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Influenza HI antibodies in dengue-positive and negative sera of febrile patients

Tan DS, Omar M, Chew V

Med J Malaysia, 1979 Jun;33(4):355-6.
PMID: 522749
Fulltext Rubella cases mistaken for dengue fever

Tan DSK, Chew V, Mohd Nuruddin N

Singapore Med J, 1980 Dec;21(6):769-70.
PMID: 7221591

7.8% (8/102) of paired sera sent for dengue investigation turned out to be positive for rubella Instead. Dual infection of dengue with rubella was observed in 3.8% (4/104) cases. The clinical features and the serious implications of misdiagnosis of rubella were discussed.
Serological evidence of group B arbovirus infection in Sabah

Kan SK, Kay RW, Lim TW, Chew V

Med J Malaysia, 1978 Jun;32(4):289-91.
PMID: 732623
Dengue hemorrhagic fever in Malaysia: the 1973 epidemic

Wallace HG, Lim TW, Rudnick A, Knudsen AB, Cheong WH, Chew V

Southeast Asian J. Trop. Med. Public Health, 1980 Mar;11(1):1-13.
PMID: 6105712

The first major Malaysian epidemic of dengue hemorrhagic fever with severe manifestations occurred in 1973, with 969 reported cases and 54 deaths. In a detailed study of 138 clinically diagnosed and laboratory confirmed cases at the General Hospital in Kuala Lumpur, hemorrhagic manifestations were observed in 68.7% and shock in 18.1% of the patients. The cases occurred mainly from May to September, largely in urban and suburban areas of the majority of the states in the country. A main focus of infection was Jinjang, a heavily populated outlying district of Kuala Lumpur, where unusually high incidences of morbidity, severe disease and mortality were seen. Severe disease was seen mostly in children under the age of 15 years, although a significant number of adults suffered milder illnesses. The Chinese population was chiefly affected, due to their living in crowded, low-income housing where the vector, Aedes aegypti, occurred in the greatest numbers. All four dengue types were recovered during the epidemic period, although dengue 3 (DEN-3) was incriminated as the major epidemic type. Entomological data revealed high indices of A. aegypti throughout the country and left little doubt that this epidemic was aegypti transmitted. Spraying and fogging operations were carried out in attempts to control vector populations.
The 1973 epidemic of dengue haemorrhagic fever in Malaysia: (a preliminary report)

Lim TW, Wallace HG, Rudnick A, Cheong WH, Knudsen AB, Chew V

Southeast Asian J. Trop. Med. Public Health, 1974 Sep;5(3):453-4.
PMID: 4432105
Fulltext A multimodal atlas of hepatocellular carcinoma reveals convergent evolutionary paths and 'bad apple' effect on clinical trajectory

Chen J, Kaya NA, Zhang Y, Kendarsari RI, Sekar K, Lee Chong S, et al.

J Hepatol, 2024 May 21.
PMID: 38782118 DOI: 10.1016/j.jhep.2024.05.017

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) is a highly fatal cancer characterized by high intra-tumor heterogeneity (ITH). A panoramic understanding of its tumor evolution, in relation to its clinical trajectory, may provide novel prognostic and treatment strategies.
METHODS: Through the Asia-Pacific Hepatocellular Carcinoma trials group (NCT03267641), we recruited one of the largest prospective cohorts of patients with HCC, with over 600 whole genome and transcriptome samples from 123 treatment-naïve patients.
RESULTS: Using a multi-region sampling approach, we revealed seven convergent genetic evolutionary paths governed by the early driver mutations, late copy number variations and viral integrations, which stratify patient clinical trajectories after surgical resection. Furthermore, such evolutionary paths shaped the molecular profiles, leading to distinct transcriptomic subtypes. Most significantly, although we found the coexistence of multiple transcriptomic subtypes within certain tumors, patient prognosis was best predicted by the most aggressive cell fraction of the tumor, rather than by overall degree of transcriptomic ITH level - a phenomenon we termed the 'bad apple' effect. Finally, we found that characteristics throughout early and late tumor evolution provide significant and complementary prognostic power in predicting patient survival.
CONCLUSIONS: Taken together, our study generated a comprehensive landscape of evolutionary history for HCC and provides a rich multi-omics resource for understanding tumor heterogeneity and clinical trajectories.
IMPACT AND IMPLICATIONS: This prospective study, utilizing comprehensive multi-sector, multi-omics sequencing and clinical data from surgically resected hepatocellular carcinoma (HCC), reveals critical insights into the role of tumor evolution and intra-tumor heterogeneity (ITH) in determining the prognosis of HCC. These findings are invaluable for oncology researchers and clinicians, as they underscore the influence of distinct evolutionary paths and the 'bad apple' effect, where the most aggressive tumor fraction dictates disease progression. These insights not only enhance prognostic accuracy post-surgical resection but also pave the way for personalized treatment strategies tailored to specific tumor evolutionary and transcriptomic profiles. The coexistence of multiple subtypes within the same tumor prompts a re-appraisal of the utilities of depending on single samples to represent the entire tumor and suggests the need for clinical molecular imaging. This research thus marks a significant step forward in the clinical understanding and management of HCC, underscoring the importance of integrating tumor evolutionary dynamics and multi-omics biomarkers into therapeutic decision-making.
CLINICAL TRIAL NUMBER: NCT03267641 (Observational cohort).