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Chometon Q, Pickup L, Arteta C, Peschl H, Ather S, Tsakok M, Santos C, Novotny P, Declerck J, Gleeson F, Kadir T. P1.11-08 AI Based Malignancy Prediction of Indeterminate Pulmonary Nodules: Robustness to CT Contrast Media. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.824] [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: 11/30/2022]
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Bocaz JA, Barja P, Bonnar J, Daly L, Carrol A, Coutinho E, Goncalves M, Tsakok M, Koh S, Thomson JM, Poller L, Heady A, Holck S, Pinol A. Differences in Coagulation and Haemostatic Parameters in Normal Women of Childbearing Age from Different Ethnic Groups and Geographical Locations. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1661571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryA comparative study of coagulation and fibrinolytic laboratory parameters was undertaken in four countries (Salvador, Brazil; Singapore; Santiago, Chile and Dublin, Ireland) among apparently healthy women of reproductive age. A continuous external quality control scheme of the laboratory measurements was employed to permit comparison among centres. Significant and consistent differences were found between the four centres. In Dublin, the prothrombin time and activated partial thromboplastin time (APTT) were accelerated, and the specific factor assays showed more activity, whereas the antiprotease levels were higher than in the other centres. In Salvador, a contrasting tendency was found with longer prothrombin times and APTT and lower Factor VII and antiprotease levels. The results from the other two centres were approximately midway between these two extremes. The study has revealed important differences in the coagulation and haemostatic tests between women from widely diverse geographical areas. It is not certain whether these are due to ethnic, nutritional or economic factors but they may be related to the apparent varying incidence of thrombosis in these ethnic groups.
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Affiliation(s)
- J A Bocaz
- The WHO Collaborating Centre for Research in Human Reproduction, Santiago, Chile
| | - P Barja
- The WHO Collaborating Centre for Research in Human Reproduction, Santiago, Chile
| | - J Bonnar
- The Dept. of Obstetrics and Gynaecology, Trinity College Medical School, St. James'and Rotunda Hospitals, University of Dublin, Dublin, Ireland
| | - L Daly
- The Dept. of Obstetrics and Gynaecology, Trinity College Medical School, St. James'and Rotunda Hospitals, University of Dublin, Dublin, Ireland
| | - A Carrol
- The Dept. of Obstetrics and Gynaecology, Trinity College Medical School, St. James'and Rotunda Hospitals, University of Dublin, Dublin, Ireland
| | - E Coutinho
- The WHO Collaborating Centre for Research in Human Reproduction, Salvador, Brazil
| | - M Goncalves
- The WHO Collaborating Centre for Research in Human Reproduction, Salvador, Brazil
| | - M Tsakok
- The WHO Collaborating Centre for Research in Human Reproduction, Singapore
| | - S Koh
- The WHO Collaborating Centre for Research in Human Reproduction, Singapore
| | - J M Thomson
- The UK Reference Laboratory for Anticoagulant Reagents and Control, Withington Hospital, University Hospital of South Manchester, Manchester, United Kingdom
| | - L Poller
- The UK Reference Laboratory for Anticoagulant Reagents and Control, Withington Hospital, University Hospital of South Manchester, Manchester, United Kingdom
| | - A Heady
- The Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - S Holck
- The Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A Pinol
- The Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
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Abstract
SummaryAlteration of the fibrinolytic system is considered to be important in the development of deep venous thrombosis (DVT). Using specific assays for tissue plasminogen activator (t-PA) activity, t-PA inhibitor (PAI) and t-PA antigen, we measured these activities in 16 women who developed DVT during their pregnancies. A group of 24 healthy females of comparable age was studied as controls. PAI was increased in 87% of these patients compared to the healthy controls. In some of these patients a defect in release of t-PA from vascular endothelium was found as well. The site at which blood was sampled for analysis appeared to be an important criterion in the ex vivo assessment of functional t-PA reserve and PAI levels, though relatively less so for the latter measurement. The unaffected lower limbs, relative to the unaffected upper limbs, showed an increase in PAI and a demonstrable decrease in t-PA release, both representing increased risk factors for rethrombosis. The affected lower limbs showed similar but more accentuated changes in these parameters.
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Affiliation(s)
- P Han
- The Haematology Division, Clinical Laboratories, National University Hospital, Singapore
| | - E S C Koay
- The Department of Biochemistry, National University of Singapore, singapore
| | - M Tsakok
- The Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapdre
| | - T C Aw
- The Department of Biochemistry, National University of Singapore, singapore
| | - L Y Wong
- The Department of Biochemistry, National University of Singapore, singapore
| | - M Pradhan
- The Haematology Division, Clinical Laboratories, National University Hospital, Singapore
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Wedgeworth E, Glover M, Irvine A, Neri I, Baselga E, Clayton T, Beattie P, Bjerre J, Burrows N, Foelster-Holst R, Hedelund L, Hernandez-Martin A, Audrain H, Bhate K, Brown S, Baryschpolec S, Darne S, Durack A, Dvorakova V, Gach J, Goldstraw N, Goodyear H, Grabczynska S, Greenblatt D, Halpern J, Hearn R, Hoey S, Hughes B, Jayaraj R, Johansson E, Lam M, Leech S, O'Regan G, Morrison D, Porter W, Ramesh R, Schill T, Shaw L, Taylor A, Taylor R, Thomson J, Tiffin P, Tsakok M, Janmohamed S, Laguda B, McPherson T, Oranje A, Patrizi A, Ravenscroft J, Shahidullah H, Solman L, Svensson A, Wahlgren C, Hoeger P, Flohr C. Propranolol in the treatment of infantile haemangiomas: lessons from the European Propranolol In the Treatment of Complicated Haemangiomas (PITCH) Taskforce survey. Br J Dermatol 2015; 174:594-601. [DOI: 10.1111/bjd.14233] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 12/25/2022]
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Affiliation(s)
- M Tsakok
- Department of Dermatology, Churchill Hospital, Oxford, UK
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Affiliation(s)
| | - H Stolp
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK
| | - Z Molnár
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK
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Abstract
The concentrations of cadmium, lead, selenium, and zinc in blood and seminal plasma were determined in 221 Singapore men. The relationship of trace element concentration to sperm density, motility, morphology, and semen volume was also investigated. The concentrations of elements were in the following descending order: Zn > Se > Pb > Cd. Except for zinc, the concentrations were generally higher in blood than in seminal plasma. The mean concentration of zinc in seminal plasma (ZnSP) was about 30 times higher than in blood (ZnB). A significant inverse correlation was observed between blood cadmium levels (CdB) and sperm density (r = -0.24, P < 0.05) in oligozoospermic men (sperm density below 20 million/mL) but not in normospermic men. Cadmium in seminal plasma (CdSP) was also associated with low semen volume (r = -0.29, P < 0.05). These findings suggest that cadmium may have an effect on the male reproductive system. In contrast, positive correlations were observed between concentrations of selenium and zinc in seminal plasma (SeSP and ZnSP) and sperm density in normospermic men but not in oligozoospermic men. The correlation coefficients with sperm density for SeSP and ZnSP were 0.35 (P < 0.05) and 0.41 (P < 0.01), respectively. The concentrations of lead in blood (PbB) or seminal plasma (PbSP) did not appear to have any correlation with the sperm parameters studied.
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Affiliation(s)
- B Xu
- Department of Occupational Epidemiology, Jiangsu Institute of Occupational Medicine, China
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Abstract
Concentrations of lead, cadmium, methylmercury and total mercury were measured in maternal and umbilical cord blood using graphite atomic absorption spectrometry. Two essential metals, copper and zinc, were also determined using ion chromatography. Lead, copper and zinc were found to be lower in the cord blood whereas methylmercury and total mercury were higher in cord blood than in maternal blood. Little differences were noted for cadmium in maternal and cord blood. Significant positive correlations were observed between the concentrations in maternal and cord blood with regard to lead (correlation coefficient, r = 0.44), copper (r = 0.34), zinc (r = 0.29), methylmercury (r = 0.44) and total mercury (r = 0.58). These results suggest that, like essential metals, most heavy metals can move rather freely across the human placenta. The potential health effects of heavy metal transfer from mothers to young infants cannot be discounted.
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Affiliation(s)
- C N Ong
- Department of Community Medicine, National University of Singapore
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Leck I, Thomson JM, Bocaz JA, Barja P, Bonnar J, Daly L, Carrol A, Coutinho E, Goncalves M, Tsakok M. A multicentre study of coagulation and haemostatic variables during oral contraception: variations with geographical location and ethnicity. Task Force on Oral Contraceptives--WHO Special Programme of Research, Development and Research Training in Human Reproduction. Int J Epidemiol 1991; 20:913-20. [PMID: 1800430 DOI: 10.1093/ije/20.4.913] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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: 12/28/2022] Open
Abstract
A comparative study of the effects of combined oral contraceptives (OC) on coagulation and fibrinolytic variables using standardized laboratory technique and methodology has been performed in Dublin (Ireland), Salvador (Brazil), Santiago (Chile) and Singapore. Of 777 entrants to the study, 622 were randomly allocated to receive one of four different OC formulations. The remainder did not opt for OC. The progestogenic component was levonorgestrel (LNG) in three of the OC formulations and norethisterone acetate (NEA) in the fourth. Results for the three LNG user groups were pooled. The changes in haematological variables observed over 12 months in the LNG and NEA users were examined in relation to the changes seen in the women not on OC. Women in Salvador differed markedly from those in the other three centres, in showing no acceleration of the prothrombin time and no increase in either fibrin plate lysis or plasminogen following the use of OC. After adjusting the findings in OC users for those in non-users, significant differences in response between centres were also detected for activated partial thromboplastin time (accelerated only in Dublin and Santiago), factor VII activity (increased mainly in Salvador and Santiago) and fibrinogen (for which the most marked changes were an increase in Dublin and a decrease in Salvador). This variability between centres in the effects of OC on coagulation and fibrinolysis suggests that OC administration in different populations may not carry equal thrombotic risks.
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Affiliation(s)
- I Leck
- Department of Public Health and Epidemiology, University of Manchester, UK
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Fong PH, Lim TS, Wong MK, Tsakok M, Tan LK. The role of fine needle aspiration for breast cancer in the climacteric--a preliminary report. Ann Acad Med Singap 1989; 18:266-8. [PMID: 2774471] [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: 01/02/2023]
Abstract
Fine needle biopsy has been used with great accuracy in the diagnosis of breast tumours. There have been few reports on its efficacy as an adjunct to other breast screening techniques like x-ray mammography. Abnormal mammograms in the absence of a palpable breast lump are sometimes detected in the climacteric and these pose a problem of tissue sampling for pathologic diagnosis. We have tried to evaluate the technique of radiologically guided fine needle aspiration in such patients. Our report is of an initial series of 13 cases of non-palpable, mammographically abnormal breast lesions. Eight cases were fibroadenoma, 4 cases mammary dysplasia and 1 a benign breast lesion. Representative cytologic samples were obtained in 11 of our 13 cases. Cytologic diagnosis should be correlated with mammographic findings.
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Affiliation(s)
- P H Fong
- Department of Plastic Surgery, Singapore General Hospital
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Han P, Koay ES, Tsakok M, Aw TC, Wong LY, Pradhan M. Altered fibrinolysis in DVT: influence of site of sampling. Thromb Haemost 1988; 60:50-3. [PMID: 3142091] [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: 01/04/2023]
Abstract
Alteration of the fibrinolytic system is considered to be important in the development of deep venous thrombosis (DVT). Using specific assays for tissue plasminogen activator (t-PA) activity, t-PA inhibitor (PAI) and t-PA antigen, we measured these activities in 16 women who developed DVT during their pregnancies. A group of 24 healthy females of comparable age was studied as controls. PAI was increased in 87% of these patients compared to the healthy controls. In some of these patients a defect in release of t-PA from vascular endothelium was found as well. The site at which blood was sampled for analysis appeared to be an important criterion in the ex vivo assessment of functional t-PA reserve and PAI levels, though relatively less so for the latter measurement. The unaffected lower limbs, relative to the unaffected upper limbs, showed an increase in PAI and a demonstrable decrease in t-PA release, both representing increased risk factors for rethrombosis. The affected lower limbs showed similar but more accentuated changes in these parameters.
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Affiliation(s)
- P Han
- Haematology Division, National University Hospital, Singapore
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Bocaz JA, Barja P, Bonnar J, Daly L, Carrol A, Coutinho E, Goncalves M, Tsakok M, Koh S, Thomson JM. Differences in coagulation and haemostatic parameters in normal women of childbearing age from different ethnic groups and geographical locations. Task Force on Oral Contraceptives--WHO Special Programme of Research, Development and Research Training in Human Reproduction. Thromb Haemost 1986; 55:390-5. [PMID: 3750268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A comparative study of coagulation and fibrinolytic laboratory parameters was undertaken in four countries (Salvador, Brazil; Singapore; Santiago, Chile and Dublin, Ireland) among apparently healthy women of reproductive age. A continuous external quality control scheme of the laboratory measurements was employed to permit comparison among centres. Significant and consistent differences were found between the four centres. In Dublin, the prothrombin time and activated partial thromboplastin time (APTT) were accelerated, and the specific factor assays showed more activity, whereas the antiprotease levels were higher than in the other centres. In Salvador, a contrasting tendency was found with longer prothrombin times and APTT and lower Factor VII and antiprotease levels. The results from the other two centres were approximately midway between these two extremes. The study has revealed important differences in the coagulation and haemostatic tests between women from widely diverse geographical areas. It is not certain whether these are due to ethnic, nutritional or economic factors but they may be related to the apparent varying incidence of thrombosis in these ethnic groups.
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Abstract
A study of maternal-infant transmission of hepatitis B virus (HBV) was conducted in Singapore between June 1980 and June 1982. HBsAg carrier rate was highest among Chinese (6.2%) followed by Malay (2.3%) and Indian (0.6%) mothers. The presence of HBeAg in maternal sera correlated well with high titre HBsAg (p = 7.34 X 10(-5)). Overall HBV transmission occurred in 27/56 (48.2%) infants from carrier mothers. The majority of the transmission was perinatal. There was a very strong correlation between transmission and HBeAg status of the mother (p = 1.85 X 10(-9); odds ratio = 68.44) and to a lesser extent with high titre HBsAg (p = 0.002; odds ratio = 6.38). A strong negative correlation was seen between transmission and anti-HBeAg (p = 8.19 X 10(-7); odds ratio = 0.04). At one year 19 (70.4%) infants were still HBsAg positive while seven (25.9%) lost the antigenemia and acquired anti-HBsAg and one developed HBsAg after one year. It could be calculated that perinatal HBV transmission contributed about 18% to the total pool of HBsAg positive infants of one year of age.
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Ratnam SS, Chew PC, Tsakok M. Experience of a comprehensive infertility clinic in the Department of Obstetrics and Gynaecology, University of Singapore. Singapore Med J 1976; 17:157-9. [PMID: 1019614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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