial of 5-fluorouracil, leucovorin and cisplatin for treatment of advanced pancreatic adenocarcinoma.

BACKGROUND: Advanced pancreatic adenocarcinoma is a rapidly fatal disease for which an active chemotherapy regimen is sought. Here we report the outcome of a phase II trial to assess the toxicity and efficacy of a combination of 5-fluorouracil (5-FU), leucovorin and cisplatin (CDDP). METHODS: A regimen combining leucovorin (200 mg/m2/d x 5d), 5-FU (375 mg/m2/d x 5d in a 2-hour infusion) and CDDP (15 mg/m2/d x 5d) was given to 52 patients with histologically-proven, previously untreated, locally advanced (n = 13) and/or metastatic (n = 39) pancreatic adenocarcinoma. RESULTS: Of 48 patients evaluable for response, 10 achieved partial responses, for an overall response rate of 21% (95% CI 9.5%-32.5%), and a palliative effect was observed in 52%. The median survival was 9.5 months (18 months for locally-advanced and 5 months for metastatic disease) with a 1-year survival of 34.6% and a median progression-free survival of 4.5 months. Chemotherapy was well tolerated with grades 3 or 4 nausea/vomiting in 12%, diarrhea in 6%, anaemia in 17%, neutropenia in 12%, and thrombocytopenia in 10%. Eleven patients (21%) had Grade 2 peripheral neuropathy. CONCLUSION: The combination of leucovorin, 5-FU and CDDP seems to be an effective palliative treatment, with moderate toxic effects, in advanced pancreatic adenocarcinoma.

Adenocarcinoma↗
PubMed1995

Randomized, controlled study of various agents for endoscopic injection sclerotherapy of bleeding canine gastric varices.

The purpose of this study was to compare the relative efficacy and technical ease of use of eight different agents for endoscopic hemostasis and obliteration of bleeding gastric varices in a canine model, as no comparative data are available on gastric variceal sclerotherapy. Large bleeding gastric varices in 20 heparinized dogs were randomized to endoscopic injection treatment with one of the following agents: cyanoacrylate; a 1:1:1 mixture of sodium tetradecyl sulfate 3%, ethanol 98%, and normal saline solution; ethanolamine oleate 5%; sodium morrhuate 5%; sodium tetradecyl sulfate 1.5%; polidocanol 1%; normal saline solution with epinephrine 1:10,000; or normal saline solution (control). The number and volume of injections and the time required to achieve complete hemostasis were evaluated; follow-up endoscopy was performed at 1 month to assess gastric variceal obliteration. Cyanoacrylate was the best agent overall in terms of immediate efficacy, low volume requirement, time required for initial hemostasis, and reduction of gastric variceal size. Cyanoacrylate, tetradecyl sulfate, and polidocanol were the most effective agents for reducing gastric variceal size. Epinephrine was effective for controlling induced or secondary bleeding caused by puncture of the gastric varices with the sclerotherapy needle during intravariceal injections. Ongoing studies are evaluating combinations of agents with different mechanisms of action, such as epinephrine (for vasoconstriction to minimize secondary bleeding) plus alcohol, and/or tetradecyl sulfate (for variceal thrombosis and sclerosis).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Free erythrocyte protoporphyrin assay in the diagnosis of iron deficiency in the anemic aged subject. A prospective study of 103 anemic patients.

We determined the relative value of the free erythrocyte protoporphyrin (FEP) assay compared to those of total iron-binding capacity (TIBC) and serum ferritin in the diagnosis of iron deficiency in a population of elderly anemic subjects. One hundred and three patients, 65 to 98 years old (mean +/- SD: 81.5 +/- 8.8), with hemoglobin levels of less than 110 milligrams (mean +/- SD: 97 +/- 12, range 53-109) were included in the study. In the patients with iron-deficiency anemia due solely to chronic bleeding, mean values for the three parameters were highly different from those in patients without chronic bleeding. In the patients with anemia due to an association of chronic bleeding and chronic inflammation, the mean FEP value was very significantly different (p less than 0.001) from that in the patients with chronic inflammation but without bleeding, whereas this was not the case for TIBC or serum ferritin. The sensitivity of FEP in the diagnosis of iron deficiency due to chronic bleeding in this population of anemic subjects was 60% (specificity 90%), compared to 13% (specificity 96%) for TIBC and 20% (specificity 100%) for serum ferritin. The FEP assay thus emerges as being highly suitable for the diagnosis of iron-deficiency anemia in the elderly subject, particularly when bone marrow is not examined.

Aged↗
PubMed1988

Correlation of minimum coronary lumen diameter with left ventricular functional impairment induced by atrial pacing.

To understand whether quantitative measurement of minimal coronary luminal diameter is a better method than percent diameter narrowing for assessing the functional impairment of myocardial contractility produced by coronary artery stenoses, measurements were made from 37 stenotic segments in 27 patients with coronary artery disease and from corresponding segments in 10 subjects without coronary artery narrowing. An assessment of the reliability of the 2 types of measurements was made by correlating them with the physiologic parameters of both segmental wall motion and global ejection fraction response induced by atrial pacing. Digitally acquired coronary angiograms were used to facilitate quantitative analysis. Measurements by edge detection and videodensitometry correlated closely (r = 0.94). Percent diameter narrowing correlated moderately with the change in ejection fraction (r = -0.41) or with the change in segmental wall motion (r = -0.44). The measurement of minimal lumen diameter correlated with the change in global ejection fraction (r = 0.61) and did so even better with the change in segmental wall motion (r = 0.78, p less than 0.05). A minimal lumen diameter of less than or equal to 1.5 mm identified patients likely to have a functional impairment during atrial pacing as assessed by either global ejection fraction or segmental wall motion defects. We conclude that minimal coronary luminal diameter provides a better method than percent diameter narrowing calculations to measure the anatomic severity of coronary artery narrowing.

Angiography↗
PubMed1975

Insanity proceedings and black-white state hospital admission rate differences.

This study attempted to determine if the higher state hospital admission rates of blacks are due to greater proportions of blacks being adjudicated incompetent at county insanity hearings. The records of 2,264 cases from 12 Florida counties in 1969 and observations and interviews in the county courts were used to answer this question. With the exception of a slight difference in middle-sized counties, the higher rates of state hospital admission were found to be due to initial differences in petitioning to the court rather than to adjudication differences. The lack of difference is due to the fact that the proportion competent, when refined, proves to be very small for both blacks and whites, thus allowing for little variation by ethnicity. The operation of a racial stereotype was, however, demonstrated in a detailed analysis of one large county.

Adolescent↗