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Risk factors associated with low anterior resection syndrome: a cross-sectional study
Lim See Liang,Wan Zain Wan Zainira,Zahari Zalina,Zakaria Andee Dzulkarnaen,Hashim Mohd Nizam Md,Wong Michael Pak-Kai,Zakaria Zaidi,Ramely Rosnelifaizur,Sidek Ahmad Shanwani Mohamed 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.5
Purpose: Oncological outcomes following rectal cancer surgery have improved significantly over recent decades with lower recurrences and longer overall survival. However, many of the patients experienced low anterior resection syndrome (LARS). This study identified the prevalence and risk factors associated with the development of LARS. Methods: This cross-sectional study involved patients who were diagnosed with rectal cancer and had undergone sphincter-preserving low anterior resection from January 2011 to December 2020. Upon clinic follow-up, patients were asked to complete an interviewed based questionnaire (LARS score) designed to assess bowel dysfunction after rectal cancer surgery. Results: Out of 76 patients, 25 patients (32.9%) had major LARS, 10 patients (13.2%) had minor LARS, and 41 patients (53.9%) had no LARS. The height of tumor from anal verge showed an association with the development of major LARS (P=0.039). Those patients with less than 8 cm tumor from anal verge had an increased risk of LARS by 3 times compared to those with 8 cm and above (adjusted odds ratio, 3.11; 95% confidence interval, 1.06–9.13). Conclusion: Results from our study show that low tumor height was a significant risk factor that has a negative impact on bowel function after surgery. The high prevalence of LARS emphasizes the need for study regarding risk factors and the importance of understanding the pathophysiology of LARS, in order for us to improve patient bowel function and quality of life after rectal cancer surgery.
Osman, Hussein Ali,Hasan, Habsah,Suppian, Rapeah,Bahar, Norhaniza,Che Hussin, Nurzam Suhaila,Rahim, Amry Abdul,Hassan, Syed,Andee, Dzulkarnaen Zakaria,Zilfalil, Bin-Alwi Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.13
Background: Helicobacter pylori (H.pylori) is one of the most important causes of dyspepsia and gastric cancer and diagnosis can be made by invasive or non-invasive methods. The Atlas Helicobacter pylori antigen test is a new rapid non-invasive method which is simple to conduct. The aim of this study was to determine its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Materials and Methods: This prospective study was conducted between July 2012 and December 2013. Stool samples of 59 dyspeptic patients who underwent upper endoscopy were evaluated for H. pylori stool antigen. Results: From the 59 patients who participated in this study, there were 36 (61%) males and 23 (39%) females. H. pylori was diagnosed in 24 (40.7%) gastric biopsies, 22 (91.7 %) of these being positive for the Atlas H. pylori antigen test. The sensitivity, specificity, PPV, NPV and accuracy were 91.7%, 100%, 100%, 94.6% and 96.6% respectively. Conclusions: The Atlas H. pylori antigen test is a new non-invasive method which is simple to perform and avails reliable results in a few minutes. Thus it can be the best option for the diagnosis of H. pylori infection due to its high sensitivity and specificity.
Shahidah Che Alhadi,Wan Zainira Wan Zain,Zalina Zahari,Mohd Nizam Md Hashim,Syed Hassan Syed Abd. Aziz,Zaidi Zakaria,Michael Pak-Kai Wong,Andee Dzulkarnaen Zakaria 대한대장항문학회 2020 Annals of Coloproctolgy Vol.36 No.6
Purpose: Guaiac fecal occult blood test (gFOBT) has been the standard for colorectal screening but it has low sensitivity and specificity. This study evaluated the use of fecal tumor M2-pyruvate kinase (M2-PK) for detection of colorectal cancer and to compare with the current surveillance tool; gFOBT in symptomatic adult subjects underwent colonoscopy.Methods: Stool samples were collected prospectively from symptomatic adults who had elective colonoscopy from September 2014 to January 2016 and were analyzed with the ScheBo M2-PK Quick test and laboratory detection of fecal hemoglobin.Results: The results were correlated to the colonoscopy findings and/or histopathology report. Eighty-five subjects (age of 56.8 ± 15.3 years [mean ± standard deviation]) were recruited with a total of 17 colorectal cancer (20.0%) and 10 colorectal adenoma patients (11.8%). The sensitivity of M2-PK test in colorectal cancer detection was higher than gFOBT (100% vs. 64.7%). M2-PK test had a lower specificity when compared to gFOBT (72.5% vs. 88.2%) in colorectal cancer detection. The positive and negative predictive values were 47.2% and 100% for M2-PK test and 57.9% and 90.9% for gFOBT.Conclusion: Fecal M2-PK Quick test has a high sensitivity for detection of colorectal cancer when compared to gFOBT, making it the potential choice for colorectal tumor screening biomarker in the future.
Juhari, Wan Khairunnisa Wan,Rahman, Wan Faiziah Wan Abdul,Sidek, Ahmad Shanwani Mohd,Hassan, Muhammad Radzi Abu,Noordin, Khairul Bariah Ahmad Amin,Zakaria, Andee Dzulkarnaen,Macrae, Finlay,Zilfalil, B Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9
Background: Lynch syndrome (LS) is an inherited predisposition to colorectal, endometrial (uterine) and other cancers. Although most cancers are not inherited, about 5 percent (%) of people who have colorectal or endometrial cancer have the Lynch syndrome. It involves the alteration of mismatch repair (MMR) genes; MLH1, MSH2, MSH6 or PMS2. In this study, we analyzed the expression of MMR proteins in colorectal cancer in a Malay cohort by immunohistochemistry. Materials and Methods: A total of 17 patients were selected fulfilling one of the Bethesda criteria: colorectal cancer diagnosed in a patient aged less than 50 years old, having synchronous and metachronous colorectal cancer or with a strong family history. Immunohistochemical staining was performed on paraffin embedded tumour tissue samples using four antibodies: MLH1, MSH2, MSH6 and PMS2. Results: Twelve out of 17 patients (70.6%) were noted to have a family history. A total of 41% (n=7) of the patients had abnormal immunohistochemical staining with one or more of the four antibodies. Loss of expression were noted in 13 tumour tissues with a negative staining score <4. Of 13 tumour tissues, four showed loss expression of MLH1. For PMS2, loss of expression were noted in five cases. Both MSH2 and MSH6 showed loss of expression in two tumour tissues respectively. Conclusions: Revised Bethesda criteria and immunohistochemical analysis constituted a convenient approach and is recommended to be a first-line screening for Lynch syndrome in Malay cohorts.
Poh Guan Tan,Imi Sairi Ab. Hadi,Zalina Zahari,Maya Mazuwin Yahya,Wan Zainira Wan Zain,Michael Pak-Kai Wong,Rosnelifaizur Ramely,Mohd Nizam Md Hashim,Syed Hassan Syed Abd. Aziz,Zaidi Zakaria,Andee Dzul 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.1
Purpose: Patients with secondary hyperparathyroidism are at high risk for developing postoperative hypocalcemia. However, there are limited data regarding predictors of postoperative hypocalcemia in renal failure patient with secondary hyperparathyroidism. This study aimed to determine the clinical presentations of renal hyperparathyroidism and the predictors of early postoperative hypocalcemia after total parathyroidectomy. Methods: Data of patients with renal hyperparathyroidism who underwent total parathyroidectomy between January 2007 to December 2014 were reviewed retrospectively. Patients were divided into 2 cohort groups according to their serum calcium levels within 24 hours of parathyroidectomy: the hypocalcemia group (calcium levels of 2 mmol/L or less), and the normocalcemia group (calcium levels more than 2 mmol/L). With the use of multivariable logistic regression analyses, the predictors of early postoperative hypocalcemia after total parathyroidectomy in patients with renal hyperparathyroidism were investigated. Results: Among 68 patients, 56 patients (82.4%) were symptomatic preoperatively. Fifty patients (73.5%) presented with bone pain and 14 patients (20.6%) had muscle weakness. Early postoperative hypocalcemia occurred in 25 patients (36.8%). Preoperative alkaline phosphatase level was the predictor of early postoperative hypocalcemia (adjusted odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P = 0.002). Conclusion: Results from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels.
Ande M. Jakoi,Gurpal Pannu,Anthony D’Oro,Zorica Buser,Martin H. Pham,Neil N. Patel,Patrick C. Hsieh,John C. Liu,Frank L. Acosta,Raymond Hah,Jeffrey C. Wang 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3
Study Design: Retrospective analysis of a nationwide private insurance database. Chi-square analysis and linear regression models were utilized for outcome measures. Purpose: The purpose of this study was to investigate any relationship between lumbar degenerative disc disease, diabetes, obesity and smoking tobacco. Overview of Literature: Diabetes, obesity, and smoking tobacco are comorbid conditions known to individually have effect on degenerative disc disease. Most studies have only been on a small populous scale. No study has yet to investigate the combination of these conditions within a large patient cohort nor have they reviewed the combination of these conditions on degenerative disc disease. Methods: A retrospective analysis of insurance billing codes within the nationwide Humana insurance database was performed, using PearlDiver software (PearlDiver, Inc., Fort Wayne, IN, USA), to identify trends among patients diagnosed with lumbar disc degenerative disease with and without the associated comorbidities of obesity, diabetes, and/or smoking tobacco. Patients billed for a comorbidity diagnosis on the same patient record as the lumbar disc degenerative disease diagnosis were compared over time to patients billed for lumbar disc degenerative disease without a comorbidity. There were no sources of funding for this manuscript and no conflicts of interest. Results: The total number and prevalence of patients (per 10,000) within the database diagnosed with lumbar disc degenerative disease increased by 241.4% and 130.3%, respectively. The subsets of patients within this population who were concurrently diagnosed with either obesity, diabetes, tobacco use, or a combination thereof, was significantly higher than patients diagnosed with lumbar disc degenerative disease alone (p <0.05 for all). The number of patients diagnosed with lumbar disc degenerative disease and smoking rose significantly more than patients diagnosed with lumbar disc degenerative disease and either diabetes or obesity (p <0.05). The number of patients diagnosed with lumbar disc degenerative disease, smoking and obesity rose significantly more than the number of patients diagnosed with lumbar disc degenerative disease and any other comorbidity alone or combination of comorbidities (p <0.05). Conclusions: Diabetes, obesity and cigarette smoking each are significantly associated with an increased diagnosis of lumbar degenerative disc disease. The combination of smoking and obesity had a synergistic effect on increased rates of lumbar degenerative disc disease. Patient education and preventative care is a vital goal in prevention of degenerative disc disease within the general population.
An Ultra Low-noise Radio Frequency Amplifier Based on a DC SQUID
Muck, Michael,Ande, Marc-Olivier,Kinion, Darin,Clarke, John The Korean Superconductivity Society 2000 Progress in superconductivity Vol.2 No.1
We have developed an extremely sensitive radio frequency amplifier based on the dc superconducting quantum interference device (dc SQUID). Unlike a conventional semiconductor amplifier, a SQUID can be cooled to ultra-low temperatures (100 mK or less) and thus potentially achieve a much lower noise temperature. In a conventional SQUID amplifier, where the integrated input coil is operated as a lumped element, parasitic capacitance between the coil and the SQUID washer limits the frequency up to which a substantial gain can be achieved to a few hundred MHz. This problem can be circumvented. by operating the input coil of the SQUID as a microstrip resonator: instead of connecting the input signal between the two ends of the coil, it is connected between the SQUID washer and one end of the coil; the other end is left open. Such amplifiers have gains of 15 dB or more at frequencies up to 3 GHz. If required, the resonant frequency of the microstrip can be tuned by means of a varactor diode connected across the otherwise open end of the resonator. The noise temperature of microstrip SQUID amplifiers was measured to be between 0.5 K $\pm$ 0.3 K at a frequency of 80 MHz and 1.5 K $\pm$: 1.2 K at 1.7 GHz, when the SQUID was cooled to 4.2 K. An even lower noise temperature can be achieved by cooling the SQUID to about 0.4 K. In this case, a noise temperature of 100 mK $\pm$ 20 mK was achieved at 90 MHz, and of about 120 $\pm$ 100 mK at 440 MHz.