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Biomedical subjects

Y K Tay

Publications and source records attributed to Y K Tay.

At least 19 recordsLinked to original sources
PubMed2004

Delaying acute graft-versus-host disease in mouse bone marrow transplantation by treating donor cells with antibodies directed at l-selectin and alpha4-integrin prior to infusion.

Acute graft-versus-host disease (GVHD) is still a major hurdle for successful bone marrow transplantation (BMT). Although many immunosuppressive drugs are available, none of them alone or in combination are able to completely abolish acute GVHD. The lifelong immunosuppression profoundly reduces the quality of life of BMT recipients. Therefore, new therapeutic approaches are needed. We previously reported that, in an acute GVHD model using SCID mice as recipient, incubating donor spleen cells with antibodies directed at CD49d and CD62L could significantly delay the occurrence of acute GVHD. To test the potential usefulness of this treatment in BMT, we examined this therapeutic protocol in a mouse BMT model. The present mouse BMT study confirmed our previous results that incubation of donor cells with antibodies directed at CD49d and CD62L prior to infusion into the recipient can effectively delay acute GVHD, allowing the recipients to recover from the side effects of total body irradiation. This one-time treatment is easy and simple and may be modified for clinical usage.

Animals↗
PubMed2003

Thermosensory abnormalities and blood flow dysfunction in psoriatic skin.

BACKGROUND: Accumulating data have shown evidence of involvement of cutaneous nerve fibres and neuropeptides in psoriasis. Although ample evidence of structural and biochemical data exist no studies have been done on assessing the function of small nerve fibres in this disease. OBJECTIVES: To investigate the function of small nerve fibres in patients with psoriasis between psoriatic plaques and non-involved skin and in comparison with healthy controls. METHODS: We performed computerized psychophysical thermal sensory testing of warmth, cold and heat pain thresholds and skin blood flow using laser Doppler imaging in psoriatic lesions vs. non-involved skin and healthy skin. We evaluated these parameters before and immediately after barrier perturbation, and 1 week after as a measure of barrier repair. RESULTS: There is a significantly elevated warm and decreased cold sensation threshold in psoriatic skin compared with non-involved skin and skin of healthy controls in the same sites. These differences were particularly abnormal 1 week poststripping. The warm sensation threshold was significantly elevated in non-involved skin in psoriatics vs. skin of healthy controls after tape stripping. These findings suggest there is an abnormal function of cutaneous nerve fibres in response to trauma to the stratum corneum, which is not limited to the visible plaque but could be generalized and aggravated by stressful events. Skin blood flow was significantly elevated in psoriatic plaques and inversely correlated to warm sensation thresholds while in healthy controls a direct correlation was noted. CONCLUSIONS: Our data demonstrate an abnormal thermosensory response in psoriasis.

Adult↗
PubMed2003

Topical calcipotriol ointment in the treatment of morphea.

A 5-year-old girl presented with a 2-month history of an indurated hypopigmented, atrophic plaque of biopsy-documented morphea over the right hip area. Previous treatment with 0,1% betamethasone valerate cream twice a day for 3 months failed to improve the lesion. She was treated with calcipotriol ointment twice daily, with nightly occlusion to the plaque for 9 months, and this resulted in resolution. No side effects were noted.

Administration, Topical↗
PubMed2002

Allopurinol hypersensitivity syndrome and acute myocardial infarction--two case reports.

INTRODUCTION: Allopurinol hypersensitivity syndrome is an idiosyncratic drug reaction characterised by an acute and severe multiorgan disease. It usually begins 2 to 6 weeks after starting allopurinol. The most important and critical characteristics are the presence of visceral involvement and haematological abnormalities; hepatitis, interstitial nephritis and eosinophilia are most frequently seen. However, cardiac involvement has not been previously reported. CLINICAL PICTURE: Two previously well young Chinese men presented with fever, rash and hepatitis 3 weeks after taking allopurinol. The clinicopathological presentation was typical of allopurinol hypersensitivity syndrome. TREATMENT AND OUTCOME: Both men received systemic corticosteroid therapy and had full recovery. A few months later, they each had an acute myocardial infarction with a fatal outcome, despite minimal cardiac risk factors and no family history of coronary artery disease. CONCLUSION: The immunologic process in allopurinol hypersensitivity syndrome may have caused coronary vasculitis and subsequent myocardial infarct. Alternatively, the idiosyncratic reaction may have damaged myocardium, with the resultant myocarditis masquerading as coronary artery disease. Patients with allopurinol hypersensitivity syndrome should be followed up for cardiac involvement.

Adult↗
PubMed2001

Pemphigus vulgaris following varicella infection.

We describe a 26-year-old Indian man who presented with chickenpox and subsequently developed pemphigus vulgaris 17 days after initial resolution of lesions. The mechanism of progression from one disease to the other is postulated to be that of epitope spreading or molecular mimicry.

Adult↗
PubMed2000

An unusual case of pemphigus vulgaris presenting as bilateral foot ulcers.

We describe an unusual presentation of pemphigus vulgaris, an autoimmune intraepidermal blistering skin disease associated with autoantibodies to the desmosome glycoprotein, desmoglein 3. A 60-year-old man presented with bilateral ulceration on the dorsum of the feet. These clinical features persisted for 4 months before more characteristic signs of pemphigus vulgaris, including mouth ulceration and skin erosions, developed. The atypical presentation led to a delay in diagnosis and initiation of the appropriate treatment. Pemphigus vulgaris may have unusual manifestations, such as nail dystrophy, paronychia, or granulation tissue-like lesions, but this case of bilateral foot ulceration highlights a further, perhaps unique, clinical presentation of this autoimmune disease.

Anti-Inflammatory Agents↗
PubMed2000

Erythema nodosum in Singapore.

A retrospective study was carried out of all patients presenting with erythema nodosum over a 3-year period (1994-1997) at the National Skin Centre, Singapore. There were 75 patients, aged 4-70 years with a peak (40%) in the 21-30-year-old age group; 65 were female and 10 were male, giving a female to male ratio of 6.5 : 1. Precipitating factors included viral respiratory tract infections and streptococcal pharyngitis in 20 cases (26%), tuberculosis in two cases (3%), pregnancy in three cases (4%) and miscellaneous conditions: Behcet's syndrome (two cases), gonorrhoea (one case), varicella (one case) and cat-scratch disease (one case). The cause was unknown in 45 cases (60%). The pattern of erythema nodosum in Singapore is similar to that reported in the Western literature except that sarcoidosis and inflammatory bowel disease are uncommon associations.

Adolescent↗
PubMed2000

Lichen amyloidosus: a bullous variant.

INTRODUCTION: Lichen amyloidosus is a common skin disease seen among Asian patients. CLINICAL PICTURE: Typical features range from macular hyperpigmentation to pruritic, lichenified, hyperpigmented papules. However, in this rare bullous variant of lichen amyloidosus, bullae and vesicles are present. Histopathologically, deposits of amyloid were seen in the papillary dermis, associated with an intraepidermal or subepidermal blister. TREATMENT AND OUTCOME: No good treatment so far, but pruritus can be relieved by topical steroid. CONCLUSION: It is important to screen for systemic amyloidosis with the relevant investigations as it can present similarly with blistering eruptions, in which the prognosis would be grave.

Adult↗
PubMed2000

Neonatal lupus erythematosus: our local experience.

INTRODUCTION: Neonatal lupus erythematosus (NLE) presents clinically with either cutaneous lesions or cardiac involvement and is related to the transplacental passage of anti-Ro antibodies from mother to foetus. We report a series of 10 cases seen at the National Skin Centre between 1990 and 1998 including a pair of siblings. CLINICAL PICTURE: The female to male ratio was 2.3:1 and most presented with rash between 3 to 5 weeks of life while 4 had lesions at birth. Four of the 9 mothers had SLE, one was diagnosed to have a lupus-like illness, 2 had Sjogren's syndrome and the remaining two had very high ANA titres but the final diagnosis was uncertain. OUTCOME: The rash resolved spontaneously by 3 to 6 months of age.

Antibodies, Antinuclear↗
PubMed2000

An unusual case of cutaneous vasculitis.

INTRODUCTION: We report an unusual case of a patient with clinical and histological features of cutaneous vasculitis. CASE PICTURE: A middle-aged Chinese male presented with livedo reticularis and digital gangrene without visceral involvement. Skin biopsy showed features suggestive of cutaneous vasculitis. Repeated testing for anticardiolipin antibody was negative. TREATMENT: He was treated with two courses of intravenous prostacyclin and pulsed with one course of intravenous methylprednisolone. He was also put on oral prednisolone, pentoxifylline, aspirin, nifedipine and colchicine in addition to symptomatic therapy. OUTCOME: There was gradual improvement of his toe discolouration and relief of pain. CONCLUSIONS: This is an interesting case of cutaneous vasculitis, which has features of polyarteritis nodosa and the antiphospholipid syndrome, who responded well to intravenous prostacyclin, steroids, pentoxifylline, aspirin, nifedipine and colchicine.

Biopsy, Needle↗
PubMed2000

Porphyria cutanea tarda.

Porphyrias are a group of rare metabolic disorders in which excessive quantities of porphyrins, or their precursors, are produced. They are due to specific enzyme deficiencies resulting in abnormalities in the control of the porphyrin-haem metabolic pathway. Porphyria cutanea tarda (PCT) is the most common of all the porphyrias. However this condition is rarely seen in our Asian countries. We describe a patient with PCT who presented clinically with blistering eruptions over the sun-exposed areas. Coral pink fluorescence of uroporphyrins in an acidified urine specimen is diagnostic. Definitive treatment involves the use of low-dose chloroquine and interval venesection.

Biopsy↗