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Biomedical subjects

S K Lie

Publications and source records attributed to S K Lie.

7 recordsLinked to original sources
PubMed1997

Effectiveness of low-dose ASA in prevention of secondary ischemic stroke, the ASA Study Group in Taiwan.

This randomized double-blind controlled study was carried out to investigate the effect of 100 mg acetylsalicylic acid (ASA) per day on the secondary prevention of ischemic stroke. Patients who suffered a first ischemic stroke from 13 participating hospitals were enrolled. They were independent or only partially dependent in activities of daily living and all had received brain CT for diagnosis. Eligible patients were randomly allocated to the 100 mg ASA or the nicametate citrate (a vasodilator) groups, and trial medications were started within three to six weeks after the onset of stroke. The primary end point was cerebral reinfarction, and intracranial hemorrhage was classified as an adverse event. Four hundred and sixty-six patients participated in this study; and 222 cases (136 males and 86 females) were allocated to the ASA group while 244 cases (150 males and 94 females) were assigned to the nicametate group. No significant difference in baseline characteristics between the two groups was observed. Cerebral reinfarction developed 6.3% (14/222) in the ASA group and 11.9% (29/244) in the nicametate group. According to the Cox's proportional hazards model, the estimated risk ratio (ASA group vs. nicametate group) was 0.538, with a 95% confidence interval of 0.284-1.019. The result was of borderline statistical significance. The risk for cerebral reinfarction was reduced by almost 50% among those who took 100 mg ASA versus those who took nicametate.

Aged↗
PubMed1995

MRI appearance of spinal lesions: metastatic tumors or infections?

Three patients with pathologically verified spinal osteomyelitis and another three with metastatic tumors of the spine were investigated. MRI of th spine of four patients showed several unusual findings. The preservation of intervertebral discs and endplates did not predict accurately the diagnosis of either infections or tumors. The "pepper and salt" appearing feature may also occur in a metastatic tumor. Plain radiographs, CT, and radioisotope bone scans were less sensitive than MRI to disclose the lesions. In cases of osteomyelitis, the systemic sources of infections were frequently not found, and the responsible microorganisms could not be identified even from the surgical specimens of two patients. However, mycobacterium tuberculosis was found in the surgical specimen of a patient with cervical spinal lesion whose MRI was indistinguishable from a metastatic tumor. Surgicopathological diagnosis was therefore crucial and mandatory in these instances.

Adult↗
PubMed1994

Acute intermittent porphyria: clinical analysis of nine cases.

BACKGROUND: Acute intermittent porphyria (AIP) is an uncommon disorder, characterized by a variety of nonspecific symptoms and signs. Many patients have undergone prolonged medical care for the condition without accurate diagnosis; some have even received unnecessary operation. Here the clinical features of nine cases are presented. METHODS: Nine patients with AIP were diagnosed and treated at this hospital during the period for 1986 to 1993. The medical records of these patients were reviewed, and diagnosis of AIP in all cases was confirmed by positive Watson-Schwartz test. In three cases, further confirmation was done with erythrocyte porphobilinogen (PBG) deaminase activity measurement. Patients with photosensitivity were excluded. RESULTS: All patients presented initially with abdominal pain; two had been operated upon for acute abdomen. Neurological presentations at diagnosis were motor and/or sensory polyneuropathy (6/9), autonomic dysfunction (6/9), mental change (5/9) and seizure (4/9). Two cases had hyponatremia. One patient died of intractable seizures. CONCLUSIONS: AIP is a frequently forgotten old disease; if not correctly recognized, repeated and unnecessary surgery may occur. However, the diagnosis is easy when the possibility of this disorder is kept in mind.

Acute Disease↗
PubMed1993

Types of basilar artery syndrome: clinicoradiologic correlation.

Twenty-two patients with ischemic stroke, as a single event, in the territory of basilar artery (BA) are reported. On the basis of the findings from computerized tomography (CT) and clinico-radiologic features, the authors propose that this heterogeneous entity--the basilar artery (BA) syndrome--can be divided into five subtypes. Type 1 (complete type), characterized by infarctions in the whole territory of BA, is incompatible with life; type 2, with extensive brain stem infarct, may result in a locked-in state; and type 3, with infarctions in part of the BA territory (incomplete form or "partial syndrome") may have a more variable clinical outcome. However, type 4, with a top of the BA syndrome, and type 5, with negative CT BA syndrome (angiographically verified), are often more benign. Although initial CT scanning may infrequently be unrevealing, serial and follow-up CT scannings have proven their usefulness in the majority of cases as a noninvasive tool, in contrast to cerebral angiography, for predicting the short-term prognosis of BA syndrome.

Aged↗
PubMed1990

Multi-infarct progressive supranuclear palsy--case report.

A patient with supranuclear upward gaze palsy, pseudobulbar palsy, dementia, asymmetrical pyramidal signs, and atypical parkinsonism that developed after recurrent strokes was reported. The clinical features closely resembled idiopathic progressive supranuclear palsy (PSP). Computerised tomography of the brain showed, in addition to dilated third ventricle and prominent quadrigeminal plate and ambient cisterns, multiple infarcts at the thalamus, striatum, frontal subcortex and corona radiata. Multi-infarct PSP (MI-PSP) was thought to be the most likely diagnosis rather than coincidental idiopathic PSP with recurrent cerebral infarcts.

Aged↗
PubMed1989

Paradoxical enlargement of intracranial tuberculomas during treatment of tuberculous meningitis: report of a case.

We report a case of a 32-year-old man who showed paradoxical enlargement of pathologically verified intracranial tuberculomas during a course of adequate antituberculous chemotherapy. Serial computed tomographic scans of the brain disclosed this uncommon phenomenon. Total excision of the lesions with concomitant four-combined antituberculous therapy proved successful. Although the mechanism of this paradoxical phenomenon is not well understood, a defective local tissue immune response with gradually increasing maturity of the lesions during antituberculous therapy, which results in poor penetration of these drugs into the lesions, might be a possible explanation.

Adult↗