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Mamun K, Chen LL, Fong T, Yong P, Lim KW, Chiang YY, Koh L. 130PREVALENCE OF ANTICHOLINERGIC DRUG USE IN OLDER ADULTS WITH DEMENTIA IN A LARGE TERTIARY HOSPITAL IN SINGAPORE. Age Ageing 2019. [DOI: 10.1093/ageing/afy206.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Mamun
- Singapore General Hospital, Singapore
| | - L L Chen
- Singapore General Hospital, Singapore
| | - T Fong
- Singapore General Hospital, Singapore
| | - P Yong
- Singapore General Hospital, Singapore
| | - K W Lim
- Singapore General Hospital, Singapore
| | | | - L Koh
- Singapore General Hospital, Singapore
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Tee SY, Win KY, Teo WS, Koh L, Liu S, Teng CP, Han M. Recent Progress in Energy-Driven Water Splitting. Adv Sci (Weinh) 2017; 4:1600337. [PMID: 28546906 PMCID: PMC5441509 DOI: 10.1002/advs.201600337] [Citation(s) in RCA: 268] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 09/30/2016] [Indexed: 05/12/2023]
Abstract
Hydrogen is readily obtained from renewable and non-renewable resources via water splitting by using thermal, electrical, photonic and biochemical energy. The major hydrogen production is generated from thermal energy through steam reforming/gasification of fossil fuel. As the commonly used non-renewable resources will be depleted in the long run, there is great demand to utilize renewable energy resources for hydrogen production. Most of the renewable resources may be used to produce electricity for driving water splitting while challenges remain to improve cost-effectiveness. As the most abundant energy resource, the direct conversion of solar energy to hydrogen is considered the most sustainable energy production method without causing pollutions to the environment. In overall, this review briefly summarizes thermolytic, electrolytic, photolytic and biolytic water splitting. It highlights photonic and electrical driven water splitting together with photovoltaic-integrated solar-driven water electrolysis.
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Affiliation(s)
- Si Yin Tee
- Institute of Materials Research and EngineeringAgency for ScienceTechnology and Research2 Fusionopolis WaySingapore138634
- Department of Biomedical EngineeringNational University of Singapore9 Engineering DriveSingapore117576
| | - Khin Yin Win
- Institute of Materials Research and EngineeringAgency for ScienceTechnology and Research2 Fusionopolis WaySingapore138634
| | - Wee Siang Teo
- School of Material Science and EngineeringNanyang Technological UniversitySingapore639798
| | - Leng‐Duei Koh
- Institute of Materials Research and EngineeringAgency for ScienceTechnology and Research2 Fusionopolis WaySingapore138634
- Department of Biomedical EngineeringNational University of Singapore9 Engineering DriveSingapore117576
| | - Shuhua Liu
- Institute of Materials Research and EngineeringAgency for ScienceTechnology and Research2 Fusionopolis WaySingapore138634
| | - Choon Peng Teng
- Institute of Materials Research and EngineeringAgency for ScienceTechnology and Research2 Fusionopolis WaySingapore138634
- Department of Biomedical EngineeringNational University of Singapore9 Engineering DriveSingapore117576
| | - Ming‐Yong Han
- Institute of Materials Research and EngineeringAgency for ScienceTechnology and Research2 Fusionopolis WaySingapore138634
- Department of Biomedical EngineeringNational University of Singapore9 Engineering DriveSingapore117576
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Koh L, Leartsakulpanitch J, Glaetzer C, Rosen S, Krauss J. Exploring the Willingness-to-Pay for Innovative Treatments for Immunology and Oncology in China. Value Health 2014; 17:A775. [PMID: 27202864 DOI: 10.1016/j.jval.2014.08.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L Koh
- Johnson & Johnson, Singapore
| | | | | | - S Rosen
- Simon-Kucher Partners, Cambridge, MA, USA
| | - J Krauss
- Simon-Kucher Partners, Singapore
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Koh L, Leartsakulpanitch J, Glaetzer C, Rosen S, Krauss J. Exploring the Willingness-to-Pay for Biologic Treatments In Immunology Diseases in China. Value Health 2014; 17:A775. [PMID: 27202865 DOI: 10.1016/j.jval.2014.08.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L Koh
- Johnson & Johnson, Singapore
| | | | | | - S Rosen
- Simon-Kucher Partners, Cambridge, MA, USA
| | - J Krauss
- Simon-Kucher Partners, Singapore
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John H, Buckley C, Koh L, Obrenovic K, Erb N, Rowe IF. Regional survey of tuberculosis risk assessment in rheumatology outpatients commencing anti-TNF-alpha treatment in relation to British Thoracic Society guidelines. Clin Med (Lond) 2009; 9:225-30. [PMID: 19634383 PMCID: PMC4953607 DOI: 10.7861/clinmedicine.9-3-225] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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] [Indexed: 11/27/2022]
Abstract
The aim of this study was to analyse tuberculosis (TB) risk assessment for rheumatology patients commencing anti-tumour necrosis factor-alpha (anti-TNF-alpha) therapy using the British Thoracic Society (BTS) guidelines. Data were obtained retrospectively on 856 outpatients regionally receiving anti-TNF-alpha. Prior to commencing treatment, patients had the following assessments documented: respiratory examination, 47.4%; chest X-ray, 84.5%; TB history, 92.9%; and advice about TB risk, 45.8%. Of the 856 patients, 94.3% were on immunosuppressives but 27% had a tuberculin test; 12.6% had > or =1 high-risk factors for TB. In total, 3.4% were referred to a TB specialist and of these, 24.1% had no risk factors for TB. Of patients with > or =1 risk factor, 76.9% were not referred. Only 4/28 patients at high risk for TB due to ethnicity or birthplace received chemoprophylaxis. Marked inter-unit variation was demonstrated and it was evident that patients require improved screening for TB. Greater awareness is necessary of patients with risk factors, particularly ethnicity, to facilitate more appropriate targeting of chemoprophylaxis. Multi-centre audit is a valuable clinical governance tool.
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Affiliation(s)
- H John
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley
| | - C Buckley
- Department of Rheumatology, Worcestershire Royal Hospital, Worcester
| | - L Koh
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley
| | - K Obrenovic
- Department of Clinical Audit, Dudley Group of Hospitals NHS Trust, Dudley
| | - N Erb
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley
| | - IF Rowe
- Department of Rheumatology, Worcestershire Royal Hospital, Worcester
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Johnston M, Zakharov A, Koh L, Armstrong D. Subarachnoid injection of Microfil reveals connections between cerebrospinal fluid and nasal lymphatics in the non-human primate. Neuropathol Appl Neurobiol 2006; 31:632-40. [PMID: 16281912 DOI: 10.1111/j.1365-2990.2005.00679.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [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: 11/27/2022]
Abstract
Based on quantitative and qualitative studies in a variety of mammalian species, it would appear that a significant portion of cerebrospinal fluid (CSF) drainage is associated with transport along cranial and spinal nerves with absorption taking place into lymphatic vessels external to the central nervous system. CSF appears to convect primarily through the cribriform plate into lymphatics associated with the submucosa of the olfactory and respiratory epithelium. However, the significance of this pathway for CSF absorption in primates has never been established unequivocally. In past studies, we infused Microfil into the subarachnoid compartment of numerous species to visualize CSF transport pathways. The success of this method encouraged us to use a similar approach in the non-human primate. Yellow Microfil was injected post mortem into the cisterna magna of 6 years old Barbados green monkeys (Cercopithecus aethiops sabeus, n = 6). Macroscopic and microscopic examination revealed that Microfil was (1) distributed throughout the subarachnoid compartment, (2) located in the perineurial spaces associated with the fila olfactoria, (3) present within the olfactory submucosa, and (4) situated within an extensive network of lymphatic vessels in the nasal submucosa, nasal septum and turbinate tissues. We conclude that the Microfil distribution patterns in the monkey were very similar to those observed in many other species suggesting that significant nasal lymphatic uptake of CSF occurs in the non-human primate.
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Affiliation(s)
- M Johnston
- Neuroscience Program, Department of Laboratory Medicine and Pathobiology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, ON, Canada.
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Zakharov A, Papaiconomou C, Koh L, Djenic J, Bozanovic-Sosic R, Johnston M. Integrating the roles of extracranial lymphatics and intracranial veins in cerebrospinal fluid absorption in sheep. Microvasc Res 2004; 67:96-104. [PMID: 14709407 DOI: 10.1016/j.mvr.2003.08.004] [Citation(s) in RCA: 51] [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: 10/27/2022]
Abstract
At relatively low cerebrospinal fluid (CSF) pressures, the majority of CSF drainage in 6- to 8-month-old sheep occurs through the cribriform plate into lymphatic vessels in the nasal submucosa. As CSF pressures are elevated, other absorption sites are recruited and these may include transport through arachnoid projections. To test for the transport of CSF directly into the venous sinus, the concentration of a tracer (131I-human serum albumin [HSA]) administered into the CSF compartment was measured in the confluence of the intracranial venous sinuses (torcular) and in the peripheral blood (inferior vena cava). CSF pressures were adjusted to favor absorption. Enrichment of the CSF tracer in the cranial venous system was most evident when the CSF-venous sinus pressure gradients were high. Peak concentration differences occurred 90 s after the CSF pressures were elevated. When pressure gradients approached 30 cm H(2)O, tracer concentrations in the torcular were approximately twofold higher than those observed in peripheral blood. The greatest concentration differences favoring the torcular were obtained when the CSF-venous sinus pressure gradients were elevated to high levels (20- to 40 cm H(2)O) and when CSF access to the paranasal lymphatics and CSF transport into the spinal subarachnoid compartment were prevented. In conjunction with previous studies, these results are compatible with the view that CSF absorption in the adult animal can occur directly into the cranial venous system. However, contrary to the established view, this pathway may represent a secondary system that is recruited to compliment lymphatic transport when global absorption capacity is stressed or compromised.
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Affiliation(s)
- A Zakharov
- Neuroscience Research, Department of Laboratory Medicine and Pathobiology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, Ontario, Canada
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Tan EK, Ho SC, Eng P, Loh LM, Koh L, Lum SY, Teoh ML, Yih Y, Khoo D. Restless legs symptoms in thyroid disorders. Parkinsonism Relat Disord 2004; 10:149-51. [PMID: 15036169 DOI: 10.1016/j.parkreldis.2003.11.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [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: 09/19/2003] [Revised: 11/20/2003] [Accepted: 11/25/2003] [Indexed: 11/28/2022]
Abstract
Dopaminergic dysfunction is associated with thyroid disorders and restless legs syndrome (RLS). In a 'face-to-face' interview, we evaluated for RLS using the diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) in patients diagnosed biochemically with either hyper- or hypothyroidism, and in controls without thyroid disorders. Amongst 146 consecutive patients with biochemically confirmed thyroid disorders, none satisfied all the IRLSSG criteria of RLS, similar to the control population (0.2%, 1/434). However, we found 8.2% (12/146) with RLS-like symptoms (satisfied the first 3 IRLSSG criteria) compared to 0.9% (4/434) in the controls (p < 0.0001). Four (33.3%) of these patients reported complete resolution of these symptoms after treatment for their thyroid condition. In conclusion, while RLS-like symptoms were observed in some patients with thyroid disorders, our study demonstrates no significant difference of RLS prevalence between patients with thyroid disorders and euthyroid controls.
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Affiliation(s)
- E K Tan
- Department of Neurology, Division of Medicine, Singapore General Hospital, Outram Road, Singapore, Singapore 169608.
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Foo KF, Tan EH, Leong SS, Wee JTS, Tan T, Fong KW, Koh L, Tai BC, Lian LG, Machin D. Gemcitabine in metastatic nasopharyngeal carcinoma of the undifferentiated type. Ann Oncol 2002; 13:150-6. [PMID: 11865813 DOI: 10.1093/annonc/mdf002] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.0] [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: 11/13/2022] Open
Abstract
BACKGROUND We conducted two parallel phase II trials in chemonaïve and previously treated patients with metastatic nasopharyngeal carcinoma (NPC) to evaluate the tumour response, progression-free and overall survival, and toxicity of gemcitabine. PATIENTS AND METHODS Gemcitabine 1250 mg/m2 was given on days 1 and 8 of a 21-day cycle. Patients with an Eastern Cooperative Oncology Group performance status <2, adequate renal, hepatic and bone marrow function, and radiologically measurable NPC were eligible. RESULTS Twenty-five chemonaïve and 27 previously treated patients were enrolled. The overall response rate was 28% [95% confidence interval (CI) 14% to 48%] for the chemonaïve and 48% (95% CI 31% to 66%) for previously treated patients. Toxicities greater than or equal to grade 3 occurred in 15 (60%) chemonaïve and 13 (48%) previously treated patients. Neutropenia was uncommon in chemonaïve patients, but occurred in 37% of previously treated patients. The median time to progression was 3.6 months (range 0.9-7.9) for chemonaïve and 5.1 months (0.9-13.1) for previously treated patients. Median overall survival time was 7.2 months (1.4-15.6) and 10.5 months (2.4-15.0) for chemonaïve and previously treated patients, respectively. CONCLUSIONS Gemcitabine has moderate activity in NPC with minimal toxicity, and is also an effective salvage agent for patients who have failed or progressed after treatment with other agents.
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Affiliation(s)
- K F Foo
- Department of Medical Oncology, National Cancer Centre, Singapore, Singapore
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Abstract
BACKGROUND Patients who present with malignant pleural/malignant effusion without a definite primary site are not well described in the medical literature. In the course of our clinical practice, we have observed certain traits that are peculiar to patients with such a presentation. We have applied the term primary intrathoracic malignant effusion (PIME) to describe this condition. STUDY OBJECTIVES Patients must fulfill the following criteria before a diagnosis of PIME can be made: clinical presentation dominated by pleural/pericardial effusion; histologic proof of malignancy obtained from the pleura and/or pericardium; no definite primary site in the lungs or elsewhere from CT scan of the chest, chest radiograph, or physical and endoscopic examination; no history of malignancy; and no history of asbestos exposure. Exposure to environmental tobacco smoke (ETS) among the nonsmokers was examined in a case-control setting. METHODS We conducted a retrospective search of our database of patients who were referred to the Department of Medical Oncology with a diagnosis of pleural/pericardial effusion from January 1993 to January 2000. RESULTS Seventy-one of 200 patients from our database met the criteria. A significant majority of the patients were women (65%) and nonsmokers (72%). All patients had adenocarcinoma shown on biopsy. The majority of patients (63%) had disease localized to the intrathoracic serosal surfaces; the rest had distant metastases involving the lung (50%), bone (27%), liver (19%), brain (8%), and skin (4%). Six patients had two or more sites of distant metastases. There was a significant association with ETS exposure when compared to a control group comprised of patients with colonic cancer, matched for sex and age. The median survival was 10 months for patients with disease localized to the pleura/pericardium and 7 months for those with distant metastases. Thirty-eight patients (54%) received chemotherapy. All had platinum-based chemotherapy, except for three patients. The median survival for patients treated or not treated with chemotherapy was 12 months and 5 months, respectively. This difference in survival was statistically significant (p = 0.003). CONCLUSIONS PIME should be viewed as a distinct entity. Its etiology remains largely unknown, although exposure to environmental tobacco smoke may play a part. Platinum-based chemotherapy may have a positive biological effect on this disease. More studies are required to elucidate the epidemiology, possible etiologic factors, and treatment options for this group of patients.
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Affiliation(s)
- P Ang
- Department of Medical Oncology, National Cancer Center, Singapore
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Koh L, Ranford J, Robinson W, Svensson J, Wang Y. Bis-tridentate iron chelating analogues of pyridoxal isonicotinyl hydrazone. J Inorg Biochem 1997. [DOI: 10.1016/s0162-0134(97)89914-x] [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: 11/30/2022]
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Koh L. Project 2000--initial experiences. Nurs Stand 1990; 5:38-40. [PMID: 2124854] [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: 12/30/2022]
Abstract
The need for adequate preparation in colleges of nursing for the introduction of Project 2000 courses, and the necessity for comprehensive and detailed forward planning, are emphasised in this article. The staff of St Mary's School of Nursing accept that some mistakes were made in their implementation arrangements, but the process was ultimately an extremely beneficial and rewarding one.
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Abstract
The incidence of the sudden infant death syndrome parallels that of respiratory tract infections in the paediatric community. On the basis that the aetiology of the sudden infant death syndrome may lie in an unusual response to a trivial intercurrent respiratory infection a necropsy study was carried out investigating pulmonary immunoglobulins in 16 victims of the syndrome and a series of infants (controls) who had died of non-pulmonary causes. Compared with the controls victims of the sudden infant death syndrome had grossly raised concentrations of IgG, IgM, and to a less extent IgA in lung lavage samples. In addition, pulmonary interstitial and terminal airway cells expressing these immunoglobulins were identified far more often in victims than controls. The study failed to determine whether the increased immunoglobulin concentrations were a consequence of an unusual response to a trivial infection or an expression of otherwise altered immunological control in the respiratory tract. Epidemiological evidence and the findings of this study suggest that the respiratory tract is the prime target organ in the sudden infant death syndrome.
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Forsyth K, Koh L, Lawrence A, Bradley J. Immunoglobulin profile of tracheal aspirate fluid in intubated children. Clin Exp Immunol 1988; 71:357-61. [PMID: 3349653 PMCID: PMC1541444] [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: 01/05/2023] Open
Abstract
Pulmonary lavage immunoglobulins IgG, IgA and IgM were measured in intubated ventilated neonates during their period of intubation (range 1-64 days, mean 12). The neonates were divided into two groups based on gestational age (group 1 26-32 weeks, group 2 33-40 weeks). IgG levels were high at birth, and decreased exponentially throughout the period of intubation. There was no statistical difference in IgG levels between the two groups. IgA and IgM levels were low at birth, and increased linearly, there being a significantly greater increase with age in Group 2 (the more mature gestationally) for both immunoglobulins. Two groups of older children were also studied (2-4 year olds, and 8-10 year olds). In the 2-4 year age group, IgG levels were similar to those seen in the immediate newborn period, were quantitatively greater than IgA and IgM, and were not significantly different from levels in the 8-10 year olds. IgA and IgM levels were also not significantly different between the two groups.
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Affiliation(s)
- K Forsyth
- Department of Paediatrics and Immunology, Flinders University of South Australia, Adelaide
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Zola H, Griffith V, Hunter I, Koh L, Bradley J. Responses of 'mature' human B lymphocyte lines to inducers of maturation and activation. Clin Exp Immunol 1986; 66:373-83. [PMID: 3493100 PMCID: PMC1542533] [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: 01/06/2023] Open
Abstract
Four human B cell lines with a mature phenotype (immunoglobulin secretion and expression of membrane markers associated with maturation) were cultured in the presence of phorbol ester (PMA), dimethyl sulphoxide (DMSO) and two conditioned media. PMA and DMSO led to changes in phenotype which suggested the cells were being activated, whilst the conditioned media resulted in increased immunoglobulin secretion, accompanied by phenotypic changes more consistent with maturation towards the plasma cell stage. The four cell lines, which had different origins (EBV-transformed normal B cell, Burkitt's lymphoma, prolymphocytic leukaemia and multiple myeloma) responded differently to the culture stimuli. These differences suggest that the changes associated with transformation affect the way in which these cells respond to agents which stimulate activation and maturation.
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Pin AL, Tho OS, Hun YB, Koh L. The use of electroconvulsive therapy in the University Hospital, Kuala Lumpur--a study of 31 patients. Med J Malaysia 1983; 38:145-9. [PMID: 6621445] [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: 01/21/2023]
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Sanders RR, Lee WH, Koh L, Brennecke A, Jones WR. Plasma prostaglandin F levels and malignant tumours of the female genital tract. Br J Obstet Gynaecol 1980; 87:139-41. [PMID: 7362801 DOI: 10.1111/j.1471-0528.1980.tb04507.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Plasma prostaglandin F (PGF) was measured by a radioimmunoassay method in 24 subjects with tumours of the female genital tract. Levels in the tumour group ranged from 25 pg/ml to 134 pg/ml and were almost all greater than the values observed in a control group of 41 healthy women who had a mean (+/-SD) level of 21 (+/-3.4)pg/ml. There was a relationship between plasma PGF levels and the stage of the disease. Patients with resectable tumours showed a fall in PGF levels postoperatively and those with disseminated malignancy demonstrated increasing levels as the disease progressed. Plasma PGF may provide a clinical prognostic marker in the management of patients with malignant tumours.
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