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Mitsudomi T, Tan D, Yang JCH, Ahn MJ, Batra U, Cho BC, Cornelio G, Lim T, Mok T, Prabhash K, Reungwetwattana T, Ren SX, Singh N, Toyooka S, Wu YL, Yang PC, Yatabe Y. Expert consensus recommendations on biomarker testing in metastatic and non-metastatic non-small cell lung cancer in Asia. J Thorac Oncol 2022; 18:436-446. [PMID: 36379356 DOI: 10.1016/j.jtho.2022.10.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Most published guidelines for genomic biomarker testing in NSCLC reflect the disease epidemiology and treatments readily available in Europe and North America. Nevertheless, 60% of annual global NSCLC cases occur in Asia, where patient characteristics, tumor molecular profiles, and treatments vary greatly from the Western world. For example, mutations in the EGFR occur at a higher prevalence in Asia than in other world regions. Although medical associations such as the International Association for the Study of Lung Cancer, European Society for Medical Oncology, and American Society of Clinical Oncology have described principles for tumor genomic biomarker testing in NSCLC, there is a need for recommendations specific for Asia. METHODS This report provides consensus recommendations for NSCLC biomarker testing from Asian lung cancer experts for clinicians working in Asia to improve patient care. Biomarker testing approaches for actionable genetic alterations in EGFR, ALK, ROS1, and others are discussed. RESULTS These recommendations are divided into nonmetastatic and metastatic forms of adenocarcinoma and squamous cell carcinoma. Owing to the higher prevalence of EGFR mutations in Asia, the experts emphasized the need for EGFR testing to include not just common mutations (exon 19 deletions and L858R substitutions) but also other uncommon EGFR mutations. In addition to the assessment of biomarkers in the tumor tissue, the role of assessing tumor biomarkers by liquid biopsy is discussed. CONCLUSION This consensus provides practical recommendations for biomarker testing in nonmetastatic and metastatic Asian NSCLC patients.
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Affiliation(s)
- Tetsuya Mitsudomi
- Division of Thoracic Surgery, Faculty of Medicine, Kindai University-Osaka-Sayama, Osaka, Japan.
| | - Daniel Tan
- Division of Medical Oncology, National Cancer Center Singapore, Singapore, Singapore
| | | | - Myung-Ju Ahn
- Section of Hematology-Oncology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Ullas Batra
- Rajiv Gandhi Cancer Institute & Research Centre, Rohini, New Delhi, India
| | - Byoung-Chul Cho
- Division of Medical Oncology, Yonsei Cancer Center, Seoul, Republic of Korea
| | - Gerardo Cornelio
- Cancer Institute, St. Luke's Medical Center-Global City, University of the Philippines-Philippine General Hospital, Metro Manila, Philippines
| | - Tony Lim
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Tony Mok
- State Key Laboratory in Translational Oncology, Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, People's Republic of China
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Thanyanan Reungwetwattana
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sheng-Xiang Ren
- Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Shinichi Toyooka
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan
| | - Yi-Long Wu
- Department of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Pan-Chyr Yang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
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Fan X, Ng CT, Guo D, Lim F, Tan JC, Law A, Goh LH, Poon ZY, Cheung A, Kong SL, Tan M, Li S, Loh A, James A, Lim T, Chen J, Thumboo J, Hwang W, Low A. Dampened Inflammation and Improved Survival After CXCL5 Administration in Murine Lupus via Myeloid and Neutrophil Pathways. Arthritis Rheumatol 2022; 75:553-566. [PMID: 36240108 DOI: 10.1002/art.42383] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the efficacy of CXCL5 administration in lupus-prone MRL/lpr (Faslpr ) mice and elucidate its working mechanisms. METHODS CXCL5 expression in blood (obtained from SLE patients and Faslpr mice) and major internal organs (obtained from Faslpr mice) was examined by Luminex, real-time polymerase chain reaction, and immunofluorescent staining analyses. Pharmacokinetic studies were performed in Faslpr mice and healthy Institute of Cancer Research mice. Efficacy of CXCL5 administration was demonstrated in Faslpr mice, and the working mechanism of CXCL5 treatment was elucidated by flow cytometry, Luminex, and RNA sequencing. RESULTS In SLE patients, serum CXCL5 levels were significantly lower than in healthy individuals (P < 0.0001) and negatively correlated with disease activity (P = 0.004). In Faslpr mice, disease severity progressed with age and was negatively associated with plasma CXCL5 levels. Intravenous administration of CXCL5 to Faslpr mice restored endogenous circulatory CXCL5, improved mice survival, and reduced anti-double-stranded DNA antibodies, proteinuria, lupus nephritis activity and chronicity indices, renal complements, and neutrophil extracellular traps over short-term (10 weeks) and long-term (2 years) time periods. In vitro and in vivo assays demonstrated that CXCL5 dictated neutrophil trafficking and suppressed neutrophil activation, degranulation, proliferation, and renal infiltration. Renal and splenic RNA sequencing further showed that CXCL5-mediated immunomodulation occurred by promoting energy production in renal-infiltrated immune cells, activating certain T cells, and reducing tissue fibrosis, granulocyte extravasation, complement components, and interferons. Further factorial design results indicated that CXCL5 appears to enhance host tolerability to cyclophosphamide in vulnerable individuals. CONCLUSION We found that serum CXCL5 levels were significantly lower in SLE patients than in healthy individuals and were negatively correlated with disease activity. By administering CXCL5 intravenously in a mouse model of lupus, mouse survival improved, and indices of disease activity reduced significantly. Taken together, these findings indicate CXCL5 administration may represent a novel myeloid/neutrophil-targeting therapy for SLE.
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Affiliation(s)
- Xiubo Fan
- Department of Clinical Translational Research, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Chin Teck Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Dianyang Guo
- Department of Clinical Translational Research, Singapore General Hospital
| | - Frances Lim
- Department of Clinical Translational Research, Singapore General Hospital
| | - Jia Chi Tan
- Single-cell Computational Immunology, Singapore Immunology Network, Singapore
| | - Annie Law
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Lim Hee Goh
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Zhi Yong Poon
- Department of Clinical Translational Research, Singapore General Hospital, and Critical Analytics for Manufacturing Personalized Medicine, SMART, Singapore
| | - Alice Cheung
- Department of Hematology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | | | - Michelle Tan
- Department of Clinical Translational Research, Singapore General Hospital
| | - Shang Li
- Cancer & Stem Cell Biology, Duke-NUS Medical School, Singapore
| | - Alwin Loh
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Anne James
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Tony Lim
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Jinmiao Chen
- Single-cell Computational Immunology, Singapore Immunology Network, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - William Hwang
- Department of Hematology, Singapore General Hospital, and National Cancer Centre Singapore, Singapore
| | - Andrea Low
- Department of Rheumatology and Immunology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Lim T, Campbell R, Jones D, Mullan A, Lichen I, Knier C, Bellamkonda V. 72 Association of Limited English Proficiency and Increased Emergency Department Waiting Room Lengths of Stay. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.095] [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: 11/01/2022]
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Namasivayam V, Koh CJ, Tsao S, Lee J, Ling KL, Khor C, Lim T, Li JW, Oo AM, Yip BCH, Hussain I, Chua TS, Toh BC, Ong HS, Wang LM, So JBY, Teh M, Yeoh KG, Ang TL. Academy of Medicine, Singapore clinical guideline on endoscopic surveillance and management of gastric premalignant lesions. Ann Acad Med Singap 2022; 51:417-435. [PMID: 35906941 DOI: 10.47102/annals-acadmedsg.2021433] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable with early detection and intervention using high-quality endoscopy. Premalignant lesions and gastric epithelial polyps are commonly encountered in clinical practice. Surveillance of patients with premalignant gastric lesions may aid in early diagnosis of GC, and thus improve chances of survival. An expert professional workgroup was formed to summarise the current evidence and provide recommendations on the management of patients with gastric premalignant lesions in Singapore. Twenty-five recommendations were made to address screening and surveillance, strategies for detection and management of gastric premalignant lesions, management of gastric epithelial polyps, and pathological reporting of gastric premalignant lesions.
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Park J, Jee J, Choi W, Lee K, Lim T, Jeon H, Seo J, Yoo J. Tissue Engineering, Embryonic, Organ and Other Tissue Specific Stem Cells: ASSESSMENT OF THE MUCOSAL HEALING EFFECT OF COLON ORGANOID TRANSPLANTATION IN RADIATION COLITIS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00402-9] [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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Park J, Lim T, Jeon H, Song H, Choi W, Lee K. Tissue Engineering, Embryonic, Organ and Other Tissue Specific Stem Cells: ORGANOID AS A REGENERATIVE MEDICINE TO HEAL ULCERS IN A PORCINE MODEL OF RADIATION PROCTITIS AND CONSIDERATION FOR FIRST IN HUMAN TRIALS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00405-4] [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: 11/03/2022]
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Tan B, Yang Y, Lawrence Cheung CC, Goh D, Lau MC, Lim X, Lim J, Nadia Lee LWJ, Tien T, Kalimuddin S, David Tai WM, Low J, Young Ng CC, Leow WQ, Tan TT, Lim T, Liu J, Yeong J. 626 Dissecting the spatial heterogeneity of SARS-CoV-2-infected tumour microenvironment reveals a lymphocyte-dominant immune response in a HBV-associated HCC patient with COVID-19 history. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundWe previously reported the presence of SARS-CoV-2 RNA in the hepatic tissues of recovered patients1 but the spatial immune profile of SARS-CoV-2 infection remains poorly understood. To address this, here we performed deep spatial profiling in tumour-adjacent normal hepatic tissue from a HBV-associated hepatocellular carcinoma (HCC) patient with history of COVID-19.MethodsWe obtained tissue from curative resection of a HCC patient 85 days post-recovery from COVID-19. Spatial immune profiling was performed by multiplex immunohistochemistry (mIHC)2 and more deeply using the Visium spatial transcriptomics platform complemented with signatures derived from single-cell RNA sequencing (scRNA-seq) and published signatures.ResultsSARS-CoV-2 nucleocapsid and spike proteins were detected in a tumour-adjacent normal hepatic section in a spatially-restricted pattern (figure 1A and B) and higher abundance of lymphocytes but not macrophages were observed in regions with virus detection (figure 1C).We employed spatial transcriptomics and scRNA-seq to further characterize the immune microenvironment of SARS-CoV-2 post-infection. Unsupervised clustering and automatic annotation3 of Visium spots revealed that the distribution of SARS-CoV-2 viral proteins partially coincided with a memory T-cell signature (figure 1D). Quantification of Visium transcriptomic spots using an independent transcriptomic signature based on genes differentially upregulated in immune cells in SARS-CoV-2 infection4 (figure 1E) resulted in an enrichment pattern similar to the SARS-CoV-2 protein distribution. Additionally, a signature derived from scRNA-seq of hepatic tumour-infiltrating lymphocytes after ex vivo peptide stimulation using a pool of SARS-CoV-2 peptides showed a strongly associated distribution, in line with a SARS-CoV2-specific immune response5 whereas that from using a pool of HBV peptides resulted in an anti-correlated distribution (figure 1F). These illustrate the ability of spatial transcriptomics to quantify with microenvironment-level resolution the SARS-CoV-2-specific immune response.Recapitulating the mIHC protein data, deconvolution of immune populations6 revealed marked spatial associations between SARS-CoV-2 viral presence and the distributions of lymphocytes but not of macrophages (figure 1G).ConclusionsWe believe this is the first deep profiling report of non-post-mortem samples which adopts a multi-modal approach combining mIHC, spatial transcriptomics, and transcriptomic signatures derived from scRNA-seq to interrogate the in situ immune response to viral infection. Applying this to SARS-CoV-2 infection, we detected tissue spatial heterogeneity in viral presence and an associated lymphocyte-dominant immune response in the COVID-19-recovered patient, in contrast to post-mortem observations of scarce lymphocytes in cases of severe COVID-19.7 Ongoing work including further validation of the findings in local and overseas cohorts and their correlation with patient clinical outcomes.ReferencesCheung CCL, et al. Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19. Gut, p. gutjnl-2021-324280, 2021. doi: 10.1136/gutjnl-2021-324280.Lim JCT, et al. An automated staining protocol for seven-colour immunofluorescence of human tissue sections for diagnostic and prognostic use. Pathology (Phila.) 2018;50(3):333–341. doi: 10.1016/j.pathol.2017.11.087.Shao X, Liao J, Lu X, Xue R, Ai N, Fan X. scCATCH: automatic annotation on cell types of Clusters from Single-Cell RNA Sequencing Data. iScience 2020;23(3):100882, doi: 10.1016/j.isci.2020.100882.Lee JS, et al. Immunophenotyping of COVID-19 and influenza highlights the role of type I interferons in development of severe COVID-19. Sci Immunol 2020;5(49):p.eabd1554. doi: 10.1126/sciimmunol.abd1554.Schub D, et al. High levels of SARS-CoV-2–specific T cells with restricted functionality in severe courses of COVID-19. JCI Insight 2020;5(20):p.e142167. doi: 10.1172/jci.insight.142167.Newman AM, et al. Robust enumeration of cell subsets from tissue expression profiles. Nat Methods 2015;12(5):453–457. doi: 10.1038/nmeth.3337.Wang Y, et al. SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19. J Hepatol 2020;73(4):807–816. doi: 10.1016/j.jhep.2020.05.002.Ethics ApprovalThis study was approved by the SingHealth Centralised Institutional Review Board (reference number: 2019/2653)Abstract 626 Figure 1Spatial heterogeneity of SARS-CoV-2 infection uncovers an association with a dominant lymphocytic response
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Song Y, Lim J, Lim T, Im K, Kim N, Nam Y, Jeon Y, Ko H, Park I, Shin J, Cho S. Human mesenchymal stem cells derived from umbilical cord and bone marrow exert immunomodulatory effects in different mechanisms. Cytotherapy 2021. [DOI: 10.1016/s1465324921003455] [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: 11/25/2022]
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Ibrahim K, Lim T, Mullee MA, Yao GL, Zhu S, Baxter M, Tilley S, Russel C, Roberts HC. 20 Comparison of Six Frailty Screening Tools in Patients Aged 65+ with An Arm Fragility Fracture. Age Ageing 2021. [DOI: 10.1093/ageing/afab028.20] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Frailty is associated with an increased risk of falling and fracture, but not routinely assessed in fracture clinic. Early identification and management of frailty among older people with arm fragility fracture could help avoid further falls and fractures, especially of the hip. We evaluated the feasibility of assessing frailty in a busy fracture clinic.
Methods
People aged 65+ years with an arm fracture in one acute trust were recruited. Frailty was assessed in fracture clinics using six tools: Fried Frailty Phenotype (FFP), FRAIL scale, PRISMA-7, electronic Frailty Index (e-FI), Clinical Frailty Score (CFS), and Study of Osteoporotic Fracture (SOF). The sensitivity and specificity of each tool was compared against FFP as a reference. Participants identified as frail by 2+ tools were referred for Comprehensive Geriatric Assessment (CGA).
Results
100 patients (mean age 75 years±7.2; 20 men) were recruited. Frailty prevalence was 9% (FRAIL scale), 13% (SOF), 14% (CFS > 6), 15% (FFP; e-FI > 0.25), and 25% (PRISMA-7). Men were more likely to be frail than women. Data were complete for all assessments and completion time ranged from one minute (PRISMA-7; CFS) to six minutes for the FFP which required most equipment. Comparing with FFP, the most accurate instrument for stratifying frail from non-frail was the PRISMA-7 (sensitivity = 93%, specificity = 87%) while the remaining tools had good specificity (range 93%–100%) but average sensitivity (range 40%–60%). Twenty patients were eligible for CGA. Five had recently had CGA and 11/15 referred were assessed. CGA led to 3–6 interventions per participant including medication changes, life-style advice, investigations, and onward referrals.
Conclusion
It was feasible to assess frailty in fracture clinic and to identify patients who benefitted from CGA. Frailty prevalence was 9%—25% depending on the tool used and was higher among men. PRISMA-7 could be a practical tool for routine use in fracture clinics.
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Affiliation(s)
- K Ibrahim
- Faculty of Medicine, University of Southampton
- National Institute for Health Research Applied Research Collaboration (NIHR ARC) Wessex
| | - T Lim
- Faculty of Medicine, University of Southampton
| | - M A Mullee
- Faculty of Medicine, University of Southampton
| | - G L Yao
- College of Life Sciences, University of Leicester University
| | - S Zhu
- Faculty of Medicine, University of Southampton
| | - M Baxter
- Medicine for Older People Department, University Hospital Southampton NHS Foundation Trust
| | - S Tilley
- Trauma and Orthopaedic department, University Hospital Southampton NHS Foundation Trust
| | - C Russel
- National Institute for Health Research Applied Research Collaboration (NIHR ARC) Wessex
| | - H C Roberts
- Faculty of Medicine, University of Southampton
- National Institute for Health Research Applied Research Collaboration (NIHR ARC) Wessex
- Medicine for Older People Department, University Hospital Southampton NHS Foundation Trust
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Tan BF, Lim T, Boontiam W. Effect of dietary supplementation with essential oils and a Bacillus probiotic on growth performance, diarrhoea and blood metabolites in weaned pigs. Anim Prod Sci 2021. [DOI: 10.1071/an18752] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Context
Dietary supplementation of essential oils or in combination with a Bacillus probiotic was investigated as an antibiotic growth promoter for weaned pigs.
Aims
To evaluate the effect of essential oils (i.e. thymol and carvacrol mixture) or in combination with a probiotic strain (i.e. Bacillus subtilis PB6) on the growth performance, diarrhoea incidence, ammonia emission and serological profiles of weaned pigs.
Methods
A total of 96 crossbred ([Yorkshire × Landrace] × Duroc) weaned pigs were randomly allotted to one of six treatments based on sex and initial bodyweight. Each group was distributed into four replicates with four pigs each according to a randomised complete block design. The treatments were: (i) positive control, basal diet supplemented with colistin 150 g/tonne and amoxicillin 200 g/tonne; (ii) negative control, basal diet without supplementation; (iii) T3, basal diet supplemented with essential oils 300 g/tonne; (iv) T4, basal diet supplemented with essential oils 600 g/tonne; (v) T5, basal diet supplemented with essential oils 1000 g/tonne; and (vi) T6, basal diet supplemented with essential oils 300 g/tonne diet and Bacillus probiotics 1000 g/tonne.
Key results
The piglets fed with supplements had a significantly higher average daily gain and lower incidence of diarrhoea than the piglets in the negative control (P = 0.001). Feeding the essential oils alone or in combination with probiotics significantly reduced faecal ammonia emission (P = 0.027) and blood urea nitrogen (P = 0.039), while markedly increasing the serum immunoglobulin G concentration of weaned pigs compared with the negative control treatment (P = 0.014). The difference in time of blood collection had significant effects on blood urea nitrogen and immunoglobulins (P = 0.001). However, no significant differences emerged in average daily feed intake, gain: feed ratio, feed efficiency and antibody against swine fever among the treatments.
Conclusions
Diet supplementation with essential oils or in combination with probiotics improved growth performance and immunity, and lowered ammonia emissions and diarrhoea incidence of weaned pigs.
Implications
These findings provide a basis for the application of phytogenic compounds and probiotics as antibiotic growth promoter alternatives in post-weaning diets for pigs.
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Asokkumar R, Tay G, Mohan BP, Lim T. "Snow-white" small bowel: What could this be? (with video). Gastrointest Endosc 2019; 90:990-991. [PMID: 31323231 DOI: 10.1016/j.gie.2019.07.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/12/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Ravishankar Asokkumar
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Gary Tay
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Babu Pappu Mohan
- Druid City Hospital Health Systems, University of Alabama, Tuscaloosa, Alabama, USA
| | - Tony Lim
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
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Suarez MA, Lim T, Robillot L, Maillot V, Lihoreau T, Bontemps P, Pazart L, Grosjean T. Miniaturized fiber dosimeter of medical ionizing radiations on a narrow optical fiber. Opt Express 2019; 27:35588-35599. [PMID: 31878728 DOI: 10.1364/oe.27.035588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023]
Abstract
Fiber dosimeters have recently drawn much interest for measuring in vivo and in real time the dose of medical radiations. This paper presents the first miniaturized fiber dosimeter integrated at the end of a narrow 125 μm outer diameter optical fiber. Miniaturization is rendered possible by exploiting the concept of a leaky wave optical antenna for interfacing the scintillators and the fiber and by taking advantage of the low propagation loss of narrow silica fibers and high detection yield of single-pixel photon counters. Upon irradiation at 6 MV in air, our fiber probe leads to a linear detection response with a signal-to-noise ratio as high as 195. Although implemented with inorganic scintillators and fiber, our miniaturized fiber probe induces minimum screening effects on ionizing radiations over a negligible area (0.153 mm2). Our nano-optically driven approach may thus result in ultra-compact fiber dosimeters of negligible footprint in the radiotherapeutic processes, even with non-water equivalent fibers and scintillators. This opens new opportunities for a large panel of therapies relying on ionizing radiations (photons or charged particles).
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Asokkumar R, Yung Ka C, Loh T, Kah Ling L, Gek San T, Ying H, Tan D, Khor C, Lim T, Soetikno R. Comparison of tissue and molecular yield between fine-needle biopsy (FNB) and fine-needle aspiration (FNA): a randomized study. Endosc Int Open 2019; 7:E955-E963. [PMID: 31367675 PMCID: PMC6656554 DOI: 10.1055/a-0903-2565] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/18/2019] [Indexed: 12/11/2022] Open
Abstract
Background and study aims Recently, a new Franseen design endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle was developed with the goal of providing more tissue for histology. We compared the tissue adequacy rate and nucleic acid yield of 22G EUS-FNB vs. 22G endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), in solid gastrointestinal and extra-intestinal lesions. Patients and methods We conducted a randomized crossover study and recruited 36 patients. We performed three passes for pancreatic lesions and two passes for other lesions, using each needle. We blinded the pathologist to needle assignment. We assessed the diagnostic tissue adequacy rate and compared the total tissue area, diagnostic tissue area, and desmoplastic stroma (DS) area in cases of carcinoma. We also examined the nucleic acid yield of the two needles in pancreatic lesions. Results The lesions included 20 pancreatic masses (55 %), six gastric subepithelial lesions (17 %), five lymph nodes (14 %) and five other abdominal masses (14 %). Mean ± SD lesion size was 3.8 ± 2.0 cm. The final diagnosis was malignant in 27 lesions (75 %) and benign in nine lesions (25 %). We found EUS-FNB procured significantly more median total tissue area (5.2 mm 2 vs. 1.9 mm 2 , P < 0.001), diagnostic tissue area (2.2 mm 2 vs. 0.9 mm 2 , P = 0.029), and DS area (2 mm 2 vs. 0.1 mm 2 , P = 0.001) in lesions diagnosed as carcinoma (n = 23), as compared to EUS-FNA. In pancreatic lesions, EUS-FNB obtained significantly more nucleic acid than EUS-FNA (median; 4,085 ng vs. 2912 ng, P = 0.02). There was no difference in the cellblock or rapid on-site cytological evaluation (ROSE) diagnostic yield between the needles. Conclusion The 22G EUS-FNB provides more histological core tissue and adequate nucleic acid yield compared to 22G EUS-FNA. In this study, the diagnostic performance was similar between the needles.
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Affiliation(s)
- Ravishankar Asokkumar
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Chin Yung Ka
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Tracy Loh
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Lim Kah Ling
- Department of Molecular Pathology, Translational Pathology Center, Singapore General Hospital, Singapore
| | - Tan Gek San
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Hao Ying
- Health Service Research Unit, Singapore General Hospital, Singapore
| | - Damien Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Christopher Khor
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Tony Lim
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Roy Soetikno
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore,Duke-NUS Graduate Medical School, Singapore,Corresponding author Roy Soetikno, MD, MS, MSM Department of Gastroenterology and HepatologyThe Academia20, College RoadSingapore-16960862273623
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Affiliation(s)
- F McGain
- Footscray, Melbourne, Victoria, Australia
| | - D Story
- Footscray, Melbourne, Victoria, Australia
| | - T Lim
- Footscray, Melbourne, Victoria, Australia
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15
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Kim W, Hur M, Park SK, Yoo S, Lim T, Yoon H, Kim JT, Bahk JH. Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis. Int J Obstet Anesth 2019; 37:5-15. [DOI: 10.1016/j.ijoa.2018.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/12/2018] [Accepted: 09/21/2018] [Indexed: 12/18/2022]
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16
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Croker J, Mincham S, Harper C, Chee R, Ng E, Lim T. EP-1378: Stereotactic body radiotherapy in an Australia centre for biopsy proven non-small cell lung cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31687-6] [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: 10/14/2022]
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17
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Croker J, Ariyapperuma M, Sharma S, Mukhedkar S, Lam W, Lim T. EP-1392: Trimodality treatment of Stage III non-small cell lung cancer in Western Australia. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31701-8] [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: 10/14/2022]
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18
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Showen R, Dunson C, Woodman GH, Christopher S, Lim T, Wilson SC. Locating fish bomb blasts in real-time using a networked acoustic system. Mar Pollut Bull 2018; 128:496-507. [PMID: 29571401 DOI: 10.1016/j.marpolbul.2018.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/13/2018] [Accepted: 01/15/2018] [Indexed: 06/08/2023]
Abstract
Results are presented of a demonstration of real-time fish blast location in Sabah, Malaysia using a networked hydroacoustic array based on the ShotSpotter gunshot location system. A total of six acoustic sensors - some fixed and others mobile - were deployed at ranges from 1 to 9 km to detect signals from controlled test blasts. This allowed the blast locations to be determined to within 60 m accuracy, and for the calculated locations to be displayed on a map on designated internet-connected computers within 10 s. A smaller three-sensor system was then installed near Semporna in Eastern Sabah that determined the locations of uncontrolled blasts set off by local fishermen. The success of these demonstrations shows that existing technology can be used to protect reefs and permit more effective management of blast fishing activity through improved detection and enforcement measures and enhanced community engagement.
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Affiliation(s)
- R Showen
- ShotSpotter Inc., Suite 210, 7979 Gateway Blvd, Newark, CA 94560, USA.
| | - C Dunson
- ShotSpotter Inc., Suite 210, 7979 Gateway Blvd, Newark, CA 94560, USA
| | - G H Woodman
- Teng Hoi Conservation Organization, Room 1906, 19/F, China Insurance Group Building, 141 Des Voeux Road, Central, Hong Kong
| | - S Christopher
- Scubazoo Images Sdn. Bhd., 3, Jalan Nosoob Hungab, 88300 Kota Kinabalu, Sabah, Malaysia
| | - T Lim
- Scubazoo Images Sdn. Bhd., 3, Jalan Nosoob Hungab, 88300 Kota Kinabalu, Sabah, Malaysia
| | - S C Wilson
- Five Oceans Environmental Services LLC, P.O. Box 660, Postal Code 131, Hamriyah, Oman
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19
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Nakamura H, Lim T, Puri P. Inflammatory bowel disease in patients with Hirschsprung's disease: a systematic review and meta-analysis. Pediatr Surg Int 2018; 34:149-154. [PMID: 28983688 DOI: 10.1007/s00383-017-4182-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 12/21/2022]
Abstract
AIM AND OBJECTIVES Hirschsprung-associated enterocolitis (HAEC) continues to be an important cause of morbidity in patients with Hirschsprung's disease (HSCR). HAEC can occur at any time during the course of the disease. The reported incidence of HAEC before surgery ranges from 6 to 50%, and after surgery, it ranges from 2 to 35%. HAEC and inflammatory bowel disease (IBD) have similar clinical presentation including diarrhea, hematochezia, and abdominal pain. In recent years, isolated cases of IBD have been reported in patients who had surgical treatment for HSCR. The exact pathogenesis of HAEC or IBD is not known. However, both conditions are characterized by an abnormal intestinal mucosal barrier function, which may be a common pathway. The purpose of this meta-analysis was to determine the clinical presentation and outcome in patients with HSCR who developed IBD after pull-through operation. MATERIALS AND METHODS A systematic literature search for relevant articles was performed in four databases using the combinations of the following terms "inflammatory bowel disease", "Crohn/Crohn's disease", "ulcerative colitis", and "Hirschsprung disease/Hirschsprung's disease" for studies published between 1990 and 2017. The relevant cohorts of HSCR associated with IBD were systematically searched for clinical presentation and outcomes. RESULTS 14 studies met defined inclusion criteria, reporting a total of 66 patients who had HSCR associated with IBD. Mean age at first operation for HSCR was 5.8 months, mean age at diagnosis of IBD was 7.7 years, and the majority of patients were male (73%). The extent of aganglionosis was total colonic aganglionosis in 41% of patients, long segment in 45%, and rectosigmoid in 14%. The majority of patients underwent a Duhamel procedure (84%) for HSCR. The distribution of IBD was Crohn's disease in 72.3% of patients, ulcerative colitis in 16.9%, and others in 10.8%. Eight articles (47 patients) reported about HAEC, and 22 patients (47%) had experienced HAEC after surgery for HSCR. CONCLUSION Male patients with extensive colonic aganglionosis who continue to suffer from postoperative HAEC after a Duhamel procedure are more susceptible to develop IBD. Recognition of IBD may be important in the long-term follow-up of HSCR patients who have had postoperative HAEC.
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Affiliation(s)
- H Nakamura
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland
| | - T Lim
- Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA
| | - P Puri
- National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland. .,School of Medicine and Medical Science and Conway Institute of Biomolecular and Biomedical Research University College Dublin, Dublin, Ireland.
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20
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Lim T, Ico G, Jung K, Bozhilov KN, Nam J, Martinez-Morales AA. Crystal growth and piezoelectric characterization of mechanically stable ZnO nanostructure arrays. CrystEngComm 2018. [DOI: 10.1039/c8ce00799c] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The highest piezoelectric performance of ZnO can be achieved by utilizing the piezoelectric operation along the c-axis due to its anisotropic permanent dipole moment.
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Affiliation(s)
- T. Lim
- College of Engineering – Center for Environmental Research and Technology
- University of California – Riverside
- Riverside
- USA
| | - G. Ico
- Department of Bioengineering
- University of California – Riverside
- Riverside
- USA
| | - K. Jung
- College of Engineering – Center for Environmental Research and Technology
- University of California – Riverside
- Riverside
- USA
- Department of Chemical and Environmental Engineering
| | - K. N. Bozhilov
- Central Facility for Advanced Microscopy and Microanalysis
- University of California – Riverside
- Riverside
- USA
| | - J. Nam
- Department of Bioengineering
- University of California – Riverside
- Riverside
- USA
| | - A. A. Martinez-Morales
- College of Engineering – Center for Environmental Research and Technology
- University of California – Riverside
- Riverside
- USA
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21
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Ler LD, Ghosh S, Chai X, Thike AA, Heng HL, Siew EY, Dey S, Koh LK, Lim JQ, Lim WK, Myint SS, Loh JL, Ong P, Sam XX, Huang D, Lim T, Tan PH, Nagarajan S, Cheng CWS, Ho H, Ng LG, Yuen J, Lin PH, Chuang CK, Chang YH, Weng WH, Rozen SG, Tan P, Creasy CL, Pang ST, McCabe MT, Poon SL, Teh BT. Loss of tumor suppressor KDM6A amplifies PRC2-regulated transcriptional repression in bladder cancer and can be targeted through inhibition of EZH2. Sci Transl Med 2017; 9:9/378/eaai8312. [PMID: 28228601 DOI: 10.1126/scitranslmed.aai8312] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 02/02/2017] [Indexed: 12/12/2022]
Abstract
Trithorax-like group complex containing KDM6A acts antagonistically to Polycomb-repressive complex 2 (PRC2) containing EZH2 in maintaining the dynamics of the repression and activation of gene expression through H3K27 methylation. In urothelial bladder carcinoma, KDM6A (a H3K27 demethylase) is frequently mutated, but its functional consequences and therapeutic targetability remain unknown. About 70% of KDM6A mutations resulted in a total loss of expression and a consequent loss of demethylase function in this cancer type. Further transcriptome analysis found multiple deregulated pathways, especially PRC2/EZH2, in KDM6A-mutated urothelial bladder carcinoma. Chromatin immunoprecipitation sequencing analysis revealed enrichment of H3K27me3 at specific loci in KDM6A-null cells, including PRC2/EZH2 and their downstream targets. Consequently, we targeted EZH2 (an H3K27 methylase) and demonstrated that KDM6A-null urothelial bladder carcinoma cell lines were sensitive to EZH2 inhibition. Loss- and gain-of-function assays confirmed that cells with loss of KDM6A are vulnerable to EZH2. IGFBP3, a direct KDM6A/EZH2/H3K27me3 target, was up-regulated by EZH2 inhibition and contributed to the observed EZH2-dependent growth suppression in KDM6A-null cell lines. EZH2 inhibition delayed tumor onset in KDM6A-null cells and caused regression of KDM6A-null bladder tumors in both patient-derived and cell line xenograft models. In summary, our study demonstrates that inactivating mutations of KDM6A, which are common in urothelial bladder carcinoma, are potentially targetable by inhibiting EZH2.
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Affiliation(s)
- Lian Dee Ler
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.,NUS Graduate School for Integrative Sciences and Engineering, 28 Medical Drive, Singapore 117456, Singapore
| | - Sujoy Ghosh
- Program in Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore 169857, Singapore.,Centre for Computational Biology, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Xiaoran Chai
- Centre for Computational Biology, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Aye Aye Thike
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Hong Lee Heng
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Ee Yan Siew
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Sucharita Dey
- Cancer Science Institute of Singapore, National University of Singapore, Centre for Life Sciences, Singapore 117456, Singapore
| | - Liang Kai Koh
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Jing Quan Lim
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Weng Khong Lim
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Swe Swe Myint
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Jia Liang Loh
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Pauline Ong
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Xin Xiu Sam
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Dachuan Huang
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Tony Lim
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Puay Hoon Tan
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Sanjanaa Nagarajan
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore.,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | | | - Henry Ho
- Department of Urology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore
| | - Lay Guat Ng
- Department of Urology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore
| | - John Yuen
- Department of Urology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore
| | - Po-Hung Lin
- Division of Urooncology, Department of Urology, Chang Gung University and Memorial Hospital at LinKou, TaoYuan, Taiwan
| | - Cheng-Keng Chuang
- Division of Urooncology, Department of Urology, Chang Gung University and Memorial Hospital at LinKou, TaoYuan, Taiwan
| | - Ying-Hsu Chang
- Division of Urooncology, Department of Urology, Chang Gung University and Memorial Hospital at LinKou, TaoYuan, Taiwan
| | - Wen-Hui Weng
- Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Steven G Rozen
- Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.,Centre for Computational Biology, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Patrick Tan
- Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Centre for Life Sciences, Singapore 117456, Singapore.,Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore 169610, Singapore.,Genome Institute of Singapore, 60 Biopolis Street Genome, Singapore 138672, Singapore
| | - Caretha L Creasy
- Cancer Epigenetics Discovery Performance Unit, Oncology R&D, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, PA 19426, USA
| | - See-Tong Pang
- Division of Urooncology, Department of Urology, Chang Gung University and Memorial Hospital at LinKou, TaoYuan, Taiwan.
| | - Michael T McCabe
- Cancer Epigenetics Discovery Performance Unit, Oncology R&D, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, PA 19426, USA.
| | - Song Ling Poon
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore. .,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Bin Tean Teh
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore. .,Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Centre for Life Sciences, Singapore 117456, Singapore.,Institute of Molecular and Cell Biology, 61 Biopolis Drive, Proteos, #07-18, Singapore 138673, Singapore
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22
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Lai G, Nahar R, Lim T, Kwang X, Liew P, Lim J, Aung Z, Takano A, Lim W, Lau D, Tan W, Ang M, Toh C, Tan B, Devanand A, Too C, Gogna A, Ong B, Koh T, Kanesvaran R, Ng Q, Jain A, Yuan J, Lim T, Lim A, Hillmer A, Zhai W, Iyer G, Tan E, Tam W, Tan D. OA 09.07 Clonality of c-MET Copy Number Gain as a Determinant of Primary TKI Resistance in EGFR-Mutant NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.380] [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: 10/18/2022]
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23
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Ahn Y, Jeong TS, Lim T, Jeon JY. Grading system for migrated lumbar disc herniation on sagittal magnetic resonance imaging: an agreement study. Neuroradiology 2017; 60:101-107. [PMID: 29085963 DOI: 10.1007/s00234-017-1943-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 06/14/2017] [Accepted: 10/18/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Migrated lumbar disc herniations (LDHs) in the sagittal plane are common. Disc migration grading can be applied as a useful measurement tool in the diagnosis, treatment, and outcome evaluation of migrated LDH. No study has evaluated the reliability of migrated LDH grading. We evaluated the reliability and functionality of the current magnetic resonance imaging (MRI) grading system for migrated LDH. METHODS We assessed a six-level grading system developed based on sagittal MRI and graded according to the direction (rostral and caudal) and degree (low, high, and very high) of disc migration. One-hundred and one migrated LDHs treated with minimally invasive endoscopic discectomy were analyzed independently by two experienced radiologists. Intraobserver and interobserver agreements were assessed by kappa statistics. RESULTS The most common migrated LDH grade was grade 4 (30.94%; caudal, low-grade migration). Rostral and caudal migrations were more common in the upper and lower lumbar levels, respectively. Interobserver agreement in the grading of migrated LDH was good at both the first (kappa = 0.737) and second assessment (kappa = 0.657). The intraobserver agreement for reader 1 was very good (kappa = 0.827) and for reader 2 was good (kappa = 0.620). CONCLUSIONS The current grading system for migrated LDH was found to be reliable and functional with good interobserver and intraobserver agreement. It may be useful in the interpretation of disc migration patterns and outcomes of various minimally invasive surgical procedures.
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Affiliation(s)
- Y Ahn
- Department of Neurosurgery, Gachon University Gil Medical Center, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea (South Korea).
| | - T S Jeong
- Department of Neurosurgery, Gachon University Gil Medical Center, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea (South Korea)
| | - T Lim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, South Korea
| | - J Y Jeon
- Department of Radiology, Gachon University Gil Medical Center, Incheon, South Korea
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24
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McGain F, Story D, Lim T, McAlister S. Financial and environmental costs of reusable and single-use anaesthetic equipment. Br J Anaesth 2017; 118:862-869. [PMID: 28505289 DOI: 10.1093/bja/aex098] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND. An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits. METHODS. We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use variants. The primary environmental costs were CO 2 emissions (in CO 2 equivalents) and water use (in litres). We compared energy source mixes between Australia, the UK/Europe, and the USA. RESULTS. For an Australian hospital with six operating rooms, the annual financial cost of converting from single-use equipment to reusable anaesthetic equipment would be an AUD$32 033 (£19 220), 46% decrease. In Australia, converting from single-use to reusable equipment would result in an increase of CO 2 emissions from 5095 (95% CI: 4614-5658) to 5575 kg CO 2 eq (95% CI: 5542-5608), a 480 kg CO 2 eq (9%) increase. Using the UK/European power mix, converting from single-use (5575 kg CO 2 eq) to reusable anaesthetic equipment (802 kg CO 2 eq) would result in an 84% reduction (4873 kg CO 2 eq) in CO 2 emissions, whilst in the USA converting to reusables would have led to a 2427 kg CO 2 eq (48%) reduction. In Australia, converting from single-use to reusable equipment would more than double water use from 34.4 to 90.6 kilolitres. CONCLUSIONS. For an Australian hospital with six operating rooms, converting from single-use to reusable anaesthetic equipment saved more than AUD$30 000 (£18 000) per annum, but increased the CO 2 emissions by almost 10%. The CO 2 offset is highly dependent on the power source mix, while water consumption is greater for reusable equipment.
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Affiliation(s)
- F McGain
- Department of Anaesthesia.,Department of Intensive Care, Western Health, Gordon Street, Footscray, VIC 3011, Australia
| | - D Story
- Department of Anaesthesia, Austin Hospital, Banksia Street, Heidelberg, VIC 3084, Australia
| | - T Lim
- Department of Anaesthesia
| | - S McAlister
- Ecoquantum Consulting Suite 43A Crisp Avenue, Brunswick, VIC 3056, Australia
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25
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See P, Dutertre CA, Chen J, Günther P, McGovern N, Irac SE, Gunawan M, Beyer M, Händler K, Duan K, Sumatoh HRB, Ruffin N, Jouve M, Gea-Mallorquí E, Hennekam RCM, Lim T, Yip CC, Wen M, Malleret B, Low I, Shadan NB, Fen CFS, Tay A, Lum J, Zolezzi F, Larbi A, Poidinger M, Chan JKY, Chen Q, Rénia L, Haniffa M, Benaroch P, Schlitzer A, Schultze JL, Newell EW, Ginhoux F. Mapping the human DC lineage through the integration of high-dimensional techniques. Science 2017; 356:science.aag3009. [PMID: 28473638 DOI: 10.1126/science.aag3009] [Citation(s) in RCA: 364] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 04/25/2017] [Indexed: 12/16/2022]
Abstract
Dendritic cells (DC) are professional antigen-presenting cells that orchestrate immune responses. The human DC population comprises two main functionally specialized lineages, whose origins and differentiation pathways remain incompletely defined. Here, we combine two high-dimensional technologies-single-cell messenger RNA sequencing (scmRNAseq) and cytometry by time-of-flight (CyTOF)-to identify human blood CD123+CD33+CD45RA+ DC precursors (pre-DC). Pre-DC share surface markers with plasmacytoid DC (pDC) but have distinct functional properties that were previously attributed to pDC. Tracing the differentiation of DC from the bone marrow to the peripheral blood revealed that the pre-DC compartment contains distinct lineage-committed subpopulations, including one early uncommitted CD123high pre-DC subset and two CD45RA+CD123low lineage-committed subsets exhibiting functional differences. The discovery of multiple committed pre-DC populations opens promising new avenues for the therapeutic exploitation of DC subset-specific targeting.
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Affiliation(s)
- Peter See
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Charles-Antoine Dutertre
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore.,Program in Emerging Infectious Disease, Duke-NUS Medical School, 8 College Road, 169857 Singapore
| | - Jinmiao Chen
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Patrick Günther
- Genomics and Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, 32115 Bonn, Germany
| | - Naomi McGovern
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Sergio Erdal Irac
- Program in Emerging Infectious Disease, Duke-NUS Medical School, 8 College Road, 169857 Singapore
| | - Merry Gunawan
- Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - Marc Beyer
- Genomics and Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, 32115 Bonn, Germany.,Platform for Single Cell Genomics and Epigenomics at the German Center for Neurodegenerative Diseases and the University of Bonn, 53175 Bonn, Germany
| | - Kristian Händler
- Genomics and Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, 32115 Bonn, Germany
| | - Kaibo Duan
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Hermi Rizal Bin Sumatoh
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Nicolas Ruffin
- Institut Curie, Paris Sciences et Lettres (PSL) Research University, INSERM U 932, F-75005, Paris, France
| | - Mabel Jouve
- Institut Curie, Paris Sciences et Lettres (PSL) Research University, INSERM U 932, F-75005, Paris, France
| | - Ester Gea-Mallorquí
- Institut Curie, Paris Sciences et Lettres (PSL) Research University, INSERM U 932, F-75005, Paris, France
| | - Raoul C M Hennekam
- Department of Pediatrics, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Tony Lim
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Chan Chung Yip
- Department of Health Promotion Board (HPB) and Transplant Surgery, Singapore General Hospital, Singapore
| | - Ming Wen
- Program in Emerging Infectious Disease, Duke-NUS Medical School, 8 College Road, 169857 Singapore
| | - Benoit Malleret
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ivy Low
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Nurhidaya Binte Shadan
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Charlene Foong Shu Fen
- Singapore Health Services Flow Cytometry Core Platform, 20 College Road, The Academia, Discovery Tower Level 10, Singapore 169856, Singapore
| | - Alicia Tay
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Josephine Lum
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Francesca Zolezzi
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Anis Larbi
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Michael Poidinger
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Jerry K Y Chan
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore.,Department of Reproductive Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.,Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore.,Experimental Fetal Medicine Group, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qingfeng Chen
- Humanized Mouse Unit, Institute of Molecular and Cell Biology (IMCB), A*STAR, Singapore
| | - Laurent Rénia
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Muzlifah Haniffa
- Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - Philippe Benaroch
- Institut Curie, Paris Sciences et Lettres (PSL) Research University, INSERM U 932, F-75005, Paris, France
| | - Andreas Schlitzer
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore.,Myeloid Cell Biology, Life and Medical Sciences (LIMES) Institute, University of Bonn, 53115 Bonn, Germany
| | - Joachim L Schultze
- Genomics and Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, 32115 Bonn, Germany.,Platform for Single Cell Genomics and Epigenomics at the German Center for Neurodegenerative Diseases and the University of Bonn, 53175 Bonn, Germany
| | - Evan W Newell
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore
| | - Florent Ginhoux
- Singapore Immunology Network (SIgN), A*STAR, 8A Biomedical Grove, Immunos Building, Level 4, Singapore 138648, Singapore.
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Teng R, Takano A, Tan WL, Ang MK, Toh CK, Ng QS, Lim WT, Tan EH, Lim T, Tan D. T790M co-exists with other secondary resistance mechanisms in EGFR mutation positive NSCLC and are associated with inferior outcomes. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.051] [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: 11/14/2022] Open
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Wang SR, Malik S, Tan IB, Chan YS, Hoi Q, Ow JL, He CZ, Ching CE, Poh DYS, Seah HM, Cheung KHT, Perumal D, Devasia AG, Pan L, Ang S, Lee SE, Ten R, Chua C, Tan DSW, Qu JZZ, Bylstra YM, Lim L, Lezhava A, Ng PC, Wong CW, Lim T, Tan P. Technical Validation of a Next-Generation Sequencing Assay for Detecting Actionable Mutations in Patients with Gastrointestinal Cancer. J Mol Diagn 2016; 18:416-424. [PMID: 26970585 DOI: 10.1016/j.jmoldx.2016.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/02/2015] [Accepted: 01/08/2016] [Indexed: 02/06/2023] Open
Abstract
Targeted next-generation sequencing is becoming increasingly common as a clinical diagnostic and prognostic test for patient- and tumor-specific genetic profiles as well as to optimally select targeted therapies. Here, we describe a custom-developed, next-generation sequencing test for detecting single-nucleotide variants (SNVs) and short insertions and deletions (indels) in 93 genes related to gastrointestinal cancer from routine formalin-fixed, paraffin-embedded clinical specimens. We implemented a validation strategy, based on the College of American Pathologists requirements, using reference DNA mixtures from cell lines with known genetic variants, which model a broad range of allele frequencies. Test sensitivity achieved >99% for both SNVs and indels, with allele frequencies >10%, with high specificity (97.4% for SNVs and 93.6% for indels). We further confirmed test accuracies using primary formalin-fixed, paraffin-embedded colorectal cancer specimens characterized by alternative and conventional clinical diagnostic technologies. Robust performance was observed on the formalin-fixed, paraffin-embedded specimens: sensitivity was 97.2% and specificity was 99.2%. We also observed high intrarun and inter-run reproducibility, as well as a low cross-contamination rate. Overall assessment using cell line samples and formalin-fixed, paraffin-embedded samples showed that our custom next-generation sequencing assay has consistent detection sensitivity down to 10% variant frequency.
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Affiliation(s)
| | - Simeen Malik
- Cancer & Stem Cell Biology Program, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Iain B Tan
- Genome Institute of Singapore, Singapore; Cancer & Stem Cell Biology Program, Duke-National University of Singapore Graduate Medical School, Singapore; Department of Medical Oncology, National Cancer Centre Singapore, Singapore; Graduate School of Integrative Sciences and Engineering, National University of Singapore, Singapore
| | | | | | - Jack L Ow
- Genome Institute of Singapore, Singapore
| | | | | | | | | | | | | | | | - Lu Pan
- Genome Institute of Singapore, Singapore
| | - Shimin Ang
- Genome Institute of Singapore, Singapore
| | | | - Rachel Ten
- Department of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Clarinda Chua
- Department of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Daniel S W Tan
- Genome Institute of Singapore, Singapore; Department of Medical Oncology, National Cancer Centre Singapore, Singapore; Division of Medical Sciences, National Cancer Centre Singapore, Singapore
| | | | - Yasmin M Bylstra
- Genome Institute of Singapore, Singapore; Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Lionel Lim
- Genome Institute of Singapore, Singapore
| | | | | | | | - Tony Lim
- Genome Institute of Singapore, Singapore; Department of Pathology, Singapore General Hospital, Singapore, Singapore.
| | - Patrick Tan
- Genome Institute of Singapore, Singapore; Cancer & Stem Cell Biology Program, Duke-National University of Singapore Graduate Medical School, Singapore; Cancer Science Institute Singapore, National University of Singapore, Singapore; Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore.
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Lim T, Jani A, Cooper S, Rossi P. Better Toxicity Outcomes With HDR and LDR Brachytherapy in Comparison With External Beam Radiation Therapy for Prostate Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lim T, Wang J, Frank S, Stafford R, Bruno T, Bathala T, Mahmood U, Pugh T, Ibbott G, Kudchadker R. SU-E-J-214: MR Protocol Development to Visualize Sirius MRI Markers in Prostate Brachytherapy Patients for MR-Based Post-Implant Dosimetry. Med Phys 2015. [DOI: 10.1118/1.4924300] [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: 11/07/2022] Open
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Ee S, Young S, Tan E, Lim D, Tan G, Jain A, Zeng W, Lim T, Takano A, Tan D. Clinical Characteristics and Response to EGFR TKI in Never Smoker Squamous Lung Cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv050.20] [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: 11/14/2022] Open
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Nalliah C, Lim T, Qian P, Bhaskaran A, Kurup R, Kizana E, Kovoor P, Ross D, Thomas S. Left atrial surface area remaining not isolated after ablation of persistent atrial fibrillation predicts long-term outcomes. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.307] [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: 11/15/2022]
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Lim T, Prabhu R, Switchenko J, Mister D, Torres M. Skin Sparing Mastectomy and Immediate Reconstruction in Locally Advanced Breast Cancer Patients Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation Therapy: Long-Term Oncologic and Patient-Reported Quality of Life Outcomes. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.677] [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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33
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Lim T, Kim T. Locally advanced or metastatic pancreatic cancer in elderly patients: Chemotherapy versus best supportive care. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.06.025] [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: 11/28/2022]
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34
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Lim T, Wang J, Kudchadker R, Stafford R, Bathala T, Pugh T, Ibbott G, Frank S. SU-C-17A-02: Sirius MRI Markers for Prostate Post-Implant Assessment: MR Protocol Development. Med Phys 2014. [DOI: 10.1118/1.4889729] [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: 11/07/2022] Open
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Abstract
BACKGROUND Asthma is becoming more prevalent with large numbers of individuals suffering from work-exacerbated asthma. AIMS To examine the characteristics of workplace exposures and working days lost in relation to work-exacerbated asthma (WEA) in a workers' compensation population. METHODS An analysis of accepted workers' compensation asthma claims in Ontario over a 5-year period. Claims among the top three industry groups were categorized based on working time lost of 1 day or less, 2-5 days and 6 days or more. Attributable agents were subdivided into dusts, smoke, chemicals and sensitizers. RESULTS Among the asthma claims, 72% (645) fulfilled criteria for WEA from their history. The commonest industry groups were services, education and health care, with 270 claims that met our analysis requirements. Within these industry groups, education had a lower proportion of workers with short exacerbations (missing 1 day or less: 27%) while the health care industry had a higher than expected proportion of short exacerbations (55%). The agents to which WEA was attributed differed across the groups, with dusts having the highest proportion in the education group (65%), smoke in the service industry (34%) and sensitizers in health care (41%). Those agents more commonly attributed to exacerbations tended to have lower rates of prolonged exacerbation compared with less commonly involved agents. CONCLUSIONS The morbidity of WEA and the type of agents to which it was attributed varied between industry groups.
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Affiliation(s)
- T Lim
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada M5T 2S8
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van Grieken NCT, Aoyama T, Chambers PA, Bottomley D, Ward LC, Inam I, Buffart TE, Das K, Lim T, Pang B, Zhang SL, Tan IB, Carvalho B, Heideman DAM, Miyagi Y, Kameda Y, Arai T, Meijer GA, Tsuburaya A, Tan P, Yoshikawa T, Grabsch HI. Erratum: KRAS and BRAF mutations are rare and related to DNA mismatch repair deficiency in gastric cancer from the East and the West: Results from a large international multicentre study. Br J Cancer 2014. [PMCID: PMC3899782 DOI: 10.1038/bjc.2013.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Nalliah C, Lim T, Koay C, Chik W, Thelander J, Zecchin R, Ross D, Thomas S. Characterisation of Symptoms in Patients With Recurrent Atrial Arrhythmia Following Catheter Ablation. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.254] [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: 10/26/2022]
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Abstract
The building industry has in recent years seen huge costs incurreddue to disputes arising on notice requirement clauses. Theseclaims could have been averted if the parties had been diligent inproviding the necessary notices. This article sets out to explorethe law briefl y as interpreted by the courts in common law andequity and discuss the possibility of defence under the principle ofpromissory estoppel. More importantly it also shares the author’sview on how such pitfalls could have been prevented by givingthe proper notices within the timeline required by the contractconditions. It cannot be emphasised enough that contractorswould be wise to comply strictly with the notice provisions in thecontract instead of relying on the estoppel principle or waiver orunconscionability to save their day. Notice clauses essentiallyrequire a competent contracts administrator to follow the time lineprovided in the contract conditions and would be most effective ifthe project team worked closely with the contracts administratorto ensure that proper notices are given when directions orinstructions are received. Although it is common to see noticeclauses which make it a condition precedent for a contractor to beentitled to claim for an extension of time or loss and expense claimbeing interpreted restrictively, in any litigation or arbitration it isalways diffi cult to predict how the courts or tribunal would be willingto uphold such notice clause. It is therefore in the interest of theparties that notice clauses should be properly observed. Suffi ceto say, failure to comply with a notice clause and time bar may befatal to a claim.
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Eisenstein A, Leung L, Lim T, Ning Z, Polanyi JC. Reaction dynamics at a metal surface; halogenation of Cu(110). Faraday Discuss 2012; 157:337-53; discussion 375-98. [DOI: 10.1039/c2fd20023f] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kang H, Cho Y, Choi H, Kang B, Lim T. 355 Comparison of Usefulness Between Linear Probe and Microconvex Probe in Ultrasound-Guided Central Venous Catheterization. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.387] [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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Mánuel JM, Morales FM, Lozano JG, García R, Lim T, Kirste L, Aidam R, Ambacher O. Growth and characterization of InAlN layers nearly lattice-matched to GaN. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/pssc.201000985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Park S, Ahn HK, Lim T, Park YH, Ahn JS, Im Y. CA 15-3 elevations according to breast cancer subtypes at initial diagnosis of metastatic breast cancer (MBC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11109] [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: 11/20/2022] Open
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Poh BK, Mancer K, Goh D, Lim T, Ng V, Ng KK, Ng FC. PlasmaKinetic™ (bipolar) transurethral resection of prostate: a prospective trial to study pathological artefacts, surgical parameters and clinical outcomes. Singapore Med J 2011; 52:336-339. [PMID: 21633766] [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
INTRODUCTION The aims of the study were to compare the degree of cautery artefacts in prostatic chips between monopolar and PlasmaKinetic™ transurethral resection of prostate (TURP), and to determine if there is any difference in the intraoperative and post surgical parameters between them. METHODS After institutional review board approval, patients were prospectively enrolled to undergo PlasmaKinetic™ TURP. Their parameters were compared with those of the historical monopolar TURP controls. All histological specimens were reviewed by a single senior pathologist. RESULTS 46 patients were recruited to undergo PlasmaKinetic™ TURP. The resection time was significantly longer for the bipolar group compared to the monopolar group (50.2 versus 36.7 min, p-value is 0.001). The speed of resection (resection weight/time) was lower for the bipolar group (0.45 versus 0.56 g/min, p-value is 0.017). More irrigant was used for the bipolar group (21.2 versus 15.6 litres, p-value is 0.001) intraoperatively. There was no statistically significant difference in terms of intraoperative drop in haemoglobin and serum sodium change between the two groups. There seems to be a lesser degree of cautery artefacts in the PlasmaKinetic™ group than the monopolar group (42.17 versus 45.07 microns); however, this was not statistically significant (p-value is 0.452). CONCLUSION Bipolar TURP seems to result in a lesser degree of cautery artefacts when compared to conventional monopolar TURP, albeit statistically insignificant, compared to monopolar TURP. TURP also resulted in a longer resection time and increased irrigant use, but no difference in blood loss and serum sodium levels.
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Affiliation(s)
- B K Poh
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore 529889.
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Lim T, Yun J, Lee J, Park S, Park J, Park Y, Lim H, Kang W. Updated survival results of the randomized phase II study comparing cisplatin/capecitabine (CX) with epirubicin plus CX (ECX) in advanced gastric cancer (AGC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
46 Background: We previously reported results of a randomized study showing that CX is equally active to ECX in terms of progression-free survival (PFS) (Yun et al. Eur J Cancer. 2010). Here we report updated overall survival (OS) results with an additional 12 months' follow-up. Methods: Ninety-one chemotherapy-naïve patients with histologically-confirmed, measurable AGC were randomized to receive CX (cisplatin 75 mg/m2 iv on day 1 and capecitabine 1,000 mg/m2 bid po on days 1-14, n=45) or ECX (epirubicin 50 mg/m2 plus CX, n=44) every 3 weeks. After CX or ECX had failed, second-line chemotherapy (SLC) was recommended for all patients if their performance status was preserved. Results: Treatment duration was similar for both arms (4.4 for CX v 4.2 months for ECX). There was no relevant difference in the occurrence of overall grade 3 or 4 toxicities between the CX and ECX arms (80% v 78%, respectively; p=0.516). However, none in the CX and 12% in the ECX arm discontinued treatment because of toxicity. There were no significant differences in therapeutic efficacy between CX and ECX with respect to the response rate (38% v 37%, respectively), PFS (6.4 v 6.5 months), as well as OS (12.7 v 13.8 months; p=0.51). After failure, 60% of patients (26 CX and 28 ECX patients) received SLC. However, OS was not differed whether a patient was treated with SLC or not (13.1 v 11.2 months; p=0.94). Conclusions: The present analysis confirms previous findings that both CX and ECX appear to be comparatively active as first-line chemotherapy for AGC. Furthermore, the role of SLC in AGC warrants further evaluation. No significant financial relationships to disclose.
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Affiliation(s)
- T. Lim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J. Yun
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J. Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S. Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J. Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y. Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - H. Lim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - W. Kang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Yi JH, Kim JH, Baek KK, Lim T, Lee DJ, Ahn YC, Kim K, Kim SJ, Ko YH, Kim WS. Elevated LDH and paranasal sinus involvement are risk factors for central nervous system involvement in patients with peripheral T-cell lymphoma. Ann Oncol 2011; 22:1636-1643. [PMID: 21220520 PMCID: PMC3121968 DOI: 10.1093/annonc/mdq645] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: The incidence and risk factors of central nervous system (CNS) involvement in peripheral T-cell lymphomas (PTCLs) are still unclear. Patients and methods: We analyzed 228 patients with PTCLs, excluding cases of extranodal natural killer/T-cell lymphoma and primary cutaneous T-cell lymphoma, by retrospectively collecting the clinical features and outcomes of the patients. Results: Twenty events (8.77%, 20/228) of CNS involvement were observed during a median follow-up period of 13.9 months (range 0.03–159.43). Based on univariate analysis, elevated serum lactate dehydrogenase (LDH) level [P = 0.019, relative risk (RR) 5.904, 95% confidence interval (CI) 1.334–26.123] and involvement of the paranasal sinus (P = 0.032, RR 3.137, 95% CI 1.105–8.908) adversely affect CNS involvement. In multivariate analysis, both were independently poor prognostic factors for CNS relapse [elevated LDH level: P = 0.011, hazard ratio (HR) 6.716, 95% CI 1.548–29.131; involvement of the paranasal sinus: P = 0.008, HR 3.784, 95% CI 1.420–10.083]. The survival duration of patients with CNS involvement was significantly shorter than that of the patients without CNS involvement (P = 0.009), with median overall survival of 7.60 months (95% CI of 4.92–10.28) versus 27.43 months (95% CI of 0.00–57.38), respectively. Conclusions: Elevated LDH level and involvement of the paranasal sinus are two risk factors for CNS involvement in patients with PTCLs. Considering the poor prognoses after CNS relapse, prophylaxis should be considered with the presence of any risk factor.
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Affiliation(s)
- J H Yi
- Division of Hematology-Oncology, Department of Medicine
| | - J H Kim
- Division of Hematology-Oncology, Department of Medicine
| | - K K Baek
- Division of Hematology-Oncology, Department of Medicine
| | - T Lim
- Division of Hematology-Oncology, Department of Medicine
| | - D J Lee
- Division of Hematology-Oncology, Department of Medicine
| | - Y C Ahn
- Department of Radiation Oncology
| | - K Kim
- Division of Hematology-Oncology, Department of Medicine
| | - S J Kim
- Division of Hematology-Oncology, Department of Medicine
| | - Y H Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W S Kim
- Division of Hematology-Oncology, Department of Medicine.
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Chik W, Lim T, Koay C, See V, McCall R, Zecchin R, Byth K, Thomas L, Ross D, Thomas S. Mitral Isthmus Ablation Line Reconnections are Common and Predicts Mitral Annular Dependent Flutters Following Pulmonary Vein Isolations for Atrial Fibrillation. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.254] [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: 10/18/2022]
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Chik W, Lim T, Koay C, See V, McCall R, Zecchin R, Byth K, Thomas L, Ross D, Thomas S. Cavotricuspid Isthmus Ablation Line Reconnections are Associated with Clinically Inducible Cavotricuspid Isthmus Dependent Flutters in Patients Undergoing Pulmonary Vein Isolation For Atrial Fibrillation. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.226] [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: 10/18/2022]
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Lim T, Koay C, See V, McCall R, Chik W, Zecchin R, Byth K, Seow S, Thomas L, Ross D, Thomas S. Larger Body Size but not BMI Predict Longer Atrial Fibrillation Ablation Procedure Times and Increased Arrhythmia Recurrences on Long Term Follow Up. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.248] [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: 10/18/2022]
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Lim T, Koay C, See V, Zecchin R, McCall R, Chik W, Byth K, Seow S, Thomas L, Ross D, Thomas S. Improvements in Quality Of Life and 6-Minute Walk Distances are Not Affected by Different Ablation Strategies or Recurrent Atrial Tachyarrhythmias but may be Worsened by Antiarrhythmic Drug Therapy. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.241] [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: 11/16/2022]
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