1.Multiloculated hydrocephalus in an adult: Role of MRI FIESTA sequence in diagnosis and management
Norlisah Ramli ; Farhana Fadzli ; Kalai Arasu Muthusamy ; Chan Kam Hong
Neurology Asia 2014;19(4):425-427
This is a case of an adult patient with hypertensive intraventricular haemorrhages complicated by
hydrocephalus that failed to respond to endoscopic third ventriculostomy (ETV). High-resolution
3D Fast Imaging Employing Steady State Acquisition (FIESTA) magnetic resonance imaging (MRI)
revealed underlying multiloculated hydrocephalus. This case report highlights the appropriate sequence
and its attributes that offer adequate preoperative information detailing the ventricular system.
2.Scanning laser polarimetry in pulmonary tuberculosis patients on chemotherapy.
Wilson W T TANG ; Jimmy S M LAI ; Clement C Y THAM ; Kam-Keung CHAN ; Kin-Sang CHAN
Annals of the Academy of Medicine, Singapore 2006;35(6):395-399
INTRODUCTIONThe aim of this study was to analyse the thickness of the retinal nerve fibre layer (RNFL) of pulmonary tuberculosis patients on ethambutol and isoniazid.
MATERIALS AND METHODSThis was a prospective cohort study where patients with newly diagnosed pulmonary tuberculosis requiring chemotherapy, including ethambutol and isoniazid, were imaged using scanning laser polarimetry. Their mean baseline RNFL thickness and various scanning laser polarimetry parameters of both eyes were measured 2 weeks after the commencement of chemotherapy. The measurements were repeated at 3 months and 6 months after treatment. The various parameters of the baseline and the follow-up measurements were compared using paired sample t-test with Bonferroni correction.
RESULTSTwenty-four patients (16 males and 8 females; mean age, 51.0 +/- 17.6 years) were recruited. There was no statistically significant difference between the baseline and the follow-up measurements in RNFL thickness and all other scanning laser polarimetry parameters.
CONCLUSIONIn this cohort of subjects, there was no subclinical change in RNFL thickness detected by scanning laser polarimetry in pulmonary tuberculosis patients on chemotherapy, including ethambutol and isoniazid, after 6 months of treatment.
Adult ; Aged ; Aged, 80 and over ; Antitubercular Agents ; adverse effects ; therapeutic use ; Diagnostic Techniques, Ophthalmological ; Ethambutol ; adverse effects ; therapeutic use ; Female ; Humans ; Isoniazid ; adverse effects ; therapeutic use ; Lasers ; Male ; Middle Aged ; Prospective Studies ; Retinal Diseases ; chemically induced ; diagnosis ; Tuberculosis, Pulmonary ; drug therapy
3.Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws.
Michael Siu Hei TSE ; Chi Hin CHAN ; Kam Kwong WONG ; Wing Cheung WONG
Asian Spine Journal 2016;10(4):705-710
STUDY DESIGN: Retrospective study. PURPOSE: To analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients. OVERVIEW OF LITERATURE: C7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width. METHODS: We have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl's technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images. RESULTS: CT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm. CONCLUSIONS: The mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan.
Adult
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Asian Continental Ancestry Group*
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Humans
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Methods
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Pedicle Screws*
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Retrospective Studies
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Spine*
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Tomography, X-Ray Computed
4.Randomized controlled trial of antibiotic prophylaxis regimens for transrectal ultrasound-guided prostate biopsy.
Eddie Shu-Yin CHAN ; Ka-Lun LO ; Chi-Fai NG ; See-Ming HOU ; Sidney Kam-Hung YIP
Chinese Medical Journal 2012;125(14):2432-2435
BACKGROUNDA prior study showed significant antibiotic resistance to quinolone in our population. In this study we aimed to evaluate and compare the efficacy of a single versus a combined prophylactic antibiotic regimen before transrectal ultrasound-guided prostate biopsy (TRUGPB).
METHODSA prospective randomized study was conducted at a university hospital. Patients undergoing TRUGPB were randomized into an amoxicillin-clavulanate alone (1 mg; one dose before and two doses after biopsy) or an amoxicillin-clavulanate + ciprofloxacin group (250 mg; one dose before and two doses after biopsy). Patients were surveyed for infection symptoms by phone on days 3 and 30 after TRUGPB. We defined an infective complication as the occurrence of symptoms including fever, chills or rigor within 30 days after prostate biopsy, requiring medical treatment or hospitalization, aided by a territory-wide electronic medical record system.
RESULTSBetween November 2007 and July 2009, 367 patients were randomized to either amoxicillin-clavulanate alone or amoxicillin-clavulanate + ciprofloxacin group. The infection rates after TRUGPB were 3.91% in the former group (7 out of 179 patients) versus 0.53% (1 out of 188 patients) in the latter. Sixty-three percent (5/8) of patients with infective complications needed hospitalization. There was no intensive care unit admission or mortality during the study period.
CONCLUSIONSCombining prophylactic antibiotics with amoxicillin-clavulanate + ciprofloxacin significantly reduced the incidence of infective complications after TRUGPB. We recommended a combination regimen, especially in centre with high incidence of post-TRUGPB infection.
Amoxicillin ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; methods ; Biopsy, Needle ; adverse effects ; methods ; Ciprofloxacin ; therapeutic use ; Clavulanic Acid ; therapeutic use ; Humans ; Male ; Prostate ; diagnostic imaging ; pathology ; surgery ; Rectum ; Ultrasonography
5.Novel mitochondrial 16S rRNA mutation, 3200T-->C, associated with adult-onset type 2 diabetes.
Tao YANG ; Ching-Wan LAM ; Man-Wo TSANG ; Sui-Fan TONG ; Grace Y W KAM ; Lisa Y S CHAN ; Priscilla M K POON ; Xiangqian WU ; Chi-Pu PANG
Chinese Medical Journal 2002;115(5):753-758
OBJECTIVETo investigate the role of a potential diabetes-related mitochondrial region, which includes two previously reported mutations, 3243A-->G and 3316G-->A, in Chinese patients with adult-onset type 2 diabetes.
METHODSA total of 277 patients and 241 normal subjects were recruited for the study. Mitochondrial nt 3116 - 3353, which spans the 16S rRNA, tRNA(leu(UUR)) and the NADH dehydrogenase 1 gene, were detected using polymerase chain reaction (PCR), direct DNA sequencing, PCR-restriction fragment length polymorphism and allele-specific PCR. Variants were analyzed by two-tailed Fisher exact test. The function of the variants in 16S rRNA were predicted for minimal free energy secondary structures by RNA folding software mfold version 3.
RESULTSFour homoplasmic nucleotide substitutions were observed, 3200T-->C, 3206C-->T, 3290T-->C and 3316G-->A. Only the 3200T-->C mutation is present in the diabetic population and absent in the control population. No statistically significant associations were found between the other three variants and type 2 diabetes. The 3200T-->C and 3206C-->T nucleotide substitutions located in 16S rRNA are novel variants. The 3200T-->C caused a great alteration in the minimal free energy secondary structure model while the 3206C-->T altered normal 16S rRNA structure little.
CONCLUSIONSThe results suggest that the 3200T-->C mutation is linked to the development of type 2 diabetes, but that the other observed mutations are neutral. In contrast to the Japanese studies, the 3316G-->A does not appear to be related to type 2 diabetes.
Age of Onset ; Aged ; Alleles ; Base Sequence ; DNA Mutational Analysis ; DNA, Mitochondrial ; chemistry ; genetics ; Diabetes Mellitus, Type 2 ; genetics ; Humans ; Middle Aged ; Models, Molecular ; Nucleic Acid Conformation ; Point Mutation ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S ; chemistry ; genetics
6.Corticosteroids are not present in a traditional Chinese medicine formulation for atopic dermatitis in children.
Kam Lun E HON ; Vivian W Y LEE ; Ting-Fan LEUNG ; Kenneth K C LEE ; Andrew K W CHAN ; Tai-Fai FOK ; Ping-Chung LEUNG
Annals of the Academy of Medicine, Singapore 2006;35(11):759-763
INTRODUCTIONTraditional Chinese medicine (TCM) has been used as an alternative in treating children with atopic dermatitis (AD) but its efficacy and potential side effects are debatable. We recently used a TCM capsule (PentaHerbs) on 9 children and observed significant reductions in clinical scores of disease severity. However, there have been concerns that the therapeutic effects of many forms of TCM are due to the presence of corticosteroids. The purpose of this study was to evaluate if common corticosteroids are present in PentaHerbs capsules.
MATERIALS AND METHODSPentaHerbs powder was analysed with thin-layer chromatography, infra-red spectrophotometry and liquid chromatography mass spectrometry.
RESULTSHydrocortisone, prednisolone, fludrocortisone and dexamethasone were not detected in the PentaHerbs capsules.
CONCLUSIONCorticosteroids are not present in the 5 familiar herbs that were earlier shown to have efficacy on AD.
Child ; Chromatography, Thin Layer ; Dermatitis, Atopic ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Glucocorticoids ; analysis ; therapeutic use ; Humans ; Mass Spectrometry ; Pilot Projects ; Spectrophotometry, Infrared
7.Aurone derivatives as Vps34 inhibitors that modulate autophagy.
Guodong LI ; Joshua William BOYLE ; Chung-Nga KO ; Wu ZENG ; Vincent Kam Wai WONG ; Jian-Bo WAN ; Philip Wai Hong CHAN ; Dik-Lung MA ; Chung-Hang LEUNG
Acta Pharmaceutica Sinica B 2019;9(3):537-544
We report in this study the identification of a natural product-like antagonist () of Vps34 as a potent autophagy modulator structure-based virtual screening. Aurone derivative strongly inhibited Vps34 activity in cell-free and cell-based assays. Significantly, prevents autophagy in human cells induced either by starvation or by an mTOR inhibitor. modeling and kinetic data revealed that could function as an ATP-competitive inhibitor of Vps34. Moreover, it suppressed autophagy and without inducing heart or liver damage in mice. could be utilized as a new motif for more selective and efficacious antagonists of Vps34 for the potential treatment of autophagy-related human diseases.