Probably more than any country, Singapore has made significant investment into the biomedical enterprise as a proportion of its economy and size. This focus recently witnessed a shift towards a greater emphasis on translational and clinical development. Key to the realisation of this strategy will be Academic Medical Centres (AMCs), as a principal tool to developing and applying useful products for the market and further improving health outcomes. Here, we explore the principal value proposition of the AMC to Singapore society and its healthcare system. We question if the values inherent within academic medicine--that of inquiry, innovation, pedagogy and clinical exceptionalism--can be compatible with the seemingly paradoxical mandate of providing cost-effective or rationed healthcare.
Academic Medical Centers ; economics ; organization & administration ; Cost-Benefit Analysis ; Financing, Government ; Health Care Costs ; Health Care Rationing ; Quality of Health Care ; Singapore

AimTo study the effects of glipizide and met formin on the serum IGF-1,IGF-2 in patients with type Ⅱ diabetes mellitus; Methods The effect of glipizide(n ＝ 40) and metformin(n ＝ 25) on serum IGF-1, IGF-2 in patients with type Ⅱ diabetes mellitus were compared with self- controlled study. Results In metformin-treated patients ,there were not significantly changes in fasting IGF-1 and IGF-2 concentrations, In glipizide-treated patients, there were markedly increased IGF-1 concentrations(181.8+ 104.5) vs (209.0+ 88.2) ng· ml-1(P＜0.05) while serum IGF-2 was not change. There was a significant reduction of blood glucose in two groups at the end of treatment(both P＜0.01), but C-peptide level was markedly increased(P＜0.05) only in glipizide-treatedpatients.Conclusion The changes of IGF-1 is markedly different between metformin-treated and glipizide-treated patients with type Ⅱ diabetes mellitus.

Aim To study the effects of glipizide and metformin on the serum IGF_1,IGF_2 in patients with type Ⅱ diabetes mellitus;Methods The effect of glipizide(n=40) and metformin(n=25) on serum IGF_1,IGF_2 in patients with type Ⅱ diabetes mellitus were compared with self_ controlled study.Results In metformin_treated patients ,there were not significantly changes in fasting IGF_1 and IGF_2 concentrations,In glipizide_treated patients,there were markedly increased IGF_1 concentrations (181.8?104.5) vs (209.0?88.2) ng?ml-1(P

20 normal full term newborns have been fed with 15% concentration of Maeil Drymilk G for 7 days at the department of Pediatrics, Seoul National University Hospital. Feeding results was obtained as follows. 1. General condition was good. They lost approximately 2% of their birth weight during the 1st day and were beginning to regain birth weight on the 4th days of age. (Fig.2) Feeding amounts were increased day by day and were sufficient. (Fig.3) 2. During the first week, they usually passed 2.8~5.5 stools per day. (Fig.4) Yellow stlools were appeared at the 5th days of his age. 95% of stools was the normal consistency and 5% was loose stool. 3. Calories and protein requirements were sufficient, but mean values of water requirement between 2nd and 6th days of age was 1.39ml/cal and it was slightly less than Recommended Dietary Allowance. (Fig.5) 4. Urine concentrations between 78 and 350mOsm/L have been observed. Mean value was 167mOsm/L. (Fig.6) 5. Stool pH between 4.9 and 6.85 have been observed. Mean value was 6.85. (Fig. 6) 6. Total protein, A/G ratio, blood glucose, BUN, Hemoglobin, Hematocrit, WBC and platelet count have been observed within normal range (Fig.6) 7. Mean values of electrolytes were as follows; Na: 142mEq/L, K:5.4mEq/L, Cl:108mEq/L, Ca:9.0mg/dl, P:7.6mg/dl. Na and K closely approximates lowest level of normal range, and P closely approxim-ates highest level of normal range (Fig. 6).
Birth Weight ; Blood Glucose ; Electrolytes ; Hematocrit ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Pediatrics ; Platelet Count ; Recommended Dietary Allowances ; Reference Values ; Seoul ; Water

OBJECTIVETo prepare and characterize the monoclonal antibody (mAb) against human SOCS3.

METHODSBALB/c mice were immunized with recombinant GST-SOCS3 protein, from which the spleen cells were isolated and fused with Sp2/0 cells. After several rounds of screening and cloning, the hybridoma cell strain secreting anti-SOCS3 mAb was obtained, whose specificity was evaluated using ELISA and Western blotting, and the titer, immunoglobulin subtype and affinity of the mAb were also measured.

RESULTSThe hybridoma cell strain secreting anti-SOCS3 mAb was identified to belong to IgG2a subtype. The mAb titers in cultural supernatant and acetic fluid were 1:640 and 1:25600, respectively, as determined by ELISA with affinity reaching 4.84x10(6) L/mol.

CONCLUSIONThe success in anti-SOCS3 mAb preparation provides the basis for further study of the negative regulation of cytokine signal transduction and the immunoregulation in microorganism infections.

Animals ; Antibodies, Monoclonal ; biosynthesis ; Humans ; Hybridomas ; secretion ; Mice ; Mice, Inbred BALB C ; Recombinant Fusion Proteins ; Suppressor of Cytokine Signaling 3 Protein ; Suppressor of Cytokine Signaling Proteins ; immunology

INTRODUCTIONAdvanced hepatocellular carcinoma (HCC) has a dismal prognosis and is notoriously chemo-resistant. We conducted a Phase II prospective study to evaluate the activity and tolerability of gemcitabine and cisplatin in chemo-naïve advanced hepatocellular carcinoma. The trial considered a "no further interest" response rate of 10% and a target response rate of 30%. Utilising a Simon's minimax two-stage design with a type I error of 0.05 and power of 80%, 25 subjects would be required. Fifteen patients would be needed in stage 1 and if fewer than 2 responses were observed, the trial would be stopped and lack of efficacy claimed.

MATERIALS AND METHODSPatients with advanced HCC, diagnosed based on histology or by World Health Organization (WHO) criteria, were administered gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on day 1 and day 8 of a 21-day schedule. Assessment of response based on computer tomography was performed after every 2 cycles of chemotherapy.

RESULTSThe trial was stopped early due to a lack of efficacy. A total of 15 patients were accrued. Twelve patients were hepatitis B positive and the other 3 patients were negative for both hepatitis B and C. Only 1 patient had a history of prior heavy alcohol use. Two patients had Child C liver cirrhosis, 5 patients had Child B cirrhosis, and the remaining 8 patients had Child A cirrhosis. This regime was well tolerated and there was only 1 patient who experienced grade IV toxicities. Only 5 of 15 patients experienced grade III toxicities (nausea and emesis, 1 patient; anemia, 1 patient; thrombocytopenia, 1 patient; and neutropaenia, 2 patients). Only 1 patient experienced a partial response to the combination of gemcitabine and cisplatin. A further 3 patients experienced stable disease and 11 patients progressed on chemotherapy. The median time to progression was 6 weeks. The progression-free curve showed a sharp descent in the initial part of the study, suggesting that many patients had disease progression after enrollment. The median overall survival was 18 weeks.

CONCLUSIONThe progression-free survival and overall survival in our study were extremely short. Based on the results of our phase 2 study, we are unable to recommend further studies utilising gemcitabine and cisplatin combination in patients with advanced HCC.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; etiology ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms ; drug therapy ; etiology ; Male ; Middle Aged ; Prospective Studies ; Time Factors ; Treatment Outcome

Inntroduction: The rapid spread of the Coronavirus disease 2019 (COVID-19) worldwide has led the World Health Organization to declare COVID-19 outbreak as a pandemic on March 11, 2020. As the local studies on factors leading to the absence or presence of clinical illness among the COVID-19 cases are sparse, the study aims to determine the factors associated with asymptomatic COVID19 patients in Petaling District, Selangor, Malaysia Methods: Data on COVID-19 patients were extracted from the database of confirmed cases in Petaling District Health Office, Selangor, Malaysia from 3rd February 2020 to 30th April 2020. An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop any symptoms. The study included socio-demographic variables, the detailed information on clinical manifestations and co-morbidity of the patients. Descriptive and multiple logistic regression analyses were conducted to determine the factors associated with asymptomatic patients. Results: The overall COVID-19 patients in Petaling District were 434. Approximately 70% (n= 292) of the patients were symptomatic while 32.7% (n= 142) were asymptomatic. Multivple logistic regression analyses revealed that factors significantly associated with asymptomatic patients were age below 40 years old (aOR: 1.79, 95% CI 1.11, 2.86), non-Malaysians (aOR: 3.22, 95% CI 1.44, 7.19) and local cases (aOR: 2.51, 95% CI 1.42, 4.42). Gender, ethnicity, comorbidity and township were not significantly associated with asymptomatic patients. Conlcusion Approximately one-third of COVID-19 patients were asymptomatic and the risk factors identified were younger age, non-Malaysians and local cases. Rigorous epidemiological investigation is helpful in identifying COVID-19 cases among these group of people who are asymptomatic.