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Variable outcome in infantile-onset inflammatory bowel disease in an Asian cohort

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World Journal of Gastroenterology 2016年第48期22卷 10653-10662页

作者： way seah lee Ruey Terng Ng Koon-Wing Chan Yu-Lung Lau Department of Paediatrics University Malaya Medical Center University Malaya Paediatric and Child Health Research Group University Malaya Department of Paediatrics and Adolescent Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong

AIM Infantile-onset inflammatory bowel disease(IO-IBD) with the onset of disease before 12 mo of age, is a different disease entity from childhood IBD. We aimed to describe the clinical features, outcome and role of mutation in interleukin-10(IL-10) and interleukin-10 receptors(IL-10R) in Asian children with IO-IBD. METHODS All cases of IO-IBD, defined as onset of disease before 12 mo of age, seen at University Malaya Medical Center, Malaysia were reviewed. We performed mutational analysis for IL10 and IL10 R genes in patients with presenting clinical features of Crohn's disease(CD).RESULTS Six [13%; CD = 3, ulcerative colitis(UC) = 2, IBDunclassified(IBD-U) = 1] of the 48 children(CD = 25; UC = 23) with IBD have IO-IBD. At final review [median(range) duration of follow-up: 6.5(3.0-20) years], three patients were in remission without immunosuppression [one each for post-colostomy(IBD-U), after standard immunosuppression(CD), and after total colectomy(UC)]. Three patients were on immunosuppression:one(UC) was in remission while two(both CD) had persistent disease. As compared with later-onset disease, IO-IBD were more likely to present with bloody diarrhea(100% vs 55%, P = 0.039) but were similar in terms of an associated autoimmune liver disease(0% vs 19%, P = 0.31), requiring biologics therapy(50% vs 36%, P = 0.40), surgery(50% vs 29%, P = 0.27), or achieving remission(50% vs 64%, P = 0.40). No mutations in either IL10 or IL10 R in the three patients with CD and the only patient with IBD-U were *** The clinical features of IO-IBD in this Asian cohort of children who were negative for IL-10 or IL-10 R mutations were variable. As compared to childhood IBD with onset of disease after 12 mo of age, IO-IBD achieved remission at a similar rate.

关键词： Infantile-onset inflammatory bowel disease Pediatric

Chronic liver disease is universal in children with biliary atresia living with native liver

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World Journal of Gastroenterology 2017年第43期23卷 7776-7784页

作者： way seah lee Sik Yong Ong Hee Wei Foo Shin Yee Wong Chen Xi Kong Ru Bin seah Ruey Terng Ng Department of Paediatrics University Malaya Medical Centre Paediatrics and Child Health Research Group University Malaya

AIM To examine the medical status of children with biliary atresia(BA) surviving with native *** In this cross-sectional review,data collected included complications of chronic liver disease(CLD)(cholangitis in the preceding 12 mo,portal hypertension,variceal bleeding,fractures,hepatopulmonary syndrome,portopulmonary hypertension) and laboratory indices(white cell and platelet counts,total bilirubin,albumin,international normalized ratio,alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transpeptidase). Ideal medical outcome was defined as absence of clinical evidence of CLD or abnormal laboratory indices. RESULTS Fifty-two children [females = 32,62%; median age 7.4 years,n = 35(67%) older than 5 years] with BA(median age at surgery 60 d,range of 30 to 148 d) survived with native liver. Common complications of CLD noted were portal hypertension(40%,n = 21; 2 younger than 5 years),cholangitis(36%) and bleeding varices(25%,n = 13; 1 younger than 5 years). Fifteen(29%) had no clinical complications of CLD and three(6%) had normal laboratory indices. Ideal medical outcome was only seen in 1 patient(2%). CONCLUSION Clinical or laboratory evidence of CLD are present in 98% of children with BA living with native livers after hepatoportoenterostomy. Portal hypertension and variceal bleeding may be seen in children younger than 5 years of age,underscoring the importance of medical surveillance for complications of BA starting at a young age.

关键词： Biliary atresia Medical status Chronic liver disease

Quality indicators in pediatric colonoscopy in a low-volume center:Implications for training

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World Journal of Gastroenterology 2018年第9期24卷 1013-1021页

作者： way-seah lee Chun-Wei Tee Zhong-Lin Koay Tat-Seng Wong Fatimah Zahraq Hee-Wei Foo Sik-Yong Ong Shin-Yee Wong Ruey-Terng Ng Department of Paediatrics University Malaya Medical CentreKuala Lumpur 59100Malaysia Paediatric and Child Health Research Group University MalayaKuala Lumpur 50603Malaysia

AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training *** We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years(January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as *** Median(± SD) age of 121 children [males = 74(61.2%)] who had 177 colonoscopies was 7.0(± 4.6) years. On average, 30 colonoscopies were performed each year(range: 19-58). Except for investigations of abdominal pain(21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient(0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease(IBD) than non-IBD(72.9% vs 50.0%; P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.

关键词： Pediatric colonoscopies Quality indicators Performance

Appropriateness, endoscopic findings and contributive yield of pediatric gastrointestinal endoscopy

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World Journal of Gastroenterology 2013年第47期19卷 9077-9083页

作者： way seah lee Hafizah Zainuddin Christopher CM Boey Pei Fan Chai Department of Paediatrics University Malaya Medical Centre50603 Kuala LumpurMalaysia University Malaya Paediatrics and Child Health Research Group University Malaya50603 Kuala LumpurMalaysia Department of Paediatrics Faculty of MedicineUniversity Technology Mara40450 SelayangSelangorMalaysia

AIM:To determine the predictability of the North American Society for Pediatric Gastroenterology,Hepatology and Nutrition(NASPGHAN)and American Society for Gastrointestinal Endoscopy(ASGE)guideline with regard to appropriate endoscopic practice in children,positive endoscopic findings and contributive yield in clinical ***:This was a descriptive,retrospective analysis,conducted at the Department of Paediatrics,University Malaya Medical Centre,*** children who had esophagogastroduodenoscopy(EGD)and colonoscopy from January 2008 to June 2011 were *** endoscopy was considered appropriate when its indication complied with the NASPGHAN and ASGE *** endoscopic findings were classified as either positive(presence of any endoscopic or histologic abnormality)or negative(no or minor abnormality,normal histology);effecting a positive contributive(a change in therapeutic decisions or prognostic consequences)or non-contributive yield(no therapeutic or prognostic consequences).RESULTS:Overall,76%of the 345 procedures(231EGD alone,26 colonoscopy alone,44 combined EGD and colonoscopy)performed in 301 children(median age 7.0 years,range 3 months to 18 years)had a positive endoscopic *** on the NASPGHAN and ASGE guideline,99.7%of the procedures performed were considered as *** only inappropriate procedure(0.3%)was in a child who had EGD for assessment of the healing of gastric ulcer following therapy in the absence of any *** overall positive contributive yield for a change in diagnosis and/or management was 44%.The presence of a positive endoscopic finding was more likely to effect a change in the therapeutic plan than an alteration of the initial diagnosis.A total of 20(5.8%)adverse events were noted,most were minor and none was ***:The NASPGHAN and ASGE guideline is more likely to predict a positive endoscopic finding but is less sensitive to effect a change in the initial clinical diagnosis or the

关键词： Pediatric gastrointestinal endoscopy Contributive yield Esophagogastroduodenoscopy North American Society for Pediatric Gastroenterology,Hepatology and Nutrition American Society for Gastrointestinal Endoscopy

Epidemiological characteristics of Asian children with inflammatory bowel disease at diagnosis: Insights from an Asian-Pacific multicentre registry network

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World Journal of Gastroenterology 2022年第17期28卷 1830-1844页

作者： James Guoxian Huang Yoko Kin Yoke Wong Kee Seang Chew Pornthep Tanpowpong Karen Sophia Calixto Mercado Almida Reodica Shaman Rajindrajith Kai-Chi Chang Yen-Hsuan Ni Suporn Treepongkaruna way-seah lee Marion Margaret Aw Khoo Teck Puat-National University Children’s Medical Institute National University Health SystemSingapore 119228Singapore Department of Pediatrics Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119228Singapore Epidemiology Singapore Clinical Research InstituteSingapore 138669Singapore Department of Paediatrics Faculty of MedicineUniversity MalayaKuala Lumpur 50603Malaysia Department of Pediatrics Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand Department of Pediatrics Makati Medical CentreManila 1229Philippines Department of Pediatrics The Medical CityManila 0900Philippines Department of Pediatrics Faculty of MedicineUniversity of ColomboColombo 00800Sri Lanka Department of Pediatrics National Taiwan University HospitalTaipei 100229Taiwan

BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data *** Clinical,endoscopic and radiologic data at diagnosis from the registry were extracted between 1^(st) January 1995 to 31^(st) December *** phenotypic characteristics were classified as per the Paris classification *** There was a distinct rise in new PIBD cases:Nearly half(48.6%)of the cohort was diagnosed in the most recent 5 years(2015-2019).The ratio of Crohn’s disease(CD):Ulcerative colitis(UC):IBDUnclassified was 55.9%:38.3%:5.8%.The mean age was 9.07 years with a high proportion of very early onset IBD(VEO-IBD)(29.3%)and EO-IBD(52.7%).An over-representation of the Indian/South Asian ethnic group was observed which accounted for 37.0% of the overall Singapore/Malaysia subcohort(6.8%-9.0%Indians in census).Indian/South Asian CD patients were also most likely to present with symptomatic perianal disease(P=0.003).CD patients presented with significantly more constitutional symptoms(fever,anorexia,malaise/fatigue and muscle-wasting)than UC and higher inflammatory indices(higher C-reactive protein and lower albumin levels).CONCLUSION We observed a high incidence of VEO-IBD and an over-representation of the Indian *** Asian CD patients were more likely to have symptomatic perianal disease.

关键词： Asia Inflammatory bowel disease Paediatrics Crohn’s disease Ulcerative colitis Registry

Comparing the Effectiveness of Coatings on Carbide andCermet Cutting Tool Inserts

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Journal of Materials Science & Technology 1995年第4期11卷 269-275页

作者： K.H. W.seah M.Rahman and C.H.lee (Dept. of Mech. & Prod. Eng., National University of Singapore, 10 Kent Ridge Crescent, Singapore 0511 T.N.Goh (Dept. of Ind. & Sys. Eng., National University of Singapore, 10 Kent Ridge Crescent, Singapore 0511) National Univ of Singapore Singapore

A series of metal cutting experiments was performed on a CNC lathe to evaluate the performance of various coatings on different tool substrates. The workpiece material was plain medium carbon steel and the cutting tool materials were carbide and cermet inserts coated with various single as well as multilayer coatings. Machining was done under various cutting conditions of speed and feed-rate, and for various durations of Cutting. The output parameters studied were the cutting forces (axial, radial and tangential), the surface roughness of the workpiece, as well as the tool wear (crater and flank wear). From these results, the performances of the various cutting inserts are evaluated and compared. Results show that cutting forces are significantly lower when using coated cermets than when using coated carbides although different coatings on the same substrate also result in different cutting forces. However, there is less difference in the surface roughness of the finished workpiece for the various coatings and substrates.

关键词： Tool Comparing the Effectiveness of Coatings on Carbide andCermet Cutting Tool Inserts

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建立安全可靠的工业系统光电耦合器应用指南

电子测试（新电子） 2005年第10期 56-59页

作者： Jeremy seah Eng lee Alexander Jaus Patrick Sullivan ChuaTeck Bee 安捷伦半导体产品事业部隔离产品分部

设备和元器件安全是设计强健、可靠及用户安全的工业系统的关键,尤其对于设计高电压系统而言。光电耦合器具有体积小、寿命长、工作温度范围宽、抗干扰性强、无触点且输入输出在电气上完全隔离等特点,因而得到广泛应用。本文针对高压应... 详细信息

设备和元器件安全是设计强健、可靠及用户安全的工业系统的关键,尤其对于设计高电压系统而言。光电耦合器具有体积小、寿命长、工作温度范围宽、抗干扰性强、无触点且输入输出在电气上完全隔离等特点,因而得到广泛应用。本文针对高压应用并结合安捷伦的光电耦合器产品,详细介绍其工作原理及性能。

关键词：光电耦合器安全可靠工业系统应用指南工作温度范围高电压系统用户安全抗干扰性