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21.
Jonathan Raphacis Chua Grace Yim Dominic Chong Jennifer Teoh 《Psychiatry, Psychology and Law》2013,20(6):877-889
The Risk–Need–Responsivity (RNR) framework is regarded as the forefront of offender rehabilitation in guiding youth offender risk assessment and interventions. This article discusses the juvenile justice system in Singapore and the local research that has been conducted in relation to the RNR framework and the associated Youth Level of Service (YLS) measures. It describes a journey that saw the implementation of the RNR framework across the juvenile justice agencies and highlights the challenges that were faced during the implementation process on the ground. Finally, the article concludes by providing future directions for the implementation of the RNR framework in Singapore. 相似文献
22.
23.
Jeremy Yuen Chun Teoh Ning Hong Chan Ho Yuen Cheung Simon See Ming Hou Chi-Fai Ng 《International urology and nephrology》2013,45(4):975-977
We report a case of a 60-year-old woman who had a delayed presentation of duodenal obstruction as a result of a bleeding right renal angiomyolipoma (AML) with retroperitoneal hematoma. Her duodenal obstruction did not improve upon conservative management, and a computed tomography (CT)-guided drainage of the retroperitoneal hematoma was subsequently performed. Post-intervention, CT scan confirmed hematoma resolution, and she was able to resume normal diet afterwards. We present this first reported case of a bleeding renal AML with retroperitoneal hematoma causing duodenal obstruction and discuss on the management of such condition. 相似文献
24.
25.
Anthony Yuen Bun Teoh Philip Wai Yan Chiu So Fei Hon Tony Wing Chung Mak Enders Kwok Wai Ng James Yun Wong Lau 《Surgical endoscopy》2013,27(4):1422-1427
Background
Endoscopic submucosal dissection (ESD) is a technically demanding procedure, and exposure of the submucosa depends on the action of gravity and submucosal injection. The aim of the study was to investigate the effectiveness of the Endolifter® as a traction device for enhancing submucosal visualization during ESD.Methods
This was a prospective ex vivo comparative study conducted between September 2010 and March 2011 in the Prince of Wales Hospital. Consecutive ESDs were performed by four experienced endoscopists in an ex vivo ESD model with or without the Endolifter®. The Endolifter® allows simultaneous grasping, retracting and lifting of the mucosa during ESD, resulting in exposure of the submucosa. Each of the procedures were recorded and reviewed later by two independent assessors. The outcome measures included the proportion of time that the submucosa was visualized during the procedures (SM ratio), procedural times, perforation rates, amount of submucosal injections, and the difficulty of the procedure.Results
Forty-eight gastric ESD procedures were performed on the model. The SM ratio was higher in the Endolifter® group (P = 0.007), particularly for lesions located at the antrum (P < 0.001). The time required for submucosal dissection and the total procedural time were also less in the Endolifter® group. The endoscopists rated the ESD procedures in the Endolifter® group as less difficult (P = 0.033).Conclusions
The Endolifter® improved submucosal visualization during gastric ESD and reduces the difficulty of performing the procedures. The device may improve the ease of performing ESD in low-volume centers or large mucosal lesions. 相似文献26.
27.
Amanda C. Y. Chan Hiu Yi Wong Yao Feng Chong Poh San Lai Hock Luen Teoh Alison Y. Y. Ng Jennifer H. M. Hung Yee Cheun Chan Kay W. P. Ng Joy Vijayan Jonathan J. Y. Ong Bharatendu Chandra Chi Hsien Tan Nurul H. Rutt Ti Myen Tan Nur Hafiza Ismail Einar Wilder-Smith Herbert Schwarz Hyungwon Choi Vijay K. Sharma Anselm Mak 《Annals of neurology》2022,91(1):66-77
28.
Kropf P Baud D Marshall SE Munder M Mosley A Fuentes JM Bangham CR Taylor GP Herath S Choi BS Soler G Teoh T Modolell M Müller I 《European journal of immunology》2007,37(4):935-945
Complex regulation of T cell functions during pregnancy is required to ensure materno-fetal tolerance. Here we reveal a novel pathway for the temporary suppression of maternal T cell responses in uncomplicated human pregnancies. Our results show that arginase activity is significantly increased in the peripheral blood of pregnant women and remarkably high arginase activities are expressed in term placentae. High enzymatic activity results in high turnover of its substrate L-arginine and concomitant reduction of this amino acid in the microenvironment. Amino acid deprivation is emerging as a regulatory pathway of lymphocyte responses and we assessed the consequences of this enhanced arginase activity on T cell responses. Arginase-mediated L-arginine depletion induces down-regulation of CD3 zeta, the main signalling chain of the TCR, and functional T cell hyporesponsiveness. Importantly, this arginase-mediated T cell suppression was reversible, as inhibition of arginase activity or addition of exogenous L-arginine restored CD3 zeta chain expression and T cell proliferation. Thus, L-arginine metabolism constitutes a novel physiological mechanism contributing to the temporary suppression of the maternal immune response during human pregnancy. 相似文献
29.
Jeremy Yuen-Chun Teoh Chak-Lam Cho Yong Wei Shuji Isotani Ho-Yee Tiong Teng-Aik Ong Kittinut Kijvikai Peggy Sau-Kwan Chu Eddie Shu-Yin Chan Chi-Fai Ng the Asian Urological Surgery Training & Education Group 《Andrologia》2020,52(8):e13708
Anatomical endoscopic enucleation of the prostate has been proposed as a potentially superior benign prostatic hyperplasia surgery than conventional transurethral resection of prostate. However, the learning curve of the procedure is steep, hence limiting its generalisability worldwide. In order to overcome the learning curve, a proper surgical training is extremely important. This review article discussed about various aspects of surgical training in anatomical endoscopic enucleation of the prostate. In summary, no matter what surgical technique or energy modality you use, the principle of anatomical enucleation should be followed. When one starts to perform prostate enucleation, a 50 to 80 g prostate appears to be the ‘best case’ to begin with. Mentorship is extremely important to shorten the learning curve and to prevent drastic complications from the procedure. A proficiency-based progression training programme with the use of simulation and training models should be the best way to teach and learn about prostate enucleation. Enucleation ratio efficacy is the preferred measure for assessing skill level and learning curve of prostate enucleation. Morcellation efficiency is commonly used to assess morcellation performance, but the importance of safety rather than efficiency must be emphasised. 相似文献
30.
The traditional transurethral resection of the prostate (TURP) is considered as gold-standard surgical treatment to relieve symptoms resulting from bladder outlet obstruction by prostate enlargement. However, with the advances of novel laser technologies and more experienced surgeon conquering the steep learning curve, anatomical endoscopic enucleation of prostate (AEEP) has become a more popular alternative surgical technique. Although AEEP has compatible functional outcome, less blood loss, shorter catheterisation duration and hospital stay, the risk of post-operative urinary incontinence (UI) is often an issue of concern. In this review, we focus on discussion about risk factors related to increased incidence of UI, some surgical tips to avoid damaging external urinary sphincter and treatment strategies to facilitate recovery of urinary continence after surgery. 相似文献