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Fulltext The pattern of amyloid deposition in the lung

Looi LM

Malays J Pathol, 1999 Jun;21(1):29-35.
PMID: 10879276

A review of routine histopathological samples and autopsies examined at the Department of Pathology, University of Malaya revealed 15 cases of amyloidosis of the lung. Two were localized depositions limited to the lung while in the remainder, lung involvement was part of the picture of systemic amyloidosis. Both cases of localized amyloidosis presented with symptomatic lung/bronchial masses and a clinical diagnosis of tumour. Histology revealed "amyloidomas" associated with heavy plasma cell and lymphocytic infiltration and the presence of multinucleated giant cells. In both cases, the amyloid deposits were immunopositive for lambda light chains and negative for kappa chains and AA protein. One was a known systemic lupus erythematosus patient with polyclonal hypergammaglobulinaemia. The other patient was found to have plasma cell dyscrasia with monoclonal IgG lambda gammopathy. Both patients did not develop systemic amyloidosis. In contrast, lung involvement in systemic AA amyloidosis was not obvious clinically or macroscopically but was histologically evident in 75% of cases subjected to autopsy. Amyloid was detected mainly in the walls of arterioles and small vessels, and along the alveolar septa. It was less frequently detected in the pleura, along the basement membrane of the bronchial epithelium and around bronchial glands. In one case of systemic AL amyloidosis associated with multiple myeloma, an "amyloidoma" occurred in the subpleural region reminiscent of localized amyloidosis. These cases pose questions on (1) whether localized "tumour-like" amyloidosis is a forme fruste of systemic AL amyloidosis and (2) the differing pattern of tissue deposition of different chemical types of amyloid fibrils, with the suggestion that light chain amyloid has a greater tendency to nodular deposition than AA amyloid.

Matched MeSH terms: Female
Modeling fish community dynamics in the Florida Everglades: role of temperature variation

Al-Rabai'ah HA, Koh HL, DeAngelis D, Lee HL

Water Sci Technol, 2002;46(9):71-8.
PMID: 12448454

Temperature variation is an important factor in Everglade wetlands ecology. A temperature fluctuation from 17 degrees C to 32 degrees C recorded in the Everglades may have significant impact on fish dynamics. The short life cycles of some of Everglade fishes has rendered this temperature variation to have even more impacts on the ecosystem. Fish population dynamic models, which do not explicitly consider seasonal oscillations in temperature, may fail to describe the details of such a population. Hence, a model for fish in freshwater marshes of the Florida Everglades that explicitly incorporates seasonal temperature variations is developed. The model's main objective is to assess the temporal pattern of fish population and densities through time subject to temperature variations. Fish population is divided into 2 functional groups (FGs) consisting of small fishes; each group is subdivided into 5-day age classes during their life cycles. Many governing sub-modules are set directly or indirectly to be temperature dependent. Growth, fecundity, prey availability, consumption rates and mortality are examples. Several mortality sub-modules are introduced in the model, of which starvation mortality is set to be proportional to the ratio of prey needed to prey available at that particular time step. As part of the calibration process, the model is run for 50 years to ensure that fish densities do not go to extinction, while the simulation period is about 8 years. The model shows that the temperature dependent starvation mortality is an important factor that influences fish population densities. It also shows high fish population densities at some temperature ranges when this consumption need is minimum. Several sensitivity analyses involving variations in temperature terms, food resources and water levels are conducted to ascertain the relative importance of temperature dependence terms.

Matched MeSH terms: Female
Malignant teratoma of the thyroid with predominantly neuroepithelial differentiation. Fine needle aspiration cytologic, histologic and immunocytochemical features of a case

Jayaram G, Cheah PL, Yip CH

Acta Cytol., 2000 May-Jun;44(3):375-9.
PMID: 10833994

BACKGROUND: Teratoma of the thyroid in adults is extremely rare, and most are malignant. Only nine cases have been adequately documented in the English-language literature, and there are no reports detailing the fine needle aspiration (FNA) cytologic characteristics.

CASE: A 32-year-old female presented with a left-sided nodular thyroid mass with left cervical lymphadenopathy. FNA cytology of the thyroid and lymph nodes was done. The cytologic and immunocytochemical features were that of a small round cell tumor with neuroepithelial (NE) differentiation, metastasizing to the cervical nodes. Microscopic study of the thyroidectomy specimen showed a tumor showing an NE pattern with occasional islands of squamous and cuboidal epithelium, leading to a diagnosis of malignant teratoma.

CONCLUSION: Knowledge of FNA cytologic features of rare but highly malignant lesions like thyroid teratomas allow early recognition so that suitable and possibly aggressive treatment protocols can be adopted in the hope of prolonging survival.

Matched MeSH terms: Female
Randomized controlled trial of heparin for prevention of blockage of peripherally inserted central catheters in neonates

Kamala F, Boo NY, Cheah FC, Birinder K

Acta Paediatr, 2002;91(12):1350-6.
PMID: 12578294

AIM: To determine whether the addition of heparin to total parenteral nutrition (TPN) fluid would prevent blockage of peripherally inserted central catheters (PICCs) in neonates.
METHODS: This was a randomized, double-blind, controlled study of 66 eligible neonates with PICCs inserted for the administration of TPN. Infants were randomized to receive TPN containing either 1 IU ml(-1) of heparin (n = 35) or no heparin (n = 31).
RESULTS: There was no significant difference in the incidence of blocked catheters between the two groups of infants (heparin: 14.3%; no-heparin: 22.6%, p = 0.4). Although a higher percentage (62.9%) of infants in the heparin group received a complete course of TPN successfully via PICC than those in the no-heparin group (48.4%), the difference was not statistically significant (p = 0.3). There were no significant differences in the incidence of catheter-related sepsis, hypertriglyceridaemia, hyperbilirubinaemia, coagulopathy or intraventricular haemorrhage between the two groups.
CONCLUSION: Addition of heparin to TPN fluid was not associated with a significant reduction in the incidence of blocked PICCs. However, the sample size of this study was too small to exclude even rather marked differences between the groups.

Matched MeSH terms: Female
A novel approach of dose mapping using a humanoid breast phantom in radiotherapy

Banjade DP, Ng BS, Zakir M, Tajuddin AA, Shukri A

Br J Radiol, 2002 Oct;75(898):812-8.
PMID: 12381690

A study of dose mapping techniques to investigate the dose distribution throughout a planned target volume (PTV) in a humanoid breast phantom exposed to a 6 MV photon beam similar to that of treatment conditions is described. For tangential breast irradiation using a 6 MV accelerator beam, the dose is mapped at various locations within the PTV using thermoluminescent dosemeters (TLDs) and radiographic films. An average size perspex breast phantom with the ability to hold the dosemeters was made. TLDs were exposed after packing them in various locations in a particular slice, as planned by the treatment planning system (TPS). To map the dose relative to the isocenter, films were exposed after tightly packing them in between phantom slices, parallel to the central axis of the beam. The dose received at every location was compared with the given dose as generated by the TPS. The mapped dose in each location in the isocentric slice from superficial to deep region was found to be in close agreement with the TPS generated dose to within +/-2%. Doses at greater depths and distant medial and lateral ends, however, were found to be lower by as much as 9.4% at some points. The mapped dose towards the superior region and closest inferior region from the isocenter was found to agree with those for TPS. Conversely, results for the farthest inferior region were found to be significantly different with a variance as much as 17.4% at some points, which is believed to be owing to the variation in size and shape of the contour. Results obtained from films confirmed this, showing similar trends in dose mapping. Considering the importance of accurate doses in radiotherapy, evaluating dose distribution using this technique and tool was found to be useful. This provides the opportunity to choose a technique and plan to provide optimum dose delivery for radiotherapy to the breast.

Matched MeSH terms: Female
Fulltext Use of the Griffiths Mental Scales in normal 2 year old Malaysian children

Ho JJ, Amar HSS, Ismail R

Med J Malaysia, 2001 Sep;56(3):331-5.
PMID: 11732079

The Griffiths Scales for Mental Development were used to assess a group of 60 normal 2-year old Malaysian children (25 Indian, 23 Malay and 12 Chinese). The mean GQ was 104.2 (SD 9.3). This was significantly higher than the test mean of 100, p < 0.001. The mean score for Malaysian children was significantly higher on the locomotor, personal social, performance and practical reasoning subscales while they were significantly lower on the hand eye subscale and did not differ from the test mean on the hearing and speech subscale. There was a significant correlation between GQ and social class, r = -0.39, p < 0.05. Scores were lower than those currently obtained on British children, p < 0.001. Minor difficulties due to language and cultural factors arose over the interpretation of several items but with standardisation of these items the test is useful in Malaysian children.

Matched MeSH terms: Female
The development and impact of a chronic pain support group: a qualitative and quantitative study

Subramaniam V, Stewart MW, Smith JF

J Pain Symptom Manage, 1999 May;17(5):376-83.
PMID: 10355217

To study the process of establishment, and evaluate the outcome of participation, in a self-help support group for people with chronic nonmalignant pain, members of a newly-established, consumer-led group participated in two interviews 5 months apart and a researcher observed group meetings. Participants reported significant benefits from participating in the group. They had a significant increase in functional ability and activity, and reported decreased recourse to health professionals, particularly family physicians. This study indicates that pain support groups can play a valuable role for people in pain, assisting with support and rehabilitation, and meeting needs that health professionals are often not appropriate or able to provide.

Matched MeSH terms: Female
Fulltext Knowledge, attitudes and beliefs related to HIV/AIDS among adolescents in Malaysia

Zulkifli SN, Wong YL

Med J Malaysia, 2002 Mar;57(1):3-23.
PMID: 14569713 MyJurnal

Findings on knowledge, attitudes and beliefs related to HIV/AIDS among 520 Malaysian adolescents, aged 15 to 21 years, based on a survey conducted in Peninsular Malaysia showed that the average score for knowledge on HIV/AIDS was high, and majority showed a positive attitude towards the disease. However, misconceptions regarding transmission and gender bias related to sexual behaviour and contracting the disease prevailed. Although 72 percent of the sexually-experienced did not use protection at first sexual intercourse, 80 percent did not perceive themselves to be at risk of contracting HIV/AIDS. A critical review of existing HIV/AIDS prevention programmes to focus on adolescent risk-taking behaviour and sexuality issues, including male-female negotiation skills, is warranted.

Matched MeSH terms: Female
Traumatic injuries to anterior teeth among schoolchildren in Malaysia

Nik-Hussein NN

Dent Traumatol, 2001 Aug;17(4):149-52.
PMID: 11585139

Evidence of traumatized permanent incisors was recorded as part of a national oral health survey of schoolchildren in Malaysia. A total of 4,085 schoolchildren aged 16 years were examined. The prevalence of injury was 4.1% and it was significantly higher in males than females, with a ratio of 2:1. Almost 75% of the subjects had one tooth affected. Out of a total of 200 fractured teeth, 78.0% involved the maxillary central incisors. A high level of untreated traumatized teeth (89%) was noted. However, of the untreated traumatized teeth, only 9% presented with problems such as discoloration of tooth, sinus or abscess formation.

Matched MeSH terms: Female
Fulltext Detection of xanthine oxidase in human plasma

Newaz MA, Adeeb NNN

Med J Malaysia, 1998 Mar;53(1):70-5.
PMID: 10968141

Xanthine oxidase is a highly versatile enzyme which is widely distributed among various species. Though the presence of the enzyme in serum is not yet established, high antibody titre of this enzyme has been reported. Xanthine oxidase is thought to be the principal source of free radical generation via degradation of nucleotides to the end product, uric acid. The aim of this study was to detect xanthine oxidase activity in human plasma and report any significant relationships found between its activity and variables such as race, age and sex for the sample size studied. Forty six normal healthy individuals (14 males and 32 females) were studied. The enzyme activity was measured by a spectrophotometric method whereby the reduction of ferricytochrome c by free radicals was calculated and expressed as nmol O2 production/ml/min. Results obtained showed that there was a positive relationship between xanthine oxidase activity with age (r = 0.415, p < 0.05) and weight (r = 0.369, p < 0.05) in the normal individual. For the age group 30-39 yrs (n = 11), a higher enzyme activity was observed in males (2.71 +/- 1.44) as compared to females (2.34 +/- 1.23) but it was not significant (p = 0.53). For racial distribution, the Malays [M] have a higher enzyme activity (2.65 +/- 0.86, N = 32) than their Indian [I] (2.27 +/- 0.58; N = 7) and Chinese counterparts [C] (1.44 +/- 1.22; N = 7) but this was also not statistically significant (M vs I: p = 0.39; M vs C: p = 0.07; I vs C: p = 0.16). In conclusion this study showed that there is a measurable amount of xanthine oxidase activity in the human plasma.

Matched MeSH terms: Female
Fulltext Typhoid thyroiditis

Jasmi AY, Rohaizak, Meah FA, Sulaiman BT

Med J Malaysia, 1998 Mar;53(1):109-11.
PMID: 10968149

Acute suppurative thyroiditis in a 62 year old lady with enteric fever is reported. Plain radiography of the neck showed a distinct localised abscess cavity with air fluid level. A rare causative agent Salmonella typhi was isolated. Needle aspiration and antibiotics resulted in complete recovery.

Matched MeSH terms: Female
Fulltext Outcome of 235 renal transplant recipients followed up at ministry of health hospitals in the State of Johor

Chan AYK, Hooi LS, Liu WJ

Med J Malaysia, 2001 Mar;56(1):82-7.
PMID: 11503302

Retrospective analysis was done on 235 recipients, 133 males and 102 females, who were transplanted between 25th September 1979 and 25th June 1999. 85.1% were Chinese, 7.7% were Indians and 7.2% Malays. 23% (54) were living related renal transplants (LRRT) all except 5 done at Hospital Kuala Lumpur. 60% (141) were living unrelated donor renal transplants (LURT) done in India. 17% (40) were cadaveric transplants (CADT) (all done in China except 2 at Hospital Kuala Lumpur and one in London). 97% (228) were first transplants. Primary renal disease was unknown in 69.4%, 17% (40) glomerulonephritis, 5.5% diabetic nephropathy and 8.1% 19 others. All were on prednisolone, 93.2% were on azathioprine and 96.6% were on cyclosporin A. The acute rejection rate was 23.4% (55 episodes). Patient survival was 88% at five years and patients alive with functioning graft was 84% at 5 years. LRRT had significantly better survival compared to LURT. 34 grafts were lost to chronic allograft nephropathy. 46 recipients died (33 died with functioning graft).

Matched MeSH terms: Female
Fulltext Knee crepitus from an unusual source

Harwant S, Borhan TA, Sivakumar S, Jeevanan J

Med J Malaysia, 2001 Mar;56(1):98-9.
PMID: 11503306

A case report of a missed appendicitis presenting with abdominal wall necrotising fasciitis which extended up to the right knee. This subcutaneous collection in the prepatella region of the right knee presented as a crepitus and mimicked an intraarticular pathology.

Matched MeSH terms: Female
Fulltext HUKM instrumentation system in surgical treatment of adolescent idiopathic scoliosis--an early experience

Razak MA, Fazir M, Ibrahim S

Med J Malaysia, 2000 Sep;55 Suppl C:2-8.
PMID: 11200040

Between May 1992 through October 1998, twenty-two patients who had adolescent idiopathic scoliosis were treated using Universiti Kebangsaan Malaysia (UKM) spinal instrumentation and fusion. The minimum length of follow-up was 2 years with an average of 2.9 years. Nineteen patients were female and three patients were male. The mean age at the time of the operation was 16.2 years (range, 13 to 24 years). The average blood loss was 1,878 ml and the average operating time was 291 minutes. The mean pre-operative curve was 61.2 degrees, with a range of 40 degrees to 90 degrees. The average post-operative correction of the Cobb's angle was 53.5 per cent, with a range of 33 per cent to 81 per cent. Post-operative immobilization consisted of a maximum of six months in a body cast. There were no neurological injuries, no deep wound infections, and no evidence of pseudoarthroses. Only three complications occurred and these did not disturb the progress of the fusion. This technique safely achieves the objectives of scoliosis correction, and is cost-effective in the treatment of adolescent idiopathic scoliosis.

Matched MeSH terms: Female
Fulltext Fatal early-onset neonatal sepsis due to Streptococcus pneumoniae

Nallusamy R

Med J Malaysia, 1998 Dec;53(4):442-5.
PMID: 10971993

Two cases of invasive early-onset neonatal pneumococcal sepsis are reported. One neonate was born at term with no risk factors and the other preterm at 35 weeks. Sepsis was not detected at birth for either of these babies and diagnosis was made at the stage of severe sepsis. A fatal outcome resulted despite treatment. Pneumococcal sepsis was confirmed after death in both these cases. Although maternal carriage was not documented in either case, the ages at presentation and progression suggested perinatal acquisition of infection. Early onset neonatal pneumococcal sepsis presents similarly as early onset neonatal Group B streptococcal (GBS) sepsis. Vaginal carriage of pneumococcus is rare but the micro-organism may have a higher invasion to colonisation ratio (attack rate) than GBS. Risk factors for invasive disease are similar to GBS.

Matched MeSH terms: Female
Fulltext The experience with fine needle aspiration cytology in the management of palpable breast lumps in the University Hospital Kuala Lumpur

Yip CH, Jayaram G, Alhady SF

Med J Malaysia, 2000 Sep;55(3):363-7.
PMID: 11200718

A total of 676 palpable breast lumps seen in the Breast Clinic, University Hospital, Kuala Lumpur from August 1993 to August 1994 were subjected to fine needle aspiration cytology. Fifty-four were reported as inadequate, 501 benign, 95 malignant and 26 suspicious. One hundred and eighty-seven aspirates had histological correlation, while 34 of the malignant aspirates had clinical correlation. The majority of the other 455 patients were followed up for a period of 60 to 72 months without any malignancies becoming apparent. For analysis, only the 221 cases with histological or clinical correlation were included, (the suspicious category was included into the positive group and the inadequate cases were excluded), giving a sensitivity of 91.7%, a specificity of 91.7% and a diagnostic accuracy of 91.7%. Breast cytology was an accurate and rapid method of diagnosis of breast diseases, and in a busy surgical unit with limited operating time, it allowed for the triage of patients with breast complaints in deciding which cases needed early open biopsy. A negative cytology does not exclude the possibility of cancer, as there was a false negative rate of 11%. However by utilising a diagnostic triad of clinical examination, radiological assessment and fine needle aspiration cytology, the risk of missing a malignancy is small.

Matched MeSH terms: Female
Fulltext Specialty choices of male and female doctors in Malaysia

Zulkifli A, Rogayah J

Med J Malaysia, 1998 Dec;53(4):327-33.
PMID: 10971974

A survey of specialisation choices was conducted for two batches of medical officers applying to the local medical schools for specialisation in Malaysia. A total of 359 doctors responded, giving a response rate of 71%, with 169 male (44.4%) and 187 female (55.6%) respondents. Surgery ranked highest among the male doctors followed by orthopaedic surgery and internal medicine. Family medicine ranked highest among female doctors followed by public health and anaesthesiology. Among the other specialties, the male doctors preferred otorhinolaryngology while female doctors preferred Pathology. Both male and female doctors chose to be a clinical consultant in a general hospital as the first choice. They prefer to work in or near their hometowns.

Matched MeSH terms: Female
Fulltext Two-stage management of mega occipito-encephalocele

Mardzuki AI, Abdullah J, Ghazaime G, Ariff AR, Ghazali M

Med J Malaysia, 2003 Mar;58(1):115-9.
PMID: 14556336 MyJurnal

We report three cases of large occipito-encephaloceles that were managed in the Neurosciences Unit, Hospital Universiti Sains Malaysia over the last 5 years. All patients had pre-operative MRI (magnetic resonance imaging) evolution and mapping of the sagittal sinus tract. The cerebrospinal fluid (CSF) of all three patients were initially diverted by means of ventricular shunt two weeks prior to shunt removal. The slow drainage of CSF prevented electrolyte and volume disturbances due to sudden decompression during their definitive occipital encephalocele operations. After 3 years follow-up, all these patients are progressing well.

Matched MeSH terms: Female
Unwanted pregnancy--medical and ethical dimensions

Ravindran J

Med J Malaysia, 2003 Mar;58 Suppl A:23-35.
PMID: 14556348

Globally, abortion mortality accounts for approximately 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high maternal mortality and morbidity from abortion tend to occur together. Unplanned and unwanted pregnancies constitute a serious public health responsibility. While fertility has declined by half in developing countries, the motivation to control and space births has risen faster than the rate of contraceptive use. Preventing maternal mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. A range of positive steps has been taken to reduce deaths and morbidity from abortion in a growing number of countries over the past 15 years. Making abortion legal is an essential prerequisite in making it safe. In this respect, changing the law does matter and assertions to the contrary are ill conceived and unsupported in practice. Although, in many countries, trends towards safer abortion have often occurred prior to or in the absence of changes in the law, legal changes need to take place if safety is to be sustained for all women. Religious laws may also require attention when legal change is being contemplated. There are three main ways of approaching this problem: liberalizing the existing law within the penal or criminal code; partially or fully legalizing abortion through a positive law or a court ruling; and decriminalising abortion by taking it out of the law. Women's health groups and other advocates, parliamentarians and health professionals, can work together to support the right of women not to die from unsafe abortions and to ensure they receive treatment for complications. Committed doctors can make a difference by providing treatment for abortion complications, interpreting the law in a liberal way and providing safe services where these are legal as well as training providers in the safest techniques to reduce mortality and morbidity. Although law, policy and women's rights are central to this issue, making abortions safe is above all a public health responsibility of governments. Moreover, reducing maternal mortality by making abortions safe is also an important part of the international commitment made in Cairo in 1994 at the ICPD and reaffirmed at the Cairo meeting in 1999.

Matched MeSH terms: Female
Fulltext Cytogenetic study of spontaneous abortion

Salwati S, Sharifah NA, Nafisah A, Zulkifli S

Med J Malaysia, 2002 Sep;57(3):374-5.
PMID: 12440281
Matched MeSH terms: Female

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