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  1. Mallika PS, Salowi MA, Thanaraj A, Chong MS, Tan AK, Chua CN
    Med J Malaysia, 2012 Apr;67(2):228-30.
    PMID: 22822654 MyJurnal
    With the pathophysiology not clearly understood and fewer than 130 cases having been reported in the literature, diabetic papillopathy presents a special challenge to the ophthalmologist. We report a case of a young patient with more than 12 years of type 1 diabetes mellitus (T1DM) on insulin with poor compliance to treatment who presented with sudden bilateral loss of vision. Ocular examination, fluorescence angiography (FA) and systemic signs were conclusive of diabetic papillopathy. His fasting blood sugar level was high and serum glycosylated haemoglobin (HbA1c) indicated a long term fluctuating blood glucose control. His vision initially improved with treatment, but later deteriorated with tight glycemic control.
    Matched MeSH terms: Diabetic Neuropathies/pathology; Optic Disk/pathology*; Optic Nerve Diseases/pathology
  2. Yap NY, Ong TA, Morais C, Pailoor J, Gobe GC, Rajandram R
    Cell Biol Int, 2019 Jun;43(6):715-725.
    PMID: 31062478 DOI: 10.1002/cbin.11150
    Renal cell carcinoma (RCC) is one of the most lethal urogenital cancers and effective treatment of metastatic RCC remains an elusive target. Cell lines enable the in vitro investigation of molecular and genetic changes leading to renal carcinogenesis and are important for evaluating cellular drug response or toxicity. This study details a fast and easy protocol of establishing epithelial and fibroblast cell cultures or cell lines concurrently from renal cancer nephrectomy tissue. The protocol involves mechanical disaggregation, collagenase digestion and cell sieving for establishing epithelial cells while fibroblast cells were grown from explants. This protocol has been modified from previous published reports with additional antibiotics and washing steps added to eliminate microbial contamination from the surgical source. Cell characterisation was carried out using immunofluorescence and quantitative polymerase chain reaction. Eleven stable epithelial renal tumour cell lines of various subtypes, including rare subtypes, were established with a spontaneous immortalisation rate of 21.6% using this protocol. Eight fibroblast cell cultures grew successfully but did not achieve spontaneous immortalisation. Cells of epithelial origin expressed higher expressions of epithelial markers such as pan-cytokeratin, cytokeratin 8 and E-cadherin whereas fibroblast cells expressed high α-smooth muscle actin. Further mutational analysis is needed to evaluate the genetic or molecular characteristics of the cell lines.
    Matched MeSH terms: Carcinoma, Renal Cell/pathology*; Kidney/pathology; Kidney Neoplasms/pathology
  3. Mahendra CK, Tan LTH, Pusparajah P, Htar TT, Chuah LH, Lee VS, et al.
    Oxid Med Cell Longev, 2020;2020:1904178.
    PMID: 32855763 DOI: 10.1155/2020/1904178
    Retinal pigment epithelial (RPE) cells are an essential part of the human eye because they not only mediate and control the transfer of fluids and solutes but also protect the retina against photooxidative damage and renew photoreceptor cells through phagocytosis. However, their function necessitates cumulative exposure to the sun resulting in UV damage, which may lead to the development of age-related macular degeneration (AMD). Several studies have shown that UVB induces direct DNA damage and oxidative stress in RPE cells by increasing ROS and dysregulating endogenous antioxidants. Activation of different signaling pathways connected to inflammation, cell cycle arrest, and intrinsic apoptosis was reported as well. Besides that, essential functions like phagocytosis, osmoregulation, and water permeability of RPE cells were also affected. Although the melanin within RPE cells can act as a photoprotectant, this photoprotection decreases with age. Nevertheless, the changes in lens epithelium-derived growth factor (LEDGF) and autophagic activity or application of bioactive compounds from natural products can reverse the detrimental effect of UVB. Additionally, in vivo studies on the whole retina demonstrated that UVB irradiation induces gene and protein level dysregulation, indicating cellular stress and aberrations in the chromosome level. Morphological changes like retinal depigmentation and drusen formation were noted as well which is similar to the etiology of AMD, suggesting the connection of UVB damage with AMD. Therefore, future studies, which include mechanism studies via in vitro or in vivo and other potential bioactive compounds, should be pursued for a better understanding of the involvement of UVB in AMD.
    Matched MeSH terms: Epithelial Cells/pathology; Macular Degeneration/pathology*; Retinal Pigment Epithelium/pathology
  4. Othman SF, Sharanjeet-Kaur, Manan FA, Zulkarnain AI, Mohamad Z, Ariffin AE
    Clin Exp Optom, 2012 Sep;95(5):484-91.
    PMID: 22716100 DOI: 10.1111/j.1444-0938.2012.00752.x
    PURPOSE:This study aimed to determine the relationship between macular thickness and spherical equivalent refraction (SER), axial length (AL) and vitreous chamber depth (VCD) in Malay subjects.
    METHODS: Sixty-three subjects (aged 19-24 years) with a mean SER of -1.79 ± 2.24 D, mean axial length of 24.26 ± 1.35 mm and mean vitreous chamber depth of 17.02 ± 1.33 mm were included in this clinical cross-sectional study. Stratus optical coherence tomography (Time Domain optical coherence tomography) was used to determine the thickness of the outer macular (perifovea) and inner macular (parafovea) at four different locations, that is, temporal, superior, nasal and inferior quadrants and also the fovea itself.
    RESULTS: Positive correlations were found between the outer macular (perifovea) thickness and SER at the temporal (R = 0.47, p < 0.05), superior (R = 0.36, p < 0.05) and inferior (R = 0.31, p < 0.05) quadrants. Foveal thickness was also positively correlated with AL (R = 0.34, p < 0.05) and VCD (R = 0.32, p < 0.05). Negative correlations were found between outer macular thickness and axial length at the temporal (R = -0.46, p < 0.05), superior (R = -0.27, p < 0.05), nasal (R = -0.25, p < 0.05) and inferior (R = -0.36, p < 0.05) quadrants. Negative correlations were also found between outer macular thickness and VCD at the temporal (R = -0.51, p < 0.05), superior (R = -0.32, p < 0.05), nasal (R = -0.31, p < 0.05) and inferior (R = -0.40, p < 0.05) quadrants.
    CONCLUSIONS: This study shows that the degree of myopia and elongation of the globe are associated with thinning of most areas of the perifovea. A trend for foveal thickening in the high myopia group is also inferred, although this does not apply to the low and moderate myopia groups.
    Study site: Optometry and ophthalmology clinics, National Institute of Ophthalmic Sciences, Tun Hussein Onn National Eye Hospital (THONEH), Petaling Jaya
    Matched MeSH terms: Macula Lutea/pathology*; Myopia/pathology*; Vitreous Body/pathology*
  5. Purbadi S, Saspriyana KY, Rustamadji P
    Med J Malaysia, 2020 07;75(4):450-451.
    PMID: 32724016
    Metastatic cervical cancers to the oral cavity are uncommon. These metastases most commonly present as lesions of the jaw bones and the mandible. A 57-year-old female patient complained of mass lesion in her oral cavity after definitive treatment for squamous cell carcinoma of the cervix stage IIIB. On examination a swelling of 3cm in size was found on the left side of buccal vestibule adjacent to the lower canine tooth. Wide local excision was performed, and histopathology results showed a squamous cell carcinoma of moderate differentiation. She was continued with segmental mandibulectomy, supraomohyoid neck dissection and plate-screw reconstruction. Radiotherapy was given as an adjuvant therapy.
    Matched MeSH terms: Carcinoma, Squamous Cell/pathology*; Cervix Uteri/pathology*; Mouth/pathology*
  6. Arumugam M, Jamil A, Amiseno RA, Rosli N, Abdul Shukor N
    Malays J Pathol, 2020 Aug;42(2):277-281.
    PMID: 32860382
    INTRODUCTION: Merkel cell carcinoma (MCC) is a rare and aggressive malignancy of the skin, with poor clinical outcomes. Typical conditions include a rapidly growing, solitary dome-shaped, violaceous nodule. Several root causes have been identified - sun exposure, age, lighter skin, immunocompromised state, and polyomavirus infection. Wide local excision is the best treatment. The tumour is radiotherapy-responsive. However, the success rate of the treatment with chemotherapy is rather limited. Immunotherapy has shown promising results. Early detection is important to prevent morbidity and mortality.

    CASE REPORT: In this literature work, we reported on a particular case of MCC, as exhibited by an 84-year-old Chinese woman, and discussed the clinical features and management of MCC.

    DISCUSSION: We highlighted that MCC cases have a link to the polyomavirus 5. Patients who were identified with the Polyomavirus 5, and underwent immunotherapy, were seen to depict much better prognosis.

    Matched MeSH terms: Skin/pathology; Skin Neoplasms/pathology; Neuroendocrine Tumors/pathology
  7. Alipour S, Eskandari A, Johar FM, Furuya S
    Arch Iran Med, 2020 07 01;23(7):488-497.
    PMID: 32657600 DOI: 10.34172/aim.2020.46
    BACKGROUND: Phyllodes tumor (PT) is a rare tumor of the breast, which may occur during pregnancy or lactation. Several studies have reviewed and discussed PT occurring in pregnancy, gathering up to 14 patients. We performed a thorough systematic review of the literature in an attempt to find all reported cases, and identify their common characteristics.

    METHODS: We searched Google scholar, PubMed, Ovid Medline, Scopus and ClinicalTrials.gov with several relevant combinations of keywords, looking for texts or abstracts without any date or language limitations, but using only English keywords. The existing literature only consisted of case reports and series; therefore any paper including one or several cases of PT presenting during pregnancy or breastfeeding was recognized as eligible. Articles with vague description of the tumor which made the diagnosis uncertain, and those lacking data about the tumor and management data were excluded. We contacted authors for more details in cases with incomplete information.

    RESULTS: After excluding those with very deficient data, we included 37 studies, counting 43 cases. The mean age of the patients was 31 years (21-43 years). Some features were different from usual PT: bilaterality (16.2%), large size (14.2 ± 8.6 cm), rapid enlargement (79.5%), and rate of malignancy (60.5%).

    CONCLUSION: Our findings show high rates of bilaterality, large size, rapid growth, and malignant pathology in the reported gestational PTs.

    Matched MeSH terms: Breast Neoplasms/pathology; Phyllodes Tumor/pathology; Pregnancy Complications, Neoplastic/pathology
  8. Fariz-Safhan MN, Tee HP, Abu Dzarr GA, Sapari S, Lee YY
    Trop Biomed, 2014 Jun;31(2):270-80.
    PMID: 25134895 MyJurnal
    During a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia, one of the worst hit areas in the country at that time, we undertook a prospective study. We aimed to describe the bleeding outcome and changes in the liver and hematologic profiles that were associated with major bleeding outcome during the outbreak. All suspected cases of dengue admitted into the only referral hospital in the region during the outbreak were screened for WHO 2002 criteria and serology. Liver function, hematologic profile and severity of bleeding outcome were carefully documented. The association between symptoms, liver and hematologic impairments with the type of dengue infection (classical vs. hemorrhagic) and bleeding outcome (major vs. non-major) was tested. Dengue fever was confirmed in 183 cases (12.5/100,000 population) and 144 cases were analysed. 59.7% were dengue hemorrhagic fever, 3.5% were dengue shock syndrome and there were 3 in-hospital deaths. Major bleeding outcome (gastrointestinal bleeding, intracranial bleeding or haemoptysis) was present in 14.6%. Elevated AST, ALT and bilirubin were associated with increasing severity of bleeding outcome (all P < 0.05). Platelet count and albumin level were inversely associated with increasing severity of bleeding outcome (both P < 0.001). With multivariable analysis, dengue hemorrhagic fever was more likely in the presence of abdominal pain (OR 1.1, 95% CI 0.02- 1.6) and elevated AST (OR 1.0, 95% CI 1.0-1.1) but the presence of pleural effusion (OR 5.8, 95% CI: 1.1-29.9) and elevated AST (OR 1.008, 95% CI: 1.005-1.01) predicted a severe bleeding outcome. As a conclusion, the common presence of a severe hemorrhagic form of dengue fever may explain the rising death toll in recent outbreaks and the worst impairment in liver and hematologic profiles was seen in major bleeding outcome.
    Study site: Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
    Matched MeSH terms: Dengue/pathology*; Hemorrhage/pathology*; Liver/pathology; Liver/physiopathology
  9. Fazalul Rahiman SS, Basir R, Talib H, Tie TH, Chuah YK, Jabbarzare M, et al.
    Trop Biomed, 2013 Dec;30(4):663-80.
    PMID: 24522137 MyJurnal
    Interleukin-27 (IL-27) has a pleiotropic role either as a pro-inflammatory or anti-inflammatory cytokine in inflammatory related diseases. The role and involvement of IL-27 during malaria was investigated and the effects of modulating its release on the production of major inflammatory cytokines and the histopathological consequences in major affected organs during the infection were evaluated. Results showed that IL-27 concentration was significantly elevated throughout the infection but no positive correlation with the parasitaemia development observed. Augmentation of IL-27 significantly elevated the release of anti-inflammatory cytokine, IL-10 whereas antagonising and neutralising IL-27 produced the opposite. A significant elevation of pro-inflammatory cytokines (IFN-γ and IL-6) was also observed, both during augmentation and inhibition of IL-27. Thus, it is suggested that IL-27 exerts an anti-inflammatory activity in the Th1 type response by signalling the production of IL-10 during malaria. Histopathological examination showed sequestration of PRBC in the microvasculature of major organs in malarial mice. Other significant histopathological changes include hyperplasia and hypertrophy of the Kupffer cells in the liver, hyaline membrane formation in lung tissue, enlargement of the white and red pulp followed by the disappearance of germinal centre of the spleen, and tubular vacuolation of the kidney tissues. In conclusion, it is suggested that IL-27 may possibly acts as an anti-inflammatory cytokine during the infection. Modulation of its release produced a positive impact on inflammatory cytokine production during the infection, suggesting its potential in malaria immunotherapy, in which the host may benefit from its inhibition.
    Matched MeSH terms: Animal Structures/pathology; Inflammation/pathology*; Malaria/pathology*
  10. Tappe D, Abdullah S, Heo CC, Kannan Kutty M, Latif B
    Trop Biomed, 2013 Sep;30(3):355-66.
    PMID: 24189667
    Sarcocystosis, an unusual parasitic zoonotic disease, is caused by coccidian/ apicomplexan protozoa in humans and animals. The parasites usually develop in a heteroxenous predator-prey life-cycle involving final (carnivore) and intermediate (omnivore/herbivore) hosts. Besides the intestinal, non-invasive form of the disease in which humans and animals are the definitive hosts for certain Sarcocystis spp., the invasive form has come to recent attention. In the latter, humans and animals serve as intermediate host harbouring sarcocysts in their muscle tissue. Already in 1991 sarcocystosis was seen as a potential emerging food borne zoonosis in Malaysia, and in 2011 and 2012 the largest cluster of symptomatic human muscular sarcocystosis world-wide was reported from Tioman Island, Pahang state. In this review, we focus on invasive sarcocystosis in humans and animals in Malaysia, review the recorded cases and epidemiology, and present hypotheses.
    Matched MeSH terms: Foodborne Diseases/pathology; Sarcocystosis/pathology; Zoonoses/pathology
  11. Zainal AI, Wong SL, Pan KL, Wong OL, Tzar MN
    Trop Biomed, 2011 Aug;28(2):444-9.
    PMID: 22041767 MyJurnal
    Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.
    Matched MeSH terms: Cryptococcosis/pathology*; Femur/pathology*; Osteomyelitis/pathology*
  12. Shastri MD, Allam VSRR, Shukla SD, Jha NK, Paudel KR, Peterson GM, et al.
    Life Sci, 2021 Oct 15;283:119871.
    PMID: 34352260 DOI: 10.1016/j.lfs.2021.119871
    Non-communicable, chronic respiratory diseases (CRDs) affect millions of individuals worldwide. The course of these CRDs (asthma, chronic obstructive pulmonary disease, and cystic fibrosis) are often punctuated by microbial infections that may result in hospitalization and are associated with increased risk of morbidity and mortality, as well as reduced quality of life. Interleukin-13 (IL-13) is a key protein that regulates airway inflammation and mucus hypersecretion. There has been much interest in IL-13 from the last two decades. This cytokine is believed to play a decisive role in the exacerbation of inflammation during the course of viral infections, especially, in those with pre-existing CRDs. Here, we discuss the common viral infections in CRDs, as well as the potential role that IL-13 plays in the virus-induced disease pathogenesis of CRDs. We also discuss, in detail, the immune-modulation potential of IL-13 that could be translated to in-depth studies to develop IL-13-based therapeutic entities.
    Matched MeSH terms: Inflammation/pathology; Influenza, Human/pathology; Lung Diseases/pathology
  13. Ng KL, Morais C, Bernard A, Saunders N, Samaratunga H, Gobe G, et al.
    J Clin Pathol, 2016 Aug;69(8):661-71.
    PMID: 26951082 DOI: 10.1136/jclinpath-2015-203585
    Numerous immunohistochemical (IHC) biomarkers have been employed to aid in the difficult differentiation between chromophobe renal cell carcinoma (chRCC) and renal oncocytoma (RO). A systematic review and meta-analysis of the published literature was carried out to summarise and analyse the evidence for discriminatory IHC biomarkers to differentiate the two entities.
    Matched MeSH terms: Carcinoma, Renal Cell/pathology; Kidney Neoplasms/pathology; Adenoma, Oxyphilic/pathology
  14. Lee SH, Reed-Newman T, Anant S, Ramasamy TS
    Stem Cell Rev Rep, 2020 12;16(6):1185-1207.
    PMID: 32894403 DOI: 10.1007/s12015-020-10031-8
    Quiescence in cancer cells is considered a therapeutic challenge as it confers dormancy in tumour, hence circumventing inherent anti-neoplastic surveillance system and standard-of-care cancer therapeutics including chemotherapy and radiotherapy. Since majority of the therapeutics target actively proliferating cancer cells, cancer cells eventually develop quiescent nature as mechanism of survival and cancer progression under both niche and therapeutic pressures. Quiescence state in cancer cells, eventually, confers resistant and aggressive nature to conventional cancer therapies, resulting in disease progression and relapse. Therefore, targeting quiescent cancer cells or cancer stem cells is a promising therapeutic approach, however an extensive review of the relevant information is needed in order to device an effective therapy. While the evidence of quiescence regulation in CSCs is rather a complex molecular and cellular network, herein, we aim to provide a comprehensive understanding of both intrinsic and extrinsic regulation in association with the function of CSCs. Findings on induction of quiescent state in CSCs population, its regulation at both cellular and molecular level, key molecular regulators, cellular events and processes including potential targets to develop therapeutics are extensively reviewed. This review also highlights the impact of CSC plasticity on quiescence which capturing the key challenge of targeting the cells in this state. Beyond understanding the mechanisms underlying quiescence nature of cancer cells, this review provides insightful perspective and future direction on insight in targeting these populations, hence collapse the tumour dormancy programme in order to eradicate tumour mass as a whole. Capability of CSCs to establish quiescent state as a mechanism of survival during unfavorable conditions, as well as its impact in cancer progression and subsequent relapse, including the potential therapeutic strategy to eradicate this CSCs sub-population in the tumor mass as an effective cancer therapy.
    Matched MeSH terms: Neoplasm Recurrence, Local/pathology; Neoplasms/pathology; Neoplastic Stem Cells/pathology*
  15. Abdul Hadi D, Mansharan Kaur CS, Effat O, Siew SF
    Trop Biomed, 2019 Dec 01;36(4):850-854.
    PMID: 33597457
    Tuberculosis (TB) is a highly infectious disease on the rise caused by the organism Mycobacterium tuberculosis and health care workers working in emergency departments, medical wards and autopsy rooms are in danger of contacting this disease. We present a case of a 42 year old man found dead under a pedestrian bridge with no medical history available. Post mortem computed tomography showed multiple cavities involving upper lobes of both lungs and areas of consolidation in both lung fields raising the suspicion of pulmonary tuberculosis. This was followed by a computed tomography guided lung biopsy and a limited conventional autopsy done in situ in a special high risk autopsy suite with appropriate ventilation. This case highlights the importance of cross sectional imaging which can be coupled with image guided biopsy in cases of infectious disease to reduce the risk of transmission to health care workers.
    Matched MeSH terms: Lung Diseases/pathology; Tuberculosis/pathology; Forensic Pathology
  16. Misra S, Gupta A, Saran RK
    Malays J Pathol, 2020 Dec;42(3):487-490.
    PMID: 33361734
    Report of a 3-month old girl child who died due to multi-systemic infection of cytomegalovirus (CMV) involving the lungs, liver and kidneys along with pneumocystis jiroveci pneumonia (PJP). The mother of the child tested positive for CMV IgG and HIV with a very low CD4 count (160/ μl). Co-infection of cytomegalovirus and pneumocystis jiroveci always occurs in the setting of immunocompromise. Congenital CMV infection is transmitted through the placenta, especially during the first trimester and causes severe multi-systemic disease whereas perinatal infection is acquired during childbirth/ breastfeeding where the babies have maternal protective antibodies leading to much milder or asymptomatic infection. PJP is more common in infancy and presents as hypoxic pneumonia. CMV causes cyto-nucleomegaly and classic "owl's eye" inclusions on histology while PJP presents with characteristic fluffy "cotton ball" alveolar exudates.
    Matched MeSH terms: Cytomegalovirus Infections/pathology*; Pneumonia, Pneumocystis/pathology*; Coinfection/pathology
  17. Jayash SN, Hashim NM, Misran M, Baharuddin NA
    J Biomed Mater Res A, 2017 02;105(2):398-407.
    PMID: 27684563 DOI: 10.1002/jbm.a.35919
    The osteoprotegerin (OPG) system plays a critical role in bone remodelling by regulating osteoclast formation and activity. The study aimed to determine the physicochemical properties and biocompatibility of a newly formulated OPG-chitosan gel. The OPG-chitosan gel was formulated using human OPG protein and water-soluble chitosan. The physicochemical properties were determined using Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). Gel morphology was determined using scanning electron microscopy (SEM) and then it was subjected to a protein release assay and biodegradability test. An in vitro cytotoxicity test on normal human periodontal ligament (NHPL) fibroblasts and normal human (NH) osteoblasts was carried out using the AlamarBlue assay. In vivo evaluation in a rabbit model involved creating critical-sized defects in calvarial bone, filling with the OPG-chitosan gel and sacrificing at 12 weeks. In vitro results demonstrated that the 25 kDa OPG-chitosan gel had the highest rate of protein release and achieved 90% degradation in 28 days. At 12 weeks, the defects filled with 25 kDa OPG-chitosan gel showed significant (p 
    Matched MeSH terms: Fibroblasts/pathology; Osteoblasts/pathology; Periodontal Ligament/pathology
  18. Khalid EB, Ayman EE, Rahman H, Abdelkarim G, Najda A
    Tumour Biol., 2016 Nov;37(11):14513-14536.
    PMID: 27651162
    The process of angiogenesis is quite well-known nowadays. Some medicines and extracts affecting this process are already used routinely in supporting the conventional treatment of many diseases that are considered angiogenic such as cancer. However, we must be aware that the area of currently used drugs of this type is much narrower than the theoretical possibilities existing in therapeutic angiogenesis. Plant substances are a large and diverse group of compounds that are found naturally in fruits, vegetables, spices, and medicinal plants. They also have different anticancer properties. The aim of this literature review article is to present the current state of knowledge concerning the molecular targets of tumor angiogenesis and the active substances (polyphenols, alkaloids, phytohormones, carbohydrates, and terpenes) derived from natural sources, whose activity against cancer angiogenesis has been confirmed.
    Matched MeSH terms: Neoplasms/pathology; Neovascularization, Pathologic/pathology; Endothelial Cells/pathology
  19. Mohd Ali MR, Mohamad Safiee AW, Thangarajah P, Fauzi MH, Muhd Besari A, Ismail N, et al.
    J Infect Public Health, 2017 Nov-Dec;10(6):894-896.
    PMID: 28330585 DOI: 10.1016/j.jiph.2017.02.009
    Leptospirosis and melioidosis are important tropical infections caused by Leptospira and Burkholdheria pseudomallei, respectively. As both infections share similar clinical manifestations yet require different managements, complementary laboratory tests are crucial for the diagnosis. We describe a case of Leptospira and B. pseudomallei co-infection in a diabetic 40-year-old woman with history of visit to a freshwater camping site in northern Malaysia. To our knowledge, this is the first case of such double-infection, simultaneously demonstrated by molecular approach. This case highlights the possibility of leptospirosis and melioidosis co-infections and their underlying challenges in the rapid and accurate detection of the etiologic microorganism.
    Matched MeSH terms: Leptospirosis/pathology; Melioidosis/pathology; Coinfection/pathology
  20. Hong-Seng G, Sayuti KA, Karim AH
    Biomed Mater Eng, 2017;28(2):75-85.
    PMID: 28372262 DOI: 10.3233/BME-171658
    BACKGROUND: Existing knee cartilage segmentation methods have reported several technical drawbacks. In essence, graph cuts remains highly susceptible to image noise despite extended research interest; active shape model is often constraint by the selection of training data while shortest path have demonstrated shortcut problem in the presence of weak boundary, which is a common problem in medical images.

    OBJECTIVES: The aims of this study is to investigate the capability of random walks as knee cartilage segmentation method.

    METHODS: Experts would scribble on knee cartilage image to initialize random walks segmentation. Then, reproducibility of the method is assessed against manual segmentation by using Dice Similarity Index. The evaluation consists of normal cartilage and diseased cartilage sections which is divided into whole and single cartilage categories.

    RESULTS: A total of 15 normal images and 10 osteoarthritic images were included. The results showed that random walks method has demonstrated high reproducibility in both normal cartilage (observer 1: 0.83±0.028 and observer 2: 0.82±0.026) and osteoarthritic cartilage (observer 1: 0.80±0.069 and observer 2: 0.83±0.029). Besides, results from both experts were found to be consistent with each other, suggesting the inter-observer variation is insignificant (Normal: P=0.21; Diseased: P=0.15).

    CONCLUSION: The proposed segmentation model has overcame technical problems reported by existing semi-automated techniques and demonstrated highly reproducible and consistent results against manual segmentation method.

    Matched MeSH terms: Cartilage, Articular/pathology; Knee Joint/pathology; Osteoarthritis, Knee/pathology
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