Displaying publications 61 - 80 of 101 in total

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  1. Lee SH, Md Tahir P, Lum WC, Tan LP, Bawon P, Park BD, et al.
    Polymers (Basel), 2020 Jul 29;12(8).
    PMID: 32751175 DOI: 10.3390/polym12081692
    Citric acid (CA) can be found naturally in fruits and vegetables, particularly citrus fruit. CA is widely used in many fields but its usage as a green modifying agent and binder for wood is barely addressed. Esterification is one of the most common chemical reactions applied in wood modification. CA contains three carboxyl groups, making it possible to attain at least two esterification reactions that are required for crosslinking when reacting with the hydroxyl groups of the cell wall polymers. In addition, the reaction could form ester linkages to bring adhesivity and good bonding characteristics, and therefore CA could be used as wood binder too. This paper presents a review concerning the usage of CA as a wood modifying agent and binder. For wood modification, the reaction mechanism between wood and CA and the pros and cons of using CA are discussed. CA and its combination with various reactants and their respective optimum parameters are also compiled in this paper. As for the major wood bonding component, the bonding mechanism and types of wood composites bonded with CA are presented. The best working conditions for the CA in the fabrication of wood-based panels are discussed. In addition, the environmental impacts and future outlook of CA-treated wood and bonded composite are also considered.
  2. Chieng BW, Lee SH, Ibrahim NA, Then YY, Loo YY
    Polymers (Basel), 2017 Aug 11;9(8).
    PMID: 30971032 DOI: 10.3390/polym9080355
    The aim was to explore the utilization of oil palm mesocarp fiber (OPMF) as a source for the production of cellulose nanocrystals (CNC). OPMF was first treated with alkali and then bleached before the production of CNC by acid hydrolysis (H₂SO₄). The produced materials were characterized using Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), thermogravimetric analysis (TGA), a scanning electron microscope (SEM) and a transmission electron microscope (TEM). It was proven that acid hydrolysis can increase the crystallinity of bleached OPMF and reduce the dimension of cellulose to nano scale. Changes in the peaks of the FTIR spectrum at 2852 (C-H stretching), 1732 (C=O stretching) and 1234 cm-1 (C-O stretching) indicated that the alkali treatment completely removed hemicelluloses and lignin from the fiber surface. This can be seen from the thermogram obtained from the TGA characterization. Morphological characterization clearly showed the formation of rod-shaped CNCs. The promising results prove that OPMF is a valuable source for the production of CNC.
  3. Ahmad Saffian H, Talib MA, Lee SH, Md Tahir P, Lee CH, Ariffin H, et al.
    Polymers (Basel), 2020 Aug 15;12(8).
    PMID: 32824275 DOI: 10.3390/polym12081833
    Mechanical strength, thermal conductivity and electrical breakdown of polypropylene/lignin/kenaf core fiber (PP/L/KCF) composite were studied. PP/L, PP/KCF and PP/L/KCF composites with different fiber and lignin loading was prepared using a compounding process. Pure PP was served as control. The results revealed that tensile and flexural properties of the PP/L/KCF was retained after addition of lignin and kenaf core fibers. Thermal stability of the PP composites improved compared to pure PP polymer. As for thermal conductivity, no significant difference was observed between PP composites and pure PP. However, PP/L/KCF composite has higher thermal diffusivity. All the PP composites produced are good insulating materials that are suitable for building. All PP composites passed withstand voltage test in air and oil state as stipulated in IEC 60641-3 except PP/L in oil state. SEM micrograph showed that better interaction and adhesion between polymer matrix, lignin and kenaf core fibers was observed and reflected on the better tensile strength recorded in PP/L/KCF composite. This study has successfully filled the gap of knowledge on using lignin and kenaf fibers as PP insulator composite materials. Therefore, it can be concluded that PP/Lignin/KCF has high potential as an insulating material.
  4. Lee CH, Khalina A, Lee SH
    Polymers (Basel), 2021 Jan 29;13(3).
    PMID: 33573036 DOI: 10.3390/polym13030438
    Plant fibers have become a highly sought-after material in the recent days as a result of raising environmental awareness and the realization of harmful effects imposed by synthetic fibers. Natural plant fibers have been widely used as fillers in fabricating plant-fibers-reinforced polymer composites. However, owing to the completely opposite nature of the plant fibers and polymer matrix, treatment is often required to enhance the compatibility between these two materials. Interfacial adhesion mechanisms are among the most influential yet seldom discussed factors that affect the physical, mechanical, and thermal properties of the plant-fibers-reinforced polymer composites. Therefore, this review paper expounds the importance of interfacial adhesion condition on the properties of plant-fiber-reinforced polymer composites. The advantages and disadvantages of natural plant fibers are discussed. Four important interface mechanism, namely interdiffusion, electrostatic adhesion, chemical adhesion, and mechanical interlocking are highlighted. In addition, quantifying and analysis techniques of interfacial adhesion condition is demonstrated. Lastly, the importance of interfacial adhesion condition on the performances of the plant fiber polymer composites performances is discussed. It can be seen that the physical and thermal properties as well as flexural strength of the composites are highly dependent on the interfacial adhesion condition.
  5. Aisyah HA, Paridah MT, Sapuan SM, Ilyas RA, Khalina A, Nurazzi NM, et al.
    Polymers (Basel), 2021 Feb 02;13(3).
    PMID: 33540731 DOI: 10.3390/polym13030471
    Over the last decade, the progressive application of natural fibres in polymer composites has had a major effect in alleviating environmental impacts. Recently, there is a growing interest in the development of green materials in a woven form by utilising natural fibres from lignocellulosic materials for many applications such as structural, non-structural composites, household utilities, automobile parts, aerospace components, flooring, and ballistic materials. Woven materials are one of the most promising materials for substituting or hybridising with synthetic polymeric materials in the production of natural fibre polymer composites (NFPCs). These woven materials are flexible, able to be tailored to the specific needs and have better mechanical properties due to their weaving structures. Seeing that the potential advantages of woven materials in the fabrication of NFPC, this paper presents a detailed review of studies related to woven materials. A variety of factors that influence the properties of the resultant woven NFRC such as yarn characteristics, fabric properties as well as manufacturing parameters were discussed. Past and current research efforts on the development of woven NFPCs from various polymer matrices including polypropylene, polylactic acid, epoxy and polyester and the properties of the resultant composites were also compiled. Last but not least, the applications, challenges, and prospects in the field also were highlighted.
  6. Lee CH, Padzil FNBM, Lee SH, Ainun ZMA, Abdullah LC
    Polymers (Basel), 2021 Apr 27;13(9).
    PMID: 33925266 DOI: 10.3390/polym13091407
    In this review, the potential of natural fiber and kenaf fiber (KF) reinforced PLA composite filament for fused deposition modeling (FDM) 3D-printing technology is highlighted. Additive manufacturing is a material-processing method in which the addition of materials layer by layer creates a three-dimensional object. Unfortunately, it still cannot compete with conventional manufacturing processes, and instead serves as an economically effective tool for small-batch or high-variety product production. Being preformed of composite filaments makes it easiest to print using an FDM 3D printer without or with minimum alteration to the hardware parts. On the other hand, natural fiber-reinforced polymer composite filaments have gained great attention in the market. However, uneven printing, clogging, and the inhomogeneous distribution of the fiber-matrix remain the main challenges. At the same time, kenaf fibers are one of the most popular reinforcements in polymer composites. Although they have a good record on strength reinforcement, with low cost and light weight, kenaf fiber reinforcement PLA filament is still seldom seen in previous studies. Therefore, this review serves to promote kenaf fiber in PLA composite filaments for FDM 3D printing. To promote the use of natural fiber-reinforced polymer composite in AM, eight challenges must be solved and carried out. Moreover, some concerns arise to achieve long-term sustainability and market acceptability of KF/PLA composite filaments.
  7. Saffian HA, Yamaguchi M, Ariffin H, Abdan K, Kassim NK, Lee SH, et al.
    Polymers (Basel), 2021 Jul 19;13(14).
    PMID: 34301116 DOI: 10.3390/polym13142359
    In this study, Kraft lignin was esterified with phthalic anhydride and was served as reinforcing filler for poly(butylene succinate) (PBS). Composites with different ratios of PBS, lignin (L), modified lignin (ML) and kenaf core fibers (KCF) were fabricated using a compounding method. The fabricated PBS composites and its counterparts were tested for thermal, physical and mechanical properties. Weight percent gain of 4.5% after lignin modification and the FTIR spectra has confirmed the occurrence of an esterification reaction. Better thermo-mechanical properties were observed in the PBS composites reinforced with modified lignin and KCF, as higher storage modulus and loss modulus were recorded using dynamic mechanical analysis. The density of the composites fabricated ranged from 1.26 to 1.43 g/cm3. Water absorption of the composites with the addition of modified lignin is higher than that of composites with unmodified lignin. Pure PBS exhibited the highest tensile strength of 18.62 MPa. Incorporation of lignin and KCF into PBS resulted in different extents of reduction in tensile strength (15.78 to 18.60 MPa). However, PBS composite reinforced with modified lignin exhibited better tensile and flexural strength compared to its unmodified lignin counterpart. PBS composite reinforced with 30 wt% ML and 20 wt% KCF had the highest Izod impact, as fibers could diverge the cracking propagation of the matrix. The thermal conductivity value of the composites ranged from 0.0903 to 0.0983 W/mK, showing great potential as a heat insulator.
  8. Zakaria R, Bawon P, Lee SH, Salim S, Lum WC, Al-Edrus SSO, et al.
    Polymers (Basel), 2021 Oct 12;13(20).
    PMID: 34685253 DOI: 10.3390/polym13203494
    The study investigated the effects of the addition of starch on the properties of oil palm biomass particleboard bonded with citric acid. Three kinds of oil palm biomasses were used in this study for the fabrication of particleboard, namely, oil palm frond (OPF), oil palm trunk (OPT), and empty fruit bunch (EFB) particles. Citric acid and tapioca starch at the mixing ratios of 100:0, 87.5:12.5, and 75:25 were prepared at a 60% solid content. A 30% resin content based on the oven-dried weight of the oil palm biomass particles was used. The sprayed particles were pre-dried at 80 °C for 12 h before being hot-pressed at 180 °C and 4 MPa pressure for 10 min. The physical and mechanical properties of the particleboard were evaluated. The mixtures of citric acid and tapioca starch were characterized by thermogravimetric analysis (TGA). Thermal stability of citric acid was reduced after the addition of tapioca starch. The addition of 12.5% tapioca starch improved the bending strength of the particleboard but increased the thickness swelling slightly. All UF-bonded particleboard exhibited significantly inferior performance than that of citric-acid-bonded particleboard. Citric-acid-bonded particleboard maintained its original shape after being subjected to a cyclic-aging treatment, while the UF-bonded particleboard disintegrated half way through the treatment. The performance of EFB particleboard was significantly inferior to its OPT and OPF counterparts.
  9. Hakimi NMF, Lee SH, Lum WC, Mohamad SF, Osman Al Edrus SS, Park BD, et al.
    Polymers (Basel), 2021 Sep 24;13(19).
    PMID: 34641056 DOI: 10.3390/polym13193241
    Natural rubber is of significant economic importance owing to its excellent resilience, elasticity, abrasion and impact resistance. Despite that, natural rubber has been identified with some drawbacks such as low modulus and strength and therefore opens up the opportunity for adding a reinforcing agent. Apart from the conventional fillers such as silica, carbon black and lignocellulosic fibers, nanocellulose is also one of the ideal candidates. Nanocellulose is a promising filler with many excellent properties such as renewability, biocompatibility, non-toxicity, reactive surface, low density, high specific surface area, high tensile and elastic modulus. However, it has some limitations in hydrophobicity, solubility and compatibility and therefore it is very difficult to achieve good dispersion and interfacial properties with the natural rubber matrix. Surface modification is often carried out to enhance the interfacial compatibilities between nanocellulose and natural rubber and to alleviate difficulties in dispersing them in polar solvents or polymers. This paper aims to highlight the different surface modification methods employed by several researchers in modifying nanocellulose and its reinforcement effects in the natural rubber matrix. The mechanism of the different surface medication methods has been discussed. The review also lists out the conventional filler that had been used as reinforcing agent for natural rubber. The challenges and future prospective has also been concluded in the last part of this review.
  10. Taghiyari HR, Ilies DC, Antov P, Vasile G, Majidinajafabadi R, Lee SH
    Polymers (Basel), 2022 Dec 16;14(24).
    PMID: 36559883 DOI: 10.3390/polym14245516
    Pull-off strength is an important property of solid wood, influencing the quality of paints and finishes in the modern furniture industry, as well as in historical furniture and for preservation and restoration of heritage objects. The thermal modification and heat treatment of solid wood have been the most used commercial wood modification techniques over the past decades globally. The effects of heat treatment at two mild temperatures (145 and 185 °C) on the pull-off strength of three common solid wood species, i.e., common beech (Fagus sylvatica L.), black poplar (Populus nigra L.), and silver fir (Abies alba Mill.), were studied in the present research work. The specimens were coated with an unpigmented sealer-clear finish based on an organic solvent. The results demonstrated a positive correlation between the density and pull-off strength in the solid wood species. Heat treatment at 145 °C resulted in an increase in the pull-off strength in all three species, due to the formation of new bonds in the cell-wall polymers. Thermal degradation of the polymers at 185 °C weakened the positive effect of the formation of new bonds, resulting in a largely unchanged pull-off strength in comparison with the control specimens. Impregnation with a silver nano-suspension decreased the pull-off strength in beech specimens. It was concluded that density is the decisive factor in determining the pull-off strength, having a significant positive correlation (R-squared value of 0.89). Heat treatment at lower temperatures is recommended, to increase pull-off strength. Higher temperatures can have a decreasing effect on pull-off strength, due to the thermal degradation of cell-wall polymers.
  11. Lim KY, Yasim-Anuar TAT, Sharip NS, Ujang FA, Husin H, Ariffin H, et al.
    Polymers (Basel), 2023 Mar 01;15(5).
    PMID: 36904501 DOI: 10.3390/polym15051258
    Lignin is a natural biopolymer with a complex three-dimensional network and it is rich in phenol, making it a good candidate for the production of bio-based polyphenol material. This study attempts to characterize the properties of green phenol-formaldehyde (PF) resins produced through phenol substitution by the phenolated lignin (PL) and bio-oil (BO), extracted from oil palm empty fruit bunch black liquor. Mixtures of PF with varied substitution rates of PL and BO were prepared by heating a mixture of phenol-phenol substitute with 30 wt.% NaOH and 80% formaldehyde solution at 94 °C for 15 min. After that, the temperature was reduced to 80 °C before the remaining 20% formaldehyde solution was added. The reaction was carried out by heating the mixture to 94 °C once more, holding it for 25 min, and then rapidly lowering the temperature to 60 °C, to produce the PL-PF or BO-PF resins. The modified resins were then tested for pH, viscosity, solid content, FTIR, and TGA. Results revealed that the substitution of 5% PL into PF resins is enough to improve its physical properties. The PL-PF resin production process was also deemed environmentally beneficial, as it met 7 of the 8 Green Chemistry Principle evaluation criteria.
  12. Aisyah HA, Paridah MT, Khalina A, Sapuan SM, Wahab MS, Berkalp OB, et al.
    Polymers (Basel), 2018 Nov 28;10(12).
    PMID: 30961245 DOI: 10.3390/polym10121320
    The effects of different fabric materials namely weave designs (plain and satin) and fabric counts (5 × 5 and 6 × 6) on the properties of laminated woven kenaf/carbon fibre reinforced epoxy hybrid composites were evaluated. The hybrid composites were fabricated from two types of fabric, i.e., woven kenaf that was made from a yarn of 500tex and carbon fibre, by using vacuum infusion technique and epoxy resin as matrix. The panels were tested for tensile, flexural, and impact strengths. The results have revealed that plain fabric is more suitable than satin fabric for obtaining high tensile and impact strengths. Using a fabric count of 5 × 5 has generated composites that are significantly higher in flexural modulus as compared to 6 × 6 which may be attributed to their structure and design. The scanned electron micrographs of the fractured surfaces of the composites demonstrated that plain woven fabric composites had better adhesion properties than satin woven fabric composites, as indicated by the presence of notably lower amount of fibre pull out.
  13. Lee SH, Wong RR, Chin CY, Lim TY, Eng SA, Kong C, et al.
    Proc Natl Acad Sci U S A, 2013 Sep 10;110(37):15067-72.
    PMID: 23980181 DOI: 10.1073/pnas.1311725110
    Burkholderia pseudomallei is a Gram-negative soil bacterium that infects both humans and animals. Although cell culture studies have revealed significant insights into factors contributing to virulence and host defense, the interactions between this pathogen and its intact host remain to be elucidated. To gain insights into the host defense responses to B. pseudomallei infection within an intact host, we analyzed the genome-wide transcriptome of infected Caenorhabditis elegans and identified ∼6% of the nematode genes that were significantly altered over a 12-h course of infection. An unexpected feature of the transcriptional response to B. pseudomallei was a progressive increase in the proportion of down-regulated genes, of which ELT-2 transcriptional targets were significantly enriched. ELT-2 is an intestinal GATA transcription factor with a conserved role in immune responses. We demonstrate that B. pseudomallei down-regulation of ELT-2 targets is associated with degradation of ELT-2 protein by the host ubiquitin-proteasome system. Degradation of ELT-2 requires the B. pseudomallei type III secretion system. Together, our studies using an intact host provide evidence for pathogen-mediated host immune suppression through the destruction of a host transcription factor.
  14. Lojanapiwat B, Lee JY, Gang Z, Kim CS, Fai NC, Hakim L, et al.
    Prostate Int, 2019 Jun;7(2):60-67.
    PMID: 31384607 DOI: 10.1016/j.prnil.2018.06.001
    The Asian Prostate Cancer (A-CaP) study is an Asia-wide initiative that was launched in December 2015 in Tokyo, Japan, with the objective of surveying information about patients who have received a histopathological diagnosis of prostate cancer (PCa) and are undergoing treatment and clarifying distribution of staging, the actual status of treatment choices, and treatment outcomes. The study aims to clarify the clinical situation for PCa in Asia and use the outcomes for the purposes of international comparison. Following the first meeting in Tokyo in December 2015, the second A-CaP meeting was held in Seoul, Korea, in September 2016. This, the third A-CaP meeting, was held on October 14, 2017, in Chiang Mai, Thailand, with the participation of members and collaborators from 12 countries and regions. In the meeting, participating countries and regions presented the current status of data collection, and the A-CaP office presented a preliminary analysis of the registered cases received from each country and region. Participants discussed ongoing challenges relating to data input and collection, institutional, and legislative issues that may present barriers to data sharing, and the outlook for further patient registrations through to the end of the registration period in December 2018. In addition to A-CaP-specific discussions, a series of special lectures were also delivered on the situation for health insurance in the United States, the correlation between insurance coverage and PCa outcomes, and the outlook for robotic surgery in the Asia-Pacific region. Members also confirmed the principles of authorship in collaborative studies, with a view to publishing original articles based on A-CaP data in the future.
  15. Lee J, Kwak YS, Kim YJ, Kim EJ, Park EJ, Shin Y, et al.
    Psychiatry Investig, 2018 Apr;15(4):336-343.
    PMID: 29669407 DOI: 10.30773/pi.2017.11.08.2
    "Comfort women" refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. "Comfort women" endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former "comfort women" currently alive in South Korea is introduced. The participants' unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former "comfort women" after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former "comfort women" throughout their lives, and even to the present day.
  16. Wong RR, Kong C, Lee SH, Nathan S
    Sci Rep, 2016 06 07;6:27475.
    PMID: 27273550 DOI: 10.1038/srep27475
    Toxins are believed to play a crucial role in Burkholderia pseudomallei pathogenicity, however to date, only a few have been identified. The discovery of additional toxic molecules is limited by the lack of a sensitive indicator of B. pseudomallei toxicity. Previously, from a whole genome transcriptome analysis of B. pseudomallei-infected Caenorhabditis elegans, we noted significant overexpression of a number of worm genes encoding detoxification enzymes, indicating the host's attempt to clear bacterial toxic molecules. One of these genes, ugt-29, a family member of UDP-glucuronosyltransferases, was the most robustly induced phase II detoxification gene. In this study, we show that strong induction of ugt-29 is restricted to infections by the most virulent species among the pathogens tested. We also noted that ugt-29 is activated upon disruption of host protein synthesis. Hence, we propose that UGT-29 could be a promising biosensor to detect B. pseudomallei toxins that compromise host protein synthesis. The identification of bactobolin, a polyketide-peptide hybrid molecule, as a toxic molecule of B. pseudomallei further verifies the utilization of this surveillance system to search for bacterial toxins. Hence, a ugt-29 based reporter should be useful in screening for other molecules that inhibit host protein synthesis.
  17. Lee SH, Yeoh ZX, Sachlin IS, Gazali N, Soelar SA, Foo CY, et al.
    Sci Rep, 2022 02 08;12(1):2111.
    PMID: 35136124 DOI: 10.1038/s41598-022-06029-6
    Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.
  18. Taghiyari HR, Antov P, Soltani A, Ilies DC, Nadali E, Lee SH, et al.
    Sci Rep, 2024 Feb 20;14(1):4168.
    PMID: 38378787 DOI: 10.1038/s41598-024-54451-9
    Sepiolite is a silicate mineral that improves the fire properties in solid wood when mixed with a water-based coating. The present study was carried out to investigate and evaluate the effects of sepiolite addition to acrylic-latex paint on the pull-off adhesion strength, as an important characteristic of paints and finishes used in the modern furniture industry and historical furniture as well for preservation and restoration of heritage objects. Sepiolite was added at the rate of 10%, and brushed onto plain-sawn beech (Fagus orientalis L.) wood specimens, unimpregnated and impregnated with a 400 ppm silver nano-suspension, which were further thermally modified at 185 °C for 4 h. The results showed that thermal modification had a decreasing effect on the pull-off adhesion strength, primarily as a result of the thermal degradation of cell-wall polymers (mostly hemicelluloses). Still, a decreased wettability as a result of condensation and plasticization of lignin was also partially influential. Based on the obtained results,thermal modification was found to have a significant influence on pull-off adhesion strength. Sepiolite addition had a decreasing effectin all treatments, though the effect was not statistically significant in all treatments. The maximum and minimum decreases due to sepiolite addition were observed in the unimpregnated control (21%) and the thermally-modified NS-impregnated (4%) specimens. Other aspects of the sepiolite addition, and further studies that cover different types of paints and coatings, should be evaluated before coming to a final firm conclusion in this regard.
  19. Wong KT, Koh KB, Lee SH, Chee CP
    Singapore Med J, 1996 Aug;37(4):441-2.
    PMID: 8993152
    Primary germinomas of the central nervous system carry a good prognosis because of their radiosensitivity. Recurrences are rare and extraneural metastases are even more unusual. One of the possible routes of extraneural spread is via ventriculo-peritoneal shunts which may be required to reduce intracranial pressure. One such case of germinoma metastasizing via a ventriculo-peritoneal shunt is reported. Patients with intracranial germinomas and ventriculo-peritoneal shunts should have close surveillance of their abdomens and may require systemic chemotherapy.
  20. Yip FW, Lee SH
    Singapore Med J, 1992 Dec;33(6):643-4.
    PMID: 1488683
    Renal angiomyolipoma is a benign tumour of the kidney which is often mistaken for a renal cell carcinoma resulting in an unnecessary nephrectomy. It can be diagnosed preoperatively and managed conservatively without surgery. Large symptomatic renal angiomyolipomas can often be treated by renal-sparing surgery. We report a case of a large renal angiomyolipoma diagnosed preoperatively and excised completely with preservation of the kidney.
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