1.Drugs and natural products:from plants and livestock to human therapeutics
GREEN T BENEDICT ; LEE STEPHEN
Chinese Journal of Pharmacology and Toxicology 2017;31(10):946-946
Plants toxic to livestock species have a significantly negative impact on agriculture but can be an important source of bioactive molecules for use in medicine. The initial research on plant toxicity is focused on the response to the poisoning and the specific livestock species impacted by the toxic plant. This research emphasizes the identification of the plant and natural product(s) responsible for the toxicity to livestock, the prevention of further poisonings, and the development of treatments for the affected animals. Once the bioactive molecules impacting the livestock species have been identified, research on these compounds is then focused on determining the mechanism of action, the development of models for further study, and the identification of potential drug candidates for the treatment of disease. Specific examples of the agricultural-based research that are relevant to Human and Veterinary Medicine include: cyclopamine from Veratrum californicum (western false hellebore), piperidine alkaloids from Lupinus species (lupines), and cicutoxin from Cicuta species (water hemlock).
2.Validation of ICD 10 on congenital anomalies in the state of Penang
Leela Anthony ; Nagarajah Lee ; Stephen Ambu ; Lokman Hakim
International e-Journal of Science, Medicine and Education 2011;5(2):12-17
Background: Database on hospital records like discharge
data, birth and death certificates are widely used for
epidemiological and research studies. However there are
a very few validation studies on these data. The aim of
this study was to validate and assess the accuracy of the
ICD 10 database on congenital anomalies in the state of
Penang. This study was carried out for three years, from
2002 to 2004.
Methods: The list of cases coded under the general coding
“Q” was extracted and approximately 30% of cases were
randomly selected from the list. Medical records for the
selected cases were checked and discrepancies for the
diagnoses between the medical records and the ICD 10
data base were recorded for three years. Verification was
done for basic demographic variables and the coding of
the diseases. Discrepancies, sensitivity and specificity
were calculated.
Results: The ICD 10 database for congenital anomalies
are classified into two types: Type 1 and Type 2.
Discrepancies on demographic information were found
among the age of patients (babies with congenital
anomalies). In Type 1, there was a discrepancy of about
0.02 % to 0.05% probability that a congenital anomaly
case can be recorded as non congenital anomaly in
the ICD 10. In Type 2 there was a discrepancy that a
non-congenital anomaly was classified as congenital
anomaly and this ranged from 26.7% to 50.0%. The
sensitivity ranged from 96.85% to 97.98%, thus it can
be concluded the ICD 10 database is highly sensitive
while the specificity ranged from 50.00% to 78.57 %. In
other words the ICD 10 is not accurate when classifying
the non- congenital anomaly cases. A fair percentage of
non-congenital anomaly cases were classified as CA in
the ICD 10 database.
Conclusion: Even though hospital databases are
used as a baseline data for a number of research and
epidemiological studies it cannot be used at face
value. Validation of these data is necessary before any
conclusions can be drawn or intervention measures are
undertaken.
3.Cercarial Dermatitis In Kelantan, Malaysia An Occupation Related Health Problem
Chiew Eng Wooi ; Susan Lim Lee Hong ; Stephen Ambu
International e-Journal of Science, Medicine and Education 2007;1(2):69-73
Introduction : Kelantan, an east coast state of
Peninsular Malaysia is rich in culture and supports a
population that is dependent on agriculture. The crops
cultivated are mainly paddy and rubber but in recent
years tobacco is beginning to gain importance over
paddy. We centered our study around Bachok District
which is about 25 kilometers east of Kota Bharu, the
state capital.
Methods: Based on case reports we focused our study on
cercarial dermatitis and also recorded the socioeconomic
status of the people in the four study villages.
Result: The ducks and cows were the common livestock
kept by the farmers and these were found to be
significantly associated (P=0.05) with the occurrence of
dermatitis. Cercariae shedding by snails were found in
waters used for irrigation.
Conclusion : The results indicate that cercarial
dermatitis is occupation specific, and its debilitating
effect was having an influence on the socioeconomic
status and general wellbeing of the population in these
villages. The dermatitis occurred only during the field
preparation and transplanting stages of paddy and was
found to be significantly associated (P=<0.05) with the
source of water used for irrigation. The water sources for
irrigation was mainly from the river and irrigation canal
and the snail Indoplanorbis exustus infected with
schistosome cercariae was found to be abundant in both
these sources during these stages. The ducks and cows
were the common livestock kept by the farmers and
these were also found to be significantly associated
(P=0.05) with the occurrence of dermatitis. Therefore
we concluded that the dermatitis among paddy farmers
in Bachok District was due to an animal schistosome.
4.The mandatory treatment order - The experience in the first year in SIngapore
Kenneth GWW Koh ; Jimmy Lee ; Stephen Phang ; Jerome Goh
ASEAN Journal of Psychiatry 2013;14(2):1-6
The Mandatory Treatment Order (MTO) became a sentencing option for select offenders with psychiatric illness in Singapore in 2011. This article aimed to
study the psychiatric characteristics of the offenders in the first year of the MTO;
Methods: A clinical audit was conducted on all the cases referred to the Institute of
Mental Health for assessment as to their suitability to receive an MTO from January to December 2011. A psychiatrist went through all the case records. Data
on the demographics, forensic history and psychiatric diagnoses were obtained from records;
Results: There were differences seen between the genders in the likelihood of being granted an MTO. Gender also played a role in the length of MTOs granted
and in the diagnoses of the individuals. The reasons for an MTO not being granted are presented.
Conclusion: Some discussion is made regarding the availability of court diversion legislature in other countries for mentally ill offenders and the
directions such diversion might take are highlighted. Potential areas for future research are pointed out.
5.Corticosteroid Resistant Asthma.
Tuberculosis and Respiratory Diseases 1995;42(6):801-812
No abstract available.
Asthma*
6.Generation of Reactive Oxygen Species via NOXa Is Important for Development and Pathogenicity of Mycosphaerella graminicola.
Yoon E CHOI ; Changsu LEE ; Stephen B GOODWIN
Mycobiology 2016;44(1):38-47
The ascomycete fungus Mycosphaerella graminicola (synonym Zymoseptoria tritici) is an important pathogen of wheat causing economically significant losses. The primary nutritional mode of this fungus is thought to be hemibiotrophic. This pathogenic lifestyle is associated with an early biotrophic stage of nutrient uptake followed by a necrotrophic stage aided possibly by production of a toxin or reactive oxygen species (ROS). In many other fungi, the genes CREA and AREA are important during the biotrophic stage of infection, while the NOXa gene product is important during necrotrophic growth. To test the hypothesis that these genes are important for pathogenicity of M. graminicola, we employed an over-expression strategy for the selected target genes CREA, AREA, and NOXa, which might function as regulators of nutrient acquisition or ROS generation. Increased expressions of CREA, AREA, and NOXa in M. graminicola were confirmed via quantitative real-time PCR and strains were subsequently assayed for pathogenicity. Among them, the NOXa over-expression strain, NO2, resulted in significantly increased virulence. Moreover, instead of the usual filamentous growth, we observed a predominance of yeast-like growth of NO2 which was correlated with ROS production. Our data indicate that ROS generation via NOXa is important to pathogenicity as well as development in M. graminicola.
Ascomycota
;
Fungi
;
Life Style
;
NADPH Oxidase
;
Reactive Oxygen Species*
;
Real-Time Polymerase Chain Reaction
;
Triticum
;
Virulence*
7.Assessment of clinical and laboratory parameters for the severity ofacute diverticulitis in a Korean emergency department
Stephen Gyung Won LEE ; Hui Jai LEE ; Jonghwan SHIN ; Kyoung Min YOU
Journal of the Korean Society of Emergency Medicine 2020;31(2):191-199
Objective:
Practice guidelines for diverticulitis have been developed in countries where left-colon diverticulitis is dominant,but there is limited information on right-colon diverticulitis. This study examined the clinical characteristics and riskfactors of clinically severe right-colon diverticulitis.
Methods:
A retrospective chart review of patients diagnosed with diverticulitis in an emergency department in Koreabetween 2013 and 2017 was performed. Clinically severe diverticulitis was defined as any cause of death, intensive careunit admission, surgery, or invasive intervention due to diverticulitis, and admission for seven or more hospital days.Multivariable logistic regression was used to identify the risk factors for clinically severe diverticulitis.
Results:
This study analyzed 302 patients. Patients with older age (odds ratio [OR], 1.044; 95% confidence interval [CI],1.009-1.080; P=0.013), complications observed on computed tomography (CT) (OR, 6.906; 95% CI, 2.514-18.968;P<0.001), rebound tenderness on a physical examination (OR, 2.542; 95% CI, 1.041-6.218; P=0.041), high alkalinephosphatase (ALP) levels (OR, 1.014; 95% CI, 1.002-1.026; P=0.026), and high C-reactive protein (CRP) levels (OR,1.095; 95% CI, 1.017-1.178; P=0.013) were at higher risk of clinically severe diverticulitis.
Conclusion
Among patients diagnosed with right-colon diverticulitis in the emergency department, those of older age,distinct complications on CT, rebound tenderness on physical examination, high ALP, and high CRP levels are related toclinically severe disease.
8.Irreversible Electroporation: A Novel Image-Guided Cancer Therapy.
Edward W LEE ; Susan THAI ; Stephen T KEE
Gut and Liver 2010;4(Suppl 1):S99-S104
Irreversible electroporation (IRE) is a novel tumor ablation technique using a non-thermal energy to create innumerable permanent nanopores in the cell membrane to disrupt cellular homeostasis. This disruption of cellular homeostasis initiates apoptosis which leads to permanent cell death. In our translational research, we have demonstrated that IRE can be a safe, fast and powerful method of tumor treatment. In this review, we present an overview of IRE ablation including a brief history of IRE, advantages and disadvantages of IRE and clinical and research implications of IRE.
Ablation Techniques
;
Apoptosis
;
Cell Death
;
Cell Membrane
;
Electroporation
;
Homeostasis
;
Nanopores
;
Translational Medical Research
9.Modulation of gene expression dynamics by co-transcriptional histone methylations.
Hyeonju WOO ; So Dam HA ; Sung Bae LEE ; Stephen BURATOWSKI ; TaeSoo KIM
Experimental & Molecular Medicine 2017;49(4):e326-
Co-transcriptional methylations of histone H3 at lysines 4 and 36, highly conserved methyl marks from yeast to humans, have profound roles in regulation of histone acetylation. These modifications function to recruit and/or activate distinct histone acetyltransferases (HATs) or histone deacetylases (HDACs). Whereas H3K4me3 increases acetylation at promoters via multiple HATs, H3K4me2 targets Set3 HDAC to deacetylate histones in 5' transcribed regions. In 3' regions of genes, H3K36me2/3 facilitates deacetylation by Rpd3S HDAC and slows elongation. Despite their important functions in deacetylation, no strong effects on global gene expression have been seen under optimized or laboratory growth conditions. Instead, H3K4me2-Set3 HDAC and Set2-Rpd3S pathways primarily delay the kinetics of messenger RNA (mRNA) and long noncoding RNA (lncRNA) induction upon environmental changes. A majority of mRNA genes regulated by these pathways have an overlapping lncRNA transcription either from an upstream or an antisense promoter. Surprisingly, the distance between mRNA and lncRNA promoters seems to specify the repressive effects of the two pathways. Given that co-transcriptional methylations and acetylation have been linked to many cancers, studying their functions in a dynamic condition or during cancer progression will be much more important and help identify novel genes associated with cancers.
Acetylation
;
Gene Expression*
;
Histone Acetyltransferases
;
Histone Deacetylases
;
Histones*
;
Humans
;
Kinetics
;
Methylation*
;
RNA, Long Noncoding
;
RNA, Messenger
;
Yeasts
10.Expanding the donor pool for liver transplantation in the setting of an "opt-out" scheme: 3 years after new legislation.
Victor T W LEE ; Chan Chung YIP ; Iyer Shridhar GANPATHI ; Stephen CHANG ; Kenneth S W MAK ; K PRABHAKARAN ; Krishnakumar MADHAVAN
Annals of the Academy of Medicine, Singapore 2009;38(4):315-317
INTRODUCTIONThe revised Human Organ Transplant Act (HOTA) was implemented in Singapore in July 2004. We aim to evaluate expanding the potential donor pool for liver transplant in Singapore with the inclusion of marginal donors.
MATERIALS AND METHODSAll donor referrals between July 2004 and June 2007 were studied. All potential deceased liver donors were heart-beating. After being reviewed by the transplant coordinator, potential donors were assessed by a transplant hepatologist and a transplant surgeon for suitability of organ donation strictly based on the programme's donor assessment protocol. Reasons for rejection as potential donors were documented. The clinical characteristics of all donor referrals were retrospectively reviewed, and an independent decision was made as to whether liver retrieval in each rejected case might have been possible.
RESULTSAmong the 128 potential donor referrals, 20 donors (15.6%) underwent liver retrieval. Of the 20 livers retrieved, 16 were implanted and 4 were not implanted (3 unfit recipients, and 1 donor liver with 40% steatosis). Another 10 donor livers were assessed intraoperatively and were rejected because of varying levels of steatosis. Of these livers assessed, 5 donor livers had steatosis <40% and 5 had steatosis >40%. Of the remaining potential donors, 45 were deemed not possible because of prolonged hypotension (9), on-going or unresolved sepsis (13), high-risk behaviour (4), non-actualisation (8), or pre-existing medical conditions (11). Another 53 donors may potentially have been suitable donors but were rejected because of possible sepsis (13), no suitable recipients (12), transient hypotension (10), transient abnormal liver function test (6), history of alcohol ingestion (5), non-actualisation because of consent (4) and other reasons (3). Overall, it was deemed that 61 donors (47.7%) might potentially have been suitable liver donors.
CONCLUSIONSDespite new legislation (HOTA) in Singapore, the utilisation of cadaveric donor livers showed no increase in the last 3 years. By expanding our donor criteria to include marginal donors, we could potentially increase the availability of deceased donor livers to meet our waiting list demands.
Adult ; Female ; Humans ; Liver Transplantation ; Living Donors ; legislation & jurisprudence ; supply & distribution ; Male ; Middle Aged ; Referral and Consultation ; organization & administration ; Retrospective Studies ; Singapore ; Tissue and Organ Procurement ; legislation & jurisprudence ; Waiting Lists