Invasive and Non-Invasive Imaging for Ischaemia with No Obstructive Coronary Artery Disease

Ming-Yen Ng,Hok Shing Tang,Lucas Chun Wah Fong,Victor Chan,Roxy Senior,Dudley John Pennell 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.3

Ischaemia with no obstructive coronary artery disease (INOCA) affects up to 50% of patients referred for coronary angiography for suspected angina. Although originally thought to be benign, recent data shows that patients with INOCA have an adverse prognosis. There are challenges in identifying and managing the underlying cause, which is most often attributed to coronary microvascular disease or coronary vasospasm. This review will cover the clinical relevance and prognosis of INOCA as well as the invasive and non-invasive imaging techniques available to identify the underlying aetiology. Upcoming technological advancements will also be discussed.

Coronary Cameral Fistula and Anomalous Right Coronary Artery: A Case Report

Ng Pan Pan,Chow Boris Chun Kei,Cheung Stephen Chi Wai,Ng Ming-Yen 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.1

Coronary artery anomalies are uncommon with variable clinical significance. We present a case of 49-year-old gentleman with atypical chest pain, who was found to have single left coronary artery, anomalous right coronary artery with pre-pulmonic course, as well as coronary- cameral fistula on coronary computed tomography angiogram (CCTA). CCTA demonstrated no significant coronary artery stenosis to suggest ischemic heart disease nor ventricular dysfunction to suggest significant hemodynamic consequence secondary to the coronary anomalies.

Characterization of exopolysaccharide-producing lactic acid bacteria from Taiwanese ropy fermented milk and their application in low-fat fermented milk

Ng Ker-Sin,Chang Yu-Chun,Chen Yen-Po,Lo Ya-Hsuan,Wang Sheng-Yao,Chen Ming-Ju 아세아·태평양축산학회 2022 Animal Bioscience Vol.35 No.2

Objective: The aim of this study was to characterize the exopolysaccharides (EPS)-producing lactic acid bacteria from Taiwanese ropy fermented milk (TRFM) for developing a clean label low-fat fermented milk. Methods: Potential isolates from TRFM were selected based on the Gram staining test and observation of turbid suspension in the culture broth. Random amplified polymorphic DNA-polymerase chain reaction, 16S rRNA gene sequencing, and API CHL 50 test were used for strain identification. After evaluation of EPS concentration, target strains were introduced to low-fat milk fermentation for 24 h. Fermentation characters were checked: pH value, acidity, viable count, syneresis, and viscosity. Sensory evaluation of fermented products was carried out by 30 volunteers, while the storage test was performed for 21 days at 4°C. Results: Two EPS-producing strains (APL15 and APL16) were isolated from TRFM and identified as Lactococcus (Lc.) lactis subsp. cremoris. Their EPS concentrations in glucose and lactose media were higher than other published strains of Lc. lactis subsp. cremoris. Low-fat fermented milk separately prepared with APL15 and APL16 reached pH 4.3 and acidity 0.8% with a viable count of 9 log colony-forming units/mL. The physical properties of both products were superior to the control yogurt, showing significant improvements in syneresis and viscosity (p<0.05). Our low-fat products had appropriate sensory scores in appearance and texture according to sensory evaluation. Although decreasing viable cells of strains during the 21-day storage test, low-fat fermented milk made by APL15 exhibited stable physicochemical properties, including pH value, acidity, syneresis and sufficient viable cells throughout the storage period. Conclusion: This study demonstrated that Lc. lactis subsp. cremoris APL15 isolated from TRFM had good fermentation abilities to produce low-fat fermented milk. These data indicate that EPS-producing lactic acid bacteria have great potential to act as natural food stabilizers for low-fat fermented milk. Objective: The aim of this study was to characterize the exopolysaccharides (EPS)-producing lactic acid bacteria from Taiwanese ropy fermented milk (TRFM) for developing a clean label low-fat fermented milk.Methods: Potential isolates from TRFM were selected based on the Gram staining test and observation of turbid suspension in the culture broth. Random amplified polymorphic DNA-polymerase chain reaction, 16S rRNA gene sequencing, and API CHL 50 test were used for strain identification. After evaluation of EPS concentration, target strains were introduced to low-fat milk fermentation for 24 h. Fermentation characters were checked: pH value, acidity, viable count, syneresis, and viscosity. Sensory evaluation of fermented products was carried out by 30 volunteers, while the storage test was performed for 21 days at 4°C.Results: Two EPS-producing strains (APL15 and APL16) were isolated from TRFM and identified as Lactococcus (Lc.) lactis subsp. cremoris. Their EPS concentrations in glucose and lactose media were higher than other published strains of Lc. lactis subsp. cremoris. Low-fat fermented milk separately prepared with APL15 and APL16 reached pH 4.3 and acidity 0.8% with a viable count of 9 log colony-forming units/mL. The physical properties of both products were superior to the control yogurt, showing significant improvements in syneresis and viscosity (p<0.05). Our low-fat products had appropriate sensory scores in appearance and texture according to sensory evaluation. Although decreasing viable cells of strains during the 21-day storage test, low-fat fermented milk made by APL15 exhibited stable physicochemical properties, including pH value, acidity, syneresis and sufficient viable cells throughout the storage period.Conclusion: This study demonstrated that Lc. lactis subsp. cremoris APL15 isolated from TRFM had good fermentation abilities to produce low-fat fermented milk. These data indicate that EPS-producing lactic acid bacteria have great potential to act as natural food stabilizers for low-fat fermented milk.

Cold chain time- and temperature-controlled transport of vaccines: a simulated experimental study

Chun Zheng Ng,Yen Loong Lean,Siang Fei Yeoh,Qi Ying Lean,Kah Seng Lee,Amal Khalil Suleiman,Kai Bin Liew,Yaman Walid Kassab,Yaser Mohammed Al-Worafi,Long Chiau Ming 대한백신학회 2020 Clinical and Experimental Vaccine Research Vol.9 No.1

Purpose: The objective of this research was to examine the cold chain temperature maintenance for the supply of vaccines and other biological products by pharmaceutical wholesaler. Materials and Methods: In this study, six configurations using cold vaccine boxes or bags made with different materials, with and without insulation, of different sizes, and number of coolant-packs were used to simulate the configuration used by the pharmaceutical wholesalers for transportation of vaccine. Model vaccines (vial, n=10) were packed using these six configurations which then stored in an incubator at 38ºC and monitored for 24 hours. Each configuration was tested repeatedly for 5 times. Results: In term of compliance to 2°C–8°C, four out of six tested configurations are effective in cold chain transportation. The effectiveness is highly dependent on the type of passive containers used, size of cold boxes, insulation, and number of coolant-packs. The configuration with a larger polystyrene foam box with five coolant-packs maintained the required temperature up to 23 hours. In contrast, configurations using a polystyrene foam box with four coolant-packs and a large vaccine cold box with two coolant-packs failed to reach below 8ºC throughout the 24 hours. Conclusion: Packaging method, the material and size of the container could have a direct impact on the effectiveness of cold chain temperature maintenance. Polystyrene foam box, cold box with polyethylene interior lining and polypropylene insulation, a cooler bag with proper number of ice packs could be effectively used for

Splenic T1-Mapping for Predicting Adenosine Stress Adequacy in Cardiac Magnetic Resonance Myocardial Perfusion Imaging: A Validation and Reproducibility Study

Wan Fiona Fong-ying,Yeung Catherine Ming-mun,Yam Pak-ki,Ng Pan Pan,Chow Boris Chun Kei,Chiang Jeanie Betsy,Lee Jonan Chun-yin,Cheung Kenneth Kai-yat,Ng Ming-yen 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.3

Objective:Splenic switch-off (SSO) sign has been utilized as a surrogate marker of adequate stress but can only be assessed after first-pass perfusion imaging. A study previously reported that drop in T1spleen ≥30 ms during adenosine infusion predicts presence of SSO, but this finding has not been externally validated. This study aimed to prospectively validate whether drop in T1spleen ≥30 ms is a reliable marker of SSO and hence adequate stress, and to assess reproducibility of T1spleen measurements. Materials and Methods: Data of fifty consecutive patients undergoing stress cardiac magnetic resonance were prospectively collected. Native T1-maps were acquired at rest and at 2.5 min after adenosine infusion in short axis slices, followed by perfusion images at 3 min. To measure T1spleen pre- and post-adenosine infusion, regions of interest were manually placed to include most splenic tissue. Adenosine stress adequacy was evaluated by visual SSO assessment and semi-quantitative splenic perfusion analysis. Results:A significant association was found between a drop in T1spleen of ≥30 ms and SSO response (p<0.001). There was excellent correlation between SSO response and semiquantitative perfusion change in spleen (rho=0.847, p<0.001). Inter-observer and intra-observer agreement for measurement of ΔT1spleen values were excellent, with intra-class correlation coefficients of 0.987 and 0.995, respectively. By receiver-operating characteristic analysis, the optimal cut-off value of ΔT1spleen for predicting presence of SSO was -28 ms, with area under the curve=0.76 (p=0.002). Conclusion:Splenic T1-mapping is accurate and reproducible for predicting SSO, potentially allowing optimization of adenosine dosage for adequate stress.