Displaying publications 1 - 20 of 311 in total

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  1. A recommended diet for West Malaysian pregnant women
    Chan LK, Lee KL, Tan SE
    Med J Malaya, 1967 Dec;22(2):94-8.
    PMID: 4231985
  2. The effects of betel-nut chewing on the buccal mucosa: a histological study
    Lee KW, Chin CT
    Br. J. Cancer, 1970 Sep;24(3):433-41.
    PMID: 5475751
    Sixty-two "leukoplakias" from the cheeks of betel-nut chewers in West Malaysia were studied histologically. Ten biopsies were from non-tobacco betel-nut chewers. An amorphous von Kossa positive layer was seen on the keratin surface in 42 specimens. Tobacco did not appear essential for its formation, and it appeared to be significantly associated with parakeratosis. Its possible significance as a cuticle-like layer prolonging contact between carcinogens and the mucosa is discussed.Parakeratosis appeared to be the most common form of cornification seen, and the mitotic activity in parakeratinized leukoplakias appeared to be significantly greater than orthokeratinized leukoplakias.Comparison with studies on other population samples using different quids suggested that severe histological changes were more likely to be seen when tobacoo-containing quids were chewed as compared to non-tobacco-containing quids.An attempt to correlate the histological changes seen with the clinical habit in leukoplakias from chewers using tobacco-containing quids suggested that epithelial atrophy appeared to be significantly related to the duration of the habit but not to the "intensity" of the habit.
  3. The effects of betel-nut chewing on the buccal mucosa of 296 Indians and Malays in West Malaysia. A clinical study
    Chin CT, Lee KW
    Br. J. Cancer, 1970 Sep;24(3):427-32.
    PMID: 5475750
    Changes in the buccal mucosa of 296 Indian and Malay betel-nut chewers in Perak, West Malaysia, were studied clinically. 167 out of 212 Indian subjects incorporated tobacco in their quids, while 45 out of 84 Malay subjects incorporated. "Gambir". The Indians appeared to show a higher proportion of mucosal changes, particularly when tobacco was used. "Gambir" did not appear to be potent in the production of mucosal changes. Comparison with studies in other parts of the world suggested comparable findings with respect to both tobacco and non-tobacco chewing samples, and there would appear to be some evidence that tobacco-containing quids are likely to produce a higher proportion of mucosal changes as compared to non-tobacco-containing quids. An attempt to demonstrate a dose-effect relationship by dividing the subjects into "slight" and "heavy" chewers did not yield significant differences between these two categories in each of the groups.
  4. Competitive binding of gangliosides and glycophorin to wheat germ agglutinin
    Lee PM, Lee KH
    Biochem Biophys Res Commun, 1989 Apr 28;160(2):780-7.
    PMID: 2719696
    Gangliosides and glycophorin are receptors for wheat germ agglutinin. The competitive binding of these molecules to wheat germ agglutinin is studied by electron spin resonance spectroscopy with spin labels attached to the oligosaccharide chains of gangliosides. Evidence shows that glycophorin is more accessible to wheat germ agglutinin binding than gangliosides. The interactions of gangliosides and glycophorin in liposomes is disrupted on low level binding of WGA.
  5. Migration, income and fertility in Malaysia: a simultaneous equations model with limited dependent variables
    Lee KS
    Appl Econ, 1989;21:1589-610.
    PMID: 12342770
  6. Fulltext Congenital leukaemia--a case report
    Lee KT
    Med J Malaysia, 1991 Sep;46(3):218-20.
    PMID: 1839915
    Congenital leukaemia which is characterised by proliferation and extrahaemopoietic infiltration of immature leucocyte precursor cells is a rare disorder encountered in the neonatal period. Although more than 100 cases of congenital leukaemia have been reported in the literature, the experience of most general paediatricians with this condition is very likely to be limited. Thus a patient presenting with congenital leukaemia admitted to Alor Star General Hospital is reported.
  7. Cardiovascular responses in the normotensive rat produced by intravenous injection of gambirine isolated from Uncaria callophylla B1. ex Korth
    Mok JS, Chang P, Lee KH, Kam TS, Goh SH
    J Ethnopharmacol, 1992 Jun;36(3):219-23.
    PMID: 1434680
    Among several alkaloids, including dimeric indoles, isolated from Uncaria callophylla, gambirine which is an alkaloid unique to this plant, has been found to be another hypotensive principle from the plant. Intravenous injections of gambirine in the dose range of 0.2 to 10.0 mg/kg caused a dose-related fall in both systolic and diastolic blood pressures as well as heart rate. At all doses gambirine showed a prompt onset of action and at the higher doses (5.0-10 mg/kg), marked persistence of hypotension accompanied by severe bradycardia were observed. In addition, higher doses of gambirine produced a more marked decrease in diastolic than systolic pressure while at lower doses both decreased equally. It is suggested that the hypotensive effect of gambirine may be peripheral in origin and is associated, at least in part, with a cardiac action.
  8. Fulltext Factors influencing pulse oximetry as compared to functional arterial saturation in multi-ethnic Singapore
    Lee KH, Hui KP, Tan WC, Lim TK
    Singapore Med J, 1993 Oct;34(5):385-7.
    PMID: 8153680
    Noninvasive oximetry provides continuous monitoring of arterial oxygen saturation and hence, early detection of hypoxia. This has proved to be a useful adjunct to patients' safety, and is considered indispensable in certain settings. However, errors may be present in the pulse oximeter estimation (SpO2) of arterial oxygen saturation (SaO2), which may be due to various parameters. We have studied a multi-ethnic population where the skin pigmentation is different, and also under different conditions comparing SpO2 with SaO2. Our results showed that SpO2 estimation of SaO2 amongst the three racial groups (Chinese, Malays, and Indians) varied significantly (ANOVA, p < 0.05). The over-estimation was more pronounced by hypoxic conditions and jaundice. Haemoglobin and systolic blood pressure did not affect the difference between SpO2 and SaO2.
  9. Covalent immobilization of aminoacylase to alginate for L-phenylalanine production
    Lee PM, Lee KH, Siaw YS
    J Chem Technol Biotechnol, 1993;58(1):65-70.
    PMID: 7763937
    Aminoacylase I (EC. 3.5.1.14) was immobilized by covalent crosslinking to alginate molecules with 1-ethyl-3-(3-dimethyl-aminopropyl)-carbodiimide HCl followed by calcium alginate bead formation for the production of L-phenylalanine from the racemic mixtures of N-acetyl-DL-phenylalanine. Different concentrations of the coupling reagent were tested and the coupling process was optimized. The immobilized and the partially purified aminoacylase were characterized in terms of the activity, operational stability, thermal stability, pH and temperature optima and kinetic constants, Km and Vmax. The activity of the enzyme covalently immobilized in calcium alginate beads was enhanced by about 75% compared to that of free enzyme. The beads showed stable activity under operational conditions, they lost about 40% of their activity after four reaction cycles. The immobilized aminoacylase was more stable over a broader pH range. Thus this simple method provides irreversible immobilization of aminoacylase to give a biocatalyst with good operational stability and enhanced activity.
  10. Immobilization of aminoacylase by encapsulation in poly-L-lysine-stabilized calcium alginate beads
    Lee KH, Lee PM, Siaw YS
    J Chem Technol Biotechnol, 1993;57(1):27-32.
    PMID: 7763683
    Aminoacylase I (EC 3.5.1.14) encapsulated in calcium alginate beads stabilized with poly-L-lysine was used for the production of L-phenylalanine by the hydrolysis of a racemic mixture of N-acetyl-DL-phenylalanine. The immobilized aminoacylase was studied with respect to operational stability, thermal stability, effects of pH and temperature and kinetic constants. The leakage of enzyme from the stabilized beads was eliminated. The immobilized enzyme retained high biological activity. The Km and Vmax values for the stabilized beads were 11.11 mmol dm-3 and 0.076 mumol min-1 respectively. The optimum pH and temperature for the hydrolysis were 6.5 and 55 degrees C respectively. Scanning electron micrographs revealed crosslinked structures on the surface of the beads. The operational performances of the beads in a batch reaction and a packed-bed bioreactor for continuous reaction were investigated. With batch reaction, only about 5% of enzyme activity was lost within ten reaction cycles and there was no significant loss of activity over 600 h of continuous operation after equilibrium was reached, and a conversion yield of about 80% was obtained.
  11. Immobilization of aminoacylase in polyethyleneimine stabilized calcium alginate beads for L-phenylalanine production
    Lee PM, Lee KH, Siaw YS
    Biomater Artif Cells Immobilization Biotechnol, 1993;21(4):563-70.
    PMID: 8260581
    Aminoacylase I (E.C.3.5.1.14) was immobilized by entrapment in calcium alginate beads coated with polyethyleneimine for the production of L-phenylalanine by the hydrolysis of a racemic mixture of N-acetyl-DL-phenylalanine. The operational stability in terms of batch operation and continuous reaction in packed-bed bioreactor were studied. Kinetic constants, Km and Vmax values of free and immobilized enzymes were studied. Polyethyleneimine treatment was found to enhance the operational stability of the enzyme though its activity was substantially reduced. When polyethyleneimine-coated calcium alginate beads were packed into packed bed bioreactor, it was stable for at least 25 days under continuous operation without appreciable loss of activity.
  12. Fulltext Fatal intra-cranial haemorrhage in 2 cases of beta-thalassaemia major
    Lee KF
    Med J Malaysia, 1995 Mar;50(1):110-3.
    PMID: 7752964
    Spontaneous intracranial haemorrhage is one of the cerebrovascular complications in beta-thalassaemia major patients. This is a report of 2 cases of fatal intracranial haemorrhage. Their ages were 12 and 7 years respectively, and they had been receiving regular blood transfusion for the past 3 and 2 years respectively. They developed acute onset of headache, loss of consciousness and convulsions at 5 and 2 days respectively after their last blood transfusion. C-T scan of the brain showed massive intracranial haemorrhage with extension into the ventricles. The spontaneous intracranial haemorrhages in these two cases was probably multi-factorial in origin. The predisposing factors included recent blood transfusion, prolonged prothrombin time and partial thromboplastin time as well as reduced platelet count.
  13. Estimation of breast radiation dose in a mammographic system
    Lee KH, Kandaiya S
    Appl Radiat Isot, 1996 Mar;47(3):361-3.
    PMID: 8935969
  14. Measuring quality of life in different cultures: translation of the Functional Living Index for Cancer (FLIC) into Chinese and Malay in Singapore
    Goh CR, Lee KS, Tan TC, Wang TL, Tan CH, Wong J, et al.
    Ann Acad Med Singap, 1996 May;25(3):323-34.
    PMID: 8876896
    Quality-of-life assessment has become an accepted method of evaluation in clinical medicine. The technique is based on a patient's self-assessment of physical, psychological, and social function, as well as the effects of distressing physical symptoms. The most important aspect of quality-of-life assessment is that it brings into focus a patient-centred view of health outcome, which is broader than the physiologic measures which predominate in Western medicine. Strategies for the development and use of assessment questionnaires have evolved over the past 15 years, and numerous questionnaires have been created. Most originate in Western societies, with English as the most common language of development. Adapting such questionnaires for use in other language and cultural settings is an imprecise practice. Language translation and equivalent cultural meaning must both be addressed. This paper reports on the language translation process and results for the Functional Living Index for Cancer (FLIC) as translated into Chinese and Malay in Singapore. We employed a step-wise process beginning with translation/back translation, followed by structured pilot field trials and population sampling. Taped versions of the questionnaire were devised to meet illiteracy problems in the sample population. Paired comparisons of the Chinese and Malay versions of individual questions with their English counterparts show good correlations and similar means most of the time. Factor analysis on a population sample of 246 (112 Chinese, 35 Malay and 98 English speaking) with cancers of minimal, extensive or palliative extent is convergent with that obtained on a North American population. However, a separate analysis of the Chinese questionnaires showed some differences in factor pattern. Specific language and cultural translation difficulties are discussed. Of note is the predicted significant decrease in total FLIC scores with extent of disease within each of the language preference populations, which provides some evidence for the validity for each language version in the Singapore culture(s). Thus, the FLIC translations into Malay and Chinese in Singapore can be considered for use in local trials, subject to ongoing evaluation.
  15. The combined Singapore-Malaysia Congress of Medicine
    Lee KO
    Ann Acad Med Singap, 1997 May;26(3):265.
    PMID: 9285013
  16. The impact of a modified ileal neobladder on the lifestyle and voiding patterns in Asian patients
    Lee KT, Li MK, Cheng WS, Foo KT
    Br J Urol, 1998 May;81(5):705-8.
    PMID: 9634045 DOI: 10.1046/j.1464-410x.1998.00586.x
    OBJECTIVE: To evaluate the impact of the modified ileal neobladder reconstruction on lifestyle, voiding habits and functional outcome in Asian patients.

    PATIENTS AND METHODS: Twenty-seven Asian patients (25 men and two women, mean age 59 years, range 41-76) underwent modified ileal neobladder reconstruction after radical cystectomy for carcinoma of the bladder. The mean (range) follow-up was 21 (3-75) months. All patients were evaluated retrospectively using case notes, reviews, interviews and voiding charts; 18 patients underwent urodynamic studies.

    RESULT: Twenty-five patients (93%) achieved diurnal and 23 (85%) nocturnal continence within 6 months. Of the 19 patients who were in employment before surgery, 15 continued to be economically active afterward; 26 patients (96%) reported no change in their daily living activities. Of 16 men who reported being potent pre-operatively only four retained some residual erectile function. Twenty-three patients were interviewed about their voiding habits and satisfaction with the outcome of surgery. Fourteen patients had no sensation of reservoir fullness and of the 21 men, 13 had to squat or sit to void effectively. The mean (range) voiding frequency was 5 (4-8) during the day and 2 (0-4) during sleep. Twenty-two patients were satisfied with the overall outcome.

    CONCLUSIONS: The modified ileal bladder provides a high urinary continence rate with minimal changes in daily living activities and occupational status. The functional outcome was very satisfactory and accepted well, despite some changes in reservoir sensation, voiding posture and erectile function. The method is a viable option for reconstruction after cystectomy in Asian patients.
  17. Fulltext Outpatient procedures for cervical dysplasia: a 3 year review of laser vaporisation and LEEP
    Lee KE, Koh CF, Watt WF
    Med J Malaysia, 1999 Mar;54(1):47-51.
    PMID: 10972004
    A 3 year retrospective review (1995 to 1997) of 127 patients with cervical dysplasia who underwent Laser Vaporisation of the cervix and LEEP at the Gynaecological Cancer Centre, KK Women's & Children's Hospital, Singapore, was undertaken. Amongst the patients in the Laser Vaporisation group, the mean age was 37.7 years (SD 8.8), the mean operating time was 14.8 minutes (SD 8.5), 63.6% were given prophylactic antibiotics and the mean follow up period was 15.3 months (SD 12.0), whilst in the LEEP group, mean age was 40.3 years (SD 8.4), mean operating time, 11.8 minutes (SD 4.9), prophylactic antibiotic rate, 53.8% and mean follow up period was 19.1 months (SD 9.3). Mild and moderate haemorrhage post procedure were the only complications encountered, 10.2% (5/49) in the Laser group and 3.8% (3/78) in the LEEP group. 98% (48/49) and 97.4% (76/78) of the Laser and LEEP groups, respectively, were free of disease on follow up. None of the 3 patients with persistent or recurrent disease were diagnosed as having invasive cancer. Overall, there were no significant differences in the patient characteristics, histopathology, operating times, follow up period, the use of prophylactic antibiotics, and complications in the 2 groups. The low complication rate, high disease-free rate and the relatively short operating time of Laser Vaporisation and LEEP in our study suggests that, indeed, both the procedures can be done safely and efficiently in the outpatient setting. However the discrepancy between the histology of colposcopically directed biopsy and that of LEEP specimens suggests that colposcopically directed biopsy may not be as accurate as one might believe, and further studies analysing the concordance between colposcopically directed biopsy and LEEP biopsy histologies are needed.
  18. The neurological manifestations of Nipah virus encephalitis, a novel paramyxovirus
    Lee KE, Umapathi T, Tan CB, Tjia HT, Chua TS, Oh HM, et al.
    Ann Neurol, 1999 Sep;46(3):428-32.
    PMID: 10482278 DOI: 10.1002/1531-8249(199909)46:3<428::AID-ANA23>3.0.C
    A novel Hendra-like paramyxovirus named Nipah virus (NiV) was the cause of an outbreak among workers from one abattoir who had contact with pigs. Two patients had only respiratory symptoms, while 9 patients had encephalitis, 7 of whom are described in this report. Neurological involvement was diverse and multifocal, including aseptic meningitis, diffuse encephalitis, and focal brainstem involvement. Cerebellar signs were relatively common. Magnetic resonance imaging scans of the brain showed scattered lesions. IgM antibodies against Hendra virus (HeV) were present in the serum of all patients. Two patients recovered completely. Five had residual deficits 8 weeks later.
  19. Nipah viral encephalitis or Japanese encephalitis? MR findings in a new zoonotic disease
    Lim CC, Sitoh YY, Hui F, Lee KE, Ang BS, Lim E, et al.
    AJNR Am J Neuroradiol, 2000 Mar;21(3):455-61.
    PMID: 10730635
    BACKGROUND AND PURPOSE: An epidemic of suspected Japanese encephalitis occurred in Malaysia in 1998-1999 among pig farmers. In neighboring Singapore, an outbreak occurred among pig slaughterhouse workers. It was subsequently established that the causative agent in the outbreak was not the Japanese encephalitis virus but a previously unknown Hendra-like paramyxovirus named Nipah virus.

    METHODS: The brain MR images of eight patients with Nipah virus infection were reviewed. All patients tested negative for acute Japanese encephalitis virus. Seven patients had contrast-enhanced studies and six had diffusion-weighted examinations.

    RESULTS: All patients had multiple small bilateral foci of T2 prolongation within the subcortical and deep white matter. The periventricular region and corpus callosum were also involved. In addition to white matter disease, five patients had cortical lesions, three had brain stem involvement, and a single thalamic lesion was detected in one patient. All lesions were less than 1 cm in maximum diameter. In five patients, diffusion-weighted images showed increased signal. Four patients had leptomeningeal enhancement and four had enhancement of parenchymal lesions.

    CONCLUSION: The brain MR findings in patients infected with the newly discovered Nipah paramyxovirus are different from those of patients with Japanese encephalitis. In a zoonotic epidemic, this striking difference in the appearance and distribution of lesions is useful in differentiating these diseases. Diffusion-weighted imaging was advantageous in increasing lesion conspicuity.

  20. A new bacterial white spot syndrome (BWSS) in cultured tiger shrimp Penaeus monodon and its comparison with white spot syndrome (WSS) caused by virus
    Wang YG, Lee KL, Najiah M, Shariff M, Hassan MD
    Dis Aquat Organ, 2000 May 25;41(1):9-18.
    PMID: 10907134
    This paper describes a new bacterial white spot syndrome (BWSS) in cultured tiger shrimp Penaeus monodon. The affected shrimp showed white spots similar to those caused by white spot syndrome virus (WSSV), but the shrimp remained active and grew normally without significant mortalities. The study revealed no evidence of WSSV infection using electron microscopy, histopathology and nested polymerase chain reaction. Electron microscopy indicated bacteria associated with white spot formation, and with degeneration and discoloration of the cuticle as a result of erosion of the epicuticle and underlying cuticular layers. Grossly the white spots in BWSS and WSS look similar but showed different profiles under wet mount microscopy. The bacterial white spots were lichen-like, having perforated centers unlike the melanized dots in WSSV-induced white spots. Bacteriological examination showed that the dominant isolate in the lesions was Bacillus subtilis. The occurrence of BWSS may be associated with the regular use of probiotics containing B. subtilis in shrimp ponds. The externally induced white spot lesions were localized at the integumental tissues, i.e., cuticle and epidermis, and connective tissues. Damage to the deeper tissues was limited. The BWS lesions are non-fatal in the absence of other complications and are usually shed through molting.
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