MyMedR

Fulltext Usefulness of conventional ultrasonography in identifying normal and abnormal gastric antrum

George J

Singapore Med J, 1996 Apr;37(2):181-3.

This study evaluates the usefulness of measuring gastric antral thickness on conventional ultrasonography as a means of suggesting gastric antral pathology. Normal and abnormal appearances of the gastric antrum are reviewed.

Matched MeSH terms: Pyloric Antrum/pathology; Stomach Neoplasms/pathology

Fulltext Mucosal enterokinase activity in cow's milk protein sensitive enteropathy

Iyngkaran N, Yadav M, Boey CG

Singapore Med J, 1995 Aug;36(4):393-6.

PMID: 8919154

Enterokinase has a critical role in initiating proteolytic digestion by hydrolysing the conversion of pancreatic trypsinogen into trypsin. The enzyme is synthesised by enterocytes of the proximal small intestine and initially incorporated into the brush border from where it is released into the intestinal lumen by the action of pancreatic secretions. The aim of the study was to analyse enterokinase activity in the duodenal mucosa of infants with diarrhoeal disease including cow's milk protein-sensitive enteropathy. Our observations show that the mean depletion of enterokinase was only 17% compared to 60-80% for other brush border enzymes like disaccharidases, peptidases and alkaline phosphatases in infants with diarrhoea. This suggests that enterokinase activity in the small bowel enteropathies may be dependent not only on the degree of mucosal damage specifically but also on the extent of damage to the goblet cell population where the enzyme is synthesised. Thus the enterokinase activity was reduced in acute and chronic diarrhoea with marked mucosal damage where significant reduction of goblet cell population was evident but the enzyme was relatively little affected when the mucosa was damaged mildly.

Matched MeSH terms: Intestinal Mucosa/pathology*; Milk Hypersensitivity/pathology

Fulltext Sclerosing haemangioma of the lung

Liam CK, Wong KT

Singapore Med J, 1995 Jun;36(3):333-4.

PMID: 8553108

An asymptomatic middle-aged women was investigated for a lung nodule detected on routine chest X-ray. Percutaneous needle biopsy revealed it to be a sclerosing haemangioma which was subsequently removed by a left lower lobectomy. The literature on this uncommon benign lesion is reviewed.

Matched MeSH terms: Lung Neoplasms/pathology; Histiocytoma, Benign Fibrous/pathology

Fulltext Ileal perforation in segmental intestinal dilatation associated with omphalocoele

Thambidorai CR, Arief H, Noor Afidah MS

Singapore Med J, 2009 Dec;50(12):e412-4.

PMID: 20087543

Localised dilatation of a segment of the intestine without any macroscopically-identifiable cause is rare, and has been reported in association with omphalocoele in only 14 children up to 2006. In most of these cases, the segmental intestinal dilatation (SID) was either diagnosed incidentally, or due to presentation with partial or complete intestinal obstruction. We report, for the first time, a 37-week-old neonate with bowel perforation in SID associated with omphalocoele. In our case, a long thin vessel that resembled the mesodiverticular vessel of a Meckel's diverticulum was present in the dilated segment, supporting the view that SID and Meckel's diverticulum may be embryologically related.

Matched MeSH terms: Ileal Diseases/pathology*; Meckel Diverticulum/pathology*

Fulltext Thyroglossal duct carcinoma

Kahairi A, Ahmad RL, Wan Islah L, Hasmah H

Singapore Med J, 2009 Dec;50(12):e404-6.

PMID: 20087540

We report a 56-year-old Malay woman with a tumour that involved the skin and caused hyoid bone erosion. There was no clinical or radiological evidence of regional lymph node involvement. A modified radical neck dissection with preservation of the accessory nerve and internal jugular vein was performed, followed by an "extended" Sistrunk operation. The surgical defect was reconstructed with a pectoralis major myocutaneous flap. Our literature review showed that this is the first reported thyroglossal duct carcinoma which involved the skin and required a pedicle flap reconstruction.

Matched MeSH terms: Adenocarcinoma, Papillary/pathology*; Head and Neck Neoplasms/pathology*

Fulltext Hearing rehabilitation in congenital canal atresia

Mazita A, Fazlina WH, Abdullah A, Goh BS, Saim L

Singapore Med J, 2009 Nov;50(11):1072-6.

PMID: 19960162

The purpose of this study was to review the results of our patients with congenital canal atresia after implantation of bone-anchored hearing aids (BAHA). The occurrence of complications was also reviewed.

Matched MeSH terms: Ear Canal/pathology; Hearing Disorders/pathology

Fulltext Differential expression of galectin-3 in advancing thyroid cancer cells: a clue toward understanding tumour progression and metastasis

Htwe TT, Karim N, Wong J, Jahanfar S, Mansur MA

Singapore Med J, 2010 Nov;51(11):856-9.

PMID: 21140111

INTRODUCTION: Galectin-3 is a member of the beta-galactoside-binding protein family that plays an important role in cell-to-cell adhesion and in cell-to-matrix interaction. Cellular expression of galectin-3 is correlated with cancer aggressiveness and metastasis.
METHODS: We examined the differential expression of galectin-3 in a collection of 142 cases of thyroid lesions, including 108 cases of papillary thyroid carcinoma (PTC) and 34 cases of follicular carcinoma (FCA). An immunohistochemical method was applied and semiquantitative scoring was performed on the staining intensity of the positive tissue. Scoring was done on cells at the central portion of the tumour foci and on cells at the periphery that were adjacent to the neighbouring normal thyroid tissue matrix.
RESULTS: A significantly higher expression (p is 0.001) of galectin-3 was observed in the advancing peripheral thyroid cancer cells compared to the centrally located cells that were not in close contact with the neighbouring stromal tissue in cases with PTC compared to those with FCA.
CONCLUSION: This finding supported the role of galectin-3 in its cell-to-cell adhesion and cell-to-matrix interaction. Galectin-3 is a potential tumour marker for indicating local and distance metastasis, especially in cases with PTC.

Matched MeSH terms: Neoplasm Metastasis/pathology*; Thyroid Neoplasms/pathology*

Fulltext Retrograde intrarenal surgery for renal stones smaller than 2 cm

Ho CC, Hafidzul J, Praveen S, Goh EH, Bong JJ, Lee BC, et al.

Singapore Med J, 2010 Jun;51(6):512-5.

PMID: 20658113

Extracorporeal shock wave lithotripsy (ESWL) is accepted as the gold standard treatment for renal stones that are smaller than 2 cm. Recently, retrograde intrarenal surgery (RIRS) has been introduced as another form of treatment. We report our experience in dealing with renal stones smaller than 2 cm using RIRS as the primary treatment and following failed ESWL.

Matched MeSH terms: Kidney/pathology; Kidney Calculi/pathology

Fulltext Multiple accessory structures in the upper limb of a single cadaver

Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rakesh V

Singapore Med J, 2008 Sep;49(9):e254-8.

PMID: 18830534

The arterial and muscular variations of the upper limbs are common but important with regard to surgical approaches. Even though anomalies of the coracobrachialis muscle are rare, anatomical variations of the biceps brachii, existence of the accessory muscles in the forearm and persistent median artery are known and well documented. During routine dissection, we observed some important anatomical variations in a 50-year-old male cadaver. The variations were unilateral. The anomalies were: third head for biceps brachii muscle, an accessory belly for coracobrachialis muscle crossing the median nerve and brachial vessels and continuing with the medial head of triceps brachii muscle to be inserted to the olecranon process (coracoulnaris), a persistent median artery and an additional muscle in the anterior compartment of forearm. Although there are individual reports about these variations, the combination of these variations in one cadaver has not previously been described in the literature. Awareness of these variations is necessary to avoid complications during radiodiagnostic procedures or surgeries in the upper limb.

Matched MeSH terms: Brachial Artery/pathology; Muscle, Skeletal/pathology*

Fulltext Pancreatoblastoma: a rare tumour accidentally found

Naik VR, Jaafar H, Leow VM, Bhavaraju VM

Singapore Med J, 2006 Mar;47(3):232-4.

PMID: 16518559

A 15-year-old girl, who was previously well, complained of a mass in the abdomen after a minor motor vehicle accident. Physical and radiological investigations revealed a mass in the body of pancreas containing proteinaceous material and multiple nodules in both lobes of liver. Serological investigations for malignancy were normal. Histopathological examination of the resected specimen showed pancreatoblastoma. Pancreatoblastoma is an unusual malignant tumour seen in infants and children although rare cases have also been reported in adults. They are clinicopathologically distinct from adult pancreatic ductal carcinoma. The histogenesis, clinical features and treatment options are discussed along with presentation of the case.

Matched MeSH terms: Abdomen/physiopathology; Pancreas/pathology; Pancreatic Neoplasms/pathology

Fulltext Biliary ascariasis and extrahepatic cholangiocarcinoma: a report of two cases

Lim KG, Sellaiah SP

Singapore Med J, 1994 Aug;35(4):400-2.

PMID: 7899902

We report two cases of rural Malay women in Perak, Malaysia, with extrahepatic cholangiocarcinoma and coexistent biliary ascariasis. In both cases, the narrowed bile duct may have resulted in inability of the migratory nematode to return to the gastrointestinal tract. It may be reasonable, also, to postulate that chronic biliary tract infestation by Ascaris lumbricoides may have contributed to the development of cholangiocarcinoma; a situation similar to that observed in liver fluke infestation.

Matched MeSH terms: Cystic Duct/pathology; Bile Ducts, Extrahepatic/pathology*

Fulltext Benign persistent pneumoperitoneum in systemic sclerosis

Wang CL, Wang F, Wong KC, Jeyamalar R

Singapore Med J, 1993 Dec;34(6):563-4.

PMID: 8153727

We describe a 50-year-old Chinese woman who had severe gastrointestinal manifestations from systemic sclerosis complicated by spontaneous pneumoperitoneum in the absence of either visceral perforation or pneumatosis cystoides intestinalis. This is a rare complication of systemic sclerosis; only four other cases have been reported. Recognition of this condition is important so as to avoid unnecessary surgery.

Matched MeSH terms: Intestine, Small/pathology; Scleroderma, Systemic/pathology

Fulltext Urinary erythrocyte morphology as a diagnostic aid in haematuria

Ahmad G, Segasothy M, Morad Z

Singapore Med J, 1993 Dec;34(6):486-8.

PMID: 8153706

The value of urinary erythrocyte morphology in diagnosing glomerular and nonglomerular haematuria was studied using phase contrast microscopy in 105 patients with significant haematuria. Fifty-eight (93.6%) out of 62 patients with glomerulonephritis had dysmorphic erythrocytes and 40 (93.1%) out of the 43 patients with nonglomerular disease had isomorphic erythrocytes in the urine. A mixed picture of glomerular and nonglomerular haematuria was seen in 5 patients. The sensitivity was 93.6%, the specificity was 97.7% and the positive predictive value was 98.3% for glomerulonephritis in patients with dysmorphic haematuria. The positive predictive value for a nonglomerular source of bleeding was 96.7% with isomorphic haematuria. It is concluded that phase contrast microscopic examination of erythrocytes in urine is a simple, inexpensive and noninvasive technique that reliably distinguishes between glomerular and nonglomerular bleeding in patients.

Matched MeSH terms: Erythrocytes/pathology*; Erythrocytes, Abnormal/pathology

Fulltext Toxic epidermal necrolysis in Malaysian adults. A retrospective study

Ting HC, Adam BA

Singapore Med J, 1985 Oct;26(6):456-9.

PMID: 2937150

We report a retrospective study of all cases of toxic epidermal necrolysis admitted to the adult medical wards of the University Hospital in Kuala Lumpur over a 16 year period from 1967 to 1983. Over this period of time only 7 cases were encountered, suggesting the condition is rare in adults in our country. All the cases were females and the age ranged from 21 to 41 years. Four cases were due to drugs, 2 were idiopathic and one was attributed to Staphylococcal infection. One patient died. The other patients recovered completely with no sequelae.

Matched MeSH terms: Skin/pathology; Stevens-Johnson Syndrome/pathology

Fulltext Small intestinal absorption studies and biopsy findings in Asians, in Singapore

Jayaratnam FJ, Tan KK, Jacob E, Seah CS, Kho KM

Singapore Med J, 1970 Dec;11(4):275-82.

PMID: 5511860

Investigations in 30 healthy control subjects of Indian, Chinese and Malay ethnic origin, revealed that all the Chinese and about two thirds of the Indians and Malays had a normal capacity to absorb D—xylose, Vitamin A, Co58 labelled Vitamin B12 and dietary fat. About a third of the Indians and Malays were unable to absorb one or two of the four test substances used in the absorption studies. Jejunal biopsies did not differ in the 3 ethnic groups and were normal or mildly abnormal. 27 patients presenting with anorexia, a sore tongue and pallor were also investigated. Indians formed the majority of the patients. Diarrhoea occurred in only 51 % of the patients. All had a megaloblastic anaemia. Absorption studies revealed malabsorption of xylose, Vitamin A and Vitamin B12 in the majority but steatorrhoea occurred in only 26% of the patients. Jejunal biopsies were mildly abnormal in 8% and moderately or severely abnormal in 92 % of the patients. All responded to folic acid or Vitamin B12 therapy. 16 patients were restudied after 5 to 24 months therapy and the majority were found to have improved. Results of investigations and response to therapy indicate that these patients were suffering from tropical sprue. These studies indicate that tropical sprue in Singapore affects Indians mainly and can often present without diarrhoea and steatorrhoea.

Matched MeSH terms: Jejunum/pathology; Sprue, Tropical/pathology

Fulltext Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes

Bipolar Disorder and Schizophrenia Working Group of the Psychiatric Genomics Consortium. Electronic address: douglas.ruderfer@vanderbilt.edu, Bipolar Disorder and Schizophrenia Working Group of the Psychiatric Genomics Consortium

Cell, 2018 Jun 14;173(7):1705-1715.e16.

PMID: 29906448 DOI: 10.1016/j.cell.2018.05.046

Schizophrenia and bipolar disorder are two distinct diagnoses that share symptomology. Understanding the genetic factors contributing to the shared and disorder-specific symptoms will be crucial for improving diagnosis and treatment. In genetic data consisting of 53,555 cases (20,129 bipolar disorder [BD], 33,426 schizophrenia [SCZ]) and 54,065 controls, we identified 114 genome-wide significant loci implicating synaptic and neuronal pathways shared between disorders. Comparing SCZ to BD (23,585 SCZ, 15,270 BD) identified four genomic regions including one with disorder-independent causal variants and potassium ion response genes as contributing to differences in biology between the disorders. Polygenic risk score (PRS) analyses identified several significant correlations within case-only phenotypes including SCZ PRS with psychotic features and age of onset in BD. For the first time, we discover specific loci that distinguish between BD and SCZ and identify polygenic components underlying multiple symptom dimensions. These results point to the utility of genetics to inform symptomology and potential treatment.

Matched MeSH terms: Bipolar Disorder/pathology; Schizophrenia/pathology

Fulltext Anticancer activity of a monobenzyltin complex C1 against MDA-MB-231 cells through induction of Apoptosis and inhibition of breast cancer stem cells

Fani S, Kamalidehghan B, Lo KM, Nigjeh SE, Keong YS, Dehghan F, et al.

Sci Rep, 2016 Dec 15;6:38992.

PMID: 27976692 DOI: 10.1038/srep38992

In the present study, we examined the cytotoxic effects of Schiff base complex, [N-(3,5-dichloro-2-oxidobenzylidene)-4-chlorobenzyhydrazidato](o-methylbenzyl)aquatin(IV) chloride, and C1 on MDA-MB-231 cells and derived breast cancer stem cells from MDA-MB-231 cells. The acute toxicity experiment with compound C1 revealed no cytotoxic effects on rats. Fluorescent microscopic studies using Acridine Orange/Propidium Iodide (AO/PI) staining and flow cytometric analysis using an Annexin V probe confirmed the occurrence of apoptosis in C1-treated MDA-MB-231 cells. Compound C1 triggered intracellular reactive oxygen species (ROS) production and lactate dehydrogenase (LDH) releases in treated MDA-MB-231 cells. The Cellomics High Content Screening (HCS) analysis showed the induction of intrinsic pathways in treated MDA-MB-231 cells, and a luminescence assay revealed significant increases in caspase 9 and 3/7 activity. Furthermore, flow cytometric analysis showed that compound C1 induced G0/G1 arrest in treated MDA-MB-231 cells. Real time PCR and western blot analysis revealed the upregulation of the Bax protein and the downregulation of the Bcl-2 and HSP70 proteins. Additionally, this study revealed the suppressive effect of compound C1 against breast CSCs and its ability to inhibit the Wnt/β-catenin signaling pathways. Our results demonstrate the chemotherapeutic properties of compound C1 against breast cancer cells and derived breast cancer stem cells, suggesting that the anticancer capabilities of this compound should be clinically assessed.

Matched MeSH terms: Breast Neoplasms/pathology; Neoplastic Stem Cells/pathology

Immunophenotyping analysis of lymph node biopsies by flow cytometry

Raja-Sabudin RZ, Hamid AA, Yusof N, Alauddin H, Aziz SA, Kulaveerasingam S, et al.

Saudi Med J, 2012 Oct;33(10):1131-3.

PMID: 23047221

Matched MeSH terms: Lymph Nodes/pathology*; Lymphoma/pathology

Fulltext Comparison of Prognostic Accuracy of the quick Sepsis-Related Organ Failure Assessment between Short- & Long-term Mortality in Patients Presenting Outside of the Intensive Care Unit - A Systematic Review & Meta-analysis

Tan TL, Tang YJ, Ching LJ, Abdullah N, Neoh HM

Sci Rep, 2018 Nov 12;8(1):16698.

PMID: 30420768 DOI: 10.1038/s41598-018-35144-6

The purpose of this meta-analysis was to compare the ability of the qSOFA in predicting short- (≤30 days or in-hospital mortality) and long-term (>30 days) mortality among patients outside the intensive care unit setting. Studies reporting on the qSOFA and mortality were searched using MEDLINE and SCOPUS. Studies were included if they involved patients presenting to the ED with suspected infection and usage of qSOFA score for mortality prognostication. Data on qSOFA scores and mortality rates were extracted from 36 studies. The overall pooled sensitivity and specificity for the qSOFA were 48% and 86% for short-term mortality and 32% and 92% for long-term mortality, respectively. Studies reporting on short-term mortality were heterogeneous (Odd ratio, OR = 5.6; 95% CI = 4.6-6.8; Higgins's I2 = 94%), while long-term mortality studies were homogenous (OR = 4.7; 95% CI = 3.5-6.1; Higgins's I2 = 0%). There was no publication bias for short-term mortality analysis. The qSOFA score showed poor sensitivity but moderate specificity for both short and long-term mortality, with similar performance in predicting both short- and long- term mortality. Geographical region was shown to have nominal significant (p = 0.05) influence on qSOFA short-term mortality prediction.

Matched MeSH terms: Multiple Organ Failure/pathology*; Sepsis/pathology*

Systematic review of pre-clinical chronic myeloid leukaemia

Kuan JW, Su AT, Leong CF, Osato M, Sashida G

Int J Hematol, 2018 Nov;108(5):465-484.

PMID: 30218276 DOI: 10.1007/s12185-018-2528-x

BACKGROUND: Studies of a provisional entity pre-clinical chronic myeloid leukaemia (CML), which precedes chronic phase (CP) without leucocytosis or blood/marrow feature of CML CP, has been increasing.

OBJECTIVE: To perform a systematic review of pre-clinical CML and analysis the data relevant to disease progression to CML CP.

METHOD: We performed a literature search on 16 July 2017 using EBSCOhost Research Databases interface and Western Pacific Region Index Medicus. Two authors selected the studies, extracted the data and evaluated the quality of studies using an 8-item tool, independently. The outcomes were percentage of Philadelphia chromosome in the number of metaphases examined (Ph%), correlation between Ph% and blood count and time progress to CML.

RESULT: Our initial search returned 4770 studies. A total of 10 studies with a total 17 subjects were included. The lowest Ph%, which eventually progresses to CML, was 10%. Absolute basophil count seemed to correlate better with Ph% compared to total white cell and absolute eosinophil count. The time from the first documented pre-clinical CML to CML ranged from 12 to 48 months. The overall quality of the included studies was average.

CONCLUSION: This is the first systematic review on pre-clinical CML. This entity requires additional large-scale studies.

Matched MeSH terms: Bone Marrow/pathology; Leukocytosis/pathology

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