Search PubMed⌕ Search

Biomedical subjects

A Tan

Publications and source records attributed to A Tan.

At least 109 records · Page 6Linked to original sources

Case report: primary systemic amyloidosis presenting as breast masses, mammographically simulating carcinoma.

A case of primary systemic amyloidosis presenting as bilateral breast masses is described. The mammographic appearance was of multiple ill-defined masses associated with clustered microcalcifications simulating carcinoma. This is the first case of amyloid of breast reported in the radiological literature. Other available literature of breast involvement in systemic amyloidosis is reviewed.

Aged↗

Unusual volar dislocation of the lunate into the distal forearm: case report.

A case of a severe wrist injury (fractures of the scaphoid, capitate, hamate, and ulnar styloid process) with volar dislocation of the lunate into the soft tissues of the forearm is presented. This degree of displacement of the lunate is exceedingly rare, and we believe has not been previously reported. Possible mechanisms, hyperextension injury forcing the lunate forward out of the carpus, or contact between the volar wrist skin surface and another object or surface propelling the dislocated lunate into the forearm, are discussed.

Adult↗

Chronic diarrhoea in children: a clinical perspective.

Chronic diarrhoea in its previously described severe malnourished presentation is not common in Singapore. A retrospective study was made of children with chronic diarrhoea between January to September 1990, at the Department of Paediatrics, National University Hospital. Chronic diarrhoea in our context included all those who presented with diarrhoea of 7 or more days duration. The age range was one month to 11 years, with 23 males and 13 female patients. Approximately half of the patients had associated symptoms like fever. Anthropometric data of these patients revealed none less than the third percentile in height and weight. Clinically the patients were mainly well nourished, mildly dehydrated with no significant pallor or oedema. Perianal erythema though not excoriation was common being present in approximately 50%. Haematological parameters and electrolytes were generally normal. Mild elevation of urea and creatinine levels especially the former was present reflecting the relatively mild dehydration status. Infection was the main cause of the diarrhoea, 55% of stool cultures being positive mainly for Salmonella or rotavirus. Treatment was mainly directed at correcting dehydration. 40% needed antibiotics. Hence, chronic diarrhoea as seen in the National University Hospital is generally not debilitating. An infective cause must first be excluded with usage of antibiotics often necessary in young children.

Anthropometry↗

Non-neurological manifestations of intracranial tumours: a report of four cases.

Brain neoplasms are a common cause of childhood morbidity and mortality. Neurological presentations usually result in a relatively early diagnosis and management of the neoplasms. Non neurological manifestations may result in later detection and possibly a higher eventual morbidity and mortality. Hence, the importance of a keen index of suspicion in assessment of cases to detect subtle neurological signs and symptoms. Cranial magnetic resonance imaging has been found to be especially useful in the definition of brain neoplasms. In this paper, four cases with non neurological manifestations are presented (one diencephalic syndrome, one failure to thrive, one precocious puberty and one gastrointestinal symptoms).

Brain Neoplasms↗

[Separation of osteoclasts by lectin affinity chromatography].

Newborn rat calvaria bone cells obtained by digestion were fractionated on columns of wheat-germ agglutinin (WGA) sepharose 6MB for osteoclast isolation. The initial nonspecific binding cells which were passed through the WGA sepharose column by a buffer acquired a high enzyme activity of alkaline phosphatase, but not that of acid phosphatase. However, elution of cells using a buffer with the addition of N-acetyl-D-glucosamine resulted in a high acid phosphatase activity but no alkaline phosphatase activity. The former WGA binding negative fraction enriched osteoblasts averaging 30 microns in size. The latter WGA binding positive fraction enriched osteoclasts ranging from 20 microns to 60 microns in size. The electron-microscope clearly demonstrated the cellular details of osteoclasts. Isolated cell counts showed a ratio of six to four. These results indicate that our method of osteoclast isolation is simple and useful in lectin affinity chromatography because all cells have sugar moieties on their surface and the binding of osteoclasts can be reversed by the addition of specific lectin-binding sugars to the eluting buffer.

Acid Phosphatase↗

Universally immunogenic T cell epitopes: promiscuous binding to human MHC class II and promiscuous recognition by T cells.

To understand the effect of human MHC class II polymorphism on antigen recognition, we analyzed the memory T cell response to three tetanus toxin epitopes defined by three short synthetic peptides (p2, p4 and p30). We found that p2 and p30 are universally immunogenic, since they are recognized by all primed donors, irrespective of their MHC haplotypes. The analysis of specific clones indicates that both peptides are very promiscuous in their capacity to bind to class II. p30 can be recognized in association with DRw11(5), 7, 9 and with DPw2 and DPw4, while p2 can be recognized in association with DR1, DRw15(2), DRw18 (3), DR4Dw4, DRw11(5), DRw13(w6), DR7, DRw8, DR9, DRw52a and DRw52b. On the contrary, the third peptide, p4, can be recognized by only half of the donors in association with only DRw52a and DRw52c. Analysis of truncated peptides shows that p30 contains three distinct epitopes, each recognized in association with different class II molecules. Therefore, the restriction specificity is already set at the level of the peptide-MHC complex and, in all cases, T cells discriminate p30 bound to different class II molecules. On the contrary, p2 contains only one epitope, which is recognized in association with all DR molecules. In this case we found two different restriction patterns. Some clones are monogamous, since they recognize the peptide in association with one DR allele, while others are promiscuous, since they recognize by peptide in association with several different DR molecules. Thus, in this case, the restriction specificity is also set at the level of the T cell receptor. We suggest that both the promiscuous binding of peptides and the promiscuous recognition by T cells are dependent on the particular structure of the DR molecules, having a monomorphic alpha chain associated with a polymorphic beta chain.

Alleles↗

The effect of alpha-human atrial natriuretic peptide on the incidence of acute renal failure in cadaveric kidney transplantation.

In previous studies in humans, mannitol (20%, 250 ml) has been shown to reduce the incidence of acute renal failure (ARF) after transplantation from 54% to 19%. In rats, atrial natriuretic peptide appears to prevent ischemia-induced ARF. We therefore decided to evaluate the effects of alpha-human atrial natriuretic peptide (alpha-h-ANP) both alone and combined with mannitol during transplantation in humans. First, we demonstrated that systemic alpha-h-ANP infusion during kidney transplantation was safe in dosages up to 0.08 micrograms/kg per minute. In these patients the calculated metabolic clearance rate of alpha-h-ANP was relatively low ranging from 0.68 to 1.80 l/min. In a second study of 11 renal graft recipients, no mannitol was used and alpha-h-ANP (0.05 micrograms/kg per minute) was infused into the donor kidney artery during transplantation for 46 +/- 2 min, followed by IV administration for 71 +/- 2 min. Our aim was to reduce the incidence of ARF. Nevertheless, ARF occurred immediately after surgery in four of the patients (36%) in this group and, as a result, mannitol was reintroduced. A third group of nine renal graft recipients received alpha-h-ANP (total dose 400 micrograms) as five IV injections within 90 min after transplantation. ARF occurred in four of these patients (44%). We conclude that alpha-h-ANP, administered according to the aforementioned protocols in such small groups of patients, does not seem to be of value in the prevention of ARF after transplantation.

Acute Kidney Injury↗

Time-resolved immunofluorometric assay of human pancreatic isoamylase in serum, with use of two monoclonal antibodies.

This new method for determining pancreatic isoamylase (EC 3.2.1.1) in serum involves two monoclonal antibodies: one immobilized in a microtitration well (the capture antibody), the other biotinylated. After the sample is incubated with the two antibodies, the captured immunocomplex is quantified by adding streptavidin labeled with a europium chelator and measuring the specific Eu3+ fluorescence in a time-resolved mode. Three assay protocols are proposed, involving incubation times of 90, 45, or 25 min. The assay has low (0.005%) cross-reactivity with the salivary isoenzyme. Analytical performance was satisfactory. Results correlate well with results obtained by measuring total amylase activity or by measuring pancreatic isoamylase activity after immunoinhibition. Unlike numerous current amylase assays, this method measures enzyme mass rather than enzyme activity. Potentially, this is a highly specific assay.

Adult↗

Attitudes and experience of Singapore doctors and dental surgeons regarding acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) positive patients.

A survey conducted in September 1987 among medical doctors and dental surgeons in Singapore found that most respondents expressed personal reservations and inadequacies in dealing with AIDS/HIV-positive patients and homosexuals. They were also concerned about exposure of their staff to AIDS patients and their likely reactions towards treating these patients. The risk of contagion with AIDS was a major deterrent expressed. The majority of the health professionals had no experience in the management of AIDS related conditions. Although many indicated interest in training, only less than half were willing to undergo what they perceived as the more effective clinically based training themselves.

Acquired Immunodeficiency Syndrome↗

Proteolytic activity of the cowpea mosaic virus encoded 24K protein synthesized in Escherichia coli.

The function of the 24-kilodalton (24K) protein encoded by cowpea mosaic virus (CPMV) has been studied by constructing a bacterial expression plasmid that contained a cloned chimeric segment consisting of partial DNA copies of CPMV M-RNA (including sequences coding for both capsid proteins) and B-RNA (including sequences coding for the 24K protein). Viral sequences were transcribed from the phage T7 promoter phi 10 of plasmid pT7-6 using T7-RNA polymerase expressed from plasmid pGP1-2 present in the same cells. Upon inducing the synthesis of T7-RNA polymerase several new polypeptides that contained CPMV-specific sequences were expressed, as demonstrated by immunoprecipitation and immunoblotting. Furthermore a proteolytic activity was detected in induced cells which cleaved the viral protein sequences specifically at two glutamine-glycine sites. One of the cleavage products represented capsid protein VP23. The proteolytic activity was absent when an 87-bp deletion was introduced in the coding region for the 24K protein, indicating that this protein represented the protease involved in the proteolytic processing at those specific sites.

Cloning, Molecular↗

U wave inversion in unstable angina due to left main coronary artery stenosis.

A 50-year-old male was admitted to hospital for repeated episodes of chest pain due to unstable angina. Serial electrocardiograms were all normal except for one electrocardiogram, recorded during chest pain, which showed isolated U wave inversion in leads I, V4 and V5. Subsequently, selective coronary arteriography showed isolated 99% stenosis of his left main coronary artery.

Angina Pectoris↗

Fetal sonography and neonatal scintigraphy of a choledochal cyst.

A choledochal cyst, observed by ultrasound at 27 wk gestation and diagnosed at 36 wk gestation, was confirmed postpartum by [99mTc]DISIDA cholescintogram. Cystic dilatation of the common bile duct was proven by surgical excision and histological verification. Ultrasonography provides in utero diagnosis of choledochal cyst, often vital for successful management. Technetium-99m DISIDA imaging is a valuable companion for defining function of the cyst.

Adolescent↗

Two-dimensional and pulsed Doppler echocardiographic abnormalities in coronary artery-pulmonary artery fistula.

We describe two patients who presented with precordial continuous murmurs which were diagnosed clinically as due to patent ductus arteriosus; however, two-dimensional echocardiographic and pulsed Doppler echocardiographic studies showed dilatation of the left main coronary artery with turbulent flow during systole in the lumen in both patients. Subsequent selective coronary angiographic studies showed bilateral coronary artery-pulmonary artery fistula in one patient and left coronary artery-pulmonary artery fistula in the other. This study illustrates that in a patient presenting with a continuous murmur which is suggestive of patent ductus arteriosus, such two-dimensional and pulsed Doppler echocardiographic findings as were seen in our patients should immediately alert the physician that he may be dealing with a case of coronary arterial fistula.

Coronary Vessels↗