Liver lesions detected in a hepatitis B core total antibody-positive patient masquerading as hepatocellular carcinoma

Chun Han Nigel Tan,Gwyneth Shook Ting Soon,Wei Chieh Alfred Kow 한국간담췌외과학회 2017 Annals of hepato-biliary-pancreatic surgery Vol.21 No.3

Peliosis Hepatis (PH) is a rare vascular disorder of the liver, characterized by the presence of cystic blood-filled cavities distributed throughout the hepatic parenchyma. The pathogenesis of PH remains controversial. The preoperative diagnosis of PH is difficult, due to the non-specific imaging characteristics of PH and almost all cases are diagnosed on histology post resection. This study presents a case of PH masquerading as hepatocellular carcinoma (HCC). The patient is a 45-year old Chinese lady, who presented with transaminitis. She was found to be hepatitis B virus core total antibody-positive with an alpha-fetoprotein (AFP) of 29.4 ng/ml. Triphasic liver computed tomography showed several arterial hypervascular lesions and hypoenhancing lesions on the venous phase, particularly in the segments 6/7. Subsequently, a magnetic resonance imaging scan showed multiple lesions in the right hemiliver with an indeterminate enhancement patterns. Subsequently, she decided to undergo a resection procedure. Histopathology revealed findings consistent with PH with some unusual features. This case demonstrates a clinical conundrum, in which PH presented with a raised AFP, in a patient with risk factors for the development of HCC. The clinical suspicion of PH should be high in patients, who present with multiple hepatic lesions with variable enhancement patterns.

Nausea, Vomiting, and Poor Oral Intake during The Immediate Postoperative Period; Diagnosis and Management

Tan Chun Hai 대한외과학회 2019 대한외과학회 학술대회 초록집 Vol.2019 No.10

Bridging therapies to liver transplantation for hepatocellular carcinoma: A bridge to nowhere?

Chun Han Nigel Tan,Yue Yu,Yan Rui Nicholas Tan,Boon Leng Kieron Lim,Shridhar Ganpathi Iyer,Krishnakumar Madhavan,Alfred Wei Chieh Kow 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.1

Backgrounds/Aims: Liver Transplantation (LT) is a recognized treatment for Hepatocellular Carcinoma (HCC). The role of Bridging Therapies (BT) remains controversial. Methods: From January 2001 to October 2012, 192 patients were referred to the National University Hospital, Singapore for consideration of LT for HCC. Sixty-five patients (33.8%) were found suitable for transplant and were placed on the waitlist. Analysis was performed in these patients. Results: The most common etiology of HCC was Hepatitis B (n=28, 43.1%). Thirty-six patients (55.4%) received BT. Seventeen patients (47.2%) received TACE only, while 10 patients (27.8%) received radiofrequency ablation (RFA) only. The remaining patients received a combination of transarterial chemoembolization (TACE) and RFA. Baseline tumor and patient characteristics were comparable between the two groups. The overall dropout rate was 44.4% and 31.0% in the BT and non-BT groups, respectively (p=0.269). The dropout rate due to disease progression beyond criteria was 6.9% (n=2) in the non-bridged group and 22.2% (n=8) in the bridged group (p=0.089). Thirty-nine patients (60%) underwent LT, of which all patients who underwent Living Donor LT did not receive BT (n=4, 21.1%, p=0.030). The median time to LT was 180 days (range, 20-558 days) in the non-BT group and 291 days (range, 17-844 days) in the BT group (p=0.214). There was no difference in survival or recurrence between the BT and non-BT groups (p=0.862). Conclusions: BT does not influence the dropout rate or survival after LT but it should be considered in patients who are on the waitlist for more than 6 months.

Perioperative Nutrition and Enhanced Recovery after Surgery in Gastrointestinal Cancer Patients

Tan Chun Hai 대한외과학회 2019 대한외과학회 학술대회 초록집 Vol.2019 No.10

Resolution-enhanced Reconstruction of 3D Object Using Depth-reversed Elemental Images for Partially Occluded Object Recognitionz

Tan-Chun Wei,Dong-Hak Shin,이병국 한국광학회 2009 Current Optics and Photonics Vol.13 No.1

Computational integral imaging (CII) is a new method for 3D imaging and visualization. However, it suffers from seriously poor image quality of the reconstructed image as the reconstructed image plane increases. In this paper, to overcome this problem, we propose a CII method based on a smart pixel mapping (SPM) technique for partially occluded 3D object recognition, in which the object to be recognized is located at far distance from the lenslet array. In the SPM-based CII, the use of SPM moves a far 3D object toward the near lenslet array and then improves the image quality of the reconstructed image. To show the usefulness of the proposed method, we carry out some experiments for occluded objects and present the experimental results.

A Novel PID Controller Gain Tuning Method for a Quadrotor Landing on a Ship Deck using the Invariant Ellipsoid Technique

Chun Kiat Tan,Jianliang Wang 제어로봇시스템학회 2014 제어로봇시스템학회 국제학술대회 논문집 Vol.2014 No.10

Quadrotors are useful in many applications. It is controlled by the thrust of each rotors. The altitude and attitude control is often achieved by PID controller due to its simplicity. Many methods such as the Ziegler Nichols method, Cohen Coon method and loop shaping methods are available to tune the gain with different objectives such as minimizing overshoot or settling time. However, few techniques are able to obtain an optimal controller gain for a system under persistent bounded disturbance. The invariant ellipsoid method based on the invariant set theory is developed to formulate an optimization problem to obtain such an optimal controller gain. The technique is applied to a ship deck landing problem of a quadrotor. The heave motion of the ship deck represents a persistent disturbance acting on the quadrotor which is required to perform a landing operation while maintaining small relative speed with the ship deck. Numerical simulation is performed to demonstrate the ability of the calculated gain to reject disturbance as compared to gain obtained by loop shaping method.

Occupational Safety & Health Management and Corporate Sustainability: The Mediating Role of Affective Commitment

Tan Zhen Chao,Tan Chun Eng,Choong Yuen Onn 한국산업안전보건공단 산업안전보건연구원 2023 Safety and health at work Vol.14 No.4

Background: Occupational safety & health management (OSH) has garnered greater attention for its significance in promoting corporate sustainability for organizations in recent decades. The construction industry, in particular, is a major contributor to Malaysia’s thirst for corporate sustainability in order to provide long-term support for the country. Thus, the main tenet of this study is to examine the mediating effect of employee affective commitment on the relationship between OSH and corporate sustainability. Methods: A questionnaire was administered to 273 full-time employees of listed construction companies in Malaysia. Smart PLS software version 3 was used to test the proposed model and hypotheses. Both the measurement model and the structural model were evaluated. Results: According to the findings, OSH and its dimensions are positively related to employee affective commitment. Employee affective commitment, on the other hand, has been found to be significantly related to corporate sustainability and its dimensions: economic, social, and environmental sustainability. Apart from this, the prominent results reveal that employee affective commitment partially mediates the relationship between OSH and corporate sustainability and its dimensions: economic, social, and environmental sustainability. Conclusion: This empirical finding adds to the existing literature in explaining how OSH and affective commitment led to corporate sustainability. Several implications are offered to various stakeholders, such as construction companies, policymakers, and relevant regulators.

초등학교 수학교육의 방향: 대만 수학교사 교육자의 관점을 중심으로

( Ning Chun Tan ) 서울敎育大學校 初等敎育硏究所 2009 한국초등교육 Vol.19 No.2

기술의 진보는 수학교육의 발달에 영향을 줄것이다. 다가치 사회 구조 하에서, 존경과 포용력은 민주주의의 기본을 구성한다. 교수의 본질은 학생들을 다루는 힘을 갖게 하는 것이고, 교수의 목표 및 방향을 어떻게 정하느냐는 교육자들이 상호 인정한 방법에 의지한다. 수학 교사의 목적은 수학 학습에 대하여 학생들이 이해를 재구성할 수 있도록 하는 방법을 찾아내게 하는 것이고, 이렇게하여 학생들로 하여금 더 큰 확신과 더나은 성과로 발전하도록 하는 것이다. 교육은 국가의 방위를 위한 요새와 비슷하여 그것의 흥망성세는 국가의 운명을 결정지을 것이다. 교육분야에서 일하는 것은 단순히 직업이나 사업이라 생각되지 않고, 오히려 이는 학생의 잠재력을 자극하고 목적지향의 삶에 대한 자부심을 가지고 학생들을 교육하는 것이다. Advancement of technology will impact the development of math education. Under the multi-valued society structure, respect and tolerance constitute the fundamental of democracy. The essence of teaching is to power students, and how to set teaching goals and directions relies on educators` mutual recognition. The purpose of math teacher is to find a way that can reconstruct students` understanding toward math learning, and thus enable them to develop with greater confidence and better performance. Education resembles the castle of a nation`s defense and its standing or collapse will predestine the nation`s fate. Working in the education field is not considered as a job or business, rather it is to stimulate students` potential and educate them with a pride of purpose-driven life.

Applying the OMOP Common Data Model to Facilitate Benefit-Risk Assessments of Medicinal Products Using Real-World Data from Singapore and South Korea

Hui Xing Tan,Desmond Chun Hwee Teo,이동윤,김청수,Jing Wei Neo,Cynthia Sung,Haroun Chahed,Pei San Ang,Doreen Su Yin Tan,박래웅,Sreemanee Raaj Dorajoo 대한의료정보학회 2022 Healthcare Informatics Research Vol.28 No.2

Objectives: The aim of this study was to characterize the benefits of converting Electronic Medical Records (EMRs) to acommon data model (CDM) and to assess the potential of CDM-converted data to rapidly generate insights for benefitriskassessments in post-market regulatory evaluation and decisions. Methods: EMRs from January 2013 to December 2016were mapped onto the Observational Medical Outcomes Partnership-CDM (OMOP-CDM) schema. Vocabulary mappingswere applied to convert source data values into OMOP-CDM-endorsed terminologies. Existing analytic codes used in a priorOMOP-CDM drug utilization study were modified to conduct an illustrative analysis of oral anticoagulants used for atrialfibrillation in Singapore and South Korea, resembling a typical benefit-risk assessment. A novel visualization is proposed torepresent the comparative effectiveness, safety and utilization of the drugs. Results: Over 90% of records were mapped ontothe OMOP-CDM. The CDM data structures and analytic code templates simplified the querying of data for the analysis. Intotal, 2,419 patients from Singapore and South Korea fulfilled the study criteria, the majority of whom were warfarin users. After 3 months of follow-up, differences in cumulative incidence of bleeding and thromboembolic events were observable viathe proposed visualization, surfacing insights as to the agent of preference in a given clinical setting, which may meaningfullyinform regulatory decision-making. Conclusions: While the structure of the OMOP-CDM and its accessory tools facilitatereal-world data analysis, extending them to fulfil regulatory analytic purposes in the post-market setting, such as benefit-riskassessments, may require layering on additional analytic tools and visualization techniques.

Theoretical research on the identification method of bridge dynamic parameters using free decay response

Tan, Guo-Jin,Cheng, Yong-Chun,Liu, Han-Bing,Wang, Long-Lin Techno-Press 2011 Structural Engineering and Mechanics, An Int'l Jou Vol.38 No.3

Input excitation and output response of structure are needed in conventional modal analysis methods. However, input excitation is often difficult to be obtained in the dynamic load test of bridge structures. Therefore, what attracts engineers' attention is how to get dynamic parameters from the output response. In this paper, a structural experimental modal analysis method is introduced, which can be used to conveniently obtain dynamic parameters of the structure from the free decay response. With known damping coefficients, this analysis method can be used to identify the natural frequencies and the mode shapes of MDOF structures. Based on the modal analysis theory, the mathematical relationship of damping ratio and frequency is obtained. By using this mathematical relationship to improve the previous method, an improved experimental modal analysis method is proposed in this paper. This improved method can overcome the deficiencies of the previous method, which can not identify damping ratios and requires damping coefficients in advance. Additionally, this improved method can also identify the natural frequencies, mode shapes and damping ratios of the bridge only from the free decay response, and ensure the stability of identification process by using modern mathematical means. Finally, the feasibility and effectiveness of this method are demonstrated by a numerical example of a simply supported reinforced concrete beam.