Browse publications by year: 2008

  1. van der Werf GR, Dempewolf J, Trigg SN, Randerson JT, Kasibhatla PS, Giglio L, et al.
    Proc Natl Acad Sci U S A, 2008 Dec 23;105(51):20350-5.
    PMID: 19075224 DOI: 10.1073/pnas.0803375105
    Drainage of peatlands and deforestation have led to large-scale fires in equatorial Asia, affecting regional air quality and global concentrations of greenhouse gases. Here we used several sources of satellite data with biogeochemical and atmospheric modeling to better understand and constrain fire emissions from Indonesia, Malaysia, and Papua New Guinea during 2000-2006. We found that average fire emissions from this region [128 +/- 51 (1sigma) Tg carbon (C) year(-1), T = 10(12)] were comparable to fossil fuel emissions. In Borneo, carbon emissions from fires were highly variable, fluxes during the moderate 2006 El Niño more than 30 times greater than those during the 2000 La Niña (and with a 2000-2006 mean of 74 +/- 33 Tg C yr(-1)). Higher rates of forest loss and larger areas of peatland becoming vulnerable to fire in drought years caused a strong nonlinear relation between drought and fire emissions in southern Borneo. Fire emissions from Sumatra showed a positive linear trend, increasing at a rate of 8 Tg C year(-2) (approximately doubling during 2000-2006). These results highlight the importance of including deforestation in future climate agreements. They also imply that land manager responses to expected shifts in tropical precipitation may critically determine the strength of climate-carbon cycle feedbacks during the 21st century.
    MeSH terms: Asia; Carbon Monoxide/analysis; Climate*; Conservation of Natural Resources*; Fires*; Satellite Communications; Ecosystem; Sphagnopsida; Droughts
  2. Ngeow WC, Choong KF, Ong TK, Shim CN, Wee JM, Lee MY, et al.
    Br Dent J, 2008 Dec 13;205(11):583.
    PMID: 19079084 DOI: 10.1038/sj.bdj.2008.1034
    MeSH terms: Dentists/economics*; Financial Management*; Great Britain; Humans; Malaysia; Motivation; Students, Dental; Training Support
  3. Hashim SE, Tan HK, Wan-Hazabbah WH, Ibrahim M
    Ann Acad Med Singap, 2008 Nov;37(11):940-6.
    PMID: 19082201
    INTRODUCTION: Refractive error remains one of the primary causes of visual impairment in children worldwide, and the prevalence of refractive error varies widely. The objective of this study was to determine the prevalence of refractive error and study the possible associated factors inducing refractive error among primary school children of Malay ethnicity in the suburban area of Kota Bharu, Kelantan, Malaysia.

    MATERIALS AND METHODS: A school-based cross-sectional study was performed from January to July 2006 by random selection on Standard 1 to Standard 6 students of 10 primary schools in the Kota Bharu district. Visual acuity assessment was measured using logMAR ETDRS chart. Positive predictive value of uncorrected visual acuity equal or worse than 20/40, was used as a cut-off point for further evaluation by automated refraction and retinoscopic refraction.

    RESULTS: A total of 840 students were enumerated but only 705 were examined. The prevalence of uncorrected visual impairment was seen in 54 (7.7%) children. The main cause of the uncorrected visual impairment was refractive error which contributed to 90.7% of the total, and with 7.0% prevalence for the studied population. Myopia is the most common type of refractive error among children aged 6 to 12 years with prevalence of 5.4%, followed by hyperopia at 1.0% and astigmatism at 0.6%. A significant positive correlation was noted between myopia development with increasing age (P <0.005), more hours spent on reading books (P <0.005) and background history of siblings with glasses (P <0.005) and whose parents are of higher educational level (P <0.005). Malays in suburban Kelantan (5.4%) have the lowest prevalence of myopia compared with Malays in the metropolitan cities of Kuala Lumpur (9.2%) and Singapore (22.1%).

    CONCLUSION: The ethnicity-specific prevalence rate of myopia was the lowest among Malays in Kota Bharu, followed by Kuala Lumpur, and is the highest among Singaporean Malays. Better socio-economic factors could have contributed to higher myopia rates in the cities, since the genetic background of these ethnic Malays are similar.

    MeSH terms: Child; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Malaysia/epidemiology; Male; Refraction, Ocular; Refractive Errors/complications; Refractive Errors/epidemiology*; Refractive Errors/physiopathology; Retrospective Studies; Schools*; Suburban Population/statistics & numerical data*; Visual Acuity; Vision, Low/etiology; Vision, Low/epidemiology; Vision, Low/physiopathology; Prevalence
  4. Barman A
    Ann Acad Med Singap, 2008 Nov;37(11):957-63.
    PMID: 19082204
    INTRODUCTION: Setting, maintaining and re-evaluation of assessment standard periodically are important issues in medical education. The cut-off scores are often "pulled from the air" or set to an arbitrary percentage. A large number of methods/procedures used to set standard or cut score are described in literature. There is a high degree of uncertainty in performance standard set by using these methods. Standards set using the existing methods reflect the subjective judgment of the standard setters. This review is not to describe the existing standard setting methods/procedures but to narrate the validity, reliability, feasibility and legal issues relating to standard setting.

    MATERIALS AND METHODS: This review is on some of the issues in standard setting based on the published articles of educational assessment researchers.

    RESULTS: Standard or cut-off score should be to determine whether the examinee attained the requirement to be certified competent. There is no perfect method to determine cut score on a test and none is agreed upon as the best method. Setting standard is not an exact science. Legitimacy of the standard is supported when performance standard is linked to the requirement of practice. Test-curriculum alignment and content validity are important for most educational test validity arguments.

    CONCLUSION: Representative percentage of must-know learning objectives in the curriculum may be the basis of test items and pass/fail marks. Practice analysis may help in identifying the must-know areas of curriculum. Cut score set by this procedure may give the credibility, validity, defensibility and comparability of the standard. Constructing the test items by subject experts and vetted by multi-disciplinary faculty members may ensure the reliability of the test as well as the standard.

    MeSH terms: Education, Medical/standards*; Educational Measurement/methods*; Humans; Reproducibility of Results
  5. Kadir Ahmad Parveez G
    Methods Mol Biol, 2008;477:301-20.
    PMID: 19082956 DOI: 10.1007/978-1-60327-517-0_23
    Physical and biological parameters affecting DNA delivery into oil palm embryogenic calli using the biolistic device are optimized. Five different promoters are also evaluated to identify the most suitable promoter for use in oil palm transformation. Finally, the effectiveness of kanamycin, geneticin (G418), neomycin, hygromycin, and herbicide Basta as selection agents to inhibit growth of oil palm embryogenic calli is evaluated. Combination of optimized parameters, best promoter and selection agent is later used to transform oil palm embryogenic calli for producing transgenic oil palm plants. Bombarded embryogenic calli are exposed to 50 mg/l of Basta after 3 weeks. Basta-resistant embryogenic calli started to emerge five to six months in medium containing Basta. The Basta-resistant embryogenic calli are proliferated until they reach a specific size, and the Basta-resistant calli are later individually isolated and regenerated to produce complete plantlets. The complete regenerated plantlets are evaluated for the presence of transgenes by PCR, Southern and thin layer chromatography analyses.
    MeSH terms: Chromatography, Thin Layer; Glucuronidase/genetics; Plant Oils/metabolism*; Regeneration; Seeds/enzymology; Biolistics/methods*; Arecaceae/embryology; Arecaceae/genetics*; Plants, Genetically Modified; Herbicide Resistance
  6. Lee CY, Sim SM, Cheng HM
    Nutr Res, 2008 Aug;28(8):555-63.
    PMID: 19083460 DOI: 10.1016/j.nutres.2008.05.001
    The use of a high quercetin dose to demonstrate its absorption and bioavailability does not reflect the real dietary situation because quercetin glycosides are usually present in small amounts in the human diet. This study aimed to demonstrate the absorption and bioavailability of quercetin in mulberry leaves that represents a more physiologic dietary situation. Mulberry leaf ethanol extract was prepared similar to tea infusion, which is the way the tea leaves are generally prepared for consumption. Accordingly, rats were fed by oral intubation the mulberry leaf ethanol extract (15 g%/rat per day) or pure rutin (135 microg/rat per day) for 2 weeks. The control group received a similar volume of the vehicle, 10% ethanol. There was a significant increase in total antioxidant activity (TAA) in the urine and feces of the antioxidants-fed rats. Phenylacetic acid, a microbial metabolite of quercetin, was detected in the urine of the test animals, and quercetin was present in the fecal samples. By using an in situ intestinal preparation, 3-hydroxyphenylacetic acid, another microbial metabolite of quercetin, was detected in the plasma when the duodenal segment was instilled with 2 mg of rutin. This microbial metabolite retained 50% of the TAA of quercetin. The results of this study indicate that in a more realistic dietary situation, an increase in TAA in the body after consumption of quercetin-containing foods is contributed mainly by the microbial metabolites.
    MeSH terms: Animals; Antioxidants/analysis; Chromatography, High Pressure Liquid; Feces/chemistry; Female; Male; Phenylacetates/analysis; Phenylacetates/blood*; Phenylacetates/urine*; Plant Extracts/administration & dosage*; Plant Extracts/pharmacokinetics; Quercetin/analysis; Quercetin/metabolism; Quercetin/pharmacokinetics; Rutin/administration & dosage; Rats, Sprague-Dawley; Plant Leaves/chemistry*; Morus/chemistry*; Rats
  7. Abdulamir AS, Hafidh RR, Abubakar F, Abbas KA
    BMC Immunol, 2008;9:73.
    PMID: 19087256 DOI: 10.1186/1471-2172-9-73
    BACKGROUND: Asthma is a complicated network of inflammatory reactions. It is classified into mild, moderate, and severe persistent asthma. The success of asthma therapy relies much on understanding the underlying mechanisms of inflammation at each stage of asthma severity. The aim of this study was to explore the differences in apoptotic potential, CD4/CD8 ratio, memory compartment, and T- helper (Th) 1 and 2 profile of peripheral blood lymphocytes (PBL) in patients with mild intermittent asthma and severe persistent asthma during exacerbation periods.
    RESULTS: Four research lines were investigated and compared among mild asthmatics, severe asthmatics, and healthy groups by applying immunocytochemical staining of PBL. Antiapoptotic and proapoptotic proteins with Bcl-2/Bax ratio, CD4, CD8 markers with CD4+/CD8+ ratio, CD45RO+, CD45RA+ markers with memory/naive ratio (CD45RO+/CD45RA+). Th2/Th1 cytokines balance represented by IL-4/IFN-gamma ratio was measured by enzyme-linked immunosorbent assay (ELISA) for in vitro PBL cytokine synthesis. It was found that Bcl-2/Bax ratio was higher in severe than in mild asthmatics which in turn was higher than in healthy group. And memory/naive ratio of PBL was higher in severe than in mild asthmatics. Moreover, memory cells, CD45RO+ and CD45RO+/CD45RA+ ratio were correlated directly with Bcl-2/Bax, in severe and mild asthma patients. In contrast, CD4+/CD8+ ratio was not changed significantly among healthy group, mild and severe asthmatics. However, CD8+ cells were correlated directly with memory cells, CD45RO+, in severe asthmatics only. Interestingly, the dominant profile of cytokines appeared to change from T helper 2 (Th2) in mild asthmatics to T helper 1 (Th1) in severe asthmatics where the lowest in vitro IL-4/IFN-gamma ratio and highest IFN-gamma were found.
    CONCLUSION: It was concluded that the underlying mechanisms of inflammation might vary greatly with asthma stage of severity. Mild intermittent asthma is mainly Th2 allergen-oriented reaction during exacerbations with good level of apoptosis making the inflammation as self-limiting, while in severe persistent asthma, the inflammatory reaction mediated mainly by Th1 cytokines with progressive loss of apoptosis leading to longer exacerbations, largely expanded memory cells, CD45RO+, leading to persistent baseline inflammation.
    MeSH terms: Adolescent; Adult; Asthma/immunology*; Asthma/metabolism; Asthma/pathology; Asthma/physiopathology; Cell Survival/immunology; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunohistochemistry; Immunologic Memory; Interferon-gamma/secretion; Lymphocyte Activation; Male; Middle Aged; Severity of Illness Index; Status Asthmaticus/immunology*; Status Asthmaticus/metabolism; Status Asthmaticus/pathology; Interleukin-4/secretion; CD4-CD8 Ratio; Apoptosis/immunology; Antigens, CD45/biosynthesis; Th1 Cells/immunology; Th1 Cells/metabolism*; Th1 Cells/pathology; Th2 Cells/immunology; Th2 Cells/metabolism*; Th2 Cells/pathology; Disease Progression; Proto-Oncogene Proteins c-bcl-2/biosynthesis
  8. Einstein JW, Mustafa MR, Nishigaki I, Rajkapoor B, Moh MA
    Methods Find Exp Clin Pharmacol, 2008 Oct;30(8):599-605.
    PMID: 19088944 DOI: 10.1358/mf.2008.30.8.1268401
    The protective effect of methanol extracts of Cassia fistula (flowers, leaves and bark) was examined in vitro in human umbilical vein endothelial cells (HUVEC) against toxicity induced by glycated protein (GFBS) in vitro. The experiments consisted of eight groups of HUVEC with five flasks in each group. Group I was treated with 15% FBS, group II with GFBS (70 microM) alone, and the other six groups were treated with GFBS plus 25 and 50 microg of each of the three types of C. fistula extracts. After 72 h of incubation, cells were collected and tested for lipid peroxidation, antioxidant enzyme activities and glutathione S-transferase (GST). The protective effect of C. fistula extracts against GFBS-induced cytotoxicity was examined in HUVEC by using trypan blue exclusion and MTT assays. Results showed that HUVEC incubated with GFBS alone showed a significant (P < 0.001) elevation of lipid peroxidation accompanied by depletion of superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx) and glutathione reductase (GR), in addition to decreased cytosolic GST. Treatment of HUVEC with C. fistula extracts at a concentration of 25 and 50 microg significantly decreased lipid peroxidation and normalized the activities of the antioxidant enzymes and GST levels in a concentration-dependent manner. Morphological changes of HUVEC were compared with respective controls; in addition, the C. fistula extracts increased the viability of HUVEC damaged by GFBS. A protective effect of C. fistula extracts on HUVEC against GFBS-induced toxicity suggested a potential beneficial effect of the extract in preventing diabetic angiopathies.
    MeSH terms: Animals; Antioxidants/metabolism; Blood Proteins/metabolism*; Blood Proteins/toxicity; Cassia*; Cattle; Cells, Cultured; Dose-Response Relationship, Drug; Endothelium, Vascular/cytology; Glutathione Transferase/metabolism; Glycoproteins/metabolism*; Glycoproteins/toxicity; Glycosylation; Humans; Plant Extracts/pharmacology; Umbilical Veins/cytology; Lipid Peroxidation/drug effects; Glycosylation End Products, Advanced/metabolism; Oxidative Stress/drug effects; Plant Leaves; Protective Agents/pharmacology*; Plant Bark; Flowers; Endothelial Cells/cytology; Endothelial Cells/drug effects*; Endothelial Cells/enzymology; Serum
  9. Gopinath VK, Ling KT, Haziani KN, Ismail NM
    J Clin Pediatr Dent, 2008;33(1):39-42.
    PMID: 19093650
    This study reports on the predisposing factors and prevalence of fractured anterior teeth among 12 and 16 years-old school children in Kubang Kerian, Kelantan, West Malaysia.
    MeSH terms: Adolescent; Child; Cross-Sectional Studies; Female; Humans; Incisor/injuries*; Malaysia/epidemiology; Male; Malocclusion/epidemiology; Risk Factors; Tooth Fractures/epidemiology*; Cohort Studies; Comorbidity; Prevalence; Age Distribution; Sex Distribution; Sentinel Surveillance; Dentition, Permanent
  10. Noor NM
    J Relig Health, 2008 Dec;47(4):476-90.
    PMID: 19093675
    Religion has been found to moderate the stress-strain relationship. This moderator role, however, may be dependent on age. The present study tested for the three-way interaction between work experience, age, and religiosity in the prediction of women's well-being, and predicted that work experience and religiosity will combine additively in older women, while in younger women religiosity is predicted to moderate the relationship between work experience and well-being. In a sample of 389 married Malay Muslim women, results of the regression analyses showed significant three-way interactions between work experience, age, and religiosity in the prediction of well-being (measured by distress symptoms and life satisfaction). While in younger women the results were in line with the predictions made, in the older women, both additive and moderator effects of religiosity were observed, depending on the well-being measures used. These results are discussed in relation to the literature on work and family, with specific reference to women's age, religion, as well as the issue of stress-strain specificity.
    MeSH terms: Adult; Age Factors; Female; Humans; Internal-External Control; Islam/psychology*; Job Satisfaction*; Malaysia; Marriage/psychology; Middle Aged; Personal Satisfaction*; Surveys and Questionnaires; Regression Analysis; Social Perception; Women, Working/psychology*; Women's Health*; Workload/psychology; Spirituality*
  11. Jirasiritham S
    J. Vasc. Surg., 2008 Dec;48(6 Suppl):81S-83S; discussion 83S.
    PMID: 19084749 DOI: 10.1016/j.jvs.2008.09.009
    Cardiovascular diseases have become more prevalent and threatening to the health of the population of Asia due to the rapidly growing number of aging people. The Asian Society for Vascular Surgery unites 13 member organizations: Japan, Korea, China, India, Hong Kong, Singapore, Malaysia, Taiwan, Bangladesh, Philippines, Saudi Arabia, Indonesia, and Thailand. The essential mission of the Asian Society for Vascular Surgery is to improve training in vascular surgery to increase the number of competent vascular surgeons in Asia. Almost every member country has its own vascular training program. Most curricula for vascular surgery training are composed of basic vascular research, clinical vascular medicine, vascular investigation, and open and endovascular surgery, with the period of training ranging from 2 to 4 years.
    MeSH terms: Asia; Education, Medical, Continuing/methods*; Humans; Specialties, Surgical/education*; Vascular Surgical Procedures/education*
  12. Lim GH, Roslani AC, Pang B, Bih-Shiou CT
    Surg Laparosc Endosc Percutan Tech, 2008 Dec;18(6):616-8.
    PMID: 19098673 DOI: 10.1097/SLE.0b013e318180c956
    The endoscopic features of cholesterol atheroembolism affecting the colon have not been extensively described in the literature, owing to the rarity of this entity. We report a middle-aged man who presented with hematochezia after recent coronary artery bypass graft surgery. Colonoscopy revealed ulcerative skip lesions with overlying slough resembling pseudomembranes distal to the transverse colon, inconsistent with the initial clinical impression of ischemic colitis. As a consequence of continued bleeding with hemodynamic instability, the patient underwent an extended low anterior resection with end transverse colostomy. Histology revealed cholesterol atheroembolism resulting in patchy ischemic ulceration of the colon. Colonic cholesterol atheroembolism can mimic the endoscopic features of pseudomembranous colitis.
    MeSH terms: Colectomy; Colon/pathology; Colon/surgery; Colostomy; Diagnosis, Differential; Enterocolitis, Pseudomembranous/diagnosis; Humans; Male; Middle Aged; Proctocolitis/diagnosis; Endoscopy, Digestive System*; Colitis, Ischemic/diagnosis*; Colitis, Ischemic/etiology; Embolism, Cholesterol/complications; Embolism, Cholesterol/diagnosis*; Embolism, Cholesterol/surgery; Asian Continental Ancestry Group
  13. Shariat M, Alias NA, Biswal BM
    Postgrad Med J, 2008 Nov;84(997):609-12.
    PMID: 19103820 DOI: 10.1136/pgmj.2008.068569
    Post-radiation large vessel injury has not received as much attention as microvascular irradiation injury. A few studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy to the head and neck. However, in most of these studies, the irradiated subjects also had other major risk factors for atherosclerosis. In this study, irradiated subjects with major risk factors such as hypertension, diabetes, history of previous cerebrovascular accident and connective tissue disorder were excluded.
    MeSH terms: Adult; Aged; Cross-Sectional Studies; Female; Head and Neck Neoplasms/radiotherapy*; Humans; Male; Middle Aged; Radiation Injuries/etiology*; Radiotherapy/adverse effects; Case-Control Studies; Carotid Artery, Common/radiation effects*; Tunica Intima/radiation effects*; Young Adult
  14. Rahmat O, Prepageran N
    Ear Nose Throat J, 2008 Dec;87(12):668-9.
    PMID: 19105136
    MeSH terms: Adult; Hoarseness/diagnosis; Hoarseness/etiology; Humans; Laryngeal Neoplasms/complications; Laryngeal Neoplasms/pathology*; Laryngeal Neoplasms/surgery; Laryngoscopy; Male; Polyps/complications; Polyps/pathology*; Vocal Cords/pathology*; Vocal Cords/surgery
  15. Ebrahimpour A, Abd Rahman RN, Ean Ch'ng DH, Basri M, Salleh AB
    BMC Biotechnol, 2008 Dec 23;8:96.
    PMID: 19105837 DOI: 10.1186/1472-6750-8-96
    BACKGROUND: Thermostable bacterial lipases occupy a place of prominence among biocatalysts owing to their novel, multifold applications and resistance to high temperature and other operational conditions. The capability of lipases to catalyze a variety of novel reactions in both aqueous and nonaqueous media presents a fascinating field for research, creating interest to isolate novel lipase producers and optimize lipase production. The most important stages in a biological process are modeling and optimization to improve a system and increase the efficiency of the process without increasing the cost.

    RESULTS: Different production media were tested for lipase production by a newly isolated thermophilic Geobacillus sp. strain ARM (DSM 21496 = NCIMB 41583). The maximum production was obtained in the presence of peptone and yeast extract as organic nitrogen sources, olive oil as carbon source and lipase production inducer, sodium and calcium as metal ions, and gum arabic as emulsifier and lipase production inducer. The best models for optimization of culture parameters were achieved by multilayer full feedforward incremental back propagation network and modified response surface model using backward elimination, where the optimum condition was: growth temperature (52.3 degrees C), medium volume (50 ml), inoculum size (1%), agitation rate (static condition), incubation period (24 h) and initial pH (5.8). The experimental lipase activity was 0.47 Uml(-1) at optimum condition (4.7-fold increase), which compared well to the maximum predicted values by ANN (0.47 Uml(-1)) and RSM (0.476 Uml(-1)), whereas R2 and AAD were determined as 0.989 and 0.059% for ANN, and 0.95 and 0.078% for RSM respectively.

    CONCLUSION: Lipase production is the result of a synergistic combination of effective parameters interactions. These parameters are in equilibrium and the change of one parameter can be compensated by changes of other parameters to give the same results. Though both RSM and ANN models provided good quality predictions in this study, yet the ANN showed a clear superiority over RSM for both data fitting and estimation capabilities. On the other hand, ANN has the disadvantage of requiring large amounts of training data in comparison with RSM. This problem was solved by using statistical experimental design, to reduce the number of experiments.

    MeSH terms: Bacillaceae/enzymology*; Bacterial Proteins; Culture Media; Lipase/biosynthesis*; Microbiological Techniques; Models, Biological; Neural Networks (Computer)*
  16. Looi LM
    Malays J Pathol, 2008 Jun;30(1):1-10.
    PMID: 19108405 MyJurnal
    The past century has seen tremendous changes in the scope and practice of pathology laboratories in tandem with the development of the medical services in Malaysia. Major progress was made in the areas of training and specialization of pathologists and laboratory technical staff. Today the pathology laboratory services have entered the International arena, and are propelled along the wave of globalization. Many new challenges have emerged as have new players in the field. Landmark developments over the past decade include the establishment of national quality assurance programmes, the mushrooming of private pathology laboratories, the establishment of a National Accreditation Standard for medical testing laboratories based on ISO 15189, and the passing of the Pathology Laboratory Act in Parliament in mid-2007. The Pathology Laboratory Act 2007 seeks to ensure that the pathology laboratory is accountable to the public, meets required standards of practice, participates in Quality Assurance programmes, is run by qualified staff, complies with safety requirements and is subject to continuous audit. The Act is applicable to all private laboratories (stand alone or hospital) and laboratories in statutory bodies (Universities, foundations). It is not applicable to public laboratories (established and operated by the government) and side-room laboratories established in clinics of registered medical or dental practitioners for their own patients (tests as in the First and Second Schedules respectively). Tests of the Third Schedule (home test blood glucose, urine glucose, urine pregnancy test) are also exempted. The Act has 13 Parts and provides for control of the pathology laboratory through approval (to establish and maintain) and licensing (to operate or provide). The approval or license may only be issued to a sole proprietor, partnership or body corporate, and then only if the entity includes a registered medical practitioner. Details of personnel qualifications and laboratory practices are left to be specified by the Director-General of Health, providing for a formal recognition process and room for revision as pathology practices evolve. Encompassed in the responsibilities of the licensee is the requirement that samples are received and results issued through, and management vested in, a registered medical or dental practitioner. This effectively prohibits "walk-ins" to the laboratory and indiscriminate public screening. The requirement for a person-in-charge in accordance with class and speciality of laboratory ensures that the laboratory is under the charge of the pathology profession. Examined carefully, the requirements of the Act are similar to laboratory accreditation, but are backed by legislation. Many of these details will be spelt out in the Regulations, and these in turn are likely to fall back on National professional guidelines, as accreditation does. Although not at first obvious, enforcement of the Act is based on self-regulation by pathology laboratory professionals. Sincere professional input is thus required to embrace its philosophy, ensure rational and transparent enforcement of legislation, and develop National guidelines for good pathology practices upon which enforcement may be based.
    MeSH terms: Accreditation/standards; Laboratories/legislation & jurisprudence*; Laboratories/standards*; Malaysia; Pathology/legislation & jurisprudence*; Pathology/standards*; Quality Assurance, Health Care; Guidelines as Topic/standards; Clinical Laboratory Techniques/standards
  17. Mok PL, Cheong SK, Leong CF
    Malays J Pathol, 2008 Jun;30(1):11-9.
    PMID: 19108406 MyJurnal
    Mesenchymal stem cells are pluripotent progenitors that could be found in human bone marrow. Mesenchymal stem cells are capable of renewing themselves without differentiation in long-term culture. These cells also have low immunogenicity and can suppress alloreactive T cell responses. In the current study, mesenchymal stem cells isolated and propagated previously from the bone marrow of a megaloblastic anaemia patient were tested for their capabilities to differentiate into adipocytes, chondrocytes and osteoblasts in vitro. The differentiated cells were determined by Oil Red O, Alcian Blue-PAS and Alizarin Red S staining, and reverse transcriptase-polymerase chain reaction to determine the expression of mRNA specific for adipogenesis, chondrogenesis and osteogenesis. The results showed that the fibroblast-like cells were capable of differentiating into adipocytes, chondrocytes and osteoblasts upon chemical induction. The adipocytes, chondrocytes and osteoblasts were stained positively to Oil Red O, Alcian Blue-PAS and Alizarin Red S respectively. The differentiated cells were also found to express mRNA specific for adipogenesis ('peroxisome proliferation-activated receptor gamma2' and lipoprotein lipase), chondrogenesis (collagen type II) and osteogenesis (osteocalcin, osteopontin and alkaline phosphatase). In conclusion, this research has successfully isolated fibroblast-like cells from human bone marrow and these cells demonstrated morphological, cytochemical and immunochemical characteristics similar to mesenchymal stem cells. These cells maintain their proliferative properties and could be differentiated into the mesoderm lineage. The success of this study is vital because mesenchymal stem cells can be used in cellular therapy to regenerate or replace damaged tissues, or as a vehicle for therapeutic gene delivery in the future.
    MeSH terms: Cell Differentiation*; Cells, Cultured; Humans; Immunohistochemistry; Osteoblasts/cytology*; Osteoblasts/metabolism; Gene Expression; Adipocytes/cytology*; Adipocytes/metabolism; Chondrocytes/cytology*; Chondrocytes/metabolism; Reverse Transcriptase Polymerase Chain Reaction; Mesenchymal Stromal Cells/cytology*; Mesenchymal Stromal Cells/metabolism; In Vitro Techniques
  18. Khoo JJ, Nurul AM
    Malays J Pathol, 2008 Jun;30(1):21-6.
    PMID: 19108407 MyJurnal
    An audit of 1122 cholecystectomies for a 6-year period from 2000 to 2005 was done to review cases of primary carcinoma of gallbladder. There were nine cases of primary carcinoma of gallbladder. Six were females and 3 males. Their ages ranged from 27 to 81 years. Pre-operatively, only 2 (11.1%) were clinically suspected of carcinoma while 3 were diagnosed as cholecystitis, two as cholelithiasis and one case each of ovarian cyst and intestinal obstruction. Intra-operatively, an additional four cases were suspected as gallbladder carcinoma with the remaining three cases diagnosed as only having gallstones. Altogether only 5 (55.6%) cases were associated with gallstones. Six (66.67%) cases of gallbladder carcinoma had abnormal macroscopical lesions noted; either papillary lesions or polypoid masses. The remaining 3 cases had thickening of the wall, consistent with chronic cholecystitis. Seven cases were found histologically to be adenocarcinoma. Of these, two were papillary carcinoma and one signet ring cell type adenocarcinoma. One case of squamous cell carcinoma and one case of adenosquamous carcinoma were noted. This study highlights the importance of careful macroscopical and microscopical evaluation of a routine pathological examination of gallbladder removed for cholecystitis or cholelithiasis. It provides the incidence of gallbladder carcinoma in patients who underwent cholecystectomies in a government hospital in Johor, Malaysia.
    MeSH terms: Adult; Aged; Aged, 80 and over; Carcinoma/complications; Carcinoma/pathology*; Carcinoma/surgery; Cholecystectomy; Cholecystitis/complications; Cholecystitis/pathology; Diagnosis, Differential; Female; Gallbladder Neoplasms/complications; Gallbladder Neoplasms/pathology*; Gallbladder Neoplasms/surgery; Humans; Malaysia; Male; Middle Aged; Retrospective Studies; Gallstones/complications; Gallstones/pathology
  19. Leong CF, Habsah A, Teh HS, Goh KY, Fadilah SA, Cheong SK
    Malays J Pathol, 2008 Jun;30(1):31-6.
    PMID: 19108409
    Peripheral blood stem cells (PBSC) mobilised with growth factor with or without chemotherapeutic regimens, are used increasingly in both autologous and allogeneic transplantation. Previously, many PBSC harvests are used directly without ex vivo manipulation, and these PBSC have been shown to be contaminated with tumour cells, which may contribute to subsequent relapses post transplantation. Therefore, requirement for purging of malignant cells from the harvest has initiated the use of various methods to reduce tumour cell contamination of the graft by the positive selection of CD34+ progenitor cells or negative selection of tumour cells using other cell-specific antigens. We report here our local experience with the CliniMACS (magnetic-activated cell separation system) in eight adult patients with haematologic malignancies.
    MeSH terms: Adult; B-Lymphocytes/cytology; Hematopoietic Stem Cells/cytology*; Humans; T-Lymphocytes/cytology; Transplantation, Autologous; Immunomagnetic Separation/instrumentation*; Immunomagnetic Separation/methods; Hematopoietic Stem Cell Transplantation/instrumentation; Hematopoietic Stem Cell Transplantation/methods; Antigens, CD34/metabolism*; Hematologic Neoplasms/therapy*; Peripheral Blood Stem Cell Transplantation/instrumentation; Peripheral Blood Stem Cell Transplantation/methods*
  20. Cheah PL, Looi LM
    Malays J Pathol, 2008 Jun;30(1):37-42.
    PMID: 19108410
    Cervical carcinoma, the second most common malignancy in Malaysian females, is aetiologically linked to the human papillomavirus (HPV). A study was conducted at the Department of Pathology, University of Malaya Medical Centre to compare the identification of HPV 6, 11, 16 and 18 in 40 archived formalin-fixed, paraffin-embedded cervical carcinoma by non-isotopic in-situ hybridisation (NISH) and polymerase chain reaction (PCR). HPV L1 ORF consensus PCR was also carried in cases which were negative on HPV type-specific PCR. NISH detected HPV 16 in 13 (32.5%) cases with one case demonstrating a concomitant HPV 18. beta-globin DNA PCR was carried out on the same paraffin block as for NISH in 27 cases and on a different paraffin block in 13, with amplification in 9 of the former and 3 of the latter. Thus only 12 cases were subjected to further HPV PCR. HPV was detected in 10 (83.3%) with HPV 16 in 9 cases and HPV L1 ORF in one. When using the same paraffin block for both methods of HPV detection, NISH detected HPV in 6 and PCR in 7. NISH failed to detect HPV in a case detected by PCR. 2 cases were negative for HPV using both methods. Hence, HPV detection results by NISH and PCR were concordant in 88.9%. Interestingly, NISH detected HPV in 2 cases with non-amplifiable beta-globin DNA. Using an alternative paraffin block for HPV PCR from NISH, HPV DNA was detected in 3 cases, two of which also showed type-specific positivity on NISH. The third case did not reveal type-specific positivity with NISH or PCR but demonstrated HPV DNA on L1 ORF consensus PCR. It thus appears that PCR and NISH can be successfully used to detect HPV in formalin-fixed, paraffin-embedded tissue and in the presence of intact DNA NISH may be as sensitive as PCR.
    MeSH terms: Uterine Cervical Neoplasms/virology*; Female; Formaldehyde; Humans; Sensitivity and Specificity; Polymerase Chain Reaction*; Paraffin Embedding; Tissue Fixation; In Situ Hybridization*; Papillomavirus Infections/diagnosis*; Human papillomavirus 18/isolation & purification; Human papillomavirus 16/isolation & purification; Human papillomavirus 6/isolation & purification; Alphapapillomavirus/isolation & purification*
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