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Yoshino T, Cervantes A, Bando H, Martinelli E, Oki E, Xu RH, Mulansari NA, Govind Babu K, Lee MA, Tan CK, Cornelio G, Chong DQ, Chen LT, Tanasanvimon S, Prasongsook N, Yeh KH, Chua C, Sacdalan MD, Sow Jenson WJ, Kim ST, Chacko RT, Syaiful RA, Zhang SZ, Curigliano G, Mishima S, Nakamura Y, Ebi H, Sunakawa Y, Takahashi M, Baba E, Peters S, Ishioka C, Pentheroudakis G. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer. ESMO Open 2023; 8:101558. [PMID: 37236086 PMCID: PMC10220270 DOI: 10.1016/j.esmoop.2023.101558] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer (mCRC), published in late 2022, were adapted in December 2022, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with mCRC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with mCRC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian countries. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with mCRC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation, coupled with a disparity in the drug approvals and reimbursement strategies, between the different countries.
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Affiliation(s)
- T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - A Cervantes
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - H Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - E Martinelli
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania 'L. Vanvitelli', Naples, Italy
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - R-H Xu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center and State Key Laboratory of Oncology in South China, Guangzhou, China
| | - N A Mulansari
- Hematology-Medical Oncology Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital/Universitas Indonesia, Jakarta, Indonesia
| | - K Govind Babu
- Department of Medical Oncology, HCG Hospital and St. John's Medical College, Bengaluru, India
| | - M A Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Tan
- Department of Oncology and Nuclear Medicine, Thomson Hospital Kota Damansara, Selangor, Malaysia
| | - G Cornelio
- Department of Medical Oncology, University of the Philipppines-Philippine General Hospital, St. Lukes Cancer Institute-Global City, The Philippines
| | - D Q Chong
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - L-T Chen
- Department of Internal Medicine, Kaohsiung Medical University Hospital and Centre for Cancer Research, Kaohsiung Medical University, Kaohsiung; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - S Tanasanvimon
- Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok
| | - N Prasongsook
- Division of Medical Oncology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - C Chua
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - M D Sacdalan
- Department of Surgery, University of the Philippines-College of Medicine and University of the Philippines-Philippine General Hospital, Manila, The Philippines
| | - W J Sow Jenson
- Department of Radiotherapy & Oncology, Aurelius Hospital, Nilai, Malaysia
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Centre, Seoul, South Korea
| | - R T Chacko
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - R A Syaiful
- Department of Surgery, Dr Cipto Mangunkusumo National General Hospital, University of Indonesia, Jakarta, Indonesia
| | - S Z Zhang
- Department of Colorectal Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan; Department of Oncology and Haematology, University of Milano, Milan, Italy
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Nakamura
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - H Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya
| | - Y Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - M Takahashi
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
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Goyal S, Chua C, Chen YS, Murphy D, O 'Neill GK. Utility of 3D printed models as adjunct in acetabular fracture teaching for Orthopaedic trainees. BMC Med Educ 2022; 22:595. [PMID: 35918716 PMCID: PMC9344721 DOI: 10.1186/s12909-022-03621-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the use of 3-D printed models as compared to didactic lectures in the teaching of acetabular fractures for Orthopaedic trainees. METHODS This was a randomised prospective study conducted in a tertiary hospital setting which consisted of 16 Orthopaedic residents. Ten different cases of acetabular fracture patterns were identified and printed as 3-D models. The baseline knowledge of orthopaedic residents regarding acetabular fracture classification and surgical approach was determined by an x-ray based pre-test. Trainees were then randomly assigned into two groups. Group I received only lectures. Group II were additionally provided with 3-D printed models during the lecture. Participants were then assessed for comprehension and retention of teaching. RESULTS Sixteen trainees participated in the trial. Both Group 1 and 2 improved post teaching with a mean score of 2.5 and 1.9 to 4.4 and 6 out of 10 respectively. The post test score for fracture classification and surgical approach were significantly higher for 3-D model group (p < 0.05). Trainees felt that the physical characteristics of the 3-D models were a good representation of acetabular fracture configuration, and should be used routinely for teaching and surgical planning. CONCLUSION 3-D printed model of real clinical cases have significant educational impact compared to lecture-based learning towards improving young trainees' understanding of complex acetabular fractures.
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Affiliation(s)
- S Goyal
- Department of Orthopaedics, University Orthopaedics and Hand & Reconstructive Microsurgery Centre, National University Health System, Level 11, Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| | - Cxk Chua
- Department of Orthopaedics, University Orthopaedics and Hand & Reconstructive Microsurgery Centre, National University Health System, Level 11, Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Y S Chen
- Department of Orthopaedic Surgery, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore
| | - D Murphy
- Department of Orthopaedics, University Orthopaedics and Hand & Reconstructive Microsurgery Centre, National University Health System, Level 11, Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - G K O 'Neill
- Department of Orthopaedics, University Orthopaedics and Hand & Reconstructive Microsurgery Centre, National University Health System, Level 11, Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
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Yoshino T, Argilés G, Oki E, Martinelli E, Taniguchi H, Arnold D, Mishima S, Li Y, Smruti BK, Ahn JB, Faud I, Chee CE, Yeh KH, Lin PC, Chua C, Hasbullah HH, Lee MA, Sharma A, Sun Y, Curigliano G, Bando H, Lordick F, Yamanaka T, Tabernero J, Baba E, Cervantes A, Ohtsu A, Peters S, Ishioka C, Pentheroudakis G. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis treatment and follow-up of patients with localised colon cancer. Ann Oncol 2021; 32:1496-1510. [PMID: 34411693 DOI: 10.1016/j.annonc.2021.08.1752] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 12/24/2022] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of localised colon cancer was published in 2020. It was decided by both the ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special virtual guidelines meeting in March 2021 to adapt the ESMO 2020 guidelines to take into account the ethnic differences associated with the treatment of localised colon cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with localised colon cancer representing the oncological societies of Japan (JSMO), China (CSCO), India (ISMPO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug availability and reimbursement situations in the different Asian countries.
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Affiliation(s)
- T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - G Argilés
- Luis Diaz Laboratory, MSKCC, Sloan Kettering Institute, New York, USA
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - E Martinelli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - H Taniguchi
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - D Arnold
- Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Germany
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Y Li
- Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - B K Smruti
- Department of Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital, Mumbai, India
| | - J B Ahn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Seoul, Korea
| | - I Faud
- Department of Radiotherapy & Oncology, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - C E Chee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - P-C Lin
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C Chua
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - H H Hasbullah
- Oncology Unit, Faculty of Medicine, UiTM Sg Buloh, Selangor, Malaysia
| | - M A Lee
- Division of Medical Oncology, Department of Internal Medicine, Cancer Research Institute, College of Medicine, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - A Sharma
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Y Sun
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS and University of Milano, Milan, Italy
| | - H Bando
- Department of Clinical Oncology, Aichi Cancer Center, Nagoya, Japan
| | - F Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center, Leipzig University Medical Center, Leipzig, Germany
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University, Kanagawa, Japan
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), UVic-UCC, IOB-Quiron, Barcelona, Spain
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Cervantes
- CIBERONC, Department of Medical Oncology, Institute of Health Research, INCLIVIA, University of Valencia, Valencia, Spain
| | - A Ohtsu
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Ishioka
- Department of Clinical Oncology, Tohoku University School of Medicine, Sendai, Japan
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Yeo JG, Wasser M, Kumar P, Pan L, Poh SL, Ally F, Arkachaisri T, Lim AJM, Leong JY, Yeo KT, Lai L, Lee ESC, Chua C, Paleja B, Tang SP, Ng SK, Tan AYJ, Lee SY, Ginhoux F, Ng TP, Larbi A, Albani S. AB0050 EXTENDED POLYDIMENSIONAL IMMUNOME CHARACTERISATION (EPIC) PLATFORM AS A TOOL FOR TRANSLATIONAL RESEARCH. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:We created a high dimensionality healthy human Immunome atlas by interrogating the peripheral blood mononuclear cells (PBMC) of >200 healthy subjects (cord blood to adult) with 63 unique mechanistic and phenotypic markers per cell by mass cytometry (CyTOF). This database is built with an open source, web-based bioinformatics toolkit, enabling its mining and uploading of datasets for comparison with the EPIC healthy database.Objectives:Here, we demonstrate the platform’s ability to identify the immunological differences of mechanistically important cell subsets in the uploaded data in comparison with EPIC.Methods:CyTOF data from 37 healthy elderly (>60 years old) was uploaded onto the EPIC Discovery tool where down-sampling, normalising and FlowSOM (Flow analysis with Self-Organising Maps) clustering were done with the EPIC database for comparison. Online visualisation outputs include cluster frequency boxplots, correspondence analysis (CA) plot and markers expression heat-map. The CA 2-dimensional plot depicts the global differences in immune cells composition between subjects with proximity between points (subjects) denoting similarity. Kruskal-Wallis test was done to identify age groups differences.Results:Increasing distances on the CA plot with age were observed with the elderly being farthest from the new-borns. Notably, we observed significant changes in naive CD4+IL8+T cells (p<1×10-20), memory CD4+IL17A+T cells (p<1×10-20) and type 2 innate lymphoid cells (ILC2) (Lin-CD7+CD25+CD127+CD161+, p<1×10-17) with increasing age. The naive CD4+IL8+T cells (median: 0.68%, interquartile range: 0.415 to 1.055% of CD45+ PBMC) and ILC2 (0.09%, 0.065 to 0.12%) were lowest and memory IL17A+T cells (0.58%, 0.41 to 0.905%) highest in the elderly. Significantly, the memory IL17A+T cells and ILC2 have been implicated in the pathogenesis of auto-immune conditions1,2.Conclusion:With EPIC, we have created an online tool enabling data uploading for comparison to a healthy database, allowing the holistic characterisation of immunological changes in different clinical scenarios. Using it, we were able to identify mechanistically important differences in immune cells composition in a distinct clinical cohort (elderly) compared to the younger ages. Translationally, the EPIC platform can be utilised similarly to catalyse the discovery process in auto-immune diseases interrogated with the EPIC antibody panels.References:[1]Fasching P, Stradner M, Graninger W, Dejaco C, Fessler J. Therapeutic Potential of Targeting the Th17/Treg Axis in Autoimmune Disorders. Molecules. 2017 Jan 14;22(1). pii: E134.[2]Klose CS, Artis D. Innate lymphoid cells as regulators of immunity, inflammation and tissue homeostasis. Nat Immunol. 2016 Jun 21; 17(7): 765-74.Disclosure of Interests:None declared
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Leong JY, Kumar P, Mijnheer G, Chen P, Yeo JG, Tay SH, Chua C, Hazirah SN, Lai L, Consolaro A, Gattorno M, Arkachaisri T, Martini A, Van Wijk F, Albani S. THU0047 THE SYNOVIUM REWIRES AN IMMUNOLOGICAL RHEOSTAT THAT DEFINES TWO FUNCTIONALLY DISPARATE PATHOGENIC CD4+HLA-DR+ SUBSETS IN HUMAN ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Despite advances in understanding how the adaptive T cell landscape is affected in human arthritis, specific T cell subset knowledge has yet to be utilised in clinical settings. We have previously discovered within active arthritic patients, a circulating pathogenic-like lymphocyte (CPLs; CD4+HLA-DR+) within the T-effector compartment, that is phenotypically similar to their synovial counterparts. CPLs are inflammatory, correlate with disease activity and overlap in synovial TCR repertoire. A similar inflammation-associated T-regulatory (iaTreg; CD4+HLA-DR+) subset, that is activated, poised to migrate to inflamed site and sharing synovial TCR overlap, suggest a common disease ontogeny that may exist between CPLs and iaTregs.Objectives:Here we seek to determine whether and how the synovial microenvironment plays a role in modulating these two functionally divergent (Teff/Treg compartments) yet pathogenically homologous subsets. This modulation, akin to an immunological rheostat, may be a feature of the disease process.Methods:We examined CD45+ immune cells from synovial and PBMCs (active JIA, inactive JIA, paediatric healthy) through mass cytometry (CyToF). CD4 T cells were sorted into CPLs, iaTregs, Teff and Treg through FACS Aria II, from active JIA PBMCs, paired JIA SFMCs and healthy paediatric PBMCs and examined through ngRNASEQ.Results:Mass cytometric analysis reveal a significant enrichment of synovium signatures in both circulatory CPLs and iaTregs subsets from active arthritic PBMCs, as compared with the conventional pool of Teff/Tregs. This immunological relationship between CPLs/iaTregs is reaffirmed by comparative differential gene expression (DEG) and phylogenetic tree analysis, which indicated transcriptomic convergence between circulatory pathogenic CPLs/iaTreg subsets and divergence from their respective conventional Teff/Treg pools. Circulatory CPLs/iaTregs exhibit (a) common pathway dysregulation in T cell signalling, (b) restriction in TCR oligoclonality and (c) common transcription factor drivers within the gene regulatory network, suggesting a common pathogenic mechanism acting on these two disparate compartments.To understand how the microenvironment plays a role in modulating these two subsets, we compared the transcriptome of CPLs/iaTreg and conventional Teff/Treg subsets from (a) healthy PBMCs, (b) JIA PBMCs and (c) paired JIA SFMCs. The convergence between CPLs/iaTreg increases across the spatial/disease continuum, culminating in 7 key common dysregulated pathways within synovium CPLs/iaTregs. Importantly we detected higher clonotypic sharing of TCRs in CPLs/iaTregs across the spatial and disease continuum, suggesting a common precursor driven by antigenic selection.Conclusion:Our data suggest that CPLs/iaTregs are dichotomic components of a systemic immune rheostat, shape through the synovium environment, modulating autoimmunity in human arthritis. As iaTreg and CPL most likely have the capacity to morph into each other, the molecular crossroads which control this plasticity represent novel therapeutic targets.Disclosure of Interests:None declared
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Bendell J, Moore K, Patel M, Chua C, Arkenau HT, Dukart G, Harrow K, Liang C. A phase I trial of vorolanib (X-82t vascular endothelial growth factor receptor (VEGFR) inhibitor, in patients (pts) with advanced solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kho HP, Leow CY, Shueb RH, Leow CH, Lim BH, Chua C. A hypothetical oxidative stress regulatory role of alpha giardins in the protozoan parasite Giardia intestinalis. Trop Biomed 2018; 35:41-49. [PMID: 33601775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Giardiasis is an intestinal infection caused by the protozoan parasite Giardia intestinalis, affecting hundreds of millions of people worldwide. This microaerophilic protozoan is capable of surviving in the host intestine in the presence of both oxygen and reactive oxygen species (ROS), despite the lack of conventional ROS-scavenging enzymes. The understanding of how G. intestinalis tolerates free radicals could help to identify essential biological processes that protect themselves against oxidative stress within the human gut. This review outlines the antioxidant mechanisms that are utilized by G. intestinalis, with an emphasis on the potential novel role of alpha giardins. The comprehensive understanding of the processes involved in oxidative stress management may provide new insights into improved treatments for giardiasis, and other medically important protozoan parasitic diseases.
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Affiliation(s)
- H P Kho
- School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - C Y Leow
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - R H Shueb
- School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - C H Leow
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - B H Lim
- School of Health Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - C Chua
- School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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Chua C, Varga A, Ayappa I, Mooney A, Burschtin O, Rapoport D. Determinants of PAP adherence in a clinical population with OSA. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Koo SL, Chua C, Nguyen A, Benz S, Tan W, Tang C, Chew M, Goh B, Chan C, Gan A, Tan W, Koh X, Lezhava A, Yan S, Rabizadeh S, Skanderup A, Tan I. Systematic identification of (personalized) tumor-specific neoantigens through whole genome & whole transcriptomic analyses of 158 Asian colorectal cancers. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Connolly MR, Chiu KL, Giblin SP, Kataoka M, Fletcher JD, Chua C, Griffiths JP, Jones GAC, Fal'ko VI, Smith CG, Janssen TJBM. Gigahertz quantized charge pumping in graphene quantum dots. Nat Nanotechnol 2013; 8:417-420. [PMID: 23666448 DOI: 10.1038/nnano.2013.73] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 03/27/2013] [Indexed: 06/02/2023]
Abstract
Single-electron pumps are set to revolutionize electrical metrology by enabling the ampere to be redefined in terms of the elementary charge of an electron. Pumps based on lithographically fixed tunnel barriers in mesoscopic metallic systems and normal/superconducting hybrid turnstiles can reach very small error rates, but only at megahertz pumping speeds that correspond to small currents of the order of picoamperes. Tunable barrier pumps in semiconductor structures are operated at gigahertz frequencies, but the theoretical treatment of the error rate is more complex and only approximate predictions are available. Here, we present a monolithic, fixed-barrier single-electron pump made entirely from graphene that performs at frequencies up to several gigahertz. Combined with the record-high accuracy of the quantum Hall effect and proximity-induced Josephson junctions, quantized-current generation brings an all-graphene closure of the quantum metrological triangle within reach. Envisaged applications for graphene charge pumps outside quantum metrology include single-photon generation via electron-hole recombination in electrostatically doped bilayer graphene reservoirs, single Dirac fermion emission in relativistic electron quantum optics and read-out of spin-based graphene qubits in quantum information processing.
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Affiliation(s)
- M R Connolly
- National Physical Laboratory, Hampton Road, Teddington TW11 0LW, UK.
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Chua C, Jeevan R, Farid M, Lee M, Ho Z, Leong F, Sairi A, Chin F, Teo M, Quek R. 9412 POSTER Brain Metastasis in Sarcoma – Presentation, Treatment Strategies and Survival in This Rare Clinical Setting. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
BACKGROUND Accurate biometry is of vital importance in achieving predictable postoperative refraction following cataract surgery. AIM To evaluate the accuracy and consistency in biometry, achieved by the new generation laser biometric system in comparison with the ultrasound biometric system. METHODS The study was randomized and prospective. Biometry was performed in 68 eyes of 39 patients by three groups of biometrists (expert, intermediate user, novice). Expert and intermediate users are compared as group A, and expert and novice are compared in group B. Axial length, anterior chamber depth (ACD), and keratometry results are compared by t-test analysis. RESULTS Axial length measurement variation between expert and non experts was 10 times less using laser than ultrasound (P<0.001). ACD measurement variation was also significantly less when using laser compared to ultrasound (P=0.003). Need for some level of user training is indicated in ACD measurement since group A achieved more consistent readings than group B. Keratometry measurements on the laser system were unreliable due to high range of results. Biometric failure was seen in 12% of eyes undergoing laser and 1% undergoing ultrasound biometry. CONCLUSION Axial length determination by laser biometry is more accurate and consistent at all levels of biometrist expertise, compared to ultrasound biometry. ACD and keratometry measurements on the laser systems need some degree of user training in order to produce consistent results.
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Affiliation(s)
- S Goel
- Department of Ophthalmology, Dewsbury District Hospital, Dewsbury, UK.
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Taylor CM, Chua C, Howie AJ, Risdon RA. Clinico-pathological findings in diarrhoea-negative haemolytic uraemic syndrome. Pediatr Nephrol 2004; 19:419-25. [PMID: 14986082 DOI: 10.1007/s00467-003-1385-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2003] [Revised: 11/12/2003] [Accepted: 11/13/2003] [Indexed: 10/26/2022]
Abstract
This is a retrospective, national clinico-pathological study of past and current patients with haemolytic uraemic syndrome not associated with diarrhoea (D- HUS). Thirty-four patients were analysed and notified by members of the British Association for Paediatric Nephrology in 1998-1999. There was a 2:1 excess of males. Ten presented in infancy. The aetiology included 5 patients with complement abnormalities, 2 patients with complications of pneumococcal infection, and 2 with malignancies. Parental consanguinity was noted in 6 patients. Five children died, 9 developed chronic renal failure, and 10 end-stage renal failure. Only 7 made full recoveries. With a single exception, the pathological findings were unlike the previously reported glomerular thrombosis that is characteristic of diarrhoea-associated HUS, or HUS complicating verocytotoxin-producing Escherichia coli infection. Early and late glomerulopathy could be distinguished. Arteriolar and arterial disease was observed in 8 and 7 patients, respectively. Arterial disease correlated with a poor outcome. The pathology of D- HUS is of prognostic value, but this study was not powered to identify specific aetiological/pathological correlations.
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Affiliation(s)
- C M Taylor
- Department of Nephrology, The Birmingham Children's Hospital, Birmingham, B4 6NH, UK.
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Goel S, Chua C, Dong B, Butcher M, Ahfat F, Hindi SK, Kotta S. Comparison between standard Goldmann applanation prism and disposable applanation prism in tonometry. Eye (Lond) 2004; 18:175-8. [PMID: 14762411 DOI: 10.1038/sj.eye.6700553] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Disposable devices are increasingly becoming the preferred choice where possible in contact medical equipment. AIM To evaluate the accuracy of the disposable applanation tonometer head as a potential substitute to the standard Goldmann applanation head. METHODS The study was prospective. The intraocular pressure recordings in 80 eyes of 42 patients were compared using the disposable and standard Goldmann applanator heads. The Bland and Altman method of assessing agreement between two methods of clinical measurement was used in the analysis. RESULTS The difference in the readings between the two types of tonometer heads was highly variable (mean difference=0.78 mm Hg, range=-1 to 11 mm Hg). This was because of the distortions on the applanating surface of the disposable device. When the readings associated with the defective heads were excluded, very strong agreement was obtained (mean=0.07 mm Hg, range=-1 to 2 mm Hg). CONCLUSION Good agreement with standard Goldmann applanation is achieved with the disposable heads except where surface distortions induce significant errors. Careful inspection to ensure well-structured disposable units is imperative in disposable applanation tonometry.
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Affiliation(s)
- S Goel
- Dewsbury District Hospital, Dewsbury, UK.
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Abstract
BACKGROUND The Royal College of Ophthalmologists' guidelines and Driver and Vehicle Licensing Agency (DVLA) recommend that a patient should not drive with dilated pupils based on the rationale that vision may be compromised in acuity and ability to tolerate glare. Arguments exist against these recommendations suggesting that pupillary dilatation does not have any real bearings on driving ability. Aim To determine the effects of pupillary dilatation on the ability to drive. METHODS The study was randomised and prospective. A total of 28 patients had their visual parameters (distance vision, near vision, licence plate reading at 20 m or shorter, and glare) measured and analysed pre- and post-tropicamide 1% dilatation. Paired two-tailed Student's t-test and chi(2)-test were used in the analysis. RESULTS At 20 min, following instillation of one drop of tropicamide 1% there is a significant reduction in visual acuity (VA), for distance Snellen and near. There is a significant reduction in the number of people who could read the licence plate at 20 m. Subjective glare assessment changed from 'none' (average score) in the undilated state to 'mild' in the dilated states. The overall patient feedback indicated that a significant 14% believed they would find it difficult to drive postdilatation. CONCLUSION This study demonstrates the rationale behind disallowing driving following pupillary dilatation. The risks to safe driving are proved significant as a result of significant reduction in visual quality and quantity after dilatation.
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Affiliation(s)
- S Goel
- SHO Ophthalmology Kent County Ophthalmic Hospital Maidstone ME14 1DT, UK.
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Ti TY, Kumarasinghe G, Taylor MB, Tan SL, Ee A, Chua C, Low A. What is true community-acquired urinary tract infection? Comparison of pathogens identified in urine from routine outpatient specimens and from community clinics in a prospective study. Eur J Clin Microbiol Infect Dis 2003; 22:242-5. [PMID: 12709838 DOI: 10.1007/s10096-003-0893-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In order to identify the true nature of community-acquired urinary tract infections, the uropathogens isolated from 100 patients with urinary tract infection included in a prospective study conducted in community clinics were compared to 244 isolates from outpatient urine specimens routinely submitted to the laboratory. Significant differences in both the spectrum of bacteria and their antibiograms were found between the two groups. Laboratory data analysis of uropathogens from outpatient urine specimens may not reflect the true bacteriology of urinary tract infections acquired in the community. Hence, surveys based on laboratory data alone may overestimate resistance rates, leading to misinformed choices being made when treatment is empirical.
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Affiliation(s)
- T Y Ti
- Department of Pharmacology, Faculty of Medicine, MD2, National University of Singapore, 18 Medical Drive, 117597 Singapore.
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Shors TJ, Chua C, Falduto J. Sex differences and opposite effects of stress on dendritic spine density in the male versus female hippocampus. J Neurosci 2001; 21:6292-7. [PMID: 11487652 PMCID: PMC6763131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Dendritic spines are postsynaptic sites of excitatory input in the mammalian nervous system. Despite much information about their structure, their functional significance remains unknown. It has been reported that females in proestrus, when estrogen levels are elevated, have a greater density of apical dendritic spines on pyramidal neurons in area CA1 of the hippocampus than females in other stages of estrous (Woolley et al., 1990). Here we replicate these findings and in addition, show that females in proestrus have a greater density of spines in area CA1 of the hippocampus than males. Moreover, this sex difference in spine density is affected in opposite directions by stressful experience. In response to one acute stressful event of intermittent tailshocks, spine density was enhanced in the male hippocampus but reduced in the female hippocampus. The decrease in the female was observed for those that were stressed during diestrus 2 and perfused 24 hr later during proestrus. The opposing effects of stress were not evident immediately after the stressor but rather occurred within 24 hr and were evident on apical and to a lesser extent on basal dendrites of pyramidal cells in area CA1. Neither sex nor stress affected spine density on pyramidal neurons in somatosensory cortex. Sex differences in hippocampal spine density correlated with sex hormones, estradiol and testosterone, whereas stress effects on spine density were not directly associated with differences in the stress hormones, glucocorticoids. In summary, males and females have different levels of dendritic spine density in the hippocampus under unstressed conditions, and their neuronal anatomy can respond in opposite directions to the same stressful event.
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Affiliation(s)
- T J Shors
- Department of Psychology and Center for Collaborative Neuroscience, Rutgers University, Piscataway, New Jersey 08854, USA.
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Rizzo A, Buckwalter J, Bowerly T, Van Der Zaag C, Humphrey L, Neumann U, Chua C, Kyriakakis C, Van Rooyen A, Sisemore D. The Virtual Classroom: A Virtual Reality Environment for the Assessment and Rehabilitation of Attention Deficits. ACTA ACUST UNITED AC 2000. [DOI: 10.1089/10949310050078940] [Citation(s) in RCA: 195] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - J.G. Buckwalter
- School of Gerontology, University of Southern California, Los Angeles, California
| | - T. Bowerly
- School of Gerontology, University of Southern California, Los Angeles, California
| | - C. Van Der Zaag
- School of Gerontology, University of Southern California, Los Angeles, California
| | - L. Humphrey
- Department of Psychiatry and Bio behavioral Sciences, UCLA School of Medicine Neuropsychiatric Institute, Center for the Health Sciences, Neuropsychology Laboratory, Los Angeles, California
| | | | - C. Chua
- Integrated Media Systems Center
| | | | - A. Van Rooyen
- Fuller Graduate School of Psychology, Pasadena, California
| | - D. Sisemore
- School of Gerontology, University of Southern California, Los Angeles, California
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Abstract
In the 2 years between 1993 and 1995, we assayed alpha-fetoprotein (AFP) in 48,412 amniotic fluids (AFs). One thousand and eighty-six (2.2 per cent) measured > or = 2.0 MOM and these were subdivided into three groups; mildly (2.0-4.9 MOM), moderately (5.0-9.9 MOM), and very elevated (> or = 10.0 MOM). Abnormalities occurred in 25 per cent of the mildly elevated compared with 88 per cent of the moderately and 98 per cent of the very elevated cases. Forty-five per cent of the neural tube defects (NTDs) had AF-AFPs in the 5.0-9.9 and 36 per cent in the > or = 10.0 MOM range. After a positive acetylcholinesterase (AChE) test, both the moderately and the very elevated groups had abnormalities in > or = 95 per cent of cases, compared with 85 per cent in the mildly elevated group. After a negative AChE test, abnormalities occurred in 79, 52 and 18 per cent in the very elevated, moderately, and mildly elevated groups, respectively. Excluding chromosome abnormalities, an abnormal twin, and bloody samples, the risk of a fetal abnormality after a normal ultrasound was less than 1 per cent if the AChE was positive in both the moderately and the very elevated groups. If the AChE was negative, the risk was 18 per cent for the moderately and 55 per cent for the very elevated groups, of which congenital nephrosis accounted for 75 per cent; AFP levels usually increased in a later AF sample. Repeat amniocentesis may be offered to women with AF-AFPs > or = 5.0 MOM if no abnormality is seen with high-resolution ultrasound.
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Affiliation(s)
- B F Crandall
- Department of Psychiatry, University of California, Los Angeles School of Medicine, USA
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Abstract
Forty-two open neural tube defects (NTDs) were identified in our series of 7440 amniocenteses tested between 11 and 15 weeks of gestation. Using a cut-off of > or = 2.0 MOM, the detection rate for open NTDs was 95 per cent; 100 per cent each for anencephaly and spina bifida; and 78 per cent for encephalocele. Two encephaloceles had AFP levels less than 2.0 MOM and negative AChEs. Thirty-four (81 per cent) of these NTDs were tested between 13 and 15 weeks and 8 (19 per cent) before 13 weeks. There were 0.6 per cent false positives by AFP (excluding serious abnormalities and fetal death) and 0.1 per cent after AChE. The likelihood of an open NTD after an elevated AFP (> or = 2.0 MOM) was 24 and 77 per cent for any serious abnormality. These results, when combined with an earlier study, indicate that amniotic fluid AFP appears to be as sensitive a test for open NTDs between 13 and 15 weeks as between 16 and 20 weeks. Additional experience is necessary to determine this before 13 weeks.
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Affiliation(s)
- B F Crandall
- Department of Pediatrics, University of California, Los Angeles, USA
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Ong YL, Aw E, Chua C, Ong PK, Lowe J. National University of Singapore students who come for psychological help. Singapore Med J 1984; 25:226-34. [PMID: 6505722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Menke JA, Bashiru M, Bada HS, Menten TG, Khanna NN, Chua C. Microcomputer evaluation of cerebral blood flow velocity studies in the neonate. Comput Biol Med 1983; 13:257-64. [PMID: 6661907 DOI: 10.1016/0010-4825(83)90001-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A semi-automated system for evaluation of Doppler cerebral blood flow studies obtained from newborn infants is described. A low cost digitizer is used to convert the graphic data from the flow tracing to digital data. A small business computer is used to analyze the data and produce a chartable report. The reliability of the digitizer is also evaluated.
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Bashiru M, Mongkolsmai C, Von Behren PA, Menke JA, Chua C, Khanna NN. Microcomputer-assisted evaluation of pediatric echocardiograms. Appl Radiol 1982; 11:55-8. [PMID: 10260615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Menke JA, Miles R, McIlhany M, Bashiru M, Chua C, Schwied E, Menten TG, Khanna NN. The fontanelle tonometer: a noninvasive method for measurement of intracranial pressure. J Pediatr 1982; 100:960-3. [PMID: 7086600 DOI: 10.1016/s0022-3476(82)80528-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The use of a modified pneumotonometer as a noninvasive method to measure intracranial pressure through the fontanel was evaluated in the animal laboratory and in the clinical setting. Pressure measured with the tonometer from a surgically created fontanel in an adult mongrel dog demonstrated good correlation with pressure measured from an epidural balloon catheter. Pressure recorded with the tonometer was compared with direct measurements in a single infant. There were 20 paired measurements with a correlation coefficient of 0.91. Fontanel pressure was measured in 72 healthy infants. The mean pressure was 7.0 mm Hg with a standard deviation of 1.75. This result compares favorably with previous reports utilizing other methods. The machine is safe and simple to use.
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Khanna NN, Somani SM, Boyer A, Miller J, Chua C, Menke JA. Cross validation of serum to saliva relationships of caffeine, theophylline and total methylxanthines in neonates. Dev Pharmacol Ther 1982; 4:18-27. [PMID: 7117087 DOI: 10.1159/000457387] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We have previously described the relationships of serum and saliva concentrations of caffeine, theophylline and total methylxanthines in premature infants. We have now extended the previous studies in order to validate the previously derived relationships with new data. The new serum to saliva relationships, derived using regression and ratio models, are cross validated against the relationships from the previous data, and vice versa. A good cross validation was observed for caffeine and total methylxanthine concentrations in infants treated with caffeine. In the theophylline treatment group, theophylline concentrations did not cross validate well, whereas the total methylxanthine concentrations did. Since in vivo conversion of theophylline to caffeine and vice versa may affect the individual methylxanthine relationships, the total methylxanthine equations are recommended for predicting serum concentrations from salivary concentrations.
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Chua C, Hoffmann EM, Adams JP, Rosse WF. Inhibitors of complement derived from the erythrocyte membrane in paroxysmal nocturnal hemoglobinuria. Blood 1980; 55:772-6. [PMID: 7362868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Extracts of the membranes of normal red cells and red cells from all subpopulations of paroxysmal nocturnal (PNH) red cells inhibited antibody-mediated complement activation. These extracts were shown to accelerate decay of the complement complex. C42, and the relative amount of inhibitory activity was similar in normal and PNH membranes. Inhibitors derived from normal red cells markedly decreased lysis of both PNH and normal cells when antibody was present in excess and complement was limiting. These same inhibitors decreased PNH cell lysis to a much lesser degree when complement was activated with cobra venom or acidified serum. The susceptibility of the PNH cell to complement lysis because of an increased fixation of C3 to its membrane is not due to a difference in membrane-associated accelerator of the decay of the C42 complex.
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Abstract
The cerebrovascular hemodynamic alterations in asphyxia and intracerebral-intraventricular hemorrhage were determined by monitoring the pulsatile flow changes in the anterior cerebral arteries using Doppler ultrasound. The pulsatility index measurements, which were calculated from the recorded changes in Doppler frequency shifts, were obtained in four groups of newborn infants with the following diagnoses: Group I--normal term (n=21); Group II--asphyxia (n=12); Group III--IC-IVH (n=14); and Group IV--asymptomatic preterm (n=11). There was no significant difference between PI values of Groups I and IV. Compared to normal term infants, those diagnosed as having asphyxia had significantly lower PI measurements and those with IC-IVH had significantly higher PI values than the asymptomatic pretern infants. Serial Doppler studies were also performed in 22 preterm infants with respiratory distress. One-half of these infants subsequently developed IC-IVH. Prior to hemorrhage, their PI measurements were significantly lower than those who did not eventually have the complication. The low PI values in asphyxia and prior to the onset of IC-IVH indicate vasodilation and decreased resistance to blood flow. In IC-IVH, the high PI measurements denote the opposite. In infants with respiratory distress in the presence of significant vasodilation and lowered vascular resistance, CBF may increase to excessive levels, resulting in IC-IVH.
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Chua C. Neonatal meningitis and ventriculitis. J Natl Med Assoc 1978; 70:794-5. [PMID: 722825 PMCID: PMC2537162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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