1
|
Tan SH, Sombuntham P. Narrow band imaging for sulcus vocalis-an often missed diagnosis. QJM 2023; 116:69-70. [PMID: 35993912 DOI: 10.1093/qjmed/hcac204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Indexed: 11/12/2022] Open
|
2
|
Huang C, Mezger STP, Looi WD, Muralidharan S, Ji S, Pastor BC, Tan SH, Charles CJ, Kofidis T, Richard AM, Chan MY, Torta FT, Heeren RMA, Bonney GK, Wang JW. Spatial-temporal lipidomics profile of acute myocardial injury. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lipidome disturbance has long been recognized to occur after myocardial infarction (MI). Accumulation of excessive fatty acids induces production of reactive oxygen species and consequently deteriorates cardiac injury in MI. However, the spatial and temporal lipid profile in the heart following ischemic injury remains unknown.
Purpose
We aim to uncover the temporal-spatial lipidome profile of the heart following ischemia reperfusion (I/R) injury and identify circulating lipids released from injured myocardium that are potentially useful for diagnosis of ischemic heart disease.
Methods
C57/BL6 mice were subjected to 30 min myocardial ischemia followed by removal of the ligature to establish reperfusion injury. Porcine I/R injury was induced by 105 min myocardial ischemia followed by reperfusion. Human plasma was obtained from 143 post-MI patients. Myocardial lipid profiles were generated by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MALDI-MSI) in different regions (infarct, remote and peri-infarct) at different time points. Moreover, the lipids in the heart and plasma were analysed by LC-MS/MS.
Results
We observed a drastic alteration in the lipidome with distinct spatial-temporal features in the injured heart by both MALDI-MSI and LC-MS/MS. In the infarct heart tissue, as revealed by LC-MS/MS, we observed an elevation of glycerolipids that peaked at 3 hours after I/R, and a sustained elevation of phospholipids and sphingolipids up to 3 days. Similar alternations in lipid profile was observed but much weaker in the remote and peri-infarct heart tissue compared to the infarct tissue. Among those lipids, PC 32:0 detected by MALDI-MSI highly overlapped CD68 staining at a single-cell level, showing a strong correlation of PC 32:0 with macrophage infiltration in mouse hearts (R2=0.93, p<0.0001). A similar increase of PC 32:0 in the infarct area was also observed in porcine hearts following I/R injury. Surprisingly, plasma levels of PC 32:0 in the mice decreased after I/R injury. In humans, plasma levels of PC 32:0 in post-MI patients were lower than that in healthy individuals (p=0.03). Further analysis demonstrated that plasma levels of PC 32:0 determined within 72 hours after percutaneous coronary intervention were negatively correlated with the 6-month post-MI cardiac ejection fraction in patients (R2=0.08, p<0.001).
Conclusions
A temporal-spatial lipidome profile was established in heart injury by synergizing LC-MS/MS and mass spectrometry imaging. PC 32:0 levels are positively correlated with myocardial macrophage infiltration but negatively correlated with cardiac function in cardiac I/R injury. Our findings indicate that PC 32:0 is a potential biomarker for cardiac injury and the inflammatory status in the injured heart.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Singapore Ministry of Health's National Medical Research Council
Collapse
|
3
|
Tee SI, Lim JHL, Tan SH. Comparative analysis of the clinical, histopathological and molecular genetic features of 29 cases comprising cutaneous B-cell lymphomas and B-cell pseudolymphomas in Singapore. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
4
|
Yew YW, Kuan A, George PP, Zhao X, Tan SH. Prevalence and burden of skin diseases among the elderly in Singapore: A 15-year clinical cohort study. J Eur Acad Dermatol Venereol 2022; 36:1648-1659. [PMID: 35535625 DOI: 10.1111/jdv.18205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Populations around the world are rapidly ageing. The profile of skin diseases in the elderly is likely to present unique demands on the healthcare system. OBJECTIVES To provide current data on the burden of skin diseases in Singaporean patients and identify differences in the pattern of skin diseases between elderly patients and the rest of the population. METHODS This was a retrospective cohort study of 858,117 patients who attended the National Skin Centre between 2004 to 2018. Prevalence was calculated by grouping International Classification of Diseases codes into different categories of skin conditions based on Global Burden of Disease and American Academy of Dermatology classifications. Years lost to disability (YLD) and disability-adjusted life years (DALY) were calculated to report the morbidity and mortality of skin diseases. Differences of each skin condition between age groups were compared. RESULTS The three most prevalent dermatoses across all age groups were dermatitis (33.3%), acne vulgaris (8.3%) and viral skin diseases (7.5%). The top three most common skin conditions among the elderly were dermatitis (37.7%), viral skin diseases (6.2%), and fungal skin diseases (4.3%). Decubitus ulcers, keratinocyte carcinomas and scabies represented a significant proportion of YLD per 100,000 in the elderly (p <0.001). Malignant melanomas, keratinocyte carcinomas, cellulitis, pyoderma, and decubitus ulcers contributed to high DALY in patients aged 70 - 80 years old. CONCLUSION Aligning health systems with specific healthcare needs will reduce the disproportionately high burden of skin disease observed in the elderly.
Collapse
|
5
|
Mangano MC, Berlino M, Corbari L, Milisenda G, Lucchese M, Terzo S, Bosch-Belmar M, Azaza MS, Babarro JMF, Bakiu R, Broitman BR, Buschmann AH, Christofoletti R, Dong Y, Glamuzina B, Luthman O, Makridis P, Nogueira AJA, Palomo MG, Dineshram R, Sanchez-Jerez P, Sevgili H, Troell M, AbouelFadl KY, Azra MN, Britz P, Carrington E, Celić I, Choi F, Qin C, Dionísio MA, Dobroslavić T, Galli P, Giannetto D, Grabowski JH, Helmuth B, Lebata-Ramos MJH, Lim PT, Liu Y, Llorens SM, Mirto S, Pećarević M, Pita C, Ragg N, Ravagnan E, Saidi D, Schultz K, Shaltout M, Tan SH, Thiyagarajan V, Sarà G. The aquaculture supply chain in the time of covid-19 pandemic: Vulnerability, resilience, solutions and priorities at the global scale. ENVIRONMENTAL SCIENCE & POLICY 2022; 127:98-110. [PMID: 34720746 PMCID: PMC8548891 DOI: 10.1016/j.envsci.2021.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high-quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID-19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land- vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm-site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.
Collapse
|
6
|
Tan SH, Chan AQY, Lim AYX, Lim MW. P–150 Does trophectoderm biopsy performed on different blastocyst stages affect the clinical outcome? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
The objective of this study is to evaluate the effect of trophectoderm (TE) biopsy on different blastocyst stages and its clinical outcome.
Summary answer
Our results showed that TE biopsy significantly reduced the clinical outcome of fully hatched blastocyst. What is known already: TE biopsy is a method widely practiced to harvest cells to determine the chromosomal constitution of a blastocyst, ensuring higher implantation and healthy pregnancies. The effect on clinical outcome after transferring blastocysts biopsied at different blastocysts stages has not been extensively studied.
Study design, size, duration
This retrospective study was conducted from January 2017 until July 2019 at Alpha IVF & Women’s Specialists. Following laser assisted hatching on day 3, TE biopsy was performed on unhatched, hatching and fully hatched day–5 blastocysts. A total of 1,020 single euploid blastocysts transfer (SBT) were performed. The average maternal age was 31.7. Implantation rates (IR) were evaluated for all stages of hatching (Unhatched: BG3 & 4; hatching: BG5; fully hatched: BG6).
Participants/materials, setting, methods
Laser assisted hatching (Hamilton Thorne Bioscience, USA) was performed on day–3 and subsequently cultured to blastocyst-stage. Different hatching stages were observed using embryoscope time-lapse system (Vitrolife, Sweden) and were recorded. Day–5 blastocysts with at least BG3BB grade (Gardner’s System) were selected for TE biopsy and the biopsied cells were sent for preimplantation genetic testing for aneuploidy (PGT-A) using Next-Generation Sequencing (Life Technologies, USA). All blastocysts were vitrified and warmed using the Cryotec Method (Cryotech, Japan). Main results and the role of chance: All 1,020 blastocysts survived post-warmed (post-warm survival rate= 100%) and were transferred in frozen transfer cycles. TE biopsy performed on unhatched blastocysts showed a comparable IR to hatching blastocysts (60.0% [15/25] and 65.2% [627/961]). While fully hatched blastocysts (44.12% [15/34]) show a significantly lower IR when compared to hatching blastocysts (65.2% [627/961]), no significant difference was seen when comparing unhatched blastocysts to fully hatched blastocysts (60.0% [15/25] and 44.12% [15/34]; p = 0.2949).
Limitations, reasons for caution
The sample size was comparatively smaller in the unhatched and fully hatched group than the hatching group. Further studies with a larger sample size is recommended to ascertain the clinical outcome. Since this is a retrospective study and biopsy was done by different embryologists, the biopsy technique was not controlled. Wider implications of the findings: To achieve higher clinical pregnancy, it is recommended to perform TE biopsy before the blastocysts is fully hatched.
Trial registration number
Not applicable
Collapse
|
7
|
Ang WX, Sarasvathy S, Kuppusamy UR, Sabaratnam V, Tan SH, Wong KT, Perera D, Ong KC. In vitro antiviral activity of medicinal mushroom Ganoderma neo-japonicum Imazeki against enteroviruses that caused hand, foot and mouth disease. Trop Biomed 2021; 38:239-247. [PMID: 34362866 DOI: 10.47665/tb.38.3.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hand, foot and mouth disease (HFMD) is a highly contagious viral disease that predominantly affects children younger than 5 years old. HFMD is primarily caused by enterovirus A71 (EVA71) and coxsackievirus A16 (CV-A16). However, coxsackievirus A10 (CV-A10) and coxsackievirus A6 (CV-A6) are being increasingly reported as the predominant causative of HFMD outbreaks worldwide since the past decade. To date, there are still no licensed multivalent vaccines or antiviral drugs targeting enteroviruses that cause HFMD, despite HFMD outbreaks are still being frequently reported, especially in Asia-Pacific countries. The high rate of transmission, morbidity and potential neurological complications of HFMD is indeed making the development of broad-spectrum antiviral drugs/agents against these enteroviruses a compelling need. In this study, we have investigated the in vitro antiviral effect of 4 Ganoderma neo-japonicum Imazeki (GNJI) crude extracts (S1-S4) against EV-A71, CV-A16, CV-A10 and CV-A6. GNJI is a medicinal mushroom that can be found growing saprophytically on decaying bamboo clumps in Malaysian forests. The antiviral effects of this medicinal mushroom were determined using cytopathic inhibition and virus titration assays. The S2 (1.25 mg/ml) hot aqueous extract demonstrated the highest broad-spectrum antiviral activity against all tested enteroviruses in human primary oral fibroblast cells. Replication of EV-A71, CV-A16 and CVA10 were effectively inhibited at 2 hours post-infection (hpi) to 72 hpi, except for CV-A6 which was only at 2 hpi. S2 also has virucidal activity against EV-A71. Polysaccharides isolated and purified from crude hot aqueous extract demonstrated similar antiviral activity as S2, suggesting that polysaccharides could be one of the active compounds responsible for the antiviral activity shown by S2. To our knowledge, this study demonstrates for the first time the ability of GNJI to inhibit enterovirus infection and replication. Thus, GNJI is potential to be further developed as an antiviral agent against enteroviruses that caused HFMD.
Collapse
|
8
|
Torumkuney D, Van PH, Thinh LQ, Koo SH, Tan SH, Lim PQ, Sivhour C, Lamleav L, Somary N, Sosorphea S, Lagamayo E, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2016-18 in Vietnam, Cambodia, Singapore and the Philippines: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. J Antimicrob Chemother 2021; 75:i19-i42. [PMID: 32337597 DOI: 10.1093/jac/dkaa082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates collected from community-acquired respiratory tract infections (CA-RTIs) in 2016-18 in four Asian countries. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS In total, 260 S. pneumoniae and 258 H. influenzae isolates were tested. Pneumococci from Vietnam (n = 161) were the least susceptible, with rates of susceptibility >90% for fluoroquinolones by CLSI breakpoints, ∼60% for amoxicillin, amoxicillin/clavulanic acid and ceftriaxone but <14% for most other agents. Pneumococcal isolates from Cambodia (n = 48) and Singapore (n = 34) showed susceptibilities ranging from ∼30% for trimethoprim/sulfamethoxazole and oral penicillin to 100% for fluoroquinolones. Among isolates of H. influenzae from Cambodia (n = 30), the Philippines (n = 59) and Singapore (n = 80), rates of susceptibility using CLSI breakpoints were >90% for amoxicillin/clavulanic acid, cephalosporins [except cefaclor in Singapore (77.5%)], macrolides and fluoroquinolones; for isolates from Vietnam (n = 89) the rates of susceptibility were >85% only for amoxicillin/clavulanic acid (95.5%), ceftriaxone (100%) and macrolides (87.6%-89.9%). Susceptibility to other antibiotics ranged from 7.9% (trimethoprim/sulfamethoxazole) to 57.3%-59.6% (fluoroquinolones) and 70.8% (cefixime). The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. A limitation of the study was the small sample sizes and only one or two sites participating per country; however, since susceptibility data are scarce in some of the participating countries any information concerning antibiotic susceptibility is of value. CONCLUSIONS Antibiotic susceptibility varied across countries and species, with isolates from Vietnam demonstrating the lowest susceptibility. Knowledge of resistance patterns can be helpful for clinicians when choosing empirical therapy options for CA-RTIs.
Collapse
|
9
|
Hooi YT, Ong KC, Tan SH, Perera D, Wong KT. Coxsackievirus A16 in a 1-Day-Old Mouse Model of Central Nervous System Infection Shows Lower Neurovirulence than Enterovirus A71. J Comp Pathol 2020; 176:19-32. [PMID: 32359633 DOI: 10.1016/j.jcpa.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 02/06/2023]
Abstract
Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) are the major causes of hand, foot and mouth disease in young children. Although less so with CV-A16, both viruses are associated with serious neurological syndromes, but the differences between their central nervous system infections remain unclear. We conducted a comparative infection study using clinically-isolated CV-A16 and EV-A71 strains in a 1-day-old mouse model to better understand the neuropathology and neurovirulence of the viruses. New serotype-specific probes for in situ hybridization were developed and validated to detect CV-A16 and EV-A71 RNA in infected tissues. Demonstration of CV-A16 virus antigens/RNA, mainly in the brainstem and spinal cord neurons, confirmed neurovirulence, but showed lower densities than in EV-A71 infected animals. A higher lethal dose50 for CV-A16 suggested that CV-A16 is less neurovirulent. Focal virus antigens/RNA in the anterior horn white matter and adjacent efferent motor nerves suggested that neuroinvasion is possibly via retrograde axonal transport in peripheral motor nerves.
Collapse
|
10
|
Ke RD, Tang AZ, Tang XL, Gong L, Fang Q, Tan SH. [Clinical application of HRCT three-dimensional reconstruction in traumatic ossicular chain interruption]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 33:1129-1133. [PMID: 31914258 DOI: 10.13201/j.issn.1001-1781.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the clinical value of HRCT three-dimensional reconstruction technique in traumatic auditory chain traumatic fracture. Method:The clinical data of 14 patients with traumatic ear ossicular chain interruption were analyzed retrospectively. To evaluate the injury site and degree of the auditory chain before surgery, all the 14 patients underwent,HRCT scanning and three-dimensional reconstruction. The reconstructed auditory chain was observed from multiple angles and compared with the surgical exploration results under microscope. Result:The coincidence rate between ossicular chain injury observed by temporal bone HRCT scan before operation and ossicular chain injury observed during surgery was only 28.57%, the coincidence rate between ossicular chain injury observed during surgery and ossicular chain injury observed by three-dimensional reconstruction is 85.71%.Therefore, three-dimensional reconstruction imaging technique could give the doctor more clearly and stereoscopic images for the destruction of ossicular chain. Conclusion:Preoperative three-dimensional reconstruction can display and diagnosis of auditory ossicular chain destruction more clearly. It can be used to accurately evaluate auditory ossicular chain pathological changes, to develop individualized surgical plans and assess the risk of surgery.
Collapse
|
11
|
Wong C, Ng SY, Tan SH. An accidental laboratory exposure to Brucella melitensis: the prospective post-exposure management and a detailed investigation into the nature of the exposure. J Med Microbiol 2020; 67:1012-1016. [PMID: 29846154 DOI: 10.1099/jmm.0.000772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Our aim was to prospectively manage 22 Brucella-exposed individuals and identify the lapses in laboratory practices that lead to the exposure. The exposed individuals were risk-stratified, assessed for post-exposure prophylaxis (PEP), counselled to self-monitor symptoms and followed-up with three serology tests. Staff laboratory practices were recorded. Ten out of 13 high-risk individuals received PEP within 48 h of exposure. Compliance with PEP and serology monitoring was 90 and 96 %, respectively. No brucellosis cases were documented. A single handler manipulated the Brucella isolate on the open bench. Movement of the isolate was tracked in detail, highlighting various points of laboratory non-conformance. Early PEP intervention is effective in preventing acquired brucellosis. Our pragmatic post-exposure management achieved high PEP and serology compliance. We experience first-hand how regular staff engagement motivated PEP adherence and interval blood sampling attendance. The enforcement of practical strategies and safety practices was also implemented without compromising our laboratory processing times.
Collapse
|
12
|
Ng YA, Lee J, Zheng XJ, Nagaputra JC, Tan SH, Wong SA. Giant pedunculated oesophageal liposarcomas: A review of literature and resection techniques. Int J Surg Case Rep 2019; 64:113-119. [PMID: 31630086 PMCID: PMC6806403 DOI: 10.1016/j.ijscr.2019.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022] Open
Abstract
Giant oesophageal liposarcomas, a rare but important cause of oesophageal tumours. A review of the current literature focusing on resection techniques. Shift in the treatment paradigm in recent years to endoscopic resection techniques. Decision on type of resection technique depends on tumour characteristics and location.
Introduction and presentation of case Liposarcomas are rare causes of oesophageal tumours, accounting for <1% of tumours. We present a case of a dedifferentiated oesophageal liposarcoma arising from a giant fibrovascular polyp for which resection was performed via a left cervical oesophagostomy with transgastric retrieval of tumour. We also review the existing literature focusing on discussion of resection techniques. Discussion To date, 62 cases of oesophageal liposarcoma have been reported in the literature. They usually occur in males (74.2%), with a median age of 66 years (range 38–84 years). Such tumours present most commonly with dysphagia (69.4%); usually arise from the cervical oesophagus (79%), and are well-differentiated. Treatment options include surgery and recently, endoscopic resection techniques such as submucosal dissection (ESD). Conclusion Giant oesophageal liposarcomas are very rare tumours. Such tumours are usually polypoid, arising from a pedicle. As such, resection techniques have shifted away from oesophagectomy to less invasive means such as endoscopic resection or oesophagostomy. Decision on type of resection technique depends on tumour characteristics and location; with the guiding principle being resection with clear margins in order to prevent local recurrence.
Collapse
|
13
|
Lim XC, Yatim SMJM, Chong SY, Wang X, Tan SH, Yang X, Chan SP, Richards AM, Charles CJ, Chan M, Wang JW. P4639Plasma tissue factor coagulation activity in post-acute myocardial infarction patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Coagulation is involved in fibroproliferative responses following acute myocardial infarction (AMI). Left ventricular (LV) remodeling following AMI is closely associated with progression to heart failure.
Purpose
We aimed to evaluate the association of plasma tissue factor (TF) coagulation activity with LV remodeling prior to heart failure in post-AMI patients.
Methods
This study was conducted in 228 subjects from the Post-AMI Left Ventricular Remodeling Biomarker Analysis (PAMILA) study and 57 healthy subjects. The post-AMI patients were divided into two age- and sex-matched groups: patients with adverse LV remodeling defined as an increase in LV end systolic volume by ≥15% over 6 months and patients with reverse LV remodeling defined as an decrease in LV end systolic volume by ≥15% over 6 months. TF coagulation activity was determined using human coagulation factor Xa generation based TF chromogenic activity assay and converted into concentrations of active TF (pM). Sodium-citrate anticoagulated plasma was collected at baseline (within 3 days after revascularization), 30 days and 6 months post-AMI. Results are presented as mean±S.E.M. One-way or two-way repeated measures ANOVA or a multiple multi-level longitudinal data analysis with structural equation model was used to assess differences in coagulation activity. P<0.05 was considered statistically significant.
Results
Plasma from healthy subjects and post-AMI patients at baseline had similar concentrations of active TF (TFa): 29.0±1.4 versus 29.1±0.7 pM. Patients treated with warfarin (15 out of 228 patients) showed lower plasma levels of TFa (mean difference −15.2 pM, [95% CI: −18.7, −11.7], p<0.001). Compared to baseline, plasma levels of TFa in the patients was significantly lower at 30 days post-AMI (mean difference −6.9 pM, [95% CI: −4.8, −8.9], p<0.001) and 6 months post-AMI (mean difference −2.8 pM, [95% CI: −0.8, −4.8], p=0.003). Intriguingly, plasma levels of TFa tended to recover from 30 days to 6 months post-AMI (mean difference 4.1 pM, [95% CI: 2.8, 5.4], p<0.001) toward the baseline level and the level in healthy subjects. Similar trends of temporal changes of plasma TFa levels were observed in patients with adverse LV remodeling and those with reverse LV remodeling although TFa levels were slightly higher in patients with reverse LV remodeling (F(2,448)=3.112, p=0.045 for interaction). After adjusting for age, gender, ethnicity, medications, lipid profile and risk factors, the temporal changes of plasma TFa levels in patients remain significant, however, the difference between patients with adverse versus reverse LV remodeling was not significant.
Conclusion
Plasma TF coagulation activity decreased post-AMI but did not differ in patients with adverse versus reverse LV remodeling.
Acknowledgement/Funding
National University Health System Singapore (NUHS O-CRG 2016 Oct-23) to JW Wang
Collapse
|
14
|
Wang JW, Yatim SMJM, Lim XC, Chong SY, Wang X, Tan SH, Yang X, Chan SP, Richards AM, Charles CJ, Chan MY. P2582Signature of plasma extracellular vesicles associated proteins in acute myocardial infarction patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Prediction of left ventricular (LV) remodeling post-acute myocardial infarction (AMI) remains challenging. Several circulating biomarkers have been associated with post-AMI LV remodeling, however, there is no biomarker available to distinguish adverse versus reverse LV remodeling.
Purpose
In this study, we aimed to assess the association of extracellular vesicles (EVs) associated proteins with LV remodeling post-AMI.
Methods
Plasma EVs were isolated via precipitation with dextran sulphate as we previously reported. The protein levels of EV associated von Willebrand factor (VWF), SerpinC1 (antithrombin-III), plasminogen and SerpinF2 (alpha 2-antiplasmin) were determined in the citrate-anticoagulated plasma from 57 healthy subjects and 200 patients recruited in the Post-AMI Left Ventricular Remodeling Biomarker Analysis (PAMILA) study. Patients were categorized into two groups: adverse LV remodeling (n=100) characterized by an increase or reverse LV remodeling (n=100) characterized by a decrease, in LV end systolic volume by ≥15% over 6 months. Patients' plasma was collected at baseline (within 3 days after percutaneous coronary intervention), 1 month and 6 months post-AMI. Log transformation of EV protein levels was performed for assessment in a multiple multi-level longitudinal data analysis with structural equation model (with level of significance fixed at 0.05).
Results
Compared to healthy subjects, baseline protein levels of EV associated VWF and SerpinF2 were significantly higher in post-AMI patients, whereas no difference was observed in SerpinC1 and plasminogen. Among the patients, those on statins (196 out of 200 patients) showed lower protein levels of EV associated VWF (p<0.001) and plasminogen (p=0.003), whereas patients treated with P2Y12 platelet inhibitors (195 out of 200 patients) showed higher protein levels of EV associated VWF (p=0.003) and plasminogen (p=0.035). Multiple multi-level longitudinal data analysis with structural equation model showed that protein levels of EV associated VWF (p<0.001) and SerpinC1 (p=0.021) were lower in patients with adverse LV remodeling than that in patients with reverse LV remodeling during the 6-month follow-up post-AMI. In contrast, protein levels of EV associated plasminogen (p=0.002) and SerpinF2 (p=0.002) were higher in patients with adverse LV remodeling. The differences in the four EV associated proteins between patients with adverse versus reverse LV remodeling remain significant after adjusting for age, gender, ethnicity, medications, lipid profile and risk factors (diabetes, hypertension, dyslipidemia and smoking).
Conclusions
Lower levels of EV associated coagulation proteins (VWF and SerpinC1) and higher levels of EV associated fibrinolytic proteins (plasminogen and SerpinF2) were presented in patients with adverse LV remodeling compared to those with reverse LV remodeling post-AMI.
Acknowledgement/Funding
National University Health System Singapore (NUHS O-CRG 2016 Oct-23) to JW Wang
Collapse
|
15
|
Lim HLJ, Tan EST, Tee SI, Ho ZY, Boey JJJ, Tan WP, Tang MBY, Shen L, Chan YH, Tan SH. Epidemiology and prognostic factors for mycosis fungoides and Sézary syndrome in a multi-ethnic Asian cohort: a 12-year review. J Eur Acad Dermatol Venereol 2019; 33:1513-1521. [PMID: 30801779 DOI: 10.1111/jdv.15526] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 01/04/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Limited information exists regarding survival of Asian patients with mycosis fungoides (MF) and Sézary syndrome (SS). OBJECTIVE To evaluate the epidemiology, outcome and prognostic factors of these patients. METHODS A retrospective review of MF/SS cases diagnosed from 2000 to 2011 at a tertiary referral dermatology centre in Singapore was performed. RESULTS Of 246 patients, 63% were male and the median age at diagnosis was 49 years. 73.2% were Chinese, 12.6% Indian, 6.9% Malay and 7.3% Caucasian. A total of 239 patients (97.2%) had MF and seven had SS. Median follow-up duration was 6.3 years, and median duration of symptoms at diagnosis was 13 months. For patients with MF, the majority had early disease (92.8% stage IA-IIA). 3.8% were stage IIB, 1.7% stage III and 1.7% stage IV. Complete response to treatment occurred in 78.2%, partial response in 9.6%, persistent but non-progressive disease in 10.0% and disease progression in 4.1% of patients. Large cell transformation occurred in 4.1% of patients. Mean overall survival during this study was 12.7 years, with death occurring in 2.5% of patients (all ≥stage IIB at diagnosis). For patients with SS, 71.4% presented with stage IVA disease, 28.6% stage IVB. Complete response to treatment occurred in 14.2%, persistent but non-progressive disease in 28.6% and disease progression in 57.2% of patients. Mean overall survival was 3.3 years within this study, with death occurring in 42.9% of SS patients. Prognostic factors associated with favourable recurrence-free survival were male gender (P = 0.008), early disease stage (T1) at diagnosis (P < 0.001) and absence of maintenance treatment after remission (P = 0.01). CONCLUSION Compared to Caucasian and East Asian cohorts, MF in South-East Asians was diagnosed at a younger age and associated with lower mortality, largely due to greater prevalence of hypopigmented MF.
Collapse
|
16
|
Tan SH, Prepageran N. Pneumo-orbita causing optic nerve compression. QJM 2018; 111:743. [PMID: 29660085 DOI: 10.1093/qjmed/hcy084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
17
|
Wan Dalina WAD, Mariatti M, Tan SH. Multi-walled carbon nanotubes buckypaper/epoxy composites: effect of loading and pressure on tensile and electrical properties. Polym Bull (Berl) 2018. [DOI: 10.1007/s00289-018-2530-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
18
|
Dang T, Tan SH, Bodaghi S, Greer G, Lavagi I, Osman F, Ramirez B, Kress J, Goodson T, Weber K, Zhang YP, Vidalakis G. First Report of Citrus viroid V Naturally Infecting Grapefruit and Calamondin Trees in California. PLANT DISEASE 2018; 102:PDIS01180100PDN. [PMID: 30095323 DOI: 10.1094/pdis-01-18-0100-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
|
19
|
Wan Dalina WAD, Mariatti M, Tan SH. Effect of black ink loading on the properties of multi-walled carbon nanotubes/glass fibre/epoxy laminated hybrid composites. Polym Bull (Berl) 2017. [DOI: 10.1007/s00289-017-2213-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
20
|
Li Z, Abraham BJ, Berezovskaya A, Farah N, Liu Y, Leon T, Fielding A, Tan SH, Sanda T, Weintraub AS, Li B, Shen S, Zhang J, Mansour MR, Young RA, Look AT. APOBEC signature mutation generates an oncogenic enhancer that drives LMO1 expression in T-ALL. Leukemia 2017; 31:2057-2064. [PMID: 28260788 PMCID: PMC5629363 DOI: 10.1038/leu.2017.75] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/27/2017] [Accepted: 02/24/2017] [Indexed: 12/16/2022]
Abstract
Oncogenic driver mutations are those that provide a proliferative or survival advantage to neoplastic cells, resulting in clonal selection. Although most cancer-causing mutations have been detected in the protein-coding regions of the cancer genome; driver mutations have recently also been discovered within noncoding genomic sequences. Thus, a current challenge is to gain precise understanding of how these unique genomic elements function in cancer pathogenesis, while clarifying mechanisms of gene regulation and identifying new targets for therapeutic intervention. Here we report a C-to-T single nucleotide transition that occurs as a somatic mutation in noncoding sequences 4 kb upstream of the transcriptional start site of the LMO1 oncogene in primary samples from patients with T-cell acute lymphoblastic leukaemia. This single nucleotide alteration conforms to an APOBEC-like cytidine deaminase mutational signature, and generates a new binding site for the MYB transcription factor, leading to the formation of an aberrant transcriptional enhancer complex that drives high levels of expression of the LMO1 oncogene. Since APOBEC-signature mutations are common in a broad spectrum of human cancers, we suggest that noncoding nucleotide transitions such as the one described here may activate potent oncogenic enhancers not only in T-lymphoid cells but in other cell lineages as well.
Collapse
|
21
|
Huan KWSJ, Tan JSW, Tan SH, Teoh LC, Yong FC. Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve: a report of 13 cases. J Hand Surg Eur Vol 2017; 42:700-705. [PMID: 27913804 DOI: 10.1177/1753193416680725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries. Six of the former group and three of the latter group achieved >90° shoulder abduction. The technique of double neurotization from a single donor nerve provides favourable results in restoring shoulder abduction in avulsion brachial plexus injuries. LEVEL OF EVIDENCE IV.
Collapse
|
22
|
Chan SL, Tham MY, Tan SH, Loke C, Foo B, Fan Y, Ang PS, Brunham LR, Sung C. Development and validation of algorithms for the detection of statin myopathy signals from electronic medical records. Clin Pharmacol Ther 2017; 101:667-674. [PMID: 27706800 DOI: 10.1002/cpt.526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/01/2016] [Accepted: 09/19/2016] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to develop and validate sensitive algorithms to detect hospitalized statin-induced myopathy (SIM) cases from electronic medical records (EMRs). We developed four algorithms on a training set of 31,211 patient records from a large tertiary hospital. We determined the performance of these algorithms against manually curated records. The best algorithm used a combination of elevated creatine kinase (>4× the upper limit of normal (ULN)), discharge summary, diagnosis, and absence of statin in discharge medications. This algorithm achieved a positive predictive value of 52-71% and a sensitivity of 72-78% on two validation sets of >30,000 records each. Using this algorithm, the incidence of SIM was estimated at 0.18%. This algorithm captured three times more rhabdomyolysis cases than spontaneous reports (95% vs. 30% of manually curated gold standard cases). Our results show the potential power of utilizing data and text mining of EMRs to enhance pharmacovigilance activities.
Collapse
|
23
|
Lau CSL, Wong JCQ, Tan SH, Tan BC, Ng CSH, Lim SM, Wong G, Sim KLD. O-113 Advance care planning for patients hospitalised for heart failure in a multiethnic south east asian cohort. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
24
|
Lim SM, Tan SH, Ng CSH, Lau CSL, Wong JCQ, Tan BC, Wong G, Sim KLD. P-87 The importance of educating healthcare workers (HWC) on advance care planning (ACP) in a south-east asian (SEA) acute hospital setting: The national heart centre singapore (NHCS) experience. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
25
|
Lau CSL, Wong JCQ, Tan SH, Tan BC, Ng CSH, Lim SM, Wong G, Sim KLD. P-84 Advance care planning for patients with heart conditions in a multiethnic south east asian cohort: Impact of nurse navigator. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|