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Biomedical subjects

P H Feng

Publications and source records attributed to P H Feng.

16 recordsLinked to original sources
PubMed1992

Acute surgical abdomen in systemic lupus erythematosus--an analysis of 10 cases.

Gastrointestinal manifestations in a lupus patient may be due to different aetiologies such as vasculitis or a surgical condition. Problems of diagnosis are frequently encountered because the clinical presentations may mimic each other. We analysed ten lupus patients with acute surgical abdomen to identify the clinical, laboratory and radiological features that may aid in early diagnosis and management. Three patients with surgical abdomen had concomitant active lupus. Intra-abdominal sepsis and bleeding peptic ulcer disease constituted two major causes of laparotomies. Overt signs of peritonitis might not be present due to steroid masking effect. There were no specific clinical features, laboratory or radiological tests that could distinguish gastrointestinal vasculitis from acute surgical abdomen. Blood cultures, C-reactive protein and CT abdomen were useful adjuncts in the management of abdominal sepsis. No correlation was found between the timing of surgery, mortality, steroid dosage and wound complication.

Abdomen, Acute↗
PubMed1992

Gout.

Gout is a common disease in the primary health care setting. Diagnosis of primary gout is definite if urate crystals are present in synovial fluid or tophi. The colchicine therapeutic trial is a useful diagnostic aid but not specific. Secondary gout is associated with myeloproliferative disease. Non-steroidal anti-inflammatory agents or colchicine are the main stays of treatment in acute gouty arthritis. In the inter-critical period, uricosuric agents or allopurinol can be used to control hyperuricaemia. Allopurinol is the treatment of choice in secondary gout. Asymptomatic hyperuricaemia is not an indication for therapy.

Adult↗
PubMed1992

HLA in Singapore Chinese with rheumatoid arthritis.

The HLA-A, B, C, DR and DQ antigens were determined in 50 Singapore Chinese patients with rheumatoid arthritis (RA). There was a significant increase in the prevalence of HLA-Bw46, DRw53 and DQ3 in patients with RA. The linkage disequilibrium between Bw46 and DRw53 explains this association. This major histocompatibility complex association differs from the HLA-DR4 link in Caucasian populations and suggests that RA is an immunogenetically heterogeneous disease.

Adult↗
PubMed1992

Mortality patterns in a medical intensive care unit.

We studied the mortality rate and patterns in a 6-bedded Medical Intensive Care Unit in a busy general hospital. We found a high mortality rate (26% in-ICU and 42% in-hospitalization) and that mortality was strongly associated with the following factors: cardiac arrest, respirator support, duration of stay in ICU, infection and the immunocompromised state. Lack of formal patient selection and entry criteria and Critical-Care Specialists may be contributing factors.

Adolescent↗
PubMed1991

Coexisting Pneumocystis carinii pneumonia, cytomegalovirus pneumonitis and salmonellosis in systemic lupus erythematosus.

Infection with opportunistic organisms, either singly or in combination, is known to occur in immunocompromised patients. A patient with systemic lupus erythematosus who developed Pneumocystis carinii pneumonia, cytomegalovirus pneumonitis, and salmonellosis is reported. She responded to early treatment with intravenous trimethoprim-sulphamethoxazole (20 mg/kg).

Adult↗
PubMed1990

Methylprednisolone in systemic lupus erythematosus.

39 patients who received pulse methylprednisolone for disease manifestations of systemic lupus erythematosus were studied for zero to twenty-four weeks following therapy. Pulse methylprednisolone was given as intravenous infusions of methylprednisolone (10 mg/kg body weight) over one hour each day for three consecutive days. 27 (69.2%) patients were treated for lupus nephritis, 12 (30.8%) patients for non-renal manifestations of lupus. 17 (63.0%) of the renal lupus patients and 7 (58.3%) of the non-renal lupus patients showed clinical response. 11 (28.2%) patients had infections from which 7 (63.6%) died. Overall, 15 (38.5%) patients died. Early deaths (occurring within the first two weeks) were mainly due to disease activity while later deaths were mainly due to infection. In conclusion, the majority of lupus patients appeared to have had a beneficial response to pulse methylprednisolone therapy.

Adolescent↗
PubMed1978

Non-specific aorto-arteritis in Singapore with special reference to hypertension.

Aorto-arteritis has recently emerged as a distinct disease entity with involvement of aorta and its major branches by a non-specific inflammation of unknown etiology. Though the distribution of this disease is worldwide, it is more prevalent in Japan, India, and South-east Asia. This paper describes a series of 48 cases seen in Singapore and emphasizes the protean nature of this disease. Though modes of clinical presentation were many, hypertension appeared to be the commonest as it occurred in 33 patients, giving an incidence of 69 per cent. This incidence was much higher than the 48 per cent reported among Europeans and 42 per cent reported among South Africans. It would therefore appear that hypertension was a far more common manifestation of aorto-arteritis among Asians. The commonest cause of hypertension in aorto-arteritis in this series was renovascular, with renal artery stenosis or occlusion occurring in 27 cases (85 per cent). The frequency of involvement of the renal artery is much greater than the 34 per cent reported by the Japanese. Therefore renovascular hypertension should be regarded as a predominant feature of aorto-arteritis in Singapore.

Adolescent↗
PubMed1978

Henoch-Schoenlein syndrome: a clinical and morphological study of renal biopsies.

Twenty-four patients, 12 children and 12 adults, with the Henoch-Schoenlein syndrome had their renal biopsy specimens studied by light and electron microscopic and immunofluorescent antibody techniques. The principal glomerular lesion was a focal and segmental proliferative glomerulonephritis in 15, a diffuse proliferative glomerulonephritis in 6 and a animal or minor change lesion with mesangial hypertrophy in 3 cases. The proliferation of the cells was mainly mesangial. Renal biopsies taken earlier in the course of the disease showed a greater number with a focal lesion. Electron dense deposits with cellular proliferation and increased matrix were seen in the mesangium. Less frequent subendothelial and occasional subepithelial deposits were found. Capillary loop changes were seen more frequently in the later stages of the disease. Heavy deposits of IgA were found in the mesangium in all cases, and less intense deposits of IgG in 60%. beta 1 C globulin and fibrinogen were found in 80% and IgD and IgM less frequently. Complement activation was via the alternate pathway as early complement components C1q and C4 were absent. Overt allergies, streptococal infections and the HBsAg could not explain the pathogenesis of the disease. Henoch-Schoenlein syndrome is a chronic disease of the mesangium; only 5 patients showed complete recovery, 15 had persistent microscopic hematuria and 3 died or developed renal insufficiency within 8 years. The prognosis was worst with diffuse proliferative glomerulonephritis, widespread focal glomerulonephritis or epithelial cresents formation.

Adolescent↗
PubMed1976

Elevated serum enzymes in patients with wasp/bee sting and their clinical significance.

Seventeen patients who had been admitted to hospital for wasp/bee sting were studied. Mild pyrexia was encountered in 7 patients, rash/urticaria in 3, angioneurotic oedema in 2, oliguria in 2, microscopic haematuria and albuminuria in 3, transient hypotension in 1. However, there were frequent elevations of serum glutamic-oxaloacetic transaminase (9 out of 17 patients), serum creatine phosphokinase (14 out of 17 patients) and serum lactate dehydrogenase (8 out of 14 patients), indicating presence of damage to muscle fibres. This was confirmed by the histological findings of a muscle-biopsy from the most severe case. Elevation of serum glutamic-pyruvic transaminase was found in 6, and elevation of serum isocitrate dehydrogenase in 5 out of 14 patients, suggesting presence of liver damage. The above enzyme elevations appeared short-lived except in the clinically most severe patient (case 9) who developed acute tubular necrosis. All patients except the latter suffered no clinical sequelae and there was no correlation between their clinical condition and the presence or degree of elevations of serum enzymes.

Adolescent↗
PubMed1976

Lupus nephritis: correlation between light, electron microscopic and immunofluorescent findings and renal function.

Percutaneous renal biopsies from 56 patients with systemic lupus erythematosus were studied to determine the relationship between renal function and the light microscopic, electron microscopic and immunofluorescent antibody findings. The glomerular lesions were classified into 5 major groups: diffuse membranoproliferative glomerulonephritis (34%), diffuse proliferative glomerulonephritis (26.8%), membranous nephropathy (12.5%), minimal lesion ('nil') and minimal lesion with increased mesangial matrix and/or cells (21.4%) and focal and segmental glomerulonephritis (5.3%). Minimal lesions and focal and segmental glomerulonephritis were invariably associated with normal renal function. Patients with moderate to severe renal involvement and the nephrotic syndrome had predominantly diffuse membranoproliferative and diffuse proliferative glomerulonephritis. Membranous nephropathy was associated with moderate renal involvement and the nephrotic syndrome in 50% of cases. Patients with pure mesangial electron dense deposits had normal renal function or mild renal involvement when the deposits were heavy. Moderate and heavy subepithelial, and intramembranous/subepithelial deposits were associated with moderate to severe renal involvement and the nephrotic syndrome. Renal involvement was most severe with heavy subendothelial deposits. Cytoplasmic tubuloreticular structures measuring approximately 18 to 20 nm in diameter and 80 to 100 nm in length were found in 93% of all biopsies, but bore no relationship to the renal function of the patients. Anti-Hu-IgG fluorescent deposits were found in all the renal biopsies; in 81.3% these were associated with less heavily stained deposits of immunoglobulin IgA, IgD and IgM. Early complement components Clq and C4 were utilized in the complement pathway of activation. Pure mesangial fluorescent deposits were associated with normal renal function or mild proteinuria. Diffuse granular and lumpy deposits along the capillary loops were usually associated with moderate to severe renal involvement and the nephrotic syndrome. In the present series of cases, there was a good correlation between renal function of patients with systemic lupus erythematosus and the glomerular lesions as determined by light, electron microscopic and immunofluorescent microscopic findings.

Adolescent↗