Browse publications by year: 2013

  1. Tiruvayipati S, Bhassu S, Kumar N, Baddam R, Shaik S, Gurindapalli AK, et al.
    Gut Pathog, 2013 Dec 11;5(1):37.
    PMID: 24330647 DOI: 10.1186/1757-4749-5-37
    Vibrio parahaemolyticus, an important human pathogen, is associated with gastroenteritis and transmitted through partially cooked seafood. It has become a major concern in the production and trade of marine food products. The prevalence of potentially virulent and pathogenic V. parahaemolyticus in raw seafood is of public health significance. Here we describe the genome sequence of a V. parahaemolyticus isolate of crustacean origin which was cultured from prawns in 2008 in Selangor, Malaysia (isolate PCV08-7). The next generation sequencing and analysis revealed that the genome of isolate PCV08-7 has closest similarity to that of V. parahaemolyticus RIMD2210633. However, there are certain unique features of the PCV08-7 genome such as the absence of TDH-related hemolysin (TRH), and the presence of HU-alpha insertion. The genome of isolate PCV08-7 encodes a thermostable direct hemolysin (TDH), an important virulence factor that classifies PCV08-7 isolate to be a serovariant of O3:K6 strain. Apart from these, we observed that there is certain pattern of genetic rearrangements that makes V. parahaemolyticus PCV08-7 a non-pandemic clone. We present detailed genome statistics and important genetic features of this bacterium and discuss how its survival, adaptation and virulence in marine and terrestrial hosts can be understood through the genomic blueprint and that the availability of genome sequence entailing this important Malaysian isolate would likely enhance our understanding of the epidemiology, evolution and transmission of foodborne Vibrios in Malaysia and elsewhere.
  2. Mire CE, Versteeg KM, Cross RW, Agans KN, Fenton KA, Whitt MA, et al.
    Virol J, 2013 Dec 13;10:353.
    PMID: 24330654 DOI: 10.1186/1743-422X-10-353
    BACKGROUND: Nipah virus (NiV) is a highly pathogenic zoonotic agent in the family Paramyxoviridae that is maintained in nature by bats. Outbreaks have occurred in Malaysia, Singapore, India, and Bangladesh and have been associated with 40 to 75% case fatality rates. There are currently no vaccines or postexposure treatments licensed for combating human NiV infection.

    METHODS AND RESULTS: Four groups of ferrets received a single vaccination with different recombinant vesicular stomatitis virus vectors expressing: Group 1, control with no glycoprotein; Group 2, the NiV fusion protein (F); Group 3, the NiV attachment protein (G); and Group 4, a combination of the NiV F and G proteins. Animals were challenged intranasally with NiV 28 days after vaccination. Control ferrets in Group 1 showed characteristic clinical signs of NiV disease including respiratory distress, neurological disorders, viral load in blood and tissues, and gross lesions and antigen in target tissues; all animals in this group succumbed to infection by day 8. Importantly, all specifically vaccinated ferrets in Groups 2-4 showed no evidence of clinical illness and survived challenged. All animals in these groups developed anti-NiV F and/or G IgG and neutralizing antibody titers. While NiV RNA was detected in blood at day 6 post challenge in animals from Groups 2-4, the levels were orders of magnitude lower than animals from control Group 1.

    CONCLUSIONS: These data show protective efficacy against NiV in a relevant model of human infection. Further development of this technology has the potential to yield effective single injection vaccines for NiV infection.

    MeSH terms: Animals; Antibodies, Viral/blood; Disease Models, Animal; Drug Carriers*; Female; Ferrets; Genetic Vectors*; Immunoglobulin G/blood; Vaccination/methods*; Vaccines, Synthetic/administration & dosage; Vaccines, Synthetic/genetics; Vaccines, Synthetic/immunology; Viral Proteins/genetics; Viral Proteins/immunology; Viral Vaccines/administration & dosage; Viral Vaccines/genetics; Viral Vaccines/immunology*; Survival Analysis; Vesiculovirus/genetics*; Nipah Virus/genetics; Nipah Virus/immunology*; Henipavirus Infections/prevention & control*; Antibodies, Neutralizing/blood
  3. Harikrishnan H, Ismail A, Banga Singh KK
    Gut Pathog, 2013;5(1):38.
    PMID: 24330657 DOI: 10.1186/1757-4749-5-38
    Bacteria exist widely in a diversity of natural environments. In order to survive adverse conditions such as nutrient depletion, biochemical and biological disturbances, and high temperature, bacteria have developed a wide variety of coping mechanisms. Temperature is one of the most important factors that can enhance the expression of microbial proteins. This study was conducted to investigate how outer membrane proteins (OMPs) of the bacterium Shigella flexneri respond to stress, especially during fever when the host's body temperature is elevated.
    MeSH terms: Adaptation, Psychological; Fever; Hot Temperature; Membrane Proteins; Shigella flexneri; Temperature
  4. Sazwi NN, Nalina T, Abdul Rahim ZH
    PMID: 24330738 DOI: 10.1186/1472-6882-13-351
    Betel quid chewing is a popular habit in Southeast Asia. It is believed that chewing betel quid could reduce stress, strengthen teeth and maintain oral hygiene. The aim of this study was to investigate the antioxidant and cytoprotective activities of each of the ingredients of betel quid and compared with betel quid itself (with and without calcium hydroxide). The correlation of their cytoprotective and antioxidant activities with phenolic content was also determined.
    MeSH terms: Analysis of Variance; Antioxidants/pharmacology*; Antioxidants/chemistry; Areca/chemistry*; Calcium Hydroxide/chemistry*; Cell Survival/drug effects; Cells, Cultured; Gingiva/cytology; Humans; Hydrogen Peroxide/toxicity; Nuts/chemistry; Oxidation-Reduction/drug effects; Phenols/chemistry; Plant Extracts/pharmacology*; Plant Extracts/chemistry; Lipid Peroxidation/drug effects; Plant Leaves/chemistry; Piper betle/chemistry*; Uncaria/chemistry*
  5. Bong LJ, Neoh KB, Lee CY, Jaal Z
    Environ Entomol, 2013 Oct;42(5):1013-9.
    PMID: 24331610 DOI: 10.1603/EN13054
    Paederus fuscipes Curtis, a dermatitis linearis causing agent, has received increasing attention from the public, as it poses a serious health threat after mass dispersal into human-dominated areas. Preventive measures against this insect have so far been unsuccessful partly because of limited knowledge about its dispersal pattern. In this study, the dispersal activity of P. fuscipes was studied at infestation-prone residential buildings in Mainland Penang, Malaysia. The dispersal activity of P. fuscipes showed two peaks, that is, from February to April and August to October. Overall, there was no statistical significant correlation between dispersal and climatic parameters, that is, temperature, relative humidity, total rainfall, at all sampling localities. However, dispersal was primarily caused by human activities in rice fields, which accounted for >60% of the variability in dispersal. Particularly, rice harvesting, including straw burning, and cultivation were the major factors triggering P. fuscipes dispersal. These activities presumably disrupted the habitat and normal activities of P. fuscipes and rendered the rice fields unfavorable refuges. In addition, the beetles might also face food shortages after the disturbance of their prey base in the crop fields. The current study provides a predictive tool of P. fuscipes flight periods to ensure insecticide residual spraying is timed in the infestation-prone residential areas before the onset of infestation.
    MeSH terms: Agriculture; Animals; Beetles/physiology*; Climate; Insect Control; Malaysia; Oryza/growth & development*; Seasons; Animal Distribution*
  6. Ooi EI, Ahem A, Zahidin AZ, Bastion ML
    BMJ Case Rep, 2013;2013.
    PMID: 24334521 DOI: 10.1136/bcr-2013-200632
    This case reports a patient who developed central retinal artery occlusion following spinal surgery in the prone position. When placed in this position, especially as a result of malposition of the head, the patient may develop external compression of the eye which leads to central retinal artery occlusion. Therefore, a special precaution must be given for adequate eye protection during prolonged prone-positioned spine surgery.
    MeSH terms: Blindness/etiology*; Blindness/pathology; Cervical Vertebrae/surgery; Diagnosis, Differential; Hematoma, Epidural, Cranial/surgery*; Humans; Male; Postoperative Complications/etiology*; Postoperative Complications/pathology; Retinal Artery Occlusion/etiology*; Prone Position; Young Adult
  7. Bong CH, Lau TL, Ab Ghani A
    Water Sci Technol, 2013;68(11):2397-406.
    PMID: 24334888 DOI: 10.2166/wst.2013.498
    This paper highlights a preliminary study on the potential of a tipping flush gate to be used in an open storm drain to remove sediment. The investigation was carried out by using a plasboard model of the tipping flush gate installed in a rectangular flume. A steady flow experiment was carried out to determine the discharge coefficients and also the outflow relationship of the tipping flush gate. The velocity produced by the gate at various distances downstream of the gate during flushing operation was measured using a flowmeter and the velocity at all the points was higher than the recommended self-cleansing design available in the literature. A preliminary experiment on the efficiency of flushing was conducted using uniform sediment with d50 sizes of 0.81, 1.53 and 4.78 mm. Results generally showed that the number of flushes required to totally remove the sediment from the initial position by a distance of 1 m increased by an average of 1.50 times as the sediment deposit bed thickness doubled. An equation relating the number of flushes required to totally remove the sediment bed for 1 m with the sediment bed deposit thickness was also developed for the current study.
    MeSH terms: Algorithms; Drainage, Sanitary*; Geologic Sediments*; Hydrology
  8. Mohktar MS, Ibrahim F, Mohd Rozi NF, Mohd Yusof J, Ahmad SA, Su Yen K, et al.
    Med Sci Monit, 2013 Dec 13;19:1159-66.
    PMID: 24335927 DOI: 10.12659/MSM.889628
    BACKGROUND: Currently, the reference standard used to clinically assess sexual function among women is a qualitative questionnaire. Hence, a generalised and quantitative measurement tool needs to be available as an alternative. This study investigated whether an electromyography (EMG) measurement technique could be used to help quantify women's sexual function.

    MATERIAL AND METHODS: A preliminary intervention study was conducted on 12 female subjects, who were randomised into a control (n=6) and an intervention (n=6) group. Intervention involved a set regimen of pelvic floor muscle exercises (Kegel) and the control group did not have any treatment. All subjects were asked to answer a validated, self-rated Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ). EMG measurements of the pelvic floor muscles (PFM) and the abdominal muscles were taken from all women at recruitment and 8 weeks after study commencement.

    RESULTS: After 8 weeks, most of the subjects in the control group did not display any noted positive difference in either PISQ score (4/6) or in their muscle strength (4/6). However, a noted progressive difference were observed in subjects who were placed in the Kegel group; PISQ score (5/6) and muscles strength (4/6).

    CONCLUSIONS: The noted difference in the Kegel group subjects was that if progress is observed in the sexual function, improvement is also observed in the strength of at least 2 types of muscles (either abdominal or PFM muscles). Thus, EMG measurement is a potential technique to quantify the changes in female sexual function. Further work will be conducted to validate this assumption.

    MeSH terms: Abdominal Muscles/physiology*; Adult; Electromyography/methods*; Exercise Therapy/methods*; Female; Humans; Malaysia; Surveys and Questionnaires; Sexual Dysfunction, Physiological/diagnosis*; Sexual Dysfunction, Physiological/therapy; Pelvic Floor/physiology*
  9. Jawad MM, Husein A, Azlina A, Alam MK, Hassan R, Shaari R
    J Biomed Opt, 2013 Dec;18(12):128001.
    PMID: 24337495 DOI: 10.1117/1.JBO.18.12.128001
    Bone regeneration is essential in medical treatment, such as in surgical bone healing and orthodontics. The aim of this study is to examine the effect of different powers of 940 nm diode low-level laser treatment (LLLT) on osteoblast cells during their proliferation and differentiation stages. A human fetal osteoblast cell line was cultured and treated with LLLT. The cells were divided into experimental groups according to the power delivered and periods of exposure per day for each laser power. The (3-(4,5-dimethylthiazol-2yl)-2,5 diphenyl tetrazolium bromide) (MTT) assay was used to determine cell proliferation. Both alkaline phosphatase and osteocalcin activity assays were assessed for cell differentiation. All treatment groups showed a significant increase in cell proliferation and differentiation compared to the control group. Regarding the exposure time, the subgroups treated with the LLLT for 6 min showed higher proliferation and differentiation rates for the powers delivered, the 300-mW LLLT group significantly increased the amount of cell proliferation. By contrast, the 100 and 200 mW groups showed significantly greater amounts of cell differentiation. These results suggest that the use of LLLT may play an important role in stimulating osteoblast cells for improved bone formation.
    MeSH terms: Alkaline Phosphatase/analysis; Alkaline Phosphatase/metabolism; Cell Differentiation/radiation effects*; Cell Line; Humans; Osteoblasts/radiation effects*; Osteogenesis; Osteocalcin/analysis; Osteocalcin/metabolism; Low-Level Light Therapy*; Cell Proliferation/radiation effects*; Lasers, Semiconductor*
  10. Md Noh UK, Ahem A, Mustapha M
    Acta Med Iran, 2013;51(9):657-60.
    PMID: 24338200
    Uncontrolled hypertension is well- known to give rise to systemic complications involving multiple central organs. Artherosclerosis leads to damage of the retinal vessels wall, contributing to venous stasis, thrombosis and finally, occlusion. Retinal vein occlusions compromise vision through development of ischaemic maculopathy, macular oedema, and rubeotic glaucoma. Laser photocoagulation remains the definitive treatment for ischaemic vein occlusion with secondary neovascularization. Timely treatment with anti- vascular endothelial growth factor prevents development of rubeotic glaucoma. We hereby report an unusual case of bilateral retinal vein occlusion complicated by rubeosis irides, which was successfully managed to improve vision and prevent rubeotic glaucoma.
    MeSH terms: Ranibizumab; Adult; Female; Humans; Iris/physiopathology; Neovascularization, Pathologic/drug therapy; Retinal Vein Occlusion/diagnosis*; Retinal Vein Occlusion/physiopathology; Retinal Vein Occlusion/surgery; Visual Acuity; Laser Coagulation; Antibodies, Monoclonal, Humanized/therapeutic use
  11. Subenthiran S, Abdullah NR, Muniandy PK, Joseph JP, Cheong KC, Ismail Z, et al.
    Genet. Mol. Res., 2013;12(4):5937-44.
    PMID: 24338387 DOI: 10.4238/2013.November.26.3
    Carbamazepine (CBZ) is used as the first line of treatment of complex partial seizures (CPS) in Malaysia. While this drug is known to be effective for the treatment of CPS, more than 30% of patients remain drug resistant to CBZ mono-therapy. We examined a possible relationship between patients' response to CBZ mono-therapy and the G2677T SNP of the ABCB1 gene. Three hundred and fourteen patients with CPS were recruited from the Neurology Department of the Kuala Lumpur Hospital, of whom 152 were responders and the other 162 were non-responders to CBZ mono-therapy. DNA was extracted from blood samples and real-time PCR was performed to detect the G2677T SNP of the ABCB1 gene. Results were described as genotype frequencies and compared by logistic regression analysis. Among the 152 responders, 74% had the GG genotype. However, among the 162 non-responders, 26.5% had the GT genotype and 39% had the TT genotype. There was a significant difference in genotype frequency (TT vs GG; odds ratio 4.70; 95% confidence interval, 2.70-8.20) between responders and non-responders. The presence of the T allele of the G2677T SNP appears to be a useful screening marker to determine if a patient is going to be resistant to CBZ as a single drug therapy in the treatment of CPS.
    MeSH terms: Adult; Anticonvulsants/therapeutic use*; Carbamazepine/therapeutic use*; Female; Gene Frequency; Humans; Malaysia; Male; Middle Aged; Status Epilepticus/drug therapy; Status Epilepticus/genetics*; Treatment Outcome; P-Glycoproteins; P-Glycoprotein/genetics*; Polymorphism, Single Nucleotide*; Genetic Association Studies
  12. Othman NH, Ab Rahman AF
    Ann Indian Acad Neurol, 2013 Oct;16(4):534-7.
    PMID: 24339574 DOI: 10.4103/0972-2327.120458
    In addition to changes in seizure frequency, pregnant women with epilepsy (WWE) are at increased risk of complications during pregnancy or delivery. In the absence of a nationwide WWE registry, hospital-based studies may provide important information regarding current management and outcomes in these patients.
  13. Ahmad SS, Seng CW, Ghani SA, Lee JF
    J Emerg Trauma Shock, 2013 Oct;6(4):293-5.
    PMID: 24339666 DOI: 10.4103/0974-2700.120384
    An 11-year-old boy was involved in an injury with a fish-hook to his eye. The hook had impaled itself to the cornea and deeper structures. There was associated corneal edema and hyphema, making visualization difficult. In this case, we performed the unusual "cut-it-out" technique to remove the hook from the eye.
    MeSH terms: Animals; Child; Cornea; Fishes; Humans; Hyphema; Male; Corneal Edema; Corneal Injuries
  14. Othman N, In LL, Harikrishna JA, Hasima N
    PLoS One, 2013;8(12):e81735.
    PMID: 24339958 DOI: 10.1371/journal.pone.0081735
    Bcl-xL is an anti-apoptotic protein that is frequently found to be overexpressed in non-small cell lung cancer leading to an inhibition of apoptosis and poor prognosis. Recently, the role of miRNAs in regulating apoptosis and cell survival during tumorigenesis has become evident, with cancer cells showing perturbed expression of various miRNAs. In this study, we utilized miRNA microarrays to determine if miRNA dysregulation in bcl-xL silenced lung adenocarcinoma cells could be involved in regulating cell death. Short interfering RNA-based transfection of A549 and SK-LU1 lung adenocarcinoma cells was successful in inducing a reduction in bcl-xL expression levels, resulting in a decrease in cell viability. A total of 10 miRNAs were found to be significantly differentially expressed when compared between siRNA-transfected and non-transfected cells including hsa-miR-181a, hsa-miR-769-5p, hsa-miR-361-5p, hsa-miR-1304 and hsa-miR-608. When overexpression studies on hsa-miR-608 was performed via transfection of miRNA mimics, cell death was found to be induced in A549 and SK-LU1 cells in comparison to untreated cells. This effect was reversed when knockdown studies involving anti-sense inhibitors were introduced. Combination of siRNA based silencing of bcl-xL (siBcl-xL) followed by anti-sense inhibitor transfection led to a decrease in the apoptotic population of A549 and SK-LU1 cells in comparison to cells only treated with siBcl-xL, illustrating the connection between bcl-xL, hsa-miR-608 and cell death. Gene target prediction analysis implicated the PI3K/AKT, WNT, TGF-β, and ERK signaling pathways as targets of bcl-xL induced miRNA alterations. We have demonstrated that bcl-xL silencing in A549 and SK-LU1 cells leads to the occurrence of cell death through the dysregulation of specific miRNAs. This study also provides a platform for anti-sense gene therapy whereby miRNA expression can be exploited to increase the apoptotic properties in lung adenocarcinoma cells.
    MeSH terms: Adenocarcinoma/genetics; Adenocarcinoma/pathology*; Adenocarcinoma/therapy; Base Sequence; Cell Survival/genetics; Humans; Lung Neoplasms/genetics; Lung Neoplasms/pathology*; Lung Neoplasms/therapy; Genetic Therapy; Up-Regulation/genetics; Gene Expression Regulation, Neoplastic/genetics*; RNA, Antisense/genetics; Cell Death/genetics; Gene Silencing*; MicroRNAs/genetics*; Cell Line, Tumor; bcl-X Protein/deficiency*; bcl-X Protein/genetics*
  15. Chen X, Tan X, Li J, Jin Y, Gong L, Hong M, et al.
    PLoS One, 2013;8(12):e82861.
    PMID: 24340064 DOI: 10.1371/journal.pone.0082861
    Coxsackievirus A16 (CVA16) is responsible for nearly 50% of all the confirmed hand, foot, and mouth disease (HFMD) cases in mainland China, sometimes it could also cause severe complications, and even death. To clarify the genetic characteristics and the epidemic patterns of CVA16 in mainland China, comprehensive bioinfomatics analyses were performed by using 35 CVA16 whole genome sequences from 1998 to 2011, 593 complete CVA16 VP1 sequences from 1981 to 2011, and prototype strains of human enterovirus species A (EV-A). Analysis on complete VP1 sequences revealed that subgenotypes B1a and B1b were prevalent strains and have been co-circulating in many Asian countries since 2000, especially in mainland China for at least 13 years. While the prevalence of subgenotype B1c (totally 20 strains) was much limited, only found in Malaysia from 2005 to 2007 and in France in 2010. Genotype B2 only caused epidemic in Japan and Malaysia from 1981 to 2000. Both subgenotypes B1a and B1b were potential recombinant viruses containing sequences from other EV-A donors in the 5'-untranslated region and P2, P3 non-structural protein encoding regions.
    MeSH terms: Base Sequence; China; DNA, Viral/analysis*; Enterovirus/classification; Enterovirus/genetics*; Genotype; Hand, Foot and Mouth Disease/epidemiology; Hand, Foot and Mouth Disease/virology*; Humans; Molecular Sequence Data; Phylogeny; Recombination, Genetic; Cluster Analysis; Genome, Viral; Sequence Analysis, DNA; Molecular Epidemiology; DNA Primers/genetics; Computational Biology/methods*; 5' Untranslated Regions; Genomics
  16. Firdaus-Nawi M, Zamri-Saad M, Nik-Haiha NY, Zuki MA, Effendy AW
    Springerplus, 2013;2:611.
    PMID: 24340241 DOI: 10.1186/2193-1801-2-611
    Histological assessments on the intestinal morphology and immunity of tiger grouper juveniles, Epinephelus fuscoguttatus help in determining the earliest age to start an oral vaccination. This study describes the morphological development of the intestinal immunity of tiger grouper of various ages. Clinically healthy tiger groupers were selected and divided into 4 groups of 20 fish per group. Groups 1, 2, 3 and 4 consisted of juveniles of 30, 60, 90 and 120 days old, respectively. The whole intestine was collected and divided into three regions, the anterior, mid and posterior intestine and fixed in 10% buffered formalin before slides were prepared for microscopic examinations. It was found that the histological structures of the anterior intestine were for absorption of nutrient from digested food particles. The significantly (p 
  17. Jain D, Darrow JJ
    Health Matrix Clevel, 2013;23(2):425-57.
    PMID: 24341078
    Access to affordable drugs for the treatment of HIV/AIDS and other diseases is increasingly challenging in many developing countries such as Brazil, South Africa, and India. These challenges are in part the result of strengthened patent laws mandated by the 1994 Trade-Related Aspects of Intellectual Property Rights (TRIPS) treaty. However, there are underutilized instruments within TRIPS that governments can use to limit the adverse effects of patent protection and thereby ensure a supply of affordable generic drugs to their people. One such instrument is compulsory licensing, which allows generic manufacturers to produce pharmaceutical products that are currently subject to patent protection. Compulsory licensing has been used by a number of countries in the last few years, including the United States, Canada, Indonesia, Malaysia, Brazil, and Thailand, and is particularly significant for countries such as India, where large numbers of people are infected with HIV. This Article explores the feasibility of compulsory licensing as a tool to facilitate access to essential medicines within the current patent regime in India, drawing on the experiences of other countries.
    MeSH terms: Health Services Accessibility*; Humans; India; Patents as Topic/legislation & jurisprudence*; HIV Infections/drug therapy; Drugs, Generic/economics; Drugs, Generic/supply & distribution*; Anti-Retroviral Agents/economics; Anti-Retroviral Agents/supply & distribution*
  18. Zaman Huri H, Chai Ling L
    BMC Public Health, 2013;13:1192.
    PMID: 24341672 DOI: 10.1186/1471-2458-13-1192
    Drug-Related Problems (DRPs) commonly occur among type 2 diabetes mellitus (T2DM) patients. However, few studies have been performed on T2DM patients with dyslipidemia. This purpose of this study was to assess drug-related problems (DRPs) and factors associated with its occurrence.
    MeSH terms: Adult; Aged; Aged, 80 and over; Hypolipidemic Agents/adverse effects*; Diabetes Mellitus, Type 2/drug therapy*; Diabetes Mellitus, Type 2/epidemiology*; Female; Humans; Hypoglycemic Agents/adverse effects*; Malaysia/epidemiology; Male; Middle Aged; Retrospective Studies; Risk Factors; Comorbidity; Treatment Outcome; Dyslipidemias/drug therapy*; Dyslipidemias/epidemiology*; Young Adult
  19. Hanafiah M, Alhabshi SM, Bag T, Low SF
    BMJ Case Rep, 2013;2013.
    PMID: 24343799 DOI: 10.1136/bcr-2013-010262
    A 55-year-old immunocompetent woman was presented with features of obstructive jaundice and a clinicoradiological picture suggestive of a hilar cholangiocarcinoma (Klatskin tumour). However, caseating granulomatous lesion associated with miliary nodules were revealed intraoperatively. The lesion responded to standard antituberculous therapy. This unusual presentation highlights the considerable diagnostic challenge in such case.
    MeSH terms: Bile Duct Neoplasms/diagnosis*; Diagnosis, Differential; Female; Humans; Middle Aged; Mycobacterium*; Tuberculosis, Hepatic/diagnosis*; Tuberculosis, Hepatic/microbiology; Tuberculosis, Hepatic/pathology; Klatskin Tumor/diagnosis*; Jaundice, Obstructive/diagnosis*; Jaundice, Obstructive/etiology; Jaundice, Obstructive/microbiology
  20. Tan KW, Stephen ID
    Perception, 2013;42(7):733-41.
    PMID: 24344549
    Human facial skin colour reflects individuals' underlying health (Stephen et al 2011 Evolution & Human Behavior 32 216-227); and enhanced facial skin CIELab b* (yellowness), a* (redness), and L* (lightness) are perceived as healthy (also Stephen et al 2009a International Journal of Primatology 30 845-857). Here, we examine Malaysian Chinese participants' detection thresholds for CIELab L* (lightness), a* (redness), and b* (yellowness) colour changes in Asian, African, and Caucasian faces and skin coloured patches. Twelve face photos and three skin coloured patches were transformed to produce four pairs of images of each individual face and colour patch with different amounts of red, yellow, or lightness, from very subtle (deltaE = 1.2) to quite large differences (deltaE = 9.6). Participants were asked to decide which of sequentially displayed, paired same-face images or colour patches were lighter, redder, or yellower. Changes in facial redness, followed by changes in yellowness, were more easily discriminated than changes in luminance. However, visual sensitivity was not greater for redness and yellowness in nonface stimuli, suggesting red facial skin colour special salience. Participants were also significantly better at recognizing colour differences in own-race (Asian) and Caucasian faces than in African faces, suggesting the existence of cross-race effect in discriminating facial colours. Humans' colour vision may have been selected for skin colour signalling (Changizi et al 2006 Biology Letters 2 217-221), enabling individuals to perceive subtle changes in skin colour, reflecting health and emotional status.
    MeSH terms: Adult; Analysis of Variance; Color*; Color Perception/physiology*; Discrimination (Psychology)/physiology*; Face; Female; Humans; Malaysia; Male; Skin Pigmentation/physiology*; Students/psychology; Recognition (Psychology)/physiology*; African Continental Ancestry Group/psychology; European Continental Ancestry Group/psychology; Asian Continental Ancestry Group/psychology; Continental Population Groups/psychology*; Young Adult
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