MyMedR

Necrotising pneumonia: A pneumonia that may need surgical intervention

Ooi SY, Lee SW

Med J Malaysia, 2017 12;72(6):367-369.

Pneumonia is primarily a disease that is usually managed medically with antibiotics. However, in rare cases it may progress to necrotising pneumonia, which is an uncommon but severe complication of bacterial pneumonia. This case illustrates a typical case of necrotising pneumonia complicated with parenchymal and pleural complication such as empyema, pneumothorax with possible bronchopleural fistula. Early consultation with thoracic surgeon can be life-saving.

Cholesteatoma in an Asian population

Lee ST

Acta Otolaryngol, 1991;111(3):536-41.

PMID: 1887780 DOI: 10.3109/00016489109138380

Two hundred Malaysian patients representing 227 ears with previously untreated cholesteatoma disease were analysed retrospectively in terms of i) type of disease, i.e. primary acquired attic defect or posterior superior retraction pocket and secondary acquired type cholesteatoma; ii) positive history of previous middle ear effusion, atelectasis or grommet insertion; and iii) likelihood of complications as initial presenting feature. The high 47.1% incidence of secondary acquired cholesteatoma disease in our patients contrasts with the predominance of primary acquired cholesteatoma in the Caucasian patient. Correlation of these two disease types with a positive history showed a significant positive association between the primary acquired group and a positive history; and conversely a significant negative association for the secondary acquired type. This supports a role for the retraction theory in primary acquired cholesteatoma but negates this theory in secondary acquired cholesteatoma. Secondary acquired cholesteatoma had a significantly higher (35.5%) complication rate against 15.8% in the primary acquired type (p = 0.001). This fact together with a 47.1% incidence of secondary acquired disease, low otolaryngologist population ratio and patient attitudes to disease account for the high total complication rate of 27.3%.

Psychogenic pain or lingual tonsillitis?

Lee ST

Br J Hosp Med, 1991 May;45(5):314-5.

PMID: 2065241

Congenital cleft lip and palate in Singapore

Fong PH, Yeap CL, Lee ST

Ann Acad Med Singap, 1983 Apr;12(2 Suppl):363-5.

PMID: 6625521

Cleft lip and palate is the most common congenital abnormality seen in the Department of Plastic Surgery, Singapore General Hospital. A total of 461 operative cases seen over a period of 5 years (1977 to 1981) is analysed. There is a relatively high incidence in the Singapore population of 2.0 per 1000 live births. In both cleft lip and cleft palate deformities, there is no significant difference in the sex distribution. The cleft patterns show that 78% of the cases are unilateral clefts, 53% are left sided, 25% are right sided and 22% of the cases are bilateral clefts.

Primary laryngeal tuberculosis mimicking carcinoma

Lee ST

Southeast Asian J. Trop. Med. Public Health, 1990 Dec;21(4):630-1.

PMID: 2098927

Anterior nasal stenosis from joss stick burns

Lee ST

J Laryngol Otol, 1990 Jun;104(6):497.

PMID: 2376711

Fulltext A delayed unusual presentation of a penetrating foreign body

Lee ST

Singapore Med J, 1992 Jun;33(3):304-5.

PMID: 1631596

Complications resulting from the penetrating percutaneous foreign bodies almost always arise in the early post injury period. Delayed presentations of previous asymptomatic foreign bodies are rare. In this case report, symptoms of tracheal irritation arose seven years following the initial penetrating shrapnel injury to the neck. Computed tomography scans enabled localisation of the foreign body at the tracheal wall and carotid sheath interface. The usefulness of this radiologic modality in the evaluation of the penetrating soft tissue injury is highlighted. A review of the phenomenon of the migrating and asymptomatic foreign body follows.

An unusual cause of chest pain in army trainee - spontaneous pneumomediastinum

Lee SS

Med J Malaysia, 2016 02;71(1):30-1.

PMID: 27130742

This is a case report of spontaneous pneumomediastinum that occurred in a 19-year-old army trainee during his 2.4km run. Spontaneous pneumomediastinum is a rare disorder. It is usually precipitated by activities related to Valsalva manoeuvres such as strenuous physical activities, retching and vomiting. Treatment is expectant and the disorder usually resolves spontaneously within a few days. However, one must be aware of the disorder so that additional advice such as avoiding activities that involve Valsalva manoeuvres can be given.

Fulltext Experiences with teflon injections in unilateral adductor vocal cord paralysis

Lee SS

Med J Malaysia, 1990 Sep;45(3):239-43.

PMID: 2152086

Six of 16 patients presenting to the University Hospital Kuala Lumpur with unilateral recurrent laryngeal nerve paralysis were treated with teflon injection of the paralysed vocal cord. The results are presented and the role of surgical therapy, in particular teflon injection is reviewed.

Female immigrants and labor in colonial Malaya: 1860-1947

Lee SM

Int Migr Rev, 1989;23(2):309-31.

PMID: 12315959

"The role of Chinese and Indian women as immigrants and workers in colonial Malaya is examined using data from censuses, immigration records, official reports and secondary sources. The article discusses the main types of work of female immigrants and their contribution to the economic development of colonial Malaya during the late nineteenth and early twentieth centuries in an attempt to redress the neglect of female immigrants' economic role in Malaya's history. Comparisons between male and female immigrants' labor and between Chinese and Indian immigrants, are drawn to highlight the different conditions of migration and labor for the different groups of immigrants."

Identification of α-tocopherol as a bioactive component of Dicranopteris linearis with disrupting property against preformed biofilm of Staphylococcus aureus

Mawang CI, Lim YY, Ong KS, Muhamad A, Lee SM

J Appl Microbiol, 2017 Nov;123(5):1148-1159.

PMID: 28869803 DOI: 10.1111/jam.13578

AIMS: The potential of Dicranopteris linearis leaves' extract and its bioactive components were investigated for the first time for its disrupting ability against Staphylococcus aureus biofilms.

METHODS AND RESULTS: The leaves of D. linearis were subjected to sonication-assisted extraction using hexane (HEX), dichloromethane, ethyl acetate and methanol (MeOH). It was found that only the MeOH fraction exhibited antimicrobial activity using broth microdilution assay; while all four fractions do not exhibit biofilm inhibition activity against S. aureusATCC 6538P, S. aureusATCC 43300, S. aureusATCC 33591 and S. aureusATCC 29213 using crystal violet assay. Among the four fractions tested, only the HEX fraction showed biofilm disrupting ability, with 60-90% disruption activity at 5 mg ml-1against all four S. aureus strains tested. Bioassay-guided purification of the active fraction has led to the isolation of α-tocopherol. α-Tocopherol does not affect the cells within the biofilms but instead affects the biofilm matrix in order to disrupt S. aureus biofilms.

CONCLUSIONS: α-Tocopherol was identified to be the bioactive component of D. linearis with disruption activity against S. aureus biofilm matrix.

SIGNIFICANCE AND IMPACT OF THE STUDY: The use of α-tocopherol as a biofilm disruptive agent might potentially be useful to treat biofilm-associated infections in the future.

Fulltext Treatment of small cell lung cancer with cyclophosphamide, adriamycin and vincristine (CAV) combination therapy: experience at University Hospital, Kuala Lumpur, Malaysia

Lee SM

Singapore Med J, 1990 Aug;31(4):317-20.

PMID: 2175049

Seventeen patients with small cell lung cancer (SCLC) were treated with cyclophosphamide, adriamycin and vincristine (CAV) combination chemotherapy. The overall response rate was 76.5% with 47% achieving complete response and 29.5% partial response. In limited and extensive stage disease, complete response was achieved in 67% and 36.5% respectively. Chinese were the predominant ethnic group affected (82%). Six patients presenting with superior vena cava obstruction responded significantly to CAV chemotherapy alone. Median survival for patients with extensive disease was 7.4 months. All patients with limited disease were still alive. Two relapsed patients with limited disease achieved significant response to VP-16/Cisplatin combination chemotherapy.

Fulltext Preliminary experience with mitomycin, vinblastine and cisplatin (MVP) combination chemotherapy in the treatment of advanced non-small cell lung cancer at University Hospital, Kuala Lumpur

Lee SM

Singapore Med J, 1990 Jun;31(3):228-32.

PMID: 2168091

Twelve patients with advanced inoperable non-small cell lung cancer (NSCLC) were treated with mitomycin, vinblastine and cisplatin (MVP) combination chemotherapy. The overall response rate was 33% (4 partial responses and no complete response) with a median survival of seven months. One responder above subsequently achieved complete remission following successful resection of his tumour and is still alive 14 months after initial chemotherapy. Responses were observed in patients with good performance status and limited disease. Side-effects were generally well tolerated and manageable. MVP is an effective regimen and the low response rate achieved here as compared to other centres is also discussed.

Fulltext Investigation on the antimicrobial activities of gingers (Etlingera coccinea (Blume) S.Sakai & Nagam and Etlingera sessilanthera R.M.Sm.) endemic to Borneo

Daniel-Jambun D, Dwiyanto J, Lim YY, Tan JBL, Muhamad A, Yap SW, et al.

J Appl Microbiol, 2017 Oct;123(4):810-818.

PMID: 28708293 DOI: 10.1111/jam.13536

AIMS: To investigate the antimicrobial properties of Etlingera coccinea and Etlingera sessilanthera and to isolate and identify the antimicrobial compounds.

METHODS AND RESULTS: Extracts were obtained via sequential solvent extraction method using hexane, dichloromethane, ethyl acetate, methanol and water. Antimicrobial activity testing was done using broth microdilution assay against 17 strains of bacteria. The leaf hexane extract of E. coccinea and rhizome hexane extract of E. sessilanthera showed best antimicrobial activities, with minimum inhibitory concentration (MIC) values ranging from 0·016 to 1 mg ml-1 against Gram-positive bacteria. From these active extracts, two antimicrobials were isolated and identified as trans-2-dodecenal and 8(17),12-labdadiene-15,16-dial with MIC values ranging from 4 to 8 μg ml-1 against Bacillus cereus, Bacillus subtilis and Staphylococcus aureus.

CONCLUSION: Etlingera coccinea and E. sessilanthera demonstrated good antimicrobial activities against clinically relevant bacteria strains. The antimicrobial compounds isolated showed low MIC values, hence suggesting their potential use as antimicrobial agents.

SIGNIFICANCE AND IMPACT OF THE STUDY: This study is the first to identify the potent antimicrobials from these gingers. The antimicrobials isolated could potentially be developed further for use in treatment of bacterial infections. Also, this study warrants further research into other Etlingera species in search for more antimicrobial compounds.

Bactericidal and cytotoxic activity of a diarylheptanoid (etlingerin) isolated from a ginger (Etlingera pubescens) endemic to Borneo

Daniel-Jambun D, Ong KS, Lim YY, Tan JBL, Yap SW, Lee SM

J Appl Microbiol, 2019 Jul;127(1):59-67.

PMID: 31006174 DOI: 10.1111/jam.14287

AIMS: The aim of this study was to investigate the antimicrobial activities of Etlingera pubescens, and to isolate and identify the antimicrobial compound.

METHODS AND RESULTS: The crude extracts of E. pubescens were obtained through methanol extraction, and evaluated for antimicrobial activities. From this extract, 1,7-bis(3,4-dihydroxyphenyl)heptan-3-yl acetate (etlingerin) was isolated. When compared to curcumin (a compound with a similar chemical structure), etlingerin showed twofold lower minimum inhibitory concentration values while also being bactericidal. Through time kill assay, etlingerin showed rapid killing effects (as fast as 60 min) against the Gram-positive bacteria (Staphylococcus aureus ATCC 43300 and Bacillus subtilis ATCC 8188). Further assessment revealed that etlingerin caused leakage of intracellular materials, therefore suggesting alteration in membrane permeability as its antimicrobial mechanism. Cytotoxicity study demonstrated that etlingerin exhibited approximately 5- to 12-fold higher IC50 values against several cell lines, as compared to curcumin.

CONCLUSIONS: Etlingerin isolated from E. pubescens showed better antibacterial and cytotoxic activities when compared to curcumin. Etlingerin could be safe for human use, though further cytotoxicity study using animal models is needed.

SIGNIFICANCE AND IMPACT OF THE STUDY: Etlingerin has a potential to be used in treating bacterial infections due to its good antimicrobial activity, while having potentially low cytotoxicity.

Mating system parameters of Dryobalanops aromatica Gaertn. f. (Dipterocarpaceae) in three different forest types and a seed orchard

Lee SL

Heredity (Edinb), 2000 Oct;85 Pt 4:338-45.

PMID: 11122411

The mating system of Dryobalanops aromatica in three different forest types and a seed orchard was quantified by allozyme analysis of progeny arrays using a mixed-mating model. The primary forest (Bukit Sai) had the highest multilocus outcrossing rate (tm=0.923 +/- 0.035), followed by logged forest (Lesong; tm=0.766 +/- 0.056) and artificial forest (FRIM; tm=0.661 +/- 0.066) with seed orchard showing the lowest (Tampin; tm=0.551 +/- 0.095). Deviations from the mixed mating model were evident from differences in pollen and ovule allele frequencies, and heterogeneity of pollen pools in all three different forest types and the seed orchard. A high rate of outcrossing in primary forest (tm=0.92) may indicate that the species is self-incompatible, but a lower value in the seed orchard (tm=0.55) might suggest further that the self-incompatibility system is weak. The outcrossing rate was greater in the primary forest (tm=0.92) than in logged forest (tm=0.77). It is argued that this might be a consequence of the lower density of flowering trees and alteration of pollinator foraging behaviour in logged forest. Higher values of correlated mating (rp) and biparental mating (tm - ts) in primary forest (0.08 and 0.39, respectively) in comparison with logged forest (0.03 and 0.11, respectively) demonstrate that logging activities might reduce the seeds produced through consanguineous mating. Compared with primary forest, it is argued that lower rates of outcrossing in artificial forest (tm=0.67) and seed orchard (tm=0. 55) might be attributed to lack of flowering synchrony and insufficient number of pollinators. The high level of correlated mating (rp=0.43) and biparental mating (tm - ts=0.12) in the seed orchard may further suggest that the seed orchard was established using related seed sources.

Fulltext Coeliac artery thrombosis: an uncommon cause of an acute abdomen

Saravana K, Zainal AA, Lee SK

Med J Malaysia, 2011 Aug;66(3):273-5.

PMID: 22111460 MyJurnal

Coeliac artery thrombosis with ischaemia is a rare condition, which usually presents with severe peptic ulcer disease symptoms. It is usually associated with risk factors for thrombosis or embolism. The manifestation is rare because of large number of collaterals between the coeliac and superior mesentery artery. Early detection and intervention is required to prevent the progression of its complications that includes gastric ischaemic necrosis.

Recurrent respiratory tract infection due to isolated absence of IgA: report of a case

Chia BL, Chew CH, Lee SK

Med J Malaya, 1970 Mar;24(3):215-7.

PMID: 4193671

Acute cholecystitis caused by Clonorchis sinensis

Rohela M, Johari S, Jamaiah I, Init I, Lee SH

Southeast Asian J. Trop. Med. Public Health, 2006 Jul;37(4):648-51.

PMID: 17121288

We are reporting a case of a 43-year-old Chinese male from Hong Kong, who came to see a doctor complaining of acute onset of severe upper abdominal pain. A diagnosis of acute cholecystitis was made and an emergency cholecystectomy was carried out. On opening the common bile duct, lancet-shaped worms were seen emerging from it. About 45 adult worms were collected and sent to the Department of Parasitology University of Malaya for identification. The worms were identified as Clonorchis sinensis. After the operation the patient was treated with praziquantel and he had an uneventful recovery.

Emphysematous pyelonephritis: drainage or nephrectomy?

Koh KB, Lam HS, Lee SH

Br J Urol, 1993 May;71(5):609-11.

PMID: 8518872

Four cases of emphysematous pyelonephritis are reported and the pathogenesis, surgical implications and preferred mode of management are discussed. We have not found percutaneous drainage to be useful, but feel there is an important place for surgical drainage alone because of the potential for renal recovery and the risks of emergency nephrectomy.

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