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Lasco G, Tan ML, Yu VG. 'Loob' and 'labas': Spatial constructions of safety and risk amid the COVID-19 pandemic in the Philippines. Health Place 2023; 79:102929. [PMID: 36542918 PMCID: PMC9676171 DOI: 10.1016/j.healthplace.2022.102929] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 11/22/2022]
Abstract
This article argues that local constructions of risky and safe spaces, as articulated by the notions 'loob' (inside) and 'labas' (outside), informed popular and political responses to the COVID-19 pandemic in the Philippines, leading to an overemphasis on staying at home and, conversely, a general avoidance or fear of outdoor spaces that was at times reinforced by public health authorities. Practices and policies related to the pandemic response rendered this binary opposition between 'loob' and 'labas' visible, from regulations concerning the use of personal protective equipment to restrictions of access to outdoor spaces. While this emergent form of bodily proxemics was contested and negotiated over time, its tenacity throughout the pandemic underscores the importance of understanding how people spatialize risk in times of health crises.
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Affiliation(s)
- Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Philippines,Development Studies Program, Ateneo de Manila University, Philippines
| | - Michael L. Tan
- Department of Anthropology, University of the Philippines Diliman, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, Ateneo de Manila University, Philippines; Social Medicine Unit, College of Medicine, University of the Philippines Manila, Philippines.
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Foong SC, Hwang YC, Foong WC, Tan ML. Baby boy blue … and mommy too! A rare case of methaemoglobinaemia presenting simultaneously in a mother-neonate pair. Med J Malaysia 2021; 76:924-926. [PMID: 34806687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Methaemoglobinaemia occurs when there is >1% methaemoglobin in erythrocytes. In an infant, they can present either congenitally or in an acquired form. We present a rare case of methaemoglobinaemia presenting simultaneously in a mother and infant pair. The mother and infant were discharged well on Day-4 post-delivery with both mother and baby recording oxygen saturation levels of 100%. On Day-7, during a routine clinic visit, they were incidentally found to be centrally cyanosed. There were no other abnormalities. On investigation, the methaemoglobin levels were elevated in the infant (23.9%) and mother (14.3%). Treatment with ascorbic acid normalised mother's methaemoglobin levels; but baby's levels remained high until the administration of oral methylene blue. Both baby and mother remained well and pink at last follow-up at 2 years 8 months of age. This case illustrates difficulties in ascertaining the cause of methaemoglobinaemia. Postdelivery, the mother-neonate pair were pink, and their haemoglobin electrophoresis were normal, hence it was unlikely to be congenital methaemoglobinaemia. The team could not identify any triggering factors for acquired methaemoglobinaemia. There was also the uncertainty of the necessity to treat the baby. This is because treatment is not without harmful effects and despite the high methaemoglobin levels, the infant was otherwise well. Only a single published paper recommended that high methaemoglobin levels must be treated, and the recommendation was not supported by evidence. Lessons learnt from our case are that neonates with methaemoglobinaemia can be safely treated with oral methylene blue, but more research is needed on the benefitrisk profile of treatment.
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Affiliation(s)
- S C Foong
- RCSI & UCD Malaysia Campus, Malaysia.
| | | | - W C Foong
- RCSI & UCD Malaysia Campus, Malaysia
| | - M L Tan
- RCSI & UCD Malaysia Campus, Malaysia
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Hsin‐Hung Chen M, Dip A, Ahmed M, Tan ML, Walterscheid JP, Sun H, Teng B, Mozayani A. Detection and Characterization of the Effect of AB-FUBINACA and Its Metabolites in a Rat Model. J Cell Biochem 2015; 117:1033-43. [PMID: 26517302 PMCID: PMC5063098 DOI: 10.1002/jcb.25421] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 10/28/2015] [Indexed: 01/05/2023]
Abstract
Synthetic cannabinoids were originally developed by academic and pharmaceutical laboratories with the hope of providing therapeutic relief from the pain of inflammatory and degenerative diseases. However, recreational drug enthusiasts have flushed the market with new strains of these potent drugs that evade detection yet endanger public health and safety. Although many of these drug derivatives were published in the medical literature, others were merely patented without further characterization. AB‐FUBINACA is an example of one of the new indazole‐carboxamide synthetic cannabinoids introduced in the past year. Even though AB‐FUBINACA has become increasingly prominent in forensic drug and toxicology specimens analyses, little is known about the pharmacology of this substance. To study its metabolic fate, we utilized Wistar rats to study the oxidative products of AB‐FUBINACA in urine and its effect on gene expressions in liver and heart. Rats were injected with 5 mg/kg of AB‐FUBINACA each day for 5 days. Urine samples were collected every day at the same time. On day 5 after treatment, we collected the organs such as liver and heart. The urine samples were analyzed by mass spectrometry, which revealed several putative metabolites and positioning of the hydroxyl addition on the molecule. We used quantitative PCR gene expression array to analyze the hepatotoxicity and cardiotoxicity on these rats and confirmed by real‐time quantitative RT‐PCR. We identified three genes significantly associated with dysfunction of oxidation and inflammation. Our study reports in vivo metabolites of AB‐FUBINACA in urine and its effect on the gene expressions in liver and heart. J. Cell. Biochem. 117: 1033–1043, 2016. © 2015 The Authors. Journal of Cellular Biochemistry Published by Wiley Periodicals. Inc.
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Affiliation(s)
| | - Aybike Dip
- Department of Administration of JusticeTexas Southern UniversityHoustonTexas77030
| | - Mostafa Ahmed
- Department of Administration of JusticeTexas Southern UniversityHoustonTexas77030
- Research Center for Human GeneticsThe Brown Foundation Institute of Molecular MedicineUniversity of Texas Health Science Center at HoustonHoustonTexas77030
| | - Michael L. Tan
- Research Center for Human GeneticsThe Brown Foundation Institute of Molecular MedicineUniversity of Texas Health Science Center at HoustonHoustonTexas77030
| | | | - Hua Sun
- Research Center for Human GeneticsThe Brown Foundation Institute of Molecular MedicineUniversity of Texas Health Science Center at HoustonHoustonTexas77030
| | - Ba‐Bie Teng
- Research Center for Human GeneticsThe Brown Foundation Institute of Molecular MedicineUniversity of Texas Health Science Center at HoustonHoustonTexas77030
- University of Texas Graduate School of Biomedical Sciences at HoustonHoustonTexas77030
| | - Ashraf Mozayani
- Department of Administration of JusticeTexas Southern UniversityHoustonTexas77030
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Mundada P, Tan ML, Soh AWE. Radiologically occult hepatocellular carcinoma in a cirrhotic liver presenting with bilateral adrenal metastases. Med J Malaysia 2015; 70:256-258. [PMID: 26358025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although it is common to have extra-hepatic metastasis of hepatocellular carcinoma (HCC) at the time of presentation, it is extremely rare to have extra-hepatic metastatic HCC without a detectable primary in the liver. We report a unique case in which a patient presented with bilateral large adrenal masses which were subsequently proven to be metastases from HCC. However, there was no tumour seen in the liver on imaging.
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Affiliation(s)
- P Mundada
- Changi General Hospital, Department of radiology, Singapore 2 Simei Street 3, Singapore 529889.
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Abad PJB, Tan ML, Baluyot MMP, Villa AQ, Talapian GL, Reyes ME, Suarez RC, Sur ALD, Aldemita VDR, Padilla CD, Laurino MY. Cultural beliefs on disease causation in the Philippines: challenge and implications in genetic counseling. J Community Genet 2014; 5:399-407. [PMID: 25026992 DOI: 10.1007/s12687-014-0193-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 06/29/2014] [Indexed: 11/30/2022] Open
Abstract
The provision of culturally competent health care is an important professional issue recognized by the pioneer genetic counselors in the Philippines. Being an archipelago consisting of 7,107 islands, the Philippines has approximately 175 ethnolinguistic groups with their own unique cultural identity and health practices. The emphasis on culture in our genetic counseling training recognizes its crucial role in molding an individual's conceptualization of health, as well as other life aspects, especially since the Filipino culture is a mixture of indigenous as well as imported and borrowed elements. As part of this endeavor, we will describe in this paper seven common Filipino cultural beliefs: namamana, lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos. We will also share examples on how these common beliefs provide explanation as cause of illness and its implications in our genetic counseling profession.
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Affiliation(s)
- Peter James B Abad
- College of Nursing, University of the Philippines Manila, Manila, Philippines,
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Chen G, Tan ML, Gao X, Jia P. Dual Regulating Effect of Shaoyao-Gangcao-Tang on COX- 2 Expression in Acute and Resolution Phases of Carrageenin-Induced Pleurisy in Rats. TROP J PHARM RES 2013. [DOI: 10.4314/tjpr.v12i5.10] [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: 11/17/2022] Open
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Tan ML, Padhy AK. Umbilical metastatic deposit from recurrent cholangiocarcinoma: F18-FDG PET-CT findings. Singapore Med J 2011; 52:e236-e238. [PMID: 22173264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 69-year-old woman was diagnosed with stage IIIA advanced Type IV Klatskin cholangiocarcinoma, which was treated with radical choledochectomy, extended right hepatectomy and left hepaticojejunostomy. About six months after surgery, she presented with painless jaundice. A 2-18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (F18-FDG PET-CT) was performed, which detected an FDG-avid umbilical metastatic nodule. We describe the F18-FDG PET-CT features of umbilical metastatic nodule in recurrent cholangiocarcinoma. It is sometimes difficult to detect the lesions when they present with non-specific soft tissue thickening on routine CT imaging. F18-FDG PET-CT would probably render these lesions easier to detect and interpret.
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Affiliation(s)
- M L Tan
- Department of Nuclear Medicine, Singapore General Hospital, Outram Road, Singapore 169608.
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Lai NM, Tan ML, Quah SY, Tan EL, Foong KW. Over-investigated and under-treated: children with febrile convulsion in a Malaysian district hospital. Singapore Med J 2010; 51:724-729. [PMID: 20938614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION We conducted a retrospective audit on the inpatient assessment and care of children admitted with febrile convulsion to Hospital Batu Pahat, a district hospital in Malaysia, using the Malaysian national clinical practice guidelines and the American Academy of Paediatrics practice parameters on febrile convulsion as the reference standards. METHODS The case notes of 100 consecutive children admitted in 2004 were analysed. The documentation of major clinical features, selection of investigations, the timeliness of antipyresis and frequency of parental education were evaluated. RESULTS In general, the major clinical features that were relevant to the presenting problem were adequately documented, although fever was not mentioned as a presenting complaint in one quarter of the cases. On an average, about five investigations were ordered for every patient on admission. There was no major difference in the number of investigations conducted between children who were more severely ill and the rest of the patients. The majority of the investigations did not yield any useful diagnostic information. Only 38 percent of the children received antipyretics and 53 percent were tepid-sponged during fever, with 23 percent having received tepid-sponging without concurrently receiving antipyretics. No parental education on febrile convulsion was recorded in half of the cases. CONCLUSION Excessive unjustified investigations, deficient antipyresis when required and inadequate communication with the family of children with febrile convulsion were observed. Awareness of such deficiencies from this audit should lead to regular staff education, monitoring and future audits in order to improve the quality of our clinical care.
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Affiliation(s)
- N M Lai
- School of Medicine and Health Sciences, Monash University Malaysia, JKR 1235, Bukit Azah, Johor Bahru 80100, Malaysia.
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Tan ML, Lam SL, Nadarajah S. Pregnancy luteoma presenting as ovarian torsion with rupture and intra-abdominal bleeding. Singapore Med J 2008; 49:e78-e81. [PMID: 18362993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We report a case of pregnancy luteoma, which had undergone torsion in a 33-year-old Indian woman, who presented with severe abdominal pain and decreasing haemoglobin levels at 33 weeks gestation. Ultrasonography showed a right adnexal mass, probably ovarian in origin, with suspicious intratumoral bleed. The pain was treated symptomatically, and the symptoms improved. A successful induction of labour was then performed at 36 weeks gestation. The pain recurred almost immediately after the delivery, and she experienced another intra-abdominal bleed. A diagnostic laparotomy and a right salpingo-oophorectomy were performed, and the diagnosis of luteoma was made based on histology. We discuss the clinical presentation of this unusual tumour, though often asymptomatic, can rarely present with severe abdominal pain from complications like torsion with rupture, leading to massive intra-abdominal bleeding. We also discuss the possible radiological investigations which can be done during pregnancy.
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Affiliation(s)
- M L Tan
- Department of Diagnostic Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899.
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Tan ML, Theeuwes HP, Feenstra L, Borst JGG. Membrane Properties and Firing Patterns of Inferior Colliculus Neurons: An In Vivo Patch-Clamp Study in Rodents. J Neurophysiol 2007; 98:443-53. [PMID: 17507499 DOI: 10.1152/jn.01273.2006] [Citation(s) in RCA: 50] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The inferior colliculus (IC) is a large auditory nucleus in the midbrain, which is a nearly obligatory relay center for ascending auditory projections. We made in vivo whole cell patch-clamp recordings of IC cells in young-adult anesthetized C57/Bl6 mice and Wistar rats to characterize their membrane properties and spontaneous inputs. We observed spikelets in both rat (18%) and mouse (13%) IC neurons, suggesting that IC neurons may be connected by electrical synapses. In many cells, spontaneous postsynaptic potentials were sufficiently large to contribute to spike irregularity. Cells differed considerably in the number of simultaneous spontaneous postsynaptic potentials that would be needed to trigger an action potential. Depolarizing and hyperpolarizing current injections showed six different types of firing patterns: buildup, accelerating, burst-onset, burst-sustained, sustained, and accommodating. Their relative frequencies were similar in both species. In mice, about half of the cells showed a clear depolarizing sag, suggesting that they have the hyperpolarization-activated current Ih. This sag was observed more often in burst and in accommodating cells than in buildup, accelerating, or sustained neurons. Cells with Ih had a significantly more depolarized resting membrane potential. They were more likely to fire rebound spikes and generally showed long-lasting afterhyperpolarizations following long depolarizations. We therefore suggest a separate functional role for Ih.
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Affiliation(s)
- M L Tan
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
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Tan ML, Borst JGG. Comparison of responses of neurons in the mouse inferior colliculus to current injections, tones of different durations, and sinusoidal amplitude-modulated tones. J Neurophysiol 2007; 98:454-66. [PMID: 17507505 DOI: 10.1152/jn.00174.2007] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [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: 11/22/2022] Open
Abstract
We made in vivo whole cell patch-clamp recordings from the inferior colliculus of young-adult, anesthetized C57/Bl6 mice to compare the responses to constant-current injections with the responses to tones of different duration or to sinusoidal amplitude-modulated (SAM) tones. We observed that voltage-dependent ion channels contributed in several ways to the response to tones. A sustained response to long tones was observed only in cells showing little accommodation during current injection. Cells showing burst-onset firing during current injection showed a small response to SAM tones, whereas burst-sustained cells showed a good response to SAM tones. The hyperpolarization-activated nonselective cation channel I(h) had a special role in shaping the responses: I(h) was associated with an increased excitability, with chopper and pauser responses, and with an afterhyperpolarization following tones. Synaptic properties were more important in determining the responses to tones of different durations. A short-latency inhibitory response appeared to contribute to the long-pass response in some cells and short-pass and band-pass neurons were characterized by their slow recovery from synaptic adaptation. Cells that recovered slowly from synaptic adaptation showed a relatively small response to SAM tones. Our results show an important role for both intrinsic membrane properties -- most notably the presence of I(h) and the extent of accommodation -- and synaptic adaptation in shaping the response to tones in the inferior colliculus.
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Affiliation(s)
- M L Tan
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
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Abstract
Operating according to UNAIDS' 'Protocol for the Identification of Discrimination against People Living with HIV', this study analysed health infrastructure in Manila, Philippines and determined that despite the existence of anti-discriminatory legislation, discrimination still occurred in practice. This was attributed to an absence of written regulations and inadequate training among health staff. Discrimination associated with HIV/AIDS has been found to be a hindrance to the development of successful preventive strategies, as it discourages people living with HIV/AIDS (PLWHA) and other people from contacting health and social services. This paper argues that if the Philippines is to maintain its low prevalence rate of HIV (and even reduce it), the discrimination that PLWHA incur must be addressed taking account of their human rights.
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Tan ML, Muhammad TST, Najimudin N, Sulaiman SF. Growth arrest and non-apoptotic programmed cell death associated with the up-regulation of c-myc mRNA expression in T-47D breast tumor cells following exposure to Epipremnum pinnatum (L.) Engl. hexane extract. J Ethnopharmacol 2005; 96:375-383. [PMID: 15619555 DOI: 10.1016/j.jep.2004.07.005] [Citation(s) in RCA: 10] [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: 07/16/2003] [Revised: 06/16/2004] [Accepted: 07/06/2004] [Indexed: 05/24/2023]
Abstract
Epipremnum pinnatum (L.) Engl. hexane extract produced a significant growth inhibition against T-47D breast carcinoma cells and analysis of cell death mechanisms indicated that the extract elicited a non-apoptotic programmed cell death. T-47D cells exposed to the extract at EC(50) concentration (72 h) for 24 h failed to demonstrate typical DNA fragmentation associated with apoptosis, as carried out using a modified TUNEL assay. In addition, acute exposure to the extract produced an insignificant regulation of caspase-3 and p53 mRNA expression but increased in the c-myc mRNA expression. Ultrastructural analysis using transmission electron microscope demonstrated distinct vacuolated cells, which strongly indicated a Type II non-apoptotic cell death although the changes in chromatin were also detected. The presence of non-apoptotic programmed cell death was then reconfirmed with annexin-V and propidium iodide staining. These findings suggested that up-regulation of c-myc mRNA expression may have contributed to the growth arrest and Type II non-apoptotic programmed cell death in the Epipremnum pinnatum (L.) Engl. hexane extract-treated T-47D cells.
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Affiliation(s)
- M L Tan
- School of Biological Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
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Tan ML, Sulaiman SF, Najimuddin N, Samian MR, Muhammad TST. Methanolic extract of Pereskia bleo (Kunth) DC. (Cactaceae) induces apoptosis in breast carcinoma, T47-D cell line. J Ethnopharmacol 2005; 96:287-94. [PMID: 15588681 DOI: 10.1016/j.jep.2004.09.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2003] [Revised: 08/09/2004] [Accepted: 09/13/2004] [Indexed: 05/05/2023]
Abstract
Currently, breast cancer is the leading cause of cancer-related death in women. Therefore, there is an urgent need to develop alternative therapeutic measures against this deadly disease. Here, we report the cytotoxicity activity and the mechanism of cell death exhibited by the methanol extract prepared from Pereskia bleo (Kunth) DC. (Cactaceae) plant against human breast carcinoma cell line, T-47D. In vitro cytotoxicity screening of methanol extract of Pereskia bleo plant indicated the presence of cytotoxicity activity of the extract against T-47D cells with EC50 of 2.0 microg/ml. T-47D cell death elicited by the extract was found to be apoptotic in nature based a clear indication of DNA fragmentation which is a hallmark of apoptosis. In addition, ultrastructural analysis also revealed apoptotic characteristics (the presence of chromatin margination and apoptotic bodies) in the extract-treated cells. RT-PCR analysis showed the mRNA expression levels of c-myc, and caspase 3 were markedly increased in the cells treated with the plant extract. However, p53 expression was only slightly increased as compared to caspase 3 and c-myc. Thus, the results from this study strongly suggest that the methanol extract of Pereskia bleo may contain bioactive compound(s) that caused breast carcinoma, T-47D cell death by apoptosis mechanism via the activation of caspase-3 and c-myc pathways.
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Affiliation(s)
- M L Tan
- School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
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Tan ML, Feenstra L. [Diagnostic image (156). A man with a hematoma behind the ear]. Ned Tijdschr Geneeskd 2003; 147:2500-1; author reply 2501. [PMID: 14708220] [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: 04/27/2023]
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Tan HH, Goh CL, Yeo MG, Tan ML. Antibiotic sensitivity of Propionibacterium acnes isolates from patients with acne vulgaris in a tertiary dermatological referral centre in Singapore. Ann Acad Med Singap 2001; 30:22-5. [PMID: 11242619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVES To study the minimum inhibitory concentrations (MICs) of Propionibacterium acnes (P. acnes) isolates to selected antibiotics from patients with acne vulgaris in Singapore and determine if resistance increases with prolonged use of antibiotics. DESIGN A single-centre prospective study. SETTING Tertiary dermatological referral centre in Singapore. PATIENTS One hundred and fifty patients with acne vulgaris seen at the National Skin Centre. RESULTS In patients who had never been on antibiotics, there were no resistant isolates of P. acnes. In patients who had been on short-term antibiotics (between 6 to 18 weeks), there were 2 resistant strains among the 34 isolates (6.25%); in patients who had been on antibiotics for longer periods, there were 11 resistant strains among the 51 isolates (21.6%). The differences in the rates of isolation of resistant strains between patients who had not been on antibiotics to those that had been on long-term antibiotics were statistically significant (P = 0.015). There was also a significant difference in isolation of resistant strains from those on short-term antibiotics compared to those who had been on long-term antibiotics (P = 0.036). Resistance to erythromycin was most commonly encountered. Most of the erythromycin-resistant strains also showed cross-resistance to clindamycin. The average MICs to antibiotics such as minocycline, erythromycin and clindamycin in those on long-term antibiotics were significantly higher when compared to patients who had not been on antibiotics. CONCLUSIONS Antibiotic resistance in P. acnes isolates in Singapore follows similar patterns to studies conducted in Europe. Resistance to erythromycin was most commonly seen, and this is associated with cross-resistance to clindamycin. Among the tetracycline group of drugs, the average MICs to tetracycline was higher than that for doxycycline, which in turn was higher than that for minocycline. Antibiotic resistance can occur with short-term antibiotic courses, and the rate of resistance increases as the duration of antibiotic consumption increases.
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Affiliation(s)
- H H Tan
- National Skin Centre, 1 Mandalay Road, Singapore 308205.
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Dowsett GW, Aggleton P, Abega SC, Jenkins C, Marshall TM, Runganga A, Schifter J, Tan ML, Tarr CM. Changing gender relations among young people: The global challenge for HIV/AIDS prevention. Critical Public Health 1998. [DOI: 10.1080/09581599808402917] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chan R, Kavi AR, Carl G, Khan S, Oetomo D, Tan ML, Brown T. HIV and men who have sex with men: perspectives from selected Asian countries. AIDS 1998; 12 Suppl B:S59-65, S67-8. [PMID: 9679630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- R Chan
- Department of STD Control, Singapore
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Yap KP, Tan ML, Tan CE. Survey of aerobic bacterial infections in paediatric surgical intensive care unit patients. Ann Acad Med Singap 1998; 27:223-6. [PMID: 9663315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Infections cause a significant amount of morbidity and mortality in paediatric surgical patients requiring intensive care. The study aims to describe the epidemiology of infection among these patients, to correlate the source of infection with the underlying medical condition, and to determine the antibiotic sensitivity pattern of the organisms. Through a retrospective review over a period of one year, 133 cases were analysed. The overall incidence of infection was 35%. Those who had emergency surgery had the highest infection rate (47%). Respiratory tract infections were the commonest source of infection, and were associated with ventilator therapy rather than the underlying medical condition. The Enterobacteriaceae were the most common isolates seen. From antibiotic sensitivity tests, the empirical antibiotics of choice are gentamicin for suspected gram-negative infection and vancomycin for severe infections where methicillin-resistant Staphylococcus aureus is a likely cause. A high rate of resistance to ampicillin was seen and its use as a first-line monotherapy drug should be discontinued in our patient population.
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Affiliation(s)
- K P Yap
- Department of Urology, Singapore General Hospital, Singapore
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Abstract
This paper analyses the potential socio-economic impact of HIV disease in the Philippines, with focus on the situation of two vulnerable populations: overseas contract workers and sex workers. The potential impact of HIV disease is examined in the context of recent developments in the Philippines, including the economic recession, widespread poverty and income inequality. The contributions of overseas workers and sex workers are then reviewed, both at the macro- (national) and micro- (household) levels. The impact is examined in terms of lost income, costs of medical care and sociopolitical disruption.
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Affiliation(s)
- M L Tan
- Department of Anthropology, College of Social Sciences and Philosophy, University of the Philippines, Diliman, Quezon City
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Tan ML. Book reviews. Health Policy Plan 1993. [DOI: 10.1093/heapol/8.3.286] [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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Tan ML. Book reviews. Health Policy Plan 1992. [DOI: 10.1093/heapol/7.1.90] [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: 11/13/2022] Open
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Abstract
Questions have been raised about the validity of labels such as 'western', 'alternative', and 'traditional' as applied to medical systems. This study shows that the rubric 'traditional' may be validly applied to clusters of medical systems sharing common elements that distinguish them from 'western' systems. At the same time, pluralism in diagnostic and therapeutic procedures must be recognized even within each system. The discussion in this paper analyzes explanatory models, drawing mainly from Asian examples and focussing on pharmaceuticals. A purely cognitive approach may however be insufficient in understanding the different medical systems. A review of socio-historical factors that influence medical systems highlights important processes such as cultural reinterpretation and indigenization that characterize what could be more appropriately described as transitional medical systems. Changes in cultural forms, such as the acceptance of western pharmaceuticals, may still rely on traditional cognitive frames of reference, suggesting eclecticism amid conservatism. Issues of theoretical and practical concern are outlined at the end of the article.
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Affiliation(s)
- M L Tan
- Department of Anthropology, University of the Philippines, Quezon City
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Lam S, Ng SC, Koh DR, Tan ML. Fatal septicaemia caused by Vibrio vulnificus. Singapore Med J 1988; 29:176-8. [PMID: 3399921] [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: 01/05/2023]
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Tan ML, Rietveld EM, van Marrewijk GA, Kool AJ. Regeneration of leaf mesophyll protoplasts of tomato cultivars (L. esculentum): factors important for efficient protoplast culture and plant regeneration. Plant Cell Rep 1987; 6:172-5. [PMID: 24248643 DOI: 10.1007/bf00268470] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/1986] [Revised: 02/11/1987] [Indexed: 05/12/2023]
Abstract
Conditions were established for efficient plant regeneration from four freshmarket cultivars of Lycopersicon esculentum. In order to increase the yield of viable protoplasts which are able to sustain cell divisions, the donor plants are preconditioned by incubation at 25°C in the dark for 18 hours, followed by a cold treatment at 4°C in the dark for the last 6 hours, prior to protoplast isolation. Browning of the dividing cell colonies can be prevented by culturing protoplasts in 100 μl droplets of low-melting agarose, surrounded by liquid medium. Alternatively, protoplasts can be cultured in liquid medium. In both procedures the plating efficiencies and percentage of shoot regeneration are increased, only when dilutions were performed with auxin-free culture medium. Shoot regeneration is obtained by using a two step procedure: initiation of greening of microcalli on a medium containing 0.2 M mannitol and 7.3 mM sucrose, which is followed by shoot development on a mannitol-free medium containing 0.5 M sucrose. In this way, plants can be regenerated within 3 months from the hybrid cultivars Bellina, Abunda, Sonatine and also from the true seedline Moneymaker. The latter one showed the highest regeneration frequency (30%).
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Affiliation(s)
- M L Tan
- Department of Genetics, Free University, De Boelelaan 1087, 1081 HV, Amsterdam, The Netherlands
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Tan ML. Book reviews. Health Policy Plan 1987. [DOI: 10.1093/heapol/2.3.269] [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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Tan ML. Rationalizing drug policies in the Philippines. Philipp J Nurs 1986; 56:34-43. [PMID: 3645674] [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: 01/06/2023]
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Tan ML. Nurses becoming a social force: psycho-social dimensions. Philipp J Nurs 1985; 55:73-5, 72. [PMID: 3853792] [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: 01/07/2023]
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