Early Recognition of Pediatric Strokes in the Emergency Department: Epidemiology, Clinical Presentation, and Factors Impeding Stroke Diagnosis in Children

Si Qi Tan(Si Qi Tan),Wen Qi Cher(Wen Qi Cher),Shu-Ling Chong(Shu-Ling Chong),Angelina Su Yin Ang(Angelina Su Yin Ang ),Sashikumar Ganapathy(Sashikumar Ganapathy ),Derrick Wei Shih Chan(Derrick Wei Shi 대한소아신경학회 2022 대한소아신경학회지 Vol.31 No.1

Purpose: Strokes are challenging to diagnose in pediatric emergency departments (EDs) as level of suspicion is low and atypical presentations are common. We analyzed clinical features, epidemiology and factors of delayed identification in arterial ischemic strokes (AIS) and hemorrhagic strokes (HS). Methods: Single-center retrospective cohort study of children aged between 29 days and 18 years old diagnosed with stroke between July 2016 to June 2021. Results: Among 36 children, 11 (30.5%) had AIS, 25 (69.4%) had HS. Median age for AIS was 9 years (interquartile range [IQR], 2 to 9) and HS 9 years (IQR, 1 to 11.5) (P=0.715). Focal neurological deficit was seen in 72.7% of AIS and 20% of HS (P=0.006). Only 18.2% of AIS and 52.0% of HS presented within 6 hours of symptoms. Median time from symptom onset to ED presentation was 24 hours (IQR, 12 to 28) for AIS and 7 hours (IQR, 1.8 to 48) for HS (P=0.595). Most (85.6%) arrived by own transport. Median time from presentation to neuroimaging was 7 hours (IQR, 0.9 to 7) for AIS and 4.8 (IQR, 1.3 to 16.8) hours for HS (P=0.376). Eleven patients, 9/25 (36.0%) HS and 2/11 (18.2%) AIS, did not have stroke as differential diagnosis at ED (P=0.714). Common initial diagnoses were viral illness or headaches. On univariate analysis, age <1 (odds ratio [OR], 17.5; 95% confidence interval [CI], 1.2 to 250.4; P=0.035) and absence of focal neurological deficit (OR, 13.091; 95% CI, 1.5 to 117.9; P=0.022) were significant factors for delayed identification. Conclusion: Index of suspicion for pediatric strokes among caregivers and clinicians should be increased. Public awareness campaigns are recommended.

Atypical Ductal Hyperplasia of the Breast on Core Needle Biopsy: Risk of Malignant Upgrade on Surgical Excision

Tiffany Sin Hui Bong,Jun Kiat Thaddaeus Tan,Juliana Teng Swan Ho,Puay Hoon Tan,Wing Sze Lau,Tuan Meng Tan,Jill Su Lin Wong,Veronique Kiak Mien Tan,Benita Kiat Tee Tan,Preetha Madhukumar,Wei Sean Yong 한국유방암학회 2022 Journal of breast cancer Vol.25 No.1

Purpose This study identified factors predicting malignant upgrade for atypical ductal hyperplasia (ADH) diagnosed on core-needle biopsy (CNB) and developed a nomogram to facilitate evidence-based decision making. Methods This retrospective analysis included women diagnosed with ADH at the National Cancer Centre Singapore (NCCS) in 2010–2015. Cox proportional hazards regression was used to identify clinical, radiological, and histological factors associated with malignant upgrade. A nomogram was constructed using variables with the strongest associations in multivariate analysis. Multivariable logistic regression coefficients were used to estimate the predicted probability of upgrade for each factor combination. Results Between 2010 and 2015, 238,122 women underwent mammographic screening under the National Breast Cancer Screening Program. Among 29,564 women recalled, 5,971 CNBs were performed. Of these, 2,876 underwent CNBs at NCCS, with 88 patients (90 lesions) diagnosed with ADH and 26 lesions upgraded to breast malignancy on excision biopsy. In univariate analysis, factors associated with malignant upgrade were the presence of a mass on ultrasound (p = 0.018) or mammography (p = 0.026), microcalcifications (p = 0.047), diffuse microcalcification distribution (p = 0.034), mammographic parenchymal density (p = 0.008). and ≥ 3 separate ADH foci found on biopsy (p = 0.024). Mammographic parenchymal density (hazard ratio [HR], 0.04; 95% confidence interval [CI], 0.005–0.35; p = 0.014), presence of a mass on ultrasound (HR, 10.50; 95% CI, 9.21–25.2; p = 0.010), and number of ADH foci (HR, 1.877; 95% CI, 1.831–1.920; p = 0.002) remained significant in multivariate analysis and were included in the nomogram. Conclusion Our model provided good discrimination of breast cancer risk prediction (C-statistic of 0.81; 95% CI, 0.74–0.88) and selected for a subset of women at low risk (2.1%) of malignant upgrade, who may avoid surgical excision following a CNB diagnosis of ADH.

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.

What Can We Do for Chronic Scrotal Content Pain?

Wei Phin Tan,Laurence A Levine 대한남성과학회 2017 The World Journal of Men's Health Vol.35 No.3

Chronic scrotal content pain remains one of the more challenging urological problems to manage. This is a frustrating disorder to diagnose and effectively treat for both the patient and clinician, as no universally accepted treatment guidelines exist. Many patients with this condition end up seeing physicians across many disciplines, further frustrating them. The pathogenesis is not clearly understood, and the treatment ultimately depends on the etiology of the problem. This article reviews the current understanding of chronic scrotal content pain, focusing on the diagnostic work-up and treatment options.

Radiation-induced Cochlea Hair Cell Death: Mechanisms and Protection

Tan, Pei-Xin,Du, Sha-Sha,Ren, Chen,Yao, Qi-Wei,Yuan, Ya-Wei Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.10

Cochlea hair cell death is regarded to be responsible for the radiation-induced sensorineural hearing loss (SNHL), which is one of the principal complications of radiotherapy (RT) for head and neck cancers. In this mini-review, we focus on the current progresses trying to unravel mechanisms of radiation-induced hair cell death and find out possible protection. P53, reactive oxygen species (ROS) and c-Jun N-terminal kinase (JNK) pathways have been proposed as pivotal in the processes leading to radiation hair cell death. Potential protectants, such as amifostine, N-acetylcysteine (NAC) and epicatechin (EC), are claimed to be effective at reducing radiation-inducedhair cell death. The RT dosage, selection and application of concurrent chemotherapy should be pre-examined in order to minimize the damage to cochlea hair cells.

An Improved PSO Algorithm Based on SA and Quantum Theory and Its Application

Wei Tan,Shoubin Dong,Xuan Liu,Bin Wang 보안공학연구지원센터 2015 International Journal of Database Theory and Appli Vol.8 No.6

Due to the low computational precision, local optimal solution and slow convergence speed of particle swarm optimization (PSO) algorithm, an improved PSO (SAQPSO) algorithm based on simulated annealing (SA) and quantum theory is proposed in this paper. The first, quantum theory is used to change the updating mode of the particles in order to improve the search speed and the convergence precision, and guarantee the simplification and effectiveness. Then the SA with probability and local search ability is introduced into quantum PSO (QPSO) in order to keep the diversity of the population, avoid falling into local optimum and enhance the global search ability. The SAQPSO algorithm keeps the characteristics of the simple and easy implementation, improves the global optimization ability and the convergence speed and the accuracy. Finally, some benchmark functions are used to prove the validity of the proposed SAQPSO algorithm. The computational results show that the proposed SAQPSO algorithm takes on the fast convergence speed, the better robustness and global search ability.

Demographic characteristics and intravenous drug use among hepatitis C patients in the Kota Setar district, Kedah, Malaysia

Wei Leong Tan,Goh Yihui,Muhammad Radzi Abu Hassan 한국역학회 2015 Epidemiology and Health Vol.37 No.-

OBJECTIVES: This study explored the demographic characteristics of hepatitis C patients in the Kota Setar (KS) district, Kedah, Malaysia, the prevalence of intravenous drug use (IVDU) as a risk factor among these patients, and the associations between IVDU and demographic characteristics. METHODS: Retrospective data pertaining to 713 patients from January 2009 to December 2013 were retrieved from hospital and disease notification records for analysis. The risk factors for hepatitis C virus (HCV) infection were grouped into IVDU and non-IVDU risk factors for analysis using multiple logistic regression. RESULTS: Of the hepatitis C patients included in this study, the most common age group was 31 to 40 years (30.2%), and male patients (91.2%) made up the overwhelming majority. Ethnic Malays constituted approximately 80.4% of the patients, and IVDU was the main risk factor (77.8%) for HCV infection. Multiple logistic regression showed that male patients were 59 times more likely to have IVDU as a risk factor for HCV infection. Single patients were 2.5 times more likely to have IVDU as a risk factor. Patients aged ≥71 years were much less likely than patients aged ≤30 years to have IVDU as a risk factor for HCV infection. CONCLUSIONS: IVDU was found to be an important risk factor for HCV infection among patients in the KS district. The factors associated with IVDU included age, sex, and marital status. Appropriate preventive measures should be developed to target the groups in which IVDU is most likely to be a risk factor for HCV infection.

Sound absorption coefficient measurement and analysis of bio-composite micro perforated panel (BC-MPP)

Tan Wei Hong,Faridah Wahab,Lee Jia Jian,Siti Hajar Ishak 대한기계학회 2023 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.37 No.7

The sound absorption performance of bio-composite micro-perforated panel (BC-MPP) made from composite polypropylene (PP) filled rice husk (PP/RH), and coconut coir (PP/CC) is presented. The sound absorption coefficient (SAC) of BC-MPP was obtained via the impedance tube two-microphone method, and the investigation was according to types of fillers, filler compositions, perforation ratio, and the air gap size. It was found that the SAC of BCMPP PP/RH provides a higher SAC value than BC-MPP PP/CC. Furthermore, the SAC peak was observed to shift to the lower frequency spectrum when there was an increment in filler content, the distance between the perforation, and the air gap size. The SAC value from the simulation also shows a good agreement with the experimental result.

Technical Note : The FasT-Fix Repair Technique for Ramp Lesion of the Medial Meniscus

( Wei Ping Li ),( Zhong Chen ),( Bin Song ),( Rui Yang ),( Wei Quan Tan ) 대한슬관절학회 2015 대한슬관절학회지 Vol.27 No.1

Introduction: This technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal. Surgical Technique: A FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point. Materials and Methods: From August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique. Results: All patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4±4.52 to postoperative 91.2±4.60. Conclusions: We believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee.

Effects of Trimebutine Maleate on Colonic Motility through Ca^2+- activated K^+ Channels and L-type Ca^2+ Channels

Wei Tan,Hong Zhang,He-Sheng Luo,Hong Xia 대한약학회 2011 Archives of Pharmacal Research Vol.34 No.6

The effects of trimebutine maleate (TM) on spontaneous contractions of colonic longitudinal muscle were investigated in guinea pigs. The contractile responses of smooth muscle strips were recorded by an isometric force transducer. Membrane and action potentials were detected by an intracellular microelectrode technique. The whole-cell patch clamp recording technique was used to record the changes in large conductance Ca^2+-activated K^+ (BKca) and L-type Ca^2+ currents in colonic smooth muscle cells. At high concentrations (30, 100, and 300 μM), TM inhibited the amplitude of spontaneous contractions. At low concentrations (1 and 10 μM), TM attenuated the frequency and tone of smooth muscle strips, whereas TM had no influence on the amplitude of spontaneous contractions. TM depolarized the membrane potentials, but decreased the amplitude and frequency of action potentials at high concentrations. TM inhibited BKca and L-type Ca^2+ currents in a dose-dependent manner. In the presence of the BKca channel opener, NS1619, TM also inhibited BKca currents. Bayk8644, a L-type Ca^2+channel opener, increased L-type Ca^2+ currents. This augmentation was also attenuated by TM. These results suggest that TM attenuates intestinal motility through inhibition of L-type Ca^2+ currents, and depolarizes membrane potentials by reducing BKca currents. Thus, TM may be a multiple-ion channel regulator in the gastrointestinal tract.