Pub Date : 2016-12-31DOI: 10.22452/JUMMEC.VOL19NO2.2
Cheong Cs, Gancevici Gg, Bee Pc, Chen Tm, Lim Cc
Haemophagocytic lymphohistiocytosis (HLH) is a clinico-pathologic entity caused by increased proliferation and activation of benign macrophages with haemophagocytosis throughout the reticulo-endothelial system. Virus-associated HLH is a well-recognised entity. Although majority of parvovirus B19 associated HLH does not require any specific treatment and carries good prognosis, outcome of children is worse than adults. We report here a case of HLH associated with acute parvovirus B19 infection in a young healthy patient with underlying hereditary spherocytosis, with bone marrow findings typical of parvovirus infection. Although this patient had spontaneous recovery of cell counts, he succumbed due to complication from prolonged ventilation. Unexpectedly, his immunoglobulin levels were inappropriately normal despite on-going ventilator associated pneumonia, which reflects inadequate humoral immune response towards infection.
{"title":"PARVOVIRUS B19 ASSOCIATED HAEMOPHAGOCYTIC LYMPHOHISTIOCYTISIS IN HEREDITARY SPHEROCYTOSIS PATIENT: A CASE REPORT","authors":"Cheong Cs, Gancevici Gg, Bee Pc, Chen Tm, Lim Cc","doi":"10.22452/JUMMEC.VOL19NO2.2","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO2.2","url":null,"abstract":"Haemophagocytic lymphohistiocytosis (HLH) is a clinico-pathologic entity caused by increased proliferation and activation of benign macrophages with haemophagocytosis throughout the reticulo-endothelial system. Virus-associated HLH is a well-recognised entity. Although majority of parvovirus B19 associated HLH does not require any specific treatment and carries good prognosis, outcome of children is worse than adults. We report here a case of HLH associated with acute parvovirus B19 infection in a young healthy patient with underlying hereditary spherocytosis, with bone marrow findings typical of parvovirus infection. Although this patient had spontaneous recovery of cell counts, he succumbed due to complication from prolonged ventilation. Unexpectedly, his immunoglobulin levels were inappropriately normal despite on-going ventilator associated pneumonia, which reflects inadequate humoral immune response towards infection.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"12-16"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68651870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-31DOI: 10.22452/JUMMEC.VOL19NO2.3
Lumbanraja Sn
Background: Kangaroo mother care (KMC) in low birth weight newborns has been found to be beneficial, but studies have shown that maternal factors might be of concern in the successful application of KMC. Aim: To study the influence of maternal factors on growth parameters in low-birth-weight babies with KMC. Methods: This is a prospective cohort study of 40 low birth weight newborns in our institutions. We randomly assigned the newborns to the group which received KMC and to the group which received conventional care. Maternal factors were recorded. We measured weight, length, and head circumferences of newborns daily for thirty days. Data was processed by SPSS x22.0. Results: A total of 40 newborns were recruited into the study. Weight parameters were significantly higher in the KMC group than in the conventional group except for the Z scores. Regarding maternal characteristics, only gestational age was found to influence the initial and the last head circumference (p=0.035). There were no differences in maternal age, parity, maternal education, mode of delivery, fetal sex, and initial Apgar score with any of the growth parameters. Conclusion: There were no maternal and fetal differences in the growth parameters of the groups, except in the delayed growth of head circumferences in preterm infants.
{"title":"INFLUENCE OF MATERNAL FACTORS ON GROWTH PARAMETERS IN LOW-BIRTH-WEIGHT BABIES WITH KANGAROO MOTHER CARE","authors":"Lumbanraja Sn","doi":"10.22452/JUMMEC.VOL19NO2.3","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO2.3","url":null,"abstract":"Background: Kangaroo mother care (KMC) in low birth weight newborns has been found to be beneficial, but studies have shown that maternal factors might be of concern in the successful application of KMC. Aim: To study the influence of maternal factors on growth parameters in low-birth-weight babies with KMC. Methods: This is a prospective cohort study of 40 low birth weight newborns in our institutions. We randomly assigned the newborns to the group which received KMC and to the group which received conventional care. Maternal factors were recorded. We measured weight, length, and head circumferences of newborns daily for thirty days. Data was processed by SPSS x22.0. Results: A total of 40 newborns were recruited into the study. Weight parameters were significantly higher in the KMC group than in the conventional group except for the Z scores. Regarding maternal characteristics, only gestational age was found to influence the initial and the last head circumference (p=0.035). There were no differences in maternal age, parity, maternal education, mode of delivery, fetal sex, and initial Apgar score with any of the growth parameters. Conclusion: There were no maternal and fetal differences in the growth parameters of the groups, except in the delayed growth of head circumferences in preterm infants.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"17-25"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68652148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-31DOI: 10.22452/JUMMEC.VOL19NO2.4
K. Siregar
Background: The majority of breast cancer cases are presented in an advanced stage; hence, there is a need to have a biomarker that is able to function both as a predictive and prognostic tool for breast cancer. Since angiogenesis has been found to be closely related to the invasiveness of breast cancer, angiogenic marker such as vascular endothelial growth factor (VEGF) may be a promising marker for this cancer. Objective: The aim of this study is to determine the association between the VEGF receptor (VEGFR) expression with human epidermal growth factor receptor-2 (HER-2)/ neu and estrogen receptor (ER) /progesterone receptor (PR) expression in an attempt to clarify the role of VEGFR as a potentially novel predictive and prognostic biomarker for breast cancer. Materials and Methods: This study examined 40 tissue biopsies taken from patients diagnosed with breast cancer in H. Adam Malik Hospital Medan, Indonesia. Samples were analyzed by immunohistochemistry to determine the histopathology, grading, lymphovascular invasion and expression of VEGFR, HER-2/neu and ER/PR. Association between dependent and independent variables was conducted using chi-square test and logistic regression. Results: The majority of the cases in this study were infiltrating ductal carcinoma (90%), in stage III (70%), and showed positive TIL (75%). VEGFR expression was found to be upregulated in 21 samples (52.5%). HER-2/neu was positive in 14 patients (35.0%) and ER/PR was positive in 22 patients (55%). The expression of VEGFR positively correlated with HER-2/neu expression (p= 0.002) and negatively correlated with ER/PR expression (p= 0.012). Conclusion: Overexpression of VEGFR is a potential valuable predictive and prognostic biomarker for breast cancer. Antagonising VEGFR may serve as the future target therapy for the disease.
背景:大多数乳腺癌病例出现在晚期;因此，我们需要一种既能作为乳腺癌预测和预后工具的生物标志物。由于血管生成已被发现与乳腺癌的侵袭性密切相关，血管生成标志物如血管内皮生长因子(VEGF)可能是一种有希望的乳腺癌标志物。目的:本研究的目的是确定VEGF受体(VEGFR)表达与人表皮生长因子受体-2 (HER-2)/ neu和雌激素受体(ER) /孕激素受体(PR)表达之间的关系，试图阐明VEGFR作为乳腺癌潜在的新型预测和预后生物标志物的作用。材料和方法:本研究检查了印度尼西亚棉兰H. Adam Malik医院诊断为乳腺癌的40例组织活检。采用免疫组化方法分析标本的组织病理学、分级、淋巴血管浸润及VEGFR、HER-2/neu和ER/PR的表达情况。因变量与自变量之间的相关性采用卡方检验和logistic回归。结果:本组病例以浸润性导管癌(90%)、ⅲ期(70%)和TIL阳性(75%)居多。21个样本(52.5%)VEGFR表达上调。HER-2/neu阳性14例(35.0%)，ER/PR阳性22例(55%)。VEGFR表达与HER-2/neu表达呈正相关(p= 0.002)，与ER/PR表达负相关(p= 0.012)。结论:VEGFR过表达是乳腺癌潜在的有价值的预测和预后生物标志物。拮抗VEGFR可能成为该疾病未来的靶向治疗。
{"title":"Vegfr Overexpression as A Promising Predictive and Prognostic Biomarker For Breast Cancer","authors":"K. Siregar","doi":"10.22452/JUMMEC.VOL19NO2.4","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO2.4","url":null,"abstract":"Background: The majority of breast cancer cases are presented in an advanced stage; hence, there is a need to have a biomarker that is able to function both as a predictive and prognostic tool for breast cancer. Since angiogenesis has been found to be closely related to the invasiveness of breast cancer, angiogenic marker such as vascular endothelial growth factor (VEGF) may be a promising marker for this cancer. Objective: The aim of this study is to determine the association between the VEGF receptor (VEGFR) expression with human epidermal growth factor receptor-2 (HER-2)/ neu and estrogen receptor (ER) /progesterone receptor (PR) expression in an attempt to clarify the role of VEGFR as a potentially novel predictive and prognostic biomarker for breast cancer. Materials and Methods: This study examined 40 tissue biopsies taken from patients diagnosed with breast cancer in H. Adam Malik Hospital Medan, Indonesia. Samples were analyzed by immunohistochemistry to determine the histopathology, grading, lymphovascular invasion and expression of VEGFR, HER-2/neu and ER/PR. Association between dependent and independent variables was conducted using chi-square test and logistic regression. Results: The majority of the cases in this study were infiltrating ductal carcinoma (90%), in stage III (70%), and showed positive TIL (75%). VEGFR expression was found to be upregulated in 21 samples (52.5%). HER-2/neu was positive in 14 patients (35.0%) and ER/PR was positive in 22 patients (55%). The expression of VEGFR positively correlated with HER-2/neu expression (p= 0.002) and negatively correlated with ER/PR expression (p= 0.012). Conclusion: Overexpression of VEGFR is a potential valuable predictive and prognostic biomarker for breast cancer. Antagonising VEGFR may serve as the future target therapy for the disease.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"9 8 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68652200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-31DOI: 10.22452/JUMMEC.VOL19NO2.1
A. Al-khateeb, H. Al-Talib
ABSTRACT Background: Familial hypercholesterolaemia (FH) is one of the most frequent inherited metabolic disorders that can lead to a risk of premature cardiovascular disease. Publications on FH are mainly from western patients as there is little research on Asians, including Malaysians. The aim of this review is to provide an up-to- date information on Malaysian studies on FH genotyping and its relation to the phenotype of the affected patients. Method: A search was conducted for data from online databases on FH in Malaysia. Results: The mutation spectrum for FH among Malaysian patients was extremely broad. The gene variants were located mainly in the low-density lipoprotein receptor (LDLR) and apolipoprotein B-100 (APOB-100) genes rather than in the proprotein convertase subtilisin kexin type 9 (PCSK9) gene. The exon 9 and 14 were the hotspots in the LDLR gene. The most frequent mutation was p.Cys255Ser, at 12.5%, followed by p.Arg471Gly, at 11%, and the most common single nucleotide polymorphism (SNP) was c.1060+7 T>C at 11.7%. The LDLR gene variants were more common compared to the APOB-100 gene variants, while variants in the PCSK9 gene were very few. Phenotype-genotype associations were identified. Subjects with LDLR and APOB-100 genes mutations had a higher frequency of cardiovascular disease, a family history of hyperlipidaemia and tendon xanthoma and a higher low-density lipoprotein cholesterol (LDL-C) level than non-carriers. Conclusion: Research on Malaysian familial hypercholesterolaemic patients by individual groups is encouraging. However, more extensive molecular studies on FH on a national scale, with a screening of the disease-causing mutations together with a comprehensive genotype-phenotype association study, can lead to a better outcome for patients with the disease.
{"title":"GENETIC RESEARCHES AMONG MALAYSIAN FAMILIAL HYPERCHOLESTEROLAEMIC POPULATION","authors":"A. Al-khateeb, H. Al-Talib","doi":"10.22452/JUMMEC.VOL19NO2.1","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO2.1","url":null,"abstract":"ABSTRACT Background: Familial hypercholesterolaemia (FH) is one of the most frequent inherited metabolic disorders that can lead to a risk of premature cardiovascular disease. Publications on FH are mainly from western patients as there is little research on Asians, including Malaysians. The aim of this review is to provide an up-to- date information on Malaysian studies on FH genotyping and its relation to the phenotype of the affected patients. Method: A search was conducted for data from online databases on FH in Malaysia. Results: The mutation spectrum for FH among Malaysian patients was extremely broad. The gene variants were located mainly in the low-density lipoprotein receptor (LDLR) and apolipoprotein B-100 (APOB-100) genes rather than in the proprotein convertase subtilisin kexin type 9 (PCSK9) gene. The exon 9 and 14 were the hotspots in the LDLR gene. The most frequent mutation was p.Cys255Ser, at 12.5%, followed by p.Arg471Gly, at 11%, and the most common single nucleotide polymorphism (SNP) was c.1060+7 T>C at 11.7%. The LDLR gene variants were more common compared to the APOB-100 gene variants, while variants in the PCSK9 gene were very few. Phenotype-genotype associations were identified. Subjects with LDLR and APOB-100 genes mutations had a higher frequency of cardiovascular disease, a family history of hyperlipidaemia and tendon xanthoma and a higher low-density lipoprotein cholesterol (LDL-C) level than non-carriers. Conclusion: Research on Malaysian familial hypercholesterolaemic patients by individual groups is encouraging. However, more extensive molecular studies on FH on a national scale, with a screening of the disease-causing mutations together with a comprehensive genotype-phenotype association study, can lead to a better outcome for patients with the disease.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68651847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.22452/JUMMEC.VOL19NO1.1
Shariffuddin, Hasan Ms, C. Th, Kwan Mk, Chan Yk
ABSTRACTBackground:Prevention of hypothermia in patients undergoing major posterior approach spinal surgery can be difficult, as alarge body surface is exposed to the cold environment of the operating theatre. We compared the efficacy of anew under-body forced-air warming blanket with that of a resistive heating blanket in preventing hypothermia.Methods:Sixty patients undergoing major posterior approach spinal surgery lasting for more than 2 hours were randomlyassigned to warming with a full under-body forced-air warming blanket or three segments of resistive heatingblankets, both set at 42°C. The ambient temperature was kept near 20°C. Nasopharyngeal, rectal and axillarytemperatures were measured at regular intervals. Changes in core temperature (average of nasopharyngealand rectal) over time were compared by the independent t-test.Results:The characteristics of the patients were comparable. The baseline core temperature was 36.36 ±0.38°C in theforced-air group and 36.27 ± 0.46°C in the resistive heating group. During the first hour, the core temperaturedecreased similarly from baseline in both groups. From 100 minutes after induction until the end of the surgery,core temperature rose in both groups. At the end of surgery, the core temperature was increased by 0.08± 0.09°C from baseline in the forced-air group but decreased by 0.40 ±0.04°C from baseline in the resistiveheating group. The difference in the change of the core temperature, at the end of the surgery, between thetwo groups is statistically significant (P<0.05).Conclusion:We demonstrated that the new under-body forced-air warming blanket is superior to the resistive heatingblanket in preventing hypothermia in patients undergoing major posterior approach spinal surgery.
{"title":"UNDER-BODY FORCED-AIR WARMING BLANKET VERSUS RESISTIVE HEATING BLANKET FOR PREVENTION OF HYPOTHERMIA DURING SPINAL SURGERY: A RANDOMIZED PROSPECTIVE STUDY","authors":"Shariffuddin, Hasan Ms, C. Th, Kwan Mk, Chan Yk","doi":"10.22452/JUMMEC.VOL19NO1.1","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO1.1","url":null,"abstract":"ABSTRACTBackground:Prevention of hypothermia in patients undergoing major posterior approach spinal surgery can be difficult, as alarge body surface is exposed to the cold environment of the operating theatre. We compared the efficacy of anew under-body forced-air warming blanket with that of a resistive heating blanket in preventing hypothermia.Methods:Sixty patients undergoing major posterior approach spinal surgery lasting for more than 2 hours were randomlyassigned to warming with a full under-body forced-air warming blanket or three segments of resistive heatingblankets, both set at 42°C. The ambient temperature was kept near 20°C. Nasopharyngeal, rectal and axillarytemperatures were measured at regular intervals. Changes in core temperature (average of nasopharyngealand rectal) over time were compared by the independent t-test.Results:The characteristics of the patients were comparable. The baseline core temperature was 36.36 ±0.38°C in theforced-air group and 36.27 ± 0.46°C in the resistive heating group. During the first hour, the core temperaturedecreased similarly from baseline in both groups. From 100 minutes after induction until the end of the surgery,core temperature rose in both groups. At the end of surgery, the core temperature was increased by 0.08± 0.09°C from baseline in the forced-air group but decreased by 0.40 ±0.04°C from baseline in the resistiveheating group. The difference in the change of the core temperature, at the end of the surgery, between thetwo groups is statistically significant (P<0.05).Conclusion:We demonstrated that the new under-body forced-air warming blanket is superior to the resistive heatingblanket in preventing hypothermia in patients undergoing major posterior approach spinal surgery.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68651413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.22452/JUMMEC.VOL19NO1.5
Ng Ym, Cheng Jt
Typhoid fever is a systemic infection caused by Salmonella typhi, which may be associated with extra-intestinal complications. Neurological manifestations, particularly Parkinsonism, are rarely reported. We report a 17-year-old patient with relapsed culture-proven Salmonella typhi infection who developed septic shock and subsequently Parkinsonism. Lumbar puncture revealed acellular cerebrospinal fluid with raised protein level. Magnetic resonance imaging revealed cerebral petechial haemorrhages resulted from small vessels vasculitis. His symptoms resolved spontaneously after 3 months.
{"title":"PARKINSONISM AND BRAIN MRI FINDINGS IN A RELAPSED CULTURE-PROVEN SALMONELLA TYPHI INFECTION: A CASE REPORT IN MALAYSIA","authors":"Ng Ym, Cheng Jt","doi":"10.22452/JUMMEC.VOL19NO1.5","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO1.5","url":null,"abstract":"Typhoid fever is a systemic infection caused by Salmonella typhi, which may be associated with extra-intestinal complications. Neurological manifestations, particularly Parkinsonism, are rarely reported. We report a 17-year-old patient with relapsed culture-proven Salmonella typhi infection who developed septic shock and subsequently Parkinsonism. Lumbar puncture revealed acellular cerebrospinal fluid with raised protein level. Magnetic resonance imaging revealed cerebral petechial haemorrhages resulted from small vessels vasculitis. His symptoms resolved spontaneously after 3 months.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"33-35"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68651817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.22452/JUMMEC.VOL19NO1.4
T. S. Ramasamy, M. Kamal, F. Amini
Glaucoma is a common eye disease that can cause irreversible damage if left undiagnosed and untreated. It is one of the most common neurodegenerative diseases causing blindness. Pre-clinical studies have been carried out on animal models of glaucoma for stem cell therapy. We carried out a systematic review to determine whether stem cell therapy had the potential to treat glaucoma. Nine studies were selected based on the predetermined inclusion and exclusion criteria. Of these nine studies, eight focused on neuroprotection conferred by stem cells, and the remaining one on neuroregeneration. Results from these studies showed that there was a potential in stem cell based therapy in treating glaucoma, especially regarding neuroprotection via neurotrophic factors. The studies revealed that a brain-derived neurotrophic factor expressed by stem cells promoted the survival of retinal ganglion cells in murine glaucoma models. The transplanted cells survived without any side effects. While these studies proved that stem cells provided neuroprotection in glaucoma, improvement of vision could not be determined. Clinical studies would be required to determine whether the protection of RGC correlated with improvement in visual function. Furthermore, these murine studies could not be translated into clinical therapy due to the heterogeneity of the experimental methods and the use of different cell lines. In conclusion, the use of stem cells in the clinical therapy of glaucoma will be an important step in the future as it will transform present-day treatment with the hope of restoring sight to patients with glaucoma.
{"title":"STEM CELL THERAPY AS A POTENTIAL TREATMENT FOR GLAUCOMA","authors":"T. S. Ramasamy, M. Kamal, F. Amini","doi":"10.22452/JUMMEC.VOL19NO1.4","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO1.4","url":null,"abstract":"Glaucoma is a common eye disease that can cause irreversible damage if left undiagnosed and untreated. It is one of the most common neurodegenerative diseases causing blindness. Pre-clinical studies have been carried out on animal models of glaucoma for stem cell therapy. We carried out a systematic review to determine whether stem cell therapy had the potential to treat glaucoma. Nine studies were selected based on the predetermined inclusion and exclusion criteria. Of these nine studies, eight focused on neuroprotection conferred by stem cells, and the remaining one on neuroregeneration. Results from these studies showed that there was a potential in stem cell based therapy in treating glaucoma, especially regarding neuroprotection via neurotrophic factors. The studies revealed that a brain-derived neurotrophic factor expressed by stem cells promoted the survival of retinal ganglion cells in murine glaucoma models. The transplanted cells survived without any side effects. While these studies proved that stem cells provided neuroprotection in glaucoma, improvement of vision could not be determined. Clinical studies would be required to determine whether the protection of RGC correlated with improvement in visual function. Furthermore, these murine studies could not be translated into clinical therapy due to the heterogeneity of the experimental methods and the use of different cell lines. In conclusion, the use of stem cells in the clinical therapy of glaucoma will be an important step in the future as it will transform present-day treatment with the hope of restoring sight to patients with glaucoma.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68652177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.22452/JUMMEC.VOL19NO1.2
H. Nah, Rosdy Nmmnm, Isa Mr, Sheikh Abdul Kadir Sh, A. Im
The positive response to tamoxifen in ERa-positive breast cancer patients is usually of a short duration as manyof the patients eventually develop resistance. Our preliminary results show that aloe emodin extracted fromthe leaves of the Aloe barbadensis Miller demonstrated a cytotoxicity that is selective to ERa-positive breastcancer cells (MCF-7), but not to ERa-negative breast cancer cells (MDA-MB-231) and to the control cells (MCF-10A). The objective of this study was to test the hypothesis that aloe emodin may enhance the response ofMCF-7 cells to treatment with tamoxifen. MCF-7 cells were treated with aloe emodin alone, tamoxifen aloneor a combination of emodin and tamoxifen, at their respective IC50 concentrations and at different time pointsof 24 hours, 48 hours and 72 hours. The respective IC50s were the concentrations of aloe emodin and tamoxifenrequired to achieve 50% inhibition of the cells in the study. Cell viability and apoptosis were determined usingtrypan blue exclusion and DNA fragmentation assays, respectively. The involvement of RAS/MEKs/ERKs genesof MAPK signalling pathways with aloe emodin was determined using QuantiGene 2.0 Plex assay. Data wasevaluated using the one-way ANOVA test. Our findings showed that aloe emodin enhanced the cytotoxicity oftamoxifen on MCF-7 cells through apoptosis by downregulation of MEK1/2 genes. Our research may provide arational basis for further in vivo studies to verify the efficacy of a combination of aloe emodin and tamoxifenon the viability of ERa-positive-breast cancer cells.
{"title":"ALOE EMODIN ENHANCES TAMOXIFEN CYTOTOXICITY EFFECT ON ERa-POSITIVE BREAST CANCER CELLS, MCF-7, THROUGH DOWNREGULATION OF MEK1 AND MEK2","authors":"H. Nah, Rosdy Nmmnm, Isa Mr, Sheikh Abdul Kadir Sh, A. Im","doi":"10.22452/JUMMEC.VOL19NO1.2","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO1.2","url":null,"abstract":"The positive response to tamoxifen in ERa-positive breast cancer patients is usually of a short duration as manyof the patients eventually develop resistance. Our preliminary results show that aloe emodin extracted fromthe leaves of the Aloe barbadensis Miller demonstrated a cytotoxicity that is selective to ERa-positive breastcancer cells (MCF-7), but not to ERa-negative breast cancer cells (MDA-MB-231) and to the control cells (MCF-10A). The objective of this study was to test the hypothesis that aloe emodin may enhance the response ofMCF-7 cells to treatment with tamoxifen. MCF-7 cells were treated with aloe emodin alone, tamoxifen aloneor a combination of emodin and tamoxifen, at their respective IC50 concentrations and at different time pointsof 24 hours, 48 hours and 72 hours. The respective IC50s were the concentrations of aloe emodin and tamoxifenrequired to achieve 50% inhibition of the cells in the study. Cell viability and apoptosis were determined usingtrypan blue exclusion and DNA fragmentation assays, respectively. The involvement of RAS/MEKs/ERKs genesof MAPK signalling pathways with aloe emodin was determined using QuantiGene 2.0 Plex assay. Data wasevaluated using the one-way ANOVA test. Our findings showed that aloe emodin enhanced the cytotoxicity oftamoxifen on MCF-7 cells through apoptosis by downregulation of MEK1/2 genes. Our research may provide arational basis for further in vivo studies to verify the efficacy of a combination of aloe emodin and tamoxifenon the viability of ERa-positive-breast cancer cells.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 3 1","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68651974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.22452/JUMMEC.VOL19NO1.3
T. Makmor, Nurulhuda Ms, R. Ra, L. Soo-Kun, N. Kok-Peng, Wan Ahmad Hafiz Wma, Y. Sook-Lu
Introduction:Living donation is an important source for organs transplantation in Malaysia. This study aims to investigate the Malaysian living donors� follow-up attendance, their preferences on medical-institutional facilities, and the financial circumstances pertaining to the follow-up costs.Materials and Methods:Primary data were collected through a survey of 80 living donors who made their donation at the University of Malaya Medical Center (UMMC) between 1991 and 2012.Results:Out total of 178 donors, only 111 were reachable and 80 of them participated in the survey (72%). The findings revealed that most of the donors (71.2%) attend the follow-up regularly. Nevertheless, donors seem to neglect the importance of follow-up as they consider themselves healthy (28.9%) or consider the follow-up as being troublesome (28.9%). Most donors (67.5%) are not in favour of being treated as patients, but prefer to be monitored under donor registry (88.8%) and getting their health service in special clinics for donors (80%). The majority of the donors fund the follow-up costs themselves (32.4%), while 25% of the donors� follow-up costs were funded by family members. Among those donors without income and those of low-income (84.8% of respondents), 60.3% believe that the follow-up costs should be borne by the government.Conclusions:Based on the findings, it is therefore suggested that the government provides all living donors with proper free health service through donor registry and donor clinics. Adequate care has to be given to the donors to pre-empt any unforeseen health complications due to the organ donation surgical procedures.
{"title":"ATTENDANCE AND INSTITUTIONAL FACILITIES OF LONG-TERM KIDNEY DONORS FOLLOW-UP","authors":"T. Makmor, Nurulhuda Ms, R. Ra, L. Soo-Kun, N. Kok-Peng, Wan Ahmad Hafiz Wma, Y. Sook-Lu","doi":"10.22452/JUMMEC.VOL19NO1.3","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL19NO1.3","url":null,"abstract":"Introduction:Living donation is an important source for organs transplantation in Malaysia. This study aims to investigate the Malaysian living donors� follow-up attendance, their preferences on medical-institutional facilities, and the financial circumstances pertaining to the follow-up costs.Materials and Methods:Primary data were collected through a survey of 80 living donors who made their donation at the University of Malaya Medical Center (UMMC) between 1991 and 2012.Results:Out total of 178 donors, only 111 were reachable and 80 of them participated in the survey (72%). The findings revealed that most of the donors (71.2%) attend the follow-up regularly. Nevertheless, donors seem to neglect the importance of follow-up as they consider themselves healthy (28.9%) or consider the follow-up as being troublesome (28.9%). Most donors (67.5%) are not in favour of being treated as patients, but prefer to be monitored under donor registry (88.8%) and getting their health service in special clinics for donors (80%). The majority of the donors fund the follow-up costs themselves (32.4%), while 25% of the donors� follow-up costs were funded by family members. Among those donors without income and those of low-income (84.8% of respondents), 60.3% believe that the follow-up costs should be borne by the government.Conclusions:Based on the findings, it is therefore suggested that the government provides all living donors with proper free health service through donor registry and donor clinics. Adequate care has to be given to the donors to pre-empt any unforeseen health complications due to the organ donation surgical procedures.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"19 1","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68652103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-29DOI: 10.22452/JUMMEC.VOL18NO2.2
T. Makmor, Nurulhuda Ms, R. Ra, A. Nawi, N. KokPeng, L. Sookun
Background: This paper examined the importance and influence of post-transplantation follow-up visits on the quality-of-life (QoL) of living kidney donors in Malaysia. Methods: Based on data collected from 80 living kidney donors, the relationship between QoL and the frequency of follow-up visits was examined. QoL was measured using standard SF-8 questions to capture its different dimensions. Results: Donors in the 1991–1998 donation cohort have low QoL, especially in the domains of physical and vitality, compared with the other two cohorts (1999–2005 and 2006–2012). The mean scores showed that donors who never went for any follow-up activities visits experience low QoL in most of the categories, particularly those related to physical activities, implying the importance of follow-up activities visits in influencing the donors’ QoL. Lower QoL was recorded for respondents that never received post-transplant treatment. Conclusion: Although this study found no serious post-transplant QoL issues in Malaysia, it is still important to set up a donor registry and provide free and mandatory follow-up visits for all donors in order to adequately monitor their health.
{"title":"The importance of long-term follow-up visits for kidney donors.","authors":"T. Makmor, Nurulhuda Ms, R. Ra, A. Nawi, N. KokPeng, L. Sookun","doi":"10.22452/JUMMEC.VOL18NO2.2","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL18NO2.2","url":null,"abstract":"Background: This paper examined the importance and influence of post-transplantation follow-up visits on the quality-of-life (QoL) of living kidney donors in Malaysia. Methods: Based on data collected from 80 living kidney donors, the relationship between QoL and the frequency of follow-up visits was examined. QoL was measured using standard SF-8 questions to capture its different dimensions. Results: Donors in the 1991–1998 donation cohort have low QoL, especially in the domains of physical and vitality, compared with the other two cohorts (1999–2005 and 2006–2012). The mean scores showed that donors who never went for any follow-up activities visits experience low QoL in most of the categories, particularly those related to physical activities, implying the importance of follow-up activities visits in influencing the donors’ QoL. Lower QoL was recorded for respondents that never received post-transplant treatment. Conclusion: Although this study found no serious post-transplant QoL issues in Malaysia, it is still important to set up a donor registry and provide free and mandatory follow-up visits for all donors in order to adequately monitor their health.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"18 1","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2015-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68651647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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