A comparison of the clinical, laboratory and epidemiological features of two divergent subpopulations of Plasmodium knowlesi.

Plasmodium knowlesi, a simian malaria parasite responsible for all recent indigenous cases of malaria in Malaysia, infects humans throughout Southeast Asia. There are two genetically distinct subpopulations of Plasmodium knowlesi in Malaysian Borneo, one associated with long-tailed macaques (termed cluster 1) and the other with pig-tailed macaques (cluster 2). A prospective study was conducted to determine whether there were any between-subpopulation differences in clinical and laboratory features, as well as in epidemiological characteristics.

Predictors of survival outcome following radical gastrectomy for gastric cancer.

Background: Radical surgery with adjuvant therapy is now the standard treatment for locally advanced gastric cancer. However, the best regimen for adjuvant therapy remains controversial. We aim to determine the predictors of survival outcome of gastric cancer patients who underwent curative surgery with or without adjuvant therapy in our institution.

Synthesis, binding ability, and cell cytotoxicity of fluorescent probes for l-arginine detection based on naphthalene derivatives: Experiment and theory.

Inspired by biological related parts, Schiff base derivatives and functional groups of chemical modification can provide efficient detection method of amino acids. Therefore, we have designed and prepared 4 compounds based on Schiff base derivatives involving ─NO , ─OH, and naphthyl group. Results indicated that compound 4 containing 2 nitro groups showed strong sensitivity and high selectivity for arginine (Arg) among normal 18 kinds of standard amino acids (alanine, valine, leucine, isoleucine, methionine, aspartic acid, glutamic acid, arginine, glycine, serine, asparagine, phenylalanine, histidine, tryptophan, proline, lysine, glutamine, and cysteine).

Genotypic characterization of multi-drug-resistant Mycobacterium tuberculosis isolates in Myanmar.

The number of multi-drug-resistant tuberculosis (MDR-TB) cases is rising worldwide. As a countermeasure against this situation, the implementation of rapid molecular tests to identify MDR-TB would be effective. To develop such tests, information on the frequency and distribution of mutations associating with phenotypic drug resistance in Mycobacterium tuberculosis is required in each country.

Monitoring the effects of treatment in colon cancer cells using immunohistochemical and histoenzymatic techniques.

Background: Monitoring the effects of treatment in malignant diseases is very important in study of the influence on the cell metabolism. Energy production in cancer cells is abnormally dependent on aerobic glycolysis. In addition to the dependency on glycolysis, cancer cells have other atypical metabolic characteristics.

Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome.

Background: Tumors arising from the esophagogastric junction (OGJ) are increasing in incidence in the west, but data from Asian populations are conflicting. Singapore has a mixed-Asian population with an international lifestyle. This study was designed to examine the changing trends in incidence of gastric cardia cancer (type III) within this population and to compare the clinicopathological characteristics and outcome of these tumors with gastric tumors.

Surgical management of obesity - National University Hospital experience.

Introduction: The Singapore National Survey of 2004 reported the prevalence of obesity to have increased to 6.9%, thus reflecting the profound changes in our society's lifestyle and eating habits. Bariatric surgery has steadily been increasing to counter the ill effects of obesity.

Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome.

Background: Superior mesenteric artery syndrome (SMAS) is a rare condition causing acute or chronic compression of the third part of the duodenum, due to a reduction in the aortomesenteric angle. Traditionally, an open duodenojejunostomy is recommended when conservative management fails. Laparoscopic duodenojejunostomy is a minimally invasive option that has been reported in up to 10 cases.

Isoniazid and rifampicin resistance-associated mutations in Mycobacterium tuberculosis isolates from Yangon, Myanmar: implications for rapid molecular testing.

Objectives: To evaluate the frequency and nature of mutations in genes associated with resistance to rifampicin and isoniazid in Mycobacterium tuberculosis isolates collected from Yangon, Myanmar.

Methods: Ninety-six isoniazid-resistant M. tuberculosis isolates, including 29 multidrug-resistant isolates, were analysed for mutations in the rpoB, katG, inhA, oxyR and ahpC genes.

Predominance of Mycobacterium tuberculosis EAI and Beijing lineages in Yangon, Myanmar.

Isolates of the Mycobacterium tuberculosis Beijing lineage are associated with high rates of transmission, hypervirulence and drug resistance. The Beijing lineage has been shown to dominate the tuberculosis (TB) epidemic in East Asia; however, the diversity and frequency of M. tuberculosis genotypes from Myanmar are unknown.

Reduction of hospital stay and cost after the implementation of a clinical pathway for radical gastrectomy for gastric cancer.

Background: Clinical pathways have been used for various surgical procedures to improve outcomes and reduce costs. Radical gastrectomy is a major surgery for the treatment of gastric cancer. This study serves to evaluate the difference in clinical outcomes before and after patients were managed on a multidisciplinary gastrectomy pathway.

Study of drug resistant cases among new pulmonary tuberculosis patients attending a tuberculosis center, Yangon, Myanmar.

A cross-sectional descriptive study was carried out at a tuberculosis center, Yangon, Myanmar from October 2003 to July 2004 to analyze the drug susceptibility of new sputum smear positive pulmonary tuberculosis patients. A total of 202 Mycobacterium tuberculosis isolates were tested for resistance to isoniazid, streptomycin, rifampicin and ethambutol. Resistance to at least one anti-tuberculosis drug was documented in 32 (15.

National anti-tuberculosis drug resistance survey, 2002, in Myanmar.

Setting: Thirty townships of Myanmar.

Objectives: To determine the proportions of drug-resistant tuberculosis (TB) in new and previously treated pulmonary tuberculosis (PTB) cases in Myanmar.

Design: A cross-sectional study.

Leiomyoma of the oesophagus managed by thoracoscopic enucleation.

The authors document two patients with oesophageal leiomyoma. In the first patient, a 41-year-old man, enucleation of the oesophageal leiomyoma was initially attempted by a thoracoscopic approach, but because of adherence of the tumour to the oesophageal mucosa, enucleation was completed by thoracotomy. Thoracoscopic enucleation was successfully performed in the second patient, a 62-year-old man.

Oesophageal-impacted denture requiring open surgery.

The successful removal of impacted denture in the oesophagus in a patient is reported, with a review of the literature. A 36-year-old Malay man complained of dysphagia after swallowing his denture. Following unsuccessful attempts at removal via a rigid oesophagoscope, open surgery was performed.

Drug-resistant tuberculosis in Yangon, Myanmar.

The extent of drug resistant tuberculosis (TB) in the capital city of Myanmar, Yangon has not yet been reported. This study aimed to determine the proportion and pattern of drug resistance to first-line anti-TB drugs, among Mycobacterium tuberculosis complex isolates from sputum smear positive TB patients who attended National TB Programme Yangon centres in April-August and October-December 2002. Drug susceptibility was determined by the Mycobacteria Growth Indicator Tube manual system (Becton Dickinson, MD, USA).

Singapore experience in obesity surgery.

Background: The outcome of bariatric surgery has been well documented in large series in the West. In Asia, where obesity has been less rampant, such surgery has been correspondingly less frequent, and there is a dearth of information on bariatric surgery on Asians.

Method: The outcome of a personal series of 40 patients who underwent "gastric stapling" and banding from 1987 to 2003 in Singapore is analyzed.

What is true community-acquired urinary tract infection? Comparison of pathogens identified in urine from routine outpatient specimens and from community clinics in a prospective study.

In order to identify the true nature of community-acquired urinary tract infections, the uropathogens isolated from 100 patients with urinary tract infection included in a prospective study conducted in community clinics were compared to 244 isolates from outpatient urine specimens routinely submitted to the laboratory. Significant differences in both the spectrum of bacteria and their antibiograms were found between the two groups. Laboratory data analysis of uropathogens from outpatient urine specimens may not reflect the true bacteriology of urinary tract infections acquired in the community.

Interventions for treating melioidosis.

Background: Melioidosis is an infectious disease that occurs in tropical regions, particularly in Thailand. It is caused by the bacterium Burkholderia pseudomallei and is a serious condition which can be fatal. Beta-lactam antibiotics have dramatically reduced the risk of death, but mortality still remains high.

Improved method of direct microscopy for detection of acid-fast bacilli in sputum.

Microscopy of direct smears for acid-fast bacilli (AFB) is the most commonly used method for diagnosis of tuberculosis. However, direct microscopy of sputum, though rapid, has low sensitivity and there is a need for improved methods. Sputum samples were collected from patients attending the Union Tuberculosis Institute, Yangon.

Use of laparoscopy in the management of mesenteric venous thrombosis.

Mesenteric vein thrombosis is a relatively rare cause of intestinal ischemia. We present a case of idiopathic superior mesenteric and portal vein thrombosis, which was not associated with any infarcted bowel. The patient was treated successfully with anticoagulation using low-molecular weight heparin and warfarin, and did not require bowel resection.

Interventions for treating melioidosis.

Background: Melioidosis is an infectious disease caused by a bacterium (Burkholderia pseudomallei) found particularly in some areas in the tropics. It is a serious condition which can be fatal. Beta lactam antibiotics have dramatically reduced the risk of death, but mortality still remains high.