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Biomedical subjects

C Y Tan

Publications and source records attributed to C Y Tan.

At least 19 recordsLinked to original sources
PubMed2006

Messenger RNA levels of genes involved in dysregulation of postprandial lipoproteins in type 2 diabetes: the role of Niemann-Pick C1-like 1, ATP-binding cassette, transporters G5 and G8, and of microsomal triglyceride transfer protein.

AIMS/HYPOTHESIS: The aim of the present study was to examine the relationship between chylomicron composition and expression of genes that regulate chylomicron production in the intestine. We examined expression of the following: (1) Niemann-Pick C1-like 1 (NPC1L1), which regulates cholesterol absorption; (2) ATP-binding cassette transporters G5 and G8 (ABCG5, ABCG8), which regulate cholesterol homeostasis through their ability to excrete enterocyte cholesterol back into the lumen of the intestine; and (3) microsomal triglyceride transfer protein (MTTP), which packages the chylomicron particle by assembling cholesterol, triglyceride, phospholipids and apolipoprotein B48. SUBJECTS, MATERIALS AND METHODS: Type 2 diabetic (26) and non-diabetic (21) patients were examined. Levels of NPC1L1, ABCG5 and ABCG8 and MTTP mRNA were measured in duodenal biopsies by real-time PCR. Lipoproteins were isolated by sequential ultracentrifugation. RESULTS: Diabetic patients had more NPC1L1 mRNA than the control subjects (p<0.02). Expression of ABCG5 and ABCG8 mRNA was lower in the diabetic patients (p<0.05) and MTTP expression was increased (p<0.05). There was a positive correlation between NPLC1L1 and MTTP mRNA (p<0.01) and a negative correlation between NPC1L1 and ABCG5 mRNA (p<0.001). Diabetic patients on statin therapy had increased ABCG5 and ABCG8 mRNA compared to those not on statin (p<0.02 and p<0.05) and less MTTP mRNA than those not on statin (p<0.05). CONCLUSIONS/INTERPRETATION: This study demonstrates that in type 2 diabetes there are important alterations to the expression of intestinal genes that regulate cholesterol absorption and chylomicron synthesis. In diabetic patients statin therapy is associated with reduced MTTP expression and increased ABCG5 and ABCG8 mRNA. The study suggests new mechanisms to explain postprandial diabetic dyslipidaemia and the beneficial effect of statins.

ATP Binding Cassette Transporter, Subfamily G, Mem↗
PubMed2005

Assessment of migraineurs referred to a specialist headache clinic in Singapore: diagnosis, treatment strategies, outcomes, knowledge of migraine treatments and satisfaction.

This study aimed to compare (i) migraineurs' diagnosis, treatment strategies and satisfaction when treated by community care physicians (CCPs) and at the specialist headache clinic; (ii) migraineurs' knowledge of migraine treatments and outcomes at baseline and at 3 months' interval. Thirty-eight patients were interviewed at baseline visit and 3 months after neurologist consultation, using a survey form which consisted of a series of self-designed questions, the MIDAS questionnaire and the SF-36 Health Survey. More patients were informed of the diagnosis of migraine by the neurologist than by CCPs. Compared with CCPs, the neurologist was more likely to employ preventive therapies, prescribe triptans and ask patients to keep a headache diary. Patients' number of days with headaches in the last 3 months, pain intensity, MIDAS score and five out of the eight SF-36 domain scores were significantly improved at the 3 months' interval (P<0.05) compared with baseline at the specialist headache clinic. More patients recognized migraine-specific therapies and reported satisfaction with treatment after the neurologist consultation. This is the first study detailing significant improvements in patients' clinical outcomes, knowledge of migraine treatments and satisfaction after consultation at a specialist headache clinic in Singapore.

Adult↗
PubMed2001

Critical role of functional decline in delayed discharge from an acute geriatric unit.

INTRODUCTION: Delayed hospital discharge of elderly patients after an acute illness poses significant problems, including bed-blockade, iatrogenesis, and increase in morbidity, dependency and social isolation. The aim of this study was to determine the factors associated with delayed discharge from an acute geriatric unit. MATERIALS AND METHODS: This was a prospective cohort study involving 172 consecutive non-institutionalised patients, 65 years and older, admitted to an acute geriatric unit. The medical, functional, psychological and social variables of each subject were documented and any decline in functional status recorded. Based on the discharge status, patients were dichotomised into the "delayed" and "non-delayed" groups. Initial bivariate analyses of the variables were performed to select those associated with the "delayed discharge" group at the P < 0.05 levels. These variables were in turn entered into a multivariate logistic regression model to identify factors significantly associated with delayed discharge. RESULTS: Forty-eight patients (27.9%) had their discharge from the acute geriatric care unit delayed despite clinically fit to be so. Variables significantly associated with delayed discharge in the multivariate model were: 1) decline in basic activities of daily living (ADL) status [P < 0.001; adjusted odds ratio (AOR), 3.63; 95% confidence interval (CI), 1.33 to 9.86] and 2) need for skilled nursing [P = 0.012; AOR, 4.57; 95% CI, 1.88 to 11.14]. CONCLUSIONS: The study demonstrates the central importance of effectively identifying elderly patients who are at risk of delayed discharge after acute hospitalisation through a multidisciplinary focus on illness-induced functional decline. It is likely therefore that proactive approaches to rehabilitation and caregiver training, and adequate community-based services, may facilitate early and effective return of these patients to their homes, thereby reducing inappropriate use of acute beds.

Activities of Daily Living↗
PubMed2000

Cutaneous cryptococcus infection due to C. albidus associated with Sézary syndrome.

Cryptococcus albidus is a non-neoformans species of the genus Cryptococcus and is a rare cause of disease. There have been only 13 previously reported cases of systemic disease in which this opportunistic yeast has been isolated from the lung, cerebrospinal fluid and blood. We report the first case of cutaneous Cryptococcus infection due to the species C. albidus, in a man with Sézary syndrome.

Aged↗
PubMed1999

[Progress in the protective medicine against [correction of aganist] rocket propellents].

To review the progress in the major assignment, the organization and implementation of protection against liquid rocket propellent. The safety detection methods of the rocket [correction of rocked] propellent in the launching field were also discussed. Three steps of the sanitation and protection of the liquid propellent, the toxicity and the toxicology of hydrazine on central nervous system, blood circulatory system, assimilation system, respiratory system, immune system, liver, kidney, eye, skin and its hereditary toxicology were described. In addition, the clinical types of poisoning, the current principle and the common ways of the prevention and treatment of hydrazine and nitrogen oxides poisoning were summarized.

Aerospace Medicine↗
PubMed1998

Analysis of corneal topography after excimer laser photorefractive keratectomy.

Excimer laser photorefractive keratectomy (PRK) is an effective treatment for myopia. We investigated the magnitude of optical zone decentration and qualitative patterns of corneal topography after this treatment. We performed computer-assisted videokeratography on 44 myopic eyes (29 patients) that had undergone PRK before and 1, 6, and 12 months after the procedure. Associations of clinical outcomes with decentration and topographic patterns were assessed. The normalized scale of the topography 1 month postoperatively showed a mean decentration of 0.33 +/- 0.23 mm (range 0-0.9). Thirty-four eyes had decentration of less than 0.50 mm; 10 had an ablation zone decentered from 0.5 to 0.9 mm. Analysis of geometric mean visual acuities between eyes with less than 0.5 mm decentration and those with 0.5 to 0.9 mm decentration demonstrated minimal differences. No eye was decentered more than 1 mm. Four main ablation patterns were noted on subtraction analysis: homogeneous, semicircular, keyhole, and central island. Over time, the number of eyes with a homogeneous pattern increased. Eyes with a homogeneous ablation pattern had significantly better uncorrected visual acuity than those with other patterns. The mean visual acuity was 20/29.1 in the homogeneous group and 20/38.5 in the pooled irregular group 1 month postoperatively (p < 0.05). There was no significant difference among the four ablation patterns at 6 or 12 months after PRK. Topographic patterns were not significantly associated with best-corrected vision.

Cornea↗
PubMed1997

Molecular pathogenesis of alcohol withdrawal seizures: the modified lipid-protein interaction mechanism.

The phrase alcohol withdrawal seizures (AWS) refers to seizures that result from the withdrawal of alcohol after a period of chronic alcohol administration. A mechanism of AWS is postulated, namely the modified lipid-protein interaction (MLPI) mechanism. This hypothesis is based upon an evaluation of the mechanisms of membrane fluidity, calcium channels, gamma-aminobutyric acid (GABA) and glutamate in the molecular pathogenesis of AWS. The mechanism hypothesizes that acute ethanol treatment alters the neuronal membrane lipids which then perturbs protein events, such as affecting the GABAA receptors, NMDA receptors and voltage-dependent Ca2+ channels synergistically or in combination. Subsequent adaptations in these systems occur after prolonged administration of ethanol. A sudden withdrawal of ethanol then leads to hyperexcitability which results in AWS.

Alcohol Withdrawal Delirium↗
PubMed1997

Neuroimaging guidelines in cognitive impairment: lessons from 3 cases of meningiomas presenting as isolated dementia.

We report three cases of large intracranial meningiomas who presented with dementia alone and no accompanying focal neurological deficits. The meningiomas were detected solely as a result of a policy of routinely scanning the brains of patients presenting with early dementia. Dramatic improvements in the cognitive functions were noted following the excision of the tumours in two of the patients (the third passed away in the perioperative period). The implications of these cases with regard to deciding when to order a brain scan for patients presenting with isolated dementia are discussed in this article and a brief review of the relevant medical literature on this topic is also presented.

Aged↗
PubMed1993

Adult onset Mongolian spot.

We report a case of adult onset, unilateral, progressive, grey-blue pigmentation on the back of an Asian male. Histology showed the pigmentation to be due to deep dermal melanocytes. The spectrum of clinical presentations of dermal melanocytosis is reviewed and the unique features of this case outlined.

Adult↗