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Clinical Prognostic Factors and Survival Outcome in Renal Cell Carcinoma Patients - A Malaysian Single Centre Perspective

  • Yap, Ning Yi;Ng, Keng Lim;Ong, Teng Aik;Pailoor, Jayalakshmi;Gobe, Glenda Carolyn;Ooi, Chong Chien;Razack, Azed Hassan;Dublin, Norman;Morais, Christudas;Rajandram, Retnagowri
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7497-7500
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    • 2013
  • Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

Attitudes Towards Colorectal Cancer (CRC) and CRC Screening Tests among Elderly Malay Patients

  • Al-Naggar, Redhwan A.;Al-Kubaisy, Waqar;Yap, Bee W.;Bobryshev, Yuri V.;Osman, Muhamed T.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.667-674
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    • 2015
  • Background: Colorectal cancer (CRC) is the third most common malignancy in Malaysia, where data are limited regarding knowledge and barriers in regard to CRC and screening tests. The aim of the study was to assess these parameters among Malaysians. Materials and Methods: The questionnaires were distributed in the Umra Private Hospital in Selangor. The questionnaire had four parts and covered social-demographic questions, respondent knowledge about CRC and colorectal tests, attitude towards CRC and respondentaction regarding CRC. More than half of Malay participants (total n=187) were female (57.2%) and 36.9% of them were working as professionals. Results: The majority of the participants (93.6%) never had a CRC screening test. The study found that only 10.2% of the study participants did not consider that their chances of getting CRC were high. A high percentage of the participants (43.3%) believed that they would have good chance of survival if the cancer would be found early. About one third of the respondents did not want to do screening because of fear of cancer, and concerns of embarrassment during the procedure adversely affected attitude to CRC screening as well. Age, gender, income, family history of CRC, vegetable intake and physical activity were found to be significant determinants of knowledge on CRC. Conclusions: The major barriers identified towards CRC screening identified in our study were fear of pain and embarrassment. The findings have implications for understanding of similarities and differences in attitude to CRC amongst elderly patients in other cultural/geographic regions.

Can Definitions Contribute to Alternative Conceptions?: A Meta-Study Approach

  • Wong, Chee Leong;Yap, Kueh Chin
    • Journal of The Korean Association For Science Education
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    • v.32 no.8
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    • pp.1295-1317
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    • 2012
  • There has been disagreement on the importance of definitions in science education. Yager (1983) believes that one crisis in science education was due to the considerable emphasis upon the learning of definitions. Hobson (2004) disagrees with physics textbooks that do not provide general definition on energy. Some textbooks explain that "there is no completely satisfactory definition of energy" or they can only "struggle to define it." In general, imprecise definitions in textbooks (Bauman, 1992) and inaccuracies in definition provided by teachers (Galili & Lehavi, 2006) may cause alternative conceptions. Besides, there are at least four challenges in defining physical concepts: precision, circularity, context and completeness in knowledge. These definitional problems that have been discussed in The Feynman Lectures, may impede the learning of physical concepts. A meta-study approach is employed to examine about five hundreds journal papers that may discuss definitions in physics, problems in defining physical concepts and how they may result in alternative conceptions. These journal papers are mainly selected from journals such as American Journal of Physics, International Journal of Science Education, Journal of Research in Science Teaching, Physics Education, The Physics Teachers, and so on. There are also comparisons of definitions with definitions from textbooks, Dictionaries of Physics, and English Dictionaries. To understand the nature of alternative conception, Lee et al. (2010) have suggested a theoretical framework to describe the learning issues by synthesizing cognitive psychology and science education approaches. Taking it a step further, this study incorporates the challenges in semantics and epistemology, proposes that there are at least four variants of alternative conceptions. We may coin the term, 'alternative definitions', to refer to the commonly available definitions, which have these four problems in defining physics concepts. Based on this study, alternative definitions may result in at least four variants of alternative conceptions. Note that these four definitional problems or challenges in definitions cannot be easily resolved. Educators should be cognizant of the four variants of alternative conceptions which can arise from alternative definitions. The concepts of alternative definitions can be useful and possibly generalized to science education and beyond.

Roles of Ki67 in Breast Cancer - Important for Management?

  • Yip, CH;Bhoo-Pathy, N;Daniel, JM;Foo, YC;Mohamed, AK;Abdullah, MM;Ng, YS;Yap, BK;Pathmanathan, R
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1077-1082
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    • 2016
  • Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

Suppressive Effect of Maslinic Acid on PMA-induced Protein Kinase C in Human B-Lymphoblastoid Cells

  • Mooi, Lim Yang;Yew, Wong Teck;Hsum, Yap Wei;Soo, Khoo Kong;Hoon, Lim Saw;Chieng, Yeo Chew
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1177-1182
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    • 2012
  • Protein kinase C (PKC) has been implicated in carcinogenesis and displays variable expression profiles during cancer progression. Studies of dietary phytochemicals on cancer signalling pathway regulation have been conducted to search for potent signalling regulatory agents. The present study was designed to evaluate any suppressive effect of maslinic acid on PKC expression in human B-lymphoblastoid cells (Raji cells), and to identify the PKC isoforms expressed. Effects of maslinic acid on PKC activity were determined using a PepTag$^{(R)}$ assay for non-radioactive detection of PKC. The highest expression in Raji cells was obtained at 20 nM PMA induced for 6 hours. Suppressive effects of maslinic acid were compared with those of four PKC inhibitors (H-7, rottlerin, sphingosine, staurosporine) and two triterpenes (oleanolic acid and ursolic acid). The $IC_{50}$ values achieved for maslinic acid, staurosporine, H-7, sphingosine, rottlerin, ursolic acid and oleanolic acid were 11.52, 0.011, 0.767, 2.45, 5.46, 27.93 and $39.29\;{\mu}M$, respectively. Four PKC isoforms, PKC ${\beta}I$, ${\beta}II$, ${\delta}$, and ${\zeta}$, were identified in Raji cells via western blotting. Maslinic acid suppressed the expression of PKC ${\beta}I$, ${\delta}$, and ${\zeta}$ in a concentration-dependent manner. These preliminary results suggest promising suppressive effects of maslinic acid on PKC activity in Raji cells. Maslinic acid could be a potent cancer chemopreventive agent that may be involved in regulating many downstream signalling pathways that are activated through PKC receptors.

A numerical study of flow and heat transfer characteristics varied by impingement jet in turbine blade cooling (터빈블레이드의 냉각에서 충돌제트에 의해 변화되는 유동 및 열전달 특성에 관한 수치해석적 연구)

  • Lee, Jeong-Hui;Kim, Sin-Il;Yu, Hong-Seon;Choe, Yeong-Gi
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.20 no.12
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    • pp.4013-4026
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    • 1996
  • A numerical simulation has been carried out for the jet impinging on a flat plate and a semi-circular concave surface. In this computation finite volume method was employed to solve the full Navier-Stokes equation based on a non-orthogonal coordinate with non staggered variable arrangement. The standard k-.epsilon. turbulent model and low Reynolds number k-.epsilon. model(Launder-Sharmar model) with Yap's correction were adapted. The accuracy of the numerical calculations were compared with various experimental data reported in the literature and showed good predictions of centerline velocity decay, wall pressure distribution and skin friction. For the jet impingement on a semi-circular concave surface, potential core length was calculated for two different nozzle(round edged nozzle and rectangular edged nozzle) to consider effects of the nozzle shape. The result showed that round edged nozzle had longer potential core length than rectangular edged nozzle for the same condition. Heat transfer rate along the concave surface with constant heat flux was calculated for various nozzle exit to surface distance(H/B) in the condition of same jet velocity. The maximum local Nusselt number at the stagnation point occurred at H/B = 8 where the centerline turbulent intensity had maximum value. The predicted Nusselt number showed good agreement with the experimental data at the stagnation point. However heat transfer predictions along the downstream were underestimated. This results suggest that the improved turbulence modeling is required.

A Simplified Synchronous Reference Frame for Indirect Current Controlled Three-level Inverter-based Shunt Active Power Filters

  • Hoon, Yap;Radzi, Mohd Amran Mohd;Hassan, Mohd Khair;Mailah, Nashiren Farzilah;Wahab, Noor Izzri Abdul
    • Journal of Power Electronics
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    • v.16 no.5
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    • pp.1964-1980
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    • 2016
  • This paper presents a new simplified harmonics extraction algorithm based on the synchronous reference frame (SRF) for an indirect current controlled (ICC) three-level neutral point diode clamped (NPC) inverter-based shunt active power filter (SAPF). The shunt APF is widely accepted as one of the most effective current harmonics mitigation tools due to its superior adaptability in dynamic state conditions. In its controller, the SRF algorithm which is derived based on the direct-quadrature (DQ) theory has played a significant role as a harmonics extraction algorithm due to its simple implementation features. However, it suffers from significant delays due to its dependency on a numerical filter and unnecessary computation workloads. Moreover, the algorithm is mostly implemented for the direct current controlled (DCC) based SAPF which operates based on a non-sinusoidal reference current. This degrades the mitigation performances since the DCC based operation does not possess exact information on the actual source current which suffers from switching ripples problems. Therefore, three major improvements are introduced which include the development of a mathematical based fundamental component identifier to replace the numerical filter, the removal of redundant features, and the generation of a sinusoidal reference current. The proposed algorithm is developed and evaluated in MATLAB / Simulink. A laboratory prototype utilizing a TMS320F28335 digital signal processor (DSP) is also implemented to validate effectiveness of the proposed algorithm. Both simulation and experimental results are presented. They show significant improvements in terms of total harmonic distortion (THD) and dynamic response when compared to a conventional SRF algorithm.

Zika Virus-Encoded NS2A and NS4A Strongly Downregulate NF-κB Promoter Activity

  • Lee, Jeong Yoon;Nguyen, Thi Thuy Ngan;Myoung, Jinjong
    • Journal of Microbiology and Biotechnology
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    • v.30 no.11
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    • pp.1651-1658
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    • 2020
  • Since Zika virus (ZIKV) was first detected in Uganda in 1947, serious outbreaks have occurred globally in Yap Island, French Polynesia and Brazil. Even though the number of infections and spread of ZIKV have risen sharply, the pathogenesis and replication mechanisms of ZIKV have not been well studied. ZIKV, a recently highlighted Flavivirus, is a mosquito-borne emerging virus causing microcephaly and the Guillain-Barre syndrome in fetuses and adults, respectively. ZIKV polyprotein consists of three structural proteins named C, prM and E and seven nonstructural proteins named NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5 in an 11-kb single-stranded positive sense RNA genome. The function of individual ZIKV genes on the host innate immune response has barely been studied. In this study, we investigated the modulations of the NF-κB promoter activity induced by the MDA5/RIG-I signaling pathway. According to our results, two nonstructural proteins, NS2A and NS4A, dramatically suppressed the NF-κB promoter activity by inhibiting signaling factors involved in the MDA5/RIG-I signaling pathway. Interestingly, NS2A suppressed all components of MDA5/RIG-I signaling pathway, but NS4A inhibited most signaling molecules, except IKKε and IRF3-5D. In addition, both NS2A and NS4A downregulated MDA5-induced NF-κB promoter activity in a dosedependent manner. Taken together, our results suggest that NS2A and NS4A signifcantly antagonize MDA5/RIG-I-mediated NF-κB production, and these proteins seem to be controlled by different mechanisms. This study could help understand the mechanisms of how ZIKV controls innate immune responses and may also assist in the development of ZIKV-specific therapeutics.

Parametric Studies of Pulsed Laser Deposition of Indium Tin Oxide and Ultra-thin Diamond-like Carbon for Organic Light-emitting Devices

  • Tou, Teck-Yong;Yong, Thian-Khok;Yap, Seong-Shan;Yang, Ren-Bin;Siew, Wee-Ong;Yow, Ho-Kwang
    • Journal of the Optical Society of Korea
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    • v.13 no.1
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    • pp.65-74
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    • 2009
  • Device quality indium tin oxide (ITO) films are deposited on glass substrates and ultra-thin diamond-like carbon films are deposited as a buffer layer on ITO by a pulsed Nd:YAG laser at 355 nm and 532 nm wavelength. ITO films deposited at room temperature are largely amorphous although their optical transmittances in the visible range are > 90%. The resistivity of their amorphous ITO films is too high to enable an efficient organic light-emitting device (OLED), in contrast to that deposited by a KrF laser. Substrate heating at $200^{\circ}C$ with laser wavelength of 355 nm, the ITO film resistivity decreases by almost an order of magnitude to $2{\times}10^{-4}\;{\Omega}\;cm$ while its optical transmittance is maintained at > 90%. The thermally induced crystallization of ITO has a preferred <111> directional orientation texture which largely accounts for the lowering of film resistivity. The background gas and deposition distance, that between the ITO target and the glass substrate, influence the thin-film microstructures. The optical and electrical properties are compared to published results using other nanosecond lasers and other fluence, as well as the use of ultra fast lasers. Molecularly doped, single-layer OLEDs of ITO/(PVK+TPD+$Alq_3$)/Al which are fabricated using pulsed-laser deposited ITO samples are compared to those fabricated using the commercial ITO. Effects such as surface texture and roughness of ITO and the insertion of DLC as a buffer layer into ITO/DLC/(PVK+TPD+$Alq_3$)/Al devices are investigated. The effects of DLC-on-ITO on OLED improvement such as better turn-on voltage and brightness are explained by a possible reduction of energy barrier to the hole injection from ITO into the light-emitting layer.

Antibacterial Mode of Action of Cinnamomum verum Bark Essential Oil, Alone and in Combination with Piperacillin, Against a Multi-Drug-Resistant Escherichia coli Strain

  • Yap, Polly Soo Xi;Krishnan, Thiba;Chan, Kok-Gan;Lim, Swee Hua Erin
    • Journal of Microbiology and Biotechnology
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    • v.25 no.8
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    • pp.1299-1306
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    • 2015
  • This study aims to investigate the mechanism of action of the cinnamon bark essential oil (CB), when used singly and also in combination with piperacillin, for its antimicrobial and synergistic activity against beta-lactamase TEM-1 plasmid-conferred Escherichia coli J53 R1. Viable count of bacteria for this combination of essential oil and antibiotic showed a complete killing profile at 20 h and further confirmed its synergistic effect by reducing the bacteria cell numbers. Analysis on the stability of treated cultures for cell membrane permeability by CB when tested against sodium dodecyl sulfate revealed that the bacterial cell membrane was disrupted by the essential oil. Scanning electron microscopy observation and bacterial surface charge measurement also revealed that CB causes irreversible membrane damage and reduces the bacterial surface charge. In addition, bioluminescence expression of Escherichia coli [pSB1075] and E. coli [pSB401] by CB showed reduction, indicating the possibility of the presence of quorum sensing (QS) inhibitors. Gas-chromatography and mass spectrometry of the essential oil of Cinnamomum verum showed that trans-cinnamaldehyde (72.81%), benzyl alcohol (12.5%), and eugenol (6.57%) were the major components in the essential oil. From this study, CB has the potential to reverse E. coli J53 R1 resistance to piperacillin through two pathways; modification in the permeability of the outer membrane or bacterial QS inhibition.