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Naidoo R, Jordaan N, Chan KW, Le Roux DM, Pienaar S, Nuttall J, Lau YL, Eley BS. A novel CYBB mutation with the first genetically confirmed case of chronic granulomatous disease in South Africa. S Afr Med J 2011; 101:768-769. [PMID: 22272860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 08/03/2011] [Indexed: 05/31/2023] Open
Abstract
A case of a child with chronic granulomatous disease (CGD) presenting with recurrent mycobacterial infections and invasive Aspergillus fumigatus disease is described. Genetic analysis confirmed X-linked CGD with a novel mutation in exon 10 of the CYBB gene - the first South African report of genetically confirmed CGD.
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Leong BDK, Chan KW, Ramu P, Kumar VM, Chuah JA. Tuberculosis of gallbladder with candidiasis, a rare entity. THE MEDICAL JOURNAL OF MALAYSIA 2011; 66:146-147. [PMID: 22106698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Gallbladder tuberculosis (GT) is an extremely rare condition. This is thought to be due to the protective property of bile against the infection. Clinical and radiological diagnosis of GT is difficult. We describe a case of GT who initially presented to us with jaundice, a right hypochondrial mass and computed tomographic findings suggestive of gallbladder empyema. Diagnosis was made from histopathological examination of the resected gallbladder which revealed epitheloid granulomas with caseating necrosis and presence of Langhan's giant cells. From a literature search and to the best of our knowledge, this is the first GT to be reported in South East Asia.
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Leung KW, Chan KW, Lo SSW. X-Ray Quiz: An Old Lady with Coffee Ground Vomiting and Decreased General Condition. HONG KONG J EMERG ME 2011. [DOI: 10.1177/102490791101800313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Yau JSY, Li JKY, Tam VHK, Fung LM, Yeung CK, Chan KW, Lee KM, Lee KF, Cheung WS, Yeung VTF, Yuen YP, Kwan WK. Phaeochromocytoma in the Hong Kong Chinese population. Hong Kong Med J 2010; 16:252-256. [PMID: 20683066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To review the clinical manifestations of phaeochromocytoma in a Hong Kong Chinese population. DESIGN Retrospective review. SETTING. Five public hospitals in Hong Kong. PATIENTS Seventeen patients with operated phaeochromocytoma between 1994 and 2003 were reviewed retrospectively. RESULTS Six patients (35%) were men, 11 (65%) were women. The mean age at presentation was 47 (range, 17-72) years. The diagnosis post-presentation was delayed by 1 to 132 months. Over 70% of the patients had hypertension. The most frequent symptoms were headache (53%), palpitations (53%), and sweating (41%); all these symptoms were present in 24% of the patients. Four (24%) had hereditary phaeochromocytoma/paraganglioma syndrome. The sensitivity of 24-hour urinary catecholamine measurements was 82%. Mean urinary adrenaline and noradrenaline concentrations were respectively 7- and 8-fold greater than the upper reference limits. Computed tomography and metaiodobenzylguanidine scintigraphy were the most widely used means for tumour localisation (sensitivity, 100% and 87% respectively). Approximately 65% of the patients had intra-adrenal tumours; 53% were on right side, 18% were bilateral. All the patients were prescribed phenoxybenzamine (dosage range, 20-120 mg/day) preoperatively. Two thirds of the patients had improved blood pressure 1 year after the operation. No malignancy was reported after a mean follow-up period of 7 years. CONCLUSION Our series of patients with phaeochromocytomas commonly had a high frequency of normotension and extra-adrenal tumours. A high index of clinical suspicion and appropriate biochemical investigations are necessary to make the diagnosis, especially for patients manifesting adrenal incidentaloma and extra-adrenal lesion.
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Chan KW, Lam KY, Srivastava G. Accumulation of p53 protein in inverted transitional cell papilloma of the urinary bladder. Mol Pathol 2010; 49:M43-5. [PMID: 16696044 PMCID: PMC408017 DOI: 10.1136/mp.49.1.m43] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Aims-To study the possible accumulation of p53 protein in inverted papilloma of the urinary bladder.Methods-Formalin fixed, paraffin wax embedded sections from 14 cases of inverted papilloma of the urinary bladder were studied retrospectively. Accumulation of p53 was detected by immunohistochemistry using a mouse monoclonal antibody directed against p53. p53 protein reactivity was scored as follows: 0 = 10%; 1 = 10% to <30%; 2 = 30% to <50%; and 3 = >50% of cells p53 positive.Results-The 14 sections were scored as follows: 3 in four cases; 2 in four cases; 1 in one case; and 0 in five cases. Overall, nine (64%) of the 14 cases were positive for p53 protein.Conclusions-The accumulation of p53 protein in inverted papilloma of the urinary bladder suggests that p53 may have has an important role in the neoplastic process of this tumour. However, the benign nature of inverted papillomas suggests that p53 protein accumulation is not related to tumour invasiveness and metastasis. p53 reactivity cannot be used as a marker of malignancy for urothelial neoplasia. Further studies are required to determine the role of p53 protein in the oncogenesis of urothelial neoplasms.
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Jude V, Chan KW. Recent advances in hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia. Curr Hematol Malig Rep 2010; 5:129-34. [PMID: 20424978 DOI: 10.1007/s11899-010-0050-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hematopoietic stem cell transplantation has been an important treatment modality in the management of high-risk or relapsed childhood acute lymphoblastic leukemia. Analysis of its efficacy has been based mostly on stratification of patients by epidemiologic criteria such as disease status at transplantation, type of donor, and conditioning regimens used. The outcome has improved only marginally over the years, with the improvement attributable mainly to better supportive care. Leukemia recurrence remains a major cause of treatment failure. Recent investigations have focused on the biology of the underlying malignancy and on transplant alloreactivity. The results of these investigations may provide a better scientific approach to indications for transplantation, donor selection, and disease monitoring.
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Uberti JP, Agovi MA, Tarima S, Haagenson M, Gandham S, Anasetti C, Baker KS, Bolwell BJ, Bornhauser M, Chan KW, Copelan E, Davies SM, Finke J, Hale GA, Kollman C, McCarthy PL, Ratanatharathorn V, Ringdén O, Weisdorf DJ, Rizzo JD. Comparative analysis of BU and CY versus CY and TBI in full intensity unrelated marrow donor transplantation for AML, CML and myelodysplasia. Bone Marrow Transplant 2010; 46:34-43. [PMID: 20400989 DOI: 10.1038/bmt.2010.81] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We retrospectively compared clinical outcomes in 1593 T-replete unrelated donor (URD) marrow transplant recipients with AML, MDS and CML who received myeloablative conditioning regimens of either BU and CY (BuCy), standard-dose Cy/TBI (1000-1260 cGy) or high-dose Cy/TBI (1320-1500 cGy). Subjects were drawn from patients transplanted between 1991 and 1999 facilitated by the National Marrow Donor Program. Patients who received high-dose Cy/TBI regimens were slightly younger, more likely to receive a mismatched transplant and to have intermediate or advanced disease compared with patients in the BuCy or standard-dose TBI group. Neutrophil recovery was significantly higher in the standard-dose CY/TBI group compared with the high-dose Cy/TBI or BuCy group. Patients who received the high-dose Cy/TBI regimen had an increased risk of developing grades III-IV aGVHD when compared with the control group who received BuCy (P = 0.011). OS, disease-free survival (DFS), TRM and relapse were not significantly different between any of the regimens. We conclude that BuCy, standard-dose and high-dose Cy/TBI regimens have equivalent efficacy profiles for OS, DFS, TRM and relapse risk in patients undergoing T-replete URD marrow transplantation for AML, CML and MDS.
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Wall DA, Chan KW, Nieder ML, Hayashi RJ, Yeager AM, Kadota R, Przepiorka D, Mezzi K, Kletzel M. Safety, efficacy, and pharmacokinetics of intravenous busulfan in children undergoing allogeneic hematopoietic stem cell transplantation. Pediatr Blood Cancer 2010; 54:291-8. [PMID: 19743300 DOI: 10.1002/pbc.22227] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE To determine the safety, efficacy, and PK profile of intravenous busulfan (Bu) in the context of a Bu and cyclophosphamide (IVBuCy) preparative regimen in children undergoing allogeneic hematopoietic stem cell transplantation (HSCT). METHODS Twenty-four children were enrolled in an open-label, multicenter trial of IVBuCy as the preparative regimen for HLA-matched sibling allogeneic HSCT. IVBu was administered q6 hr for 16 doses with a targeted area under the curve (AUC) of 900-1,350 microMol-min. The initial dose was 0.8 mg/kg for children >4 years of age and 1 mg/kg for those <4 years of age. PK of the first dose IVBu was determined to calculate a single dosage adjustment, and with the 9th and 13th doses to confirm steady-state PK. RESULTS The targeted AUC was achieved with the first dose in 17/24 (71%) of the children using the age-adjusted dosing approach. Dosing was increased in five patients, and reduced in two patients to achieve target values. After dose adjustment based on PK, 91% of the children had an AUC within the target range at steady state (AUCss). Median final dosing and clearance (CL) of IVBu were 1.1 mg/kg and 4.1 ml/min/kg in patients < or =4 years, and 0.9 mg/kg and 2.9 ml/min/kg in patients >4 years. All children were engrafted with documented donor chimerism. No late rejections or graft failures occurred. Four patients had veno-occlusive disease, three of which resolved within 2 weeks of onset. Two children died from transplant-related causes unrelated to Bu. CONCLUSION IVBu is a safe and effective and offers the benefit of predictable and consistent systemic exposure.
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Lau KK, Chan KW, Lok CM, Lam AWS, Lee HHC, Luk WF, Mak CM, Ching CK, Lo J, Li SM, Chan AYW. Circulatory collapse in a patient with gastrinoma after metoclopramide administration. Hong Kong Med J 2009; 15:478-481. [PMID: 19966355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
A patient who was given metoclopramide for vomiting and diarrhoea developed circulatory collapse with his blood pressure dropping to 50/20 mm Hg. A gastrinoma was diagnosed histologically. The extent of the tumour was defined by octreotide scanning and magnetic resonance imaging. Metoclopramide was again given for colicky abdominal pain and the patient developed circulatory collapse a second time. A laparotomy involving extensive resection of the tumour was performed. The MEN1 mutation was not detected in blood or tumour tissue. Follow-up octreotide scanning did not show any residual tumour. Possible causes for the circulatory collapse are discussed. Our case is probably the first patient with gastrinoma to develop circulatory collapse after being given metoclopramide.
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Mou JWC, Tang PMY, Chan KW, Tam YH, Lee KH. Imperforate hymen: cause of lower abdominal pain in teenage girls. Singapore Med J 2009; 50:e378-e379. [PMID: 19960149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Imperforate hymen is a relatively rare congenital anomaly. However, it is not an uncommon cause of lower abdominal pain presenting in teenage girls. Without careful history taking and thorough examination, the condition can be missed easily. We report an imperforate hymen presenting as abdominal pain in three teenage girls aged 12, 12 and 13 years, respectively, within a six-month period. The presentation was reviewed and the various types of hymenotomy were discussed.
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Petropoulos D, Chan KW. Carlecortemcel-l: anex vivoexpanded umbilical cord blood cell graft for allogeneic transplantation. Expert Opin Biol Ther 2009; 9:1437-44. [DOI: 10.1517/14712590903321447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Yau JSY, Chu KS, Li JKY, Chan KW, Lau IT, Yum SW, Chan CW, Mo LKK, Kwan WK. Usage of a fixed dose of radioactive iodine for the treatment of hyperthyroidism: one-year outcome in a regional hospital in Hong Kong. Hong Kong Med J 2009; 15:267-273. [PMID: 19652233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES To evaluate the efficacy of a fixed dose of radioactive iodine (131-I) in the treatment of thyrotoxicosis, and to identify risk factors associated with treatment failure. DESIGN Retrospective study. SETTING Thyroid Clinic of a regional hospital in Hong Kong. PATIENTS Patients receiving their first dose of radioactive iodine for the treatment of thyrotoxicosis during the inclusive period September 1999 to August 2004. MAIN OUTCOME MEASURES Relapse rate and time to relapse. RESULTS A total of 113 patients received a fixed dose of 5 mCi (185 MBq), 6 mCi (222 MBq), 8 mCi (296 MBq), and 10 mCi (370 MBq) 131-I in a proportion of 1:6:71:35. At 1 year, 42 (37%) of the patients had relapsed, of which 69% received a second 131-I dose. The median time to relapse after first receiving 131-I was 4 months. At 1 year, the remaining 71 (63%) of the patients were successfully treated; 46 (41%) were euthyroid, and 25 (22%) had became permanently hypothyroid. Basal free thyroxine level and goitre size were significantly associated with a relapse rate after a single dose of 131-I; larger goitres showed a trend towards high rates of relapse. Patients pretreated with propylthiouracil had a higher rate of relapse during the first year after radioactive iodine than those pretreated with carbimazole, but the difference was not significant when combined with other pretreatment variables. CONCLUSIONS A single fixed dose of radioactive iodine is a simple, safe, and effective treatment for hyperthyroidism. High basal free thyroxine concentration and large goitre size are associated with higher chance of relapse. Higher radioiodine doses may be considered to improve the cure rate.
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Cox JD, Giralt SA, Veazie ML, Ajani JA, Bruner JM, Chan KW, Hittelman WN, Hunt KK, Iyer RB, Karp DD, Kuban DA, Lippman SM, Raad II, Rodriguez-Bigas MA, Zwelling LA, Markman M. Evaluating quality in clinical cancer research: the M.D. Anderson Cancer Center experience. Oncology 2009; 77:75-81. [PMID: 19571599 DOI: 10.1159/000226772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 04/17/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Despite the unquestionable importance of clinically oriented research designed to test the safety and efficacy of new therapies in patients with malignant disease, there is limited information regarding strategies to evaluate the quality of such efforts at academic institutions. METHODS To address this issue, a committee of senior faculty at the University of Texas M.D. Anderson Cancer Center established specific criteria by which investigators from all departments engaged in clinical research could be formally evaluated. Scoring criteria were established and revised based on the results of a pilot study. Beginning in January 2004, the committee evaluated all faculty involved in clinical research within 35 departments. Scores for individual faculty members were assigned on a scale of 1 (outstanding) to 5; a score of 3 was set as the standard for the institution. Each department also received a score. The results of the evaluation were shared with departmental chairs and the Chief Academic Officer. RESULTS 392 faculty were evaluated. The median score was 3. Full professors more frequently received a score of 1, but all faculty ranks received scores of 4 and 5. As a group, tenure/tenure track faculty achieved superior scores compared to nontenure track faculty. CONCLUSIONS Based on our experience, we believe it is possible to conduct a rigorous consensus-based evaluation of the quality of clinical cancer research being conducted at an academic medical center. It is reasonable to suggest such evaluations can be used as a management tool and may lead to higher-quality clinical research.
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Chan KW, Ngai HY, Ip KK, Lam KH, Lai WW. Co-morbidities of patients with knee osteoarthritis. Hong Kong Med J 2009; 15:168-172. [PMID: 19494370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES To study the co-morbidities of general practice patients with knee osteoarthritis. DESIGN Cross-sectional study. SETTING Two private general practice clinics in Hong Kong. PATIENTS All patients presenting at the two clinics were screened for osteoarthritis of the knee based on American College of Rheumatology diagnostic criteria. Patients with osteoarthritis then completed a semi-instructed questionnaire. RESULTS A total of 455 patients were recruited into the study. Over half (56%) had knee pain plus more than three other diagnostic criteria. Almost all (95%) of the patients with osteoarthritis had no signs of inflammation at the time of screening. Their mean age was 54 years. Overall, 78% of them had at least one musculoskeletal co-morbidity and 82% had at least one non-musculoskeletal co-morbidity. On average they had 3.2 co-morbidities, of which 1.7 were musculoskeletal and 1.5 were non-musculoskeletal. Problems related to the back, upper limbs, neck, and lower limbs were the four most common musculoskeletal co-morbidities, of which neck problems were significantly more common among younger patients (55 years or below) [odds ratio for older to younger patients was 0.62; 95% confidence interval, 0.4-0.9]. The four commonest non-musculoskeletal co-morbidities were cardiovascular, gastro-intestinal, respiratory, and endocrine, of which cardiovascular diseases (odds ratio=8.76; 95% confidence interval, 5.6-13.7), endocrine problems (4.56; 2.8-7.4), and central nervous system diseases (12.74; 1.6-102.8) were significantly likely among older patients (more than 55 years). CONCLUSION General practitioners should be alert to the presence of co-morbidities when managing patients with osteoarthritis of the knee.
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Wong SW, Chan KW, Paulose NM, Leong HT. Scan-directed unilateral neck exploration for primary hyperparathyroidism: eight-year results from a regional hospital. Hong Kong Med J 2009; 15:118-121. [PMID: 19342737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To determine the results of scan-directed unilateral neck exploration for primary hyperparathyroidism. DESIGN Retrospective study. SETTING Regional hospital, Hong Kong. PATIENTS Patients who underwent parathyroid surgery for primary hyperparathyroidism between January 2000 and December 2007 were included. MAIN OUTCOME MEASURES The demographic, imaging, biochemical, and pathological data, as well as surgical outcomes were analysed according to the treatment received. RESULTS A total of 78 patients were included in this study; 65 underwent unilateral neck exploration with image guidance by ultrasonography or technetium Tc99m sestamibi scan. The scan sensitivity for localising the side of the lesion was 66% for ultrasound scans, 71% for technetium Tc99m sestamibi scans, and 85% for both scans used in combination. Pathological analysis showed that 95% (74/78) of the patients had a single parathyroid adenoma, two had hyperplasia of four glands, one had a double adenoma, and one a parathyroid carcinoma. Among the patients undergoing scan-directed unilateral neck exploration, one defaulted follow-up, while the remaining 64 patients achieved normal calcium levels at a median follow-up of 6 months. CONCLUSION Scan-directed unilateral neck exploration is a safe alternative form of treatment for patients with primary hyperparathyroidism, with a cure rate similar to conventional therapy.
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Lui SL, Yung S, Tsang R, Zhang F, Chan KW, Tam S, Chan TM. Rapamycin prevents the development of nephritis in lupus-prone NZB/W F1 mice. Lupus 2008; 17:305-13. [PMID: 18413412 DOI: 10.1177/0961203307088289] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rapamycin is a potent immunosuppressive drug currently used mainly for rejection prophylaxis in renal transplantation. The aim of this study was to determine the effect of rapamycin treatment on the development of nephritis in lupus-prone New Zealand Black/White F1 (NZB/W F1) mice. Twelve-week-old female NZB/W F1 mice were treated with rapamycin (3 mg/kg body weight) or saline once daily by oral gavage for 20 weeks. The severity of nephritis was assessed by clinical and biochemical parameters, renal histology, immunohistochemistry and gene expression studies. Rapamycin treatment markedly reduced proteinuria, improved renal function, decreased serum anti-double stranded DNA antibody levels and diminished splenomegaly. Kidney sections from saline-treated mice showed marked mesangial proliferation, tubular dilation with protein cast deposition and interstitial inflammatory cell infiltration. Rapamycin-treated mice had near normal renal histology, with marked reduction in glomerular immune deposition and the infiltration by T cells, B cells and macrophages. Rapamycin treatment was associated with down-regulation of intra-renal expression of monocyte chemoattractant protein-1 (MCP-1) mRNA and protein. We conclude that rapamycin is highly effective in preventing the development of nephritis in NZB/W F1 mice. The beneficial effects of rapamycin are mediated through inhibition of lymphoproliferation and reduced MCP-1 expression.
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Leung KM, Lam KK, Tse PY, Yeoh GPS, Chan KW. Characteristics of false-negative ThinPrep cervical smears in women with high-grade squamous intraepithelial lesions. Hong Kong Med J 2008; 14:292-295. [PMID: 18685162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To examine the cellular characteristics and other possible factors affecting the correct prediction of ThinPrep cervical smears from patients with high-grade squamous intraepithelial lesions. DESIGN Retrospective study. SETTING Private anatomical pathology service, Hong Kong. PATIENTS Patients (n=98) with biopsy-confirmed high-grade squamous intraepithelial lesion of the uterine cervix encountered between 2004 and 2006. MAIN OUTCOME MEASURES Correct prediction of the cervical ThinPrep Papanicolaou tests. RESULTS There were no significant differences in age, hormonal status, degree of inflammation, and the presence or absence of endocervical/metaplastic cells between the true-positive and false-negative groups. There was a significant difference in the number of abnormal cells present and the screening time between the two groups. Approximately 79% (34/43) false-negative smears had 100 or less abnormal cells, while only 11% (5/45) true-positive smears had 100 or less abnormal cells (P<0.001). The true-positive smears were also more likely to contain koilocytic cells and abnormal cells with hyperchromatic nuclei. CONCLUSIONS The number of abnormal cells present, the presence or absence of koilocytic cells, and the presence or absence of abnormal cells with nuclear hyperchromasia appeared to be independent factors affecting the correct prediction of smears from patients with high-grade squamous intraepithelial lesions.
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Chan KW, Lee KH, Mou JWC, Cheung ST, Tam YH. The use of laparoscopy in the management of Littre's hernia in children. Pediatr Surg Int 2008; 24:855-8. [PMID: 18437397 DOI: 10.1007/s00383-008-2161-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2008] [Indexed: 10/22/2022]
Abstract
Littre's hernia is a rare complication of Meckel's diverticulum. It was originally defined as 'the presence of a Meckel's diverticulum in any hernia sac' by Rieke in 1841. It is difficult to diagnose before surgery. With the advances in the development of laparoscopic surgery in children, diagnosis of this rare condition, together with subsequent repair of Littre's hernia and Meckel's diverticulectomy can be performed by laparoscopy. We herein report the use of laparoscopy in the management of two boys with Littre's hernia, including one with incarcerated hernia.
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Wall DA, Chan KW. Selection of cord blood unit(s) for transplantation. Bone Marrow Transplant 2008; 42:1-7. [PMID: 18469873 DOI: 10.1038/bmt.2008.100] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Selection of cord blood (CB) units for transplantation involves combining both cell dose and HLA matching as independent yet overlapping variables. Cell dose and cell yield at the time of transplant are critical given that the transplants are being performed with minimal cells for reliable engraftment. In transplants for malignant disorders, the greater allogenicity and lower relapse rate associated with the less well-matched units balance any benefit of better HLA matching on TRM. The only factor that has repeatedly been associated with improved outcome post CB transplant is cell dose. The CB inventories are rapidly increasing in size and the quality of CB units being banked (larger, better characterized) is improving. With this, some of our current limitations in CB availability will soon become moot. Explorations into CB expansion and multiple CB unit transplants are addressing the limited cell doses attainable with a single CB collection. At this point, one must conclude that bigger is better when selecting CB units for transplantation.
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Mou JWC, Lee KH, Tam YH, Cheung ST, Chan KW, Thakre A. Urinary bladder pheochromocytoma, an extremely rare tumor in children: case report and review of the literature. Pediatr Surg Int 2008; 24:479-80. [PMID: 17828544 DOI: 10.1007/s00383-007-2013-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2007] [Indexed: 11/28/2022]
Abstract
We report a case of pheochromocytoma in the urinary bladder of a 14-year-old girl who presented with headache and palpitation after voiding. This is an extremely rare condition in pediatric age group and thus can be missed easily. This case is the seventh case reported in the reviewed literature.
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Howard EW, Leung SCL, Yuen HF, Chua CW, Lee DT, Chan KW, Wang X, Wong YC. Decreased adhesiveness, resistance to anoikis and suppression of GRP94 are integral to the survival of circulating tumor cells in prostate cancer. Clin Exp Metastasis 2008; 25:497-508. [PMID: 18340425 DOI: 10.1007/s10585-008-9157-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 02/24/2008] [Indexed: 01/08/2023]
Abstract
The presence of circulating tumor cells (CTC) is common in prostate cancer patients, however until recently their clinical significance was unknown. The CTC stage is essential for the formation of distant metastases, and their continuing presence after radical prostatectomy has been shown to predict recurrent or latent disease. Despite their mechanistic and prognostic importance, due both to their scarcity and difficulties in their isolation, little is known about the characteristics that enable their production and survival. The aim of this study was to investigate the molecular mechanisms underlying the survival of CTC cells. A novel CTC cell line from the bloodstream of an orthotopic mouse model of castration-resistant prostate cancer was established and compared with the primary tumor using attachment assays, detachment culture, Western blot, flow cytometry and 2D gel electrophoresis. Decreased adhesiveness and expression of adhesion molecules E-cadherin, beta4-integrin and gamma-catenin, together with resistance to detachment and drug-induced apoptosis and upregulation of Bcl-2 were integral to the development of CTC and their survival. Using proteomic studies, we observed that the GRP94 glycoprotein was suppressed in CTC. GRP94 was also shown to be suppressed in a tissue microarray study of 79 prostate cancer patients, indicating its possible role in prostate cancer progression. Overall, this study suggests molecular alterations accounting for the release and survival of CTC, which may be used as drug targets for either anti-metastatic therapy or the suppression of latent disease. We also indicate the novel involvement of GRP94 suppression in prostate cancer metastasis.
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Chan KW, Grimley MS, Taylor C, Wall DA. Early identification and management of graft failure after unrelated cord blood transplantation. Bone Marrow Transplant 2008; 42:35-41. [DOI: 10.1038/bmt.2008.40] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lee PPW, Jiang LP, Wang XC, Chan KW, Tu WW, Lau YL. Severe mycobacterial infections in two pairs of Chinese siblings with interleukin-12 receptor beta1 deficiency. Eur J Pediatr 2008; 167:231-2. [PMID: 17387515 DOI: 10.1007/s00431-007-0430-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Accepted: 01/18/2007] [Indexed: 11/25/2022]
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Wong WCW, Wun YT, Chan KW, Liu Y. Silent killer of the night: a feasibility study of an outreach well-women clinic for cervical cancer screening in female sex workers in Hong Kong. Int J Gynecol Cancer 2008; 18:110-5. [PMID: 17466035 DOI: 10.1111/j.1525-1438.2007.00970.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to see if an outreach model could be a feasible option for early detections of preinvasive cervical cancer in women with double identities of female sex workers (FSW) and illegal migrant workers in Hong Kong who most needed cervical screening but were often deprived of such a service. High turnover rates, acceptability, and compliance for follow-ups could potentially render such a clinical model unsuccessful. A total of 245 FSW were screened at the outreach clinic from January 2004 to December 2005, which was set up in a nongovernmental organization in a red light district. A questionnaire regarding their lifestyles and demographic details was used before a gynecological history, Papanicolaou (PAP) smear, and other health checkup were conducted. Chi-square test and multinomial logistic regression were used to analyze the results. Of 235 women tests, 9.8% of them had CIN I-III, and places of origin were found to be important risk factors for abnormal PAP smears. The nonlocal workers were significantly more likely to have abnormal PAP smears (chi(2)= 10.55, P= 0.04). Among the women, 88.1% of them who had the tests returned for follow-up with poorer compliance among those with an abnormal result. We conclude that an outreach well-women clinic seems to be an acceptable option for these women and an effective way for the early detection of cervical cancer.
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Chan KW, Grimley MS, Taylor C, Wall DA. 12: Management of Primary Graft Failure after Unrelated Umbilical Cord Blood Transplantation. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2007.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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