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Long-term effects of hepatitis B and C infection in renal transplantation

Teo SM, Morad Z

Transplant Proc, 2000 Nov;32(7):1950-1.
PMID: 11120015
Fulltext Tubercular synovitis mimicking rheumatoid nodules

Teo SC, George J, Kamarul T

Med J Malaysia, 2008 Jun;63(2):159-61.
PMID: 18942309 MyJurnal

Tubercular tenosynovitis is an uncommon condition and usually affects the upper limb. We report a case of a patient with Systemic Lupus Erythematosus who presented with wrist swelling. The clinical findings were suggestive of rheumatoid nodules, but the radiographic finding of calcification associated with the nodules and marked erosive changes primarily of the radio-carpal joint with sparing of the metacarpal joints led the radiologist to believe that the nodules may not be rheumatoid nodules. The presence of solid and fluid nature of the nodule and hyperechoic small echogenic foci (matted rice bodies within thickened synovium) on ultrasound suggested the presence of chronic synovitis of tuberculous infection rather than rheumatoid nodule as in our case. We recommend the use of ultrasound to determine the nature of nodular swellings seen clinically in patients with arthropathy.
Fulltext Treatment and renal outcome of lupus nephritis: single center experience

Go KW, Teo SM

Med J Malaysia, 2006 Oct;61(4):447-50.
PMID: 17243522

Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disease with renal involvement being one of the most frequent and serious manifestations of the disease. The aim of the study is to analyze the treatment and renal outcome of patients with lupus nephritis (LN) WHO class III and IV on cyclophosphamide (CYC). We retrospectively identified 41 patients with biopsy proven LN who was given either oral or intravenous CYC. The male: female ratio was 4:37; with a mean age of 31.7 +/- 9.8 years at presentation. 36 patients (87.8%) had LN class IV and only five patients (12.2%) with LN class III. The mean serum creatinine at presentation was 87.4 +/- 37.2 micromol/L with mean follow-up of 84 +/- 78 months. A total of 30 patients (73.2%) completed 12 courses of IV CYC and one patient (2.4%) completed three months of oral CYC. 71.0% (n = 22) had complete response (CR), 25.8% (n = 8) had partial response and 3.2% (n = 1) had no response (NR). Of the remaining 11 patients, two patients (4.9%) died during the treatment, three patients (7.3%) defaulted treatment and five patients (12.2%) are still receiving ongoing treatment. Presence of hypertension (p < 0.003) and evidence of chronicity on renal biopsy (p < 0.016) were significantly correlated with the progressive deterioration of renal function in our population. In conclusion, hypertension and evidence of chronicity on renal biopsy, proved to be risk factors for progressive renal impairment in our study population. The achieved global outcome can be considered good.
Study site: Hospital Ipoh, Ipoh, Perak, Malaysia
Comparison of patient survival between various subgroups among renal transplant patients: a single center experience

Go KW, Teo SM

Transplant Proc, 2004 Sep;36(7):2046-7.
PMID: 15518740

To compare patient graft survival between various subgroups among renal transplant patients.
Hypersecretion of growth hormone in an acromegalic of 25 years' duration

Teo SK, Cheah JS

Med J Malaysia, 1973 Mar;27(3):220-2.
PMID: 4268929
Face presentation

Ong HC, Teo SP

Med J Malaysia, 1976 Sep;31(1):42-5.
PMID: 1023012
Fulltext A review of breast cancer research in Malaysia

Yip CH, Bhoo Pathy N, Teo SH

Med J Malaysia, 2014 Aug;69 Suppl A:8-22.
PMID: 25417947 MyJurnal

Four hundred and nineteen articles related to breast cancer were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. One hundred and fifty four articles were selected and reviewed on the basis of clinical relevance and future research implications. Overall, Malaysian women have poor survival from breast cancer and it is estimated that half of the deaths due to breast cancer could be prevented. Five-year survival in Malaysia was low and varies among different institutions even within the same disease stage, suggesting an inequity of access to optimal treatment or a lack of compliance to optimal treatment. Malaysian women have poor knowledge of the risk factors, symptoms and methods for early detection of breast cancer, leading to late presentation. Moreover, Malaysian women experience cancer fatalism, belief in alternative medicine, and lack of autonomy in decision making resulting in delays in seeking or avoidance of evidence-based medicine. There are ethnic differences in estrogen receptor status, HER2 overexpression and incidence of triple negative breast cancer which warrant further investigation. Malay women present with larger tumours and at later stages, and even after adjustment for these and other prognostic factors (stage, pathology and treatment), Malay women have a poorer survival. Although the factors responsible for these ethnic differences have not been elucidated, it is thought that pharmacogenomics, lifestyle factors (such as weight-gain, diet and exercise), and psychosocial factors (such as acceptance of 2nd or 3rd line chemotherapy) may be responsible for the difference in survival. Notably, survivorship studies show self-management programmes and exercise improve quality of life, highlighting the need to evaluate the psychosocial impact of breast cancer on Malaysian women, and to design culturally-, religiously- and linguistically-appropriate psycho-education programmes to help women cope with the disease and improve their quality of life. Research done in the Caucasian populations may not necessarily apply to local settings and it is important to embark on local studies particularly prevention, screening, diagnostic, prognostic, therapeutic and psychosocial research.
The impact on patients' time-to-theatre following colour coding classification in emergency operation theatre, Sarawak General Hospital

Khaw SK, Teo SC, Bujang MA

Med J Malaysia, 2020 07;75(4):379-384.
PMID: 32723998

INTRODUCTION: A proper prioritisation system of emergency cases allows appropriate timing of surgery and efficient allocation of resources and staff expertise. The aim of this study was to determine the impact of colour coding classification on Time-to- theatre (TTT) of patients in comparison with the normal practice.
METHOD: Categorisation was a surgical judgment call after thorough clinical assessment. There were 4 levels of urgency with their respective TTT; Red (2 hours), Yellow (8 hours), Green (24 hours), Blue (72 hours). Caesarean cases were excluded in colour coding due to pre - existing classification. The data for mean TTT was collected 4 weeks before the implementation (Stage 1), and another 4 weeks after implementation (Stage II). As there was a violation in the assumption for parametric test, Mann Whitney U test was used to compare the means between these two groups. Using logarithmic (Ln) transformation for TTT, Analysis of Covariance (ANCOVA) was conducted for multivariate analysis to adjust the effect of various departments. The mean TTT for each colour coding classification was also calculated.
RESULTS: The mean TTT was reduced from 13 hours 48 min to 10 hours, although more cases were completed in Stage II (428 vs 481 cases). Based on Mann-Whitney U test, the difference in TTT for Stage I (Median=6.0, /IQR=18.9) and Stage II (Median=4.2, IQR=11.5) was significantly different (p=0.023). The result remained significant (p=0.039) even after controlled for various department in the analysis. The mean/median TTT after colour coding was Red- 2h 24min/1h, Yellow- 8h 26min/3h 45 min, Green- 15h 8min/8h 15min, and Blue- 13h 46min/13h 5min.
CONCLUSION: Colour coding classification in emergency Operation (OT) was effective in reducing TTT of patients for non-caesarean section cases.
A case of atypical imaging of Nasopharyngeal Carcinoma in an adolescent: A diagnostic challenge

Teo SW, Noorafidah MD, Laili SAL

Med J Malaysia, 2020 03;75(2):175-177.
PMID: 32281604

Nasopharyngeal mass in paediatric population is usually benign and malignant nasopharyngeal tumours such as carcinoma is rare. We report a case of nasopharyngeal carcinoma (NPC) in an adolescent with atypical imaging findings that mimicked a benign mass. This highlights the importance of a comprehensive review on the distinctive radiographic features of paediatric nasopharyngeal mass. We discuss the imaging features of NPC in the paediatric group, which differ from the elderly patients. By recognising these distinctive imaging features, it may help in diagnosing typical case. This case report serves as a reminder that NPC, despite being uncommon, should be considered in the differential diagnosis of a juvenile nasopharyngeal mass.
Occurrence of gastrointestinal nematodes in captive nonhuman primates at Matang Wildlife Centre, Sarawak

Teo SZ, Tuen AA, Madinah A, Aban S, Chong YL

Trop Biomed, 2019 Sep 01;36(3):594-603.
PMID: 33597481

Gastrointestinal nematodes can cause assorted health problems to human and other primates. The status of gastrointestinal nematodes in non-human primates remained less documented in Malaysia. This study aimed to determine the occurrence of gastrointestinal nematodes recovered from the fecal samples of captive non-human primates at the Matang Wildlife Centre (MWC), Sarawak. Fresh fecal samples were collected from 60 non-human primates of six species (i.e. Orangutan, Bornean gibbon, Silvered Leaf monkey, Slow loris, Pig-tailed macaque, and Long-tailed macaque) and processed using simple fecal floatation method and fecal sedimentation method. This study shows high prevalence of nematode infection (>=50%) and co-infection (22 from 45 infected individuals) in all species of captive non-human primates found in MWC, except one individual of young Silvered Leaf monkey was negative for nematode. From these, eight genera of 11 species and one unknown nematode larvae were recovered and among them Oesophagostomum sp., Ascaris sp., and Strongyloides sp. were the most common nematodes infecting the non-human primates. All the Bornean gibbon (n=7) were found to be infected with nematodes. Moreover, Long-tailed macaques at the centre were heavily infected by Ascaris sp. (number of total count, nt = 2132; total mean abundance, MA=113.70). This is the first report of high prevalence nematode infection on multiple species of captive non-human primates in a wildlife centre located in Sarawak. Some of the nematodes are of zoonotic potential. This information is important for health care management, both in-situ and ex-situ conservations of captive and free-ranging nonhuman primates.
Fulltext Ultrathin Assembles of Porous Array for Enhanced H2 Evolution

Islam A, Hwa Teo S, Awual MR, Taufiq-Yap YH

Sci Rep, 2020 Feb 11;10(1):2324.
PMID: 32047187 DOI: 10.1038/s41598-020-59325-4

Since the complexity of photocatalyst synthesis process and high cost of noble cocatalyst leftovers a major hurdle to producing hydrogen (H2) from water, a noble metal-free Ni-Si/MgO photocatalyst was realized for the first time to generate H2 effectively under illumination with visible light. The catalyst was produced by means of simple one-pot solid reaction using self-designed metal reactor. The physiochemical properties of photocatalyst were identified by XRD, FESEM, HRTEM, EDX, UV-visible, XPS, GC and PL. The photocatalytic activities of Ni-Si/MgO photocatalyst at different nickel concentrations were evaluated without adjusting pH, applied voltage, sacrificial agent or electron donor. The ultrathin-nanosheet with hierarchically porous structure of catalyst was found to exhibit higher photocatalytic H2 production than hexagonal nanorods structured catalyst, which suggests that the randomly branched nanosheets are more active surface to increase the light-harvesting efficiency due to its short electron diffusion path. The catalyst exhibited remarkable performance reaching up to 714 µmolh-1 which is higher among the predominant semiconductor catalyst. The results demonstrated that the photocatalytic reaction irradiated under visible light illumination through the production of hydrogen and hydroxyl radicals on metals. The outcome indicates an important step forward one-pot facile approach to prepare noble ultrathin photocatalyst for hydrogen production from water.
p53 Status does not affect photodynamic cell killing induced by hypericin

Lee HB, Ho AS, Teo SH

Cancer Chemother Pharmacol, 2006 Jul;58(1):91-8.
PMID: 16211395

Given that p53 is a tumor suppressor that plays a central role in the cellular response to DNA damage and that more than 50% of all cancers have mutated p53, the wider utility of photodynamic therapy (PDT) in the treatment of cancer will depend on an understanding of whether p53 status modulates response to PDT. In this study, we investigated the photosensitivity of isogenic cell lines that differ only in their p53 status to PDT using hypericin as the photosensitizer.
Molecular cloning, homology modeling and site-directed mutagenesis of vanadium-dependent bromoperoxidase (GcVBPO1) from Gracilaria changii (Rhodophyta)

Baharum H, Chu WC, Teo SS, Ng KY, Rahim RA, Ho CL

Phytochemistry, 2013 Aug;92:49-59.
PMID: 23684235 DOI: 10.1016/j.phytochem.2013.04.014

Vanadium-dependent haloperoxidases belong to a class of vanadium enzymes that may have potential industrial and pharmaceutical applications due to their high stability. In this study, the 5'-flanking genomic sequence and complete reading frame encoding vanadium-dependent bromoperoxidase (GcVBPO1) was cloned from the red seaweed, Fracilaria changii, and the recombinant protein was biochemically characterized. The deduced amino acid sequence of GcVBPO1 is 1818 nucleotides in length, sharing 49% identity with the vanadium-dependent bromoperoxidases from Corralina officinalis and Cor. pilulifera, respectively. The amino acid residues associated with the binding site of vanadate cofactor were found to be conserved. The Km value of recombinant GcVBPO1 for Br(-) was 4.69 mM, while its Vmax was 10.61 μkat mg(-1) at pH 7. Substitution of Arg(379) with His(379) in the recombinant protein caused a lower affinity for Br(-), while substitution of Arg(379) with Phe(379) not only increased its affinity for Br(-) but also enabled the mutant enzyme to oxidize Cl(-). The mutant Arg(379)Phe was also found to have a lower affinity for I(-), as compared to the wild-type GcVBPO1 and mutant Arg(379)His. In addition, the Arg(379)Phe mutant has a slightly higher affinity for H2O2 compared to the wild-type GcVBPO1. Multiple cis-acting regulatory elements associated with light response, hormone signaling, and meristem expression were detected at the 5'-flanking genomic sequence of GcVBPO1. The transcript abundance of GcVBPO1 was relatively higher in seaweed samples treated with 50 parts per thousand (ppt) artificial seawater (ASW) compared to those treated in 10 and 30 ppt ASW, in support of its role in the abiotic stress response of seaweed.
Fulltext Clinical characteristics of triple-negative breast cancer: experience in an Asian developing country

Tan GH, Taib NA, Choo WY, Teo SH, Yip CH

Asian Pac J Cancer Prev, 2009 Jul-Sep;10(3):395-8.
PMID: 19640180

INTRODUCTION: Triple negative (TN) breast cancers are defined by a lack of expression of oestrogen, progesterone, and HER2 receptors. They tend to have a higher grade, with a poorer outcome compared to non-TN breast cancers.
OBJECTIVE: The aim of this study is to determine the incidence of TN breast cancer in an Asian country consisting of Malays, Chinese and Indians, and to determine the factors associated with this type of breast cancer.
RESULTS: The incidence of TN breast cancer in the University Malaya Medical Center is 17.6%. There is no significant difference amongst the Malays, Chinese and Indians. In bivariate analysis, TN breast cancer was significantly associated with younger age and Grade 3. However, in multivariate analysis using logistic regression, TN breast cancer was only associated with Grade 3.
CONCLUSION: The incidence of TN breast cancer in our study is similar to other studies, and associated with a higher grade.
Study site: University Malaya Medical Centre (UMMC)
Fulltext An immunohistochemical and molecular study of gastrointestinal stromal tumours

Teong YT, Teo ST, Tan LP, Wu BQ, Peh SC

Med J Malaysia, 2006 Dec;61(5):526-33.
PMID: 17623951 MyJurnal

Gastrointestinal stromal tumour (GIST) is a rare but most common mesenchymal tumour in the gastrointestinal tract. Although GIST research has been carried out extensively worldwide, it has yet to be studied in Malaysia. To establish the immunohistochemical expression pattern of CD117 (c-KIT), CD34, S-100 and Desmin, the incidence of c-KIT and PDGFRA genes mutation in GISTs, and correlate it with clinicopathological parameters. Eleven clinically diagnosed GISTs were stained for CD117, CD34, Desmin and S-100 protein by immunohistochemical technique, and c-KITand PDGFRA gene mutations were studied by PCR-CSGE-DNA sequencing method. All GISTs (7 cases) stain positive for CD117, and co-expressed CD34. None of these cases express Desmin, and only one expressed S-100 protein focally. Fifty-seven percent (4/7 cases) of GIST harboured mutations at exon 11 of c-KIT gene, and they were all high risk and malignant cases. No mutation was detected at exons 9, 13 and 17 of KIT gene, and exons 12 and 18 of PDGFRA gene. Immunohistochemistry using a panel of antibodies shows consistent pattern of CD117 and CD34 expression in GIST, and mutational study may be a useful prognostic marker for kinase inhibitor treatment of GIST.
Disseminated nocardiosis with bilateral intraocular involvement in a renal allograft patient

Tan SY, Tan LH, Teo SM, Thiruventhiran T, Kamarulzaman A, Hoh HB

Transplant Proc, 2000 Nov;32(7):1965-6.
PMID: 11120022
Fulltext Pregnancy in patients with renal transplants in Malaysia

Hooi LS, Rozina G, Wan Shaariah MY, Teo SM, Tan CHH, Bavanandan S, et al.

Med J Malaysia, 2003 Mar;58(1):27-36.
PMID: 14556324

There were 72 pregnancies in 46 renal transplants (RTs) between 1984 and 2001, 89% from living donors, 11% cadaveric. Mean age at RT was 26.9 +/- 4.3 years and at pregnancy 30.7 +/- 4.7 years. Mean time to pregnancy after RT was 4.5 +/- 3.1 years. 54% were unplanned. 45 (63%) resulted in surviving infants, 37% delivered by Caesarean section. 35% were premature. Mean birth weight was 2.38 +/- 0.57 kg. 64% were on cyclosporine. No patient had an acute rejection during pregnancy; 38% had pre-existing hypertension. Complications include urinary infection (13%), proteinuria (15%) and preeclampsia (15%). Mean serum creatinine before pregnancy was 112.7 +/- 32.6 umol/l, 1 year post-pregnancy it was 119.4 +/- 38.7. The mean time of follow up of mothers is 4.9 +/- 3.5 years. 10 year graft survival was 83% and patient survival 94%.
Cadaveric organ donation at University Hospital Kuala Lumpur

Chen TP, Teo SM, Tan JC, Koh SN, Ambalavanar N, Tan SY

Transplant Proc, 2000 Nov;32(7):1809-10.
PMID: 11119946
Fulltext Peritoneal implantation of ureter in a cadaveric kidney transplant recipient

Tan SY, Lim CS, Teo SM, Lee SH, Razack A, Loh CS

Med J Malaysia, 2003 Dec;58(5):769-70.
PMID: 15190667

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.
Identification of a recurrent BRCA1 exon 21-22 genomic rearrangement in Malay breast cancer patients

Hasmad HN, Sivanandan K, Lee V, Yip CH, Mohd Taib NA, Teo SH

Clin Genet, 2015 Apr;87(4):392-4.
PMID: 25066186 DOI: 10.1111/cge.12451

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