Displaying publications 1 - 20 of 33 in total

Abstract:
Sort:
  1. Bosco J
    Ann Acad Med Singap, 1988 Apr;17(2):251-3.
    PMID: 3044263
    Immunology is a discipline that traverses all branches of clinical medicine. Thus since about ten years ago major hospitals in Malaysia established routine clinical immunology services particularly in the diagnosis of autoimmune/connective tissue disorders. More recently these laboratories have ventured into basic research in Dengue Haemorrhagic Fever, Leukaemia Immunology, Nasopharyngeal Cancer and Leprosy. The rationale for these projects together with early results from them are discussed.
  2. Bosco J, Pathmanathan R
    Aust N Z J Med, 1991 Aug;21(4):454-6.
    PMID: 1953537
    Peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes are often the presenting features of the POEMS syndrome. Approximately 50% of these are associated with osteosclerotic myeloma, a rare variant of multiple myeloma and some with Castleman's disease, an unusual lympho-proliferative disorder. The underlying pathogenetic mechanisms have not been elucidated but amelioration of symptoms with the disappearance of the M-component suggests possible etiopathogenic mechanisms. We present a 40-year-old woman with manifestations of all three disorders.
  3. Teh A, Bosco JJ
    Br J Clin Pract, 1994 Sep-Oct;48(5):276-7.
    PMID: 7917827
    A young patient presenting with splenomegaly and hypersplenism was inadvertently found to have selective IgA deficiency. There were no symptoms of immunodeficiency and the patient responded well to splenectomy, with return of blood counts to normal without adverse effects. No other cause for the hypersplenism was found. We postulate selective IgA deficiency as a cause of splenomegaly and hypersplenism.
  4. Deshmukh RG, Bosco J
    Med J Malaysia, 1995 Dec;50(4):417-9.
    PMID: 8668067
    A 26-year-old male presented with claw toes and Factor XIII deficiency. Correction for his deformity was undertaken. Pre, intra and post-operative transfusions of plasma and blood prevented any haemorrhagic complications.
  5. Chin NS, Bosco J, Teh A
    Med J Malaysia, 1990 Mar;45(1):23-8.
    PMID: 2152065
    Chronic lymphocytic leukaemia (CLL) is rare locally. Seven CLL patients which constituted 0.9% of the total 747 cases of leukaemic patients were diagnosed over a 5 year period. They had similar haematological profiles as Western patients though most of them had advanced disease at presentation. Treatment of CLL patients was palliative and should be reserved for symptomatic patients and/or patients with progressive disease.
  6. Dyck JA, Bosco JJ
    Br J Haematol, 1989 May;72(1):64-7.
    PMID: 2736243
    Forty-six Malaysian patients with chronic granulocytic leukaemia were found to be rearranged in the breakpoint cluster region (BCR) of chromosome 22, molecular evidence of Philadelphia chromosome (t9.22) translocation. Through the use of a 1.2 kb 3' BCR probe and two restriction enzyme digests, patients' breakpoints could be localized either to 5' or 3' regions of the BCR. Breakpoint site localization at the time of DNA sampling did not show any positive statistical association to clinical status defined as chronic phase, chronic phase with less than 6 months to blast crisis, accelerated phase and blast crisis. This was in contrast to earlier reports which indicated that patients with breakpoint at 3' site were at a higher biologic risk for entering blast crisis.
  7. Pereira RA, Bosco J, Pang T
    Singapore Med J, 1981 Aug;22(4):203-C.
    PMID: 7034209
    An immunofluorescence test (IFT) using platelet suspensions was used to detect the presence of serum anti-platelet antibodies (APA) in the sera of Malaysian patients with idiopathic thrombocytopenic purpura. Of the 28 patients tested, 19 (or 68%) had detectable APA with percentage platelet fluorescence ranging from 34% - 80% (mean 51% +/- 10). Normal sera gave fluorescence values of 6 - 15% (mean 9% +/- 5). Sera from patients with SLE, thyrotoxicosis and dengue haemorrhagic fever gave mean values of 29%, 8% and 9% respectively. Additionally, no apparent correlation was observed between percentage platelet fluorescence and the severity of thrombocytopenia. The importance and significance of these findings are discussed.
  8. Bosco JJ, Dyck JA
    Singapore Med J, 1989 Aug;30(4):363-7.
    PMID: 2814539
    Rearrangements in the DNA of chronic myelogenous leukemia patients of Chinese, Malay and Indian origin were detected in the breakpoint cluster region of chromosome 22 using molecular techniques. The DNA of fifty patients was examined using a 1.2 kb DNA probe. Rearrangements were detected in 46/50 patients. Karyotypic data were available in nine patients, all of whom were Philadelphia chromosome positive and exhibited DNA rearrangement. Detection of the Philadelphia translocation by molecular methods, at this institution, where cytogenetics is not routinely performed, confirms its diagnostic value. The rearrangement data obtained in this study is consistent with molecular features of chronic myelogenous leukemia patients of Western countries.
  9. Leong KW, Teh A, Bosco JJ
    Med J Malaysia, 2000 Jun;55(2):277-9.
    PMID: 19839162
    Acute promyelocytic leukemia (APL) in pregnancy poses serious danger to both the mother and fetus. Cytotoxic chemotherapy may cause teratogenicity to the fetus. APL is unique because it is usually associated with a coagulopathy that markedly increases the risk for the mother and fetus. A 21 year old lady with APL in her third trimester of pregnancy was treated with oral tretinoin. Tretinoin reversed the coagulopathy and normalised her blood counts without causing cytotoxic damage associated with cancer chemotherapy. Fetal distress occurred at 37 weeks of gestation and an emergency caesarean section was performed without complications and no blood transfusion support was needed as her coagulopathy and thrombocytopenia had resolved. A remission was achieved with only tretinoin induction. She subsequently had consolidation and maintenance chemotherapy. The mother and baby remain well at 4 years from completion of chemotherapy. A total of 10 pregnancies associated with APL have been reported in the current literature. Premature delivery and a fetal arrhythmia were the only complications. Although retinoin is considered teratogenic, its use so far in second and third trimester has been safe.
  10. Wang CL, Wang F, Bosco JJ
    Lupus, 1995 Feb;4(1):11-4.
    PMID: 7767332 DOI: 10.1177/096120339500400103
    Ninety-two women with systemic lupus erythematosus treated with oral cyclophosphamide were studied to ascertain the prevalence and the factors associated with ovarian dysfunction. Menstrual disturbance during treatment occurred in 55% of patients: 36% had amenorrhoea and 19% had oligomenorrhoea. Sustained oligomenorrhoea occurred in 12% patients. Permanent amenorrhoea (> 12 months) after cessation of oral cyclophosphamide occurred in 27% of patients. Hormonal studies in these patients were consistent with ovarian failure. Older age at initiation of treatment and high cumulative dose of cyclophosphamide were found to be associated with this outcome. There was a trend towards linear relationship between the age of initiation of cyclophosphamide therapy and frequency of amenorrhoea. A statistically significant association between amenorrhoea and cumulative dose of cyclophosphamide after adjustment for age was found whereas no such association was linked to the duration of treatment. Fourteen of the 23 women who wished to become pregnant after cessation of treatment conceived resulting in 20 live births and two abortions.
  11. Chin IY, Koh CL, Bosco JJ
    Acta Haematol., 1992;87(1-2):107-8.
    PMID: 1585764
  12. Leong KW, Teh A, Bosco JJ, Lim J
    Postgrad Med J, 1995 Oct;71(840):625-7.
    PMID: 8545293
    Pregnancy following idiopathic aplastic anaemia is rare and is difficult to manage because of life-threatening episodes of bleeding and infections. Only a handful of cases has been reported in the literature. The pregnancies were unsuccessful in the majority. The present report describes a patient with moderately severe idiopathic aplastic anaemia who was managed with intensive haematological support leading to delivery of a healthy infant by caesarean section. Despite platelet transfusion refractoriness as a result of transfusions prior to pregnancy, adequate platelet transfusions prevented excessive bleeding. The literature is reviewed and management with platelet transfusions is discussed.
  13. Leong KW, Bosco JJ, Shaik IB
    Postgrad Med J, 1995 Feb;71(832):112-3.
    PMID: 7724422
    Acute aortic thrombosis is a rare condition, occurring mainly as a result of trauma or atherosclerosis and occasionally secondary to hypercoagulable states. We report a patient with relapsed acute myeloid leukaemia who developed an unusual complication, acute aortic thrombosis.
  14. Leong KW, Bosco JJ, Teh A
    Eur. J. Haematol., 1994 Oct;53(4):237-41.
    PMID: 7957809
    Induction of remission of acute promyelocytic leukaemia (APL) needs intensive blood support (16) to prevent bleeding attributed to disseminated intravascular coagulation. Between 1989 and 1991, at the University Hospital in Kuala Lumpur, Malaysia, the remission rate of APL was only 27% with conventional chemotherapy as a result of inadequate transfusion resources. The use of all trans retinoic acid in induction therapy followed by consolidation and maintenance chemotherapy has improved the situation dramatically. Twelve patients entered the study. Ten patients achieved remission (83%), indicating how ATRA had significantly improved the results (p = 0.003). Blood component transfusions were also significantly reduced (p = 0.003). Two ethnic Chinese patients developed pulmonary leucostasis. Published Chinese (2, 6) and Japanese (11) studies have not reported this serious adverse effect. We can now state that leucostasis is not a phenomenon limited to the Western population. ATRA has proved to be extremely beneficial for patients at this centre. Early analysis also suggests that consolidation and maintenance chemotherapy has prolonged remission duration. ATRA should be made available for the treatment of APL in all countries where there are inadequate transfusion services.
  15. Chin YM, Bosco JJ, Koh CL
    Med J Malaysia, 1992 Jun;47(2):110-3.
    PMID: 1494330
    Deoxyribonucleic acid (DNA) of twenty chronic myeloid leukemia (CML) and thirty acute lymphoblastic leukemia (ALL) patients were analysed by Southern hybridization. The DNA was digested with BglII and hybridized with a 4.5-kilobase (kb) ph1/bcr-3 DNA probe. All the 20 CML patients showed gene rearrangement within a 5.8-kb segment (the major breakpoint cluster region, M-bcr) of the breakpoint cluster region (bcr) gene of chromosome 22, indicating the presence of the Philadelphia chromosome. M-bcr rearrangement at the bcr gene of chromosome twenty-two was not detected in all the thirty ALL patients (nine adults and twenty-one children) and two normal controls.
  16. Doi SA, Azman W, Leong KW, Bosco J
    Ann Acad Med Singap, 1995 May;24(3):459-61.
    PMID: 7574433
    A typical case of chronic pericardial effusion resulting in cardiac tamponade is presented. A pericardiocentesis was done for diagnosis and drainage, followed by a pleuro-pericardial window as definitive therapy. The minimal cumulative dose expected to produce pericardial disease is about 4000 rads, and the disease usually manifests within 12 months of such radiation exposure, as in this patient. It is concluded that for symptomatic pericardial effusions, available evidence justifies a subtotal pericardiectomy, a window procedure being reserved to tide over ill patients as in this patient. No strong evidence exists for the efficacy of steroid therapy; such therapy is reserved for asymptomatic mild effusions, which may also resolve spontaneously.
  17. Bosco J, Cherian R, Lin HP, Pang T
    Leuk. Res., 1985;9(6):789-91.
    PMID: 3874337
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links