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Low JM, Tan MY, Joseph R. Authors’ reply: Comment on: Doctors and social media: knowledge gaps and unsafe practices. Singapore Med J 2022; 63:171. [DOI: 10.11622/smedj.2022049] [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: 11/18/2022]
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Guo X, Zhong K, Zou L, Xue H, Zheng S, Guo J, Lv H, Duan K, Huang D, Tan M. Effect of Lactobacillus casei fermented milk on fracture healing in osteoporotic mice. Front Endocrinol (Lausanne) 2022; 13:1041647. [PMID: 36387894 PMCID: PMC9649960 DOI: 10.3389/fendo.2022.1041647] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Abstract
The interaction between the gut microbiota and the host has been described experimentally by germ-free animals or by antibiotic-disturbed gut microbiota. Studies on germ-free mice have shown that gut microbiota is critical for bone growth and development in mice, emphasizing that microbiota dysbiosis may interfere with normal bone development processes. This study aimed to clarify the effect of antibiotic treatment on disturbed gut microbiota on bone development in mice and to investigate the effect of probiotic treatment on fracture healing in mice with dysbiosis. Our results showed that 4 weeks old female Kunming mice showed significantly lower abundance and diversity of the gut microbiota and significantly lower bone mineral density after 12 weeks of antibiotic treatment and significantly increased levels of RANKL and Ang II in serum (p<0.05). Mice with dysbiosis received 5 mL of Lactobacillus casei fermented milk by daily gavage after internal fixation of femoral fractures, and postoperative fracture healing was evaluated by X-ray, micro-CT scan, and HE staining, which showed faster growth of the broken ends of the femur and the presence of more callus. Serological tests showed decreased levels of RANKL and Ang II (p<0.05). Similarly, immunohistochemical results also showed increased expression of α smooth muscle actin in callus tissue. These results suggest that oral antibiotics can lead to dysbiosis of the gut microbiota in mice, which in turn leads to the development of osteoporosis. In contrast, probiotic treatment promoted fracture healing in osteoporotic mice after dysbiosis, and the probiotic effect on fracture healing may be produced by inhibiting the RAS/RANKL/RANK pathway.
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Affiliation(s)
- Xing Guo
- Department of Burn and Plastic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kai Zhong
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - LongFei Zou
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hao Xue
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - ShuLing Zheng
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jiang Guo
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hui Lv
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ke Duan
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - DengHua Huang
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - MeiYun Tan
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: MeiYun Tan,
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Guo X, Lv H, Fan Z, Duan K, Liang J, Zou L, Xue H, Huang D, Wang Y, Tan M. Effects of hypoxia on Achilles tendon repair using adipose tissue-derived mesenchymal stem cells seeded small intestinal submucosa. J Orthop Surg Res 2021; 16:570. [PMID: 34579755 PMCID: PMC8474963 DOI: 10.1186/s13018-021-02713-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/08/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The study was performed to evaluate the feasibility of utilizing small intestinal submucosa (SIS) scaffolds seeded with adipose-derived mesenchymal stem cells (ADMSCs) for engineered tendon repairing rat Achilles tendon defects and to compare the effects of preconditioning treatments (hypoxic vs. normoxic) on the tendon healing. METHODS Fifty SD rats were randomized into five groups. Group A received sham operation (blank control). In other groups, the Achilles tendon was resected and filled with the original tendon (Group B, autograft), cell-free SIS (Group C), or SIS seeded with ADMSCs preconditioned under normoxic conditions (Group D) or hypoxic conditions (Group E). Samples were collected 4 weeks after operation and analyzed by histology, immunohistochemistry, and tensile testing. RESULTS Histologically, compared with Groups C and D, Group E showed a significant improvement in extracellular matrix production and a higher compactness of collagen fibers. Group E also exhibited a significantly higher peak tensile load than Groups D and C. Additionally, Group D had a significantly higher peak load than Group C. Immunohistochemically, Group E exhibited a significantly higher percentage of MKX + cells than Group D. The proportion of ADMSCs simultaneously positive for both MKX and CM-Dil observed from Group E was also greater than that in Group D. CONCLUSIONS In this animal model, the engineered tendon grafts created by seeding ADMSCs on SIS were superior to cell-free SIS. The hypoxic precondition further improved the expression of tendon-related genes in the seeded cells and increased the rupture load after grafting in the Achilles tendon defects.
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Affiliation(s)
- Xing Guo
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - Hui Lv
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - ZhongWei Fan
- Department of Orthopaedic Surgery, The First People's Hospital of Neijiang, Neijiang, 641100, Sichuan, China
| | - Ke Duan
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - Jie Liang
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - LongFei Zou
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - Hao Xue
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - DengHua Huang
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - YuanHui Wang
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China
| | - MeiYun Tan
- Department of Orthopaedics, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
- Sichuan Provincial Lab of Orthopaedic Engineering, Luzhou, 646000, Sichuan, China.
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Tan MY, Ong T, Sivam J, Al-Shuft H, Sahota O, Salem K. 32THE ROLE OF DYNAMIC SUPINE-SITTING SPINAL RADIOGRAPHS IN THE MANAGEMENT OF VERTEBRAL FRAGILITY FRACTURES ADMITTED TO HOSPITAL. Age Ageing 2018. [DOI: 10.1093/ageing/afy124.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Y Tan
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust
| | - T Ong
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust
| | - J Sivam
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust
| | - H Al-Shuft
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust
| | - O Sahota
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust
| | - K Salem
- Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust
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Tan MY, Syngelaki A, Poon LC, Rolnik DL, O'Gorman N, Delgado JL, Akolekar R, Konstantinidou L, Tsavdaridou M, Galeva S, Ajdacka U, Molina FS, Persico N, Jani JC, Plasencia W, Greco E, Papaioannou G, Wright A, Wright D, Nicolaides KH. Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation. Ultrasound Obstet Gynecol 2018; 52:186-195. [PMID: 29896812 DOI: 10.1002/uog.19112] [Citation(s) in RCA: 199] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/04/2018] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the performance of screening for early, preterm and term pre-eclampsia (PE) at 11-13 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery (UtA) pulsatility index (PI), serum placental growth factor (PlGF) and serum pregnancy-associated plasma protein-A (PAPP-A). METHODS The data for this study were derived from three previously reported prospective non-intervention screening studies at 11 + 0 to 13 + 6 weeks' gestation in a combined total of 61 174 singleton pregnancies, including 1770 (2.9%) that developed PE. Bayes' theorem was used to combine the prior distribution of gestational age at delivery with PE, obtained from maternal characteristics, with various combinations of biomarker multiples of the median (MoM) values to derive patient-specific risks of delivery with PE at < 37 weeks' gestation. The performance of such screening was estimated. RESULTS In pregnancies that developed PE, compared to those without PE, the MoM values of UtA-PI and MAP were increased and those of PAPP-A and PlGF were decreased, and the deviation from normal was greater for early than late PE for all four biomarkers. Combined screening by maternal factors, UtA-PI, MAP and PlGF predicted 90% of early PE, 75% of preterm PE and 41% of term PE, at a screen-positive rate of 10%; inclusion of PAPP-A did not improve the performance of screening. The performance of screening depended on the racial origin of the women; on screening by a combination of maternal factors, MAP, UtA-PI and PlGF and using a risk cut-off of 1 in 100 for PE at < 37 weeks in Caucasian women, the screen-positive rate was 10% and detection rates for early, preterm and term PE were 88%, 69% and 40%, respectively. With the same method of screening and risk cut-off in women of Afro-Caribbean racial origin, the screen-positive rate was 34% and detection rates for early, preterm and term PE were 100%, 92% and 75%, respectively. CONCLUSION Screening by maternal factors and biomarkers at 11-13 weeks' gestation can identify a high proportion of pregnancies that develop early and preterm PE. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.
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Affiliation(s)
- M Y Tan
- King's College Hospital, London, UK
- King's College London, London, UK
| | | | - L C Poon
- King's College Hospital, London, UK
- King's College London, London, UK
| | | | | | - J L Delgado
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - R Akolekar
- Medway Maritime Hospital, Gillingham, UK
| | | | | | - S Galeva
- University Hospital Lewisham, London, UK
| | - U Ajdacka
- Southend University Hospital, Essex, UK
| | - F S Molina
- Hospital Universitario San Cecilio, Granada, Spain
| | - N Persico
- Ospedale Maggiore Policlinico, Milan, Italy
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | - E Greco
- Royal London Hospital, London, UK
| | | | - A Wright
- University of Exeter, Exeter, UK
| | - D Wright
- University of Exeter, Exeter, UK
| | - K H Nicolaides
- King's College Hospital, London, UK
- King's College London, London, UK
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Tan MY, Poon LC, Rolnik DL, Syngelaki A, de Paco Matallana C, Akolekar R, Cicero S, Janga D, Singh M, Molina FS, Persico N, Jani JC, Plasencia W, Greco E, Papaioannou G, Wright D, Nicolaides KH. Prediction and prevention of small-for-gestational-age neonates: evidence from SPREE and ASPRE. Ultrasound Obstet Gynecol 2018; 52:52-59. [PMID: 29704277 DOI: 10.1002/uog.19077] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To examine the effect of first-trimester screening for pre-eclampsia (PE) on the prediction of delivering a small-for-gestational-age (SGA) neonate and the effect of prophylactic use of aspirin on the prevention of SGA. METHODS The data for this study were derived from two multicenter studies. In SPREE, we investigated the performance of screening for PE by a combination of maternal characteristics and biomarkers at 11-13 weeks' gestation. In ASPRE, women with a singleton pregnancy identified by combined screening as being at high risk for preterm PE (> 1 in 100) participated in a trial of aspirin (150 mg/day from 11-14 until 36 weeks' gestation) compared to placebo. In this study, we used the data from the ASPRE trial to estimate the effect of aspirin on the incidence of SGA with birth weight < 10th , < 5th and < 3rd percentile for gestational age. We also used the data from SPREE to estimate the proportion of SGA in the pregnancies with a risk for preterm PE of > 1 in 100. RESULTS In SPREE, screening for preterm PE by a combination of maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor identified a high-risk group that contained about 46% of SGA neonates < 10th percentile born at < 37 weeks' gestation (preterm) and 56% of those born at < 32 weeks (early); the overall screen-positive rate was 12.2% (2014 of 16 451 pregnancies). In the ASPRE trial, use of aspirin reduced the overall incidence of SGA < 10th percentile by about 40% in babies born at < 37 weeks' gestation and by about 70% in babies born at < 32 weeks; in babies born at ≥ 37 weeks, aspirin did not have a significant effect on incidence of SGA. The aspirin-related decrease in incidence of SGA was mainly due to its incidence decreasing in pregnancies with PE, for which the decrease was about 70% in babies born at < 37 weeks' gestation and about 90% in babies born at < 32 weeks. On the basis of these results, it was estimated that first-trimester screening for preterm PE and use of aspirin in the high-risk group would potentially reduce the incidence of preterm and early SGA by about 20% and 40%, respectively. CONCLUSION First-trimester screening for PE by the combined test identifies a high proportion of cases of preterm SGA that can be prevented by the prophylactic use of aspirin. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.
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Affiliation(s)
- M Y Tan
- Kings College Hospital, London, UK
- Kings College London, London, UK
- University Hospital Lewisham, London, UK
| | - L C Poon
- Kings College London, London, UK
- Chinese University of Hong Kong, Hong Kong SAR
| | | | | | | | - R Akolekar
- Medway Maritime Hospital, Gillingham, UK
| | - S Cicero
- Homerton University Hospital, London, UK
| | - D Janga
- North Middlesex University Hospital, London, UK
| | - M Singh
- Southend University Hospital, Essex, UK
| | - F S Molina
- Hospital Universitario San Cecilio, Granada, Spain
| | - N Persico
- Ospedale Maggiore Policlinico, Milan, Italy
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | - E Greco
- Royal London Hospital, London, UK
| | | | - D Wright
- University of Exeter, Exeter, UK
| | - K H Nicolaides
- Kings College Hospital, London, UK
- Kings College London, London, UK
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Poon LC, Rolnik DL, Tan MY, Delgado JL, Tsokaki T, Akolekar R, Singh M, Andrade W, Efeturk T, Jani JC, Plasencia W, Papaioannou G, Blazquez AR, Carbone IF, Wright D, Nicolaides KH. ASPRE trial: incidence of preterm pre-eclampsia in patients fulfilling ACOG and NICE criteria according to risk by FMF algorithm. Ultrasound Obstet Gynecol 2018; 51:738-742. [PMID: 29380918 DOI: 10.1002/uog.19019] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/23/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To report the incidence of preterm pre-eclampsia (PE) in women who are screen positive according to the criteria of the National Institute for Health and Care Excellence (NICE) and the American College of Obstetricians and Gynecologists (ACOG), and compare the incidence with that in those who are screen positive or screen negative by The Fetal Medicine Foundation (FMF) algorithm. METHODS This was a secondary analysis of data from the ASPRE study. The study population consisted of women with singleton pregnancy who underwent prospective screening for preterm PE by means of the FMF algorithm, which combines maternal factors and biomarkers at 11-13 weeks' gestation. The incidence of preterm PE in women fulfilling the NICE and ACOG criteria was estimated; in these patients the incidence of preterm PE was then calculated in those who were screen negative relative to those who were screen positive by the FMF algorithm. RESULTS A total of 34 573 women with singleton pregnancy delivering at ≥ 24 weeks' gestation underwent prospective screening for preterm PE, of which 239 (0.7%) cases developed preterm PE. At least one of the ACOG criteria was fulfilled in 22 287 (64.5%) pregnancies and the incidence of preterm PE was 0.97% (95% CI, 0.85-1.11%); in the subgroup that was screen positive by the FMF algorithm the incidence of preterm PE was 4.80% (95% CI, 4.14-5.55%), and in those that were screen negative it was 0.25% (95% CI, 0.18-0.33%), with a relative incidence in FMF screen negative to FMF screen positive of 0.051 (95% CI, 0.037-0.071). In 1392 (4.0%) pregnancies, at least one of the NICE high-risk criteria was fulfilled, and in this group the incidence of preterm PE was 5.17% (95% CI, 4.13-6.46%); in the subgroups of screen positive and screen negative by the FMF algorithm, the incidence of preterm PE was 8.71% (95% CI, 6.93-10.89%) and 0.65% (95% CI, 0.25-1.67%), respectively, and the relative incidence was 0.075 (95% CI, 0.028-0.205). In 2360 (6.8%) pregnancies fulfilling at least two of the NICE moderate-risk criteria, the incidence of preterm PE was 1.74% (95% CI, 1.28-2.35%); in the subgroups of screen positive and screen negative by the FMF algorithm the incidence was 4.91% (95% CI, 3.54-6.79%) and 0.42% (95% CI, 0.20-0.86%), respectively, and the relative incidence was 0.085 (95% CI, 0.038-0.192). CONCLUSION In women who are screen positive for preterm PE by the ACOG or NICE criteria but screen negative by the FMF algorithm, the risk of preterm PE is reduced to within or below background levels. The results provide further evidence to support the personalized risk-based screening method that combines maternal factors and biomarkers. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- L C Poon
- King's College London, London, UK
- Chinese University of Hong Kong, Hong Kong SAR
| | | | - M Y Tan
- King's College Hospital, London, UK
- Lewisham University Hospital, London, UK
| | - J L Delgado
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - T Tsokaki
- King's College Hospital, London, UK
- North Middlesex University Hospital, London, UK
| | - R Akolekar
- King's College Hospital, London, UK
- Medway Maritime Hospital, Gillingham, UK
| | - M Singh
- King's College Hospital, London, UK
- Southend University Hospital, Essex, UK
| | | | - T Efeturk
- King's College Hospital, London, UK
- Homerton University Hospital, London, UK
| | - J C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | | | - A R Blazquez
- Hospital Universitario San Cecilio, Granada, Spain
| | | | - D Wright
- University of Exeter, Exeter, UK
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Dai L, Guo X, Huang HJ, Liao XM, Luo XQ, Li D, Zhou H, Gao XC, Tan MY. [Effects of exogenous high mobility group protein box 1 on angiogenesis in ischemic zone of early scald wounds of rats]. Zhonghua Shao Shang Za Zhi 2018; 34:219-224. [PMID: 29690740 DOI: 10.3760/cma.j.issn.1009-2587.2018.04.006] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe effects of exogenous high mobility group protein box 1 (HMGB1) on angiogenesis in ischemic zone of early scald wounds of rats. Methods: Thirty-six Sprague-Dawley rats were divided into HMGB1 group and simple scald (SS) group according to the random number table, with 18 rats in each group. Comb-like copper mould was placed on the back of rats for 20 s after being immersed in 100 ℃ hot water for 3 to 5 min to make three ischemic zones of wound. Immediately after scald, rats in HMGB1 group were subcutaneously injected with 0.4 μg HMGB1 and 0.1 mL phosphate buffer solution (PBS), and rats in SS group were subcutaneously injected with 0.1 mL PBS from boarders of ischemic zone of scald wound. At post scald hour (PSH) 24, 48, and 72, 6 rats in each group were collected. Protein expressions of vascular endothelial growth factor (VEGF) in ischemic zone of wound at PSH 24, 48, and 72 and protein expressions of CD31 in ischemic zone of wound at PSH 48 and 72 were detected by immunohistochemistry. The number of microvessel in CD31 immunohistochemical sections of ischemic zone of wound at PSH 48 and 72 was calculated after observing by the microscope. The mRNA expressions of VEGF and CD31 in ischemic zone of wound were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction at PSH 24, 48, and 72. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) At PSH 24, 48, and 72, protein expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=7.496, 4.437, 5.402, P<0.05 or P<0.01). At PSH 48 and 72, protein expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were 0.038 8±0.007 9 and 0.057 7±0.001 2 respectively, significantly higher than 0.013 4±0.004 9 and 0.030 3±0.004 0 of rats in SS group (t=10.257, 15.055, P<0.01). (2) At PSH 48 and 72, the number of microvessel in ischemic zone of wound of rats in HMGB1 group was obviously more than that of rats in SS group (t=3.536, 4.000, P<0.05). (3) At PSH 24, 48, and 72, mRNA expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.406, 3.821, 3.356, P<0.05). At PSH 24 and 48, mRNA expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.113, 3.466, P<0.05). At PSH 72, mRNA expressions of CD31 in ischemic zone of wound of rats in 2 groups were close (t=0.010, P>0.05). Conclusions: Exogenous HMGB1 can promote angiogenesis in ischemic zone of early scald wounds of rats by increasing expressions of VEGF and CD31.
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Affiliation(s)
- L Dai
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
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Tan MY, Koutoulas L, Wright D, Nicolaides KH, Poon LCY. Protocol for the prospective validation study: 'Screening programme for pre-eclampsia' (SPREE). Ultrasound Obstet Gynecol 2017; 50:175-179. [PMID: 28295773 DOI: 10.1002/uog.17467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 02/19/2017] [Accepted: 02/28/2017] [Indexed: 06/06/2023]
Abstract
Pre-eclampsia (PE), which affects about 2% of pregnancies, is a major cause of maternal and perinatal morbidity and mortality. Early detection of PE can improve pregnancy outcome by providing timely intervention and closer monitoring. The current guideline from the UK National Institute for Health and Care Excellence (NICE) recommends that, at the booking visit, women identified with one major risk factor or more than one moderate risk factor for PE should be advised to take low-dose aspirin daily from 12 weeks until delivery. However, performance of the current method of screening is poor and identifies only about 35% of PE. Extensive studies in the last decade have established that the best performance for early prediction of PE can be achieved by using a novel Bayes' theorem-based method that combines maternal characteristics and medical history together with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) at 11-13 weeks' gestation. This forms the 'combined test', which could be simplified to the 'mini combined test' when only maternal factors, MAP and PAPP-A are taken into consideration. We present the protocol (version 3.1, 14 November 2016) for the 'Screening programme for pre-eclampsia' (SPREE) study, a prospective multicenter cohort study that will be carried out in seven National Health Service maternity hospitals in England. Eligible pregnant women attending their routine scan at 11-13 weeks' gestation will be invited to participate in this study. Maternal characteristics and history and measurements of MAP, UtA-PI, serum PAPP-A and PlGF will be recorded according to standardized protocols. The patient-specific risk for PE will be calculated and data on pregnancy outcomes collected. We hypothesize that the first-trimester mini combined test and combined test for PE screening, using the Bayes' theorem-based method, are likely to be superior to the current method recommended by NICE that is based on maternal demographics and history alone. Enrollment for the study commenced in April 2016. The study is registered on the International Standard Randomised Controlled Trial Number (ISRCTN) registry. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Y Tan
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L Koutoulas
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - L C Y Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Huang YL, Tan MY, Jiang X, Li B, Chen QY, Jia XF, Tang CF, Liu JL, Liu L. [Genetic analysis of TPO, DUOX2 and DUOXA2 genes in children with permanent congenital hypothyroidism suspected dyshormonogenesis]. Zhonghua Er Ke Za Zhi 2017; 55:210-214. [PMID: 28273705 DOI: 10.3760/cma.j.issn.0578-1310.2017.03.009] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the TPO, DUOX2 and DUOXA2 genotypes and phenotypes of children with permanent congenital hypothyroidism(PCH) suspected dyshormonogenesis in Guangzhou, identified and treated at Guangzhou Newborn Screening Center. Six of them were born between 2011 and 2012. Method: Retrospectively analyzed the clinical data of 9 children with PCH suspected dyshormonogenesis. Genetic analysis of TPO, DUOX2 and DUOXA2 genes were performed with Sanger sequencing. Result: Of the 9 patients, four were identified variants in TPO gene including three cases with biallelic variants and one case with monoallelic variant. Novel c. 1784G>C( p. R595T) variant in TPO was predicted to be damaging by SIFT and PolyPhen-2. Four patients harbored monoallelic known variants in DUOX2 gene and the other one harbored heterozygous known mutation c. 738C>G(p.Y246X) in DUOXA2 gene.Two adolescent patients with biallelic variants in TPO gene showed classical PCH phenotypes with thyroid goiter or nodules. The six patients with monoallelic variant in TPO, DUOX2 or DUOXA2 presented variable phenotypes. Among the 433 578 newborns in the 2011-2012 cohort, there were 156 cases of CH. Six of these cases were PCH suspected dyshormonogenesis, among which 1 case was confirmed TPO biallelic variants and 5 cases were monoallelic variants of TPO, DUOX2, or DUOXA2 genes. Conclusion: TPO and DUOX2 variants are the common molecular pathogenesis in children with PCH suspected dyshormonogenesis. Monoallelic variants in TPO, DUOX2 or DUOXA2 are associated with PCH and showed wide variability in their phenotypes. The novel variant p. R595T in TPO is probably a pathologic variant. The prevalence of PCH caused by TPO gene defects is rare in Guangzhou.
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Affiliation(s)
- Y L Huang
- Department of Guangzhou Newborn Screening Center, Guangzhou Women and Children's Medical Center, Guangzhou 510180, China
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Tan MY, Wright D, Koutoulas L, Akolekar R, Nicolaides KH. Comparison of screening for pre-eclampsia at 31-34 weeks' gestation by sFlt-1/PlGF ratio and a method combining maternal factors with sFlt-1 and PlGF. Ultrasound Obstet Gynecol 2017; 49:201-208. [PMID: 27671370 DOI: 10.1002/uog.17307] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To estimate the patient-specific risk of pre-eclampsia (PE) at 31-34 weeks' gestation by a combination of maternal characteristics and medical history with multiples of the median (MoM) values of serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFlt-1) and to compare the performance of screening to that achieved by the sFlt-1/PlGF ratio. METHODS This was a prospective observational study in women attending a third-trimester ultrasound scan at 31-34 weeks as part of routine pregnancy care. We estimated the performance of screening for PE with delivery within 4 weeks of assessment and PE with delivery from 4 weeks after assessment up to 40 weeks' gestation by the sFlt-1/PlGF ratio and by a method utilizing Bayes' theorem that combines maternal factors and MoM values of sFlt-1 and PlGF. The significance of the difference in screening performance between the two methods was assessed by comparison of the areas under the receiver-operating characteristics curves (AUC). RESULTS The study population of 8063 singleton pregnancies included 231 (2.9%) that subsequently developed PE. In the prediction of delivery with PE at < 4 weeks from assessment, the performance of the method utilizing Bayes' theorem was similar to that using the sFlt-1/PlGF ratio (AUC, 0.987 (95% CI, 0.979-0.995) vs 0.988 (95% CI, 0.981-0.994); P = 0.961). In contrast, the performance of screening for delivery with PE at ≥ 4 weeks after assessment up to 40 weeks' gestation was better with the method utilizing Bayes' theorem than that with the sFlt-1/PlGF ratio (AUC, 0.884 (95% CI, 0.854-0.914) vs 0.818 (95% CI, 0.775-0.860); P < 0.0001). CONCLUSION At 31-34 weeks' gestation the performance of screening for PE delivering at < 4 weeks from assessment by the method utilizing Bayes' theorem is similar to that using the sFlt-1/PlGF ratio, but the former is superior to the latter in prediction of PE delivering ≥ 4 weeks from assessment. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Y Tan
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - L Koutoulas
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Fetal Medicine, Medway Maritime Hospital, Gillingham, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Abstract
The rabbit left anterior descending coronary artery is not macroscopically apparent; this often leads to failure in creation of an acute myocardial infarction
(AMI) model. In order to devise a simple method with good reproducibility and high success rate for use as a rabbit AMI model, a new surgical technique was
developed, in which the obtuse marginal (OM) branch of the left circumflex coronary artery was coagulated with an electric knife using a left parasternal
approach. Four weeks after OM branch coagulation, an electrocardiogram (ECG), blood biochemistry analysis, echocardiographic measurements and pathologic
analysis were performed. The left parasternal approach provided the surgeon clear visualization of the targeted blood vessel to accurately identify the proper
site to occlude. The successful development of AMI was confirmed by ST segment elevation on the ECG, by high levels of AMI-related markers in blood samples, by
cardiac functional damage reflected on echocardiographic images and by changes in pathological sections. Furthermore, an acceptable success rate and low
mortality were achieved. Hence, this surgical technique was suggested to be a highly reliable and reproducible method to induce AMI in rabbits for the
assessment of new therapeutic interventions or regenerative approaches.
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Affiliation(s)
- Mei-Yun Tan
- Department of Bone and Joint Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
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Poon LCY, Tan MY, Yerlikaya G, Syngelaki A, Nicolaides KH. Birth weight in live births and stillbirths. Ultrasound Obstet Gynecol 2016; 48:602-606. [PMID: 27854393 DOI: 10.1002/uog.17287] [Citation(s) in RCA: 98] [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] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 08/18/2016] [Accepted: 08/31/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To establish a normal range of birth weights for gestational age at delivery and to compare the proportion of live births and stillbirths that are classified as small-for-gestational age (SGA) according to our normal range vs that of the INTERGROWTH-21st standard. METHODS The study population comprised 113 019 live births and 437 (0.4%) stillbirths. The inclusion criterion for establishing a normal range of birth weights for gestational age was the live birth of a phenotypically normal neonate ≥ 24 weeks' gestation and the exclusion criteria were smoking and prepregnancy hypertension, diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, pre-eclampsia, gestational hypertension, gestational diabetes mellitus or iatrogenic preterm birth for fetal growth restriction in the current pregnancy. Inclusion criteria were met by 92 018 live births. The proportions of live births and stillbirths with birth weights < 5th and < 10th percentiles of our normal range and those according to the INTERGROWTH-21st standard were determined and compared by the chi-square test and McNemar test. RESULTS The proportions of live births and stillbirths with a birth weight < 5th percentile according to our standard were significantly higher than and discordant with the proportion according to the INTERGROWTH-21st standard (live birth: 5.6% vs 3.4%; stillbirth: 37.2% vs 22.7%). Similarly, the proportion of live births and stillbirths with a birth weight < 10th percentile according to our standard were significantly higher than and discordant with those according to the INTERGROWTH-21st standard (live birth: 11.2% vs 6.9%; stillbirth: 44.3% vs 32.6%). CONCLUSION The INTERGROWTH-21st standard underestimates the proportion of SGA live births and stillbirths in our population. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- L C Y Poon
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - M Y Tan
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Yerlikaya
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - A Syngelaki
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Guo X, Xia B, Lu XB, Zhang ZJ, Li Z, Li WL, Xiong AB, Deng L, Tan MY, Huang YC. Grafting of mesenchymal stem cell-seeded small intestinal submucosa to repair the deep partial-thickness burns. Connect Tissue Res 2016; 57:388-97. [PMID: 27485758 DOI: 10.1080/03008207.2016.1193173] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Regenerative medicine provides many treatments for burn wounds, of which cell-seeded substitutes are encouraging for large and deep burns. To assess the feasibility of mesenchymal stem cell (MSC)-seeded small intestinal submucosa (SIS) to repair the deep partial-thickness burns, a rat study was performed. MATERIALS & METHODS The burn model was created by contacting the dorsal surface directly with boiled water for 10 seconds. MSCs at passage 3 were seeded on the SIS before implantation. Three days after burn injury, the grafts were implanted onto the burn area. At 3, 7, 14 and 21 days post implantation, gross observation and histological assessments were performed. RESULTS SIS alone and MSC-seeded SIS were able to accelerate the burn wound closure by enhancing granulation tissue formation, increasing wound maturity, improving revascularization, and inducing the proliferation of neo-epidermal cells. Additionally, MSC-seeded SIS was much more effective than SIS alone for the repair of deep partial-thickness burns. CONCLUSION Both SIS and MSC-seeded SIS were able to repair the large and deep burn wounds and the loaded MSCs possessed positive effects to accelerate the wound closure in a rat model.
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Affiliation(s)
- Xing Guo
- a Department of Burns and Plastic Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Bo Xia
- b Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Xiao-Bo Lu
- b Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Zhong-Jie Zhang
- b Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Zhong Li
- b Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Wei-Ling Li
- c Department of Oncology , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Ai-Bing Xiong
- a Department of Burns and Plastic Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Li Deng
- d Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy , West China Hospital, Sichuan University , Chengdu , China
| | - Mei-Yun Tan
- b Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , Luzhou , China
| | - Yong-Can Huang
- e Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Hong Kong SAR , China.,f Shenzhen Engineering Laboratory of Orthopaedic Regenerative Technologies , Orthopaedics Research Center, Peking University Shenzhen Hospital , Shenzhen , China
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Abstract
Abstract
Background: Mammography is the only clinically acceptable imaging modality in current population-based breast cancer screening, but it has a relatively low sensitivity in detecting early cancers. Although breast magnetic resonance imaging (MRI) is much more sensitive in detecting early or mammography-occult cancers, the low cancer detection yield in the general screening population (∼1%) prohibits breast MRI as a screening tool with wide applicability. In order to solve this clinical dilemma, in this preliminary study, we tested the potential of applying a new mammographic image feature analysis model that serves as a short-term breast cancer risk prediction model to identify women at high risk of harboring mammography-occult breast cancers, which can be detected by breast MRI.
Methods: An image dataset involving 30 women who had both mammography and breast MRI screening examinations was retrospectively assembled. All mammograms were interpreted as negative by the radiologists during the original image interpretation. When applying breast MRI examinations to these women immediately following the negative mammography, 5 women were positive with cancer detected and 25 remained negative. We developed a computer-aided detection scheme to process the bilateral CC view mammograms of the left and right breasts. Ten (10) texture-based mammographic image features were computed and compared from the bilateral mammograms. These features were then fused to build a new artificial neural network (ANN) based risk model. Based on the threshold of 0.5 applying to the ANN-generated risk prediction scores (ranging from 0 to 1), we stratified these 30 women into two groups with high and low risk of harboring mammography-occult cancer.
Results: Using the ANN-generated risk scores, 9 and 21 cases were assigned to high-risk and low-risk group, respectively. All 5 breast MRI-detected cancer cases were classified into the high-risk group (with 100% sensitivity), while 4 negative cases were also classified into the high-risk group resulting in a 16% false-positive rate (4/25). All 21 cases in the low-risk group were negative cases. Hence, our risk prediction model yielded an overall prediction accuracy of 86.7% in which 26 of 30 cases were correctly classified. The potential clinical impact is that based on the case stratification result, the maximum cancer detection yield of using breast MRI is 56% (5/9) in this dataset. Meanwhile, it can also eliminate 84% (21/25) unnecessary (negative) breast MRI screening examinations.
Conclusions: This is the first study, which demonstrated that by computing and analyzing the variation of mammographic image features, we are able to develop a new quantitative image feature analysis model that can be applied to predict the short-term risk of a woman having a mammography-occult cancer that can be detected by breast MRI. This new strategy has the potential to significantly increase cancer detection yield of breast MRI and thus make breast MRI a more cost-effective imaging modality in breast cancer screening.
Citation Format: Zheng B, Hollingsworth AB, Tan MY, Stough RG, Liu H. Improving efficacy of applying breast MRI to detect mammography-occult breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-02-06.
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Affiliation(s)
- B Zheng
- University of Oklahoma, Norman, OK; Mercy Health Center, Oklahoma City, OK
| | - AB Hollingsworth
- University of Oklahoma, Norman, OK; Mercy Health Center, Oklahoma City, OK
| | - MY Tan
- University of Oklahoma, Norman, OK; Mercy Health Center, Oklahoma City, OK
| | - RG Stough
- University of Oklahoma, Norman, OK; Mercy Health Center, Oklahoma City, OK
| | - H Liu
- University of Oklahoma, Norman, OK; Mercy Health Center, Oklahoma City, OK
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Xie HL, Zhang Y, Huang YZ, Li S, Wu CG, Jiao XF, Tan MY, Huang YC, Deng L. Regulation of high mobility group box 1 and hypoxia in the migration of mesenchymal stem cells. Cell Biol Int 2014; 38:892-7. [PMID: 24687575 DOI: 10.1002/cbin.10279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 02/20/2014] [Indexed: 02/05/2023]
Abstract
Mesenchymal stem cells (MSCs) have been increasingly offered for tissue regeneration with the premise that they can survive and thrive amidst the microenvironment of injured or degenerate tissues. The role of high mobility group box 1 (HMGB1) and hypoxia in the proliferation and migration of rat bone marrow MSCs (rBM-MSCs) has been investigated. First, the effect of HMGB1 on the proliferation of rBM-MSCs was determined. Second, to evaluate the regulation of hypoxia and HMGB1 in the migration of rBM-MSCs, cells in the wound healing model were exposed to four conditions: normoxia (20% O2) and complete medium, normoxia and HMGB1, hypoxia (1% O2) and complete medium, hypoxia and HMGB1. RT-PCR and Western blotting were used to measure the expression of migration-related genes and proteins. HMGB1 inhibited the proliferation of rBM-MSCs; HMGB1 alone or together with hypoxia and promoted the migration of MSCs and upregulated the expression of HIF-1α and SDF-1. These results demonstrated that HMGB1 arrested the proliferation of rBM-MSCs, but enhanced the migration of rBM-MSCs which could be further improved by hypoxia. This study strengthens current understanding of the interaction between MSCs and the microenvironment of damaged tissues.
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Affiliation(s)
- Hong-Lei Xie
- Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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17
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Ang CH, Tan MY, Teo C, Seah DW, Chen JC, Chan MYP, Tan EY. Blue dye is sufficient for sentinel lymph node biopsy in breast cancer. Br J Surg 2014; 101:383-9; discussion 389. [PMID: 24492989 DOI: 10.1002/bjs.9390] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND Most previous studies have reported superior results when blue dye and radiocolloids were used together for sentinel lymph node (SLN) biopsy in early breast cancer. Blue dye was reported to perform poorly when used alone, although more recent studies have found otherwise. This study reviewed the authors' practice of performing SLN biopsy with blue dye alone. METHODS This was a retrospective review of patients who underwent SLN biopsy using blue dye alone from 2001 to 2005, when SLN biopsy was performed selectively and always followed by axillary lymph node dissection (ALND), and from 2006 to 2010, when SLN biopsy was offered to all suitable patients and ALND done only when the SLN was not identified or positive for metastasis. RESULTS Between 2001 and 2005, 170 patients underwent SLN biopsy with blue dye alone. The overall SLN non-identification rate was 8·4 per cent. The overall false-negative rate was 34 per cent, but decreased with each subsequent year to 13 per cent in 2005. From 2006 to 2010, 610 patients underwent SLN biopsy with blue dye alone. The SLN was not identified in 12 patients (2·0 per cent) and no significant contributing factor was identified. A median of 2 (range 1-11) SLNs were identified. A non-SLN was found to be positive for metastasis in two patients with negative SLNs. Axillary nodal recurrence developed in one patient; none developed internal mammary nodal recurrence. Anaphylaxis occurred in one patient. CONCLUSION Blue dye performed well as a single modality for SLN biopsy. Non-identification, axillary nodal recurrence and serious allergic reactions were uncommon.
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Affiliation(s)
- C H Ang
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
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18
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Tan B, Wei RQ, Tan MY, Luo JC, Deng L, Chen XH, Hou JL, Li XQ, Yang ZM, Xie HQ. Tissue engineered esophagus by mesenchymal stem cell seeding for esophageal repair in a canine model. J Surg Res 2013; 182:40-8. [PMID: 22925499 DOI: 10.1016/j.jss.2012.07.054] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 06/20/2012] [Accepted: 07/20/2012] [Indexed: 02/05/2023]
Abstract
PURPOSE Acellular porcine small intestinal submucosa (SIS) has been successfully used for esophagoplasty in dogs. However, this has not led to complete epithelialization and muscular regeneration. We undertook the present study to assess the effect of tissue-engineered esophagus generated by seeding bone marrow mesenchymal stem cells (BMSCs) onto an SIS scaffold (BMSCs-SIS) in a canine model. METHODS We cultured, passaged, and measured autologous BMSCs and myoblasts with cell proliferation and immunohistochemical assays. We labeled the third passage of BMSCs with PKH-26, a fluorescent dye, before seeded it onto the SIS. We resected canine cervical esophagus to generate a defect 5 cm in length and 50% in circumference, which we repaired with BMSCs-SIS or SIS alone. RESULTS Four weeks later, barium esophagram demonstrated that esophageal lumen surface of the patch graft was smoother in the BMSCs-SIS group compared with the SIS group. Histological examination suggested a strong similarity between BMSCs and esophageal myoblasts in terms of morphology and function. Although both BMSCs-SIS and SIS repaired the esophageal defects, we noted complete re-epithelialization with almost no inflammation only in the former group. By 12 wk after the surgery, we observed long bundles of skeletal muscles only in the BMSCs-SIS group, where the microvessel density was also much greater. CONCLUSIONS Bone marrow mesenchymal stem cells on an SIS scaffold can promote re-epithelialization, revascularization, and muscular regeneration. This approach may provide an attractive option for esophageal regeneration.
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Affiliation(s)
- Bo Tan
- Laboratory of Stem Cell and Tissue Engineering, Regenerative Medicine Research Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, PR China
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Tan MY, Magarey JM, Chee SS, Lee LF, Tan MH. A brief structured education programme enhances self-care practices and improves glycaemic control in Malaysians with poorly controlled diabetes. Health Educ Res 2011; 26:896-907. [PMID: 21715653 DOI: 10.1093/her/cyr047] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We assessed the effectiveness of a brief structured diabetes education programme based on the concept of self-efficacy on self-care and glycaemic control using single-blind study design. One hundred and sixty-four participants with poorly controlled diabetes from two settings were randomized using computer-generated list into control (n = 82) and intervention (n = 82) groups, of which 151 completed the study. Monthly interventions over 12 weeks addressed the self-care practices of diet, physical activity, medication adherence and self-monitoring of blood glucose (SMBG). These self-care practices were assessed at Weeks 0 and 12 using pre- and post-questionnaires in both groups together with glycated haemoglobin A1c (HbA1c) and diabetes knowledge. In the intention-to-treat analysis (n = 164), the intervention group improved their SMBG (P = <0.001), physical activity (P = 0.001), HbA1c (P = 0.03), diabetes knowledge (P = <0.001) and medication adherence. At Week 12, HbA1c difference adjusted for SMBG frequency, medication adherence and weight change remained significant (P = 0.03) compared with control group. For within group comparisons, diabetes knowledge (P = <0.001), HbA1c level (P = <0.001), SMBG (P = <0.001) and medication adherence (P = 0.008) improved from baseline in the intervention group. In the control group, only diabetes knowledge improved (P = <0.001). These findings can contribute to the development of self-management diabetes education in Malaysia.
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Affiliation(s)
- M Y Tan
- Department of Nursing, Damai Medical and Heart Clinic, Melaka 75300, Malaysia.
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20
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Wei RQ, Tan B, Tan MY, Luo JC, Deng L, Chen XH, Li XQ, Zuo X, Zhi W, Yang P, Xie HQ, Yang ZM. Grafts of porcine small intestinal submucosa with cultured autologous oral mucosal epithelial cells for esophageal repair in a canine model. Exp Biol Med (Maywood) 2009; 234:453-61. [PMID: 19176869 DOI: 10.3181/0901-rm-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [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: 01/12/2023] Open
Abstract
The acellular porcine small intestinal submucosa (SIS) has been successfully used for esophagoplasty. However, it does not lead to a complete epithelialization in a canine model. A cellular component may be required for better reconstruction. The present study was undertaken to investigate the feasibility and effectiveness of the combination of SIS and autologous oral mucosal epithelial cells (OMECs) for esophageal reconstruction. The OMECs harvested from beagle dogs were cultured and propagated, and the 3rd passage cells were seeded on a single-layer SIS. Male beagle dogs were subjected to surgical resection to produce cervical esophageal defects (5 cm in length, 180 degrees in range). SIS with or without OMECs was patched on the esophageal defects. Barium esophagram, immunohistochemistry, and histology were performed to evaluate the therapeutic effectiveness. Four weeks after surgery, the histological examination showed a complete re-epithelialization and almost no inflammation in the SIS with OMECs group. But in the SIS group, only a partial epithelialization was observed along with inflammation. Eight weeks after surgery, the squamous epithelium was found to cover the entire graft surface in both groups; however, the muscular regeneration was observed in the SIS with OMECs, but not in the SIS group. The graft of SIS combined with autologous OMECs promotes re-epithelialization and muscular regeneration. It is an effective alternative method for esophageal repair.
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Affiliation(s)
- Ren-Qian Wei
- Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
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Guo X, Tan MY, Xiong AB, Guo L. [Effect of rheum on gastrointestinal hormones in rats with severe scald injury]. Zhonghua Shao Shang Za Zhi 2008; 24:111-113. [PMID: 18785410] [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: 05/26/2023]
Abstract
OBJECTIVE To observe the changes in motilin (MTL), substance P (SP), vasoactive intestinal peptide (VIP) and somatostatin (SS) in plasma of rats with severe scald injury at early stage and the effect of rheum on their changes. METHODS Eighty-eight Wistar rats were randomly divided into normal control group (NC, n = 8), scald group (S, gavage of distilled water after full-thickness scald, n = 40), therapeutic group (T, gavage of rheum solution after full-thickness scald, n = 40). The blood samples were harvested from inferior vena cava at 6, 12, 24, 48, 72 post scald hours (PSH) to determine the levels of MTL, SS, SP and VIP with radioimmunoassay. RESULTS (1) The levels of MTL and SP were (198 +/- 28), (61 +/- 10) ng/L, respectively, in NC group. The levels of MTL and SP in S group reached their minimum values [(110 +/- 15), (30 +/- 5) ng/L, respectively] at 6 PSH, then ascended slowly, peaked at 72 PSH but still lower than those in NC group (P < 0.05). The levels of MTL and SP slowly descended in T group, reached normal levels at 48 PSH, and obviously higher than those in NC group at 72 PSH [(232 +/- 32), (73 +/- 11) ng/ L, respectively, P < 0.05], which were higher than those in S group at 6 -72 PSH. (2) The levels of VIP and SS were (35 +/- 6), (30 +/- 5) ng/L, respectively, in NC group. The levels of VIP and SS in S group were (70 +/- 12), (49 +/- 9) ng/L at 6 PSH, which were obviously higher than those in NC group (P < 0.01), then descended slowly, but still higher than normal level at 72 PSH (P < 0.05). The levels of VIP and SS in T group ascended slowly, reached the normal level at 48 PSH, which were lower than those in S group at each time points, and VIP reached peak value at 12 PSH. CONCLUSION Rheum may regulate secretion and release of gastrointestinal hormones to plasma in rats with severe scald injury at early stage.
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Affiliation(s)
- Xing Guo
- Department of Burns and Plastic Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou 646000, PR China
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Jansen MA, van den Noort RE, Tan MY, Prinsen E, Lagrimini LM, Thorneley RN. Phenol-oxidizing peroxidases contribute to the protection of plants from ultraviolet radiation stress. Plant Physiol 2001; 126:1012-23. [PMID: 11457952 PMCID: PMC116458 DOI: 10.1104/pp.126.3.1012] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2000] [Revised: 01/12/2001] [Accepted: 03/20/2001] [Indexed: 05/18/2023]
Abstract
We have studied the mechanism of UV protection in two duckweed species (Lemnaceae) by exploiting the UV sensitivity of photosystem II as an in situ sensor for radiation stress. A UV-tolerant Spirodela punctata G.F.W. Meyer ecotype had significantly higher indole-3-acetic acid (IAA) levels than a UV-sensitive ecotype. Parallel work on Lemna gibba mutants suggested that UV tolerance is linked to IAA degradation rather than to levels of free or conjugated IAA. This linkage is consistent with a role for class III phenolic peroxidases, which have been implicated both in the degradation of IAA and the cross-linking of various UV-absorbing phenolics. Biochemical analysis revealed increased activity of a specific peroxidase isozyme in both UV-tolerant duckweed lines. The hypothesis that peroxidases play a role in UV protection was tested in a direct manner using genetically modified tobacco (Nicotiana sylvestris). It was found that increased activity of the anionic peroxidase correlated with increased tolerance to UV radiation as well as decreased levels of free auxin. We conclude that phenol-oxidizing peroxidases concurrently contribute to UV protection as well as the control of leaf and plant architecture.
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Affiliation(s)
- M A Jansen
- Department of Biological Chemistry, John Innes Centre, Norwich Research Park, Norwich NR4 7UH, United Kingdom.
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Chen DY, Lu MS, Tan MY. [Clinical study on treatment of protracted pain by continuously administering different dose of fentanyl by ocupoint embedding micropump]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2001; 21:431-2. [PMID: 12577438] [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: 02/28/2023]
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Abstract
Although praziquantel (PZQ) is the primary drug of choice in the treatment of schistosomiasis, its poor solubility has restricted its delivery via the oral route. In spite of its poor solubility, PZQ is well absorbed across the gastrointestinal tract, but large doses are required to achieve adequate concentrations at the target sites. Improving the solubility would enable the parenteral route to be used, thereby avoiding significant first pass metabolism. The aqueous solubility of PZQ was improved by forming inclusion complexes with alpha-, beta- and gamma-cyclodextrins (CDs). These complexes were assessed and confirmed by solubility analysis, Fourier transform infrared analysis, elemental analysis, differential scanning calorimetry and mass spectrometry. Dissolution of PZQ from the alpha-, beta- and gamma-CD complexes was 2.6-, 5- and 8-fold greater, respectively, than that of the pure drug. However, only the beta-complex had a stability constant in the optimum range for pharmaceutical use, suggesting that the preferred complex for further development would be a water-soluble beta-CD derivative.
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Affiliation(s)
- G Becket
- School of Pharmacy, University of Otago, P.O. Box 913, Dunedin, New
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25
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Tan MY, Seow KH, Tay BK. The Mitchell distal metatarsal osteotomy for hallux valgus--the Singapore General Hospital experience. Singapore Med J 1998; 39:547-50. [PMID: 10067399] [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: 02/11/2023]
Abstract
BACKGROUND Fifty-five Mitchell distal metatarsal osteotomies for hallux valgus performed over a period of four years have been retrospectively reviewed. The 38 patients were followed for an average of 30 months (range 12 to 60 months). RESULTS The preoperative hallux valgus angle averaged 30.9 degrees +/- 8.2 degrees SD (range 18 degrees to 60 degrees) and the postoperative angle averaged 12.2 degrees +/- 4.6 degrees (range 5 degrees to 20 degrees). CONCLUSION Ninety-two percent of the patients were satisfied with the result of the procedure. They stated that, given the identical situation, they would undergo the operation again.
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Affiliation(s)
- M Y Tan
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
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Tan MY, Seow KH, Tay BK. Chevron osteotomy for hallux valgus--SGH experience. Med J Malaysia 1998; 53:63-9. [PMID: 10968140] [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: 02/17/2023]
Abstract
Thirty-one chevron osteotomies for hallux valgus performed over a period of four years were reviewed. Their follow-up period ranged from one to five years. All the patients had pain over the bunion prior to operation. After operation, there was marked decrease of pain over the first matatarsophalangeal joint. The preoperative hallux valgus angle average 27 degrees and the postoperative angle averaged 12 degrees. The preoperative intermetatarsal angle averaged 13 degrees and the postoperative angle, 8 degrees. Ninety-one per cent of the patients were satisfied with the result of the procedure.
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Affiliation(s)
- M Y Tan
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
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Tan MY, Yeo SJ, Tay BK. Anterior cruciate ligament reconstruction using patellar tendon autografts--a review of results. Singapore Med J 1997; 38:529-34. [PMID: 9550920] [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: 02/07/2023]
Abstract
AIM The aim of this retrospective study was to review the results of anterior cruciate ligament reconstruction using patellar tendon autografts. METHODS Forty-one knees were available for evaluation at a minimum of 24 months follow-up. Objective, subjective, functional and KT-1000 arthrometric tests were performed. RESULTS 92.7% had a negative or trace pivot shift at follow-up. None of the patients had rupture of the autografts at review. The mean post-operative single-legged hop was 81%. The KT-1000 arthrometric evaluation post-operatively revealed a mean maximum manual difference of 0.5 mm; 90.2% of these patients had a maximum manual difference of less than 4 mm. Five patients (12.2%) had a "tighter" reconstructed knee (a negative mean maximum manual difference). More than 70% of the patients in this series had good to excellent results on functional, subjective and objective evaluation scores. CONCLUSION Excellent motion recovery, reliable stabilisation rates, good arthrometric results and encouraging post-operative functional, subjective and objective evaluation scores can be expected in patients undergoing anterior cruciate ligament reconstruction with patellar tendon autografts.
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Affiliation(s)
- M Y Tan
- Department of Orthopaedic Surgery Singapore General Hospital, Singapore
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28
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Wang ZZ, Su ZW, Li CG, Zheng HC, Tan MY, Wang ZS. [Pharmacognostical identification and investigation of commercial product of traditional Chinese drug jiuyanduhuo]. Zhongguo Zhong Yao Za Zhi 1994; 19:707-9, 761. [PMID: 7718129] [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: 01/26/2023]
Abstract
Through investigation on original plants and commercial products of the traditional Chinese drug Jiuyanduhuo, the authors have ascertained its botanical origin and present medicinal usage, and found out that Aralia cordata is the main species of Jiuyanduhuo, and A. fargesii is another species that has come into use due to short supply of the main species, and A. henyri is used only in Sichuan and Hubei Provinces. Principal identification features of the original plants and crude drugs with 2 keys have been given, and TLC identification for 3 kinds of Jiuyanduhuo have also been carried out.
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Affiliation(s)
- Z Z Wang
- Department of Pharmacognosy, Second Military Medical University, Shanghai
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Tan MY, Low CK, Tan SK. De Quervain's tenosynovitis and ganglion over first dorsal extensor retinacular compartment. Ann Acad Med Singap 1994; 23:885-6. [PMID: 7741505] [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: 01/26/2023]
Abstract
Between 1988 to 1991, 80 cases of de Quervain's disease were managed at the Department of Orthopaedic Surgery, Singapore General Hospital. Six of them had an associated ganglion over the first dorsal retinacular compartment. Five out of 6 cases had intracompartment injections of hydrocortisone and lignocaine but the treatment was not effective in relieving the pain of de Quervain's tenosynovitis. All 6 cases had excision of the ganglion and decompression of the first extensor compartment. All the lumps were found arising from the dorsal aspect of the retinaculum and no intracompartment extension of the ganglion was found.
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Affiliation(s)
- M Y Tan
- Department of Orthopaedic Surgery 'O' Unit, Singapore General Hospital
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Lu TB, Tang N, Tan MY, Liu Y, Yu KB, Inoue Y, Hakushi T. Studies on Crown Ether Complexes. XXXI. Synthesis, Properties and Structure of the Complexes of Lighter Lanthanide Nitrates With (Z)-2,3-Diphenyl-1,4,7,10,13-pentaoxacyclopentadec-2-ene (Stilbeno-15-crown-5). Aust J Chem 1993. [DOI: 10.1071/ch9931817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Complexes of the lighter lanthanide nitrates with stilbeno-15-crown-5 (L) have been prepared in ethyl acetate. These new complexes with the general formula Ln (NO3)3.L.H2O ( Ln = La, Ce , Pr, Nd ) have been characterized by means of elemental analyses, i.r . spectra, 1H n.m.r. spectra and conductivity measurements. The crystal structure of La(NO3)3.L has been determined by X-ray methods, and refined to a residual R 0.0513 for 4937 independent reflections with I ≥ 1.5σ(I). It crystallizes in the monoclinic space group P21/a with a 16.090(5), b 15.654(8), c
22.687(2) Ǻ, β 93.96(4)°, V 5700(4)Ǻ3, and Z 8. There are two independent La(NO3)3.L monomers in one asymmetric unit; in each the coordination number is 11.
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Tan LT, Tan MY, Veith I. Acupuncture therapy: current Chinese practice. Geriatrics (Basel) 1973; 28:97-102. [PMID: 4721745] [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: 01/12/2023] Open
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