Sun Exposure and the Risk of Prostate Cancer in the Singapore Prostate Cancer Study: a Case-control Study

Chia, Sin-Eng,Wong, Kin-Yoke,Cheng, Christopher,Lau, Weber,Tan, Puay-Hoon Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.7

Background: Most of the epidemiology studies on the effects of sun exposure and prostate cancer were conducted among the temperate countries of North America and Europe. Little is known about the influence on Asian populations. The purpose of current study was to evaluate any association of sun exposure with risk of prostate cancer in Chinese, Malays and Indians who reside in the tropics. Methods: The Singapore Prostate Cancer Study is a hospital-based case-control study of 240 prostate cancer incident cases and 268 controls conducted in Singapore between April 2007 and May 2009. Detailed information on outdoor activities in the sun, skin colour, sun sensitivity and other possible risk factors were collected in personal interviews. Cases were further classified by Gleason scores and TNM staging. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis, adjusted for age, ethnicity, education, family history of any cancers, BMI and skin colour. Results: We found that prostate cancer risk was increased in subjects with black/dark-brown eyes (OR 5.88, 95%CI 3.17-10.9), darker skin colour e.g. tan/dark brown/black (OR 7.62, 95%CI 3.41-17.0), frequent sunburn in lifetime (OR 4.30, 95%CI 1.7-11.2) and increased general sun exposure in adulthood per week (OR 2.03, 95%CI 1.09-3.81). The increased risk was consistent for high grade tumours and advanced stage prostate cancers. Conclusion: The findings from this study suggest that excessive sun exposure is a risk factor for prostate cancer in Asians.

Role Distribution in Insolvency Proceedings : Singapore

Christopher Eng 법무부 2010 선진상사법률연구 Vol.- No.52

Christopher Eng is a legal officer with the Insolvency and Public Trustee's Office in Singapore. He had practiced for a number of years in insolvency law in Singapore's largest law firm, M/s Rajah & Tahn. He is involved in a number of law reform initiatives including the Omnibus Insolvency Bill. He is also an associate lecturer at PSB Academy of Singapore. He has won the Bronze Award in 2005 at the prestigious International Institute of Insolvency for his outstanding research work in cross-border insolvency.

Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study

Xeng Inn Fam,Praveen Singam,Christopher Chee Kong Ho,Radhika Sridharan,Rozita Hod,Badrulhisham Bahadzor,Eng Hong Goh,Guan Hee Tan,Zulkifli Zainuddin 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.1

Purpose: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stonesis the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. Materials and Methods: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteralstones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB)ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of acomputed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. Results: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. Ananalysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stoneimpacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the uretericstrictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration ofimpaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. Conclusions: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that allpatients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impactedureteral stones.

Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

Guan Hee Tan,Shamsul Azhar Shah,Nurayub Md Ali,Eng Hong Goh,Praveen Singam,Christopher Chee Kong Ho,Zulkifli Md Zainuddin 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.3

Purpose: This study aimed to determine the urethral stricture (US) rate and identify clinical and surgical risk factors associated with US occurrence after transurethral resection of the prostate using the bipolar Gyrus PlasmaKinetic Tissue Management System (PK-TURP). Materials and Methods: This was an age-matched case-control study of US occurrence after PK-TURP. Retrospective data were collected from the hospital records of patients who had a minimum of 36 months of follow-up information. Among the data collected for analysis were prostate-specific antigen level, estimated prostate weight, the amount of prostate resected, operative time, history of urinary tract infection, previous transurethral resection of the prostate, and whether the PK-TURP was combined with other endourological procedures. The resection rate was calculated from the collected data. Univariate and multivariate analyses were performed to identify clinical and surgical risk factors related to US formation. Results: A total of 373 patients underwent PK-TURP between 2003 and 2009. There were 13 cases of US (3.5%), and most of them (10 of 13, 76.9%) presented within 24 months of surgery. Most of the US cases (11 of 13, 84.6%) occurred at the bulbar urethra. Multivariable logistic regression analyses identified slow resection rate as the only risk factor significantly associated with US occurrence. Conclusions: The US rate of 3.5% after PK-TURP in this study is comparable to contemporary series. A slow resection rate seems to be related to US occurrence. This should be confirmed by further studies; meanwhile, we must be mindful of this possibility when operating with the PK-TURP system.

Stratifying Patients with Haematuria into High or Low Risk Groups for Bladder Cancer: a Novel Clinical Scoring System

Tan, Guan Hee,Shah, Shamsul Azhar,Ann, Ho Sue,Hemdan, Siti Nurhafizah,Shen, Lim Chun,Abdul Galib, Nurudin Al-Fahmi,Singam, Praveen,Kong, Ho Chee Christopher,Hong, Goh Eng,Bahadzor, Badrulhisham,Zainud Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.11

Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross-sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low r isk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.

Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction

Zahra Rashidbenam,Mohd Hafidzul Jasman,Pezhman Hafez,Guan Hee Tan,Eng Hong Goh,Xeng Inn Fam,Christopher Chee Kong Ho,Zulkifli Md Zainuddin,Reynu Rajan,Fatimah Mohd Nor,Mohamad Aznan Shuhaili,Nik Ritza 한국조직공학과 재생의학회 2019 조직공학과 재생의학 Vol.16 No.4

BACKGROUND: Urinary tract is subjected to a variety of disorders such as urethral stricture, which often develops as a result of scarring process. Urethral stricture can be treated by urethral dilation and urethrotomy; but in cases of long urethral strictures, substitution urethroplasty with genital skin and buccal mucosa grafts is the only option. However a number of complications such as infection as a result of hair growth in neo-urethra, and stone formation restrict the application of those grafts. Therefore, tissue engineering techniques recently emerged as an alternative approach, aiming to overcome those restrictions. The aim of this review is to provide a comprehensive coverage on the strategies employed and the translational status of urethral tissue engineering over the past years and to propose a combinatory strategy for the future of urethral tissue engineering. METHODS: Data collection was based on the key articles published in English language in years between 2006 and 2018 using the searching terms of urethral stricture and tissue engineering on PubMed database. RESULTS: Differentiation of mesenchymal stem cells into urothelial and smooth muscle cells to be used for urologic application does not offer any advantage over autologous urothelial and smooth muscle cells. Among studied scaffolds, synthetic scaffolds with proper porosity and mechanical strength is the best option to be used for urethral tissue engineering. CONCLUSION: Hypoxia-preconditioned mesenchymal stem cells in combination with autologous cells seeded on a prevascularized synthetic and biodegradable scaffold can be said to be the best combinatory strategy in engineering of human urethra.

도산절차에서 역할의 배분

Herbert M. Graves,Christopher Eng,Mireille-France LeBlanc 법무부 2010 선진상사법률연구 Vol.- No.52

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