1
|
Liu MN, Au M, Bishara M, Worland T, Con D, Chew S, McNiece A, Gronbaek H, Sluka P, Nicoll AJ. Serum interleukin-4 is elevated in clinical drug-induced liver injury. Scand J Gastroenterol 2023; 58:1499-1504. [PMID: 37464727 DOI: 10.1080/00365521.2023.2237154] [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: 04/08/2023] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Drug-induced liver injury (DILI) remains a challenging diagnosis due to an absence of specific biomarkers. DILI due to volatile anaesthetics (VA-DILI) is characterised by trifluoroacetyl and CYP2E1 antibodies, but may not be seen for weeks after injury. Interleukin-4 (IL-4) may be involved in the production of these antibodies and may serve as a clinically useful early biomarker of VA-DILI. AIM To prospectively compare serum IL-4 levels between patients who develop VA-DILI and controls following exposure to the volatile anaesthetic. METHODS A nested case-control study of patients exposed to VA during surgery was conducted. Thirteen DILI cases were identified from the original cohort, and 26 controls were matched according to age, sex and VA agent. Serum samples were collected before and 48-96 h after VA exposure, and analysed for IL-4 using quantitative enzyme-linked immunosorbent assay techniques. RESULTS There was a statistically significant difference in serum IL-4 in post-VA samples between DILI cases and controls (control: 0.030 pg/mL, IQR: 0.030 - 0.030 pg/mL vs DILI: 0.044 pg/mL, IQR: 0.030 - 0.061 pg/mL; p = 0.039). A greater proportion of DILI cases had post-VA IL-4 levels above the assay lower limit of detection compared to controls (control: 23% vs DILI: 69%; p = 0.013). CONCLUSION IL-4 is a potential biomarker of DILI. Clinical diagnosis and understanding of DILI disease mechanisms may be improved by further investigation of novel biomarkers, and this IL-4 signal in serum is important as proof of concept for prospective study designs.
Collapse
Affiliation(s)
- M N Liu
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - M Au
- Department of Gastroenterology, Eastern Health, Box Hill, VIC, Australia
| | - M Bishara
- Department of Gastroenterology, Eastern Health, Box Hill, VIC, Australia
| | - T Worland
- Department of Gastroenterology, Eastern Health, Box Hill, VIC, Australia
| | - D Con
- Department of Gastroenterology, Eastern Health, Box Hill, VIC, Australia
| | - S Chew
- Department of Anaesthetics, Eastern Health, Box Hill, VIC, Australia
| | - A McNiece
- Department of Anaesthetics, Eastern Health, Box Hill, VIC, Australia
| | - H Gronbaek
- Department of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark
| | - P Sluka
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - A J Nicoll
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
- Department of Gastroenterology, Eastern Health, Box Hill, VIC, Australia
| |
Collapse
|
2
|
Niederer RL, Wong ABC, Ma T, Chew S, Sims J. Predictors of glaucoma in patients with uveitis and scleritis. Eye (Lond) 2023; 37:1254-1257. [PMID: 35610358 PMCID: PMC10101954 DOI: 10.1038/s41433-022-02101-7] [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] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 03/28/2022] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To examine risk factors for development of glaucoma in a large cohort of subjects with uveitis and scleritis. METHODS Retrospective review of subjects diagnosed with uveitis or scleritis between 2006 and 2019 at Auckland District Health Board. Subjects were excluded if they had glaucoma due to another cause. Main outcome measure was development of glaucoma. Data for local steroid use was not available. RESULTS 3462 eyes of 2414 subjects were included in the study. Mean follow-up was 5.7 years (total follow-up time 19,897 eye years). Median age was 44.3 years and 1189 (49.3%) were female. Glaucoma developed in 222 eyes (6.3%) during the follow-up. Five-year cumulative risk of glaucoma was 6.2% (CI 5.0-7.5%) for anterior uveitis, 5.4% (CI 3.2-9.0%) for intermediate uveitis, 1.6% (CI 0.4-6.7%) for posterior uveitis, 8.7% (CI 6.5-11.7%) for panuveitis, and 3.2% (CI 1.0-9.5%) for scleritis. Five-year cumulative risk of glaucoma was lowest in HLA-B27 uveitis at 0.9% (CI 0.4-2.1%) and highest in viral uveitis 15.1% (CI 10.1-22.3%), sarcoidosis 9.9% (CI 6.1-15.9%) and tuberculosis 9.7% (CI 5.4-17.0%). On multivariate analysis, risk factors for development of glaucoma were older age at presentation, higher presenting intraocular pressure, chronic inflammation, and cystoid macular oedema. CONCLUSIONS Glaucoma is a common complication of uveitis and scleritis and was more frequent in older subjects, high presenting IOP, chronic inflammation and those with cystoid macular oedema. Local steroid therapy contributes to this, but is not quantifiable in this study. Targeted screening is required to avoid irreversible progression of glaucomatous optic neuropathy.
Collapse
Affiliation(s)
- R L Niederer
- Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand.
- Department of Ophthalmology, Faculty of Medical & Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - A B C Wong
- Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
| | - T Ma
- Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
| | - S Chew
- Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
| | - J Sims
- Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
| |
Collapse
|
3
|
Al-Sendi M, Chew S, Edward M, Walsh S. Adjuvant therapy and long-term outcomes in older women with early breast cancer: A single institution experience. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00475-6] [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: 11/28/2022]
|
4
|
Pitman B, Chew S, Wong C, Jaghoori A, Iwai S, Lyrtzis E, Lim M, Chew R, Chew A, Sanders P, Lau D. Atrial Fibrillation Prevalence and Risk Factors in a Semi-Rural African Population: Findings From the Australian-led TEFF-AF Study. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.133] [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: 11/28/2022]
|
5
|
Chew S, Gleeson JP, McCarthy A, Watson GA, O'Dwyer R, Nicholson S, Capra M, Owens C, McDermott M, Daly P, Grant C. Leptomeningeal Relapse of Embryonal Rhabdomyosarcoma after 15 years. Ir Med J 2020; 112:1026. [PMID: 32311247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aim Rhabdomyosarcoma (RMS) is the most common malignant soft tissue tumour of childhood. We present the case of a late relapse of RMS to the leptomeninges after 15 years. Methods A 20 year old male presented with a 3 week history of headaches and nausea. He previously had RMS of his right ear diagnosed at age 5 years which was treated with concurrent chemoradiotherapy. An MRI Brain and Spine confirmed extensive leptomeningeal disease and CSF analysis confirmed the presence of recurrent embryonal RMS. Results He completed two cycles of cyclophosphamide and topotecan followed by 45Gy/25Fr of craniospinal radiotherapy. Conclusion Late relapses beyond five years can be seen in up to 9% of patients, however very late recurrences (>10 years) are exceedingly rare. Molecular based methods such as gene expression profiling can aid risk stratification and survivorship clinics may become increasingly useful in following patients with high risk features.
Collapse
Affiliation(s)
- S Chew
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - J P Gleeson
- Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland
| | - A McCarthy
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - G A Watson
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - R O'Dwyer
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - S Nicholson
- Department of Histopathology, St James's Hospital, Dublin 8, Ireland
| | - M Capra
- Department of Medical Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - C Owens
- Department of Medical Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - M McDermott
- Department of Histopathology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - P Daly
- Department of Radiation Oncology, St James's Hospital, Dublin 8, Ireland
| | - C Grant
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| |
Collapse
|
6
|
Browne I, Chew S, Fennelly D, Crown J, Murray H, Rahman R, McCaffrey J, Kelly C, Osman N. 57P The efficacy and safety of pembrolizumab in advanced cervical cancer: A real-world treatment study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.544] [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: 11/29/2022] Open
|
7
|
Chew S, Reilly A, Brady M, Kamel D, McDermott R, Walshe J, McCaffrey J, Kelly C. 20P Next generation sequencing and associated treatment changes: Results from Ireland East Hospital Group. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
8
|
Kanninen KM, Lampinen R, Rantanen LM, Odendaal L, Jalava P, Chew S, White AR. Olfactory cell cultures to investigate health effects of air pollution exposure: Implications for neurodegeneration. Neurochem Int 2020; 136:104729. [PMID: 32201281 DOI: 10.1016/j.neuint.2020.104729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/18/2019] [Revised: 03/01/2020] [Accepted: 03/18/2020] [Indexed: 12/18/2022]
Abstract
Air pollution is a major, global public health concern. A growing body of evidence shows that exposure to air pollutants may impair the brain. Living in highly polluted areas has been linked to several neurodegenerative diseases, where exposure to complex mixtures of air pollutants in urban environments may have harmful effects on brain function. These harmful effects are thought to originate from elevated inflammation and oxidative stress. The olfactory epithelium is a key entry site of air pollutants into the brain as the particles are deposited in the upper airways and the nasal region. A potential source of patient-derived cells for study of air pollutant effects is the olfactory mucosa, which constitutes a central part of the olfactory epithelium. This review first summarizes the current literature on the available in vitro models of the olfactory epithelium. It then describes how alterations of the olfactory mucosa are linked to neurodegeneration and discusses potential therapeutic applications of these cells for neurodegenerative diseases. Finally, it reviews the research performed on the effects of air pollutant exposure in cells of the olfactory epithelium. Patient-derived olfactory epithelial models hold great promise for not only elucidating the molecular and cellular pathophysiology of neurodegenerative disorders, but for providing key understanding about air pollutant particle entry and effects at this key brain entry site.
Collapse
Affiliation(s)
- K M Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Finland
| | - R Lampinen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Finland
| | - L M Rantanen
- Mental Health Program, Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia
| | - L Odendaal
- Mental Health Program, Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia
| | - P Jalava
- Inhalation Toxicology Laboratory, Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - S Chew
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Finland
| | - A R White
- Mental Health Program, Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia.
| |
Collapse
|
9
|
Pitman B, Chew S, Wong C, Jaghoori A, Iwai S, Chew A, Sanders P, Lau D. 009 Performance of a Mobile Single-Lead Electrocardiogram Technology for Atrial Fibrillation Screening in a Semi-Rural African Population: Insights from the Australian Led TEFF-AF Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.016] [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]
|
10
|
Abstract
Joint problems commonly occur in people with diabetes. Cheiroarthropathy affects the hands and results in painless limited finger joint extension, appearing to be associated with longer diabetes duration and the presence of microvascular complications. The prevalence of cheiroarthropathy seems to be falling, perhaps as a result of improvements in glycaemic management. Non-enzymatic glycation of collagen results in abnormally crosslinked protein resistant to degradation with subsequent increased build-up of collagen in joints. The management of cheiroarthropathy is predominantly conservative, with occupational and hand therapy at the forefront. Tendinopathy is more common in people with diabetes than those without, and is associated with obesity and insulin resistance. As with cheiroarthropathy, the exact causative mechanism of tendinopathy in diabetes is not known, but may be linked to inflammation, apoptosis and increased vascularity of affected tendons, driven by hyperinsulinaemia. Local fat pads have also been suggested to play a role in the pathogenesis of tendinopathy.
Collapse
Affiliation(s)
- N E Hill
- Imperial College Healthcare NHS Trust, London
| | - D Roscoe
- Defence Medical Rehabilitation Centre, Loughborough
- University of Loughborough, Loughborough
| | - M J Stacey
- Imperial College Healthcare NHS Trust, London
- Defence Medical Services, Lichfield, UK
| | - S Chew
- Imperial College Healthcare NHS Trust, London
| |
Collapse
|
11
|
Mongelli M, Yuxin NG, Biswas A, Chew S. Accuracy of ultrasound dating formulae in the late second-trimester in pregnancies conceived with in-vitro fertilization. Acta Radiol 2016; 44:452-5. [PMID: 12846699 DOI: 10.1080/j.1600-0455.2003.00089.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 01/10/2023]
Abstract
Purpose: To investigate the accuracy of ultrasound dating formulae in the late second trimester of pregnancy. Material and Methods: A dataset of 136 singleton pregnancies conceived by artificial reproductive techniques was studied to assess the accuracy of ultrasound dating formulae in the late second trimester, and compared with early second trimester. A total of 21 published ultrasound-dating formulae were tested. Results: For most formulae, late second trimester scans yielded results that were marginally less accurate than the early second trimester. The best performance was obtained with dating formulae based on femur length, either alone or combined with the biparietal diameter. These formulae had mean absolute errors of 3–3.5 days. Combining two or more parameters did not result in any substantial gain in accuracy. Conclusions: Pregnancy dating by ultrasound in the late second trimester is sufficiently accurate for routine clinical use. Formulae based on femur length appear to be at least as accurate as head measurements.
Collapse
Affiliation(s)
- M Mongelli
- Department of Obstetrics and Gynecology, National University Hospital, Singapore, Republic of Singapore.
| | | | | | | |
Collapse
|
12
|
Bakocevic N, Claser C, Yoshikawa S, Jones LA, Chew S, Goh CC, Malleret B, Larbi A, Ginhoux F, de Lafaille MC, Karasuyama H, Renia L, Ng LG. CD41 is a reliable identification and activation marker for murine basophils in the steady state and during helminth and malarial infections. Eur J Immunol 2014; 44:1823-34. [DOI: 10.1002/eji.201344254] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/29/2014] [Accepted: 02/27/2014] [Indexed: 01/21/2023]
Affiliation(s)
- Nadja Bakocevic
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Carla Claser
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Soichiro Yoshikawa
- Department of Immune Regulation; Tokyo Medical and Dental University Graduate School; Tokyo Japan
| | - Leigh Ann Jones
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Samantha Chew
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Chi Ching Goh
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Benoit Malleret
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Anis Larbi
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Florent Ginhoux
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Maria Curotto de Lafaille
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Hajime Karasuyama
- Department of Immune Regulation; Tokyo Medical and Dental University Graduate School; Tokyo Japan
| | - Laurent Renia
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| | - Lai Guan Ng
- Singapore Immunology Network (SIgN); Agency for Science Technology and Research (A*STAR); Biopolis Singapore
| |
Collapse
|
13
|
Chew S, Noake J. SPORT AND EXERCISE MEDICINE (SEM) IN PRIMARY CARE: A NOVEL DUAL ARMED APPROACH TO IMPROVING PHYSICAL ACTIVITY (PA) AND MUSCULOSKELETAL (MSK) SERVICES IN A HERTFORDSHIRE GENERAL PRACTICE. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093035.1] [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: 11/04/2022]
|
14
|
Devi S, Wang Y, Chew WK, Lima R, A-González N, Mattar CNZ, Chong SZ, Schlitzer A, Bakocevic N, Chew S, Keeble JL, Goh CC, Li JLY, Evrard M, Malleret B, Larbi A, Renia L, Haniffa M, Tan SM, Chan JKY, Balabanian K, Nagasawa T, Bachelerie F, Hidalgo A, Ginhoux F, Kubes P, Ng LG. Neutrophil mobilization via plerixafor-mediated CXCR4 inhibition arises from lung demargination and blockade of neutrophil homing to the bone marrow. ACTA ACUST UNITED AC 2013; 210:2321-36. [PMID: 24081949 PMCID: PMC3804935 DOI: 10.1084/jem.20130056] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The CXCR4 antagonist plerixafor augments frequency of circulating neutrophils via release from the lung and prevents neutrophil homing to the bone marrow. Blood neutrophil homeostasis is essential for successful host defense against invading pathogens. Circulating neutrophil counts are positively regulated by CXCR2 signaling and negatively regulated by the CXCR4–CXCL12 axis. In particular, G-CSF, a known CXCR2 signaler, and plerixafor, a CXCR4 antagonist, have both been shown to correct neutropenia in human patients. G-CSF directly induces neutrophil mobilization from the bone marrow (BM) into the blood, but the mechanisms underlying plerixafor-induced neutrophilia remain poorly defined. Using a combination of intravital multiphoton microscopy, genetically modified mice and novel in vivo homing assays, we demonstrate that G-CSF and plerixafor work through distinct mechanisms. In contrast to G-CSF, CXCR4 inhibition via plerixafor does not result in neutrophil mobilization from the BM. Instead, plerixafor augments the frequency of circulating neutrophils through their release from the marginated pool present in the lung, while simultaneously preventing neutrophil return to the BM. Our study demonstrates for the first time that drastic changes in blood neutrophils can originate from alternative reservoirs other than the BM, while implicating a role for CXCR4–CXCL12 interactions in regulating lung neutrophil margination. Collectively, our data provides valuable insights into the fundamental regulation of neutrophil homeostasis, which may lead to the development of improved treatment regimens for neutropenic patients.
Collapse
Affiliation(s)
- Sapna Devi
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), Biopolis, 138648 Singapore
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Schlitzer A, McGovern N, Teo P, Zelante T, Atarashi K, Low D, Ho A, See P, Shin A, Wasan P, Hoeffel G, Malleret B, Heiseke A, Chew S, Jardine L, Purvis H, Hilkens C, Tam J, Poidinger M, Stanley E, Krug A, Renia L, Sivasankar B, Ng L, Collin M, Ricciardi-Castagnoli P, Honda K, Haniffa M, Ginhoux F. IRF4 transcription factor-dependent CD11b+ dendritic cells in human and mouse control mucosal IL-17 cytokine responses. Immunity 2013; 38:970-83. [PMID: 23706669 PMCID: PMC3666057 DOI: 10.1016/j.immuni.2013.04.011] [Citation(s) in RCA: 627] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/25/2013] [Indexed: 12/11/2022]
Abstract
Mouse and human dendritic cells (DCs) are composed of functionally specialized subsets, but precise interspecies correlation is currently incomplete. Here, we showed that murine lung and gut lamina propria CD11b+ DC populations were comprised of two subsets: FLT3- and IRF4-dependent CD24+CD64− DCs and contaminating CSF-1R-dependent CD24−CD64+ macrophages. Functionally, loss of CD24+CD11b+ DCs abrogated CD4+ T cell-mediated interleukin-17 (IL-17) production in steady state and after Aspergillus fumigatus challenge. Human CD1c+ DCs, the equivalent of murine CD24+CD11b+ DCs, also expressed IRF4, secreted IL-23, and promoted T helper 17 cell responses. Our data revealed heterogeneity in the mouse CD11b+ DC compartment and identifed mucosal tissues IRF4-expressing DCs specialized in instructing IL-17 responses in both mouse and human. The demonstration of mouse and human DC subsets specialized in driving IL-17 responses highlights the conservation of key immune functions across species and will facilitate the translation of mouse in vivo findings to advance DC-based clinical therapies. Mucosal CD11b+ DCs consist of CD24+CD64− DCs and CD24−CD64+ macrophages Mucosal CD24+CD11b+ DCs are IRF4-dependent IRF4-dependent CD24+CD11b+ DCs secrete IL-23α and control mucosal IL-17 responses Human CD1c+CD11b+ DCs are functional homologs of murine CD24+CD11b+ DCs
Collapse
Affiliation(s)
- Andreas Schlitzer
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Naomi McGovern
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Pearline Teo
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Teresa Zelante
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Koji Atarashi
- Department of Immunology, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Donovan Low
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Adrian W.S. Ho
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Peter See
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Amanda Shin
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Pavandip Singh Wasan
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Guillaume Hoeffel
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Benoit Malleret
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Alexander Heiseke
- II Medical Department, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Samantha Chew
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Laura Jardine
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Harriet A. Purvis
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | | | - John Tam
- National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Michael Poidinger
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - E. Richard Stanley
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Anne B. Krug
- II Medical Department, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Laurent Renia
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Baalasubramanian Sivasankar
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore 529825, Singapore
| | - Lai Guan Ng
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Matthew Collin
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Paola Ricciardi-Castagnoli
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
| | - Kenya Honda
- Department of Immunology, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Muzlifah Haniffa
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Florent Ginhoux
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 138648 Singapore
- Corresponding author
| |
Collapse
|
16
|
Gok Oguz E, Olmaz R, Turgutalp K, Muslu N, Sungur MA, Kiykim A, Van Biesen W, Vanmassenhove J, Glorieux G, Vanholder R, Chew S, Forster K, Kaufeld T, Kielstein J, Schilling T, Haverich A, Haller H, Schmidt B, Hu P, Liang X, Liang X, Chen Y, LI R, Jiang F, LI Z, Shi W, Lim CCW, Lim CCW, Chia CML, Tan AK, Tan CS, Hu P, Liang X, Liang X, Chen Y, LI R, Jiang F, LI Z, Shi W, Ng R, Subramani S, Chew S, Perez de Jose A, Bernis Carro C, Madero Jarabo R, Bustamante J, Sanchez Tomero JA, Chung W, Ro H, Chang JH, Lee HH, Jung JY, Vanmassenhove J, Van Biesen W, Glorieux G, Vanholder R, Fazzari L, Giuliani A, Scrivano J, Pettorini L, Benedetto U, Luciani R, Roscitano A, Napoletano A, Coclite D, Cordova E, Punzo G, Sinatra R, Mene P, Pirozzi N, Shavit L, Shavit L, Manilov R, Algur N, Wiener-Well Y, Slotki I, Pipili C, Pipili C, Vrettou CS, Avrami K, Economidou F, Glynos K, Ioannidou S, Markaki V, Douka E, Nanas S, De Pascalis A, De Pascalis A, Cofano P, Proia S, Valletta A, Vitale O, Russo F, Buongiorno E, Filiopoulos V, Biblaki D, Lazarou D, Chrysis D, Fatourou M, Lafoyianni S, Vlassopoulos D, Zakiyanov O, Kriha V, Vachek J, Svarcova J, Zima T, Tesar V, Kalousova M, Kaushik M, Kaushik M, Ronco C, Cruz D, Zhang L, Zhang W, Zhang W, Chen N, Ejaz AA, Kambhampati G, Ejaz N, Dass B, Lapsia V, Arif AA, Asmar A, Shimada M, Alsabbagh M, Aiyer R, Johnson R, Chen TH, Chang CH, Chang MY, Tian YC, Hung CC, Fang JT, Yang CW, Chen YC, Cantaluppi V, Quercia AD, Figliolini F, Giacalone S, Pacitti A, Gai M, Guarena C, Leonardi G, Leonardi G, Biancone L, Camussi G, Segoloni GP, De Cal M, Lentini P, Clementi A, Virzi GM, Scalzotto E, Ronco C, Lacquaniti A, Lacquaniti A, Donato V, Fazio MR, Lucisano S, Cernaro V, Lupica R, Buemi M, Turgutalp K, Helvaci I, Anik E, Kiykim A, Wani M, Wani DI, Bhat DMA, Banday DK, Najar DMS, Reshi DAR, Palla DNA, Turgutalp K, Kiykim A, Helvaci I, Iglesias P, Olea T, Vega-Cabrera C, Heras M, Bajo MA, Del Peso G, Arias MJ, Selgas R, Diez JJ, Daher E, Costa PL, Pereira ENS, Santos RDP, Abreu KL, Silva Junior G, Pereira EDB, Raimundo M, Crichton S, Syed Y, Martin J, Whiteley C, Bennett D, Ostermann M, Gjyzari A, Thereska N, Koroshi A, Barbullushi M, Kodra S, Idrizi A, Strakosha A, Petrela E, Raimundo M, Crichton S, Syed Y, Martin J, Lemmich Smith J, Bennett D, Ostermann M, Klimenko A, Tuykhmenev E, Villevalde S, Kobalava Z, Avdoshina S, Villevalde S, Tyukhmenev E, Efremovtseva M, Kobalava Z, Hayashi H, Hayashi H, Suzuki S, Kataoka K, Kondoh Y, Taniguchi H, Sugiyama D, Nishimura K, Sato W, Maruyama S, Matsuo S, Yuzawa Y, Geraldine D, Muriel F, Alexandre H, Eric R, Fu P, Zhang L, Pozzato M, Ferrari F, Cecere P, Mesiano P, Vallero A, Livigni S, Quarello F, Hudier L, Decaux O, Haddj-Elmrabet A, Mandart L, Lino-Daniel M, Bridoux F, Renaudineau E, Sawadogo T, Le Pogamp P, Vigneau C, Famee D, Koo HM, Oh HJ, Han SH, Choi KH, Kang SW, Mehdi M, Nicolas M, Mariat C, Shah P, Kute VB, Vanikar A, Gumber M, Patel H, Trivedi H, Pipili C, Pipili C, Manetos C, Vrettou CS, Poulaki S, Tripodaki ES, Papastylianou A, Routsi C, Nanas S, Uchida K, Kensuke U, Yamagata K, Saitou C, Okada M, Chita G, Davies M, Veriawa Y, Naicker S, Mukhopadhyay P, Mukherjee D, Mishra R, Kar M, Zickler D, Wesselmann H, Schindler R, Gutierrez* E, Egido J, Rubio-Navarro A, Buendia I, Blanco-Colio LM, Toldos O, Manzarbeitia F, De Lorenzo A, Sanchez R, Praga^ M, Moreno^ JA, Kim MY, Kang NR, Jang HR, Lee JE, Huh W, Kim YG, Kim DJ, Hong SC, Kim JS, Oh HY, Okamoto T, Kamata K, Naito S, Tazaki H, Kan S, Anne-Kathrin LG, Matthias K, Speer T, Andreas L, Heinrich G, Thomas V, Poppleton A, Danilo F, Matthias K, Lai CF, Wu VC, Shiao CC, Huang TM, Wu KD, Bedford M, Farmer C, Irving J, Stevens P, Patera F, Patera F, Mattozzi F, Battistoni S, Fagugli RM, Park MY, Choi SJ, Kim JG, Hwang SD, Xie H, Chen H, Xu S, He Q, Liu J, Hu W, Liu Z, Dalboni M, Blaya R, Quinto BM, Narciso R, Oliveira M, Monte J, Durao M, Cendoroglo M, Batista M, Hanemann AL, Liborio A, Daher E, Martins A, Pinheiro MCC, Silva Junior G, Meneses G, De Paula Pessoa R, Sousa M, Bezerra FSM, Albuquerque PLMM, Lima JB, Lima CB, Veras MDSB, Silva Junior G, Daher E, Nemoto Matsui T, Totoli C, Cruz Andreoli MC, Vilela Coelho MP, Guimaraes de Souza NK, Ammirati AL, De Carvalho Barreto F, Ferraz Neto BH, Fortunato Cardoso Dos Santos B, Abraham A, Abraham G, Mathew M, Duarte PMA, Duarte FB, Barros EM, Castro FQS, Silva Junior G, Daher E, Palomba H, Castro I, Sousa SR, Jesus AN, Romano T, Burdmann E, Yu L, Kwon SH, You JY, Hyun YK, Woo SA, Jeon JS, Noh HJ, Han DC, Tozija L, Tozija L, Petronievic Z, Selim G, Nikolov I, Stojceva-Taneva O, Cakalaroski K, Lukasz A, Beneke J, Schmidt B, Kielstein J, Haller H, Menne J, Schiffer M, Polanco N, Hernandez E, Gutierrez E, Gutierrez Millet V, Gonzalez Monte E, Morales E, Praga M, Francisco Javier L, Nuria GF, Jose Maria MG, Bes Rastrollo M, Angioi A, Conti M, Cao R, Atzeni A, Pili G, Matta V, Murgia E, Melis P, Binda V, Pani A, Thome* F, Leusin F, Barros E, Morsch C, Balbinotto A, Pilla C, Premru V, Buturovic-Ponikvar J, Ponikvar R, Marn-Pernat A, Knap B, Kovac J, Gubensek J, Kersnic B, Krnjak L, Prezelj M, Granatova J, Havrda M, Hruskova Z, Kratka K, Remes O, Mokrejsova M, Bolkova M, Lanska V, Rychlik I, Uniacke MD, Lewis RJ, Harris S, Roderick P, Thome* F, Balbinotto A, Barros E, Morsch C, Martin N, Ulrich K, Jan B, Jorn B, Reinhard B, Jan K, Hermann H, Meyer Tobias F, Leyla R, Schmidt Bernhard MW, Harald S, Jurgen S, Tanja K, Menne J, Mario S, Jan B, Jan B, Sang Hi E, Leyla R, Claus M, Frank V, Aleksej S, Sengul S, Jan K, Jorn B, Reinhard B, Meyer Tobias F, Schmidt Bernhard MW, Mario S, Martin N, Ulrich K, Robert S, Karin W, Tanja K, Hermann H, Menne J, Leyla R, Leyla R, Jan K, Jan B, Reinhard B, Feikah G, Hermann H, Tanja K, Ulrich K, Menne Tobias F, Claus M, Martin N, Mario S, Schmidt Bernhard MW, Harald S, Jurgen S, Menne J, Claus M, Claus M, Jan K, Jan B, Reinhard B, Feikah G, Hermann H, Ulrich K, Menne Tobias F, Meyer Tobias N, Martin N, Leyla R, Schmidt Bernhard MW, Harald S, Jurgen S, Tanja K, Mario S, Menne J, Kielstein J, Beutel G, Fleig S, Steinhoff J, Meyer T, Hafer C, Bramstedt J, Busch V, Vischedyk M, Kuhlmann U, Ries W, Mitzner S, Mees S, Stracke S, Nurnberger J, Gerke P, Wiesner M, Sucke B, Abu-Tair M, Kribben A, Klause N, Schindler R, Merkel F, Schnatter S, Dorresteijn E, Samuelsson O, Brunkhorst R, Stec-Hus Registry G, Reising A, Hafer C, Kielstein J, Schmidt B, Bange FC, Hiss M, Vetter F, Kielstein J, Beneke J, Bode-Boger SM, Martens-Lobenhoffer J, Schiffer M, Schmidt BMW, Haller H, Menne J, Kielstein JT, Shin HS, Jung YS, Rim H. AKI - Clinical. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Chew S, Mullin BH, Lewis JR, Spector TD, Prince RL, Wilson SG. Homozygous deletion of the UGT2B17 gene is not associated with osteoporosis risk in elderly Caucasian women. Osteoporos Int 2011; 22:1981-6. [PMID: 20878390 PMCID: PMC3605783 DOI: 10.1007/s00198-010-1405-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 08/18/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED Previously, homozygous deletion of the UGT2B17 gene has shown association with hip fracture. Using a high-throughput qRT-PCR assay, we genotyped UGT2B17 copy number variation (CNV) in 1,347 elderly Caucasian women and examined for effects on bone phenotypes. We found no evidence of association between UGT2B17 CNV and osteoporosis risk in this population. INTRODUCTION Genetic studies of osteoporosis commonly examine SNPs in candidate genes or whole genome analyses, but insertions and deletions of DNA, collectively called CNV, also comprise a large amount of the genetic variability between individuals. Previously, homozygous deletion of the UGT2B17 gene in CNV 4q13.2, which encodes an enzyme that mediates the glucuronidation of steroid hormones, has shown association with the risk of hip fracture. METHODS We used a quantitative real-time PCR assay for genotyping the UGT2B17 CNV in a well-characterized population study of 1,347 Caucasian women aged 75.2 ± 2.7 years (mean ± SD), to assess the effect of the CNV on bone mass density (BMD) at the total hip site and osteoporosis risk. RESULTS The UGT2B17 CNV distribution was consistent with the expected Hardy-Weinberg distribution and not different from frequencies previously reported in a Caucasian population. Data from ANCOVA of age- and weight-adjusted BMD for UGT2B17 CNV genotype showed no significant difference between genotype groups. Individuals with homozygous or heterozygous deletion of the UGT2B17 gene showed no increased risk of incident fragility fracture. CONCLUSIONS These data suggest that quantitative real-time PCR is a rapid and efficient technique for determination of candidate CNVs, including the UGT2B17 CNV; however, we found no evidence of an effect of UGT2B17 CNV on osteoporosis risk in elderly Caucasian women.
Collapse
Affiliation(s)
- S Chew
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia.
| | | | | | | | | | | |
Collapse
|
18
|
Komarow H, Yang B, Nelson C, Young M, O'Brien M, Medic N, Chew S, Milner J, Gadina M, Metcalfe D. Lack of Evidence for Activation of the Inflammasome in Typical Physical Urticarias. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
19
|
Davidson A, Chew S. Book Review: Manual of Pediatric Anesthesia. Sixth Edition. Anaesth Intensive Care 2010. [DOI: 10.1177/0310057x1003800628] [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: 11/16/2022]
|
20
|
Chew S, Li H, Singh O, Lim WT, Tan E, Lee J, Chowbay B. The effects of SLCO1B3, ABCG2, MDR1, and CYP3A5 single nucleotide polymorphisms on the pharmacokinetics and pharmacodynamics of docetaxel in nasopharyngeal carcinoma patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e13569] [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: 11/20/2022] Open
|
21
|
Anandakumar C, Chew S, Wong YC, Chia D, Ratnam SS. Role of Ultrasound Colour Flow Mapping in Differentiating Between Benign and Malignant Ovarian Cysts. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619509020700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
22
|
Affiliation(s)
- X. F. Dong
- Laboratory for Simulation and Modelling of Particulate Systems, School of Materials Science and Engineering, The University of New South Wales, Sydney, NSW 2052, Australia
| | - A. B. Yu
- Laboratory for Simulation and Modelling of Particulate Systems, School of Materials Science and Engineering, The University of New South Wales, Sydney, NSW 2052, Australia
| | - J. M. Burgess
- Laboratory for Simulation and Modelling of Particulate Systems, School of Materials Science and Engineering, The University of New South Wales, Sydney, NSW 2052, Australia
| | - D. Pinson
- Bluescope Steel Research, P.O. Box 202, Port Kembla, NSW 2505, Australia
| | - S. Chew
- Bluescope Steel Research, P.O. Box 202, Port Kembla, NSW 2505, Australia
| | - P. Zulli
- Bluescope Steel Research, P.O. Box 202, Port Kembla, NSW 2505, Australia
| |
Collapse
|
23
|
Perniola G, Shek C, Chong CCW, Chew S, Cartmill J, Dietz HP. Defecation proctography and translabial ultrasound in the investigation of defecatory disorders. Ultrasound Obstet Gynecol 2008; 31:567-571. [PMID: 18409183 DOI: 10.1002/uog.5337] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Defecation proctography is the standard method used in the investigation of obstructed defecation. Translabial ultrasound has recently been shown to demonstrate rectocele, enterocele and rectal intussusception. We performed a comparative clinical study to determine agreement between the two methods. METHODS Thirty-seven women scheduled to undergo defecation proctography for obstructed defecation were recruited. Using both proctography and translabial ultrasound, we determined the anorectal angle, presence of a rectocele and rectocele depth, rectal intussusception and prolapse. Measurements were obtained by operators blinded to all other data. All patients rated discomfort on a scale of 0-10. RESULTS Six women did not attend defecation proctography, leaving 31 cases for comparison. The mean age was 53 years. Patients rated discomfort at a median of 1 (range 0-10) for ultrasound and 7 (range 0-10) for defecation proctography (P < 0.001). Defecation proctography suggested rectocele and rectal intussusception/prolapse more frequently than did ultrasound. While the positive predictive value of ultrasound (considering defecation proctography to be the definitive test) was 0.82 for rectocele and 0.88 for intussusception/prolapse, negative predictive values were only 0.43 and 0.27, respectively. Cohen's kappa values were 0.26 and 0.09, respectively. There was poor agreement between ultrasound and defecation proctography measurements of anorectal angle and rectocele depth. CONCLUSIONS Translabial ultrasound can be used in the initial investigation of defecatory disorders. It is better tolerated than defecation proctography and also yields information on the lower urinary tract, pelvic organ prolapse and levator ani. Agreement between ultrasound and defecation proctography in the measurement of quantitative parameters was poor, but when intussusception or rectocele was diagnosed on ultrasound these results were highly predictive of findings on defecation proctography.
Collapse
Affiliation(s)
- G Perniola
- La Sapienza University of Rome, Rome, Italy
| | | | | | | | | | | |
Collapse
|
24
|
Mamo J, Galloway S, Parabellage M, Jian L, Johnsen R, Chew S, Takechi R, James A. PO11-312 IS BETA-AMYLOID, THE PRIMARY PROTEIN IN SENILE PLAQUES OF SUBJECTS WITH ALZHEIMER'S DISEASE A REGULATING APOLIPOPROTEIN? ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71322-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
25
|
Mongelli M, Chew S, Yuxin NG, Biswas A. Third-trimester ultrasound dating algorithms derived from pregnancies conceived with artificial reproductive techniques. Ultrasound Obstet Gynecol 2005; 26:129-31. [PMID: 16041677 DOI: 10.1002/uog.1939] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To derive an accurate formula for ultrasound estimation of gestational age in late pregnancy. METHODS A database of 123 singleton pregnancies conceived by artificial reproductive techniques with third-trimester ultrasound measurements was studied. Biometry variables included the fetal head circumference (HC) and femur length (FL). The dataset was equally divided into a derivation sample and a target sample. To derive the equations of best fit, regression analysis was used, with true menstrual age as the dependent variable and fetal biometry measurements as independent variables. The formulae were tested on the target set and the menstrual age estimates were compared with the actual menstrual age. Clinical performance was estimated in terms of systematic and random errors, absolute errors and their 95% CI values. RESULTS The menstrual ages at time of scanning ranged from 26 to 41 weeks, with a mean of 33 weeks. The best performing derived formula was a combination of HC and FL. This had a random error of 7.5 days and prediction errors within a 95% confidence limit of -13 to +17 days. With FL only, the random error was 8.2 days, whereas using the HC only yielded a random error of 9.4 days. CONCLUSIONS Ultrasound estimation of gestational age in late pregnancy is better than indicated by older publications. It is more accurately estimated by combining the HC with the FL than by using the FL measurements alone.
Collapse
Affiliation(s)
- M Mongelli
- Division of Women and Children's Health, Nepean Hospital, Penrith, NSW, Australia.
| | | | | | | |
Collapse
|
26
|
Affiliation(s)
- B-H Tan
- Department of Internal Medicine, Singapore General Hospital, Republic of Singapore.
| | | | | | | |
Collapse
|
27
|
Affiliation(s)
- P Kojodjojo
- Department of General Medicine, St Mary's Hospital, London W2 1NY, UK.
| | | | | | | |
Collapse
|
28
|
Affiliation(s)
- P Kojodjojo
- Department of General Medicine, St Mary's Hospital, London W2 1NY, UK.
| | | | | | | |
Collapse
|
29
|
Fan DSP, Rao SK, Cheung EYY, Islam M, Chew S, Lam DSC. Astigmatism in Chinese preschool children: prevalence, change, and effect on refractive development. Br J Ophthalmol 2004; 88:938-41. [PMID: 15205242 PMCID: PMC1772230 DOI: 10.1136/bjo.2003.030338] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To study the prevalence, type, and progression of astigmatism in Chinese preschool children, and its effect on refractive development. METHODS A cross sectional study of preschool children was carried out in two randomly selected kindergartens. A cohort study was performed on a subset of children, five years after initial examination. Refractive error (measured by cycloplegic autorefraction) and axial ocular dimensions (measured by ultrasonography) were the main study outcomes. RESULTS 522 children participated in the study; the mean age was 55.7 months (SD 10.9; range 27 to 77). Mean cylinder reading was -0.65 D (SD 0.58; range 0.00 to -4.75), and with the rule astigmatism was predominant (53%). In the 108 children studied longitudinally, the mean cylinder reading reduced from -0.62 D to -0.50 D (p = 0.019). The presence of astigmatism in initial examination predisposed the eyes towards greater myopisation (p<0.001). In addition, children with increased astigmatism had greater myopic progression (p<0.001) and axial length growth (p = 0.002). CONCLUSIONS This study reports a high prevalence of astigmatism in Chinese preschool children. The presence of astigmatism, and particularly with increasing astigmatism, appears to predispose the children to progressive myopia. Further studies are warranted.
Collapse
Affiliation(s)
- D S P Fan
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, 3/F, University Eye Center, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong.
| | | | | | | | | | | |
Collapse
|
30
|
Lingam RK, Sohaib SA, Rockall AG, Isidori AM, Chew S, Monson JP, Grossman A, Besser GM, Reznek RH. Diagnostic performance of CT versus MR in detecting aldosterone-producing adenoma in primary hyperaldosteronism (Conn's syndrome). Eur Radiol 2004; 14:1787-92. [PMID: 15241622 DOI: 10.1007/s00330-004-2308-2] [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] [Subscribe] [Scholar Register] [Received: 10/23/2003] [Revised: 02/19/2004] [Accepted: 03/04/2004] [Indexed: 01/31/2023]
Abstract
The aim of the present study is to compare the diagnostic performance of CT and MR imaging in detecting aldosterone-producing adenoma and to compare the interobserver variability in the detection of an aldosterone-producing adenoma on CT and MR. A retrospective study of 34 patients with primary hyperaldosteronism was performed. A total of 17 cases of aldosterone-producing adenoma and 17 cases of bilateral adrenal hyperplasia were included. The final diagnosis of an adenoma was made by surgery with histological confirmation, whereas that of bilateral adrenal hyperplasia was made on adrenal venous sampling or a good biochemical and clinical response following medical treatment alone and in the absence of a unilateral radiological abnormality. The CT (n=30) and MR (n=24) scans were reviewed independently by two radiologists experienced in adrenal imaging, who were unaware of the cause of the primary hyperaldosteronism. The diagnostic performances of both observers in detecting an aldosterone-producing adenoma on CT and MR imaging were compared. The 16 adenomatous nodules that were detected on imaging ranged from 1 to 4.75 cm in diameter. The calculated sensitivity and specificity for detecting aldosterone-producing adenoma were 87 and 93% for one observer and 85 and 82% for the other observer on CT, and 83 and 83% for one observer and 92 and 92% for the other observer on MR, respectively. Receptor operating characteristics curve analysis showed similar performances of both observers in detecting an aldosterone-producing adenoma on CT and MR imaging. There was good interobserver agreement on CT (k=0.71) and on MR (k=0.67). We have demonstrated comparable diagnostic performance and good interobserver agreement on CT and MR imaging for the detection of aldosterone-producing adenoma.
Collapse
Affiliation(s)
- R K Lingam
- Department of Diagnostic Imaging, St Bartholomew's Hospital, West Smithfield, EC1A 7BE, London, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Mongelli M, Yuxin NG, Biswas A, Chew S. Accuracy of ultrasound dating formulae in the late second-trimester in pregnancies conceived with in-vitro fertilization. Acta Radiol 2003. [PMID: 12846699 DOI: 10.1034/j.1600-0455.2003.00089.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the accuracy of ultrasound dating formulae in the late second trimester of pregnancy. MATERIAL AND METHODS A dataset of 136 singleton pregnancies conceived by artificial reproductive techniques was studied to assess the accuracy of ultrasound dating formulae in the late second trimester, and compared with early second trimester. A total of 21 published ultrasound-dating formulae were tested. RESULTS For most formulae, late second trimester scans yielded results that were marginally less accurate than the early second trimester. The best performance was obtained with dating formulae based on femur length, either alone or combined with the biparietal diameter. These formulae had mean absolute errors of 3-3.5 days. Combining two or more parameters did not result in any substantial gain in accuracy. CONCLUSIONS Pregnancy dating by ultrasound in the late second trimester is sufficiently accurate for routine clinical use. Formulae based on femur length appear to be at least as accurate as head measurements.
Collapse
Affiliation(s)
- M Mongelli
- Department of Obstetrics and Gynecology, National University Hospital, Singapore, Republic of Singapore.
| | | | | | | |
Collapse
|
32
|
Chew S, Ng SC. Hormone replacement therapy (HRT) and ischaemic heart disease: getting to the heart of the matter. Singapore Med J 2002; 43:41-4. [PMID: 12008777] [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: 02/25/2023]
Abstract
Numerous observational studies have previously shown that estrogen therapy (ERT) or estrogen/progestin hormone replacement therapy (HRT) can significantly reduce the risk of Coronary Artery Disease (CAD) in healthy postmenopausal women by up to 50%. However, due to statistical limitations inherent in these earlier studies, several large randomised trials are now under way. The results from some of these randomised trials are expected sometime in 2005 and will certainly help confirm or refute the present perceived cardio-protective effects of ERT/HRT in healthy menopausal women. On the other hand, the role of hormonal therapy in menopausal women with established CAD is more controversial. Although results from earlier observational trials have been encouraging, more recent randomised controlled data from the Heart and Estrogen/Progestin Replacement (HER) study and the Estrogen Replacement and Atherosclerosis (ERA) study have been more sober. In fact, both have generally reported on the failure of ERT/HRT to reduce the overall rate of ischaemic cardiovascular events or to halt the progression of coronary atherosclerosis in menopausal women with established CAD. However, these studies are not without their own limitations. As such, more future trials will be needed before the role of postmenopausal hormone therapy in the secondary prevention of CAD can be firmly established.
Collapse
Affiliation(s)
- S Chew
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
| | | |
Collapse
|
33
|
Abstract
BACKGROUND To evaluate whether grey-scale, real-time, B-mode ultrasound (US) is a reliable alternative to nasopharyngoscopy for assessing vocal cord function post-thyroid and post-parathyroid surgery. METHODS A prospective validation study was undertaken comparing grey-scale, real-time, B-mode vocal cord US with the standard of nasopharyngoscopy in 100 consecutive patients undergoing thyroid and parathyroid surgery between 1 February 1999 and 31 August 1999, with seven patients with known cord palsy. The sensitivity and specificity of grey-scale, real-time vocal cord US for the detection of vocal cord palsy when compared to the standard of nasopharyngoscopy was analysed. RESULTS In the postsurgical group, there were six nerves (3.2% of the nerves at risk) transient and no permanent vocal cord palsies. US identified four of six transient palsies and reported two false negatives and three false positives. US identified four of seven cord palsies in the non-surgical group with known cord palsy. Analysis of the 107 combined patients showed US had sensitivity of 62% (8/13), specificity of 97% (91/94), a positive predictive value of 73% (8/11) and a negative predictive value of 95% (91/96) for detecting cord paralysis compared to the standard of nasopharyngoscopy. CONCLUSION Despite the enthusiasm of earlier reports, our initial experience with grey-scale, real-time, B-mode US suggests it is not a reliable alternative to nasopharyngoscopy for assessing vocal cord function post-thyroid and post-parathyroid surgery. Further recruitment of patients with known vocal cord palsy is required to confirm or refute these initial impressions.
Collapse
Affiliation(s)
- S Sidhu
- Endocrine Surgical Unit, Liverpool Hospital, New South Wales 2170, Australia
| | | | | | | | | | | |
Collapse
|
34
|
Chew S, Anandakumar C. Medical management of cervical pregnancy--a report of two cases. Singapore Med J 2001; 42:537-9. [PMID: 11876382] [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: 02/24/2023]
Abstract
Cervical ectopic pregnancy is a rare life-threatening condition that can be managed conservatively. In this report, the authors describe the use of systemic methotrexate and prostaglandin (sulprostone) in the management of two cases of viable cervical pregnancy. Both cases were successfully treated without the need for surgical intervention.
Collapse
Affiliation(s)
- S Chew
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
| | | |
Collapse
|
35
|
Chew S, Ng SC. Laparoscopic treatment of a twisted hyperstimulated ovary after IVF. Singapore Med J 2001; 42:228-9. [PMID: 11513063] [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: 02/21/2023]
Abstract
Ovarian Hyperstimulation Syndrome (OHSS) is a common problem associated with modern In-Vitro Fertilisation techniques (IVF). However, torsion of a hyperstimulated ovary occurring after IVF is a much rarer event. In this case report, we will describe the laparoscopic management of a pregnant patient with a twisted hyperstimulated ovary after an IVF programme.
Collapse
Affiliation(s)
- S Chew
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
| | | |
Collapse
|
36
|
Abstract
Although no ionizing radiation is involved, patients undergoing magnetic resonance imaging (MRI) are exposed to powerful static magnetic fields, magnetic field gradients, and radio-frequency fields that may be potentially damaging. Our study aims to document the effect of MRI imaging sequences on early murine embryo development (two-cell to blastocyst stage) in vitro. Two-cell murine embryos were exposed to various lengths of MRI using pulse sequences employed in present day clinical imaging. Early murine embryo development was documented in vitro, and blastocyst development rates were computed for both the control and exposed groups. There were no significant differences detected in the rate of blastocyst formation between the control groups and the embryos exposed to MRI.
Collapse
Affiliation(s)
- S Chew
- Consultant, Department of O & G, National University Hospital, Singapore
| | | | | | | |
Collapse
|
37
|
Anandakumar C, Chew S, Wong YC, Goh VH, Tain CF, Ratnam SS. The sensitivity of the trivariate analysis using maternal serum alpha-feto protein, human chorionic gonadotrophin and maternal age in screening for fetal aneuploidy in mothers above the age of 35. J Perinat Med 1999; 27:178-82. [PMID: 10503178 DOI: 10.1515/jpm.1999.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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] [Indexed: 11/15/2022]
Abstract
This study was undertaken to assess the usefulness of maternal serum human chorionic gonadotrophin, alpha-fetoprotein and maternal age in screening for fetuses with abnormal chromosomes in pregnant women aged 35 years and over. From 1989 to 1991, 1208 women seen at the National University Hospital had karyotyping procedures performed for maternal age > 35 years as well as second trimester serum samples taken for alpha-fetoprotein and human chorionic gonadotrophin. Sixteen (1.3%) chromosomal abnormalities were present. Using cut off risk levels of 1:250 and 1:384, the sensitivity of the analysis in screening for Down's syndrome pregnancies was 71.5% and 86% respectively. For the non Down's chromosomal abnormalities, using cut off risk levels of 1:250 and 1:384, the sensitivity of the analysis was only 22.3% and 33.4% respectively. Thus risk calculations based on the two serum markers and maternal age failed to identify all fetuses with abnormal chromosomes.
Collapse
Affiliation(s)
- C Anandakumar
- Department of Obstetrics and Gynecology, National University of Singapore
| | | | | | | | | | | |
Collapse
|
38
|
Garduno C, Chew S, Forbess J, Smith PK, Grocott HP. Persistent left superior vena cava and partial anomalous pulmonary venous connection: incidental diagnosis by transesophageal echocardiography during coronary artery bypass surgery. J Am Soc Echocardiogr 1999; 12:682-5. [PMID: 10441226 DOI: 10.1053/je.1999.v12.a98795] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Transesophageal echocardiography plays an important role in the intraoperative treatment of the heart surgery patient. Its utility in the description of both known and unexpected cardiac pathology is well established. We describe a patient with a previously undiagnosed partial anomalous pulmonary venous connection along with a persistent left superior vena cava scheduled for routine coronary artery bypass graft surgery (CABG).
Collapse
Affiliation(s)
- C Garduno
- Department of Anesthesiology, Duke Heart Center, Durham, NC, USA
| | | | | | | | | |
Collapse
|
39
|
Garduno C, Chew S, Grocott HP. Microbubble intravenous contrast during transesophageal echocardiography: agitated 0.9% saline versus agitated 0.9% saline with benzyl alcohol. J Cardiothorac Vasc Anesth 1999; 13:513. [PMID: 10468277 DOI: 10.1016/s1053-0770(99)90251-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
40
|
Razvi K, Chew S, Yong EL, Kumar J, Ng SC. The clinical management of male infertility. Singapore Med J 1999; 40:291-7. [PMID: 10487088] [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: 02/14/2023]
Abstract
Male infertility is a common cause of subfertility for which sperm disorders are the single most common cause. Genetic abnormalities, for example, microdeletions associated with the Y chromosome, defects in the androgen receptor gene and cystic fibrosis have gained recent prominence and it is envisaged that many of the 60% of men for which no cause is found may have a genetic basis for their subfertility. Although an abnormal semen analysis is commonly the first indicator of a male factor problem, further tests are usually required. Empirical treatment with hormones, varicocelectomy and immunological treatment have been proven to be disappointing whilst the treatment of infection and obstruction do not always translate into significantly higher fertility rates. Ejaculatory disorders and impotence can be effectively treated today whilst donor insemination can be offered to men with untreatable infertility. The advent of assisted reproduction and micromanipulation has greatly improved prospects for fertility of men with very poor semen quality. However, the genetic implications of these procedures have to be quickly addressed so that fertility is maximised without risk to the progeny.
Collapse
Affiliation(s)
- K Razvi
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore
| | | | | | | | | |
Collapse
|
41
|
Chew S, Chan C, Ng SC, Ratnam SS. Laparoscopic adhesiolysis for subfertility. Singapore Med J 1998; 39:491-5. [PMID: 10067385] [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
AIM Laparoscopic adhesiolysis has been associated with pregnancy rates of 12% to 58%. This study looks at our experience with laparoscopic adhesiolysis in the management of subfertile patients. METHOD & RESULTS Between January 1992 and March 1995, 27 subfertile patients who had laparoscopic adhesiolysis done were studied. Four patients (15%) had a second look laparoscopy. The overall pregnancy rate (after excluding 6 patients with bilateral tubal blockage or severe male factor) was 33% (7/21). The take home baby rate was 14.3% (3/21) and the ectopic pregnancy rate was 4.7% (1/21). CONCLUSION Laparoscopic adhesiolysis still remains a useful and effective procedure for infertile couples with pelvic adhesions.
Collapse
Affiliation(s)
- S Chew
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore
| | | | | | | |
Collapse
|
42
|
Machulda MM, Bergquist TF, Ito V, Chew S. Relationship between stress, coping, and postconcussion symptoms in a healthy adult population. Arch Clin Neuropsychol 1998; 13:415-24. [PMID: 14590606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Study 1 examined the association between intensity of postconcussive symptoms (PCS), impact of daily stress, and level of perceived stress over the past month in a group of healthy young adults. There was a significant relationship between intensity of PCS and impact of daily stress, as well as level of perceived stress over the past month, independent of the frequency of stressful events experienced. Study 2 assessed the stability of the relationship between PCS and stress. Subjects rated intensity of PCS, impact of daily stress, and level of perceived stress on two separate occasions approximately 1 month apart. The Perceived Stress Scale demonstrated high test-retest reliability. Significant relationships were again found between intensity of PCS and level of perceived stress at both time points, independent of the frequency of stressful events. These results suggest that persistent symptoms in some individuals with postconcussive syndrome may be due, at least in part, to individual differences in the perceived stress of incurring a mild traumatic brain injury.
Collapse
|
43
|
Machulda MM, Bergquist TF, Ito V, Chew S. Relationship Between Stress, Coping, and Postconcussion Symptoms in a Healthy Adult Population. Arch Clin Neuropsychol 1998. [DOI: 10.1093/arclin/13.5.415] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
44
|
Abstract
A diabetic patient who underwent a triple procedure (penetrating keratoplasty, cataract extraction and posterior chamber intraocular lens implantation), developed endophthalmitis caused by Proteus mirabilis. The source of infection was the infected donor cornea, which was imported from Sri Lanka. The organism was resistant to gentamicin, which was the only antibiotic present in the storage medium. On top of an aggressive antibiotic treatment regime (topical, systemic and intravitreal), exchange of the infected with a fresh corneal graft and pars plana vitrectomy were performed. The patient had a speedy recovery and the visual outcome was 20/40 two and a half years after the incident. To our knowledge, post-keratoplasty endophthalmitis caused by P. mirabilis has never been reported in the literature. We report herein such a case with good visual outcome. Newer storage medium, such as Optisol GS, might have a role in preventing keratoplasty-related infection.
Collapse
Affiliation(s)
- D S Lam
- Department of Ophthalmology & Visual Sciences, Chinese University of Hong Kong, Prince of Wales Hospital Shatin, N. T., Hong Kong.
| | | | | |
Collapse
|
45
|
Lam DS, Wong AK, Fan DS, Chew S, Kwok PS, Tso MO. Intraoperative mitomycin C to prevent recurrence of pterygium after excision: a 30-month follow-up study. Ophthalmology 1998; 105:901-4; discussion 904-5. [PMID: 9593395 DOI: 10.1016/s0161-6420(98)95034-5] [Citation(s) in RCA: 121] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The purpose of the study was to examine the efficacy of intraoperative mitomycin C (MMC) in preventing recurrence of pterygium after excision and the postoperative complications encountered. DESIGN The study design was a prospective, randomized, clinical trial. PARTICIPANTS A total of 180 primary and recurrent pterygia were recruited for the study. They were randomized into five groups: A, control with no MMC; B, 0.02% MMC for 5 minutes; C, 0.04% MMC for 5 minutes; D, 0.02% MMC for 3 minutes; and E, 0.04% MMC for 3 minutes. INTERVENTION All patients received pterygium excision with or without the above four modes of intraoperative MMC application. MAIN OUTCOME MEASURES Recurrence of pterygium and postoperative complications such as superficial scleral melting were measured. RESULTS At a mean follow-up of 30 (groups A-C) and 20 months (groups D and E), the respective recurrence rates in groups A through E were 75%, 8.3%, 8.6%, 42.9%, and 22.9%. There were two cases of postoperative superficial scleral melting in group C. Otherwise, no major postoperative complications were encountered. CONCLUSIONS The midterm results of a single intraoperative application of MMC at the concentration of 0.02% for 5 minutes are encouraging. Its application as an adjunctive therapy for the surgical treatment of pterygium appeared to be safe and effective. However, because of the possibility of serious late complications, the authors suggest that this procedure be reserved for patients who have high probability of recurrence after excision of pterygium.
Collapse
Affiliation(s)
- D S Lam
- Prince of Wales Hospital, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin
| | | | | | | | | | | |
Collapse
|
46
|
Abstract
Tea tree oil (TTO) stimulates autolysis in exponential and stationary phase cells of Escherichia coli. Electron micrographs of cells grown in the presence of TTO showed the loss of electron dense material, coagulation of cell cytoplasm and formation of extracellular blebs. Stationary phase cells demonstrated less TTO-stimulated autolysis and also had greater tolerance to TTO-induced cell death, compared to exponentially grown cells. It was also revealed that subpopulation of stationary phase cells demonstrated increased tolerance to TTO-bactericidal effects.
Collapse
Affiliation(s)
- J E Gustafson
- Microbiology Group, School of Biomedical Sciences, Curtin University of Technology, Perth, Western Australia.
| | | | | | | | | | | | | |
Collapse
|
47
|
Chew S, Biswas A. Caesarean and postpartum hysterectomy. Singapore Med J 1998; 39:9-13. [PMID: 9557096] [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 OF STUDY To review the cases of caesarean and post-partum hysterectomy performed over a 10-year period (1986-1996) in a teaching hospital, looking specifically at the associated morbidity. METHOD Retrospective review of case files. RESULTS During the study period, there were 14 cases of caesarean and post-partum hysterectomy. Caesarean hysterectomy was performed in 0.17% of caesarean sections and a hysterectomy was done in 0.02% of cases following a vaginal delivery. Uterine atony was associated with 43% of cases. Histological evidence of placenta accreta or increta was noted in 7 (50%) cases, while 8 (57%) cases had placenta praevia. A subtotal hysterectomy was performed in 7 cases, where the mean operating time was significantly shorter than that in cases of total hysterectomy. There were no maternal deaths. Fever (28%), urinary tract infection (21%) and chest infection/atelectasis (21%) were the common post-operative morbidity. Relaparotomy for continuing vaginal bleeding was required in 2 cases. CONCLUSIONS Emergency peri-partum hysterectomy for obstetric haemorrhage is a rare operation (1 in 2,550 deliveries). In spite of the intra-operative risks and post-operative morbidity, it remains a potentially life-saving procedure.
Collapse
Affiliation(s)
- S Chew
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | | |
Collapse
|
48
|
Abstract
A funded study to investigate best practice in nursing rosters in a busy metropolitan Melbourne children's hospital, identified the complexity of the shiftwork issues when the people who work them are placed centre stage. This paper explores a key finding of the study, which strongly endorses the need to take account of scientific knowledge on health and safety issues of shiftwork, but argues that the personal, socio-cultural and environmental perspective of the nurse needs to be given more attention by the various stakeholders involved with rostering.
Collapse
Affiliation(s)
- A Street
- Centre for Research in Nursing, School of Nursing, La Trobe University, Bundoora, Victoria
| | | | | | | | | | | |
Collapse
|
49
|
Chew S, Tham KF, Ratnam SS. A series of ovarian clear cell and endometrioid carcinoma and their association with endometriosis. Singapore Med J 1997; 38:289-91. [PMID: 9339094] [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: 02/05/2023]
Abstract
AIM To present our department's experience with clear cell carcinoma and endometrioid carcinoma of the ovary, paying particular attention to their relationship with endometriosis and concomitant endometrial pathology. METHOD Retrospective review of case records. RESULTS From July 1986 to March 1995, 11 patients with clear cell carcinoma and 20 patients with endometrioid carcinoma of the ovary were treated. Of the patients with clear cell carcinoma, five (45%) had associated endometriosis. One patient (9%) also had endometrial adenomatous hyperplasia. Of the 20 cases of ovarian endometrioid carcinoma, four (20%) had endometriosis present during histopathological examination. Six patients (30%) had concomitant endometrial pathology (five cases of endometrial carcinoma and one with adenomatous hyperplasia). CONCLUSION Our series shows that the clear cell ovarian carcinoma may often be associated with endometriosis, more so than the endometrioid type of ovarian carcinoma. However, the patient with ovarian endometrioid carcinoma may also harbour a concurrent endometrial pathology.
Collapse
Affiliation(s)
- S Chew
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | | | | |
Collapse
|
50
|
|