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Cyclosporine-associated encephalopathy: a case report and literature review

Chang SH, Lim CS, Low TS, Chong HT, Tan SY

Transplant Proc, 2001 12 26;33(7-8):3700-1.
PMID: 11750577
Fulltext Reefing Viability Index for Rigs-to-Reefs (R2R) in Malaysia

Mohd MH, Rahman MAA, Nazri MN, Tan CH, Mohamad Y, Lim CS, et al.

ScientificWorldJournal, 2020;2020:4695894.
PMID: 33223970 DOI: 10.1155/2020/4695894

Decommissioning of the offshore platform as an artificial reef, known as Rigs-to-Reefs (R2R), has become a sustainable approach for oil companies. The platform was reused to serve the underwater ecosystem as an artificial reef for a new marine ecosystem which helps to tackle food security issue. This paper presents the findings of the formulation of the reefing viability index to recognize an offshore region that can be used for R2R projects within the South China Sea. The combined effects of spatial data, numerical modelling, and geographic system (GIS) are proposed to study the relationship of spawning ground coral reefs, diversity, and planula larvae in the process of colonization to establish a map of the reef potential environment. Coral connectivity and spawning behaviour were studied to determine the possible source of coral seedling released during the spawning season, twice a year. A geographic reef viability index was established consisting of seven parameters which are coral larval density, pelagic larval length, sea currents, temperature, chlorophyll-a, depth, and substrate availability. The ocean hydrodynamic model was designed to resemble the pattern of larval scattering. By using the simulations and rankings, there were 95 (21%) sites which could probably be used for in situ reefing, whereas 358 (79%) sites were likely ideal for ex situ reefing. Validation of the viability index was carried out using media footage assessment of remotely operated vehicle (ROV).
Response of exhaled nitric oxide to inhaled corticosteroids in patients with stable COPD: A systematic review and meta-analysis

Lim CS, Rani FA, Tan LE

Clin Respir J, 2018 Jan;12(1):218-226.
PMID: 27328740 DOI: 10.1111/crj.12518

INTRODUCTION: To our knowledge, no meta-analysis has investigated the response of FeNO levels to corticosteroid treatment in ex-smokers with chronic obstructive pulmonary disease (COPD).

OBJECTIVES: This meta-analysis assessed the potential role of fraction of exhaled nitric oxide (FeNO) as a biomarker for corticosteroid response in ex-smokers with stable COPD.

METHODS: Medline, Cochrane, EMBASE, Google Scholar databases were searched until November 5, 2014 using the following terms: corticosteroid, chronic obstructive pulmonary disease, COPD, nitric oxide, NO, exhaled nitric oxide. Only randomized controlled trials (RCT) or two-arm prospective studies were included. The primary outcome measure was FeNO before and after treatment with inhaled corticosteroids (ICS) in ex-smokers with COPD. Sensitivity analysis was also performed.

RESULTS: Five studies were included in the analysis with a total of 171 COPD patients. All five studies included 125 ex-smokers and two of these also included 46 current smokers. There was a significant decrease of FeNO in ex-smoking COPD patients following inhaled corticosteroid treatment (-7.51, 95% CI: -11.51 to -3.51; P =0.003); and in a population of subjects that included both smokers and ex-smokers (-1.99, 95% CI: -3.41 to -0.56; P =0.006).

CONCLUSION: Our findings indicate that FeNO levels significantly decreased with corticosteroid treatment in ex-smokers with COPD. Additional studies are required to evaluate whether concurrent smoking has significant effect on FeNO response to ICS.
Fulltext Peritoneal implantation of ureter in a cadaveric kidney transplant recipient

Tan SY, Lim CS, Teo SM, Lee SH, Razack A, Loh CS

Med J Malaysia, 2003 Dec;58(5):769-70.
PMID: 15190667

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.
A comparative study of Eldoncards for blood grouping ABO and RH0 (d) with the Tile Method of typing

Kuah KB, Lim CS

Med J Malaysia, 1974 Jun;28(4):273-5.
PMID: 4278822
A note on the residual life of the insecticide malathion

REID JA, LIM CS

Med J Malaya, 1959 Mar;13(3):239-42.
PMID: 13666192
Wilms tumour with poor response to pre-operative chemotherapy: A report of 2 cases

Tan HCL, Tan JH, Vellusamy VM, Vasavan Y, Lim CS

Malays J Pathol, 2020 Aug;42(2):267-271.
PMID: 32860380

INTRODUCTION: Majority of Wilms tumour (WT) responds well to pre-operative chemotherapy. In Malaysia, incidence of WT is rare with only two cases reported per one million populations yearly. This case report is to highlight on the awareness of WT in an Asian population and highlight two cases and challenges faced after pre-operative chemotherapy.
CASE REPORT: In this case series, we report on two cases of WT which had poor response to pre-operative chemotherapy. Both cases underwent surgery after pre-operative chemotherapy and recovery was uneventful during a two-year follow-up.
DISCUSSION: Both patients had chemotherapy prior planned surgery, but had unfortunate poor tumour response. The tumour progressed in size which required a radical nephrectomy. The histology report for the first case had more than 60% blastemal cells remaining despite giving pre-operative chemotherapy with no focal anaplasia. This showed poor response to chemotherapy evidenced by the high number of blastemal cells. The second case was a stromal type WT which is known for poor response and may lead to enhancement of growth and maturation induced by chemotherapy. These were the possible reason of poor response of WT in these two cases.
Fulltext Plasmon-enhanced reduced graphene oxide photodetector with monometallic of Au and Ag nanoparticles at VIS-NIR region

Rohizat NS, Ripain AHA, Lim CS, Tan CL, Zakaria R

Sci Rep, 2021 Oct 04;11(1):19688.
PMID: 34608217 DOI: 10.1038/s41598-021-99189-w

Hybrids plasmonic nanoparticles (NPs) and unique 2D graphene significantly enhanced the photoresponse of the photodetectors. The metallic NPs that exhibit localized surface plasmon resonance (LSPR) improves strong light absorption, scattering and localized electromagnetic field by the incident photons depending on the optimum condition of NPs. We report high-performance photodetectors based on reduced graphene oxide (rGO) integrated with monometallic of Au and Ag nanoparticles via a familiar fabrication technique using an electron beam evaporation machine. Under 680 nm illumination of light, our rGO photodetector exhibited the highest performance for Au-rGO with the highest responsivity of 67.46 AW-1 and the highest specific detectivity (2.39 × 1013 Jones). Meanwhile, Ag-rGO achieved the highest responsivity of 17.23 AW-1, specific detectivity (7.17 × 1011 Jones) at 785 nm. The response time are 0.146 µs and 0.135 µs for Au-rGO and Ag-rGO respectively for both wavelengths. The proposed photodetector with combining monometallic and graphene provide a new strategy to construct reliable and next-generation optoelectronic devices at VIS-NIR region.
Fulltext Antibacterial activity of biosynthesized gold nanoparticles using biomolecules from Lignosus rhinocerotis and chitosan

Katas H, Lim CS, Nor Azlan AYH, Buang F, Mh Busra MF

Saudi Pharm J, 2019 Feb;27(2):283-292.
PMID: 30766441 DOI: 10.1016/j.jsps.2018.11.010

A simple, cost-effective, and environmentally friendly method is needed for synthesizing metal nanoparticles, including gold nanoparticles (AuNPs). In this study, AuNPs were synthesized with Lignosus rhinocerotis sclerotial extract (LRE) and chitosan (CS) as reducing and stabilizing agents, respectively. Different LRE concentrations from cold and hot water extraction (CWE and HWE, respectively) were used to reduce chloroauric acid (HAuCl4) to form AuNPs. Positively charged chitosan stabilized AuNPs (CS-AuNPs) mediated by LRE exhibited a surface plasmon resonance (SPR) band at 533 nm. The CS-AuNPs synthesized using CWE had a smaller particle size (49.5 ± 6.7-82.4 ± 28.0 nm) compared to that of the HWE samples (80.3 ± 23.4-125.3 ± 41.5 nm), depending on LRE concentration. FTIR results suggested protein and polysaccharides in LRE were the sources of reducing power, reducing gold ions to AuNPs. CS-AuNPs were mostly spherical with higher LRE concentrations, whereas some triangular, pentagonal, irregular, and rod shaped AuNPs were observed at lower LRE concentrations. CS-AuNPs mediated by LRE displayed effective antibacterial activity against gram-negative (Pseudomonas aeruginosa and Escherichia coli) and gram-positive bacteria (Staphylococcus aureus and Bacillus sp.). Thus, the biosynthesized AuNPs using LRE and chitosan provide opportunities for developing stable and eco-friendly nanoparticles with effective antibacterial properties.
Recombinant production of Epstein-Barr virus BZLF1 trans-activator and characterization of its DNA-binding specificity

Lim CS, Goh SL, Krishnan G, Ng CC

Protein Expr Purif, 2014 Mar;95:8-12.
PMID: 24291446 DOI: 10.1016/j.pep.2013.11.007

This paper describes the recombinant production of a biologically active Epstein-Barr virus BZLF1 trans-activator, i.e., Z-encoded broadly reactive activator (ZEBRA), that recognized specific DNA motifs. We used auto-induction for histidine-tagged BZLF1 expression in Escherichia coli and immobilized cobalt affinity membrane chromatography for protein purification under native conditions. We obtained the purified BZLF1 at a yield of 5.4mg per gram of wet weight cells at 75% purity, in which 27% of the recombinant BZLF1 remained biologically active. The recombinant BZLF1 bound to oligonucleotides containing ZEBRA response elements, either AP-1 or ZIIIB, but not a ZIIIB mutant. The recombinant BZLF1 showed a specific DNA-binding activity which could be useful for functional studies.
Fulltext Semi-analytical modelling and evaluation of uniformly doped silicene nanotransistors for digital logic gates

Chuan MW, Wong KL, Riyadi MA, Hamzah A, Rusli S, Alias NE, et al.

PLoS One, 2021;16(6):e0253289.
PMID: 34125874 DOI: 10.1371/journal.pone.0253289

Silicene has attracted remarkable attention in the semiconductor research community due to its silicon (Si) nature. It is predicted as one of the most promising candidates for the next generation nanoelectronic devices. In this paper, an efficient non-iterative technique is employed to create the SPICE models for p-type and n-type uniformly doped silicene field-effect transistors (FETs). The current-voltage characteristics show that the proposed silicene FET models exhibit high on-to-off current ratio under ballistic transport. In order to obtain practical digital logic timing diagrams, a parasitic load capacitance, which is dependent on the interconnect length, is attached at the output terminal of the logic circuits. Furthermore, the key circuit performance metrics, including the propagation delay, average power, power-delay product and energy-delay product of the proposed silicene-based logic gates are extracted and benchmarked with published results. The effects of the interconnect length to the propagation delay and average power are also investigated. The results of this work further envisage the uniformly doped silicene as a promising candidate for future nanoelectronic applications.
Fulltext Device performances analysis of p-type doped silicene-based field effect transistor using SPICE-compatible model

Chuan MW, Riyadi MA, Hamzah A, Alias NE, Mohamed Sultan S, Lim CS, et al.

PLoS One, 2022;17(3):e0264483.
PMID: 35239699 DOI: 10.1371/journal.pone.0264483

Moore's Law is approaching its end as transistors are scaled down to tens or few atoms per device, researchers are actively seeking for alternative approaches to leverage more-than-Moore nanoelectronics. Substituting the channel material of a field-effect transistors (FET) with silicene is foreseen as a viable approach for future transistor applications. In this study, we proposed a SPICE-compatible model for p-type (Aluminium) uniformly doped silicene FET for digital switching applications. The performance of the proposed device is benchmarked with various low-dimensional FETs in terms of their on-to-off current ratio, subthreshold swing and drain-induced barrier lowering. The results show that the proposed p-type silicene FET is comparable to most of the selected low-dimensional FET models. With its decent performance, the proposed SPICE-compatible model should be extended to the circuit-level simulation and beyond in future work.
Fulltext R54C Mutation of NOTCH3 Gene in the First Rungus Family with CADASIL

Lim KS, Tan AH, Lim CS, Chua KH, Lee PC, Ramli N, et al.

PLoS One, 2015;10(8):e0135470.
PMID: 26270344 DOI: 10.1371/journal.pone.0135470

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare hereditary stroke caused by mutations in NOTCH3 gene. We report the first case of CADASIL in an indigenous Rungus (Kadazan-Dusun) family in Kudat, Sabah, Malaysia confirmed by a R54C (c.160C>T, p.Arg54Cys) mutation in the NOTCH3. This mutation was previously reported in a Caucasian and two Korean cases of CADASIL. We recruited two generations of the affected Rungus family (n = 9) and found a missense mutation (c.160C>T) in exon 2 of NOTCH3 in three siblings. Two of the three siblings had severe white matter abnormalities in their brain MRI (Scheltens score 33 and 50 respectively), one of whom had a young stroke at the age of 38. The remaining sibling, however, did not show any clinical features of CADASIL and had only minimal changes in her brain MRI (Scheltens score 17). This further emphasized the phenotype variability among family members with the same mutation in CADASIL. This is the first reported family with CADASIL in Rungus subtribe of Kadazan-Dusun ethnicity with a known mutation at exon 2 of NOTCH3. The penetrance of this mutation was not complete during the course of this study.
Fulltext Regulation of apoptotic effects by erythrocarpine E, a cytotoxic limonoid from Chisocheton erythrocarpus in HSC-4 human oral cancer cells

Nagoor NH, Shah Jehan Muttiah N, Lim CS, In LL, Mohamad K, Awang K

PLoS One, 2011;6(8):e23661.
PMID: 21858194 DOI: 10.1371/journal.pone.0023661

The aim of this study was to determine the cytotoxic and apoptotic effects of erythrocarpine E (CEB4), a limonoid extracted from Chisocheton erythrocarpus on human oral squamous cell carcinoma. Based on preliminary dimethyl-2-thiazolyl-2,5-diphenyl-2H-tetrazolium bromide (MTT) assays, CEB4 treated HSC-4 cells demonstrated a cytotoxic effect and inhibited cell proliferation in a time and dose dependent manner with an IC(50) value of 4.0±1.9 µM within 24 h of treatment. CEB4 was also found to have minimal cytotoxic effects on the normal cell line, NHBE with cell viability levels maintained above 80% upon treatment. Annexin V-fluorescein isothiocyanate (FITC), poly-ADP ribose polymerase (PARP) cleavage and DNA fragmentation assay results showed that CEB4 induces apoptosis mediated cell death. Western blotting results demonstrated that the induction of apoptosis by CEB4 appeared to be mediated through regulation of the p53 signalling pathway as there was an increase in p53 phosphorylation levels. CEB4 was also found to up-regulate the pro-apoptotic protein, Bax, while down-regulating the anti-apoptotic protein, Bcl-2, suggesting the involvement of the intrinsic mitochondrial pathway. Reduced levels of initiator procaspase-9 and executioner caspase-3 zymogen were also observed following CEB4 exposure, hence indicating the involvement of cytochrome c mediated apoptosis. These results demonstrate the cytotoxic and apoptotic ability of erythrocarpine E, and suggest its potential development as a cancer chemopreventive agent.
Fulltext Analytical modeling of glucose biosensors based on carbon nanotubes

Pourasl AH, Ahmadi MT, Rahmani M, Chin HC, Lim CS, Ismail R, et al.

Nanoscale Res Lett, 2014 Jan 15;9(1):33.
PMID: 24428818 DOI: 10.1186/1556-276X-9-33

In recent years, carbon nanotubes have received widespread attention as promising carbon-based nanoelectronic devices. Due to their exceptional physical, chemical, and electrical properties, namely a high surface-to-volume ratio, their enhanced electron transfer properties, and their high thermal conductivity, carbon nanotubes can be used effectively as electrochemical sensors. The integration of carbon nanotubes with a functional group provides a good and solid support for the immobilization of enzymes. The determination of glucose levels using biosensors, particularly in the medical diagnostics and food industries, is gaining mass appeal. Glucose biosensors detect the glucose molecule by catalyzing glucose to gluconic acid and hydrogen peroxide in the presence of oxygen. This action provides high accuracy and a quick detection rate. In this paper, a single-wall carbon nanotube field-effect transistor biosensor for glucose detection is analytically modeled. In the proposed model, the glucose concentration is presented as a function of gate voltage. Subsequently, the proposed model is compared with existing experimental data. A good consensus between the model and the experimental data is reported. The simulated data demonstrate that the analytical model can be employed with an electrochemical glucose sensor to predict the behavior of the sensing mechanism in biosensors.
Fulltext Investigation on the Effects of the Formation of a Silver "Flower-Like Structure" on Graphene

Zakaria R, Yusoff SFAZ, Law KC, Lim CS, Ahmad H

Nanoscale Res Lett, 2017 Dec;12(1):50.
PMID: 28101853 DOI: 10.1186/s11671-016-1793-y

In this report, we experimentally investigate the formation of "flower-like silver structures" on graphene. Using an electrochemical deposition technique with deposition times of 2.5 and 5 min, agglomerations of silver nanoparticles (AgNPs) were deposited on the graphene surfaces, causing the formation of "flower-like structures" on the graphene substrate. Localized surface plasmon resonance (LSPR) was observed in the interaction between the structures and the graphene substrate. The morphology of the samples was observed using a field-emission scanning electron microscope (FESEM) and Raman spectroscopy. Thereafter, the potential of the flower-like Ag microstructures on graphene for use in Raman spectroscopic applications was examined. The signal showed a highest intensity value after a deposition time of 5 min, as portrayed by the intense local electromagnetic fields. For a better understanding, the CST Microwave Studio software, based on the finite element method (FEM), was applied to simulate the absorption characteristics of the structures on the graphene substrate. The absorption peak was redshifted due to the increment of the nanoparticle size.
Fulltext Lazertinib Versus Gefitinib Tyrosine Kinase Inhibitors in Treatment-Naíve Patients With EGFR-Mutated Advanced NSCLC: Analysis of the Asian Subpopulation in LASER301

Reungwetwattana T, Cho BC, Lee KH, Pang YK, Fong CH, Kang JH, et al.

J Thorac Oncol, 2023 Oct;18(10):1351-1361.
PMID: 37702629 DOI: 10.1016/j.jtho.2023.06.016

INTRODUCTION: Lazertinib is a third-generation central nervous system-penetrant tyrosine kinase inhibitor targeting mutant EGFR in NSCLC. Lazertinib exhibited improved efficacy versus gefitinib in the LASER301 study; this subset analysis compared lazertinib with gefitinib among Asian patients.
METHODS: The phase 3 LASER301 study evaluated lazertinib efficacy and safety in treatment-naive patients with EGFR-mutated (exon 19 deletion or L858R) locally advanced or metastatic NSCLC. Patients were randomized one-to-one and received either lazertinib or gefitinib. The primary end point was investigator-assessed progression-free survival using Response Evaluation Criteria in Solid Tumors version 1.1. Secondary end points included overall survival, objective response rate, duration of response, and safety.
RESULTS: Between February 13, 2020, and July 29, 2022, among 258 patients of Asian descent, the median progression-free survival was significantly longer with lazertinib than gefitinib (20.6 versus 9.7 mo; hazard ratio: 0.46; 95% confidence interval [CI]: 0.34-0.63, p < 0.001), and the benefit was consistent across predefined subgroups (exon 19 deletion, L858R, baseline central nervous system metastases). Objective response rate and disease control rates were similar between treatment groups. The median duration of response was 19.4 months (95% CI: 16.6-24.9) versus 9.6 months (95% CI: 6.9-12.4) in the lazertinib versus gefitinib group. Adverse event rates in Asian patients were comparable with the overall LASER301 population. Adverse events leading to discontinuation in the lazertinib and gefitinib groups were 13% and 12%, respectively.
CONCLUSIONS: In LASER301, efficacy and safety results in Asian patients were consistent with the overall population. Lazertinib exhibited better efficacy than gefitinib in Asian patients with a tolerable safety profile.
Fulltext Central Nervous System Outcomes of Lazertinib Versus Gefitinib in EGFR-Mutated Advanced NSCLC: A LASER301 Subset Analysis

Soo RA, Cho BC, Kim JH, Ahn MJ, Lee KH, Zimina A, et al.

J Thorac Oncol, 2023 Dec;18(12):1756-1766.
PMID: 37865896 DOI: 10.1016/j.jtho.2023.08.017

INTRODUCTION: Lazertinib, a third-generation mutant-selective EGFR tyrosine kinase inhibitor, improved progression-free survival compared with gefitinib in the phase 3 LASER301 study (ClinicalTrials.gov Identifier: NCT04248829). Here, we report the efficacy of lazertinib and gefitinib in patients with baseline central nervous system (CNS) metastases.
METHODS: Treatment-naive patients with EGFR-mutated advanced NSCLC were randomized one-to-one to lazertinib (240 mg/d) or gefitinib (250 mg/d). Patients with asymptomatic or stable CNS metastases were included if any planned radiation, surgery, or steroids were completed more than 2 weeks before randomization. For patients with CNS metastases confirmed at screening or subsequently suspected, CNS imaging was performed every 6 weeks for 18 months, then every 12 weeks. End points assessed by blinded independent central review and Response Evaluation Criteria in Solid Tumors version 1.1 included intracranial progression-free survival, intracranial objective response rate, and intracranial duration of response.
RESULTS: Of the 393 patients enrolled in LASER301, 86 (lazertinib, n = 45; gefitinib, n = 41) had measurable and or non-measurable baseline CNS metastases. The median intracranial progression-free survival in the lazertinib group was 28.2 months (95% confidence interval [CI]: 14.8-28.2) versus 8.4 months (95% CI: 6.7-not reached [NR]) in the gefitinib group (hazard ratio = 0.42, 95% CI: 0.20-0.89, p = 0.02). Among patients with measurable CNS lesions, the intracranial objective response rate was numerically higher with lazertinib (94%; n = 17) versus gefitinib (73%; n = 11, p = 0.124). The median intracranial duration of response with lazertinib was NR (8.3-NR) versus 6.3 months (2.8-NR) with gefitinib. Tolerability was similar to the overall LASER301 population.
CONCLUSIONS: In patients with CNS metastases, lazertinib significantly improved intracranial progression-free survival compared with gefitinib, with more durable responses.
Fulltext The effect of dietary carbohydrate on gastroesophageal reflux disease

Wu KL, Kuo CM, Yao CC, Tai WC, Chuah SK, Lim CS, et al.

J Formos Med Assoc, 2018 Nov;117(11):973-978.
PMID: 29339035 DOI: 10.1016/j.jfma.2017.11.001

BACKGROUND: Acid changes in gastroesophageal reflux with vary component in the food have less been studied, especially carbohydrate. We plan to clarify the effect of different carbohydrate density on low esophageal acid and reflux symptoms of patients with gastroesophgeal reflux disease.
METHODS: Twelve patients (52 ± 12 years old; five female) with gastroesophageal reflux disease were recruited for the prospective crossover study. Each patient was invited for panendoscope, manometry and 24 h pH monitor. The two formulated liquid meal, test meal A: 500 ml liquid meal (containing 84.8 g carbohydrate) and B: same volume liquid meal (but 178.8 g carbohydrate) were randomized supplied as lunch or dinner. Reflux symptoms were recorded.
RESULTS: There are significant statistic differences in more Johnson-DeMeester score (p = 0.019), total reflux time (%) (p = 0.028), number of reflux periods (p = 0.026) and longest reflux (p = 0.015) after high carbohydrate diet than low carbohydrate. Total reflux time and number of long reflux periods more than 5 min are significant more after high carbohydrate diet.
CONCLUSION: More acid reflux symptoms are found after high carbohydrate diet. High carbohydrate diet could induce more acid reflux in low esophagus and more reflux symptoms in patients with gastroesophageal reflux disease.
An alternative Candida spp. cell wall disruption method using a basic sorbitol lysis buffer and glass beads

Lim CS, Tung CH, Rosli R, Chong PP

J Microbiol Methods, 2008 Dec;75(3):576-8.
PMID: 18727938 DOI: 10.1016/j.mimet.2008.07.026

This report describes a modified, cost-effective method of cell wall disruption for the yeast Candida spp., which employs the use of glass beads in a simple sorbitol lysis buffer. This method can be used in conjunction with a commercial RNA or genomic DNA isolation method to obtain high-quality RNA or DNA.

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