Displaying publications 1 - 20 of 25 in total

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  1. Tang IP, Ngui LX, Ramachandran K, Lim LY, Voon PJ, Yu KL, et al.
    Eur Arch Otorhinolaryngol, 2019 Sep;276(9):2475-2482.
    PMID: 31227870 DOI: 10.1007/s00405-019-05522-5
    PURPOSE: To study the surgical and oncological outcomes of endoscopic endonasal transpterygoid nasopharyngectomy (EETN) in salvaging locally recurrent nasopharyngeal carcinoma (NPC).

    METHOD: This was a retrospective clinical record review study carried out at a tertiary centre from June 2013 until May 2017. A total of 55 locally recurrent NPC patients (rT1-rT4) underwent EETN performed by single skull base surgeon with curative intention with postoperative adjuvant chemotherapy but without postoperative radiotherapy.

    RESULTS: There were 44 (80.0%) males and 11 (20.0%) females, with mean age of 52.5 years. The mean operating time was 180 min (range 150-280 min). 85% (47/55) of patients achieved en bloc tumour resection. 93% (51/55) of patients obtained negative microscopic margin based on postoperative histopathological evaluation. Intraoperatively, one (1.8%) patient had internal carotid artery injury which was successfully stented and had recovered fully without neurological deficit. There were no major postoperative complications reported. During a mean follow-up period of 18-month (range 12-48 months) postsurgery, five patients (9.1%) had residual or recurrence at the primary site. All five patients underwent re-surgery. One patient at rT3 passed away 6 months after re-surgery due to distant metastasis complicated with septicaemia. The 1-year local disease-free rate was 93% and the 1-year overall survival rate was 98%.

    CONCLUSIONS: EETN is emerging treatment options for locally recurrent NPC, with relatively low morbidity and encouraging short-term outcome. Long-term outcome is yet to be determined with longer follow-up and bigger cohort study. However, a successful surgical outcome required a very experienced team and highly specialised equipment.

  2. Tiong TJ, Chu JK, Lim LY, Tan KW, Hong Yap Y, Asli UA
    Ultrason Sonochem, 2019 Sep;56:46-54.
    PMID: 31101285 DOI: 10.1016/j.ultsonch.2019.03.026
    In the field of ultrasonic emulsification, the formation and cavitation collapse is one major factor contributing to the formation of micro- and nano-sized emulsion droplets. In this work, a series of experiments were conducted to examine the effects of varying the ultrasonic horn's position to the sizes of emulsion droplets formed, in an attempt to compare the influence of the simulated acoustic pressure fields to the experimental results. Results showed that the intensity of the acoustic pressure played a vital role in the formation of smaller emulsion droplets. Larger areas with acoustic pressure above the cavitation threshold in the water phase have resulted in the formation of smaller emulsion droplets ca. 250 nm and with polydispersity index of 0.2-0.3. Placing the ultrasonic horn at the oil-water interface has hindered the formation of small emulsion droplets, due to the transfer of energy to overcome the interfacial surface tension of oil and water, resulting in a slight reduction in the maximum acoustic pressure, as well as the total area with acoustic pressures above the cavitation threshold. This work has demonstrated the influence of the position of the ultrasonic horn in the oil and water system on the final emulsion droplets formed and can conclude the importance of generating acoustic pressure above the cavitation threshold to achieve small and stable oil-in-water emulsion.
  3. Lim LY, Mohd Firdaus CA, Fam XI, Goh EH
    J Comput Assist Tomogr, 2017 Jan;41(1):65-66.
    PMID: 27680416 DOI: 10.1097/RCT.0000000000000487
    Computed tomography (CT) is a widely used imaging modality. Although hyponatremia after CT imaging is rare, its effects can be devastating. Hyperosmolar radiocontrast acts as effective osmoles and causes fluid migration from intracellular into extracellular compartment. Dilutional hyponatremia will ensue if translocation of fluid is in excess of diuresis. This case report detailed an unusual case of acute symptomatic hyponatremia after CT renal protocol and the treatments given after its recognition.
  4. Lim LY, Chang SJ, Yang SS
    J Pediatr Urol, 2023 Aug;19(4):367.e1-367.e6.
    PMID: 37029009 DOI: 10.1016/j.jpurol.2023.03.026
    INTRODUCTION: Elevated post void residual (PVR) is a significant risk factor for urinary tract infections (UTI). It is also a significant predictor of treatment outcomes in cases of vesicoureteral reflux, pediatric enuresis, and non-neurogenic LUT dysfunction. However, the absence of age-specific nomograms for adolescents may limit PVR's use in clinical practice.

    OBJECTIVE: To establish age- and gender-specific normal PVR urine volume in adolescents.

    MATERIAL AND METHODS: Healthy adolescents aged 12-18 years were recruited to undergo two uroflowmetry and PVR studies whenever they felt the urge to urinate. Adolescents with neurological disorders, known LUT dysfunction or UTI were excluded.

    RESULTS: A total of 1050 adolescents were invited, but only 651 consented. Fourteen participants were excluded due to low bladder volume (BV 100 ml (n = 5) and missing information (n = 6). Ultimately, 894 uroflowmetry and PVR from 605 adolescents (mean age 14.6 ± 1.5 years) were analyzed. PVRs were higher in adolescents aged 15-18 years than in those aged 12-14 years (P 20 ml (7% BV) for males of both the age groups, and PVR >25 ml (9% BV) and PVR >35 ml (>10% BV) for females aged 12-14 and 15-18 years, respectively. Further investigation may be warranted if the repeat PVR is above the 95th percentile, i.e., PVR >30 ml (8% BV) and >30 ml (11% BV) for males aged 12-14 and 15-18 years, respectively, and PVR >35 ml (11% BV) and >45 ml (13% BV) for females aged 12-14 and 15-18 years, respectively.

    CONCLUSION: PVR increases with age and varies by gender; thus, age-and gender-specific reference values should be used. Further data from other countries is required to determine whether the study's recommendations can be applied globally.

  5. Shamsi S, Chen Y, Lim LY
    Int J Pharm, 2015 Nov 10;495(1):194-203.
    PMID: 26319630 DOI: 10.1016/j.ijpharm.2015.08.066
    Curcumin (CUR) has been formulated into a host of nano-sized formulations in a bid to improve its in vivo solubility, stability and bioavailability. The aim of this study was to investigate whether the encapsulation of CUR in nanocarriers would impede its biological interactivity, specifically its potential anti-cancer adjuvant activity via the modulation of CYP enzymes in vitro. NanoCUR, a micellar dispersion prepared via a thin film method using only Pluronic F127 as excipient, was amenable to lyophilization, and retained its nano-sized spherical dimensions (17-33 nm) upon reconstitution with water followed by dilution to 5 μM with HBSS or EMEM. NanoCUR was a weaker cytotoxic agent compared to CUR in solution (sCUR), affecting HepG2 cell viability only when the incubation time was prolonged from 4h to 48 h. Correlation with 2h uptake data suggests this was due to a lower cellular uptake rate of CUR from NanoCUR than from sCUR. The poorer CUR accessibility might also account for NanoCUR being a weaker inhibitor of CYP2C9 and CYP2D6 than sCUR. NanoCUR was, however, 1.76-fold more potent against the CYP3A4 (IC50 5.13 ± 0.91 μM) metabolic function. The higher activity against CYP3A4 might be attributed to the synergistic action of Pluronic F127, since the blank micellar dispersion also inhibited CYP3A4 activity. Both sCUR and NanoCUR had no effect on the CYP3A4 mRNA levels in the HepG2 cells. NanoCUR therefore, maintained most of the biological activities of CUR in vitro, albeit at a lower potency and response rate.
  6. Alfatama M, Lim LY, Wong TW
    Carbohydr Polym, 2021 Dec 01;273:118487.
    PMID: 34560934 DOI: 10.1016/j.carbpol.2021.118487
    This study designed chitosan species-coated calcium alginate beads through concurrent core-coat formation. Chitosan oleate was synthesized by carbodiimide chemistry and characterized by 1H NMR and FTIR techniques. Chitosan or chitosan oleate was coated onto the forming alginate or alginate/tripolyphosphate core using vibratory nozzle extrusion-microencapsulation approach, followed by calcium crosslinking. Chlorpheniramine maleate served as a model water-soluble drug. The molecular characteristics, size, shape, morphology, swelling, erosion, water uptake, drug content and drug release profiles of beads were evaluated. Discrete spherical coated beads were obtained through minimizing successive bead adhesion through an interplay of nozzle vibrational frequency and polymeric solution flow rate. The tripolyphosphate ions in the core possessed higher diffusional kinetics than alginate and were better able to attract chitosan species onto bead surfaces to facilitate alginate-chitosan coacervation. Amphiphilic chitosan oleate formed smaller aggregates than chitosan. It interacted with greater ease with core alginate and tripolyphosphate. The gain in alginate/tripolyphosphate interaction with chitosan oleate at the core-coat interface enhanced bead robustness against swelling and water uptake with drug release consequently dependent on the loss of alginate-drug interaction.
  7. Quek DK, Lim LY, Ong SB
    Med J Malaysia, 1989 Sep;44(3):210-23.
    PMID: 2626136
    In a prospective case-control study over a two-year period involving 1006 women, 264 women with acute myocardial infarction (AMI), 305 with non-infarct acute coronary syndromes (CAD) were compared with 437 women with no coronary heart disease (Controls), to determine the relationship between cigarette smoking and other risks factors with coronary heart disease. A history of current cigarette smoking was strongly associated with the risk of coronary events for both AMI And CAD (p less than 0.001). 23.9% of patients with acute coronary syndromes were current smokers, compared with only 12.8% among controls. Overall, women smokers had about a two-fold increase in risk for all coronary events. Younger women smokers (less than 40 years) and those between 61-70 years had particularly higher risks (10.3 and 2.7 times respectively (p less than 0.01, p less than 0.02). A dose-response pattern of increased AMI risks (from 2.0 to 2.9 times) among women smokers was also found, corresponding to the number of cigarettes smoked per day (p less than 0.05). Other significant coronary risk factors established were: postmenopausal status (OR 6.5), diabetes mellitus (OR 5.1), hypertension (OR 1.6), family history of premature coronary heart disease less than 50 years (OR 1.3) and use of oral contraceptive pills (OR 1.4). Our results thus emphasize that cigarette smoking is an important determinant of acute coronary events even among Malaysian women.
  8. Subramaniam S, Balasubramaniam V, Sinniah M, Thayan R, Lim LY
    Malays J Pathol, 1993 Dec;15(2):143-6.
    PMID: 8065176
    HIV-1 antibody patterns in two groups, those infected by the intravenous route (IV drug users) and those infected by the sexual route (prostitutes, male homosexuals and sexually transmitted disease patients) were compared using the Western blot technique. A total of 160 cases were studied. The intravenous drug user (IVDU) group appeared to respond to fewer antibody markers than the sexually infected group, the difference being significant for markers p31, p51, p55, p66, gp41 and gp120. Furthermore, a higher proportion (63%) of the sexually infected group carried antibodies to all Western blot markers as compared to the IVDU group (49%).
  9. Shamsi S, Tran H, Tan RS, Tan ZJ, Lim LY
    Drug Metab. Dispos., 2017 01;45(1):49-55.
    PMID: 27821437
    Inhibition of cytochrome P450 (P450) enzymes (CYP) has been shown to lower the metabolism of drugs that are P450 substrates and to consequently alter their pharmacokinetic profiles. Curcumin (CUR), piperine (PIP), and capsaicin (CAP) are spice components (SC) that inhibit the activities of a range of P450 enzymes, but the selection of which SC to be prioritized for further development as an adjuvant will depend on the ranking order of the inhibitory potential of the SCs on specific P450 isozymes. We used common human recombinant enzyme platforms to provide a comparative evaluation of the inhibitory activities of CUR, PIP, and CAP on the principal drug-metabolizing P450 enzymes. SC-mediated inhibition of CYP3A4 was found to rank in the order of CAP (IC501.84 ± 0.71 µM) ∼ PIP (2.12 ± 0.45 µM) > CUR (11.93 ± 3.49 µM), while CYP2C9 inhibition was in the order of CAP (11.95 ± 4.24 µM) ∼ CUR (14.58 ± 4.57 µM) > PIP (89.62 ± 9.17 µM). CAP and PIP were significantly more potent inhibitors of CYP1A2 (IC502.14 ± 0.22 µM and 14.19 ± 4.15 µM, respectively) than CUR (IC50> 100 µM), while all three SCs exhibited weak activity toward CYP2D6 (IC5095.42 ± 12.09 µM for CUR, 99.99 ± 5.88 µM for CAP, and 110.40 ± 3.23 µM for PIP). Of the three SCs, CAP thus has the strongest potential for further development into an inhibitor of multiple CYPs for use in the clinic. Data from this study are also useful for managing potential drug-SC interactions.
  10. Lim LY, Ab Majid AH
    J Insect Sci, 2021 Jul 01;21(4).
    PMID: 34297812 DOI: 10.1093/jisesa/ieab047
    Tapinoma indicum (Forel) (Hymenoptera: Formicidae) is a nuisance pest in Asia countries. However, studies on T. indicum are limited, especially in the field of molecular biology, to investigate the species characteristic at the molecular level. This paper aims to provide valuable genetic markers as tools with which to study the T. indicum population. In this study, a total of 143,998 microsatellite markers were developed based on the 2.61 × 106 microsatellites isolated from T. indicum genomic DNA sequences. Fifty selected microsatellite markers were amplified with varying numbers of alleles ranging from 0 to 19. Seven out of fifty microsatellite markers were characterized for polymorphism with the Hardy-Weinberg equilibrium (HWE) and linkage disequilibrium (LD) analysis. All seven microsatellite markers demonstrated a high polymorphic information content (PIC) value ranging from 0.87 to 0.93, with a mean value of 0.90. There is no evidence of scoring errors caused by stutter peaks, no large allele dropout, and no linkage disequilibrium among the seven loci; although loci Ti-Tr04, Ti-Tr09, Ti-Te04, Ti-Te13, and Ti-Pe5 showed signs of null alleles and deviation from the HWE due to excessive homozygosity. In conclusion, a significant amount of microsatellite markers was developed from the data set of next-generation sequencing, and seven of microsatellite markers were validated as informative genetic markers that can be utilized to study the T. indicum population.
  11. Lim LY, Ab Majid AH
    Data Brief, 2020 Aug;31:105903.
    PMID: 32637504 DOI: 10.1016/j.dib.2020.105903
    Tapinoma indicum is a household pest that is widely distributed in Asian countries. It is known as nuisance pest that causes annoyance and disturbance by constructing nests and foraging in building for food and water. This article documents the draft genome dataset of T. indicum collected in Penang Island, Malaysia using the next-generation sequencing known as the Illumina platform. This article presents the pair-end 150 bp genome dataset and the quality of the sequencing result. This dataset provides the information for further understanding of T. indicum in the molecular aspect and the opportunity to develop a novel method for pest control and regulation. The dataset is available under Sequence Read Archive (SRA) databases with the accession number SRR10848807.
  12. Lim LY, Lee CT, Bong CPC, Lim JS, Klemeš JJ
    J Environ Manage, 2019 Aug 15;244:431-439.
    PMID: 31153031 DOI: 10.1016/j.jenvman.2019.05.050
    Waste prevention and management become a significant issue worldwide to achieve sustainable development. Similar to many developing countries, Malaysia has faced severe problems in waste management due to its rapid economic growth and urbanisation. The municipal solid waste (MSW) production rate in Malaysia had increased significantly in a recent year, ranging from 0.8 to 1.25 kg/person∙d. The wastes generated contain a high amount of organic portion with high moisture content. Improper MSW management practice or delayed in waste collection and transportation can lead to severe health issues. This paper presents a case study in Johor Bahru, Malaysia (FOLO Farm), in which a composting prototype is used as the waste management technology to recycle the food and vegetable wastes. The greenhouse gases (GHG) mitigation and economic feasibility of the integrated composting and organic farming in this study are reported. This study showed a reduction of 27% of GHG by diverting the food and vegetable wastes from open dumping to the composting plant. Higher reduction rate (∼44%) can be achieved with better planning of waste collection route and applying the mitigation strategies during the composting process. By adapting the membership concept, this project not only ensures the economic feasibility of running a composting plant but also secures a channel for the growth of vegetable distribution. This study provides an insight into the feasibility and desirability to implement a pilot-scale composting for organic waste management to achieve the low carbon and self-sustain community.
  13. Choy C, Lim LY, Chan LW, Cui Z, Mao S, Wong TW
    Pharmacol Rev, 2022 Oct;74(4):962-983.
    PMID: 36779351 DOI: 10.1124/pharmrev.122.000631
    Subcutaneous and inhaled insulins are associated with needle phobia, lipohypertrophy, lipodystrophy, and cough in diabetes treatment. Oral nanoinsulin has been developed, reaping the physiologic benefits of peroral administration. This review profiles intestinal receptors exploitable in targeted delivery of oral nanoinsulin. Intestinal receptor targeting improves oral insulin bioavailability and sustains blood glucose-lowering response. Nonetheless, these studies are conducted in small animal models with no optimization of insulin dose, targeting ligand type and content, and physicochemical and molecular biologic characteristics of nanoparticles against the in vivo/clinical diabetes responses as a function of the intestinal receptor population characteristics with diabetes progression. The interactive effects between nanoinsulin and antidiabetic drugs on intestinal receptors, including their up-/downregulation, are uncertain. Sweet taste receptors upregulate SGLT-1, and both have an undefined role as new intestinal targets of nanoinsulin. Receptor targeting of oral nanoinsulin represents a viable approach that is relatively green, requiring an in-depth development of the relationship between receptors and their pathophysiological profiles with physicochemical attributes of the oral nanoinsulin. SIGNIFICANCE STATEMENT: Intestinal receptor targeting of oral nanoinsulin improves its bioavailability with sustained blood glucose-lowering response. Exploring new intestinal receptor and tailoring the design of oral nanoinsulin to the pathophysiological state of diabetic patients is imperative to raise the insulin performance to a comparable level as the injection products.
  14. Khoo HC, Lim LY, Shukor S, Zainal Adwin ZA, Zulkifli MZ, Fam XI
    Med J Malaysia, 2022 Nov;77(6):764-767.
    PMID: 36448397
    Laparoscopic retroperitoneal partial nephrectomy (LRPN) is a technically demanding kidney surgery due to the limited space and unfamiliar approach in the retroperitoneal space. The aim of this study is to review the outcome of our initial experience in performing this procedure. All patients who underwent LRPN between 2019 to 2022 were included in this retrospective review. A total of 23 patients underwent LRPN. The mean operating time was 178±43 minutes and mean warm ischemia time was 20±5 minutes. The average estimated blood lost was 89±68ml and the mean postoperative hospital stay was 3.6±0.8 days. Two patients (11.1%) had positive margin and no local recurrence was seen after mean follow up of 15.8±12.0 months. Our initial experience on LRPN showed promising results to perform partial nephrectomy safely and effectively.
  15. Hsu CK, Chang SJ, Lim LY, Chang HH, Shei-Dei Yang S
    J Vasc Res, 2023;60(3):137-147.
    PMID: 37285812 DOI: 10.1159/000529916
    N-methyl-D-aspartate (NMDA) receptors were found to be dysfunctional in hypertensive rats. Methyl palmitate (MP) has been shown to diminish the nicotine-induced increase in blood flow in the brainstem. The aim of this study was to determine how MP modulated NMDA-induced increased regional cerebral blood flow (rCBF) in normotensive (WKY), spontaneously hypertensive (SHR), and renovascular hypertensive (RHR) rats. The increase in rCBF after the topical application of experimental drugs was measured using laser Doppler flowmetry. Topical NMDA application induced an MK-801-sensitive increase in rCBF in anesthetized WKY rats, which was inhibited by MP pretreatments. This inhibition was prevented by pretreatment with chelerythrine (a PKC inhibitor). The NMDA-induced increase in rCBF was also inhibited by the PKC activator in a concentration-dependent manner. Neither MP nor MK-801 affected the increase in rCBF induced by the topical application of acetylcholine or sodium nitroprusside. Topical application of MP to the parietal cortex of SHRs, on the other hand, increased basal rCBF slightly but significantly. MP enhanced the NMDA-induced increase in rCBF in SHRs and RHRs. These results suggested that MP had a dual effect on the modulation of rCBF. MP appears to play a significant physiological role in CBF regulation.
  16. Lim LY, Vidnovic N, Ellisen LW, Leong CO
    Br. J. Cancer, 2009 Nov 3;101(9):1606-12.
    PMID: 19773755 DOI: 10.1038/sj.bjc.6605335
    p53 is the most commonly mutated tumour-suppressor gene in human cancers. Unlike other tumour-suppressor genes, most p53 cancer mutations are missense mutations within the core domain, leading to the expression of a full-length mutant p53 protein. Accumulating evidence has indicated that p53 cancer mutants not only lose tumour suppression activity but also gain new oncogenic activities to promote tumourigenesis.
  17. Quek DK, Ong SB, Lim LY
    Med J Malaysia, 1989 Mar;44(1):14-22.
    PMID: 2626108
    Circadian variations have been observed in the onset of acute coronary syndromes including acute myocardial infarction. We studied 422 acute myocardial infarction patients who presented to the coronary care unit of General Hospital Kuala Lumpur. Of the 318 (75.4%) patients whose data was complete, a circadian rhythm with bimodal peak was demonstrated. The second quarter of the day i.e. 6.00 a.m. to 12 noon was shown to have a significantly increased frequency of onset of acute myocardial infarction (p less than 0.05). Time delay in presenting to the hospital was also determined. This showed that 56.8% of acute myocardial infarction patients presented early, within four hours of the onset of symptoms. By six hours, more than 71% had sought hospital care. This early presentation to the hospital may offer a realistic opportunity for optimal thrombolytic therapy should this treatment modality be offered as routine to infarct patients.
  18. Lim LY, Yang SS
    Neurourol Urodyn, 2024 Jan;43(1):81-87.
    PMID: 37767698 DOI: 10.1002/nau.25294
    OBJECTIVE: To establish a normal reference value of postvoid residual (PVR) urine volume in "healthy" adults.

    METHODS: Adults were recruited to undergo uroflowmetry and PVR. Those with neurological disorders, malignancy, diabetes, known lower urinary tract dysfunction, and urinary tract infection within the previous 3 months, were excluded from the study. Constipation was defined as Rome IV ≥ 2.

    RESULTS: Of the 883 adults enrolled in this study, 194 (22.3%) did not complete the questionnaires or perform the uroflowmetry, 103 (11.7%) met ≥1 exclusion criteria and thus were excluded. In addition, 30 and 38 uroflowmetry were excluded due to artifacts and low bladder volume (BV) (<100 mL), respectively. Finally, 515 uroflowmetry and PVR data from adults aged 36-89 (mean: 59.0 ± 9.5) were examined. There was a significant nonlinear relationship between BV and PVR (p 

  19. Lim LY, Miao H, Lim JS, Lee SC, Bhoo-Pathy N, Yip CH, et al.
    Cancer Med, 2017 Jan;6(1):173-185.
    PMID: 28000426 DOI: 10.1002/cam4.985
    We aim to identify clinicopathologic predictors for response to neoadjuvant chemotherapy and to evaluate the prognostic value of pathologic complete response (pCR) on survival in Asia. This study included 915 breast cancer patients who underwent neoadjuvant chemotherapy at five public hospitals in Singapore and Malaysia. pCR following neoadjuvant chemotherapy was defined as 1) no residual invasive tumor cells in the breast (ypT0/is) and 2) no residual invasive tumor cells in the breast and axillary lymph nodes (ypT0/is ypN0). Association between pCR and clinicopathologic characteristics and treatment were evaluated using chi-square test and multivariable logistic regression. Kaplan-Meier analysis and log-rank test, stratified by other prognostic factors, were conducted to compare overall survival between patients who achieved pCR and patients who did not. Overall, 4.4% of nonmetastatic patients received neoadjuvant chemotherapy. The median age of preoperatively treated patients was 50 years. pCR rates were 18.1% (pCR ypT0/is) and 14.4% (pCR ypT0/is ypN0), respectively. pCR rate was the highest among women who had higher grade, smaller size, estrogen receptor negative, human epidermal growth factor receptor 2-positive disease or receiving taxane-based neoadjuvant chemotherapy. Patients who achieved pCR had better overall survival than those who did not. In subgroup analysis, the survival advantage was only significant among women with estrogen receptor-negative tumors. Patients with poor prognostic profile are more likely to achieve pCR and particularly when receiving taxane-containing chemotherapy. pCR is a significant prognostic factor for overall survival especially in estrogen receptor-negative breast cancers.
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