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1.  Assessing students approaches to learning using a matrix framework in a Malaysian public university 
SpringerPlus  2014;3:54.
This study aims to evaluate the learning characteristics of students using a matrix framework of learning approaches (MFLA) in a Malaysian public university. A survey form based on Biggs’s study process questionnaire (SPQ) was distributed to a total of 350 students. This study employed a descriptive correlation research design to address the research objectives. The findings revealed that Malaysian students are prone to applying the achieving approach in their studies. The achieving approach is the most preferable learning characteristic. The results also indicated that four of the nine hypothetical learning approaches exist, two of which are positive in nature. As a result, a proposed teaching method based on the MFLA was introduced to suit the needs of these major learning characteristics among students.
doi:10.1186/2193-1801-3-54
PMCID: PMC3935033  PMID: 24600539
Student approaches to learning; Matrix framework of learning approaches; Malaysian universities
2.  RsaI but not DraI polymorphism in CYP2E1 gene increases the risk of gastrointestinal cancer in Malaysians: a case–control study 
BMJ Open  2014;4(1):e004109.
Objectives
Our study aimed to investigate the association of CYP2E1 C-1019T RsaI and T7678A DraI polymorphisms and factors such as age, gender and ethnicity to the risk of gastrointestinal cancer (GIC) in Malaysians.
Design
Case–control study.
Setting
Malaysia.
Participants
520 consented healthy blood donors with no previous GIC record and 175 patients with GIC.
Measurements
C-1019T RsaI and T7678A DraI genotyping of CYP2E1 gene; direct sequencing.
Results
This study reveals that the variant c2 allele and carrier with at least one c2 allele of C-1019T single nucleotide polymorphism (SNP) significantly increased the risk of GIC but no significant association was found between T7678A SNP and combined analysis of C-1019T and T7678A SNPs to risk of GIC. The Malaysian Chinese had greater risk of GIC compared with the Malays, Indians and KadazanDusun. An increased risk of GIC was observed in individuals aged >40 years and women had a 2.22-fold and 1.58-fold increased risk of stomach and colorectal cancers, respectively, when compared with men.
Limitations
The future research should be conducted with a larger sample population and including the gene–gene and gene–environmental interactions.
Conclusions
Our study suggests that the rare c2 allele and carrier with at least one c2 allele of CYP2E1 RsaI polymorphism significantly elevated the risk of GIC and may be used as a genetic biomarker for early screening of GIC in Malaysians. The risk age-group has been shifted to a younger age at 40s and women showed a significant greater risk of stomach and colorectal cancers than men.
doi:10.1136/bmjopen-2013-004109
PMCID: PMC3902529  PMID: 24394801
Gastroenterology; Molecular Biology
3.  Degradation of Bacterial Quorum Sensing Signaling Molecules by the Microscopic Yeast Trichosporon loubieri Isolated from Tropical Wetland Waters 
Sensors (Basel, Switzerland)  2013;13(10):12943-12957.
Proteobacteria produce N-acylhomoserine lactones as signaling molecules, which will bind to their cognate receptor and activate quorum sensing-mediated phenotypes in a population-dependent manner. Although quorum sensing signaling molecules can be degraded by bacteria or fungi, there is no reported work on the degradation of such molecules by basidiomycetous yeast. By using a minimal growth medium containing N-3-oxohexanoylhomoserine lactone as the sole source of carbon, a wetland water sample from Malaysia was enriched for microbial strains that can degrade N-acylhomoserine lactones, and consequently, a basidiomycetous yeast strain WW1C was isolated. Morphological phenotype and molecular analyses confirmed that WW1C was a strain of Trichosporon loubieri. We showed that WW1C degraded AHLs with N-acyl side chains ranging from 4 to 10 carbons in length, with or without oxo group substitutions at the C3 position. Re-lactonisation bioassays revealed that WW1C degraded AHLs via a lactonase activity. To the best of our knowledge, this is the first report of degradation of N-acyl-homoserine lactones and utilization of N-3-oxohexanoylhomoserine as carbon and nitrogen source for growth by basidiomycetous yeast from tropical wetland water; and the degradation of bacterial quorum sensing molecules by an eukaryotic yeast.
doi:10.3390/s131012943
PMCID: PMC3859043  PMID: 24072030
basidiomycetous; biosensor; lactonase; N-acylhomoserine lactone; quorum sensing; quorum quenching; Rapid Resolution Liquid Chromatography; Trichosporon loubieri; yeast
4.  Prevalence and risk factors of methotrexate hepatoxicity in Asian patients with psoriasis 
World Journal of Hepatology  2013;5(5):275-280.
AIM: To establish the prevalence of liver fibrosis and to evaluate the possible risk factors for fibrosis and progression in Asian with psoriasis treated with methotrexate (MTX) based on liver histology.
METHODS: Patients with psoriasis treated with MTX referred to the Department of Gastroenterology, Tan Tock Seng Hospital for liver biopsy were identified and retrospectively studied. Patient case notes and electronic records were retrieved from the hospital database and relevant data collated. Histological changes of liver biopsies were staged according to Roengik score. The factors assessed were age, gender, ethnicity, cumulative dose of MTX, presence of comorbid conditions such as diabetes, hypertension, hyperlipidemia, and ethanol use. We also assessed the histological change in those with multiple liver biopsies. Statistical analysis was performed using Stata V.9.2.
RESULTS: There were altogether 59 patients (median age 50 years old, range 22-81 years old, male, 88%) with 98 biopsies liver biopsies; 6 normal [median cumulative dose (MCD), 2285 mg]; 62 grade I (MCD 2885 mg), 23 grade II (MCD 1800 mg) and 7 grade III (MCD 1500 mg). There was no grade IV or cirrhosis. The prevalence of liver fibrosis (grade III) was 12%. Of the factors assessed, diabetes (P = 0.001) and hypertension (P = 0.003) were significant for fibrosis on univariate analysis but not on multivariate analysis. Of the 26 patients who had more than one biopsy (median 2, range 2-6), 57.7% (n = 15) were stable, 34.6% (n = 9) had progression and 7.7% (n = 2) had regression of histological grades. On univariate analysis, non-Chinese ethnicity (P = 0.031), diabetes (P = 0.018), and hyperlipidemia (P = 0.011) were predictive of progression of grades, but these were not significant on multivariate analysis.
CONCLUSION: Liver fibrosis in Asian psoriatic population on MTX is comparable to the West. Cumulative dose was not associated with liver fibrosis. Metabolic syndrome is important factors.
doi:10.4254/wjh.v5.i5.275
PMCID: PMC3664285  PMID: 23717738
Hepatotoxicity; Liver fibrosis; Methotrexate; Risk factors; Cirrhosis
5.  Plant-Derived Natural Products as Sources of Anti-Quorum Sensing Compounds 
Sensors (Basel, Switzerland)  2013;13(5):6217-6228.
Quorum sensing is a system of stimuli and responses in relation to bacterial cell population density that regulates gene expression, including virulence determinants. Consequently, quorum sensing has been an attractive target for the development of novel anti-infective measures that do not rely on the use of antibiotics. Anti-quorum sensing has been a promising strategy to combat bacterial infections as it is unlikely to develop multidrug resistant pathogens since it does not impose any selection pressure. A number of anti-quorum sensing approaches have been documented and plant-based natural products have been extensively studied in this context. Plant matter is one of the major sources of chemicals in use today in various industries, ranging from the pharmaceutical, cosmetic, and food biotechnology to the textile industries. Just like animals and humans, plants are constantly exposed to bacterial infections, it is therefore logical to expect that plants have developed sophisticated of chemical mechanisms to combat pathogens. In this review, we have surveyed the various types of plant-based natural products that exhibit anti-quorum sensing properties and their anti-quorum sensing mechanisms.
doi:10.3390/s130506217
PMCID: PMC3690052  PMID: 23669710
anti-infective; autoinducer; bacterial cell-to-cell communication; biofilm; infectious diseases; N-acylhomoserine lactones; pathogen; quorum quenching; quorum sensing; virulence factors
6.  Transplantation of Oligodendrocyte Precursor Cells Improves Locomotion Deficits in Rats with Spinal Cord Irradiation Injury 
PLoS ONE  2013;8(2):e57534.
Demyelination contributes to the functional impairment of irradiation injured spinal cord. One potential therapeutic strategy involves replacing the myelin-forming cells. Here, we asked whether transplantation of Olig2+-GFP+-oligodendrocyte precursor cells (OPCs), which are derived from Olig2-GFP-mouse embryonic stem cells (mESCs), could enhance remyelination and functional recovery after spinal cord irradiation injury. We differentiated Olig2-GFP-mESCs into purified Olig2+-GFP+-OPCs and transplanted them into the rats’ cervical 4–5 dorsal spinal cord level at 4 months after irradiation injury. Eight weeks after transplantation, the Olig2+-GFP+-OPCs survived and integrated into the injured spinal cord. Immunofluorescence analysis showed that the grafted Olig2+-GFP+-OPCs primarily differentiated into adenomatous polyposis coli (APC+) oligodendrocytes (54.6±10.5%). The staining with luxol fast blue, hematoxylin & eosin (LFB/H&E) and electron microscopy demonstrated that the engrafted Olig2+-GFP+-OPCs attenuated the demyelination resulted from the irradiation. More importantly, the recovery of forelimb locomotor function was enhanced in animals receiving grafts of Olig2+-GFP+-OPCs. We concluded that OPC transplantation is a feasible therapy to repair the irradiated lesions in the central nervous system (CNS).
doi:10.1371/journal.pone.0057534
PMCID: PMC3583877  PMID: 23460872
7.  Role of Dietary Long-Chain Polyunsaturated Fatty Acids in Infant Allergies and Respiratory Diseases 
Maternal nutrition has critical effects on the developing structures and functions of the fetus. Malnutrition during pregnancy can result in low birth weight and small for gestational age babies, increase risk for infection, and impact the immune system. Long-chain polyunsaturated fatty acids (PUFAs) have been reported to have immunomodulatory effects. Decreased consumption of omega-6 PUFAs, in favor of more anti-inflammatory omega-3 PUFAs in modern diets, has demonstrated the potential protective role of omega-3 PUFAs in allergic and respiratory diseases. In this paper, we examine the role of PUFAs consumption during pregnancy and early childhood and its influence on allergy and respiratory diseases. PUFAs act via several mechanisms to modulate immune function. Omega-3 PUFAs may alter the T helper (Th) cell balance by inhibiting cytokine production which in turn inhibits immunoglobulin E synthesis and Th type 2 cell differentiation. PUFAs may further modify cellular membrane, induce eicosanoid metabolism, and alter gene expression. These studies indicate the benefits of omega-3 PUFAs supplementation. Nevertheless, further investigations are warranted to assess the long-term effects of omega-3 PUFAs in preventing other immune-mediated diseases, as well as its effects on the later immunodefense and health status during early growth and development.
doi:10.1155/2012/730568
PMCID: PMC3461300  PMID: 23049602
8.  Prevalence of Adhesion and Regulation of Biofilm-Related Genes in Different Clones of Staphylococcus aureus 
Clinical information about genotypically different clones of biofilm-producing Staphylococcus aureus is largely unknown. We examined whether different clones of methicillin-sensitive and methicillin-resistant S. aureus (MSSA and MRSA) differ with respect to staphylococcal microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) in biofilm formation. The study used 60 different types of spa and determined the phenotypes, the prevalence of the 13 MSCRAMM, and biofilm genes for each clone. The current investigation was carried out using a modified Congo red agar (MCRA), a microtiter plate assay (MPA), polymerase chain reaction (PCR), and reverse transcriptase polymerase chain reaction (RT-PCR). Clones belonging to the same spa type were found to have similar properties in adheringto the polystyrene microtiter plate surface. However, their ability to produce slime on MCRA medium was different. PCR experiments showed that 60 clones of MSSA and MRSA were positive for 5 genes (out of 9 MSCRAMM genes). icaADBC genes were found to be present in all the 60 clones tested indicating a high prevalence, and these genes were equally distributed among the clones associated with MSSA and those with MRSA. The prevalence of other MSCRAMM genes among MSSA and MRSA clones was found to be variable. MRSA and MSSA gene expression (MSCRAMM and icaADBC) was confirmed by RT-PCR.
doi:10.1155/2012/976972
PMCID: PMC3372070  PMID: 22701309
9.  Enabling Universal Memory by Overcoming the Contradictory Speed and Stability Nature of Phase-Change Materials 
Scientific Reports  2012;2:360.
The quest for universal memory is driving the rapid development of memories with superior all-round capabilities in non-volatility, high speed, high endurance and low power. Phase-change materials are highly promising in this respect. However, their contradictory speed and stability properties present a key challenge towards this ambition. We reveal that as the device size decreases, the phase-change mechanism changes from the material inherent crystallization mechanism (either nucleation- or growth-dominated), to the hetero-crystallization mechanism, which resulted in a significant increase in PCRAM speeds. Reducing the grain size can further increase the speed of phase-change. Such grain size effect on speed becomes increasingly significant at smaller device sizes. Together with the nano-thermal and electrical effects, fast phase-change, good stability and high endurance can be achieved. These findings lead to a feasible solution to achieve a universal memory.
doi:10.1038/srep00360
PMCID: PMC3324128  PMID: 22496956
10.  Genome Sequence of Rhodococcus sp. Strain R04, a Polychlorinated-Biphenyl Biodegrader ▿  
Journal of Bacteriology  2011;193(18):5032-5033.
The genus Rhodococcus has proved to be a promising option for the cleanup of polluted sites and application of a microbial biocatalyst. Rhodococcus sp. strain R04, isolated from oil-contaminated soil, can biodegrade polychlorinated biphenyls. Here we report the draft genome sequence of Rhodococcus sp. strain R04, which could be used to predict genes for xenobiotic biodegradation and provide important insights into the applications of this strain.
doi:10.1128/JB.05635-11
PMCID: PMC3165690  PMID: 21742862
11.  77 Recurrent Wheezing in Infancy: Epidemiological Changes Between EISL Phase i and iii 
Background
Prevalence of allergic diseases has increased in the last years. Data on recurrent wheezing (≥3 episodes) in infancy is scarce. The aim of this study was to verify changing in prevalence of recurrent wheezing infants in the south of Brazil.
Methods
Cross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) with questions: Has your baby had wheezing or whistling in the chest area or bronchitis in the first 12 months of life? Has your baby had 3 or more wheezing episodes in the first year of life? Parents of infants, ages 12 to 15 months that attended to Health Centers for routine immunization were interviewed between August 2005 to December 2006 (EISL Phase I) and September 2009 to September 2010 (EISL Phase III). Categorical variables are shown as proportion and differences verified by chi-square test, and continuous variables were expressed as mean ± SD and analyzed by Student t test.
Results
Three thousand three parents of infants answered questionnaire in the EISL Phase I, and 45.4% had had at least one wheezing episode; 50.7% were male, and 22.6% had recurrent wheezing episode starting at 5.5 ± 3.1 months. Five years later, in the EISL Phase III, 1003 parents participated in the survey: 40.6% had at least one wheezing episode (P = 0.46), 51.1% were male, and 19.8% had recurrent wheezing (P = 0.1) starting at 6.1 ± 3 months (P = 0.06).
Conclusions
Recurrent wheezing in infancy is highly prevalent and starts early in life. In our population, recurrent wheezing rates did not modify in the time period of study.
doi:10.1097/01.WOX.0000411822.54505.e5
PMCID: PMC3512761
12.  539 Asthma Treatment May Be Useful to Treat Recurrent Wheezing in Infancy 
Background
There are controversies in treating recurrent wheezing (≥3 episodes) in pre-school children. The aim of this study was to verify changes in treatment of recurrent wheezing infants.
Methods
Cross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) that covers physician diagnosis of asthma, and frequency, severity, and treatment of wheezing episodes. Regarding treatment specific questions are: Has your baby been treated with inhaled short-acting β2-agonists by metered dose inhaler or nebulizer? Has your baby been treated with inhaled corticosteroids? Has your baby been treated with antileukotrienes? Has your baby been treated with oral corticosteroids? Parents of infants, ages 12 to 15 months that attended to Health Centers for routine immunization were interviewed between August/2005 to December/2006 (EISL Phase I) and September/2009 to September/2010 (EISL Phase III). Categorical variables are showed as proportion and differences verified by chi-square test.
Results
Three thousand and 3 parents of infants answered questionnaire in the EISL Phase I and 22.6% had recurrent wheezing episodes. Five years later, in the EISL Phase III, 1003 parents participated in the survey and 19.8% had recurrent wheezing (P = 0.1). Inhaled short-acting β2-agonists continued to be prescribed in the same frequency (89.6% vs 86.5%, P = 0.21), however anti-asthmatic drugs were more used [antileukotrienes (6.9% vs 33%, P < 0.001), inhaled steroids (23.6% vs 37.5%, P = 0.001) and oral steroids (18.6% vs 26.5%, P = 0.01)] and doctor diagnosis of asthma has increased (16.2% vs 23%, P = 0.03). There were reductions on night-time symptoms (73% vs 61.5%, P = 0.001), severity (59.3% vs 42%, P = 0.001) and emergency room visits (69.3% vs 41.5%, P < 0.001) for recurrent wheezing infants, but no difference was seen in hospitalization (17.1% vs 12.5%, P = 0.12).
Conclusions
Recurrent wheezing treatment in infancy has increased in past years and may have contributed for reducing emergency room visits, night-time symptoms and severity for wheezing infants.
doi:10.1097/01.WOX.0000423198.23900.68
PMCID: PMC3512977
13.  54 Antibiotics but not Paracetamol Reduce the Risk for Recurrent Wheezing in Infants 
Background
Paracetamol (PCM) and antibiotic (ATB) use have been associated with risk for wheezing and asthma in children. The aim of this study was to verify the association of recurrent wheezing (≥3 episodes) in infancy and use of ATB or PCM in the first year of life.
Methods
Cross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) with questions: Has your baby had wheezing or whistling in the chest area or bronchitis in the first 12 months of life? Has your baby had 3 or more wheezing episodes in the first year of life? How often has your baby used antibiotics in the first year of life? How often has your baby used paracetamol in the first year of life? Parents of infants, ages 12 to 15 months that attended to Health Centers for routine immunization were interviewed between September 2009 to September 2010 (EISL Phase III). Risk was demonstrated using Odds ratio and 95% CI.
Results
One thousand and 3 parents participated in the survey and 19.8% of infants had recurrent wheezing starting at 6.1 ± 3 months. The use of PCM was not related to the presence of recurrent wheezing [No PCM (OR = 0.91; 95% CI, 0.38-2.19; P = 0.83), PCM 1–3 times (OR = 1.21; 95% CI, 0.77-1.91; P = 0.4), PCM 4–6 times (OR = 1.21; 95% CI, 0.77-1.9; P = 0.41) and PCM ≥7 times (OR = 0.76; 95% CI, 0.51-1.13; P = 0.17)], while more frequent use of ATB reduced the risk of recurrent wheezing in the first year of life [No ATB (OR = 2.18; 95% CI, 1.35-3.51; P = 0.001), ATB 1–3 times (OR = 1.39; 95% CI, 0.93-2.07; P = 0.1), ATB 4–6 times (OR = 0.37; 95% CI, 0.22-0.62; P = 0.001) and PCM≥7 times (OR = 0.22; 95% CI, 0.07-0.66; P = 0.001)].
Conclusions
The frequent use of ATB reduced the risk of recurrent wheezing in the first year of life unlike PCM that was not associated with recurrent wheezing in this study population.
doi:10.1097/01.WOX.0000411799.18173.a9
PMCID: PMC3513161
14.  Characterization of Quorum Sensing and Quorum Quenching Soil Bacteria Isolated from Malaysian Tropical Montane Forest 
Sensors (Basel, Switzerland)  2012;12(4):4846-4859.
We report the production and degradation of quorum sensing N-acyl-homoserine lactones by bacteria isolated from Malaysian montane forest soil. Phylogenetic analysis indicated that these isolates clustered closely to the genera of Arthrobacter, Bacillus and Pseudomonas. Quorum quenching activity was detected in six isolates of these three genera by using a series of bioassays and rapid resolution liquid chromatography analysis. Biosensor screening and high resolution liquid chromatography-mass spectrometry analysis revealed the production of N-dodecanoyl-L-homoserine lactone (C12-HSL) by Pseudomonas frederiksbergensis (isolate BT9). In addition to degradation of a wide range of N-acyl-homoserine lactones, Arthrobacter and Pseudomonas spp. also degraded p-coumaroyl-homoserine lactone. To the best of our knowledge, this is the first documentation of Arthrobacter and Pseudomonas spp. capable of degrading p-coumaroyl-homoserine lactone and the production of C12-HSL by P. frederiksbergensis.
doi:10.3390/s120404846
PMCID: PMC3355444  PMID: 22666062
Arthrobacter; Bacillus; liquid chromatography mass spectrometry (LC-MS); N-acylhomoserine lactone; N-dodecanoyl-L-homoserine lactone; p-coumaroylhomoserine lactone; Pseudomonas frederiksbergensis; quorum quenching; quorum sensing; rapid resolution liquid chromatography (RRLC)
15.  Impact of Diabetes on Postoperative Outcomes Following Colon Cancer Surgery 
Background
Diabetes is the sixth most common cause of death in the US and causes significant postoperative mortality and morbidity.
Objective
To characterize the impact of diabetes among patients undergoing surgery for colorectal cancer.
Design
This is is a retrospective cohort study.
Participants
Patients in the Nationwide Inpatient Sample (NIS) who had undergone colorectal cancer surgery between 1998 and 2005.
Measurements
Using multivariate regression, we determined the association of diabetes status with postoperative mortality, postoperative complications, and length of stay.
Key Results
An estimated 218,534 patients had undergone surgery for colorectal cancer. We categorized subjects by the presence of diabetes, the prevalence of which was 15%. Crude postoperative in-hospital mortality was lower among diabetics compared to non-diabetics (2.5% vs. 3.2%, P < 0.0001). Adjusted mortality was 23% lower in those with diabetes compared to non-diabetics (aOR 0.77; 95% CI: 0.71–0.84). Diabetics also had lower adjusted post-operative complications compared to non-diabetics (aOR 0.82; 95% CI: 0.79–0.84). In uninsured individuals and patients <50 years of age, there was no protective association between diabetes and either in-hospital mortality or postoperative complications.
Conclusions
In patients undergoing colorectal cancer surgery, those with diabetes had a 23% lower mortality and fewer postoperative complications compared to non-diabetics. The mechanisms underlying this unexpected observation warrant further investigation.
doi:10.1007/s11606-010-1336-7
PMCID: PMC2896591  PMID: 20352362
diabetes; nationwide; colorectal cancer; hyperglycemia
16.  Traumatic Right Diaphragmatic Rupture Combined with Avulsion of the Right Kidney and Herniation of the Liver into the Thorax 
Right-sided diaphragmatic rupture is less common and more difficult to diagnose than left-sided lesion. It is rarely combined with the herniation of the abdominal organs into the thorax. High level of suspicion is the key to early diagnosis, and a delay in diagnosis is implicated with a considerable risk of mortality and morbidity. We experienced a case of right-sided diaphragmatic rupture combined with complete avulsion of the right kidney and herniation of the liver into the thoracic cavity.
doi:10.5090/kjtcs.2011.44.1.76
PMCID: PMC3249279  PMID: 22263130
Diaphragm; Kidney; Liver; Trauma; Diaphragm, trauma
17.  Nosocomial Outbreak of Pediatric Gastroenteritis Caused by CTX-M-14-Type Extended-Spectrum β-Lactamase-Producing Strains of Salmonella enterica Serovar London 
Journal of Clinical Microbiology  2005;43(7):3519-3521.
CTX-M-14-type extended-spectrum β-lactamase was first detected in Salmonella enterica serovar London strains which were isolated from three hospitalized pediatric patients with gastroenteritis. The isolates had pulsed-field gel electrophoresis patterns identical to those of the previously isolated antimicrobial-susceptible strains from community-acquired gastroenteritis, suggesting the susceptible clone acquired the resistance.
doi:10.1128/JCM.43.7.3519-3521.2005
PMCID: PMC1169098  PMID: 16000495
18.  Lung Cancer Screening with Low-Dose Helical CT in Korea: Experiences at the Samsung Medical Center 
Journal of Korean Medical Science  2005;20(3):402-408.
To determine overall detection rates of lung cancer by low-dose CT (LDCT) screening and to compare histopathologic and imaging differences of detected cancers between high- and low-risk groups, this study included 6,406 asymptomatic Korean adults with ≥45 yr of age who underwent LDCT for lung cancer screening. All were classified into high- (≥20 pack-year smoking; 3,353) and low-risk (3,053; <20 pack-yr smoking and non-smokers) groups. We compared CT findings of detected cancers and detection rates between high- and low-risk. At initial CT, 35% (2,255 of 6,406) had at least one or more non-calcified nodule. Lung cancer detection rates were 0.36% (23 of 6,406). Twenty-one non-small cell lung cancers appeared as solid (n=14) or ground-glass opacity (GGO) (n=7) nodules. Cancer likelihood was higher in GGO nodules than in solid nodules (p<0.01). Fifteen of 23 cancers occurred in high-risk group and 8 in low-risk group (p=0.215). Therefore, LDCT screening help detect early stage of lung cancer in asymptomatic Korean population with detection rate of 0.36% on a population basis and may be useful for discovering early lung cancer in low-risk group as well as in high-risk group.
doi:10.3346/jkms.2005.20.3.402
PMCID: PMC2782194  PMID: 15953860
Mass Screening; Lung Neoplasms; Tomography, Spiral Computed; Smoking
20.  TREATABLE LEIGH-LIKE ENCEPHALOPATHY PRESENTING IN ADOLESCENCE 
BMJ case reports  2013;2013:200838.
SUMMARY
Wernicke’s encephalopathy is a triad of ophthalmoplegia, ataxia and confusion seen in alcoholics with dietary vitamin B1 (thiamine) deficiency. A rare genetic defect of thiamine transporter-2 may lead to similar clinical features, biotin-thiamine responsive basal ganglia disease (BTBGD). A 15-year-old female developed rapid onset ptosis and ophthalmoplegia evolving into a subacute encephalopathy. Neuroimaging demonstrated symmetrical basal ganglia and midbrain lesions reminiscent of Leigh’s subacute necrotising encephalomyelopathy. Oral biotin and thiamine were commenced, and symptoms improved dramatically the next day. The therapeutic response suggested SLC19A3, encoding thiamine transporter-2, as a strong candidate gene and Sanger sequencing revealed a novel homozygous c.517A>G;p.Asn173Asp mutation, which segregated with disease within the family. BTBGD is a potentially treatable neurological disorder and should be considered in the differential diagnosis of Leigh syndrome and Wernicke’s encephalopathy. Since delayed treatment results in permanent neurological dysfunction or death, prompt diagnosis and early initiation of biotin and thiamine therapy are essential.
doi:10.1136/bcr-2013-200838
PMCID: PMC3822156  PMID: 24099834
21.  Transfusion of Stored Autologous Blood Does Not Alter Reactive Hyperemia Index in Healthy Volunteers 
Anesthesiology  2012;117(1):56-63.
Background
Transfusion of human blood stored for over 2 weeks is associated with increased mortality and morbidity. During storage, packed erythrocytes progressively release hemoglobin, which avidly binds nitric oxide. We hypothesized that the nitric oxide mediated hyperemic response following ischemia would be reduced after transfusion of packed erythrocytes stored for 40 days.
Methods and results
We conducted a cross-over randomized interventional study, enrolling 10 healthy adults. Nine volunteers completed the study. Each volunteer received one unit of 40-day and one of 3-day stored autologous leukoreduced packed erythrocytes, on different study days according to a randomization scheme. Blood withdrawal and reactive hyperemia index measurements were performed before and 10 min, 1 h, 2 h, and 4 h after transfusion. The reactive hyperemia index during the first 4 h after transfusion of 40-day as compared to 3-day stored packed erythrocytes was unchanged. Plasma hemoglobin and bilirubin levels were higher after transfusion of 40-day than after 3-day stored packed erythrocytes (p = 0.02, [95% CI difference 10-114mg/l] and 0.001, [95% CI difference 0.6-1.5mg/dl], respectively). Plasma levels of potassium, Lactate dehydrogenase, haptoglobin, cytokines, as well as blood pressure, did not differ between the two transfusions and remained within the normal range. Plasma nitrite concentrations increased after transfusion of 40-day stored packed erythrocytes, but not after transfusion of 3-day stored packed erythrocytes (p = 0.01, [95% CI difference 0.446 - 0.66 μM]).
Conclusions
Transfusion of autologous packed erythrocytes stored for 40 days is associated with increased hemolysis, an unchanged reactive hyperemia index, and increased levels of plasma nitrite.
doi:10.1097/ALN.0b013e31825575e6
PMCID: PMC3980575  PMID: 22531338
22.  From Commodity Polymers to Functional Polymers 
Scientific Reports  2014;4:4604.
Functional polymers bear specified chemical groups, and have specified physical, chemical, biological, pharmacological, or other uses. To adjust the properties while keeping material usage low, a method for direct synthesis of functional polymers is indispensable. Here we show that various functional polymers can be synthesized by in situ cross-linked polymerization/copolymerization. We demonstrate that the polymers synthesized by the facile method using different functional monomers own outstanding pH-sensitivity and pH-reversibility, antifouling property, antibacterial, and anticoagulant property. Our study opens a route for the functionalization of commodity polymers, which lead to important advances in polymeric materials applications.
doi:10.1038/srep04604
PMCID: PMC3978497  PMID: 24710333
23.  Stability and Synchronization for Discrete-Time Complex-Valued Neural Networks with Time-Varying Delays 
PLoS ONE  2014;9(4):e93838.
In this paper, the synchronization problem for a class of discrete-time complex-valued neural networks with time-varying delays is investigated. Compared with the previous work, the time delay and parameters are assumed to be time-varying. By separating the real part and imaginary part, the discrete-time model of complex-valued neural networks is derived. Moreover, by using the complex-valued Lyapunov-Krasovskii functional method and linear matrix inequality as tools, sufficient conditions of the synchronization stability are obtained. In numerical simulation, examples are presented to show the effectiveness of our method.
doi:10.1371/journal.pone.0093838
PMCID: PMC3979734  PMID: 24714386
24.  Successful treatment of liver abscess secondary to foreign body penetration of the alimentary tract: A case report and literature review 
Hepatic abscess caused by foreign body penetration of the alimentary tract is rare. We report a case of gastric antrum penetration due to a toothpick complicated by liver abscess formation. A 41-year-old man was admitted to our hospital with the chief complaint of upper abdominal pain for 2 mo. Esophagogastroduodenoscopy performed at a local clinic revealed a toothpick penetrating the gastric antrum. Computed tomography (CT) of the abdomen at our hospital revealed a gastric foreign body embedded in the posterior wall of gastric antrum with regional phlegmon over the lesser sac and adhesion to the pancreatic body without notable vascular injury, and a hepatic abscess seven cm in diameter over the left liver lobe. Endoscopic removal of the foreign body was successfully performed without complication. The liver abscess was treated with parenteral antibiotics without drainage. The patient’s recovery was uneventful. Abdominal ultrasonography demonstrated complete resolution of the hepatic abscess six months after discharge. Relevant literature from the PubMed database was reviewed and the clinical presentations, diagnostic modalities, treatment strategies and outcomes of 88 reported cases were analyzed. The results showed that only 6 patients received conservative treatment with parenteral antibiotics, while the majority underwent either image-guided abscess drainage or laparotomy. Patients receiving abscess drainage via laparotomy had a significantly shorter length of hospitalization compared with those undergoing image-guided drainage. There was no significant difference in age between those who survived and those who died, however, the latter presented to hospitals in a more critical condition than the former. The overall mortality rate was 7.95%.
doi:10.3748/wjg.v20.i13.3703
PMCID: PMC3974541
Hepatic abscess; Foreign body; Endoscopy; Laparotomy; Drainage
25.  Facilitation Drives the Positive Effects of Plant Richness on Trace Metal Removal in a Biodiversity Experiment 
PLoS ONE  2014;9(4):e93733.
Background
Phytoextraction is an environmentally acceptable and inexpensive technique for mine tailing rehabilitation that uses metallophyte plants. These plants reduce the soil trace metal contents to environmentally acceptable levels by accumulating trace metals. Recently, whether more trace metals can be removed by species-rich communities of these plants received great attention, as species richness has been reported having positive effects on ecosystem functions. However, how the species richness affects trace metals removal of plant communities of mine tailing is rarely known.
Methodology/Principal Findings
We examined the effects of species richness on soil trace metal removal in both natural and experimental plant communities. The root lengths and stem heights of each plant species were measured in order to calculate the functional diversity indices. Our results showed that trace metal (Cu, Cd, Pb and Zn) concentrations in mine tailing soil declined as species richness increased in both the natural and experimental plant communities. Species richness, rather than functional diversity, positively affected the mineralomass of the experimental plant communities. The intensity of plant-plant facilitation increased with the species richness of experimental communities. Due to the incremental role of plant-plant facilitation, most of the species had higher biomasses, higher trace metal concentrations in their plant tissues and lower malondialdehyde concentrations in their leaves. Consequently, the positive effects of species richness on mineralomass were mostly attributable to facilitation among plants.
Conclusions/Significance
Our results provide clear evidence that, due to plant-plant facilitation, species richness positively affects the removal of trace metals from mine tailing soil through phytoextraction and provides further information on diversity conservation and environmental remediation in a mine tailing environment.
doi:10.1371/journal.pone.0093733
PMCID: PMC3973567  PMID: 24695538

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