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Abstract
The Jarvik 2000 Flowmaker® is an intraventricular continuous axial flow left ventricular assist device. We describe the anaesthetic management and considerations for five patients with end-stage heart failure who underwent implantation of the Jarvik 2000 Flowmaker® as a bridge to transplantation or as destination therapy.
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Affiliation(s)
- L H Tan
- Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
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Chua TH, Emmanuel J, Lee KT, Kan FK, Tee KS, Abidin Z, Ganeswrie R, Tan LH, Low EC, Lim YAL, Menon J. Taeniasis and neurocysticercosis among Malaysians. Trop Biomed 2017; 34:7-13. [PMID: 33592974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Taeniasis, endemic in Southeast Asia, is caused by Taenia saginata (for beef) or Taenia solium and Taenia asiatica (for pork). T. solium also causes cysticercosis which can affect various organs. Taeniasis and cysticercosis cases are rarely reported in Malaysia. We report here two separate cases of beef taeniasis, and an interesting case of neurocysticercosis in a Malay Muslim. The taeniasis cases involved a Malaysian Chinese and a native Sabahan. Proglottids were recovered from them, and identification of the tapeworm done either from the microscopic examination of the egg or using PCR-based molecular diagnosis. Upon confirmation of taeniasis, both cases were given praziquantel and had been asymptomatic since. The neurocysticercosis case involving a Muslim who presented with seizure, was confirmed by histopathological examination of tissue sections taken from craniotomy excision of the brain lesion. He was given one month course of albendazole 400 mg bid and dexamethasone, and had been well and seizure free since. The two cases of taeniasis documented here had acquired the disease through eating raw or undercooked contaminated beef. For the neurocyticercosis case, it is suspected that he might have acquired the infection in one of his travels through human to human transmission via contaminated food or water consumption, given that Malaysia is not T. solium endemic area. Lastly praziquantel is an effective drug for beef taeniasis, while a combination of albendazole and dexamethasone work well for neurocysticercosis.
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Affiliation(s)
- T H Chua
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - J Emmanuel
- Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - K T Lee
- Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - F K Kan
- Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - K S Tee
- Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - Z Abidin
- Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - R Ganeswrie
- Department of Pathology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - L H Tan
- Department of Medicine, Sunway Medical Centre, Petaling Jaya, Selangor, Malaysia
| | - E C Low
- Department of Medicine, Sunway Medical Centre, Petaling Jaya, Selangor, Malaysia
| | - Y A L Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - J Menon
- Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
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Gao YH, Li CW, Wang JY, Tan LH, Duanmu CL, Jing XH, Chang XR, Liu JL. Effect of electroacupuncture on the cervicospinal P2X7 receptor/fractalkine/CX3CR1 signaling pathway in a rat neck-incision pain model. Purinergic Signal 2016; 13:215-225. [PMID: 28028627 DOI: 10.1007/s11302-016-9552-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/13/2016] [Indexed: 01/16/2023] Open
Abstract
Increasing evidence supports that acupuncture intervention is an effective approach for intraoperative and postoperative pain. Neuron-microglia crosstalk, mediated by the purinergic P2X7 receptor (R)/fractalkine/CX3CR1 cascade in the spinal cord dorsal horn, plays a pivotal role in pain processing. However, its involvement in the analgesic effect of electroacupuncture (EA) remains unclear. In this study, a rat neck-incision pain model was established by making a longitudinal incision along the midline of the neck and subsequent repeated mechanical stimulation. EA stimulation was applied to bilateral LI18, LI4-PC6, or ST36-GB34. The thermal pain threshold, cervicospinal ATP concentration, expression levels of purinergic P2XR and P2YR subunits mRNAs, and fractalkine, CX3CR1 and p38 MAPK proteins, were detected separately. The neck incision induced strong thermal hyperalgesia and upregulation of spinal ATP within 48 h. No significant change was found in thermal hyperalgesia after a single session of EA intervention. However, a single session of EA dramatically enhanced the neck incision-induced upregulation of ATP and upregulated the expression of P2X7R, which was reversed by two sessions of EA. Two sessions of EA at bilateral LI18 or LI4-PC6 attenuated hyperalgesia significantly, accompanied with downregulation of P2X7R/fractalkine/ CX3CR1 signaling after three sessions of EA. EA stimulation of LI18 or LI4-PC6 alleviates thermal hyperalgesia in neck-incision pain rats, which may be associated with its effects in regulating the neck incision-induced increase of ATP and P2X7R and subsequently suppressing fractalkine/CX3CR1 signaling in the cervical spinal cord.
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Affiliation(s)
- Y H Gao
- Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - C W Li
- College of Acupuncture and Moxibustion and Tui-na, Hunan University of Chinese Medicine, Changsha, Hunan Province, 410208, China.,First Affiliated Hospital of Hunan Traditional Chinese Medical College, Zhuzhou, Hunan Province, 412012, China
| | - J Y Wang
- Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - L H Tan
- Department of Biochemistry and Moleculobiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - C L Duanmu
- Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - X H Jing
- Meridian Research Center, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - X R Chang
- College of Acupuncture and Moxibustion and Tui-na, Hunan University of Chinese Medicine, Changsha, Hunan Province, 410208, China
| | - J L Liu
- Department of Physiology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Tan LH, Philpot S. P-116 End of life care of patients on extracorporeal membrane oxygenation (ECMO) support. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ng CK, Azuhairy A, Tan LH, Nordin A. Giant Chondrosarcoma of Proximal Humerus in an Adult Female Patient: A Case Report. Malays Orthop J 2015; 9:51-53. [PMID: 28435611 PMCID: PMC5333670 DOI: 10.5704/moj.1507.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Chondrosarcoma is the third most common primary tumour of the bone, after myeloma and osteosarcoma. Most of the chondrosarcoma grow slowly and rarely metastasize, and they have an excellent prognosis after adequate surgery. However most of them are chemo or radio-resistant. We report a case of primary chondrosarcoma of proximal humerus in a 36-year-old female who presented with a six years history of left shoulder swelling and restricted range of motion. Trucut biopsy showed a well-differentiated chondrosarcoma. The patient underwent forequarter amputation of left upper limb and was started on chemotherapy following operation.
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Affiliation(s)
- C K Ng
- Department of Orthopaedics, Seberang Jaya Hospital, Seberang Jaya, Malaysia
| | - A Azuhairy
- Department of Orthopaedics, Pulau Pinang Hospital, Georgetown, Malaysia
| | - L H Tan
- Department of Orthopaedics, Pulau Pinang Hospital, Georgetown, Malaysia
| | - A Nordin
- Department of Orthopaedics, Seberang Jaya Hospital, Seberang Jaya, Malaysia
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Santamaria R, Martinez E, Kratochwill S, Soria C, Tan LH, Nuñez A, Dimaano E, Villegas E, Bendezú H, Kroeger A, Castelobranco I, Siqueira JB, Jaenisch T, Horstick O, Lum LCS. Comparison and critical appraisal of dengue clinical guidelines and their use in Asia and Latin America. Int Health 2013; 1:133-40. [PMID: 24036557 DOI: 10.1016/j.inhe.2009.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The World Health Organization (WHO) dengue classification scheme for dengue fever (DF) and dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS) has been adopted as the standard for diagnosis, clinical management and reporting. In recent years, difficulties in applying the WHO case classification have been reported in several countries. A multicenter study was carried out in Asia and Latin America to analyze the variation and utility of dengue clinical guidelines (DCGs) taking as reference the WHO/PAHO guidelines (1994) and the WHO/SEARO guidelines (1998). A document analysis of 13 dengue guidelines was followed by a questionnaire and Focus Group discussions (FGDs) with 858 health care providers in seven countries. Differences in DCGs of the 13 countries were identified including the concept of warning signs, case classification, use of treatment algorithms and grading into levels of severity. The questionnaires and FGDs revealed (1) inaccessibility of DCGs, (2) lack of training, (3) insufficient number of staff to correctly apply the DCGs at the frontline and (4) the unavailability of diagnostic tests. The differences of the DCGs and the inconsistency in their application suggest a need to re-evaluate and standardise DCGs. This applies especially to case classification and case management.
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Affiliation(s)
- R Santamaria
- Department of Tropical Hygiene and Public Health, University Hospital Heidelberg, Germany, INF 324, 69120 Heidelberg, Germany
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Malevich P, Andriukaitis G, Flöry T, Verhoef AJ, Fernández A, Ališauskas S, Pugžlys A, Baltuška A, Tan LH, Chua CF, Phua PB. High energy and average power femtosecond laser for driving mid-infrared optical parametric amplifiers. Opt Lett 2013; 38:2746-2749. [PMID: 23903130 DOI: 10.1364/ol.38.002746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We have developed the first (to our knowledge) femtosecond Tm-fiber-laser-pumped Ho:YAG room-temperature chirped pulse amplifier system delivering scalable multimillijoule, multikilohertz pulses with a bandwidth exceeding 12 nm and average power of 15 W. The recompressed 530 fs pulses are suitable for broadband white light generation in transparent solids, which makes the developed source ideal for both pumping and seeding optical parametric amplifiers operating in the mid-IR spectral range.
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Affiliation(s)
- P Malevich
- Photonics Institute, Vienna University of Technology, Vienna, Austria
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Tan LH, Delaney A. HOW OFTEN DOES THE MEDICAL EMERGENCY TEAM IMPLEMENT END OF LIFE CARE? A SYSTEMATIC REVIEW. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tan LH, Chua CF, Phua PB. Coherent polarization locking: an approach to mitigating optical damage in a pulsed Ho:YAG laser. Opt Lett 2013; 38:1025-1027. [PMID: 23546231 DOI: 10.1364/ol.38.001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Intracavity optical damage is mitigated in a pulsed Ho:YAG laser cavity using the coherent polarization locking (CPL) technique. By splitting the available pump power into two individual Ho:YAG laser rods, we passively coherently locked two orthogonal polarization lasers with 9.13 mJ output pulse energies and 14 ns pulsewidths, and operating at 800 Hz repetition rate. A conventional Ho:YAG laser cavity with the same pump and cavity configuration results in severe optical damage when operating at <2 kHz repetition rate, thus limiting the output pulse energies to <5 mJ. We also demonstrated, to the best of our knowledge, the first pulsed operation within the entire CPL Ho:YAG laser cavity by Q-switching in one of the polarization arms, producing nanosecond pulses with no sign of pulse instability.
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Affiliation(s)
- L H Tan
- DSO National Laboratories, Singapore
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Tan LH, Chua CF, Phua PB. Preserving a diffraction-limited beam in Ho:YAG laser using coherent polarization locking. Opt Lett 2012; 37:4621-4623. [PMID: 23164858 DOI: 10.1364/ol.37.004621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We overcome several thermal issues present in Ho:YAG lasers by distributing the gain over a larger volume and achieve a diffraction-limited beam using coherent polarization locking. Increased single-pass absorption, suppression of output power saturation, and improvement in beam quality were shown using the coherent polarization locking technique as compared to a conventional Ho:YAG laser cavity with the same pump and cavity configuration. Ten watts of CW Ho:YAG laser power was generated with >96% coherent combining efficiency.
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Affiliation(s)
- L H Tan
- DSO National Laboratories, 20 Science Park Drive, Singapore 118230, Singapore
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Fong MY, Wong KT, Rohela M, Tan LH, Adeeba K, Lee YY, Lau YL. Unusual manifestation of cutaneous toxoplasmosis in a HIV-positive patient. Trop Biomed 2010; 27:447-450. [PMID: 21399585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report a case of unusual cutaneous toxoplasmosis manifestation in a HIV-positive patient. He presented with hard and painful nodular lesions on the arms, hands and chest. Serology tests for anti-Toxoplasma antibody were negative. However, histopathologic examination of the lesion revealed foci of macrophages containing crescent-shaped organisms resembling the zoites of the protozoan parasite Toxoplasma gondii. Ultrastructure examination under electron microscopy and PCR confirmed the organism as T. gondii.
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Affiliation(s)
- M Y Fong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Hu L, Tan LH. Sildenafil attenuates pulmonary vascular remodeling and upregulates Kv1.5 mRNA expression in pulmonary hypertension secondary to left-to-right shunt in rats. Crit Care 2010. [PMCID: PMC2934077 DOI: 10.1186/cc8363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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13
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Tan LH, Kay P, Wang WSY, Chan AHD, Siok WT. Effects of language on categorical perception of color are modulated by the visual hemifield as revealed by fMRI. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Tan LH, Cokis CJ, Weightman WM, Manopas AR, Paech MJ, Nazirt HS, Hackett LP. Effect of open-chest surgery in the lateral position on blood propofol concentration during target-controlled infusion of propofol. Anaesth Intensive Care 2009; 36:798-801. [PMID: 19115647 DOI: 10.1177/0310057x0803600608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Our research hypothesis was that single lung ventilation during thoracic surgery in the lateral position increases the blood concentration of propofol during target-controlled infusion. Thirty adult patients in two tertiary referral hospitals undergoing open-chest surgery were studied. Anaesthesia was induced and maintained with propofol using a Diprifusor (Graseby 3500) computer-controlled pump set to deliver a blood concentration of 4 tg.ml(-1). Blood samples were taken with the patient positioned in (1) the supine position 20 minutes after induction (supine); (2) the lateral position just prior to one-lung ventilation (lateral); (3) the lateral position five minutes after commencing one-lung ventilation (OLV5) and (4) the lateral position 20 minutes after commencing one-lung ventilation (OLV20). Propofol concentrations were determined by high performance liquid chromatography. The target-controlled infusion target level was maintained at 4 microg.ml(-1) during the study period for all cases. The mean (SD) propofol blood concentration (microg.ml(-1)) at each stage was 5.5 (1.5) supine, 5.3 (1.1) lateral, 5.3 (1.2) OLV5 and 5.1 (1.2) OLV20. Repeated measures ANOVA showed an F value 1.9, lambda 5.5 and P value 0.15. Post hoc analysis did not identify a significant difference between the sample times. During target-controlled infusion of propofol, mean blood propofol concentrations did not change significantly from those obtained with the patient supine after up to 50 minutes in the lateral position during thoracic surgery, or 20 minutes after commencing one-lung ventilation.
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Affiliation(s)
- L H Tan
- Department of Anaesthesia, Sir Charles Gairdner Hospital, Nedlands and Royal Perth Hospital, Perth, Western Australia, Australia
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Tan DBA, Yong YK, Tan HY, Kamarulzaman A, Tan LH, Lim A, James I, French M, Price P. Immunological profiles of immune restoration disease presenting as mycobacterial lymphadenitis and cryptococcal meningitis. HIV Med 2008; 9:307-16. [PMID: 18400078 DOI: 10.1111/j.1468-1293.2008.00565.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES A proportion of HIV patients beginning antiretroviral therapy (ART) develop immune restoration disease (IRD). Immunological characteristics of IRD were investigated in a cohort of HIV patients beginning therapy in Kuala Lumpur, Malaysia. METHODS Peripheral blood mononuclear cells were collected at weeks 0, 6, 12, 24 and 48 of ART from five patients experiencing IRD [two with cryptococcal and three with Mycobacterium tuberculosis (Mtb) disease], eight non-IRD controls who had begun ART with CD4 T-cell counts of <100 cells/microL and 17 healthy controls. Leukocytes producing interferon-gamma (IFNgamma) were quantified by enzyme-linked immunospot assay after stimulation with purified protein derivative (PPD), early secretory antigenic target-6 (ESAT-6), Cryptococcus neoformans or Cytomegalovirus antigens. Plasma immunoglobulin (IgG) antibodies reactive with these antigens were assessed by enzyme-linked immunosorbent assay. Proportions of activated (HLA-DR(hi)) and regulatory (CD25 CD127(lo) and CTLA-4(+)) CD4 T-cells were quantified by flow cytometry. RESULTS Plasma HIV RNA declined and CD4 T-cell counts rose within 8-27 weeks on ART. Mtb IRD patients displayed elevated IFNgamma responses and/or plasma IgG to PPD, but none responded to ESAT-6. Cryptococcal IRD occurred in patients with low baseline CD4 T-cell counts and involved clear IFNgamma and antibody responses to cryptococcal antigen. Proportions of activated and regulatory CD4 T-cells declined on ART, but remained higher in patients than in healthy controls. At the time of IRD, proportions of activated CD4 T-cells and regulatory CD4 T-cells were generally elevated relative to other patients. CONCLUSIONS Cryptococcal and Mtb IRD generally coincide with peaks in the proportion of activated T-cells, pathogen-specific IFNgamma responses and reactive plasma IgG. IRD does not reflect a paucity of regulatory CD4 T-cells.
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Affiliation(s)
- D B A Tan
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
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Abstract
Oil-loaded microspheres were produced by spray drying emulsions consisting of fish oil and modified starch suspensions with different oil loadings. The emulsion stability was assessed by oil droplet size analysis. Microspheres were characterized in terms of size, morphology, yield and microencapsulation efficiency. It was found that an increase in oil loading resulted in emulsions containing larger oil droplets. This corresponded with larger mean microsphere diameters and rounder microspheres. However, high oil loadings produced lower yields and affected microencapsulation efficiencies.
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Affiliation(s)
- L H Tan
- National University of Singapore, Singapore
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Chan LW, Tan LH, Heng PWS. Process analytical technology: application to particle sizing in spray drying. AAPS PharmSciTech 2008; 9:259-66. [PMID: 18446490 PMCID: PMC2976913 DOI: 10.1208/s12249-007-9011-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 09/19/2007] [Indexed: 11/30/2022] Open
Abstract
The purpose of this research was to explore the possibility of employing PAT for particle sizing during spray drying with the use of an in-line and at-line laser diffraction system. Microspheres were made using maltodextrin and modified starch as wall material and size results obtained using PAT compared with those determined with off-line laser diffraction and light microscopy. Median particle size results were highest for in-line laser diffraction, followed by at-line and off-line laser diffraction and finally light microscopy. This was due to the presence of agglomerates which were measured as discrete microspheres in the in-line set-up. At-line and off-line laser diffraction gave results more closely correlated with individual microsphere sizes due to agglomerate breakdown during the measurement process. Light microscopy allowed direct observation of the particle morphology, however, its use for particle sizing was tedious and sample size was much smaller compared to laser diffraction. Although PAT was found to be an efficient and convenient tool, careful data interpretation was needed taking into account the cohesiveness of the material measured. The at-line set-up appeared to be more suitable in this particular application.
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Affiliation(s)
- L. W. Chan
- GEA-NUS Pharmaceutical Processing Research Laboratory, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543 Singapore
| | - L. H. Tan
- GEA-NUS Pharmaceutical Processing Research Laboratory, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543 Singapore
| | - Paul W. S. Heng
- GEA-NUS Pharmaceutical Processing Research Laboratory, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543 Singapore
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Tajunisah I, Reddy SC, Tan LH. Acute retinal necrosis by cytomegalovirus in an immunocompetent adult: case report and review of the literature. Int Ophthalmol 2007; 29:85-90. [DOI: 10.1007/s10792-007-9171-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2007] [Accepted: 10/23/2007] [Indexed: 11/27/2022]
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Vijayananthan A, Tan LH, Owen A, Bhat R, Edwards R, Robertson I, Moss JG, Nicholls R. Accidental blood exposure: risk and prevention in interventional radiology. Biomed Imaging Interv J 2006; 2:e55. [PMID: 21614335 PMCID: PMC3097815 DOI: 10.2349/biij.2.4.e55] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2006] [Revised: 10/16/2006] [Accepted: 11/23/2006] [Indexed: 11/23/2022] Open
Abstract
There is a growing concern about the transmission of bloodborne pathogens during medical procedures among health care workers and patients. Over the last three decades, radiological services have undergone many changes with the introduction of new modalities. One of these new disciplines is interventional radiology (IR) which deals with procedures such as arteriography, image-guided biopsies, intravascular catheter insertions, angioplasty and stent placements. Despite these developments, the potential for accidental blood exposure and exposure to other infectious material continues to exist. Therefore, it is important for all radiologists who perform invasive procedures to observe specific recommendations for infection control. In this review, we look at the different policies for protection and universal standards on infection control.
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Affiliation(s)
- A Vijayananthan
- Department of Biomedical Imaging (Radiology), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - LH Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A Owen
- Department of Radiology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - R Bhat
- Department of Radiology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - R Edwards
- Department of Radiology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - I Robertson
- Department of Radiology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - JG Moss
- Department of Radiology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - R Nicholls
- Department of Radiology, Gartnavel General Hospital, Glasgow, United Kingdom
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Tan LH, Johnson BA, Mawad ME, Chang AC. Neonate with vein of Galen malformation and heart failure: serial changes in plasma B-type natriuretic peptide following endovascular embolization. Pediatr Cardiol 2006; 27:276-8. [PMID: 16501882 DOI: 10.1007/s00246-005-1088-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2005] [Indexed: 10/25/2022]
Abstract
We report a neonate with vein of Galen malformation (VGM) who developed congestive heart failure (CHF) early after birth. Serial changes in plasma B-type natriuretic peptide (BNP) following an endovascular embolization procedure for VGM were mirrored in his clinical CHF status. The plasma BNP level markedly increased to 1800 pg/ml (normal, <100 pg/ml) in accordance with the severity of CHF. It rapidly decreased to 356 pg/ml during the first week after endovascular embolization for VGM. In the following 3 weeks there was an unexpected upward trend in plasma BNP despite echocardiography revealing normal biventricular function. After additional evaluation and treatment for CHF, BNP decreased again and the patient's clinical status concurrently improved. The patient was discharged with a normal BNP level. Monitoring serial plasma BNP provides valuable information regarding the need for additional evaluation or treatment of newborns with CHF and may be used to document improvement.
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Affiliation(s)
- L H Tan
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA
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Eng PH, Tan LH, Wong KS, Cheng CW, Fok AC, Khoo DH. Cushing's syndrome in a patient with a corticotropin-releasing hormone-producing pheochromocytoma. Endocr Pract 2005; 5:84-7. [PMID: 15251695 DOI: 10.4158/ep.5.2.84] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To present the first case of Cushing's syndrome attributable solely to ectopic production of corticotropin-releasing hormone by a pheochromocytoma. METHODS We summarize the clinical features and results of laboratory investigations in a patient with symptoms characteristic of Cushing's syndrome. RESULTS Although Cushing's syndrome is usually caused by ectopic production of adrenocorticotropic hormone (ACTH), our current patient had clinical and biochemical evidence of hypercortisolism in conjunction with "normal" ACTH levels and nonsuppressible serum and urinary cortisol levels on low-dose and high-dose dexamethasone suppression testing. An abdominal computed tomographic scan revealed a 7.7-cm mass in the left adrenal gland. Light microscopic examination and immunohistochemical staining showed a pheochromocytoma with mild cortical hyperplasia. Immunostaining was positive for corticotropin-releasing hormone but negative for ACTH. CONCLUSION To our knowledge, this is the first case of Cushing's syndrome in a patient with pheochromocytoma caused only by ectopic secretion of corticotropin-releasing hormone without accompanying secretion of ACTH.
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Affiliation(s)
- P H Eng
- Department of Endocrinology, Singapore General Hospital, Singapore
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23
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Liao EY, Peng YQ, Zhou HD, Mackie EJ, Li J, Hu PA, Zhou SH, Wen GB, Zhai MX, Luo XH, Tan LH, Ni JD. Gene symbol: WISP3. Disease: spondyloepihyseal dysplasia tarda with progressive arthropathy. Hum Genet 2004; 115:174. [PMID: 15300987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- E Y Liao
- Institute of Metabolism and Endocrinology, Centralsouth University, Hunan, China.
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24
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Tan LH. Lymphomas involving Waldeyer's ring: placement, paradigms, peculiarities, pitfalls, patterns and postulates. Ann Acad Med Singap 2004; 33:15-26. [PMID: 15389302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
INTRODUCTION This review revisits Waldeyer's ring lymphomas as classified by the World Health Organisation. MATERIALS AND METHODS Sources of data include international studies on Waldeyer's ring lymphomas as well as from personal observations gleaned from lymphoma statistics of Singapore General Hospital, Changi General Hospital, Tan Tock Seng Hospital and National University Hospital within the last decade or so. RESULTS Waldeyer's ring shares many of the histopathological trends of the rest of mucosa-associated lymphoid tissue (MALT), such as the high frequency of diffuse large B-cell lymphomas, and the relative rarity of follicular lymphomas in spite of its rich endowment with reactive lymphoid follicles. However, extranodal marginal zone lymphoma or "MALToma" may not be as frequently encountered as in other mucosal sites. Furthermore, the placement of Waldeyer's ring is unique in that stark comparisons with the lymphopathology of the immediately anterior oronasal cavities can be made, with intriguing peculiarities such as the abrupt reversal of the ratio of B-cell to T/NK-cell lymphoma frequency upon crossing the imaginary line that separates the 2 regions. The differential diagnosis with regionally common lymphoma mimics, in particular reactive parafollicular hyperplasia and nasopharyngeal undifferentiated (lymphoepithelial) carcinoma of Schmincke pattern, both often aetiologically related to Epstein-Barr viral infection, is also discussed. CONCLUSIONS Recognition of the peculiarities and patterns of Waldeyer's ring lymphomas is important for accurate pathologic assessment. Postulates that attempt to account for the patterns and peculiarities of Waldeyer's ring lymphopathology can be used to direct further research.
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Affiliation(s)
- L H Tan
- Department of Pathology, National University Hospital, Singapore.
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25
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Liao EY, Peng YQ, Zhou HD, Mackie EJ, Li J, Hu PA, Zhou SH, Wen GB, Zhai MX, Luo XH, Tan LH, Ni JD. Gene symbol: WISP3. Disease: spondyloepiphyseal dysplasia tarda with progressive arthropathy. Hum Genet 2004; 115:169. [PMID: 15300964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- E Y Liao
- Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Centralsouth University, Hunan, China.
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26
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Bee PC, Chow SK, Tan LH. A case of severe leptospirosis with pancytopaenia. Med J Malaysia 2003; 58:777-9. [PMID: 15190670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Pancytopaenia is a rare clinical presentation of severe leptospirosis. We would like to report a case of severe leptospirosis that progressed to pancytopaenia despite initial penicillin therapy. The patient needed a second course of antibiotic with doxycycline to improve his persistent symptoms and cytopaenia. Persistent pancytopaenia in severe leptospirosis and its management were reviewed.
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Affiliation(s)
- P C Bee
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur
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27
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Kochunov P, Fox P, Lancaster J, Tan LH, Amunts K, Zilles K, Mazziotta J, Gao JH. Localized morphological brain differences between English-speaking Caucasians and Chinese-speaking Asians: new evidence of anatomical plasticity. Neuroreport 2003; 14:961-4. [PMID: 12802183 DOI: 10.1097/01.wnr.0000075417.59944.00] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Deformation field morphometry was applied to magnetic resonance images to detect differences in brain shape between English-speaking Caucasians and Chinese-speaking Asians. Anatomical differences between these two groups were limited to gyri in the frontal, temporal and parietal lobes, which are known (through functional imaging studies) to differentiate Chinese speakers from English speakers. We interpret these anatomical differences as evidence of neural plasticity shaped by the process of language acquisition during childhood. While anatomical plasticity due to manual skill acquisition (e.g. in musicians) has been established, to our knowledge this is the first report of a brain anatomical difference attributable to a learned cognitive strategy.
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Affiliation(s)
- P Kochunov
- Research Imaging Center, University of Texas Health Science Center at San Antonio, 78284, USA.
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28
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Nissapatorn V, Kamarulzaman A, Init I, Tan LH, Rohela M, Norliza A, Chan LL, Latt HM, Anuar AK, Quek KF. Seroepidemiology of toxoplasmosis among HIV-infected patients and healthy blood donors. Med J Malaysia 2002; 57:304-10. [PMID: 12440270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
A cross-sectional study was carried out in University of Malaya Medical Centre, Kuala Lumpur. Blood samples from 100 HIV-infected patients and 203 Healthy Blood Donors (HBD) were collected and anti-Toxoplasma antibodies were detected by using conventional ELISA. The seroprevalence of toxoplasmosis in HIV/AIDS and Healthy Blood Donors were found to be 21% and 28.1% respectively. There was no significant association between the seroprevalence of toxoplasmosis and various possible risk factors i.e. contact with cat, consumption of undercooked meat and history of blood transfusion in both groups. No significant differences between Toxoplasma seroprevalence in HIV/AIDS and Healthy Blood Donors in association with presence of single or multiple risk factors were found. The mean CD4 count among HIV/AIDS patients in this study was 202.23 cell/cumm. There was no significant association between CD4 count and seropositivity for Toxoplasma antibodies in HIV/AIDS patients.
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Affiliation(s)
- V Nissapatorn
- Department of Parasitology, University of Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia
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29
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Chow MYH, Tan LH, Agasthian T. Anaesthetic considerations for lung volume reduction surgery--a case report. Ann Acad Med Singap 2002; 31:223-7. [PMID: 11957562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
INTRODUCTION This case describes some of the unique problems faced by the thoracic anaesthesiologists during anaesthesia for lung volume reduction surgery. CLINICAL PICTURE The usual pulmonary function requirements for lobectomy are normally not met in these patients with severe emphysema. TREATMENT Maintenance of the functional residual capacity of the lung and normocapnia during anaesthesia are not as important. Instead problems due to barotrauma and dynamic hyperinflation from positive pressure ventilation are. OUTCOME Modification of ventilation strategy and providing an anaesthetic tailored towards early extubation is the cornerstone of the anaesthetic plan. CONCLUSION A good understanding of the respiratory physiology in patients with severe emphysema is essential.
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Affiliation(s)
- M Y H Chow
- Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Outram Road, Singapore 169608
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30
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Affiliation(s)
- K H Lim
- Division of Respiratory Medicine, Department of Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia.
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31
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Abstract
BACKGROUND Meningiomas rarely extend out of their intracranial confines through skull foramina to present as cervical tumors, where they would be accessible to fine needle aspiration (FNA) and thereby create difficulties in cytodiagnosis by mimicking other, more commonly aspirated head and neck tumors. CASE A psammomatous meningioma arising intracranially and extending through the jugular foramen presented as a mass at the angle of the jaw clinically. On FNA cytology the diagnosis was suggested, but the cytomorphologic features overlapped with those of more commonly aspirated head and neck tumors, such as acinic cell carcinoma arising primarily in a salivary gland, metastatic papillary thyroid carcinoma and paraganglioma (glomus jugulare tumor). These possibilities had to be excluded through correlation with radiologic and intraoperative findings, which showed a dural-based tumor extending through the jugular foramen to assume a parapharyngeal location. Histology of the final excision specimen confirmed a psammomatous meningioma. CONCLUSION The possibility of meningioma should be considered in the cytologic differential diagnosis of parapharyngeal tumors, particularly since its cytomorphologic features may mimic those of some of the more commonly encountered and aspirated head and neck tumors.
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Affiliation(s)
- L H Tan
- Department of Pathology, National University of Singapore, Singapore
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32
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Pu Y, Liu HL, Spinks JA, Mahankali S, Xiong J, Feng CM, Tan LH, Fox PT, Gao JH. Cerebral hemodynamic response in Chinese (first) and English (second) language processing revealed by event-related functional MRI. Magn Reson Imaging 2001; 19:643-7. [PMID: 11672622 DOI: 10.1016/s0730-725x(01)00379-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Comparative functional neuroimaging studies using the block design paradigm have previously demonstrated that there are no significant differences in the location of areas of cerebral activation when native Chinese speakers independently process single words or sentences in both the Chinese (first) and English (second) languages. While it has also been documented that significant domains of brain response include the inferior to middle left frontal lobe, the latency, amplitude and duration of the associated hemodynamic changes during isolated neural processing of Chinese and English languages still remain unknown. The aim of this study, therefore, was to examine the characteristics of the hemodynamic alterations in the above-mentioned regions with event-related functional MRI (ER-fMRI) when native Chinese speakers performed verb generation tasks in both the Chinese (first) and English (second) languages. Our results demonstrate the presence of a similar neural activity-induced hemodynamic response in the inferior to middle left frontal lobe during both tasks. Further, there were also no statistically significant differences among the variables that described the hemodynamic response curves. These findings strongly imply that the underlying neural mechanism for Chinese (first) and English (second) language processing may be similar in native Chinese speakers.
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Affiliation(s)
- Y Pu
- Research Imaging Center, University of Texas Health Science Center, San Antonio, TX, USA
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33
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Abstract
Written Chinese as logographic script differs notably from alphabets such as English in visual form, orthography, phonology, and semantics. Thus, research on the Chinese language is important to advance our understanding of the universality and particularity of the organization of language systems in the brain. In this study, we examine the neural systems associated with logographic reading using functional magnetic resonance imaging. Two experimental tasks were devised, one based on semantic decision and the other on homophone decision. Compared to the fixation baseline, peak activations resulting from semantic as well as homophony decisions were localized in the left middle frontal gyrus (BA 9). Left inferior frontal cortex also mediated Chinese processing. In addition, more right hemisphere cortical regions (i.e., BAs 47/45, 7, 40/39, and the right visual system) were involved in reading Chinese relative to reading English. This is attributed to the square shape of the logograph which requires an elaborated analysis of the spatial information and locations of various strokes comprising the logographic character. We suggest that the left middle frontal area (BA 9) coordinates and integrates the intensive visuospatial analysis demanded by logographs' square configuration and the semantic (or phonological) analysis required by the present experimental tasks. Our study has implicated brain regions common to both logographic and alphabetic languages as well as brain regions specialized in processing logographs.
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Affiliation(s)
- L H Tan
- Laboratory for Language Neuroscience and Cognition, Department of Linguistics, University of Hong Kong, Pokfulam Road, Hong Kong
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34
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Ang ES, Tan KC, Tan LH, Ng RT, Song IC. 2-octylcyanoacrylate-assisted microvascular anastomosis: comparison with a conventional suture technique in rat femoral arteries. J Reconstr Microsurg 2001; 17:193-201. [PMID: 11336151 DOI: 10.1055/s-2001-14351] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Standard microvascular anastomosis using only sutures is a well-established and successful technique; however, it is time-consuming and may cause vessel narrowing, needle trauma, and tissue reaction. The authors' hypothesis was that 2-octylcyanoacrylate could simplify microvascular anastomosis and reduce wall trauma and reaction. End-to-end anastomoses of the femoral arteries were performed in 20 adult rats. Each animal served as its own control. The time taken for each anastomosis (from first stitch to release of clamps) was noted, and the patency assessed. At day 7, the anastomoses were reassessed for patency, and the vessels evaluated histologically. 2-octylcyanoacrylate reduced the need to insert more sutures. Anastomotic time in the study group was statistically significantly shorter (p < 0.001), and the patency rate was 90 percent, compared to 85 percent with the standard suture technique. There was also less intense inflammatory reaction, with fewer foreign-body granulomata. This is the first report on the use of 2-octylcyanocrylate, currently approved for cutaneous use, for vessel anastomosis. Further work on the biomechanics and long-term histologic effects will be carried out. 2-octylcyanoacrylate has the potential for simplifying and improving the patency rates of arterial microanastomosis.
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Affiliation(s)
- E S Ang
- Department of Plastic Surgery, Singapore General Hospital, Singapore
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35
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Abstract
Event-related functional magnetic resonance imaging (ER-fMRI) was used to investigate how the human brain processes phonology and transforms a word's visual form (orthography) into phonological form during reading in logographic Chinese, a writing system that differs markedly from alphabetic languages. We found that reading aloud of irregular words produced larger MR signal intensity changes over extensive regions involving left infero-middle frontal cortex, left motor cortex, right infero-frontal gyri, bilateral anterior superior temporal areas, and anterior cingulate cortex. Right superior parietal lobule, the cuneus in bilateral visual cortex, and thalamus participated in the processing of irregular, but not regular, words. These findings were discussed in comparison to neuroimaging findings from alphabetic languages, as well as in relation to models of reading.
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Affiliation(s)
- L H Tan
- Department of Linguistics, University of Hong Kong, Hong Kong
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36
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Tan SY, Tan LH, Teo SM, Thiruventhiran T, Kamarulzaman A, Hoh HB. Disseminated nocardiosis with bilateral intraocular involvement in a renal allograft patient. Transplant Proc 2000; 32:1965-6. [PMID: 11120022 DOI: 10.1016/s0041-1345(00)01514-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Y Tan
- Department of Renal Medicine, University Hospital, Kuala Lumpur, Malaysia
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37
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Pollatsek A, Tan LH, Rayner K. The role of phonological codes in integrating information across saccadic eye movements in Chinese character identification. J Exp Psychol Hum Percept Perform 2000. [PMID: 10811166 DOI: 10.1037//0096-1523.26.2.607] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prior research has generally assumed either that phonological codes do not contribute to Chinese character identification or that they do so only through a look-up process at the character level. In 3 experiments, a homophone seen parafoveally aided the identification of a target character that was fixated following an eye movement to the preview location. Moreover, high-frequency phonetically regular characters were named faster than high-frequency, phonetically irregular characters. Thus, both lexical and sublexical phonological codes of Chinese characters are involved early in the process of character identification. Orthographic information from the preview was also used in character identification, as orthographically similar previews facilitated target identification as well. The evidence for the extraction of semantic information from parafoveal previews was mixed, as synonym previews facilitated in Experiment 2 but not in Experiment 1.
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Affiliation(s)
- A Pollatsek
- Department of Psychology, University of Massachusetts at Amherst, 01003, USA.
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38
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Abstract
Two experiments with the Stroop paradigm were conducted to investigate the role of phonological codes in access to the meaning of Chinese characters. Subjects named the ink color of viewed characters or color patches. Key items were color characters, their homophones with the same tone, homophones with different tones, and semantic associates. Apart from finding the usual Stroop interference effect, homophones produced significant interference in the incongruent condition, provided that they had the same tone as the color characters. The interference effect from homophones, however, was significantly smaller than that from color characters. Semantic associates generated an interference effect in the incongruent condition, an effect of the same magnitude as the effect from the same-tone homophones. Finally, in the congruent conditions, all the key items yielded facilitations compared to neutral controls, though the facilitation from color characters was larger than the facilitations from other types of characters. These findings suggest that phonological codes in Chinese are activated obligatorily and provide early sources of constraint in access to meaning.
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Affiliation(s)
- J A Spinks
- Cognitive Science Program, University of Hong Kong, Pokfulam Road, Hong Kong, China
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39
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Abstract
Does phonology play a role in silent reading? This issue was addressed in Chinese. Phonology effects are less expected in Chinese than in alphabetical languages like English because the basic units of written Chinese (the characters) map directly into units of meaning (morphemes). This linguistic property gave rise to the view that phonology could be bypassed altogether in Chinese. The present study, however, shows that this is not the case. We report two experiments that demonstrate pure phonological frequency effects in processing written Chinese. Characters with a high phonological frequency were processed faster than characters with a low phonological frequency, despite the fact that the characters were matched on orthographic (printed) frequency. The present research points to a universal phonological principle according to which phonological information is routinely activated as a part of word identification. The research further suggests that part of the classic word-frequency effect may be phonological.
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Affiliation(s)
- J C Ziegler
- Laboratoire de Psychologie Cognitive, Centre National de la Recherche Scientifique, Aix-en-Provence, France
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40
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Tan LH, Spinks JA, Gao JH, Liu HL, Perfetti CA, Xiong J, Stofer KA, Pu Y, Liu Y, Fox PT. Brain activation in the processing of Chinese characters and words: a functional MRI study. Hum Brain Mapp 2000; 10:16-27. [PMID: 10843515 PMCID: PMC6871809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/1999] [Accepted: 02/03/2000] [Indexed: 02/16/2023] Open
Abstract
Functional magnetic resonance imaging was used to identify the neural correlates of Chinese character and word reading. The Chinese stimuli were presented visually, one at a time. Subjects covertly generated a word that was semantically related to each stimulus. Three sorts of Chinese items were used: single characters having precise meanings, single characters having vague meanings, and two-character Chinese words. The results indicated that reading Chinese is characterized by extensive activity of the neural systems, with strong left lateralization of frontal (BAs 9 and 47) and temporal (BA 37) cortices and right lateralization of visual systems (BAs 17-19), parietal lobe (BA 3), and cerebellum. The location of peak activation in the left frontal regions coincided nearly completely both for vague- and precise-meaning characters as well as for two-character words, without dissociation in laterality patterns. In addition, left frontal activations were modulated by the ease of semantic retrieval. The present results constitute a challenge to the deeply ingrained belief that activations in reading single characters are right lateralized, whereas activations in reading two-character words are left lateralized.
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Affiliation(s)
- L H Tan
- Cognitive Science Program, University of Hong Kong, Hong Kong.
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41
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Pollatsek A, Tan LH, Rayner K. The role of phonological codes in integrating information across saccadic eye movements in Chinese character identification. J Exp Psychol Hum Percept Perform 2000; 26:607-33. [PMID: 10811166 DOI: 10.1037/0096-1523.26.2.607] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prior research has generally assumed either that phonological codes do not contribute to Chinese character identification or that they do so only through a look-up process at the character level. In 3 experiments, a homophone seen parafoveally aided the identification of a target character that was fixated following an eye movement to the preview location. Moreover, high-frequency phonetically regular characters were named faster than high-frequency, phonetically irregular characters. Thus, both lexical and sublexical phonological codes of Chinese characters are involved early in the process of character identification. Orthographic information from the preview was also used in character identification, as orthographically similar previews facilitated target identification as well. The evidence for the extraction of semantic information from parafoveal previews was mixed, as synonym previews facilitated in Experiment 2 but not in Experiment 1.
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Affiliation(s)
- A Pollatsek
- Department of Psychology, University of Massachusetts at Amherst, 01003, USA.
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42
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Abstract
Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SHML) is primarily a nodal-based, idiopathic, benign proliferative disorder of histiocytes with 43% of these cases also involving extranodal sites. The breast is an unusual site of occurrence of RDD. We report two cases of this exceptional event. The first represents an intramammary nodal Rosai-Dorfman disease, while the second is an extranodal disease with sole involvement of the breast. In both, the possibility of malignancy was raised. Histological examination of the two breast lesions revealed sheets of characteristic large histiocytes displaying emperipolesis, a microscopic hallmark of this disease. Immunohistochemical and ultrastructural studies were also performed; the former showed cytoplasmic staining of histiocytes for S-100 protein, while histiocytes that engulfed lymphocytes and plasma cells were identified on electron microscopy.
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Affiliation(s)
- S B Ng
- Department of Pathology, Singapore General Hospital, Singapore
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43
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Kumar G, Tan LH, Lun KC. The Internal Medicine Center--an integrated solution for information on internal medicine on the World Wide Web. Int J Med Inform 1999; 55:77-81. [PMID: 10471243 DOI: 10.1016/s1386-5056(99)00022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The World Wide Web (WWW) has grown from being a resource center for a select group of scientists to a large database of information that is available to both professionals and public. The amount of medical information on the Web has been increasing exponentially and thus, it has become increasingly difficult for anyone to be able to search for a specific quantum of information among this mass. Even in mid 1996, it was noted that the amount of information on internal medicine was growing rapidly. Hence, on 21 March 1997, the Internal Medicine Center (IMC) was created and launched. The IMC is an unique concept and it represents the first time that medical data on the web has been organized into a form that intimately parallels clinical medicine. The rationale behind the creation of the IMC can be summarized in three words: information, speed and convenience. The interface used by this center reflects these goals because overuse of large image files are avoided, hence decreasing the access time and yet keeping the information in an easily comprehensible manner. In conclusion, the IMC serves as a useful tool for the layman as well as the expert because the comprehensive information that it offers can be accessed rapidly and conveniently.
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Affiliation(s)
- G Kumar
- Faculty of Medicine, National University of Singapore, Singapore.
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44
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Abstract
Diazepam is routinely used in obstetrics in the treatment of maternal eclampsia or as anesthetic induction during deliveries or cesarean sections. We investigated here the effects of perinatal diazepam treatment on the liver of Sprague Dawley rats. From 15th day of gestation to birth pregnant rats were treated daily in the first experimental group (DZ1) with 2.5 mg DZ/kg b.w., s.c., the second (DZ2) with 5 and the third (DZ3) with 10 mg DZ/kg b.w. After birth respective treatment was continued to the pups till 5th day postnatal. One half of pups from DZ2 and control was sacrificed at 12th day, the other were raised to 120th day and then sacrificed. After fixation in formaldehyde serial paraffin sections were processed with proliferating cell nuclear antigen (PCNA), autofluorescence of lipofuscin and Elastica v. Gieson staining. Livers from 12 day old rats showed increased levels of PCNA marked hepatocytes and lipofuscin containing cells. Livers from 120 day old animals exhibited increased levels of PCNA cells especially with weakly stained nuclei, the number of lipofuscin containing cells were decreased in DZ1 and DZ2 but reached in DZ3 the similar number as control. Statistical analysis showed that quantification of Kupffer cells lacked significance. To conclude livers of 12 day old animals demonstrated a stimulated DNA synthesis and an accumulation of nondegradable residues. Livers from 120 day old rats demonstrated an increase in number of potentially proliferating hepatocytes by increased levels of weakly stained PCNA nuclei. At lower dosage DZ seems to inhibit lipofuscinogenesis, at highest dosage DZ accumulates non-degradable residues. Elastica v. Gieson staining was not suitable to quantify Kupffer cells with certainty.
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Affiliation(s)
- L H Tan
- Institute of Anatomy, Heinrich Heine University, Düsseldorf, Germany
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45
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Affiliation(s)
- V F Chong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
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46
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Abstract
To study the role of erythropoietin (Epo) in the pathogenesis of anemia in acute renal failure (ARF), organ Epo mRNA was measured by RNase protection assay in rats with ARF induced by a one hour-occlusion of the left renal artery. Hematocrit was significantly decreased two hours, 24 hours and one week after renal artery occlusion. A significant reduction in serum haptoglobin at two hours and an increase in serum LDH at 24 hours indicated that hemolysis was the likely cause of the initial fall in hematocrit. However, despite the reduced hematocrit, serum Epo concentrations were not significantly different from controls, suggesting that the anemia is maintained because of lack of an appropriate Epo response. Right renal Epo mRNA levels were not significantly different in all groups, but Epo mRNA levels in post-ischemic kidneys were 50 to 67% lower than in contralateral kidneys. However, Epo mRNA in the post-ischemic kidney was increased sixfold by acute hemorrhage, a rise comparable to the ninefold increase observed in contralateral kidneys. In ARF rats exposed to 7.5% O2 for four hours, right kidney Epo mRNA increased 200-fold over normoxic levels, to a value similar to sham-operated hypoxic controls. Epo mRNA in the post-ischemic kidney also increased 200-fold, to 50% of the level in the contralateral kidney. Hepatic Epo mRNA levels were elevated to comparable levels in both groups. In this ARF model, mild anemia is associated with relative Epo deficiency. In the post-ischemic kidney, a substantial capacity for Epo production is retained but the sensitivity of the Epo response to blood oxygen availability is significantly reduced.
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Affiliation(s)
- C C Tan
- Department of Medicine, National University of Singapore, Singapore
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47
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Jansen JJ, Tan LH, van der Vleuten CP, van Luijk SJ, Rethans JJ, Grol RP. Assessment of competence in technical clinical skills of general practitioners. Med Educ 1995; 29:247-253. [PMID: 7623721 DOI: 10.1111/j.1365-2923.1995.tb02839.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Technical clinical procedures constitute an important part of the work of general practitioners. Assessment of competence in the relevant skills is important from the perspective of quality assurance. In this study, the psychometric characteristics of three different methods for assessment of competence in technical clinical skills in general practice were evaluated. A performance-based test (8 stations), a written knowledge test of skills (125 items) and a self-assessment questionnaire (41 items) on technical clinical skills were administered to 49 GPs and 47 trainees in general practice. The mean scores on the performance-based test and the written knowledge test of skills showed no substantial differences between GPs and trainees, whereas the GPs scored higher on the self-assessment questionnaire. While the correlation of the score on the knowledge test of skills with the score on the performance-based test was moderately high, the score on the self-assessment questionnaire showed a rather low correlation with the performance-based test. Although performance-based testing is obviously the best method to assess proficiency in hands-on skills, a written test can serve as a reasonable alternative, particularly for screening and research purposes.
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Affiliation(s)
- J J Jansen
- Centre for Research in Quality Assurance in General Practice, University of Nijmegen, The Netherlands
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48
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Carver JD, McDermott RJ, Jacobson HN, Sherin KM, Kanarek K, Pimentel B, Tan LH. Infant mortality statistics do not adequately reflect the impact of short gestation. Pediatrics 1993; 92:229-32. [PMID: 8337021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To determine the accuracy of National Center for Health Statistics cause-specific infant mortality data. The National Center for Health Statistics compiles these data by applying World Health Organization (WHO) selection rules to death certificate data. The WHO rules arrange medical entities into a hierarchical order and select a single underlying cause of death (ULCD). DESIGN A comparison was made between ULCD assigned to a cohort of 335 infant death certificates by (1) a neonatologist panel, and (2) application of WHO selection rules by the Florida State Office of Vital Statistics (OVS). RESULTS Among the 146 infants with birth weights 1500 to 4649 g, agreement between neonatologists and OVS was 88%, while among the 189 infants with birth weights 0 to 1499 g (very low birth weight), agreement was just 41%. Neonatologists selected short gestation as the underlying cause of death for 82% of very low birth weight infant records, vs 25% by OVS. Due to the application of specific WHO selection rules, OVS frequently selected immediate causes of death, such as "cardiac arrest," as the ULCD, even when the medical certifier had indicated short gestation as the ULCD. In vital statistics reports, many of these immediate causes are reported as "other respiratory conditions of newborn," or "all other perinatal conditions." CONCLUSION WHO ULCD selection rules should be modified to allow short gestation to have a higher priority over immediate causes of infant death.
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Affiliation(s)
- J D Carver
- Department of Pediatrics, University of South Florida College of Medicine, Tampa
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49
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50
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Guan R, Tay HH, Yap I, Smith R, Tan LH. The immune response of low dose recombinant DNA hepatitis B vaccine in teenagers in Singapore. Trans R Soc Trop Med Hyg 1990; 84:731-2. [PMID: 2148992 DOI: 10.1016/0035-9203(90)90167-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- R Guan
- Department of Medicine, National University Hospital, Singapore
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