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Biomedical subjects

L C Lim

Publications and source records attributed to L C Lim.

72 records · Page 4Linked to original sources
PubMed1992

Coronary artery bypass surgery in young patients.

Coronary atherosclerosis is being increasingly observed in young patients. However results of surgery in such patients have so far been disappointing both in terms of operative mortality, symptomatic relief and long-term survival. Reasons given for this include the increased prevalence of risk factors in young patients and a higher incidence of graft occlusion. In the treatment of Asian patients, a further negative factor is the belief that coronary artery disease is more often diffuse and the vessels smaller. Between January 1987 and May 1991, a total of 66 patients under the age of 45 years at the time of surgery had coronary artery bypass grafting performed. The demographic, clinical, angiographic and operative data were analysed. Eighty-nine per cent of the patients were male and their racial distribution was 63% Chinese, 8% Malays, 26% Indians and 3% Others. Their mean age was 40.8 years. The presence of risk factors was high: 45.6% had hypertension; 34.8% were smokers; 21.2% had diabetes mellitus; and 12.1% had hyperlipidaemia. The main indication in these patients was either angina or a previous myocardial infarction (53%). There were no patients with perioperative infarction diagnosed by the presence of new Q wave. There was no hospital death. The stay of the patients ranged from 6 to 28 days with a mean of 10 days. Follow-up ranged from 3 to 54 months. There were no late deaths. It was concluded that there is a high incidence of risk factors among young patients with coronary artery disease, which follows the pattern of many other studies. The operative risk in these patients is low and morbidity is minimal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Molecular cloning of the alpha-globin transcription factor CP2.

CP2, a transcription factor that binds the murine alpha-globin promoter, was purified and subjected to amino acid sequence analysis. Oligonucleotide primers derived from the sequence were used to obtain murine and human cDNA clones for the factor. The murine cDNA spans approximately 4 kb and contains two coextensive open reading frames (ORFs) which encode deduced polypeptides of 529 (ORF-1; molecular weight, 59,802) and 502 (ORF-2; molecular weight, 56,957) amino acids, slightly smaller than the purified factor as estimated from its mobility in sodium dodecyl sulfate-polyacrylamide gels (64,000 to 66,000). The human cDNA contains a single ORF of 501 amino acids that is nearly contiguous with murine ORF-2. Indeed, comparison of deduced human and murine amino acid sequences shows that the two polypeptides are 96.4% identical. A strictly conserved region is rich in serine and threonine (17.5%) and in proline (11%) residues (S-T-P domain). This S-T-P domain is immediately amino terminal to a string of 10 glutamines (in the human sequence) or a tract of alternating glutamine and proline residues (in the mouse sequence). Bacterial expression of the full-length (502-amino-acid) murine factor or of a core region comprising amino acids 133 to 395 generated polypeptides with the DNA binding specificity of CP2. These results confirmed the cloning of CP2 and delimited the region sufficient for specific DNA sequence recognition. Antisera produced against the core region recognized polypeptide species with Mrs of 64,000 and 66,000 in immune blots of nuclear extracts prepared from both murine and human cell lines, consistent with the size of the purified factor. Lastly, a data base search revealed that amino acids 63 to 270 of the murine factor are distantly related to a domain in the Drosophila gene regulatory factor Elf-1.

Amino Acid Sequence↗
PubMed1992

An investigation of solvent-induced neuro-psychiatric disorders in spray painters.

An index case of chronic toxic encephalopathy is described in a 28 year old male spray painter with eleven years of exposure to solvents at work. The patient had progressive affective symptoms following repeated past episodes suggestive of acute solvent intoxication. He also showed impaired performance on tests of auditory memory, perceptual speed, visual scanning, and manual dexterity, as well as electromyographic evidence of prolongation of distal terminal latency and slowing of conduction velocities. The case investigation was followed up with an epidemiological study of the factory where he worked, to determine if other spray painters might have similar excessive complaints of neuropsychiatric symptoms and/or objective neurobehavioural deficits. This involved 15 other male spray painters employed for at least five years, and a sex- and age-matched group of 15 control workers not exposed to solvents. The spray painters reported significantly more numbers of neurobehavioural symptoms than the controls. There were little differences in neurobehavioural test results, except for aiming test (psychomotor co-ordination) and Benton visual retention test (visual memory). Spray painters with four or more neurobehavioural symptoms also performed more poorly on Digit Symbol (perceptual speed) compared with those with less number of symptoms. The epidemiological results provide strong circumstantial basis for the diagnosis of chronic toxic encephalopathy in the patient, and also indicates a need for vigilance of the hazards of central nervous system disorders in workers with chronic exposure to solvents in Singapore.

Adult↗
PubMed1992

The prevalence of schizophrenia in relatives of schizophrenic patients.

This study examines the prevalence of schizophrenia in 871 first-degree relatives of schizophrenic probands (N = 121) and 658 first-degree relatives of age-matched controls. The controls (N = 126) were medical inpatients referred for psychiatric opinion in a general hospital. Diagnoses in the probands fulfilled the ICD criteria for schizophrenic psychoses. Information on the relatives were obtained from enquiry of the family history and the hospital case records. The prevalence of schizophrenia in first-degree relatives of schizophrenic probands was 22 times that of the medical controls (6.8% versus 0.3%) (p < 0.05). The result supports the observation that schizophrenia is a familial disorder.

Adult↗
PubMed1992

Parasuicide in male conscripts: a Singapore experience.

This is a retrospective study of 156 cases of parasuicide in a homogenous population of male conscripts in the Singapore Armed Forces. The rate of parasuicide was 12.5 per 100,000 soldiers at risk. Suicide attempters were from the lower rank and one-third were undergoing basic military training at the time of their attempts. Drug ingestion was the commonest method and this was followed by jumping from a height, a method unique to the Singapore experience. Most of the conscripts gave no prior warning and appeared to have no strong desire to kill themselves. Interpersonal problems was the predominant reason given for their suicide attempts.

Adolescent↗
PubMed1991

Psychiatric manifestation of systemic lupus erythematosus in Singapore. A cross-cultural comparison.

In a case-control, cross-cultural study of the psychiatric morbidity of systemic lupus erythematosus in an Oriental population, 30 patients suffering from SLE and 29 controls with rheumatoid arthritis were interviewed. The SLE patients in Singapore exhibited greater psychiatric morbidity than their Western counterparts. Significant correlation was observed between psychiatric morbidity and the clinical disease activity. The patient's perception of the severity of arthritis, myalgia and dermatological lesions was an important aetiological factor. Culturally determined, disease-related psychological stresses also contributed to the psychopathology.

Adult↗
PubMed1991

Munchausen syndrome by proxy.

Munchausen syndrome by proxy is the falsification of symptoms by parents which results in their children having unnecessary and sometimes harmful hospital procedures. We describe a case of Munchausen syndrome by proxy in a 15 month-old toddler. The diagnosis, management and outcome of this syndrome is also discussed.

Child Abuse↗
PubMed1991

Mortality among psychiatric inpatients in Singapore.

This study examines the Standardized Mortality Ratio (SMR) by age, sex and cause of death among psychiatric inpatients in Singapore. Mortality in mentally ill inpatients was found to be 2.79 times that of the general population. The SMR decreased with age and the SMR for those 70 years and above was lower than that reported in the literature. The mortality ratio was most accentuated in the younger patients, especially in the female. Excess mortality was observed in both the natural as well as the unnatural causes of death. Among the natural causes of death, infection and pneumonia showed high excess in mortality. In the unnatural causes of death, suicide was predominant.

Adolescent↗
PubMed1991

Validation of the General Health Questionnaire in female video display unit (VDU) operators in Singapore.

Fifty-seven Chinese female Video Display Unit operators employed in a multi-national company were asked to complete the 28-item General Health Questionnaire (GHQ-28). This is part of a study on stress and asthenopia in this group of workers. Validity of the GHQ-28 was determined by comparison with the Clinical Interview Schedule (CIS). The GHQ-28 was found to give optimum results with a cut-off score of 5/6. The CIS classified 28.07% as cases and this was comparable to the estimated prevalence of 28.03% derived from the GHQ.

Adult↗
PubMed1991

Suicide and schizophrenia in Singapore--a fifteen year follow-up study.

This is a prospective follow-up study of 482 schizophrenic patients. At the end of 15 years, 41 had died of suicide and 30 had died of natural causes, giving a suicide rate of 567 per 100,000 per year. Suicide patients were significantly younger and experienced less delusion at the time of their first presentation. There were otherwise no significant differences in the socio-demographic or clinical variables between the suicide group and the controls (surviving patients). Jumping from height was the commonest method of suicide and our rate of suicide for schizophrenia is comparable to those reported in the literature.

Adolescent↗
PubMed1991

Delayed emergence of post-traumatic stress disorder.

Post-traumatic Stress Disorder (PTSD) is the development of characteristic symptoms following a psychologically distressing event that is outside the range of usual human experience. A Chinese male with a delayed onset, non-combat post-traumatic stress disorder is described and discussed. This is an unusual case because the symptoms were reexperienced four years after a life threatening vehicular accident. The patient responded to a combination of antidepressant treatment and individual psychotherapy. He remained well on follow up one year later.

Accidents, Traffic↗
PubMed1990

Rapid detection of bacteria in cerebrospinal fluid by immunofluorescence staining on membrane filters.

A filter-fluorescent-antibody (FFA) staining procedure was developed for detection of bacteria in cerebrospinal fluid (CSF). The sensitivity of this procedure was determined and compared with that of the slide Gram stain of centrifuged samples, latex agglutination, and a previously developed filter Gram stain. Serial 10-fold dilutions of filter-sterilized CSF seeded with logarithmic-phase organisms were examined by each method and cultured to determine colony-forming bacteria. The bacteria included Haemophilus influenzae type b; Neisseria meningitidis group B, C, and W135; Streptococcus pneumoniae types 6A and 23F; and group B Streptococcus species. FFA was found to be equal in sensitivity to the filter Gram stain (P greater than 0.30). Both filter-staining procedures had greater sensitivity than the slide Gram stain of centrifuged sediment (P less than 0.02) and latex agglutination (P less than 0.0001). Addition of human leukocytes at a concentration of 5 to 10 cells per oil immersion field did not decrease sensitivity of the FFA procedure, although background fluorescence increased. FFA is a rapid and dependable procedure for detection of low numbers of bacteria in CSF. Evaluation of FFA with clinical specimens is needed.

Bacteria↗
PubMed1990

A study of police referrals to Woodbridge Hospital.

This is a retrospective study of 127 cases brought by the police under Section 32 of the Mental Health Act (1973). The aims of the study were to collect epidemiological data and to review the mental health provisions. Majority of the patients were Chinese, male, 20-39 age-group, single, unemployed, schizophrenic with previous admissions to Woodbridge Hospital. Aggressive behaviour and public nuisance were the commonest reasons for police interventions. Ninety percent of the patients required admissions to hospital. There was no apparent misuse of the Mental Health Act.

Adult↗
PubMedDate not supplied

Association between allele 1 of T102C polymorphism, 5-hydroxytryptamine 2a receptor gene and schizophrenia in Chinese males in Singapore.

The T102C polymorphism at the 5-hydroxytryptamine 2a receptor (5HTR2a) gene was studied in 101 Chinese male schizophrenics and 103 controls. Genotyping revealed a predominance of allele 1 among schizophrenics. This is in contrast to previous reports in Caucasians and Japanese which showed an association of allele 2 of this polymorphism with schizophrenia.

Alleles↗
PubMedDate not supplied

Coronary artery bypass grafting in patients with left main coronary artery stenosis. Improved survival in a predominantly Oriental population.

Over the last 10 years, there has been a reduction of surgical mortality in coronary bypass grafting for left main coronary artery disease. Most of the available literature reports are of Caucasian populations. We report our experience of the surgical treatment of this disease in a predominantly Oriental population. From 1 January 1987 to 30 June 1991, 86 consecutive patients had coronary artery bypass surgery for left main stenosis. There were 65 men and 21 women with an age range of 34 to 80 years (mean age: 58 years SD +/- 8.63). There were no operative deaths and 1 hospital death (1.2%) from a non-cardiac cause. The perioperative myocardial infarction rate was 3.5% (3/86). These results are better than some earlier series in which hospital mortality was reported as high as 12.6% and the preoperative myocardial infarction rate 11.8%. In this series where the patients are predominantly Oriental, the results are comparable if not better than in series reported in centres where the population is predominantly Caucasian.

Age Factors↗