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Tan SH, Sombuntham P. Narrow band imaging for sulcus vocalis-an often missed diagnosis. QJM 2023; 116:69-70. [PMID: 35993912 DOI: 10.1093/qjmed/hcac204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- S H Tan
- Department of Otolaryngology, Faculty of Medicine, Universiti Malaya, Jalan Universiti, Kuala Lumpur 50603, Malaysia
| | - P Sombuntham
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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Huang C, Mezger STP, Looi WD, Muralidharan S, Ji S, Pastor BC, Tan SH, Charles CJ, Kofidis T, Richard AM, Chan MY, Torta FT, Heeren RMA, Bonney GK, Wang JW. Spatial-temporal lipidomics profile of acute myocardial injury. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lipidome disturbance has long been recognized to occur after myocardial infarction (MI). Accumulation of excessive fatty acids induces production of reactive oxygen species and consequently deteriorates cardiac injury in MI. However, the spatial and temporal lipid profile in the heart following ischemic injury remains unknown.
Purpose
We aim to uncover the temporal-spatial lipidome profile of the heart following ischemia reperfusion (I/R) injury and identify circulating lipids released from injured myocardium that are potentially useful for diagnosis of ischemic heart disease.
Methods
C57/BL6 mice were subjected to 30 min myocardial ischemia followed by removal of the ligature to establish reperfusion injury. Porcine I/R injury was induced by 105 min myocardial ischemia followed by reperfusion. Human plasma was obtained from 143 post-MI patients. Myocardial lipid profiles were generated by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MALDI-MSI) in different regions (infarct, remote and peri-infarct) at different time points. Moreover, the lipids in the heart and plasma were analysed by LC-MS/MS.
Results
We observed a drastic alteration in the lipidome with distinct spatial-temporal features in the injured heart by both MALDI-MSI and LC-MS/MS. In the infarct heart tissue, as revealed by LC-MS/MS, we observed an elevation of glycerolipids that peaked at 3 hours after I/R, and a sustained elevation of phospholipids and sphingolipids up to 3 days. Similar alternations in lipid profile was observed but much weaker in the remote and peri-infarct heart tissue compared to the infarct tissue. Among those lipids, PC 32:0 detected by MALDI-MSI highly overlapped CD68 staining at a single-cell level, showing a strong correlation of PC 32:0 with macrophage infiltration in mouse hearts (R2=0.93, p<0.0001). A similar increase of PC 32:0 in the infarct area was also observed in porcine hearts following I/R injury. Surprisingly, plasma levels of PC 32:0 in the mice decreased after I/R injury. In humans, plasma levels of PC 32:0 in post-MI patients were lower than that in healthy individuals (p=0.03). Further analysis demonstrated that plasma levels of PC 32:0 determined within 72 hours after percutaneous coronary intervention were negatively correlated with the 6-month post-MI cardiac ejection fraction in patients (R2=0.08, p<0.001).
Conclusions
A temporal-spatial lipidome profile was established in heart injury by synergizing LC-MS/MS and mass spectrometry imaging. PC 32:0 levels are positively correlated with myocardial macrophage infiltration but negatively correlated with cardiac function in cardiac I/R injury. Our findings indicate that PC 32:0 is a potential biomarker for cardiac injury and the inflammatory status in the injured heart.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Singapore Ministry of Health's National Medical Research Council
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Affiliation(s)
- C Huang
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - S T P Mezger
- Maastricht University, Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry , Maastricht , The Netherlands
| | - W D Looi
- Bruker Singapore Pte. Ltd. , singapore , Singapore
| | - S Muralidharan
- National University of Singapore, Department of Biochemistry, Singapore Lipidomics Incubator (SLING), Yong Loo Lin School of Medicine , Singapore , Singapore
| | - S Ji
- National University of Singapore, Department of Biochemistry, Singapore Lipidomics Incubator (SLING), Yong Loo Lin School of Medicine , Singapore , Singapore
| | - B C Pastor
- Maastricht University, Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry , Maastricht , The Netherlands
| | - S H Tan
- National University of Singapore, Department of Medicine, Cardiovascular Research Institute, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - C J Charles
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - T Kofidis
- National University of Singapore, Department of Surgery, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - A M Richard
- National University of Singapore, Department of Medicine, Cardiovascular Research Institute, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - M Y Chan
- National University of Singapore, Department of Medicine, Cardiovascular Research Institute, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - F T Torta
- National University of Singapore, Department of Biochemistry, Singapore Lipidomics Incubator (SLING), Yong Loo Lin School of Medicine , Singapore , Singapore
| | - R M A Heeren
- Maastricht University, Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry , Maastricht , The Netherlands
| | - G K Bonney
- National University Hospital, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery , Singapore , Singapore
| | - J W Wang
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute, Yong Loo Lin School of Medicine , Singapore , Singapore
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Tee SI, Lim JHL, Tan SH. Comparative analysis of the clinical, histopathological and molecular genetic features of 29 cases comprising cutaneous B-cell lymphomas and B-cell pseudolymphomas in Singapore. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00628-1] [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: 11/25/2022]
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Yew YW, Kuan A, George PP, Zhao X, Tan SH. Prevalence and burden of skin diseases among the elderly in Singapore: A 15-year clinical cohort study. J Eur Acad Dermatol Venereol 2022; 36:1648-1659. [PMID: 35535625 DOI: 10.1111/jdv.18205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Populations around the world are rapidly ageing. The profile of skin diseases in the elderly is likely to present unique demands on the healthcare system. OBJECTIVES To provide current data on the burden of skin diseases in Singaporean patients and identify differences in the pattern of skin diseases between elderly patients and the rest of the population. METHODS This was a retrospective cohort study of 858,117 patients who attended the National Skin Centre between 2004 to 2018. Prevalence was calculated by grouping International Classification of Diseases codes into different categories of skin conditions based on Global Burden of Disease and American Academy of Dermatology classifications. Years lost to disability (YLD) and disability-adjusted life years (DALY) were calculated to report the morbidity and mortality of skin diseases. Differences of each skin condition between age groups were compared. RESULTS The three most prevalent dermatoses across all age groups were dermatitis (33.3%), acne vulgaris (8.3%) and viral skin diseases (7.5%). The top three most common skin conditions among the elderly were dermatitis (37.7%), viral skin diseases (6.2%), and fungal skin diseases (4.3%). Decubitus ulcers, keratinocyte carcinomas and scabies represented a significant proportion of YLD per 100,000 in the elderly (p <0.001). Malignant melanomas, keratinocyte carcinomas, cellulitis, pyoderma, and decubitus ulcers contributed to high DALY in patients aged 70 - 80 years old. CONCLUSION Aligning health systems with specific healthcare needs will reduce the disproportionately high burden of skin disease observed in the elderly.
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Affiliation(s)
- Y W Yew
- Dermatology, National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Ahy Kuan
- Internal Medicine, Tan Tock Seng Hospital, Singapore
| | - P P George
- Health Services & Outcome Research, National Healthcare Group, Singapore
| | - X Zhao
- Dermatology, National Skin Centre, Singapore
| | - S H Tan
- Dermatology, National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Mangano MC, Berlino M, Corbari L, Milisenda G, Lucchese M, Terzo S, Bosch-Belmar M, Azaza MS, Babarro JMF, Bakiu R, Broitman BR, Buschmann AH, Christofoletti R, Dong Y, Glamuzina B, Luthman O, Makridis P, Nogueira AJA, Palomo MG, Dineshram R, Sanchez-Jerez P, Sevgili H, Troell M, AbouelFadl KY, Azra MN, Britz P, Carrington E, Celić I, Choi F, Qin C, Dionísio MA, Dobroslavić T, Galli P, Giannetto D, Grabowski JH, Helmuth B, Lebata-Ramos MJH, Lim PT, Liu Y, Llorens SM, Mirto S, Pećarević M, Pita C, Ragg N, Ravagnan E, Saidi D, Schultz K, Shaltout M, Tan SH, Thiyagarajan V, Sarà G. The aquaculture supply chain in the time of covid-19 pandemic: Vulnerability, resilience, solutions and priorities at the global scale. Environ Sci Policy 2022; 127:98-110. [PMID: 34720746 PMCID: PMC8548891 DOI: 10.1016/j.envsci.2021.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high-quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID-19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land- vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm-site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.
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Affiliation(s)
- M C Mangano
- Department of Integrated Marine Ecology, Stazione Zoologica Anton Dohrn, Sicily Marine Centre, Lungomare Cristoforo Colombo (complesso Roosevelt), 90142 Palermo, Italy
| | - M Berlino
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- National Institute of Oceanography and Applied Geophysics - OGS, via A. Piccard 54, Trieste, 34151, Italy
| | - L Corbari
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- Department of Engineering, University of Palermo, Viale delle Scienze, Ed. 8, 90128 Palermo, Italy
| | - G Milisenda
- Department of Integrated Marine Ecology, Stazione Zoologica Anton Dohrn, Sicily Marine Centre, Lungomare Cristoforo Colombo (complesso Roosevelt), 90142 Palermo, Italy
| | - M Lucchese
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- National Institute of Oceanography and Applied Geophysics - OGS, via A. Piccard 54, Trieste, 34151, Italy
| | - S Terzo
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, Viale Fernando Stagno d'Alcontres 3, University of Messina, Messina, Italy
- Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy
| | - M Bosch-Belmar
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
| | - M S Azaza
- Aquaculture Laboratory, National Institute of Marine Science and Technology, 2025 Salammbo, Tunis, Tunisia
| | - J M F Babarro
- Instituto de Investigaciones Marinas IIM-CSIC, Eduardo Cabello 6, 36208 Vigo, Spain
| | - R Bakiu
- Department of Aquaculture and Fisheries, Agricultural University of Tirana, Tirane, Albania
| | - B R Broitman
- Departamento de Ciencias, Universidad Adolfo Ibáñez, Viña del Mar Chile & Millenium Institute for Coastal Socio-Ecology (SECOS), Chile
| | - A H Buschmann
- Centro i-mar & CeBiB, Universidad de Los Lagos, Puerto Montt, Chile
| | - R Christofoletti
- Institute of Marine Sciences, Federal University of São Paulo (UNIFESP/IMar), Brazil
| | - Y Dong
- The Key Laboratory of Mariculture, Ministry of Education, Fisheries College, Ocean University of China, Qingdao 266003, China
| | - B Glamuzina
- Department of Applied Ecology, University of Dubrovnik, Ćira Carića 4, 20000 Dubrovnik, Croatia
| | - O Luthman
- School of Natural Science, Technology and Environmental Studies, Södertörn University, Alfred Nobels allé 7, 141 89 Huddinge, Sweden
| | - P Makridis
- Department of Biology, University of Patras, University Campus, Rio Achaias 26504, Greece
| | - A J A Nogueira
- Departamento de Biologia & CESAM, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - M G Palomo
- Laboratory of Marine Ecology, Natural History Museum of Argentina, CONICET, Argentina
| | - R Dineshram
- Biological Oceanography Division, CSIR-National Institute of Oceanography, Dona Paula, Goa 403004, India
| | - P Sanchez-Jerez
- Department of Marine Science and Applied Biology, University of Alicante. Ap.C. 99. Spain
| | - H Sevgili
- Fisheries Application and Research Center & Department of Aquaculture, Eğirdir Faculty of Fisheries, Isparta University of Applied Sciences, Çünür, Isparta, Turkey
| | - M Troell
- Stockholm Resilience Centre, Stockholm University, Kräftriket 2B, 10691 Stockholm, Sweden and Beijer Institute of Ecological Economics, Royal Swedish Academy of Sciences, SE-104 05 Stockholm, Sweden
| | - K Y AbouelFadl
- Aquatic ecology Department, Faculty of Fish and Fisheries Technology, Aswan University, Egypt
| | - M N Azra
- Institute of Marine Biotechnology, Universiti Malaysia Terengganu, 21030 Terengganu, Malaysia
| | - P Britz
- Rhodes University, Department of Ichthyology and Fisheries Science, Grahamstown, South Africa
| | - E Carrington
- Department of Biology and Friday Harbor Laboratories, University of Washington, 620 University Road, Friday Harbor, WA 98250, USA
| | - I Celić
- National Institute of Oceanography and Applied Geophysics - OGS, via A. Piccard 54, Trieste, 34151, Italy
| | - F Choi
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - C Qin
- South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, China
| | - M A Dionísio
- MARE-Marine and Environmental Sciences Centre, Faculty of Science, University of Lisbon, Campo Grande, 1749-016 Lisbon, Portugal
| | - T Dobroslavić
- Department of Applied Ecology, University of Dubrovnik, Ćira Carića 4, 20000 Dubrovnik, Croatia
| | - P Galli
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Italy
| | - D Giannetto
- Department of Biology, Faculty of Science, Muğla Sıktı Koçman University, 48000 Muğla, Turkey
| | - J H Grabowski
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - B Helmuth
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - M J H Lebata-Ramos
- Aquaculture Department, Southeast Asian Fisheries Development Center, Tigbauan, Iloilo 5021, Philippines
| | - P T Lim
- Bachok Marine Research Station, Institute of Ocean and Earth Sciences, University of Malaysia, 16310 Bachok Kelantan, Malaysia
| | - Y Liu
- Faculty of Biosciences, Fisheries and Economics, UiT The Arctic University of Norway, Norway
| | - S M Llorens
- Departamento de Ciencia Animal, Universitat Politècnica de València, Spain
| | - S Mirto
- Institute of Anthropic Impact and Sustainability in Marine Environment, National Research Council (IAS-CNR), Lungomare Cristoforo Colombo 4521, 90142 Palermo, Italy
| | - M Pećarević
- Department of Applied Ecology, University of Dubrovnik, Ćira Carića 4, 20000 Dubrovnik, Croatia
| | - C Pita
- International Institute for Environment and Development (IIED), London, United Kingdom
- CESAM - Centre for Environmental and Marine Studies, Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - N Ragg
- Cawthron Institute, Aquaculture Group, Nelson, New Zealand
| | - E Ravagnan
- NORCE Climate&Environment, Nygårdsgaten 112, 5008 Bergen, Norway
| | - D Saidi
- Faculty of Natural Sciences and life, Department of Water and Environment, University Hassiba Benbouali of Chlef, Algeria
| | - K Schultz
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - M Shaltout
- Faculty of Science, Department of Oceanography, University of Alexandria, Alexandria, Egypt
| | - S H Tan
- Centre For Marine & Coastal Studies, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - V Thiyagarajan
- The Swire Institute of Marine Science and School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - G Sarà
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
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Tan SH, Chan AQY, Lim AYX, Lim MW. P–150 Does trophectoderm biopsy performed on different blastocyst stages affect the clinical outcome? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
The objective of this study is to evaluate the effect of trophectoderm (TE) biopsy on different blastocyst stages and its clinical outcome.
Summary answer
Our results showed that TE biopsy significantly reduced the clinical outcome of fully hatched blastocyst. What is known already: TE biopsy is a method widely practiced to harvest cells to determine the chromosomal constitution of a blastocyst, ensuring higher implantation and healthy pregnancies. The effect on clinical outcome after transferring blastocysts biopsied at different blastocysts stages has not been extensively studied.
Study design, size, duration
This retrospective study was conducted from January 2017 until July 2019 at Alpha IVF & Women’s Specialists. Following laser assisted hatching on day 3, TE biopsy was performed on unhatched, hatching and fully hatched day–5 blastocysts. A total of 1,020 single euploid blastocysts transfer (SBT) were performed. The average maternal age was 31.7. Implantation rates (IR) were evaluated for all stages of hatching (Unhatched: BG3 & 4; hatching: BG5; fully hatched: BG6).
Participants/materials, setting, methods
Laser assisted hatching (Hamilton Thorne Bioscience, USA) was performed on day–3 and subsequently cultured to blastocyst-stage. Different hatching stages were observed using embryoscope time-lapse system (Vitrolife, Sweden) and were recorded. Day–5 blastocysts with at least BG3BB grade (Gardner’s System) were selected for TE biopsy and the biopsied cells were sent for preimplantation genetic testing for aneuploidy (PGT-A) using Next-Generation Sequencing (Life Technologies, USA). All blastocysts were vitrified and warmed using the Cryotec Method (Cryotech, Japan). Main results and the role of chance: All 1,020 blastocysts survived post-warmed (post-warm survival rate= 100%) and were transferred in frozen transfer cycles. TE biopsy performed on unhatched blastocysts showed a comparable IR to hatching blastocysts (60.0% [15/25] and 65.2% [627/961]). While fully hatched blastocysts (44.12% [15/34]) show a significantly lower IR when compared to hatching blastocysts (65.2% [627/961]), no significant difference was seen when comparing unhatched blastocysts to fully hatched blastocysts (60.0% [15/25] and 44.12% [15/34]; p = 0.2949).
Limitations, reasons for caution
The sample size was comparatively smaller in the unhatched and fully hatched group than the hatching group. Further studies with a larger sample size is recommended to ascertain the clinical outcome. Since this is a retrospective study and biopsy was done by different embryologists, the biopsy technique was not controlled. Wider implications of the findings: To achieve higher clinical pregnancy, it is recommended to perform TE biopsy before the blastocysts is fully hatched.
Trial registration number
Not applicable
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Affiliation(s)
- S H Tan
- IVF Nexus, IVF laboratory, Petaling Jaya, Malaysia
| | - A Q Y Chan
- IVF Nexus, IVF laboratory, Petaling Jaya, Malaysia
| | - A Y X Lim
- IVF Nexus, IVF laboratory, Petaling Jaya, Malaysia
| | - M W Lim
- IVF Nexus, IVF laboratory, Petaling Jaya, Malaysia
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7
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Ang WX, Sarasvathy S, Kuppusamy UR, Sabaratnam V, Tan SH, Wong KT, Perera D, Ong KC. In vitro antiviral activity of medicinal mushroom Ganoderma neo-japonicum Imazeki against enteroviruses that caused hand, foot and mouth disease. Trop Biomed 2021; 38:239-247. [PMID: 34362866 DOI: 10.47665/tb.38.3.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hand, foot and mouth disease (HFMD) is a highly contagious viral disease that predominantly affects children younger than 5 years old. HFMD is primarily caused by enterovirus A71 (EVA71) and coxsackievirus A16 (CV-A16). However, coxsackievirus A10 (CV-A10) and coxsackievirus A6 (CV-A6) are being increasingly reported as the predominant causative of HFMD outbreaks worldwide since the past decade. To date, there are still no licensed multivalent vaccines or antiviral drugs targeting enteroviruses that cause HFMD, despite HFMD outbreaks are still being frequently reported, especially in Asia-Pacific countries. The high rate of transmission, morbidity and potential neurological complications of HFMD is indeed making the development of broad-spectrum antiviral drugs/agents against these enteroviruses a compelling need. In this study, we have investigated the in vitro antiviral effect of 4 Ganoderma neo-japonicum Imazeki (GNJI) crude extracts (S1-S4) against EV-A71, CV-A16, CV-A10 and CV-A6. GNJI is a medicinal mushroom that can be found growing saprophytically on decaying bamboo clumps in Malaysian forests. The antiviral effects of this medicinal mushroom were determined using cytopathic inhibition and virus titration assays. The S2 (1.25 mg/ml) hot aqueous extract demonstrated the highest broad-spectrum antiviral activity against all tested enteroviruses in human primary oral fibroblast cells. Replication of EV-A71, CV-A16 and CVA10 were effectively inhibited at 2 hours post-infection (hpi) to 72 hpi, except for CV-A6 which was only at 2 hpi. S2 also has virucidal activity against EV-A71. Polysaccharides isolated and purified from crude hot aqueous extract demonstrated similar antiviral activity as S2, suggesting that polysaccharides could be one of the active compounds responsible for the antiviral activity shown by S2. To our knowledge, this study demonstrates for the first time the ability of GNJI to inhibit enterovirus infection and replication. Thus, GNJI is potential to be further developed as an antiviral agent against enteroviruses that caused HFMD.
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Affiliation(s)
- W X Ang
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S Sarasvathy
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Mushroom Research Centre, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - U R Kuppusamy
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Mushroom Research Centre, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - V Sabaratnam
- Mushroom Research Centre, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - S H Tan
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K T Wong
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - D Perera
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - K C Ong
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Torumkuney D, Van PH, Thinh LQ, Koo SH, Tan SH, Lim PQ, Sivhour C, Lamleav L, Somary N, Sosorphea S, Lagamayo E, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2016-18 in Vietnam, Cambodia, Singapore and the Philippines: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. J Antimicrob Chemother 2021; 75:i19-i42. [PMID: 32337597 DOI: 10.1093/jac/dkaa082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates collected from community-acquired respiratory tract infections (CA-RTIs) in 2016-18 in four Asian countries. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS In total, 260 S. pneumoniae and 258 H. influenzae isolates were tested. Pneumococci from Vietnam (n = 161) were the least susceptible, with rates of susceptibility >90% for fluoroquinolones by CLSI breakpoints, ∼60% for amoxicillin, amoxicillin/clavulanic acid and ceftriaxone but <14% for most other agents. Pneumococcal isolates from Cambodia (n = 48) and Singapore (n = 34) showed susceptibilities ranging from ∼30% for trimethoprim/sulfamethoxazole and oral penicillin to 100% for fluoroquinolones. Among isolates of H. influenzae from Cambodia (n = 30), the Philippines (n = 59) and Singapore (n = 80), rates of susceptibility using CLSI breakpoints were >90% for amoxicillin/clavulanic acid, cephalosporins [except cefaclor in Singapore (77.5%)], macrolides and fluoroquinolones; for isolates from Vietnam (n = 89) the rates of susceptibility were >85% only for amoxicillin/clavulanic acid (95.5%), ceftriaxone (100%) and macrolides (87.6%-89.9%). Susceptibility to other antibiotics ranged from 7.9% (trimethoprim/sulfamethoxazole) to 57.3%-59.6% (fluoroquinolones) and 70.8% (cefixime). The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. A limitation of the study was the small sample sizes and only one or two sites participating per country; however, since susceptibility data are scarce in some of the participating countries any information concerning antibiotic susceptibility is of value. CONCLUSIONS Antibiotic susceptibility varied across countries and species, with isolates from Vietnam demonstrating the lowest susceptibility. Knowledge of resistance patterns can be helpful for clinicians when choosing empirical therapy options for CA-RTIs.
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Affiliation(s)
- D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - P H Van
- Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam
| | - L Q Thinh
- Children Hospital 1, Ho Chi Minh City, Vietnam
| | - S H Koo
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei Street 3, 529889 Singapore
| | - S H Tan
- Department of Laboratory Medicine, 2 Simei Street 3, 529889 Singapore
| | - P Q Lim
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei Street 3, 529889 Singapore
| | - C Sivhour
- Battambang Provincial Referral Hospital Prek Mohatep Village, Svaypor Commune, Battambang City and Battambang Province, Cambodia
| | - L Lamleav
- Siem Reap Provincial Referral Hospital Mondul 1 Village, Svay Dangum Commune, Siem Reap City, Siem Reap Province, Cambodia
| | - N Somary
- Kampong Cham Provincial Referral Hospital, Praketmealea Road, #7 Village, Kampong Cham Commune, Kampong Cham City, Kampong Cham Province, Cambodia
| | - S Sosorphea
- Takeo Provincial Referral Hospital, Phumi 3 Village, RokaKnong Commune, Daunkeo Town, Takeo Province, Cambodia
| | - E Lagamayo
- St. Luke's Medical Center Quezon City, Institute of Pathology, Microbiology Section, 279 E Rodriguez SR. BLVD Cathedral Heights, Quezon City, Philippines
| | - I Morrissey
- IHMA Europe Sàrl, Route de l'Ile-au-Bois 1A, 1870 Monthey/VS, Switzerland
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Hooi YT, Ong KC, Tan SH, Perera D, Wong KT. Coxsackievirus A16 in a 1-Day-Old Mouse Model of Central Nervous System Infection Shows Lower Neurovirulence than Enterovirus A71. J Comp Pathol 2020; 176:19-32. [PMID: 32359633 DOI: 10.1016/j.jcpa.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/13/2019] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 02/06/2023]
Abstract
Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) are the major causes of hand, foot and mouth disease in young children. Although less so with CV-A16, both viruses are associated with serious neurological syndromes, but the differences between their central nervous system infections remain unclear. We conducted a comparative infection study using clinically-isolated CV-A16 and EV-A71 strains in a 1-day-old mouse model to better understand the neuropathology and neurovirulence of the viruses. New serotype-specific probes for in situ hybridization were developed and validated to detect CV-A16 and EV-A71 RNA in infected tissues. Demonstration of CV-A16 virus antigens/RNA, mainly in the brainstem and spinal cord neurons, confirmed neurovirulence, but showed lower densities than in EV-A71 infected animals. A higher lethal dose50 for CV-A16 suggested that CV-A16 is less neurovirulent. Focal virus antigens/RNA in the anterior horn white matter and adjacent efferent motor nerves suggested that neuroinvasion is possibly via retrograde axonal transport in peripheral motor nerves.
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Affiliation(s)
- Y T Hooi
- Department of Pathology, University of Malaya, Kuala Lumpur, Malaysia
| | - K C Ong
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S H Tan
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - D Perera
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - K T Wong
- Department of Pathology, University of Malaya, Kuala Lumpur, Malaysia.
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10
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Ke RD, Tang AZ, Tang XL, Gong L, Fang Q, Tan SH. [Clinical application of HRCT three-dimensional reconstruction in traumatic ossicular chain interruption]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 33:1129-1133. [PMID: 31914258 DOI: 10.13201/j.issn.1001-1781.2019.12.004] [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] [Received: 05/16/2019] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the clinical value of HRCT three-dimensional reconstruction technique in traumatic auditory chain traumatic fracture. Method:The clinical data of 14 patients with traumatic ear ossicular chain interruption were analyzed retrospectively. To evaluate the injury site and degree of the auditory chain before surgery, all the 14 patients underwent,HRCT scanning and three-dimensional reconstruction. The reconstructed auditory chain was observed from multiple angles and compared with the surgical exploration results under microscope. Result:The coincidence rate between ossicular chain injury observed by temporal bone HRCT scan before operation and ossicular chain injury observed during surgery was only 28.57%, the coincidence rate between ossicular chain injury observed during surgery and ossicular chain injury observed by three-dimensional reconstruction is 85.71%.Therefore, three-dimensional reconstruction imaging technique could give the doctor more clearly and stereoscopic images for the destruction of ossicular chain. Conclusion:Preoperative three-dimensional reconstruction can display and diagnosis of auditory ossicular chain destruction more clearly. It can be used to accurately evaluate auditory ossicular chain pathological changes, to develop individualized surgical plans and assess the risk of surgery.
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Affiliation(s)
- R D Ke
- Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,530021,China
| | - A Z Tang
- Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,530021,China
| | - X L Tang
- Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,530021,China
| | - L Gong
- Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,530021,China
| | - Q Fang
- Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,530021,China
| | - S H Tan
- Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning,530021,China
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11
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Wong C, Ng SY, Tan SH. An accidental laboratory exposure to Brucella melitensis: the prospective post-exposure management and a detailed investigation into the nature of the exposure. J Med Microbiol 2020; 67:1012-1016. [PMID: 29846154 DOI: 10.1099/jmm.0.000772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Our aim was to prospectively manage 22 Brucella-exposed individuals and identify the lapses in laboratory practices that lead to the exposure. The exposed individuals were risk-stratified, assessed for post-exposure prophylaxis (PEP), counselled to self-monitor symptoms and followed-up with three serology tests. Staff laboratory practices were recorded. Ten out of 13 high-risk individuals received PEP within 48 h of exposure. Compliance with PEP and serology monitoring was 90 and 96 %, respectively. No brucellosis cases were documented. A single handler manipulated the Brucella isolate on the open bench. Movement of the isolate was tracked in detail, highlighting various points of laboratory non-conformance. Early PEP intervention is effective in preventing acquired brucellosis. Our pragmatic post-exposure management achieved high PEP and serology compliance. We experience first-hand how regular staff engagement motivated PEP adherence and interval blood sampling attendance. The enforcement of practical strategies and safety practices was also implemented without compromising our laboratory processing times.
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Affiliation(s)
- C Wong
- Department of Microbiology, Laboratory Medicine, Changi General Hospital, Singapore
| | - S Y Ng
- Department of Microbiology, Laboratory Medicine, Changi General Hospital, Singapore
| | - S H Tan
- Department of Microbiology, Laboratory Medicine, Changi General Hospital, Singapore
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12
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Ng YA, Lee J, Zheng XJ, Nagaputra JC, Tan SH, Wong SA. Giant pedunculated oesophageal liposarcomas: A review of literature and resection techniques. Int J Surg Case Rep 2019; 64:113-119. [PMID: 31630086 PMCID: PMC6806403 DOI: 10.1016/j.ijscr.2019.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022] Open
Abstract
Giant oesophageal liposarcomas, a rare but important cause of oesophageal tumours. A review of the current literature focusing on resection techniques. Shift in the treatment paradigm in recent years to endoscopic resection techniques. Decision on type of resection technique depends on tumour characteristics and location.
Introduction and presentation of case Liposarcomas are rare causes of oesophageal tumours, accounting for <1% of tumours. We present a case of a dedifferentiated oesophageal liposarcoma arising from a giant fibrovascular polyp for which resection was performed via a left cervical oesophagostomy with transgastric retrieval of tumour. We also review the existing literature focusing on discussion of resection techniques. Discussion To date, 62 cases of oesophageal liposarcoma have been reported in the literature. They usually occur in males (74.2%), with a median age of 66 years (range 38–84 years). Such tumours present most commonly with dysphagia (69.4%); usually arise from the cervical oesophagus (79%), and are well-differentiated. Treatment options include surgery and recently, endoscopic resection techniques such as submucosal dissection (ESD). Conclusion Giant oesophageal liposarcomas are very rare tumours. Such tumours are usually polypoid, arising from a pedicle. As such, resection techniques have shifted away from oesophagectomy to less invasive means such as endoscopic resection or oesophagostomy. Decision on type of resection technique depends on tumour characteristics and location; with the guiding principle being resection with clear margins in order to prevent local recurrence.
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Affiliation(s)
- Y Annalisa Ng
- Department of General Surgery, Changi General Hospital, Singapore.
| | - June Lee
- Department of General Surgery, Changi General Hospital, Singapore
| | - X J Zheng
- Department of General Surgery, Changi General Hospital, Singapore
| | - J C Nagaputra
- Department of Pathology, Changi General Hospital, Singapore
| | - S H Tan
- Department of Pathology, Changi General Hospital, Singapore
| | - S A Wong
- Department of General Surgery, Changi General Hospital, Singapore
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13
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Lim XC, Yatim SMJM, Chong SY, Wang X, Tan SH, Yang X, Chan SP, Richards AM, Charles CJ, Chan M, Wang JW. P4639Plasma tissue factor coagulation activity in post-acute myocardial infarction patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Coagulation is involved in fibroproliferative responses following acute myocardial infarction (AMI). Left ventricular (LV) remodeling following AMI is closely associated with progression to heart failure.
Purpose
We aimed to evaluate the association of plasma tissue factor (TF) coagulation activity with LV remodeling prior to heart failure in post-AMI patients.
Methods
This study was conducted in 228 subjects from the Post-AMI Left Ventricular Remodeling Biomarker Analysis (PAMILA) study and 57 healthy subjects. The post-AMI patients were divided into two age- and sex-matched groups: patients with adverse LV remodeling defined as an increase in LV end systolic volume by ≥15% over 6 months and patients with reverse LV remodeling defined as an decrease in LV end systolic volume by ≥15% over 6 months. TF coagulation activity was determined using human coagulation factor Xa generation based TF chromogenic activity assay and converted into concentrations of active TF (pM). Sodium-citrate anticoagulated plasma was collected at baseline (within 3 days after revascularization), 30 days and 6 months post-AMI. Results are presented as mean±S.E.M. One-way or two-way repeated measures ANOVA or a multiple multi-level longitudinal data analysis with structural equation model was used to assess differences in coagulation activity. P<0.05 was considered statistically significant.
Results
Plasma from healthy subjects and post-AMI patients at baseline had similar concentrations of active TF (TFa): 29.0±1.4 versus 29.1±0.7 pM. Patients treated with warfarin (15 out of 228 patients) showed lower plasma levels of TFa (mean difference −15.2 pM, [95% CI: −18.7, −11.7], p<0.001). Compared to baseline, plasma levels of TFa in the patients was significantly lower at 30 days post-AMI (mean difference −6.9 pM, [95% CI: −4.8, −8.9], p<0.001) and 6 months post-AMI (mean difference −2.8 pM, [95% CI: −0.8, −4.8], p=0.003). Intriguingly, plasma levels of TFa tended to recover from 30 days to 6 months post-AMI (mean difference 4.1 pM, [95% CI: 2.8, 5.4], p<0.001) toward the baseline level and the level in healthy subjects. Similar trends of temporal changes of plasma TFa levels were observed in patients with adverse LV remodeling and those with reverse LV remodeling although TFa levels were slightly higher in patients with reverse LV remodeling (F(2,448)=3.112, p=0.045 for interaction). After adjusting for age, gender, ethnicity, medications, lipid profile and risk factors, the temporal changes of plasma TFa levels in patients remain significant, however, the difference between patients with adverse versus reverse LV remodeling was not significant.
Conclusion
Plasma TF coagulation activity decreased post-AMI but did not differ in patients with adverse versus reverse LV remodeling.
Acknowledgement/Funding
National University Health System Singapore (NUHS O-CRG 2016 Oct-23) to JW Wang
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Affiliation(s)
- X C Lim
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - S M J M Yatim
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - S Y Chong
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - X Wang
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - S H Tan
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - X Yang
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - S P Chan
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - A M Richards
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - C J Charles
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - M Chan
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - J W Wang
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
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14
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Wang JW, Yatim SMJM, Lim XC, Chong SY, Wang X, Tan SH, Yang X, Chan SP, Richards AM, Charles CJ, Chan MY. P2582Signature of plasma extracellular vesicles associated proteins in acute myocardial infarction patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Prediction of left ventricular (LV) remodeling post-acute myocardial infarction (AMI) remains challenging. Several circulating biomarkers have been associated with post-AMI LV remodeling, however, there is no biomarker available to distinguish adverse versus reverse LV remodeling.
Purpose
In this study, we aimed to assess the association of extracellular vesicles (EVs) associated proteins with LV remodeling post-AMI.
Methods
Plasma EVs were isolated via precipitation with dextran sulphate as we previously reported. The protein levels of EV associated von Willebrand factor (VWF), SerpinC1 (antithrombin-III), plasminogen and SerpinF2 (alpha 2-antiplasmin) were determined in the citrate-anticoagulated plasma from 57 healthy subjects and 200 patients recruited in the Post-AMI Left Ventricular Remodeling Biomarker Analysis (PAMILA) study. Patients were categorized into two groups: adverse LV remodeling (n=100) characterized by an increase or reverse LV remodeling (n=100) characterized by a decrease, in LV end systolic volume by ≥15% over 6 months. Patients' plasma was collected at baseline (within 3 days after percutaneous coronary intervention), 1 month and 6 months post-AMI. Log transformation of EV protein levels was performed for assessment in a multiple multi-level longitudinal data analysis with structural equation model (with level of significance fixed at 0.05).
Results
Compared to healthy subjects, baseline protein levels of EV associated VWF and SerpinF2 were significantly higher in post-AMI patients, whereas no difference was observed in SerpinC1 and plasminogen. Among the patients, those on statins (196 out of 200 patients) showed lower protein levels of EV associated VWF (p<0.001) and plasminogen (p=0.003), whereas patients treated with P2Y12 platelet inhibitors (195 out of 200 patients) showed higher protein levels of EV associated VWF (p=0.003) and plasminogen (p=0.035). Multiple multi-level longitudinal data analysis with structural equation model showed that protein levels of EV associated VWF (p<0.001) and SerpinC1 (p=0.021) were lower in patients with adverse LV remodeling than that in patients with reverse LV remodeling during the 6-month follow-up post-AMI. In contrast, protein levels of EV associated plasminogen (p=0.002) and SerpinF2 (p=0.002) were higher in patients with adverse LV remodeling. The differences in the four EV associated proteins between patients with adverse versus reverse LV remodeling remain significant after adjusting for age, gender, ethnicity, medications, lipid profile and risk factors (diabetes, hypertension, dyslipidemia and smoking).
Conclusions
Lower levels of EV associated coagulation proteins (VWF and SerpinC1) and higher levels of EV associated fibrinolytic proteins (plasminogen and SerpinF2) were presented in patients with adverse LV remodeling compared to those with reverse LV remodeling post-AMI.
Acknowledgement/Funding
National University Health System Singapore (NUHS O-CRG 2016 Oct-23) to JW Wang
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Affiliation(s)
- J W Wang
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - S M J M Yatim
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - X C Lim
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - S Y Chong
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - X Wang
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - S H Tan
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - X Yang
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - S P Chan
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - A M Richards
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
| | - C J Charles
- National University of Singapore, Department of Surgery, Cardiovascular Research Institute (CVRI), Singapore, Singapore
| | - M Y Chan
- National University of Singapore, Department of Medicine and Cardiovascular Research Institute, Singapore, Singapore
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Lim HLJ, Tan EST, Tee SI, Ho ZY, Boey JJJ, Tan WP, Tang MBY, Shen L, Chan YH, Tan SH. Epidemiology and prognostic factors for mycosis fungoides and Sézary syndrome in a multi-ethnic Asian cohort: a 12-year review. J Eur Acad Dermatol Venereol 2019; 33:1513-1521. [PMID: 30801779 DOI: 10.1111/jdv.15526] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 01/04/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Limited information exists regarding survival of Asian patients with mycosis fungoides (MF) and Sézary syndrome (SS). OBJECTIVE To evaluate the epidemiology, outcome and prognostic factors of these patients. METHODS A retrospective review of MF/SS cases diagnosed from 2000 to 2011 at a tertiary referral dermatology centre in Singapore was performed. RESULTS Of 246 patients, 63% were male and the median age at diagnosis was 49 years. 73.2% were Chinese, 12.6% Indian, 6.9% Malay and 7.3% Caucasian. A total of 239 patients (97.2%) had MF and seven had SS. Median follow-up duration was 6.3 years, and median duration of symptoms at diagnosis was 13 months. For patients with MF, the majority had early disease (92.8% stage IA-IIA). 3.8% were stage IIB, 1.7% stage III and 1.7% stage IV. Complete response to treatment occurred in 78.2%, partial response in 9.6%, persistent but non-progressive disease in 10.0% and disease progression in 4.1% of patients. Large cell transformation occurred in 4.1% of patients. Mean overall survival during this study was 12.7 years, with death occurring in 2.5% of patients (all ≥stage IIB at diagnosis). For patients with SS, 71.4% presented with stage IVA disease, 28.6% stage IVB. Complete response to treatment occurred in 14.2%, persistent but non-progressive disease in 28.6% and disease progression in 57.2% of patients. Mean overall survival was 3.3 years within this study, with death occurring in 42.9% of SS patients. Prognostic factors associated with favourable recurrence-free survival were male gender (P = 0.008), early disease stage (T1) at diagnosis (P < 0.001) and absence of maintenance treatment after remission (P = 0.01). CONCLUSION Compared to Caucasian and East Asian cohorts, MF in South-East Asians was diagnosed at a younger age and associated with lower mortality, largely due to greater prevalence of hypopigmented MF.
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Affiliation(s)
- H L J Lim
- National Skin Centre, Singapore, Singapore
| | - E S T Tan
- National Skin Centre, Singapore, Singapore
| | - S I Tee
- National Skin Centre, Singapore, Singapore
| | - Z Y Ho
- Ministry of Health Holdings, Singapore, Singapore
| | - J J J Boey
- Ministry of Health Holdings, Singapore, Singapore
| | - W P Tan
- National Skin Centre, Singapore, Singapore
| | - M B Y Tang
- National Skin Centre, Singapore, Singapore
| | - L Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Y H Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - S H Tan
- National Skin Centre, Singapore, Singapore
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16
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Tan SH, Prepageran N. Pneumo-orbita causing optic nerve compression. QJM 2018; 111:743. [PMID: 29660085 DOI: 10.1093/qjmed/hcy084] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S H Tan
- Department of Otolaryngology, Faculty of Medicine, University Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| | - N Prepageran
- Department of Otolaryngology, Faculty of Medicine, University Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
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Dang T, Tan SH, Bodaghi S, Greer G, Lavagi I, Osman F, Ramirez B, Kress J, Goodson T, Weber K, Zhang YP, Vidalakis G. First Report of Citrus viroid V Naturally Infecting Grapefruit and Calamondin Trees in California. Plant Dis 2018; 102:PDIS01180100PDN. [PMID: 30095323 DOI: 10.1094/pdis-01-18-0100-pdn] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- T Dang
- Department of Microbiology and Plant Pathology, University of California Riverside, 92521
| | - S H Tan
- Department of Microbiology and Plant Pathology, University of California Riverside, 92521
| | - S Bodaghi
- Department of Microbiology and Plant Pathology, University of California Riverside, 92521
| | - G Greer
- Department of Microbiology and Plant Pathology, University of California Riverside, 92521
| | - I Lavagi
- Department of Microbiology and Plant Pathology, University of California Riverside, 92521
| | - F Osman
- Department Plant Pathology, University of California Davis, 95616
| | - B Ramirez
- Department of Microbiology and Plant Pathology, University of California Riverside, 92521
| | - J Kress
- California Department of Food and Agriculture Nursery Service Program, Sacramento, 95814
| | - T Goodson
- California Department of Food and Agriculture Nursery Service Program, Sacramento, 95814
| | - K Weber
- California Department of Food and Agriculture Nursery Service Program, Sacramento, 95814
| | - Y P Zhang
- California Department of Food and Agriculture Nursery Service Program, Sacramento, 95814
| | - G Vidalakis
- Department of Microbiology and Plant Pathology, University of California Riverside, CA 92521
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Li Z, Abraham BJ, Berezovskaya A, Farah N, Liu Y, Leon T, Fielding A, Tan SH, Sanda T, Weintraub AS, Li B, Shen S, Zhang J, Mansour MR, Young RA, Look AT. APOBEC signature mutation generates an oncogenic enhancer that drives LMO1 expression in T-ALL. Leukemia 2017; 31:2057-2064. [PMID: 28260788 PMCID: PMC5629363 DOI: 10.1038/leu.2017.75] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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: 11/14/2016] [Revised: 01/27/2017] [Accepted: 02/24/2017] [Indexed: 12/16/2022]
Abstract
Oncogenic driver mutations are those that provide a proliferative or survival advantage to neoplastic cells, resulting in clonal selection. Although most cancer-causing mutations have been detected in the protein-coding regions of the cancer genome; driver mutations have recently also been discovered within noncoding genomic sequences. Thus, a current challenge is to gain precise understanding of how these unique genomic elements function in cancer pathogenesis, while clarifying mechanisms of gene regulation and identifying new targets for therapeutic intervention. Here we report a C-to-T single nucleotide transition that occurs as a somatic mutation in noncoding sequences 4 kb upstream of the transcriptional start site of the LMO1 oncogene in primary samples from patients with T-cell acute lymphoblastic leukaemia. This single nucleotide alteration conforms to an APOBEC-like cytidine deaminase mutational signature, and generates a new binding site for the MYB transcription factor, leading to the formation of an aberrant transcriptional enhancer complex that drives high levels of expression of the LMO1 oncogene. Since APOBEC-signature mutations are common in a broad spectrum of human cancers, we suggest that noncoding nucleotide transitions such as the one described here may activate potent oncogenic enhancers not only in T-lymphoid cells but in other cell lineages as well.
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Affiliation(s)
- Z Li
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - B J Abraham
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | - A Berezovskaya
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - N Farah
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Y Liu
- Department of Computational Biology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - T Leon
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - A Fielding
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - S H Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - T Sanda
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - A S Weintraub
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | - B Li
- Department of Hematology and Oncology, Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S Shen
- Department of Hematology and Oncology, Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Zhang
- Department of Computational Biology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - M R Mansour
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - R A Young
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A T Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Division of Hematology/Oncology, Children’s Hospital, Boston, MA, USA
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19
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Huan KWSJ, Tan JSW, Tan SH, Teoh LC, Yong FC. Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve: a report of 13 cases. J Hand Surg Eur Vol 2017; 42:700-705. [PMID: 27913804 DOI: 10.1177/1753193416680725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/03/2023]
Abstract
UNLABELLED In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries. Six of the former group and three of the latter group achieved >90° shoulder abduction. The technique of double neurotization from a single donor nerve provides favourable results in restoring shoulder abduction in avulsion brachial plexus injuries. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- K W S J Huan
- 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J S W Tan
- 2 Department of Hand Surgery, Singapore General Hospital, Singapore
| | - S H Tan
- 2 Department of Hand Surgery, Singapore General Hospital, Singapore
| | - L C Teoh
- 3 Department of Hand and Microsurgery, Tan Tock Seng Hospital, Singapore
| | - F C Yong
- 3 Department of Hand and Microsurgery, Tan Tock Seng Hospital, Singapore
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20
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Chan SL, Tham MY, Tan SH, Loke C, Foo B, Fan Y, Ang PS, Brunham LR, Sung C. Development and validation of algorithms for the detection of statin myopathy signals from electronic medical records. Clin Pharmacol Ther 2017; 101:667-674. [PMID: 27706800 DOI: 10.1002/cpt.526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/01/2016] [Accepted: 09/19/2016] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to develop and validate sensitive algorithms to detect hospitalized statin-induced myopathy (SIM) cases from electronic medical records (EMRs). We developed four algorithms on a training set of 31,211 patient records from a large tertiary hospital. We determined the performance of these algorithms against manually curated records. The best algorithm used a combination of elevated creatine kinase (>4× the upper limit of normal (ULN)), discharge summary, diagnosis, and absence of statin in discharge medications. This algorithm achieved a positive predictive value of 52-71% and a sensitivity of 72-78% on two validation sets of >30,000 records each. Using this algorithm, the incidence of SIM was estimated at 0.18%. This algorithm captured three times more rhabdomyolysis cases than spontaneous reports (95% vs. 30% of manually curated gold standard cases). Our results show the potential power of utilizing data and text mining of EMRs to enhance pharmacovigilance activities.
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Affiliation(s)
- S L Chan
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research, Singapore
| | - M Y Tham
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore
| | - S H Tan
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore
| | - C Loke
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore
| | - Bpq Foo
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore
| | - Y Fan
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore.,Genome Institute of Singapore, Singapore
| | - P S Ang
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore
| | - L R Brunham
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology and Research, Singapore.,Department of Medicine, Center for Heart and Lung Innovation, University of British Columbia, Canada
| | - C Sung
- Vigilance and Compliance Branch, Health Products Regulation Group, Health Sciences Authority, Singapore.,Duke-NUS Medical School, Singapore
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Lau CSL, Wong JCQ, Tan SH, Tan BC, Ng CSH, Lim SM, Wong G, Sim KLD. O-113 Advance care planning for patients hospitalised for heart failure in a multiethnic south east asian cohort. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.112] [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: 11/03/2022]
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22
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Lim SM, Tan SH, Ng CSH, Lau CSL, Wong JCQ, Tan BC, Wong G, Sim KLD. P-87 The importance of educating healthcare workers (HWC) on advance care planning (ACP) in a south-east asian (SEA) acute hospital setting: The national heart centre singapore (NHCS) experience. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.216] [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: 11/03/2022]
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23
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Lau CSL, Wong JCQ, Tan SH, Tan BC, Ng CSH, Lim SM, Wong G, Sim KLD. P-84 Advance care planning for patients with heart conditions in a multiethnic south east asian cohort: Impact of nurse navigator. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.213] [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]
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24
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Wong JCQ, Lau CSL, Tan SH, Tan BC, Ng CSH, Lim SM, Wong G, Sim KLD. P-66 Contribution factors of end-of-life care options for patients in south east asian cohort. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.196] [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: 11/03/2022]
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25
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Lim SM, Tan SH, Ng CSH, Lau CSL, Wong JCQ, Tan BC, Wong G, Sim KLD. P-2 Advance care planning (ACP): The national heart centre singapore (NHCS) experience. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.132] [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]
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26
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Ng C, Tan SH, Lim SM, Lau CSL, Wong JCQ, Tan BC, Wong G, Sim KLD. P-56 An evaluation of the satisfaction level and change in knowledge level towards advance care planning (ACP) among heart failure patients using a pre and post survey. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.186] [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]
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27
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Tan SH, Yam AWY, Lawton LN, Wong RWJ, Young RA, Look AT, Sanda T. TRIB2 reinforces the oncogenic transcriptional program controlled by the TAL1 complex in T-cell acute lymphoblastic leukemia. Leukemia 2015. [PMID: 26202930 DOI: 10.1038/leu.2015.195] [Citation(s) in RCA: 11] [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] [Indexed: 11/09/2022]
Affiliation(s)
- S H Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - A W Y Yam
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - L N Lawton
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | - R W J Wong
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - R A Young
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA.,Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A T Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Division of Hematology/Oncology, Children's Hospital, Boston, MA, USA
| | - T Sanda
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tan BS, Tiong KH, Choo HL, Chung FFL, Hii LW, Tan SH, Yap IKS, Pani S, Khor NTW, Wong SF, Rosli R, Cheong SK, Leong CO. Mutant p53-R273H mediates cancer cell survival and anoikis resistance through AKT-dependent suppression of BCL2-modifying factor (BMF). Cell Death Dis 2015; 6:e1826. [PMID: 26181206 PMCID: PMC4650736 DOI: 10.1038/cddis.2015.191] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [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] [Received: 04/15/2015] [Revised: 05/25/2015] [Accepted: 06/09/2015] [Indexed: 12/31/2022]
Abstract
p53 is the most frequently mutated tumor-suppressor gene in human cancers. Unlike other tumor-suppressor genes, p53 mutations mainly occur as missense mutations within the DNA-binding domain, leading to the expression of full-length mutant p53 protein. Mutant p53 proteins not only lose their tumor-suppressor function, but may also gain new oncogenic functions and promote tumorigenesis. Here, we showed that silencing of endogenous p53-R273H contact mutant, but not p53-R175H conformational mutant, reduced AKT phosphorylation, induced BCL2-modifying factor (BMF) expression, sensitized BIM dissociation from BCL-XL and induced mitochondria-dependent apoptosis in cancer cells. Importantly, cancer cells harboring endogenous p53-R273H mutant were also found to be inherently resistant to anoikis and lack BMF induction following culture in suspension. Underlying these activities is the ability of p53-R273H mutant to suppress BMF expression that is dependent on constitutively active PI3K/AKT signaling. Collectively, these findings suggest that p53-R273H can specifically drive AKT signaling and suppress BMF expression, resulting in enhanced cell survivability and anoikis resistance. These findings open the possibility that blocking of PI3K/AKT will have therapeutic benefit in mutant p53-R273H expressing cancers.
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Affiliation(s)
- B S Tan
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - K H Tiong
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Oral Cancer Research and Co-ordinating Center (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia [3] Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
| | - H L Choo
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - F Fei-Lei Chung
- Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - L-W Hii
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - S H Tan
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - I K S Yap
- School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - S Pani
- ANU Medical School, Canberra Hospital Campus, The Canberra Hospital Building 4, Garran, Australia
| | - N T W Khor
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - S F Wong
- School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - R Rosli
- UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - S-K Cheong
- Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - C-O Leong
- 1] School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [2] Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia [3] School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
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Seghers AC, Goh BK, Tan SH, Tang BYM. Simplified noncultured autologous cell grafting for the treatment of chronic nonhealing ulcers: the six-well plate technique. Clin Exp Dermatol 2015; 39:620-3. [PMID: 24934915 DOI: 10.1111/ced.12352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2014] [Indexed: 11/28/2022]
Abstract
Chronic recalcitrant ulcers are associated with severe morbidity, and there are few effective treatment options available. Living skin substitutes are an important form of adjuvant therapy to enhance healing of such wounds. We investigated a novel, simplified, noncultured, autologous, cell grafting procedure, using a six-well plate technique, to treat chronic recalcitrant wounds. This was a prospective pilot study that involved harvesting an ultrathin split-skin graft from the gluteal region, which was washed, separated and prepared in six different wells to obtain an autologous mixture of keratinocytes, melanocytes and fibroblasts; this was subsequently applied directly to the wound using a hyaluronic acid (HA) matrix. Eight patients with a total of 14 ulcers were recruited. The primary endpoint assessed was the percentage of re-epithelialization of the ulcers. Secondary endpoints included quality of life and wound bed indices. At baseline, the median wound surface area was 7.4 cm(2) (mean 17.6 ± 23.6 cm(2) , range 0.5-80.0 cm(2) ) with a median duration of 18 months (mean 70.2 ± 95.9, range 3-216 months). The median wound surface area was reduced by 74.3%, from 7.4-1.9 cm(2) , at the final visit. Overall, 28.3% of the ulcers achieved complete healing, and 71.3% of the ulcers had reduction in wound size. Post-graft, there was also improvement in secondary wound bed parameters and all quality of life domains of the Cardiff Wound Impact Schedule. These results suggest that this noncultured autologous six-well technique might be beneficial for treating recalcitrant ulcers.
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Cai SCS, Allen JC, Lim YL, Chua SH, Tan SH, Tang MBY. Mortality of bullous pemphigoid in Singapore: risk factors and causes of death in 359 patients seen at the National Skin Centre. Br J Dermatol 2014; 170:1319-26. [PMID: 24372558 DOI: 10.1111/bjd.12806] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune-mediated subepidermal blistering skin disease and is associated with significant morbidity and mortality. OBJECTIVES To determine the 3-year mortality rate, risk factors and causes of death in patients with BP in Singapore, compared with the general population. METHODS We conducted a retrospective cohort study of all newly diagnosed patients with BP seen at the National Skin Centre from 1 April 2004 to 31 December 2009. Demographic and clinical data on comorbidities and treatment were recorded. Mortality information was obtained from the National Registry of Diseases. RESULTS In total 359 patients were included in our study. The 1-, 2-, 3-year mortality rates were 26·7%, 38·4% and 45·7%, respectively. The 3-year standardized mortality risk for patients with BP was 2·74 (95% confidence interval 2·34-3·19) times higher than for the age- and sex-matched general population. Parkinson disease, heart failure and chronic renal disease were associated with increased mortality, while combination treatment with low-to-moderate-dose corticoste-roids and immunomodulatory agents such as doxycycline and/or nicotinamide was associated with lower mortality. Overall, infections were the most common cause of death (59·8%), with the main causes of death being pneumonia (42·7%), cardiovascular disease (14·6%) and stroke (11·6%). CONCLUSIONS This study confirms an increased 3-year mortality rate for patients with BP in Singapore. Risk factors for increased mortality include medical comorbidities, especially neurological, cardiac and renal diseases. Treatment with combination therapy, including the use of low-to-moderate-dose corticosteroid, appeared to decrease mortality risk in patients with BP.
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Affiliation(s)
- S C S Cai
- Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore
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Gsponer JR, Braun M, Scheble VJ, Zellweger T, Bachmann A, Perner S, Vlajnic T, Srivastava M, Tan SH, Dobi A, Sesterhenn IA, Srivastava S, Bubendorf L, Ruiz C. ERG rearrangement and protein expression in the progression to castration-resistant prostate cancer. Prostate Cancer Prostatic Dis 2014; 17:126-31. [PMID: 24469092 DOI: 10.1038/pcan.2013.62] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 12/02/2013] [Accepted: 12/17/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Approximately half of the prostate carcinomas are characterized by a chromosomal rearrangement fusing the androgen-regulated gene TMPRSS2 to the oncogenic ETS transcription factor ERG. Aim of this study was to comprehensively analyze the role and impact of the ERG rearrangement and protein expression on the progression to castration-resistant (CR) disease. METHODS We used a tissue microarray (TMA) constructed from 114 hormone naive (HN) and 117 CR PCs. We analyzed the ERG rearrangement status by fluorescence in situ hybridization and the expression profiles of ERG, androgen receptor (AR) and the proliferation marker Ki67 by immunohistochemistry. RESULTS Nearly half of the PC tissue specimens (HN: 38%, CR: 46%) harbored a TMPRSS2-ERG gene fusion. HN PCs with positive translocation status showed increased tumor cell proliferation (P<0.05). As expected, TMPRSS2-ERG gene fusion was strongly associated with increased ERG protein expression in HN and CR PCs (both P<0.0001). Remarkably, the study revealed a subgroup (26%) of CR PCs with ERG rearrangement but without any detectable ERG protein expression. This subgroup showed significantly lower levels of AR protein expression and androgen-regulated serum PSA (both P<0.05). CONCLUSIONS In this study, we identified a subgroup of ERG-rearranged CR PCs without detectable ERG protein expression. Our results suggest that this subgroup could represent CR PCs with a dispensed AR pathway. These tumors might represent a thus far unrecognized subset of patients with AR-independent CR PC who may not benefit from conventional therapy directed against the AR pathway.
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Affiliation(s)
- J R Gsponer
- Institute for Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - M Braun
- Department of Prostate Cancer Research, Institute of Pathology, University Hospital of Bonn, Bonn, Germany
| | - V J Scheble
- Institute of Pathology, Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - T Zellweger
- Division of Urology, St Claraspital, Basel, Switzerland
| | - A Bachmann
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - S Perner
- Department of Prostate Cancer Research, Institute of Pathology, University Hospital of Bonn, Bonn, Germany
| | - T Vlajnic
- Institute for Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - M Srivastava
- Department of Anatomy, Physiology, and Genetics, and Institute for Molecular Medicine, Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, MD, USA
| | - S H Tan
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - A Dobi
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - S Srivastava
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - L Bubendorf
- Institute for Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - C Ruiz
- Institute for Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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Tan SH, Low MEY. The Mediterranean and Eastern Atlantic species of Spinolambrus Tan & Ng, 2007: S. macrochelos (Herbst, 1790), S. notialis (Manning & Holthuis, 1981), and S. verrucosus (Studer, 1883), with a note on the identity of Lambrus spinosissimus Osório, 1923 (Crustacea: Decapoda: Brachyura: Parthenopidae). Zootaxa 2014; 3753:96-100. [PMID: 24872282 DOI: 10.11646/zootaxa.3753.1.8] [Citation(s) in RCA: 2] [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] [Received: 12/31/2014] [Indexed: 11/04/2022]
Affiliation(s)
- S H Tan
- Raffles Museum of Biodiversity Research, National University of Singapore, 6 Science Drive 2, Singapore 119260, Republic of Singapore.;
| | - Martyn E Y Low
- Raffles Museum of Biodiversity Research, National University of Singapore, 6 Science Drive 2, Singapore 119260, Republic of Singapore.;
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Phelan PL, Silk PJ, Northcott CJ, Tan SH, Baker TC. Chemical identification and behavioral characterization of male wing pheromone ofEphestia elutella (Pyralidae). J Chem Ecol 2013; 12:135-46. [PMID: 24306403 DOI: 10.1007/bf01045597] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/1985] [Accepted: 05/31/1985] [Indexed: 11/30/2022]
Abstract
Behavioral and chemical evidence is presented for the identity of the male wing pheromone ofEphestia elutella (Hübner) and the role of this pheromone in courtship success is evaluated. Males with the forewing removed experienced a mating success rate less than half of that of either intact males or males that had only the wing gland area remaining of their forewings. GC-MS analysis and microchemical reactions indicated the presence of (E)-phytol and a series of saturated γ-lactones in a methylene chloride extract of the wings. Using an assay of female courtship behavioral response, (E)-phytol was found to evoke an intermediate level of response in females when presented alone, while the complete array of insect-derived γ-lactones produced no significant response. The combination of either γ-decalactone or γ-undecalactone with (E)-phytol in a 1∶2 ratio, however, elicited a female response equivalent to that produced by the unfractionated wing extract.
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Affiliation(s)
- P L Phelan
- Department of Entomology, University of California, 92521, Riverside, California
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Sim DKL, Tan SH, Tan BC, Neo CL, Wong G. ADVANCE CARE PLANNING FOR PATIENTS WITH HEART FAILURE IN A MULTIETHNIC SOUTH EAST ASIAN COHORT. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.85] [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: 11/04/2022]
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Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MWY, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi MG, Tan SH, Voss D. The effects of biocompatible compared with standard peritoneal dialysis solutions on peritonitis microbiology, treatment, and outcomes: the balANZ trial. Perit Dial Int 2013; 32:497-506. [PMID: 22991015 DOI: 10.3747/pdi.2012.00052] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND A multicenter, multi-country randomized controlled trial (the balANZ study) recently reported that peritonitis rates significantly improved with the use of neutral-pH peritoneal dialysis (PD) solutions low in glucose degradation products ("biocompatible") compared with standard solutions. The present paper reports a secondary outcome analysis of the balANZ trial with respect to peritonitis microbiology, treatment, and outcomes. METHODS Adult incident PD patients with residual renal function were randomized to receive either biocompatible or conventional (control) PD solutions for 2 years. RESULTS The safety population analysis for peritonitis included 91 patients in each group. The unadjusted geometric mean peritonitis rates in those groups were 0.30 [95% confidence interval (CI): 0.22 to 0.41] episodes per patient-year for the biocompatible group and 0.49 (95% CI: 0.39 to 0.62) episodes per patient-year for the control group [incidence rate ratio (IRR): 0.61; 95% CI: 0.41 to 0.90; p = 0.01]. When specific causative organisms were examined, the rates of culture-negative, gram-positive, gram-negative, and polymicrobial peritonitis episodes were not significantly different between the biocompatible and control groups, although the biocompatible group did experience a significantly lower rate of non-pseudomonal gram-negative peritonitis (IRR: 0.41; 95% CI: 0.18 to 0.92; p = 0.03). Initial empiric antibiotic regimens were comparable between the groups. Biocompatible fluid use did not significantly reduce the risk of peritonitis-associated hospitalization (adjusted odds ratio: 0.80; 95% CI: 0.48 to 1.34), but did result in a shorter median duration of peritonitis-associated hospitalization (6 days vs 11 days, p = 0.05). Peritonitis severity was more likely to be rated as mild in the biocompatible group (37% vs 10%, p = 0.001). Overall peritonitis-associated technique failures and peritonitis-related deaths were comparable in the two groups. CONCLUSIONS Biocompatible PD fluid use was associated with a broad reduction in gram-positive, gram-negative, and culture-negative peritonitis that reached statistical significance for non-pseudomonal gram-negative organisms. Peritonitis hospitalization duration was shorter, and peritonitis severity was more commonly rated as mild in patients receiving biocompatible PD fluids, although other peritonitis outcomes were comparable between the groups.
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Affiliation(s)
- David W Johnson
- Department of Nephrology, University of Queensland, Brisbane, Australia.
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Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MWY, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi MG, Tan SH, Voss D. The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial. Nephrol Dial Transplant 2012; 27:4445-53. [PMID: 22859794 PMCID: PMC3520083 DOI: 10.1093/ndt/gfs314] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [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: 11/25/2022] Open
Abstract
Background The balANZ trial recently reported that neutral pH, low glucose degradation product (biocompatible) peritoneal dialysis (PD) solutions significantly delayed anuria and reduced peritonitis rates compared with conventional solutions. This article reports a secondary outcome analysis of the balANZ trial with respect to peritoneal membrane function. Methods Adult, incident PD patients with residual renal function were randomized to receive either biocompatible or conventional (control) PD solutions for 2 years. Peritoneal equilibration tests were performed at 1, 6, 12, 18 and 24 months. Peritoneal small solute clearances and ultra-filtration (UF) were measured at 3, 6, 9, 12, 18 and 24 months. Results Of the 185 patients recruited into the trial, 85 patients in the Balance group and 82 patients in the control group had peritoneal membrane function evaluated. Mean 4-h dialysate:plasma creatinine ratios (D:P Cr 4h) at 1 month were significantly higher in the Balance group compared with controls (0.67 ± 0.10 versus 0.62 ± 0.10, P = 0.002). Over the 2-year study period, mean D:P Cr 4 h measurements remained stable in the Balance group but increased significantly in controls [difference −0.004 per month, 95% confidence interval (95% CI) −0.005 to −0.002, P < 0.001]. Similar results were obtained for dialysate glucose ratios (D/D0 glucose). Peritoneal UF was significantly lower in the Balance group than in controls at 3 and 6 months. Over the 2-year study period, peritoneal UF increased significantly in the Balance group but remained stable in controls (difference 24 mL/day/month, 95% CI 9–39, P = 0.002). No differences in peritoneal small solute clearances, prescribed dialysate fill volumes or peritoneal glucose exposure were observed between the two groups. Conclusions Biocompatible and conventional PD solutions exert differential effects on peritoneal small solute transport rate and UF over time. Adequately powered trials assessing the impact of these differential membrane effects on PD technique and patient survival rates are warranted.
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Affiliation(s)
- David W Johnson
- Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia.
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Liang M, Oon HH, Lim YL, Tan SH. A rare postmastectomy vascular rash. Clin Exp Dermatol 2012; 37:578-80. [PMID: 22712864 DOI: 10.1111/j.1365-2230.2011.04221.x] [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: 11/28/2022]
Affiliation(s)
- M Liang
- Department of Dermatology, National Skin Centre, Singapore.
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Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MWY, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi M, Tan SH, Voss D. Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. J Am Soc Nephrol 2012; 23:1097-107. [PMID: 22440906 DOI: 10.1681/asn.2011121201] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The clinical benefits of using "biocompatible" neutral pH solutions containing low levels of glucose degradation products for peritoneal dialysis compared with standard solutions are uncertain. In this multicenter, open-label, parallel-group, randomized controlled trial, we randomly assigned 185 incident adult peritoneal dialysis patients with residual renal function to use either biocompatible or conventional solution for 2 years. The primary outcome measure was slope of renal function decline. Secondary outcome measures comprised time to anuria, fluid volume status, peritonitis-free survival, technique survival, patient survival, and adverse events. We did not detect a statistically significant difference in the rate of decline of renal function between the two groups as measured by the slopes of GFR: -0.22 and -0.28 ml/min per 1.73 m(2) per month (P=0.17) in the first year in the biocompatible and conventional groups, respectively, and, -0.09 and -0.10 ml/min per 1.73 m(2) per month (P=0.9) in the second year. The biocompatible group exhibited significantly longer times to anuria (P=0.009) and to the first peritonitis episode (P=0.01). This group also had fewer patients develop peritonitis (30% versus 49%) and had lower rates of peritonitis (0.30 versus 0.49 episodes per year, P=0.01). In conclusion, this trial does not support a role for biocompatible fluid in slowing the rate of GFR decline, but it does suggest that biocompatible fluid may delay the onset of anuria and reduce the incidence of peritonitis compared with conventional fluid in peritoneal dialysis.
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Affiliation(s)
- David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia.
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Tan SW, Ng SW, Tan SH, Teoh LC. Arthroscopic debridement of intercarpal ligament and triangular fibrocartilage complex tears. Singapore Med J 2012; 53:188-191. [PMID: 22434293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Wrist arthroscopy has evolved since its inception to become an essential diagnostic and therapeutic tool for the management of various wrist disorders. Our study aimed to examine the outcomes of arthroscopic debridement in the treatment of scapholunate (SL), lunotriquetral (LT) and triangular fibrocartilage complex (TFCC) tears. METHODS We conducted a retrospective review of 68 consecutive wrist arthroscopies performed at our institution between January 2000 and July 2005. All the patients complained of wrist pain, which often interfered with their daily activities, work or sports. A standard arthroscopic technique was employed in all. Any intercarpal ligament or TFCC tears found were debrided. RESULTS There were 42 patients with TFCC tears, 58 with SL tears and 49 with LT tears. At a mean follow-up time of 16.6 months, 85.3% of the patients reported an improvement in symptoms and 27.9% had improved range of motion. Grip strength improved by 11.8%. All except two patients returned to their original activities. Outcome following arthroscopic debridement was determined using the Mayo Modified Wrist Score. Based on the postoperative wrist scores of 47 patients, 24 were rated excellent, 17 good, four fair and two poor. By comparing the pre- and postoperative wrist scores of 31 patients, we were able to demonstrate significant improvement in patients who underwent wrist arthroscopies. CONCLUSION Our study demonstrated that there is a definite role for arthroscopic debridement in the management of SL, LT and TFCC tears.
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Affiliation(s)
- S W Tan
- Department of Hand Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
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Goh SH, Pan Y, You GF, Chan YH, Ran H, Herrman T, Heller T, Lim VSK, Mai ZH, Lam J, Chua CM, Chua WP, Tan SH. Effectiveness of frequency mapping on 28 nm device broken scan chain failures. Rev Sci Instrum 2012; 83:023702. [PMID: 22380094 DOI: 10.1063/1.3680584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Frequency mapping methodology is an effective diagnostic tool for detection of manufacturing defects in scan chains. It analyses reflected laser modulations from toggling scan cells to localize defective scan path or scan cell. In this paper, we demonstrate experimentally that the use of solid immersion lens technology to enhance signal and spatial resolution is not a prerequisite for this technique up till 28 nm technology node. We present case studies to show the effectiveness of frequency mapping for detecting systematic and random broken scan chain failures on a 28 nm technology node test chip. We achieved 81% success rate in this methodology.
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Affiliation(s)
- S H Goh
- GLOBALFOUNDRIES, Technology Development, New Technology Prototyping, Singapore.
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Tan EH, Goh C, Lim WT, Soo KC, Khoo ML, Tan T, Tan DSW, Ang MK, Ng QS, Tan PH, Lim A, Hwang J, Teng YHF, Lim TH, Tan SH, Baskaran N, Hui KM. Gefitinib, cisplatin, and concurrent radiotherapy for locally advanced head and neck cancer: EGFR FISH, protein expression, and mutational status are not predictive biomarkers. Ann Oncol 2011; 23:1010-6. [PMID: 21768327 DOI: 10.1093/annonc/mdr327] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Gefitinib was demonstrated to be synergistic with cisplatin and radiotherapy (RT) in in vitro studies. Biomarkers predictive of response to gefitinib in squamous cell head and neck cancer is still lacking. METHODS Thirty-one patients with locally advanced and easily accessible primary tumor sites for biopsies were recruited. Gefitinib was started 3 weeks before the start of cisplatin/concurrent radiotherapy (CTRT) and continued during the CTRT phase and thereafter for 4 months as consolidation phase. Two baselines and a repeat tumor sample were taken after 2 weeks of gefitinib alone to study its impact on tumor gene expression. Epidermal growth factor receptor (EGFR) protein expression, FISH and mutational status, and matrix metallopeptidase 11 (MMP11) protein expression were correlated with response and survival outcome. RESULTS The overall response rate to gefitinib alone was 9.7%. The survival outcome is as follows: median disease free 1.3 years, median survival time 2.4 years, 3-year disease free 42.9%, and 3-year overall survival 48.4%. EGFR FISH, protein expression, and mutational status did not predict for response nor survival outcome of patients. Although MMP11 overexpression did not predict for response, it predicted significantly for a poorer survival outcome. CONCLUSIONS Gefitinib can be combined safely with cisplatin/RT. More studies are needed to uncover predictive biomarkers of benefit to gefitinib.
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Affiliation(s)
- E-H Tan
- Department of Medical Oncology, National Cancer Centre, Singapore.
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Chuah BYS, Putti T, Salto-Tellez M, Charlton A, Iau P, Buhari SA, Wong CI, Tan SH, Wong ALA, Chan CW, Goh BC, Lee SC. Serial changes in the expression of breast cancer-related proteins in response to neoadjuvant chemotherapy. Ann Oncol 2011; 22:1748-54. [PMID: 21355070 DOI: 10.1093/annonc/mdq755] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Tumour expression of cyclooxygenase-2 (COX-2), epidermal growth factor receptor (EGFR), erythroblastic leukaemia viral oncogene homologue-2 (ErbB2), Ki-67 and p53 in breast cancer are associated with poorer outcomes. We investigated in vivo changes of these proteins with neoadjuvant chemotherapy. PATIENTS AND METHODS Four core biopsies were taken from 100 breast cancer patients at baseline, during and upon completion of neoadjuvant chemotherapy. Immunohistochemical expression of these proteins were evaluated and correlated with clinicopathological features, clinical response and progression-free survival (PFS). RESULTS There was a statistically significant change from positivity to negativity in COX-2 expression with chemotherapy (P = 0.002), predominantly in clinical responders (P = 0.002). COX-2-positive tumours that remained positive had shorter PFS than those that turned negative. Estrogen receptor (ER)+ and COX-2+ tumours at baseline that remained COX-2+ fared worse than those that became COX-2 negative (PFS 27 versus 52 months, P = 0.002). No significant changes in IHC expression were observed for ER, progesterone receptor, ErbB2, EGFR, p53 or Ki67. CONCLUSIONS Chemotherapy induced change in COX-2 expression from positivity to negativity predominantly among clinical responders and is associated with longer PFS. Interaction between COX-2 and ER was observed, suggesting that some hormone receptor-positive patients may benefit from combining COX-2 inhibition with hormonal therapy.
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Affiliation(s)
- B Y S Chuah
- Department of Haematology-Oncology, National University Health System, Singapore
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Lam CRI, Tan MJ, Tan SH, Tang MBY, Cheung PCF, Tan NS. TAK1 regulates SCF expression to modulate PKBα activity that protects keratinocytes from ROS-induced apoptosis. Cell Death Differ 2011; 18:1120-9. [PMID: 21233843 DOI: 10.1038/cdd.2010.182] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Dysregulated reactive oxygen species (ROS) generation contributes to many human pathologies, including cancer and diabetes. During normal wound repair, inflammation-induced ROS production must be tightly controlled, but the mechanisms reining their generation remain unclear. Herein, we show that transforming growth factor β-activated kinase 1 (TAK1) directly regulates stem cell factor (SCF) expression, which activates the protein kinase B (PKB)α pro-survival pathway in a cell-autonomous manner to protect keratinocytes from ROS-mediated cell death. TAK1 is a pivotal inflammatory mediator whose expression was transiently elevated during wound healing, paralleling the ROS production profile. TAK1 deficiency in keratinocytes led to increased apoptosis in response to anoikis and TNF-α treatment and was associated with elevated ROS level as analyzed by FACS. Using organotypic skin co-culture and comparative growth factor array analysis, we revealed a cell-autonomous mechanism that involved the SCF/c-Kit/PKBα signaling cascade. Ectopic expression of TAK1 or treatment with exogenous recombinant SCF restored the increased ROS production and apoptotic cell death in TAK1-deficient keratinocytes. Conversely, normal keratinocytes treated with various inhibitors targeting the SCF/c-Kit/PKBα pathway exhibited increased ROS production and TNF-α- or anoikis-induced apoptosis. Our study reveals a novel anti-apoptotic role for SCF in keratinocytes and identifies TAK1 as a novel player uniting inflammation and ROS regulation in skin redox biology.
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Affiliation(s)
- C R I Lam
- School of Biological Sciences, Nanyang Technological University, Singapore
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Tan SH, Mohd Aris E, Kurahashi H, Mohamed Z. A new record of Iranihindia martellata (Senior-White,1924) (Diptera: Sarcophagidae) from peninsular Malaysia and female identification using both morphology and DNA-based approaches. Trop Biomed 2010; 27:287-293. [PMID: 20962727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Iranihindia martellata (Senior-White, 1924) is recorded from peninsular Malaysia for the first time. Male and female specimens in the recent collections of forensically important sarcophagid flies were examined and identified based on morphology and DNA sequencing analysis. Male genitalia offer unambiguous species identification characteristics in the traditional taxonomy of flesh flies but the female flies are very similar to one another in general morphology. Female of I. martellata was determined by DNA sequencing (COI and COII) and PCR-RFLP (COI) analysis. Identified females were carefully examined and compared with the morphologically similar species, Liopygia ruficornis (Fabricius, 1794). Female genitalia are re-described and illustrated in this paper.
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Affiliation(s)
- S H Tan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Abstract
The incidence rate difference (IRD) is a parameter of interest in many medical studies. For example, in vaccine studies, it is interpreted as the vaccine-attributable reduction in disease incidence. This is an important parameter, because it shows the public health impact of an intervention. The IRD is difficult to estimate for various reasons, especially when there are quantitative covariates or the duration of follow-up is variable. In this paper, the authors propose an approach based on weighted least-squares regression for estimating the IRD. It is very easy to implement because it boils down to performing ordinary least-squares regression analysis of transformed variables. Furthermore, if the outcome events are repeatable, the authors propose that data on all events be analyzed instead of first events only. Four versions of the Huber-White robust standard error are considered for statistical inference. Simulation studies are used to examine the performance of the proposed method. In a variety of scenarios simulated, the method provides an unbiased estimate for the IRD, and the empirical coverage proportion of the 95% confidence interval is very close to the nominal level. The method is illustrated with data from a vaccine trial carried out in the Gambia in 2001-2004.
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Affiliation(s)
- Ying Xu
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore.
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Toh HC, Chia WK, Sun L, Thng CH, Soe Y, Phoon YP, Yap SP, Lim WT, Tai WM, Hee SW, Tan SH, Leong SS, Tan EH. Graft-vs-tumor effect in patients with advanced nasopharyngeal cancer treated with nonmyeloablative allogeneic PBSC transplantation. Bone Marrow Transplant 2010; 46:573-9. [PMID: 20661236 PMCID: PMC3072519 DOI: 10.1038/bmt.2010.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 12/17/2022]
Abstract
While nonmyeloablative peripheral blood stem cell transplantation (NST) has shown efficacy against several solid tumors, it is untested in nasopharyngeal cancer (NPC). In a phase II clinical trial, 21 patients with pretreated metastatic NPC underwent NST with sibling PBSC allografts, using CY conditioning, thymic irradiation and in vivo T-cell depletion with thymoglobulin. Stable lymphohematopoietic chimerism was achieved in most patients and prophylactic CYA was tapered at a median of day +30. Seven patients (33%) showed partial response and three (14%) achieved stable disease. Four patients were alive at 2 years and three showed prolonged disease control of 344, 525 and 550 days. With a median follow-up of 209 (4-1147) days, the median PFS was 100 days (95% confidence interval (CI), 66-128 days), and median OS was 209 days (95% CI, 128-236 days). Patients with chronic GVHD had better survival-median OS 426 days (95% CI, 194-NE days) vs 143 days (95% CI, 114-226 days) (P=0.010). Thus, NST may induce meaningful clinical responses in patients with advanced NPC.
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Affiliation(s)
- H C Toh
- Department of Medical Oncology, National Cancer Centre, Singapore, Singapore.
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Tan WP, Tan SH, Tan AW. An extensive painful leg ulcer in a patient with rheumatoid arthritis. Primary cutaneous cryptococcosis. Clin Exp Dermatol 2010; 35:e46-7. [PMID: 20500175 DOI: 10.1111/j.1365-2230.2009.03324.x] [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: 10/19/2022]
Affiliation(s)
- W P Tan
- National Skin Centre, Singapore city, Singapore.
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Seow CJ, Barkham T, Wong PM, Lin L, Pada SK, Tan SH. Brucellosis in a Singaporean with prolonged fever. Singapore Med J 2009; 50:e312-e314. [PMID: 19787157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Brucellosis, a zoonotic disease of worldwide distribution, is common in many developing countries as well as in countries of the Mediterranean basin. We report brucellosis in a 52-year-old man, who had a recent travel history to Saudi Arabia, and who presented with prolonged fever and deranged liver enzymes. In view of the rarity of brucellosis and its potential life-threatening complications, patients returning from an endemic country need to be questioned for possible Brucella exposure, to ensure that diagnostic tests and treatment are carried out in a timely fashion. In addition to notifying the authorities, the clinician should also warn the laboratory early as cultures of brucellosis are highly transmissible and are one of the most common laboratory-acquired infections.
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Affiliation(s)
- C J Seow
- Department of General Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
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Neoh CY, Tan AWH, Mohamed K, Sun YJ, Tan SH. Characterization of the inflammatory cell infiltrate in herald patches and fully developed eruptions of pityriasis rosea. Clin Exp Dermatol 2009; 35:300-4. [PMID: 19663842 DOI: 10.1111/j.1365-2230.2009.03469.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pityriasis rosea (PR) is a common cutaneous papulosquamous disorder affecting young adults. Previous studies have suggested possibilities of a viral aetiology and the involvement of cell-mediated immunity, but these remain unproven to date. AIM To elucidate the possible pathomechanisms in PR by characterizing the inflammatory cellular infiltrate in herald patches and fully developed PR eruptions. METHODS In total, 12 biopsy specimens from 6 patients diagnosed with PR were examined. For each patient, biopsies were taken from both a herald patch and a secondary patch. Specimens were processed for histopathological examination and immunohistochemical staining with a large panel of monoclonal antibodies. RESULTS Histopathologically, all specimens showed epidermal changes such as parakeratosis, orthokeratosis, epidermal hyperplasia and spongiosis. Less common results included epidermal exocytosis and focal parakeratosis. In all biopsies, the dermal infiltrate of lymphocytes stained positively for monoclonal antibodies specific for T cells. The ratio of the CD4+ (helper) vs. CD8+ (cytotoxic) T cells in the dermal infiltrate was increased in most specimens. Increased staining for Langerhans cells was seen within the dermis of lesional skin. There were no marked differences found in histopathology and immunohistochemistry between the herald patch and secondary lesions. Overall, there was a lack of natural killer cell and B-cell activities in PR lesions. CONCLUSIONS Our results support a predominantly T-cell mediated immunity in the development of PR.
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Affiliation(s)
- C Y Neoh
- Department of Dermatology, National Skin Centre, Singapore, Singapore.
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Lim SC, Liu JJ, Low HQ, Morgenthaler NG, Li Y, Yeoh LY, Wu YS, Goh SK, Chionh CY, Tan SH, Kon YC, Soon PC, Bee YM, Subramaniam T, Sum CF, Chia KS. Microarray analysis of multiple candidate genes and associated plasma proteins for nephropathy secondary to type 2 diabetes among Chinese individuals. Diabetologia 2009; 52:1343-51. [PMID: 19415232 DOI: 10.1007/s00125-009-1368-x] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2009] [Accepted: 03/25/2009] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS Evolving research suggests that common and rare alleles jointly constitute the genetic landscape of complex disease. We studied the association between 43 pathway-related candidate genes with 'intermediate phenotype' (i.e. corresponding plasma protein) and diabetic nephropathy in a customised microarray of 1,536 SNPs. METHODS In this case-control study of type 2 diabetic Chinese individuals with and without diabetic nephropathy, cases (n = 545) were defined on the basis of a spot urinary albumin/creatinine ratio (ACR) > 113 mg/mmol; the value for controls (n = 503) was ACR < 3.3 mg/mmol. Genotyping was performed using Illumina GoldenGate assay. RESULTS No single nucleotide polymorphism (SNP) remained significant in single locus analysis after correction for multiple testing. Therefore, we explored the best approximately 1% SNPs. Of these 13 SNPs, four clustered to a 5' end NADPH oxidase homologue 4 (NOX4) haplotype (GGCC frequency = 0.776) with estimated OR for diabetic nephropathy of 2.05 (95% CI 1.04-4.06) (heterozygous) and 2.48 (1.27-4.83) (homozygous) (p = 0.0055). The haplotype was correlated with plasma Cu/Zn superoxide dismutase (SOD) concentration, suggesting increased oxidative burden. Endothelin-1 SNP (rs1476046G>A, frequency = 0.252) was correlated with plasma C-terminal pro-endothelin-1 concentrations with an estimated OR for diabetic nephropathy of (heterozygous) 1.26 (0.96-1.66) and (homozygous) 1.87 (1.13-3.12) (p = 0.0072). Nitric oxide synthase 1 (NOS1) 5' haplotype (TGTC frequency = 0.38) also revealed a suggestive association with diabetic nephropathy: heterozygous 1.26 (0.95-1.67), homozygous 1.57 (1.04-2.35) (p = 0.0073). A rare NADPH oxidase homologue 1 (NOX1)-coding non-synonymous SNP (Arg315His, frequency = 0.006) was found exclusively among cases. CONCLUSIONS/INTERPRETATION Our preliminary observations suggest that common haplotypes from NOX4 and endothelin-1 SNP correlated with plasma Cu/Zn SOD and C-terminal pro-endothelin-1 concentrations, respectively, and might have conferred diabetic nephropathy susceptibility. Common NOS1 and rare NOX1 variants also revealed a suggestive association with diabetic nephropathy. Future studies to validate our observation are needed.
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Affiliation(s)
- S C Lim
- Department of Medicine, Alexandra Hospital, 378 Alexandra Road, Singapore, Republic of Singapore.
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