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Hepatic adenoma mimicking a metastatic lesion on computed tomography-positron emission tomography scan

World Journal of Gastroenterology 2013年第27期19卷 4432-4436页

作者： Darryl lim Ser Yee Lee kiat hon lim Chung Yip Chan Department of General Surgery Singapore General Hospital Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital Department of Surgical Oncology National Cancer Centre Duke-National University of Singapore (NUS) Graduate Medical School Department of Pathology Singapore General Hospital

Positron emission tomography (PET) using 18F-fluorodeoxyglucose ( 18F-FDG) is an imaging modality which reflects cellular glucose metabolism. Most malignant cells accumulate and trap 18F-FDG, allowing the visualisation of increased uptake. It is hence widely used to differentiate malignant from benign lesions. "False positive" findings of hepatic lesions have been described in certain instances such as hepatic abscesses, but are rare in cases involving hepatocellular adenomas. To our knowledge, there have been only 7 reports in the English literature documenting PET-avid hepatocellular adenomas; 6 of the 7 reports were published in the last 3 years with the first report by Patel et al. We report the case of a 44-year-old Chinese female patient with a history of cervical adenocarcinoma, referred for a hepatic lesion noted on a surveillance computed tomography (CT) scan. A subsequent CT-PET performed showed a hypermetabolic lesion (standardized uptake value 7.9) in segment Ⅳb of the liver. After discussion at a multidisciplinary hepato-pancreato-biliary conference, the consensus was that of a metastatic lesion from her previous cervical adenocarcinoma, and a resection of the hepatic lesion was performed. Histology revealed features consistent with a hepatocyte nuclear factor-1 α inactivated steatotic hepatocellular adenoma.

关键词： Hepatic adenoma Positron emission tomography 18F-fluorodeoxyglucose Hepatocellular adenoma Hepatocyte nuclear factor-1 α

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Overview of multiplex immunohistochemistry/immunofluorescence techniques in the era of cancer immunotherapy

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Cancer Communications 2020年第4期40卷 135-153页

作者： Wei Chang Colin Tan Sanjna Nilesh Nerurkar Hai Yun Cai Harry Ho Man Ng Duoduo Wu Yu Ting Felicia Wee Jeffrey Chun Tatt lim Joe Yeong Tony kiat hon lim Yong Loo Lin School of Medicine National University of SingaporeSingapore169856Singapore Department of Anatomical Pathology Singapore General HospitalSingapore169856Singapore Institute of Molecular Cell Biology(IMCB) Agency of ScienceTechnology and Research(A*STAR)Singapore169856Singapore Singapore Immunology Network Agency of Science(SIgN)Technology and Research(A*STAR)Singapore169856Singapore Duke-NUS Medical School Singapore169856Singapore

Conventional immunohistochemistry(IHC)is a widely used diagnostic technique in tissue ***,this technique is associated with a number of limitations,including high inter-observer variability and the capacity to label only one marker per tissue *** review details various highly multiplexed techniques that have emerged to circumvent these constraints,allowing simultaneous detection of multiple markers on a single tissue section and the comprehensive study of cell composition,cellular functional and cell-cell *** these techniques,multiplex Immunohistochemistry/Immunofluorescence(mIHC/IF)has emerged to be particularly ***/IF provides high-throughput multiplex staining and standardized quantitative analysis for highly reproducible,efficient and cost-effective tissue *** technique has immediate potential for translational research and clinical practice,particularly in the era of cancer immunotherapy.

关键词： immunofluorescence immunohistochemistry immunotherapy multiplex overview

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Pancreatic lymphangioma:two case reports from an institutional experience with a rare entity and review of literature

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Journal of Pancreatology 2022年第2期5卷 98-109页

作者： Alfonso Tan-Garcia Ser Yee Lee Jen San Wong Thomas W.T.Ho Keng Sin Ng kiat hon Tony lim Division of Pathology Department of Anatomical PathologySingapore General HospitalSingapore Surgical Associates Mount Elizabeth Medical CentreSingapore Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Hepatobiliary and Pancreatic Surgery Centre Mount Elizabeth Medical CentreSingapore Digestive Surgical Oncology Department of Diagnostic Imaging Mount Alvernia HospitalSingapore

Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic *** such,pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised *** present 2 cases of pancreatic lymphangioma,determine its prevalence at our institution and perform a detailed review of published literature since *** 1 is a 36-year-old male and case 2 is a 35-year-old female,both of which presented with abdominal *** were the only cases of pancreatic lymphangiomas reported at our institution since *** reviewed 69 cases of pancreatic lymphangiomas from 52 *** affects predominantly females with a median age of 43 and such patients typically present with abdominal pain(58.8%)or are asymptomatic(27.9%).The median size is 8.6 cm,the most common location is the head of pancreas and the most common imaging finding is that of a multilocular *** of patients underwent surgical resection(69.6%).Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid,elevated fluid triglyceride levels(15/16 cases)and numerous lymphocytes on *** majority of patients with elevated fluid triglyceride levels(13/15 cases)were managed *** lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical,radiological,biochemical and cytological features,allowing greater confidence in the selection of patients who can be managed conservatively.

关键词： Case report Cystic Diagnostic features Literature review Lymphangioma management Pancreas Prevalence

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Dynamic phenotypic heterogeneity and the evolution of multiple RNA subtypes in hepatocellular carcinoma:the PLANET study

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National Science Review 2022年第3期9卷 96-109页

作者： Weiwei Zhai Hannah Lai Neslihan Arife Kaya Jianbin Chen Hechuan Yang Bingxin Lu Jia Qi lim Siming Ma Sin Chi Chew Khi Pin Chua Jacob Josiah Santiago Alvarez Pauline Jieqi Chen Mei Mei Chang Lingyan Wu Brian K.P.Goh Alexander Yaw-Fui Chung Chung Yip Chan Peng Chung Cheow Ser Yee Lee Juinn Huar Kam Alfred Wei-Chieh Kow Iyer Shridhar Ganpathi Rawisak Chanwat Jidapa Thammasiri Boon Koon Yoong Diana Bee-Lan Ong Vanessa H.de Villa Rouchelle D.Dela Cruz Tracy Jiezhen Loh Wei Keat Wan Zeng Zeng Anders Jacobsen Skanderup Yin Huei Pang Krishnakumar Madhavan Tony kiat-hon lim Glenn Bonney Wei Qiang Leow Valerie Chew Yock Young Dan Wai Leong Tam Han Chong Toh Roger Sik-Yin Foo Pierce Kah-Hoe Chow Genome Institute of Singapore Agency for Science Technology and Research Key Laboratory of Zoological Systematics and Evolution Institute of Zoology Chinese Academy of Sciences Center for Excellence in Animal Evolution and Genetics Chinese Academy of Sciences School of Biological Sciences Nanyang Technological University Division of Biosciences Faculty of Life Sciences Division of Surgery and Surgical Oncology National Cancer Centre Department of Hepato-Pancreato-Biliary and Transplant Surgery Singapore General Hospital Division of Hepatobiliary and Pancreatic Surgery Department of Surgery University Surgical Cluster National University Health System Hepato-Pancreato-Biliary Surgery Unit Department of Surgery National Cancer Institute Division of Pathology National Cancer Institute Department of Surgery Faculty of Medicine University of Malaya Department of Surgery and Center for Liver Disease Management and Transplantation The Medical City Department of Laboratories The Medical City Department of Pathology Singapore General Hospital Institute for Infocomm Research ASTAR Department of Pathology National University Health System Translational Immunology Institute (TII) Sing Health Duke-NUS Academic Medical Centre Division of Gastroenterology and Hepatology University Medicine Cluster National University Hospital Department of Biochemistry Yong Loo Lin School of Medicine National University of Singapore Cancer Science Institute of Singapore National University of Singapore Division of Medical Oncology National Cancer Center Singapore Cardiovascular Research Institute National University of Singapore National University Healthcare System Singhealth-Duke-NUS Academic Surgery Program Duke-NUS Graduate Medical School Institute of Molecular and Cell Biology Agency for Science Technology and Research

Intra-tumor heterogeneity(ITH) is a key challenge in cancer treatment, but previous studies have focused mainly on the genomic alterations without exploring phenotypic(transcriptomic and immune)heterogeneity. Using one of the largest prospective surgical cohorts for hepatocellular carcinoma(HCC)with multi-region sampling, we sequenced whole genomes and paired transcriptomes from 67 HCC patients(331 samples). We found that while genomic ITH was rather constant across stages, phenotypic ITH had a very different trajectory and quickly diversified in stage Ⅱ patients. Most strikingly, 30% of patients were found to contain more than one transcriptomic subtype within a single tumor. Such phenotypic ITH was found to be much more informative in predicting patient survival than genomic ITH and explains the poor efficacy of single-target systemic therapies in HCC. Taken together, we not only revealed an unprecedentedly dynamic landscape of phenotypic heterogeneity in HCC, but also highlighted the importance of studying phenotypic evolution across cancer types.

关键词： hepatocellular carcinoma intra-tumor heterogeneity phenotypic evolution tumor evolution

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肿瘤免疫治疗时代的多重免疫组织化学/免疫荧光技术

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癌症 2021年第9期40卷 367-387页

常规免疫组织化学(immunohistochemistry,IHC)是组织病理学中广泛应用的诊断技术。但该技术存在诸多局限性,包括观察者间的变异性高,每张组织切片仅能标记一个标志物。本文详细描述了各种多重检测技术,这些技术克服了上述局限性,可在单... 详细信息

常规免疫组织化学(immunohistochemistry,IHC)是组织病理学中广泛应用的诊断技术。但该技术存在诸多局限性,包括观察者间的变异性高,每张组织切片仅能标记一个标志物。本文详细描述了各种多重检测技术,这些技术克服了上述局限性,可在单张切片上同时检测多个标志物,可对细胞组成、细胞功能和细胞间相互作用进行整合研究。在这些技术中,多重免疫组织化学/免疫荧光(multiplex immunohistochemistry/immunofluorescence,mIHC/IF)已成为最具应用前景的技术。mIHC/IF为开展高重复性、高效、高性价比的组织研究提供了高通量多重染色技术和标准化的定量分析。该技术在转化研究和临床实践中,尤其是肿瘤免疫治疗中极具应用价值。

关键词：免疫荧光免疫组织化学免疫治疗多重概述

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Understanding Risk Governance:Introducing Sociological Neoinstitutionalism and Foucauldian Governmentality for Further Theorizing

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International Journal of Disaster Risk Science 2011年第3期2卷 11-20页

作者： Wee-kiat lim Department of Sociology University of Colorado Boulder Colorado 80309 USA Natural Hazards Center Institute of Behavioral Science Boulder Colorado 80309 USA

This article traces the career of risk across prominent theoretical approaches by highlighting their key assumptions and premises,specifically the technical approach found in the physical sciences,and economics,psychology,and sociology in the social *** each discipline,the strengths and limitations of each theoretical approach are pointed *** discussion focuses on sociology in particular because other approaches—in treating risks as dominantly technical,psychological,or economic phenomena—tend to downplay the broader historical and socio-political context that impinges on risk construction and production,and its differential impact across *** exploration points out that institutions play an important role in creating,managing,and distributing risks in *** highlighting the integrated risk governance framework as a nascent practice-oriented framework,the framework is examined theoretically using sociological neoinstitutionalism and Foucault’s concept of *** conclusion elaborates the challenges of using these two bodies of knowledge to study risk governance of extreme *** Foucault’s concept of governmentality corrects neoinstitutional theory’s ambivalence toward power,more work needs to be done in order to reconcile their divergent intellectual commitments.

关键词： extreme sociology governmental

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Emission wavelength selection via anomalous polarized fluorescence in ZnO-C nanowires

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Nano Research 2024年第5期17卷 4489-4497页

作者： Joon kiat Kang Kim Yong lim Chorng Haur Sow Department of Physics National University of SingaporeSingapore 117542Singapore

Defect fluorescence from high aspect ratio semiconductor nanowires typically displays a weak polarization parallel to the nanowire’s long axis due to dielectric mismatch in high aspect ratio ***,anomalous 2.2 eV defect fluorescence distinctly polarized perpendicular to the nanowire is observed and measured from carbon-incorporated zinc oxide *** observations are significant because polarized defect emissions with consistent polarization on a mesoscopic scale are *** a systematic study and comparison of experimental results with density functional theory calculations,an oriented defect complex comprising carbon substituting on an oxygen site and an oxygen vacancy(CO-VO)is deduced to be responsible for the anomalous yellow fluorescence,demonstrating a method for relating atomic-scale defect geometry to mesoscopic *** anomalous emission can appear in both green-and red-fluorescing nanowires grown with different carbon concentrations,verifying the independence and uniqueness of the 2.2 eV *** allows for polarization-dependent emission wavelength selection from a single nanowire.

关键词： anomalous polarization defects fluorescence zinc oxide carbon

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Design of Multi-layered Protection Against Guided Mortar Threats Yhrough Numerical Modeling

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Defence Technology（防务技术） 2023年第11期29卷 55-65页

作者： Bonny Thawani Seng kiat lim Laura Brown Richard Critchley Rachael Hazael Cranfield Forensic Institute Cranfield UniversityDefence Academy of the United KingdomShrivenhamSN68LAUK

The trade—off between protection and weight is a constant consideration when designing a portable protective *** mobility is a desirable attribute and protection must therefore adapt,prompting a demand for lightweight,simple to construct,low-cost and effective ballistic protection *** strength and ductility,wave spreading capability and good energy absorption are key properties for ballistic *** materials,polycarbonate,Kevlar?-epoxy,polyurethane foam,and aluminium alloy,possess these properties and were selected for analysis by numerical *** configurations were proven to be an optimal solution,by exploiting the advantages of each material without having large penalties of mass and *** modelling using ANSYS AUTODYN?is used to simulate monolithic and multi-layered target configurations,to obtain the penetration mitigation *** results are analysed to select configurations based on different requirements,such as lowest cost,lowest mass,best performance,and optimal configuration which balanced the three key parameters *** optimal configuration of Aluminium,Kevlar-Epoxy,Polyurethane,and Polycarbonate has layers with thickness of 7,3,38,2 mm respectively with a total mass of 7.97 kg,total cost of$39.86 and penetration of 29.34%(14.67 mm).Polynomial relationships between performance and mass/cost are also determined.

关键词： Hydrocode Fragmentation High velocity Composite structures Foams

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A comprehensive review on the chemical constituents,sesquiterpenoid biosynthesis and biological activities of Sarcandra glabra

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Natural Products and Bioprospecting 2023年第1期13卷 30-92页

作者： Jin-Ning Chu Premanand Krishnan Kuan-hon lim School of Pharmacy University of Nottingham MalaysiaJalan Broga43500 SemenyihSelangorMalaysia Foundation in Science University of Nottingham MalaysiaJalan Broga43500 SemenyihSelangorMalaysia

Sarcandra glabra(Thunb.)Nakai is a perennial evergreen herb categorised within the Sarcandra Gardner genus under the Chloranthaceae *** to tropical and subtropical regions of East Asia and India,this species is extensively distributed across China,particularly in the southern regions(Sichuan,Yunnan,and Jiangxi).In addition to its high ornamental value,*** has a rich history of use in traditional Chinese medicine,evident through its empirical prescriptions for various ailments like pneumonia,dysentery,fractures,bruises,numbness,amenorrhea,rheumatism,and other ***,modern pharmacological studies have revealed various biological activities,such as antitumour,anti-bacterial,anti-viral anti-inflammatory and immunomodulatory *** diverse chemical constituents of *** have fascinated natural product researchers since the *** date,over 400 compounds including terpenoids,coumarins,lignans,flavonoids,sterols,anthraquinones,organic acids,and organic esters have been isolated and characterised,some featuring unprecedented *** review comprehensively examines the current understanding of ***’s phytochemistry and pharmacology,with emphasis on the chemistry and biosynthesis of its unique chemotaxonomic marker,the lindenane-type sesquiterpenoids.

关键词： Sarcandra glabra CaoShanHu Traditional Chinese medicine Lindenane-type sesquiterpenoids Biosynthetic pathway Biological activities

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Will not bagging an excised tumour immediately during partial nephrectomy possibly result in tumour seeding?A case report

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第3期5卷 128-130页

作者： Xin Ling Teo Han Jie Lee Sey kiat lim Department of Urology Changi General Hospital2 Simei Street 3529889Singapore

Partial nephrectomy is now a standard approach for small renal masses and tumour recurrences after partial nephrectomy are *** the absence of spillage,port site recurrences are most commonly *** report a case of tumour recurrence near the surgical site as well as beyond the posterior renal fascia and Gerotas fascia in a 60-year-old woman who underwent robot-assisted partial ne-phrectomy for a 4.6 cm suspicious left renal tumour despite the absence of gross tumour spillage or rupture *** showed a 5 cm clear cell renal cell carcinoma with negative surgical margins,nuclear grade 4 with focal malignant rhabdoid *** practice of not bagging the specimen immediately after tumour excision especially for higher risk tumours should be reviewed as there may be inadvertent microscopic spillage of tumour cells.

关键词： Tumour seeding Tumour recurrence Partial nephrectomy

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