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Djalal A, Wong SY, Colombel JF, Ungaro R, Kayal M. Problem with Hookups: Perianal Fistula After Ileal Pouch-Anal Anastomosis. Dig Dis Sci 2024; 69:1102-1104. [PMID: 38446307 DOI: 10.1007/s10620-024-08344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Arafa Djalal
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Serre-Yu Wong
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-Frédéric Colombel
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Ungaro
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maia Kayal
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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2
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Dallari S, Martinez Pazos V, Munoz Eusse J, Wellens J, Thompson C, Colombel JF, Satsangi J, Cadwell K, Wong SY. Cytokine signature in convalescent SARS-CoV-2 patients with inflammatory bowel disease receiving vedolizumab. Sci Rep 2024; 14:186. [PMID: 38168138 PMCID: PMC10761911 DOI: 10.1038/s41598-023-50035-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
While differential antibody responses SARS-CoV-2 in patients with inflammatory bowel disease (IBD) receiving infliximab and vedolizumab are well-characterized, the immune pathways underlying these differences remain unknown. Prior to COVID-19 vaccine development, we screened 235 patients with IBD receiving biological therapy for antibodies to SARS-CoV-2 and measured serum cytokines. In seropositive patients, we prospectively collected clinical data. We found a cytokine signature in patients receiving vedolizumab who are seropositive compared with seronegative for SARS-CoV-2 antibodies that may be linked to repeated SARS-CoV-2 infections. However, there were no differences between seropositive and seronegative patients receiving infliximab. In this single-center cohort of patients with IBD with anti-SARS-CoV-2 antibodies at the onset of the COVID-19 pandemic, and therefore without influence of vaccination, there is a cytokine signature in patients receiving vedolizumab but not infliximab. These findings lay the groundwork for further studies on immune consequences of viral infection in patients with IBD, which is postulated to evolve from aberrant host-microbe responses.
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Affiliation(s)
- Simone Dallari
- Department of Microbiology, New York University Grossman School of Medicine, New York, USA
| | - Vicky Martinez Pazos
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA
| | | | - Judith Wellens
- Department of Gastroenterology and Hepatology, Leuven University Hospitals, Leuven, Belgium
| | - Craig Thompson
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Warwick, UK
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA
| | - Jack Satsangi
- Nuffield Department of Medicine, Translational Gastroenterology Unit, University of Oxford, Oxford, UK
| | - Ken Cadwell
- Division of Gastroenterology and Hepatology, Department of Medicine, Department of Systems Pharmacology and Translational Therapeutics, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Serre-Yu Wong
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA.
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3
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Wong SY, Colombel JF. Cancer Screening in Patients With Inflammatory Bowel Disease: Don't Forget the Anus! Inflamm Bowel Dis 2023:izad267. [PMID: 37951594 DOI: 10.1093/ibd/izad267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Serre-Yu Wong
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-Frederic Colombel
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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González Cueto E, Edmans M, Wellens J, Cadwell K, Thompson C, Satsangi J, Wong SY. Antibody, not Cellular, Immune Responses to SARS-CoV-2 Vaccination Outperform Infection in Inflammatory Bowel Disease Patients. Inflamm Bowel Dis 2023:izad265. [PMID: 37935466 DOI: 10.1093/ibd/izad265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 11/09/2023]
Affiliation(s)
| | - Matthew Edmans
- University of Oxford, Peter Medawar Building for Pathogen Research, Oxford, United Kingdom
| | - Judith Wellens
- University Hospitals Leuven-KU Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium
- University of Oxford, Translational Gastroenterology Unit, Nuffield Department of Medicine, Oxford, United Kingdom
| | - Ken Cadwell
- Warwick Medical School- University of Warwick, Division of Biomedical Sciences, Coventry, United Kingdom
| | - Craig Thompson
- University of Pennsylvania-Perelman School of Medicine, Division of Gastroenterology, Department of Medicine, Philadelphia, United States
| | - Jack Satsangi
- University of Oxford, Translational Gastroenterology Unit, Nuffield Department of Medicine, Oxford, United Kingdom
| | - Serre-Yu Wong
- Icahn School of Medicine at Mount Sinai, The Henry D. Janowitz Division of Gastroenterology, New York, United States
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Wong SY, Wellens J, Helmus D, Marlow L, Brann S, Martinez Pazos V, Weinberg A, Moran HR, McGregor C, Vermeire S, Watanabe K, Kamikozuru K, Ahuja V, Vermani S, Lindsay JO, Kingston A, Dutta U, Kaur H, Silverberg MS, Milgrom R, Chien Ng S, Mak JWY, Cadwell K, Thompson C, Colombel JF, Satsangi J. Geography Influences Susceptibility to SARS-CoV-2 Serological Response in Patients With Inflammatory Bowel Disease: Multinational Analysis From the ICARUS-IBD Consortium. Inflamm Bowel Dis 2023; 29:1693-1705. [PMID: 37354560 DOI: 10.1093/ibd/izad097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Indexed: 06/26/2023]
Abstract
BACKGROUND Beyond systematic reviews and meta-analyses, there have been no direct studies of serological response to COVID-19 in patients with inflammatory bowel disease (IBD) across continents. In particular, there has been limited data from Asia, with no data reported from India. The ICARUS-IBD (International study of COVID-19 Antibody Response Under Sustained immunosuppression in IBD) consortium assessed serological response to SARS-CoV-2 in patients with IBD in North America, Europe, and Asia. METHODS The ICARUS-IBD study is a multicenter observational cohort study spanning sites in 7 countries. We report seroprevalence data from 2303 patients with IBD before COVID-19 vaccination between May 2020 and November 2021. SARS-CoV-2 anti-spike and anti-nucleocapsid antibodies were analyzed. RESULTS The highest and lowest SARS-CoV-2 anti-spike seropositivity rates were found in Asia (81.2% in Chandigarh and 57.9% in Delhi, India; and 0% in Hong Kong). By multivariable analysis, country (India: odds ratio [OR], 18.01; 95% confidence interval [CI], 12.03-26.95; P < .0001; United Kingdom: OR, 2.43; 95% CI, 1.58-3.72; P < .0001; United States: OR, 2.21; 95% CI, 1.27-3.85; P = .005), male sex (OR, 1.46; 95% CI, 1.07-1.99; P = .016), and diabetes (OR, 2.37; 95% CI, 1.04-5.46; P = .039) conferred higher seropositivity rates. Biological therapies associated with lower seroprevalence (OR, 0.22; 95% CI, 0.15-0.33; P < .0001). Multiple linear regression showed associations between anti-spike and anti-nucleocapsid titers with medications (P < .0001) but not with country (P = .3841). CONCLUSIONS While the effects of medications on anti-SARS-CoV-2 antibody titers in patients with IBD were consistent across sites, geographical location conferred the highest risk of susceptibility to serologically detectable SARS-CoV-2 infection. Over half of IBD patients in India were seropositive prior to vaccination. These insights can help to inform shielding advice, therapeutic choices, and vaccine strategies in IBD patients for COVID-19 and future viral challenges.
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Affiliation(s)
- Serre-Yu Wong
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Judith Wellens
- Department of Gastroenterology and Hepatology, Leuven University Hospitals, Leuven, Belgium
| | - Drew Helmus
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Luke Marlow
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Stephanie Brann
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Vicky Martinez Pazos
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan Weinberg
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hunter R Moran
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Colleen McGregor
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Séverine Vermeire
- Department of Gastroenterology and Hepatology, Leuven University Hospitals, Leuven, Belgium
| | - Kenji Watanabe
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Koji Kamikozuru
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Vineet Ahuja
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Shubi Vermani
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - James O Lindsay
- Center for Immunobiology, Blizard Institute, Queen Mary University of London - Barts Health NHS Trust, London, United Kingdom
| | - Ashley Kingston
- Center for Immunobiology, Blizard Institute, Queen Mary University of London - Barts Health NHS Trust, London, United Kingdom
| | - Usha Dutta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harmandeep Kaur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mark S Silverberg
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Raquel Milgrom
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Siew Chien Ng
- Division of Gastroenterology and Hepatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Joyce Wing Yan Mak
- Division of Gastroenterology and Hepatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Ken Cadwell
- Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA, USA
| | - Craig Thompson
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Jean-Frédéric Colombel
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jack Satsangi
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Wellens J, Edmans M, Obolski U, McGregor CG, Simmonds P, Turner M, Jarvis L, Skelly D, Dunachie S, Barnes E, Eyre DW, Colombel JF, Wong SY, Klenerman P, Lindsay JO, Satsangi J, Thompson CP. Combination therapy of infliximab and thiopurines, but not monotherapy with infliximab or vedolizumab, is associated with attenuated IgA and neutralisation responses to SARS-CoV-2 in inflammatory bowel disease. Gut 2022; 71:1919-1922. [PMID: 34911744 DOI: 10.1136/gutjnl-2021-326312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/06/2021] [Indexed: 12/08/2022]
Affiliation(s)
- Judith Wellens
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Translational Gastroenterology Unit, University of Oxford, Oxford, UK
| | - Matthew Edmans
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK.,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Uri Obolski
- School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Porter School of Environmental and Earth Sciences, Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Marc Turner
- National Microbiology Reference Unit, Scottish National Blood Transfusion Service, Edinburgh, Edinburgh, UK
| | - Lisa Jarvis
- National Microbiology Reference Unit, Scottish National Blood Transfusion Service, Edinburgh, Edinburgh, UK
| | - Donal Skelly
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Susanna Dunachie
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Eleanor Barnes
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK.,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David W Eyre
- Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Serre-Yu Wong
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA
| | - Paul Klenerman
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK.,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - James O Lindsay
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK
| | - Jack Satsangi
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK
| | - Craig P Thompson
- Warwick Medical School, University of Warwick, Coventry, UK .,Department of Zoology, University of Oxford, Oxford, UK
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Wong SY, Foley S, Cantwell CP, Ryan R, Lucey J, Maher P, McNulty JP. THE EFFECTS OF CONE-BEAM COMPUTED TOMOGRAPHY IMAGING GUIDANCE ON PATIENT RADIATION EXPOSURES IN TRANS-ARTERIAL CHEMOEMBOLISATION FOR HEPATOCELLULAR CARCINOMA. Radiat Prot Dosimetry 2022; 198:441-447. [PMID: 35640248 PMCID: PMC9248773 DOI: 10.1093/rpd/ncac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/21/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
This study investigated the effects of cone-beam computed tomography (CBCT) guidance in trans-arterial chemoembolisation (TACE) procedures on the number of digital subtraction angiography (DSA) runs acquired and total patient radiation exposure in patients with hepatocellular carcinoma (HCC). A retrospective, analytical cross-sectional, single institution, study was conducted. Dose data were compared across the control (DSA guidance alone) and study (DSA and CBCT guidance) groups. A total of 122 procedures were included within the study. There was a significant reduction in the number of DSA runs (3 vs 5, p < 0.001) and DSA air kerma-area product (PKA) (3077.3 vs 4276.6 μGym2, p = 0.042) for the study group when compared to the control group. Total procedural PKA and total procedural reference air kerma (Ka,r) were shown to be 50 and 73% higher, respectively, for the study group when compared to the control group. CBCT imaging guidance does reduce the number of DSA runs and DSA PKA required to complete the TACE procedure for patients diagnosed with HCC; however, a substantial increase in total procedural PKA is to be expected and it is thus important that this increased dose is carefully considered and justified.
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Affiliation(s)
- S Y Wong
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4, Ireland
- Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
- Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore
| | - S Foley
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4, Ireland
- Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
| | - C P Cantwell
- Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - R Ryan
- Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - J Lucey
- Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - P Maher
- Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
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Wong SY, Peraza J, Grinspan LT, Agrawal M. One Step Forward, Two Steps Back? Disproportionate Loss of Scientific Productivity With Long-Term Effects Among Women and Caregivers During the Pandemic. Gastroenterology 2022; 162:2125-2126. [PMID: 35358507 DOI: 10.1053/j.gastro.2022.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Serre-Yu Wong
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jellyana Peraza
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Lauren T Grinspan
- Division of Liver Diseases, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Manasi Agrawal
- The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
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Zhao JJ, Tashi S, Lim EJ, Wong SY, Wang YW, Sultana R, Leong S, Chua JME, Too CW, Chandramohan S. Octyl cyanoacrylate skin adhesive with or without subcuticular suture for skin closure after implantable venous port placement for oncology patients: a propensity-score matching analysis. Clin Radiol 2022; 77:628-635. [PMID: 35659114 DOI: 10.1016/j.crad.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/21/2022] [Indexed: 11/03/2022]
Abstract
AIM To compare peri-operative outcomes of skin closure with octyl cyanoacrylate (OCA) skin adhesive (Dermabond) with or without subcuticular sutures after deep dermal suturing for implantable venous port placement closure. MATERIALS AND METHODS Seven hundred and ninety-two single-lumen implantable venous port insertions for chemotherapy were reviewed from September 2019 to March 2021 in a retrospective single-centre study. Propensity-score matching by a 1:1 nearest neighbour algorithm was conducted to control for confounding baseline differences. Distances were determined by logistic regression. Propensity-score matching was performed based on the following variables: age at procedure, gender, race, operator's seniority, use of anchoring polypropylene suture (PROLENE), port model, and volume of intra-operative local analgesia. The primary outcome was wound dehiscence at the first follow-up (∼1 week). RESULTS The 792 port insertions were conducted in 302 males (38.1%), median age 63 years (IQR: 54-69). Of the 656 wounds closed with subcuticular sutures and skin adhesive, 136 were matched in a 1:1 fashion against procedures closed without a subcuticular suture. No significant differences were demonstrated in pain scores, bleeding, swelling, bruising, fever, wound dehiscence, and discharge at postoperative day 1 (POD1) and at first follow-up between the groups (all p>0.05). Of note, no significant differences in wound dehiscence at first follow-up was found in both unmatched (p=0.133) and matched cohorts (McNemar-Bowker's χ2 = 1.167, p=0.761). CONCLUSION These findings suggest that the omission of subcuticular sutures during implantable venous port closure may not compromise peri-operative outcomes when OCA skin adhesives were used.
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Affiliation(s)
- J J Zhao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - S Tashi
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - E J Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - S Y Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Y W Wang
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - R Sultana
- Center of Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore
| | - S Leong
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - J M E Chua
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - C W Too
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore
| | - S Chandramohan
- Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore; Division of Radiological Sciences, Singapore General Hospital, Singapore; Radiological Sciences Academic Clinical Program, SingHealth-Duke-NUS Academic Medical Centre, Singapore.
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Peraza J, Agrawal M, Wong SY. Disparities in gastroenterology grand rounds speakerships in the USA. Lancet Gastroenterol Hepatol 2021; 6:781-782. [PMID: 34509191 DOI: 10.1016/s2468-1253(21)00265-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jellyana Peraza
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
| | - Manasi Agrawal
- Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Serre-Yu Wong
- Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
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Wong SY, Dixon R, Martinez Pazos V, Gnjatic S, Colombel JF, Cadwell K. Serologic Response to Messenger RNA Coronavirus Disease 2019 Vaccines in Inflammatory Bowel Disease Patients Receiving Biologic Therapies. Gastroenterology 2021; 161:715-718.e4. [PMID: 33887219 PMCID: PMC8055494 DOI: 10.1053/j.gastro.2021.04.025] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/10/2021] [Accepted: 04/13/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Serre-Yu Wong
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Rebekah Dixon
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vicky Martinez Pazos
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sacha Gnjatic
- The Precision Immunology Institute, Tisch Cancer Institute, Division of Hematology/Oncology, Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ken Cadwell
- Skirball Institute of Biomolecular Medicine, Department of Microbiology, Division of Gastroenterology and Hepatology, Department of Medicine, New York University School of Medicine, New York, New York
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12
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Dallari S, Heaney T, Rosas-Villegas A, Neil JA, Wong SY, Brown JJ, Urbanek K, Herrmann C, Depledge DP, Dermody TS, Cadwell K. Enteric viruses evoke broad host immune responses resembling those elicited by the bacterial microbiome. Cell Host Microbe 2021; 29:1014-1029.e8. [PMID: 33894129 PMCID: PMC8192460 DOI: 10.1016/j.chom.2021.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/04/2021] [Accepted: 03/23/2021] [Indexed: 02/08/2023]
Abstract
The contributions of the viral component of the microbiome-the virome-to the development of innate and adaptive immunity are largely unknown. Here, we systematically defined the host response in mice to a panel of eukaryotic enteric viruses representing six different families. Infections with most of these viruses were asymptomatic in the mice, the magnitude and duration of which was dependent on the microbiota. Flow cytometric and transcriptional profiling of mice mono-associated with these viruses unveiled general adaptations by the host, such as lymphocyte differentiation and IL-22 signatures in the intestine, as well as numerous viral-strain-specific responses that persisted. Comparison with a dataset derived from analogous bacterial mono-association in mice identified bacterial species that evoke an immune response comparable with the viruses we examined. These results expand an understanding of the immune space occupied by the enteric virome and underscore the importance of viral exposure events.
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Affiliation(s)
- Simone Dallari
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Thomas Heaney
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Adriana Rosas-Villegas
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Jessica A Neil
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Serre-Yu Wong
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, USA; Department of Medicine, Henry D. Janowitz Division of Gastroenterology, Susan and Leonard Feinstein Inflammatory Bowel Disease Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Judy J Brown
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Biology, Trevecca Nazarene University, Nashville, TN, USA
| | - Kelly Urbanek
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christin Herrmann
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Daniel P Depledge
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Terence S Dermody
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ken Cadwell
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA; Division of Gastroenterology and Hepatology, Department of Medicine, New York University Langone Health, New York, NY, USA.
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13
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Affiliation(s)
- Loren Galler Rabinowitz
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michelle Kang Kim
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Serre-Yu Wong
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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14
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Abstract
Since the beginning of the pandemic, patients with inflammatory bowel diseases [IBD] have been considered at high risk for infection and complications of COVID-19. IBD patients and patients taking immunosuppressive therapy were excluded from clinical phase III vaccine trials, complicating the assessment of effectiveness of these new vaccines. From past experience we know that adapted vaccination strategies may be appropriate in some IBD patients to optimise immunogenicity. We review current evidence on SARS-CoV-2 vaccination relevant to IBD patients, including immune responses from humoral to cellular, emerging data on new variants, and off-label vaccination schemes. We also identify clinical and scientific knowledge gaps that can be translated into both large-scale population-based studies and targeted vaccine studies to describe the precise immune responses induced by SARS-CoV-2 vaccines in IBD patients. We strongly endorse the recommendation of vaccinating IBD patients to ensure maximal protection from COVID-19 both for the individual and the community.
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Affiliation(s)
- Judith Wellens
- Translational Gastro-intestinal Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford,Translational Research for Gastrointestinal Diseases, University hospitals Leuven, Herestraat, Leuven, Belgium,Address for correspondence: Judith Wellens, . +32474815145 Experimental Medicine Division, Level 5, Room 5800, John Radcliffe Hospital, Headley Way, Headington, OX3 9DU, United Kingdom
| | - Jean-Frédéric Colombel
- Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York city, New York, USA. One Gustavo L. Levy Place, New York, NY, USA
| | - Jack J Satsangi
- Lee Placito of Gastroenterology, Translational Gastro-intestinal Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford
| | - Serre-Yu Wong
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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15
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Koo HC, Kaur S, Chan KQ, Soh WH, Ang YL, Chow WS, Hew MK, Wong SY, Yap MP. Whole-grain intake and its inverse relationships with fatty acids intake among multiethnic Malaysian schoolchildren. J Hum Nutr Diet 2020; 33:670-677. [PMID: 32250007 DOI: 10.1111/jhn.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Little is known about the relationship of whole-grain intake with dietary fatty acids intake. The present study aimed to assess the whole-grain intake and its relationships with dietary fatty acids intake among multiethnic schoolchildren in Kuala Lumpur, Malaysia. METHODS This cross-sectional study was conducted among 392 schoolchildren aged 9-11 years, cluster sampled from five randomly selected schools in Kuala Lumpur. Whole-grain and fatty acids intakes were assessed by 3-day, 24-h diet recalls. All whole-grain foods were considered irrespective of the amount of whole grain they contained. RESULTS In total, 55.6% (n = 218) were whole-grain consumers. Mean (SD) daily intake of whole grain in the total sample was 5.13 (9.75) g day-1 . In the whole-grain consumer's only sample, mean (SD) intakes reached 9.23 (11.55) g day-1 . Significant inverse associations were found between whole-grain intake and saturated fatty acid (SAFA) intake (r = -0.357; P < 0.001), monosaturated fatty acid (MUFA) (r = -0.373; P < 0.001) and polyunsaturated fatty acid (PUFA) (r = -0.307; P < 0.001) intake. Furthermore, whole-grain intake was a significant predictor of SAFA (β = -0.077; P = 0.004), MUFA (β = -0.112; P = <0.001) and PUFA (β = -0.202; P = <0.001) intakes, after controlling for sex, age and ethnicity. CONCLUSIONS Whole-grain intake in Malaysia was well below recommendations. Schoolchildren who consumed higher whole grain tend to reduce fat intake; however, it would also reduce the SAFA, MUFA and PUFA intakes. Future collaboration may be conducted between industry, government and universities to promote unsaturated fatty acids-rich foods and whole-grain food, although not to promote processed whole-grain foods with a high sugar and salt content.
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Affiliation(s)
- H C Koo
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - S Kaur
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - K Q Chan
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - W H Soh
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - Y L Ang
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - W S Chow
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - M K Hew
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - S Y Wong
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - M P Yap
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
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16
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Karadedou CT, Gomes AR, Chen J, Petkovic M, Ho KK, Zwolinska AK, Feltes A, Wong SY, Chan KYK, Cheung YN, Tsang JWH, Brosens JJ, Khoo US, Lam EWF. Correction: FOXO3a represses VEGF expression through FOXM1-dependent and -independent mechanisms in breast cancer. Oncogene 2019; 38:5111-5112. [PMID: 30867566 DOI: 10.1038/s41388-019-0770-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the published version of this article, the images for cytoplasmic and nuclear FGF7 in MDA-MB-231 cells were duplicated and mistaken for total FGF7 in SKBR-3 and MDA-MB-231 cells.
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Affiliation(s)
- C T Karadedou
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - A R Gomes
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - J Chen
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK.,Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - M Petkovic
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - K-K Ho
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - A K Zwolinska
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - A Feltes
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - S Y Wong
- Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - K Y K Chan
- Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - Y-N Cheung
- Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - J W H Tsang
- Department of Clinical Oncology Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - J J Brosens
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - U-S Khoo
- Department of Pathology, The University of Hong Kong, Hong Kong SAR, China
| | - E W-F Lam
- Department of Surgery and Cancer, Cancer Research-UK Labs, Imperial College London, Hammersmith Hospital Campus, London, UK.
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17
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Tsui KL, Wong SY, Wu JT, Chow CB, Goldsman DM, Nizam A. Development of adaptable pandemic simulation models. Hong Kong Med J 2018; 24 Suppl 6:23-25. [PMID: 30229732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- K L Tsui
- Department of Systems Engineering and Engineering Management, City University of Hong Kong
| | - S Y Wong
- Department of Systems Engineering and Engineering Management, City University of Hong Kong
| | - J T Wu
- School of Public Health, The University of Hong Kong
| | - C B Chow
- Infectious Disease Centre, Hospital Authority
| | - D M Goldsman
- School of Industrial and Systems Engineering, Georgia Institute of Technology, USA
| | - A Nizam
- Department of Biostatistics and Bioinformatics, Emory University, USA
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18
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Affiliation(s)
- Serre-Yu Wong
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University School of Medicine, New York, New York, United States of America
- Department of Medicine, Henry D. Janowitz Division of Gastroenterology, Susan and Leonard Feinstein Inflammatory Bowel Disease Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Ken Cadwell
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University School of Medicine, New York, New York, United States of America
- Department of Microbiology, New York University School of Medicine, New York, New York, United States of America
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19
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Wong SY, Coffre M, Ramanan D, Hines MJ, Gomez LE, Peters LA, Schadt EE, Koralov SB, Cadwell K. B Cell Defects Observed in Nod2 Knockout Mice Are a Consequence of a Dock2 Mutation Frequently Found in Inbred Strains. J Immunol 2018; 201:1442-1451. [PMID: 30012848 DOI: 10.4049/jimmunol.1800014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/22/2018] [Indexed: 02/06/2023]
Abstract
Phenotypic differences among substrains of laboratory mice due to spontaneous mutations or pre-existing genetic variation confound the interpretation of targeted mutagenesis experiments and contribute to challenges with reproducibility across institutions. Notably, C57BL/6 Hsd mice and gene-targeted mice that have been backcrossed to this substrain have been reported to harbor a duplication in exons 28 and 29 of Dock2 In this study, we demonstrate the presence of this Dock2 variant in the widely used Nod2-/- mice. Nucleotide-binding oligomerization domain-containing protein 2 (NOD2) is a cytosolic innate immune receptor associated with inflammatory bowel disease susceptibility. Consistent with a role of NOD2 in an immunological disorder, Nod2-/- mice bred at our institution displayed multiple B cell defects including deficiencies in recirculating B cells, marginal zone B cells, and B1a cells in vivo, as well as defects in class switch recombination in vitro. However, we found that these effects are due to the Dock2 variant and are independent of Nod2 deletion. Despite originating from the same gene-targeted founder mice, Nod2-/- mice from another source did not harbor the Dock2 variant or B cell defects. Finally, we show that Dock2-/- mice display the same B cell defects as mice harboring the Dock2 variant, confirming that the variant is a loss-of-function mutation and is sufficient to explain the alterations to the B cell compartment observed in Nod2-/- mice. Our findings highlight the effects of confounding mutations from widely used inbred strains on gene-targeted mice and reveal new functions of DOCK2 in B cells.
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Affiliation(s)
- Serre-Yu Wong
- Kimmel Center for Biology and Medicine, Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY 10016.,Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Maryaline Coffre
- Department of Pathology, New York University School of Medicine, New York, NY 10016
| | - Deepshika Ramanan
- Kimmel Center for Biology and Medicine, Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY 10016
| | - Marcus J Hines
- Department of Pathology, New York University School of Medicine, New York, NY 10016
| | - Luis E Gomez
- Kimmel Center for Biology and Medicine, Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY 10016
| | - Lauren A Peters
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029.,Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029.,Sema4, a Mount Sinai Venture, Stamford, CT 06902; and
| | - Eric E Schadt
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029.,Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029.,Sema4, a Mount Sinai Venture, Stamford, CT 06902; and
| | - Sergei B Koralov
- Department of Pathology, New York University School of Medicine, New York, NY 10016
| | - Ken Cadwell
- Kimmel Center for Biology and Medicine, Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY 10016; .,Department of Microbiology, New York University School of Medicine, New York, NY 10016
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20
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Hoe YC, Gibernau M, Wong SY. Diversity of pollination ecology in the Schismatoglottis Calyptrata Complex Clade (Araceae). Plant Biol (Stuttg) 2018; 20:563-578. [PMID: 29316090 DOI: 10.1111/plb.12687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 12/26/2017] [Indexed: 06/07/2023]
Abstract
Field studies integrating pollination investigations with an assessment of floral scent composition and thermogenesis in tropical aroids are rather few. Thus, this study aimed to investigate the pollination biology of nine species belonging to Schismatoglottis Calyptrata Complex Clade. The flowering mechanism, visiting insect activities, reproductive system, thermogenesis and floral scent composition were examined. Anthesis for all species started at dawn and lasted 25-29 h. Colocasiomyia (Diptera, Drosophilidae) are considered the main pollinators for all the investigated species. Cycreon (Coleoptera, Hydrophilidae) are considered secondary pollinators as they are only present in seven of the nine host plants, despite the fact that they are the most effective pollen carrier, carrying up to 15 times more pollen grains than Colocasiomyia flies. However, the number of Colocasiomyia individuals was six times higher than Cycreon beetles. Chaloenus (Chrysomelidae, Galeuricinae) appeared to be an inadvertent pollinator. Atheta (Coleoptera, Staphylinidae) is considered a floral visitor in most investigated species of the Calyptrata Complex Clade in Sarawak, but a possible pollinator in S. muluensis. Chironomidae midges and pteromalid wasps are considered visitors in S. calyptrata. Thermogenesis in a biphasic pattern was observed in inflorescences of S. adducta, S. calyptrata, S. giamensis, S. pseudoniahensis and S. roh. The first peak occurred during pistillate anthesis; the second peak during staminate anthesis. Inflorescences of all investigated species of Calyptrata Complex Clade emitted four types of ester compound, with methyl ester-3-methyl-3-butenoic acid as a single major VOC (volatile organic compound). The appendix, pistillate zone, staminate zone and spathe emitted all these compounds. A mixed fly-beetle pollination system is considered an ancestral trait in the Calyptrata Complex Clade, persisting in Sarawak taxa, whereas the marked reduction of interpistillar staminodes in taxa from Peninsular Malaysia and especially, Ambon, Indonesia, is probably linked to a shift in these taxa to a fly-pollinated system.
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Affiliation(s)
- Y C Hoe
- Tunku Abdul Rahman University College, Johor Branch Campus, Johor, Malaysia
- Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - M Gibernau
- Natural Resources Project, Vignola Route des Sanguinaires Ajaccio, CNRS - University of Corsica, Ajaccio, France
| | - S Y Wong
- Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
- Harvard University Herbaria, Cambridge, MA, USA
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21
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Yeo W, Luk MY, Soong IS, Yuen TY, Ng TY, Mo FK, Chan K, Wong SY, Tsang J, Leung C, Suen JJ, Ngan RK. Efficacy and tolerability of trastuzumab emtansine in advanced human epidermal growth factor receptor 2-positive breast cancer. Hong Kong Med J 2018; 24:56-62. [PMID: 29326401 DOI: 10.12809/hkmj176808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer has changed dramatically with the introduction and widespread use of HER2-targeted therapies. There is, however, relatively limited real-world information about the effectiveness and safety of trastuzumab emtansine (T-DM1) in Hong Kong Chinese patients. We assessed the efficacy and toxicity profiles among local patients with HER2-positive advanced breast cancer who had received T-DM1 therapy in the second-line setting and beyond. METHODS This retrospective study involved five local centres that provide service for over 80% of the breast cancer population in Hong Kong. The study period was from December 2013 to December 2015. Patients were included if they had recurrent or metastatic histologically confirmed HER2+ breast cancer who had progressed after at least one line of anti-HER2 therapy including trastuzumab. Patients were excluded if they received T-DM1 as first-line treatment for recurrent or metastatic HER2+ breast cancer. Patient charts including biochemical and haematological profiles were reviewed for background information, T-DM1 response, and toxicity data. Adverse events were documented during chemotherapy and 28 days after the last dose of medication. RESULTS Among 37 patients being included in this study, 28 (75.7%) had two or more lines of anti-HER2 agents and 26 (70.3%) had received two or more lines of palliative chemotherapy. Response assessment revealed that three (8.1%) patients had a complete response, eight (21.6%) a partial response, 11 (29.7%) a stable disease, and 12 (32.4%) a progressive disease; three patients could not be assessed. The median duration of response was 17.3 (95% confidence interval, 8.4-24.8) months. The clinical benefit rate (complete response + partial response + stable disease, ≥12 weeks) was 37.8% (95% confidence interval, 22.2%-53.5%). The median progression-free survival was 6.0 (95% confidence interval, 3.3- 9.8) months and the median overall survival had not been reached by the data cut-off date. Grade 3 or 4 toxicities included thrombocytopaenia (13.5%), raised alanine transaminase (8.1%), anaemia (5.4%), and hypokalaemia (2.7%). No patient died as a result of toxicities. CONCLUSIONS In patients with HER2-positive advanced breast cancer who have been heavily pretreated with anti-HER2 agents and cytotoxic chemotherapy, T-DM1 is well tolerated and provided a meaningful progression-free survival of 6 months and an overall survival that has not been reached. Further studies to identify appropriate patient subgroups are warranted.
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Affiliation(s)
- W Yeo
- Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M Y Luk
- Department of Clinical Oncology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - I S Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - T Ys Yuen
- Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - T Y Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - F Kf Mo
- Comprehensive Clinical Trials Unit, Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K Chan
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - S Y Wong
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - J Tsang
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - C Leung
- Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - J Js Suen
- Department of Clinical Oncology, Prince of Wales Hospital, Shatin, Hong Kong
| | - R Kc Ngan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong
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22
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Naymagon S, Naymagon L, Wong SY, Ko HM, Renteria A, Levine J, Colombel JF, Ferrara J. Acute graft-versus-host disease of the gut: considerations for the gastroenterologist. Nat Rev Gastroenterol Hepatol 2017; 14:711-726. [PMID: 28951581 PMCID: PMC6240460 DOI: 10.1038/nrgastro.2017.126] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Haematopoietic stem cell transplantation (HSCT) is central to the management of many haematological disorders. A frequent complication of HSCT is acute graft-versus-host disease (GVHD), a condition in which immune cells from the donor attack healthy recipient tissues. The gastrointestinal system is among the most common sites affected by acute GVHD, and severe manifestations of acute GVHD of the gut portends a poor prognosis in patients after HSCT. Acute GVHD of the gastrointestinal tract presents both diagnostic and therapeutic challenges. Although the clinical manifestations are nonspecific and overlap with those of infection and drug toxicity, diagnosis is ultimately based on clinical criteria. As reliable serum biomarkers have not yet been validated outside of clinical trials, endoscopic and histopathological evaluation continue to be utilized in diagnosis. Once a diagnosis of gastrointestinal acute GVHD is established, therapy with systemic corticosteroids is typically initiated, and non-responders can be treated with a wide range of second-line therapies. In addition to treating the underlying disease, the management of complications including profuse diarrhoea, severe malnutrition and gastrointestinal bleeding is paramount. In this Review, we discuss strategies for the diagnosis and management of acute GVHD of the gastrointestinal tract as they pertain to the practising gastroenterologist.
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Affiliation(s)
- Steven Naymagon
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai
| | - Leonard Naymagon
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai
| | - Serre-Yu Wong
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai
| | - Huaibin Mabel Ko
- Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai.,Lillian and Henry M. Stratton-Hans Popper Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, New York 10029, USA
| | - Anne Renteria
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai
| | - John Levine
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai
| | | | - James Ferrara
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai
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23
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Ho CS, Wong SY, Chiu MM, Ho RC. Global Prevalence of Elder Abuse: A Meta-analysis and Meta-regression. East Asian Arch Psychiatry 2017; 27:43-55. [PMID: 28652497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Elder abuse is increasingly recognised as a global public health and social problem. There has been limited inter-study comparison of the prevalence and risk factors for elder abuse. This study aimed to estimate the pooled and subtype prevalence of elder abuse worldwide and identify significant associated risk factors. METHODS We conducted a meta-analysis and meta-regression of 34 population-based and 17 non-population-based studies. RESULTS The pooled prevalences of elder abuse were 10.0% (95% confidence interval, 5.2%-18.6%) and 34.3% (95% confidence interval, 22.9%-47.8%) in population-based studies and third party- or caregiver-reported studies, respectively. Being in a marital relationship was found to be a significant moderator using random-effects model. CONCLUSIONS This meta-analysis revealed that third parties or caregivers were more likely to report abuse than older abused adults. Subgroup analyses showed that females and those resident in non-western countries were more likely to be abused. Emotional abuse was the most prevalent elder abuse subtype and financial abuse was less commonly reported by third parties or caregivers. Heterogeneity in the prevalence was due to the high proportion of married older adults in the sample. Subgroup analysis showed that cultural factors, subtypes of abuse, and gender also contributed to heterogeneity in the pooled prevalence of elder abuse.
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Affiliation(s)
- C Sh Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - S Y Wong
- Faculty of Medicine, University of Aberdeen, United Kingdom
| | - M M Chiu
- Department of Applied Social Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - R Cm Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
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Long BL, Li H, Mahadevan A, Tang T, Balotin K, Grandel N, Soto J, Wong SY, Abrego A, Li S, Qutub AA. GAIN: A graphical method to automatically analyze individual neurite outgrowth. J Neurosci Methods 2017; 283:62-71. [PMID: 28336360 DOI: 10.1016/j.jneumeth.2017.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/18/2017] [Accepted: 03/18/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Neurite outgrowth is a metric widely used to assess the success of in vitro neural stem cell differentiation or neuron reprogramming protocols and to evaluate high-content screening assays for neural regenerative drug discovery. However, neurite measurements are tedious to perform manually, and there is a paucity of freely available, fully automated software to determine neurite measurements and neuron counting. To provide such a tool to the neurobiology, stem cell, cell engineering, and neuroregenerative communities, we developed an algorithm for performing high-throughput neurite analysis in immunofluorescent images. NEW METHOD Given an input of paired neuronal nuclear and cytoskeletal microscopy images, the GAIN algorithm calculates neurite length statistics linked to individual cells or clusters of cells. It also provides an estimate of the number of nuclei in clusters of overlapping cells, thereby increasing the accuracy of neurite length statistics for higher confluency cultures. GAIN combines image processing for neuronal cell bodies and neurites with an algorithm for resolving neurite junctions. RESULTS GAIN produces a table of neurite lengths from cell body to neurite tip per cell cluster in an image along with a count of cells per cluster. COMPARISON WITH EXISTING METHODS GAIN's performance compares favorably with the popular ImageJ plugin NeuriteTracer for counting neurons, and provides the added benefit of assigning neurites to their respective cell bodies. CONCLUSIONS In summary, GAIN provides a new tool to improve the robust assessment of neural cells by image-based analysis.
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Affiliation(s)
- B L Long
- Department of Bioengineering, Rice University, Houston, TX 77030 USA.
| | - H Li
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - A Mahadevan
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - T Tang
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - K Balotin
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - N Grandel
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - J Soto
- Department of Bioengineering, University of California, Berkeley, CA 94720 USA
| | - S Y Wong
- Department of Bioengineering, University of California, Berkeley, CA 94720 USA
| | - A Abrego
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - S Li
- Department of Bioengineering, University of California, Los Angeles, CA 90095 USA
| | - A A Qutub
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
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Hoe YC, Gibernau M, Maia ACD, Wong SY. Flowering mechanisms, pollination strategies and floral scent analyses of syntopically co-flowering Homalomena spp. (Araceae) on Borneo. Plant Biol (Stuttg) 2016; 18:563-576. [PMID: 26780890 DOI: 10.1111/plb.12431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/12/2016] [Indexed: 06/05/2023]
Abstract
In this study, the flowering mechanisms and pollination strategies of seven species of the highly diverse genus Homalomena (Araceae) were investigated in native populations of West Sarawak, Borneo. The floral scent compositions were also recorded for six of these species. The selected taxa belong to three out of four complexes of the section Cyrtocladon (Hanneae, Giamensis and Borneensis). The species belonging to the Hanneae complex exhibited longer anthesis (53-62 h) than those of the Giamensis and Borneensis complexes (ca. 30 h). Species belonging to the Hanneae complex underwent two floral scent emission events in consecutive days, during the pistillate and staminate phases of anthesis. In species belonging to the Giamensis and Borneensis complexes, floral scent emission was only evident to the human nose during the pistillate phase. A total of 33 volatile organic compounds (VOCs) were detected in floral scent analyses of species belonging to the Hanneae complex, whereas 26 VOCs were found in samples of those belonging to the Giamensis complex. The floral scent blends contained uncommon compounds in high concentration, which could ensure pollinator discrimination. Our observations indicate that scarab beetles (Parastasia gestroi and P. nigripennis; Scarabaeidae, Rutelinae) are the pollinators of the investigated species of Homalomena, with Chaloenus schawalleri (Chrysomelidae, Galeuricinae) acting as a secondary pollinator. The pollinators utilise the inflorescence for food, mating opportunities and safe mating arena as rewards. Flower-breeding flies (Colocasiomyia nigricauda and C. aff. heterodonta; Diptera, Drosophilidae) and terrestrial hydrophilid beetles (Cycreon sp.; Coleoptera, Hydrophilidae) were also frequently recovered from inflorescences belonging to all studied species (except H. velutipedunculata), but they probably do not act as efficient pollinators. Future studies should investigate the post-mating isolating barriers among syntopically co-flowering Homalomena sharing the same visiting insects.
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Affiliation(s)
- Y C Hoe
- Department of Plant Science and Environmental Ecology, Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - M Gibernau
- CNRS - University of Corsica, UMR 6134 - SPE, Natural Resources Project, Ajaccio, France
| | - A C D Maia
- Programa de Pós-graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, Brazil
| | - S Y Wong
- Department of Plant Science and Environmental Ecology, Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
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O'Mahony M, Atassi-Sheldon S, Wong J, Klapman-Baker K, Wong SY. Salt Taste Sensitivity and Stimulus Volume: Sips and Drops. Some Implications for the Henkin Taste Test. Perception 2016; 13:725-37. [PMID: 6543952 DOI: 10.1068/p130725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Various presentation procedures and stimulus volumes were compared in their effect on salt taste sensitivity. For sodium chloride (NaCl) stimuli pipetted onto the tongue, subjects had comparable measured sensitivity to 10 ml and 1 ml volumes but a reduced sensitivity to 0.1 ml volumes. The greatest sensitivity was achieved with 10 ml sipped volumes. Modification of the Henkin dropwise triangluar taste test, by increasing the stimulus volumes, increased subjects' sensitivity. Only the 1 ml pipette presentation increased the sensitivity of the Henkin procedure, albeit slightly, to the detection of changes in taste sensitivity, the purpose for which the procedure was actually designed. Such modification did not perturb salivary NaCl levels more than the regular Henkin procedure, so it would not be expected to introduce sensitivity drift.
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Low SL, Wong SY, Ooi IH, Hesse M, Städler Y, Schönenberger J, Boyce PC. Floral diversity and pollination strategies of three rheophytic Schismatoglottideae (Araceae). Plant Biol (Stuttg) 2016; 18:84-97. [PMID: 25688576 DOI: 10.1111/plb.12320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/12/2015] [Indexed: 06/04/2023]
Abstract
Homoplastic evolution of 'unique' morphological characteristics in the Schismatoglottideae - many previously used to define genera - prompted this study to compare morphology and function in connection with pollination biology for Aridarum nicolsonii, Phymatarum borneense and Schottarum sarikeense. Aridarum nicolsonii and P. borneense extrude pollen through a pair of horned thecae while S. sarikeense sheds pollen through a pair of pores on the thecae. Floral traits of spathe constriction, presence and movement of sterile structures on the spadix, the comparable role of horned thecae and thecae pores, the presence of stamen-associated calcium oxalate packages, and the timing of odour emission are discussed in the context of their roles in pollinator management. Pollinators for all investigated species were determined to be species of Colocasiomyia (Diptera: Drosophilidae).
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Affiliation(s)
- S L Low
- Department of Plant Science and Environmental Ecology, Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - S Y Wong
- Department of Plant Science and Environmental Ecology, Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - I H Ooi
- Department of Plant Science and Environmental Ecology, Faculty of Resource Science and Technology, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - M Hesse
- Department of Structural and Functional Botany, University of Vienna, Vienna, Austria
| | - Y Städler
- Department of Structural and Functional Botany, University of Vienna, Vienna, Austria
| | - J Schönenberger
- Department of Structural and Functional Botany, University of Vienna, Vienna, Austria
| | - P C Boyce
- Institute of Biodiversity and Environmental Conservation, Universiti Malaysia Sarawak, Sarawak, Malaysia
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Santiago-Ortiz J, Ojala DS, Westesson O, Weinstein JR, Wong SY, Steinsapir A, Kumar S, Holmes I, Schaffer DV. AAV ancestral reconstruction library enables selection of broadly infectious viral variants. Gene Ther 2015; 22:934-46. [PMID: 26186661 PMCID: PMC4509550 DOI: 10.1038/gt.2015.74] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/22/2015] [Accepted: 07/08/2015] [Indexed: 01/19/2023]
Abstract
Adeno-associated virus (AAV) vectors have achieved clinical efficacy in treating several diseases. However, enhanced vectors are required to extend these landmark successes to other indications and protein engineering approaches may provide the necessary vector improvements to address such unmet medical needs. To generate new capsid variants with potentially enhanced infectious properties and to gain insights into AAV's evolutionary history, we computationally designed and experimentally constructed a putative ancestral AAV library. Combinatorial variations at 32 amino acid sites were introduced to account for uncertainty in their identities. We then analyzed the evolutionary flexibility of these residues, the majority of which have not been previously studied, by subjecting the library to iterative selection on a representative cell line panel. The resulting variants exhibited transduction efficiencies comparable to the most efficient extant serotypes and, in general, ancestral libraries were broadly infectious across the cell line panel, indicating that they favored promiscuity over specificity. Interestingly, putative ancestral AAVs were more thermostable than modern serotypes and did not use sialic acids, galactose or heparan sulfate proteoglycans for cellular entry. Finally, variants mediated 19- to 31-fold higher gene expression in the muscle compared with AAV1, a clinically used serotype for muscle delivery, highlighting their promise for gene therapy.
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Affiliation(s)
- J Santiago-Ortiz
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA
| | - D S Ojala
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA
| | - O Westesson
- Department of Bioengineering, University of California, Berkeley, CA, USA
| | - J R Weinstein
- Department of Chemistry, University of California, Berkeley, CA, USA
| | - S Y Wong
- Department of Bioengineering, University of California, Berkeley, CA, USA
| | - A Steinsapir
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA
| | - S Kumar
- Department of Bioengineering, University of California, Berkeley, CA, USA
| | - I Holmes
- Department of Bioengineering, University of California, Berkeley, CA, USA
| | - D V Schaffer
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, CA, USA.,Department of Bioengineering, University of California, Berkeley, CA, USA.,The Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
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Wong LJ, H'ng PS, Wong SY, Lee SH, Lum WC, Chai EW, Wong WZ, Chin KL. Termite digestomes as a potential source of symbiotic microbiota for lignocelluloses degradation: a review. Pak J Biol Sci 2015; 17:956-63. [PMID: 26031014 DOI: 10.3923/pjbs.2014.956.963] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Termites thrive in great abundance in terrestrial ecosystems and the symbiotic gut microbiota play important roles in digestion of lignocelluloses and nitrogen metabolism. Termites are excellent models of biocatalysts as they inhabit dense microbes in their guts that produce digestive enzymes to decompose lignocelluloses and convert it to end products such as sugars, hydrogen, and acetate. Different of digestive system between lower and higher termites which lower termites dependent on their dual decomposing system, consisting of termite's own cellulases and gut's protists. Higher termites decompose cellulose using their own enzymes, because of the absence of symbiotic protists. Termite gut prokaryotes efficiently support lignocelluloses degradation. In this review, a brief overview of recent experimental works, development and commercialization is discussed. Significant progress has been made to isolate cellulolytic strains from termites and optimise the digestion efficiency of cellulose. Future perspective should emphasize the isolation of cellulolytic strains from termites, genetically modifying or immobilization of the microbes which produce the desired enzyme and thus benefits on the microbiology and biotechnology.
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Liu KSH, Hung IFN, Seto WKW, Tong T, Hsu ASJ, Lam FYF, But DYK, Wong SY, Leung WK. Ten day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for Helicobacter pylori in Chinese patients: an open label, randomised, crossover trial. Gut 2014; 63:1410-5. [PMID: 24295850 DOI: 10.1136/gutjnl-2013-306120] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Treatments with sequential therapy (SEQ) or bismuth quadruple (QUAD) therapy have been proposed as empirical firstline regimens for Helicobacter pylori. We compared the efficacy and tolerability of 10 day SEQ with 10 day modified QUAD as both firstline and secondline treatments for H pylori in a randomised crossover study. DESIGN H pylori positive and treatment naïve patients were randomly assigned to receive either 10 day SEQ (esomeprazole for 10 days, amoxicillin for an initial 5 days, followed by clarithromycin and metronidazole for a subsequent 5 days) or modified QUAD (esomeprazole, bismuth subcitrate, tetracycline and metronidazole). H pylori eradication was confirmed by urea breath test at 8 weeks. Patients who failed the initial assigned treatment were crossed over to receive the alternate regimen. The primary outcome was eradication rates of firstline treatment by intention to treat (ITT) and per protocol (PP) analyses. RESULTS 357 patients were randomised to receive either SEQ or QUAD. The PP eradication rates of the SEQ and QUAD groups were 95.2% and 98.8%, respectively (p=0.10). Based on ITT analysis, the corresponding eradication rates were 89.4% and 92.7%, respectively (p=0.36). Eight (4.8%) patients in the SEQ and two (1.2%) patients in the QUAD who failed the firstline treatment were crossed over to the alternate regimen with 100% retreatment success. The overall incidence of adverse events was higher in the QUAD (16.7%) than in the SEQ (8.1%; p=0.032) group. CONCLUSIONS Ten day sequential and modified bismuth quadruple therapies are both highly effective as empirical firstline therapies for H pylori in Chinese patients. CLINICALTRIALSGOV NCT 01760824.
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Affiliation(s)
- Kevin S H Liu
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Ivan F N Hung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - W K Walter Seto
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Teresa Tong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Axel S J Hsu
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Frank Y F Lam
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - David Y K But
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - S Y Wong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Wai K Leung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
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Leung WK, Lo OSH, Liu KSH, Tong T, But DYK, Lam FYF, Hsu ASJ, Wong SY, Seto WKW, Hung IFN, Law WL. Detection of colorectal adenoma by narrow band imaging (HQ190) vs. high-definition white light colonoscopy: a randomized controlled trial. Am J Gastroenterol 2014; 109:855-63. [PMID: 24751581 DOI: 10.1038/ajg.2014.83] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 02/18/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The benefits of narrow band imaging (NBI) on enhancing colorectal adenoma detection remain questionable. We tested whether the new generation of NBI (190-NBI), which is twice as bright as the previous version, would improve adenoma detection when compared with high-definition white light (HD-WL) colonoscopy. METHODS It was a randomized controlled trial with tandem colonoscopy. We recruited patients who underwent colonoscopy for symptoms, screening, or surveillance. Patients were randomized for the use of either 190-NBI or HD-WL on withdrawal. Tandem colonoscopy was performed by using the same assigned colonoscope and withdrawal method. Lesions detected on first-pass and second-pass examination were used for adenoma detection and miss rates, respectively. The primary outcomes were adenoma and polyp detection rates. RESULTS A total of 360 patients were randomized to undergo either 190-NBI or HD-WL colonoscopy. Both the adenoma and polyp detection rates were significantly higher in the 190-NBI group compared with the HD-WL group (adenoma: 48.3% vs. 34.4%, P=0.01; polyps: 61.1% vs. 48.3%, P=0.02). The mean number of polyps detected per patient was higher in the 190-NBI group (1.49% vs. 1.13, P=0.07). There was no significant difference in the adenoma miss rates between the two groups (21.8% vs. 21.2%). Multivariate analysis showed that the use of 190-NBI (odds ratio (OR) 1.85; 95% confidence interval (CI) 1.10-3.12), withdrawal time (OR 1.29; CI 1.19-1.38), patient's age (OR 1.04; CI 1.01-1.06), and male gender (OR 2.38; CI 1.42-3.99) were associated with adenoma detection. CONCLUSIONS 190-NBI colonoscopy was superior to the conventional HD-WL in detecting colorectal adenomas or polyps, but there was no significant difference in adenoma miss rates.
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Affiliation(s)
- Wai K Leung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Oswens S H Lo
- Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Kevin S H Liu
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Teresa Tong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - David Y K But
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Frank Y F Lam
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Axel S J Hsu
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - S Y Wong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - W K Walter Seto
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Ivan F N Hung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - W L Law
- Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
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Liu KSH, Hung IFN, Seto WKW, Tong T, Hsu ASJ, Lam FYF, But DYK, Wong SY, Leung WK. Ten day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for Helicobacter pylori in Chinese patients: an open label, randomised, crossover trial. Gut 2013. [PMID: 24295850 DOI: 10.1136/gutjnl-2013-30612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
OBJECTIVE Treatments with sequential therapy (SEQ) or bismuth quadruple (QUAD) therapy have been proposed as empirical firstline regimens for Helicobacter pylori. We compared the efficacy and tolerability of 10 day SEQ with 10 day modified QUAD as both firstline and secondline treatments for H pylori in a randomised crossover study. DESIGN H pylori positive and treatment naïve patients were randomly assigned to receive either 10 day SEQ (esomeprazole for 10 days, amoxicillin for an initial 5 days, followed by clarithromycin and metronidazole for a subsequent 5 days) or modified QUAD (esomeprazole, bismuth subcitrate, tetracycline and metronidazole). H pylori eradication was confirmed by urea breath test at 8 weeks. Patients who failed the initial assigned treatment were crossed over to receive the alternate regimen. The primary outcome was eradication rates of firstline treatment by intention to treat (ITT) and per protocol (PP) analyses. RESULTS 357 patients were randomised to receive either SEQ or QUAD. The PP eradication rates of the SEQ and QUAD groups were 95.2% and 98.8%, respectively (p=0.10). Based on ITT analysis, the corresponding eradication rates were 89.4% and 92.7%, respectively (p=0.36). Eight (4.8%) patients in the SEQ and two (1.2%) patients in the QUAD who failed the firstline treatment were crossed over to the alternate regimen with 100% retreatment success. The overall incidence of adverse events was higher in the QUAD (16.7%) than in the SEQ (8.1%; p=0.032) group. CONCLUSIONS Ten day sequential and modified bismuth quadruple therapies are both highly effective as empirical firstline therapies for H pylori in Chinese patients. CLINICALTRIALSGOV NCT 01760824.
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Affiliation(s)
- Kevin S H Liu
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Ivan F N Hung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - W K Walter Seto
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Teresa Tong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Axel S J Hsu
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Frank Y F Lam
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - David Y K But
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - S Y Wong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Wai K Leung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
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Wong SY, Lo SH, Chan CH, Chui HS, Sze WK, Tung Y. Is it feasible to discuss an advance directive with a Chinese patient with advanced malignancy? A prospective cohort study. Hong Kong Med J 2012; 18:178-185. [PMID: 22665680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVES Advance directives have been implemented for years in western countries, but the concept is new to Asian cultures. According to traditional Chinese culture, family members usually play a decisive role in a patient's treatment plan. Thus it may be hard to implement an advance directive despite its importance to the treatment of patients. The objectives of this study were to assess the feasibility of advance directive engagement and to explore significant contributing factors to achieving such a goal. DESIGN Prospective cohort study. SETTING Palliative Care Unit of Clinical Oncology, Tuen Mun Hospital, Hong Kong. PATIENTS The subjects of the investigation were adult patients diagnosed to have advanced malignancy and newly referred to the hospice service from 24 April 2009 to 30 July 2009. Data were collected from nursing assessment forms, locally designed advance directive forms, a checklist completed by oncologists, and details available in the electronic hospital record. RESULTS Of the 191 eligible patients, 120 (63%) had the advance directive, whereas 71 (37%) did not. In the Cox regression model, the patient having insight of a poor prognosis was the most significant factor facilitating advance directive engagement (P=0.001). Any family objection in the discussion of advance directives was also an important factor, though it did not reach statistical significance (P=0.082). Other factors like age, gender, education, religion, financial status, living environment, understanding the diagnosis, bereavement experience, type of cancer, nature of illness, courses of chemotherapy or radiotherapy received, main caregiver, in-house supporter, nurse-led clinic attendance, clinical psychologist consultation, and in-patient hospice nurse coordinator interview were all statistically insignificant. CONCLUSIONS Our study demonstrated that it was feasible to discuss an advance directive with Chinese patients with advanced malignancy. When patients have insight about their poor prognosis and family members have no objection, it may be appropriate to discuss an advance directive.
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Affiliation(s)
- S Y Wong
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong.
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Wong SY, Lua PL. Chocolate: food for moods. Malays J Nutr 2011; 17:259-269. [PMID: 22303579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Chocolate is a popular food and its consumption has long been associated with enjoyment and pleasure. The effect of chocolate on mood too has long been recognised. Chocolate is thought to have interactions with neurotransmitters which contribute to mood modulation and appetite regulation. However, the evidence in chocolate and mood studies remains highly controversial. As more is known about the influence of chocolate on mood, the reasons for these effects appear increasingly complex and inter-related. METHODS We reviewed chocolate's properties and the principal hypotheses addressing its mood altering propensities. RESULTS The relationship between chocolate and mood are highly complex, combining psychopharmacological components, nutritional and sensory characteristics of the food. Individual and situational differences on chocolate consumption may also exert influence on mood and the mixed results in previous research indicate that the direction of the association remains unclear. CONCLUSION The association between chocolate consumption and emotions warrants further multi-prong investigations to substantiate chocolate's mood alterating propensity.
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Affiliation(s)
- S Y Wong
- Centre for Clinical and Quality of Life Studies (CCQoLS), Faculty of Medicine and Health Sciences, Universiti Sultan ZainalAbidin (UniSZA), Kampus Kota, 20400 Kuala Terengganu, Terengganu, Malaysia
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Liu J, Malik R, Schoenthaler A, Wong SY, Saunders J, Parikh M. SHF-05: Obesity-related comorbidity resolution after laparoscopic adjustable gastric banding: A comparison of patients with bmi ≤ 40 kg/m2 vs. bmi > 40 kg/m2. Surg Obes Relat Dis 2010. [DOI: 10.1016/j.soard.2010.03.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wong SY, Youn HA, Ren-Fielding CJ, Kurian M, Saunders J, Parikh M. P-96: Does insurance payor status affect outcomes after laparoscopic adjustable gastric banding? A matched comparison between medicaid patients and commercially insured patients at 2 hospitals in the same academic system. Surg Obes Relat Dis 2010. [DOI: 10.1016/j.soard.2010.03.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lope RJR, Kong WK, Lee VWM, Tiew WT, Wong SY. Sleep position and infant care practices in an urban community in Kuala Lumpur. Med J Malaysia 2010; 65:45-48. [PMID: 21265248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Several modifiable risk factors for sudden infant death syndrome (SIDS) have been identified such as sleeping prone or on the side, sleeping on a soft surface, bed-sharing, no prenatal care and maternal ante-natal smoking. A cross-sectional survey of infant sleep and care practices was conducted among parents of babies aged below 8 months to determine the prevalence and predictors of non-supine sleep position and the prevalence of other high-risk infant care practices for SIDS. Of 263 infants, 24.7% were placed to sleep in the non-supine position and age of infants was a factor positively associated with this (adjusted odds ratio 1.275, 95% CI=1.085, 1.499). The most common modifiable risk factor was the presence of soft toys or bedding in the infants' bed or cot (89.4%). Results from this study indicate that although the predominant sleep position of Malaysian infants in this population is supine, the majority of infants were exposed to other care practices which have been shown to be associated with SIDS.
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Affiliation(s)
- R J Raja Lope
- Department of Paediatrics, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000 Kuala Lumpur, Malaysia.
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Ling GR, Singh K, Wong SY, Toh VKL. Severe neuroglycopaenia secondary to severe hypoglycaemia from serendipitous overdose of gliclazide without adrenergic or autonomic response. Diabet Med 2009; 26:1182-3. [PMID: 19930002 DOI: 10.1111/j.1464-5491.2009.02851.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wong SY, Mercer SM, Leung J, Woo J. The relationship between clinically relevant depressive symptoms and episodes and duration of all cause hospitalization in Southern Chinese elderly. J Affect Disord 2009; 113:272-8. [PMID: 18639936 DOI: 10.1016/j.jad.2008.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 06/03/2008] [Accepted: 06/03/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Identification of depression as an independent factor for increased hospital service utilization, or as part of other factors, is important for primary healthcare in possibly preventing use of hospitals. The objective of this study was to study the effects of having clinically relevant depressive symptoms in community dwelling elderly on all cause hospitalization in the elderly. METHODS We administered the validated Chinese version of Geriatric Depression Scale on 3770 men and women aged 65 years and over. Duration and episodes of hospitalization were assessed using 4-monthly telephone interviews and database from the Hospital Authority over a 4-year period. The associations between the presence of clinically relevant depressive symptoms and the number of hospitalizations and duration of hospitalization were studied by multiple Poisson regression analysis. RESULTS The presence of clinically relevant depressive symptoms was independently associated with increased episodes (RR: 1.29; CI: 1.16-1.43) and increased length of stay (RR: 1.18; CI: 1.10-1.25) for all cause hospitalization in those with and without chronic conditions at baseline. LIMITATION Our study relied on self report of chronic medical conditions. As a result, under-diagnosis of diseases and misclassification of disease status could not be excluded. CONCLUSION It was shown that clinically relevant depressive symptoms are independently associated with inpatient utilization over a 4-year period after adjustment for socioeconomic and health status in these elderly subjects. Identification and effective management of depression in primary care may be one way to reduce hospital service utilization in the elderly in China.
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Affiliation(s)
- S Y Wong
- Department of Community and Family Medicine, School of Public Health, The Chinese University of Hong Kong, Hong Kong SAR China.
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Abstract
Economic and social factors are determinants of health, as are psychosocial factors. The present study compared self-perceived social status and its relation to health, health related quality of life and lifestyle in older women with men, adjusting for age, education level and maximum lifetime income. A cross-sectional study was conducted of 4,000 men and women aged 65 years and over in a community in the North Eastern part of Hong Kong, a Special Administrative Region in China. Participants were asked to rate their community status, education, income and occupation, on two ladders, each with ten rungs. The distributions of the two ladder scores differed, showing that although participants may not have been ranked highly in terms of money, education and job respectability, they may have ranked their community standing highly. Women and older participants tended to rank their community standing highly in spite of lower ratings in the objective measures. A social gradient in self-perceived social status, independent of objective socioeconomic measures, was noted for physical performance and health-related quality of life, rather than related to presence of specific chronic diseases or lifestyle. However, the different ratings of the two ladders suggested that mechanisms by which the gradient operates may differ between women and men. Further studies are needed to explore the health and psychosocial consequences of the gender difference in self-rated social status.
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Affiliation(s)
- J Woo
- Department of Medicine and Therapeutics, School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong.
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Rajekar H, Wai CT, Majeed TA, Lee KH, Wong SY, Leong SO, Singh R, Tay KH, Soosaynathan C, Tan KC. Prognostic factors in patients with acute liver failure undergoing live donor liver transplantation. Transplant Proc 2008; 410:1-8. [PMID: 18929776 DOI: 10.1016/j.gene.2007.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Revised: 11/27/2007] [Accepted: 11/29/2007] [Indexed: 01/24/2023]
Abstract
Mortality from acute liver failure (ALF) is high. Live donor liver transplantation (LDLT) is the treatment of choice for ALF in Asia, because cadaveric donors are rare. We sought to review our results in ALF patients with undergoing LDLT at our center. One hundred two LDLTs were performed at our center from April 2002 to November 2007, 15 (14%) because of ALF. Mean (SEM; median, range) follow-up was 1,065 (189; 1400; 3-2046) days. Nine patients (60%) had acute exacerbation of chronic hepatitis B; and 6 (40%) had drug-induced liver injury. Age was 47 (3; 50; 27-65) years. Ten patients (67%) were men. At transplantation, laboratory values were included bilirubin, 449 (35) micromol/L; creatinine concentration, 182 (32) mmol/L. The international normalized ratio was 2.4 (0.2). The Model for End-Stage Liver Disease (MELD) score was 34 (2). Both inpatient and long-term mortality was 20% 3 of 15 patients died. The 5-year survival was 80%. Compared with survivors, patients who died had a significantly higher creatinine concentration 289 vs 155 micromol/L, international normalized ratio (3.4 vs 2.1), MELD score (47 vs 32). We conclude that despite being sick with median and mean MELD scores of 32 and 34, 80% of patients with ALF can achieve good long-term survival after LDLT.
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Affiliation(s)
- H Rajekar
- Asian Center for Liver Diseases and Transplantation, Singapore
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Rajekar H, Wai CT, Majeed TA, Lee KH, Wong SY, Leong SO, Singh R, Tay KH, Soosaynathan C, Tan KC. Prognostic factors in patients with acute liver failure undergoing live donor liver transplantation. Transplant Proc 2008; 40:2492-3. [PMID: 18929776 DOI: 10.1016/j.transproceed.2008.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Mortality from acute liver failure (ALF) is high. Live donor liver transplantation (LDLT) is the treatment of choice for ALF in Asia, because cadaveric donors are rare. We sought to review our results in ALF patients with undergoing LDLT at our center. One hundred two LDLTs were performed at our center from April 2002 to November 2007, 15 (14%) because of ALF. Mean (SEM; median, range) follow-up was 1,065 (189; 1400; 3-2046) days. Nine patients (60%) had acute exacerbation of chronic hepatitis B; and 6 (40%) had drug-induced liver injury. Age was 47 (3; 50; 27-65) years. Ten patients (67%) were men. At transplantation, laboratory values were included bilirubin, 449 (35) micromol/L; creatinine concentration, 182 (32) mmol/L. The international normalized ratio was 2.4 (0.2). The Model for End-Stage Liver Disease (MELD) score was 34 (2). Both inpatient and long-term mortality was 20% 3 of 15 patients died. The 5-year survival was 80%. Compared with survivors, patients who died had a significantly higher creatinine concentration 289 vs 155 micromol/L, international normalized ratio (3.4 vs 2.1), MELD score (47 vs 32). We conclude that despite being sick with median and mean MELD scores of 32 and 34, 80% of patients with ALF can achieve good long-term survival after LDLT.
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Affiliation(s)
- H Rajekar
- Asian Center for Liver Diseases and Transplantation, Singapore
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Wong SY, Lu CP, Roth DB. A RAG1 mutation found in Omenn syndrome causes coding flank hypersensitivity: a novel mechanism for antigen receptor repertoire restriction. J Immunol 2008; 181:4124-30. [PMID: 18768869 DOI: 10.4049/jimmunol.181.6.4124] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hypomorphic RAG mutants with severely reduced V(D)J recombination activity cause Omenn Syndrome (OS), an immunodeficiency with features of immune dysregulation and a restricted TCR repertoire. Precisely how RAG mutants produce autoimmune and allergic symptoms has been unclear. Current models posit that the severe recombination defect restricts the number of lymphocyte clones, a few of which are selected upon Ag exposure. We show that murine RAG1 R972Q, corresponding to an OS mutation, renders the recombinase hypersensitive to selected coding sequences at the hairpin formation step. Other RAG1 OS mutants tested do not manifest this sequence sensitivity. These new data support a novel mechanism for OS: by selectively impairing recombination at certain coding flanks, a RAG mutant can cause primary repertoire restriction, as opposed to a more random, limited repertoire that develops secondary to severely diminished recombination activity.
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Affiliation(s)
- Serre-Yu Wong
- Program in Molecular Pathogenesis, Helen L. and Martin S. Kimmel Center for Biology and Medicine at the Skirball Institute for Biomolecular Medicine, and Department of Pathology, New York University School of Medicine, New York, NY 10016, USA
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Hsu LY, Kwa AL, Lye DC, Chlebicki MP, Tan TY, Ling ML, Wong SY, Goh LG. Reducing antimicrobial resistance through appropriate antibiotic usage in Singapore. Singapore Med J 2008; 49:749-755. [PMID: 18946605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Two alarming trends threaten the future utility of antimicrobial agents: rise of antimicrobial resistance and decline in development of new antibiotics. The continuing emergence and spread of antimicrobial-resistant microbes--a global public health issue--exacerbates the problem of paucity of new antimicrobial agents. Singapore's public sector hospitals currently have some of the highest rates of antimicrobial resistance worldwide, evolving with surprising speed over the past two decades. Because there was no systematic surveillance until fairly recently, this healthcare problem has not been emphasised. In contrast, it is difficult to assess the scale of antimicrobial resistance in the community in view of the lack of recent research, although indirect evidence suggests that this is also a source of concern. A panel comprising representatives from multiple professional healthcare societies was convened to address the issue of antimicrobial resistance in Singapore, focusing on the conservation of antibiotics against resistance. From a review of the medical literature, potentially successful strategies involve facilitating prudent and appropriate use of antimicrobial agents in tandem with other interventions in infection control. Presently, there is a lack of data on the appropriate use of antibiotics in Singapore. The recommendations of the panel are: The professions should look into ways and means to support systematic data collection on antibiotic use and appropriateness of use; The Ministry of Health should take a more active and positive role in regulating antibiotic usage; Hospitals should actively support effective antimicrobial stewardship programmes; Educators should coordinate programmes to give greater emphasis on appropriate antimicrobial prescription, and support good clinical practice; and, Local and regional branches of pharmaceutical companies should adopt the Pharmaceutical Research and Manufacturers of America's updated code of conduct on interactions with physicians as a step towards re-aligning the industry-physician relationship in the direction of educational and informational support.
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Affiliation(s)
- L Y Hsu
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074.
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Corneo B, Wendland RL, Deriano L, Cui X, Klein IA, Wong SY, Arnal S, Holub AJ, Weller GR, Pancake BA, Shah S, Brandt VL, Meek K, Roth DB. Rag mutations reveal robust alternative end joining. Nature 2007; 449:483-6. [PMID: 17898768 DOI: 10.1038/nature06168] [Citation(s) in RCA: 255] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Accepted: 08/17/2007] [Indexed: 12/15/2022]
Abstract
Mammalian cells repair DNA double-strand breaks (DSBs) through either homologous recombination or non-homologous end joining (NHEJ). V(D)J recombination, a cut-and-paste mechanism for generating diversity in antigen receptors, relies on NHEJ for repairing DSBs introduced by the Rag1-Rag2 protein complex. Animals lacking any of the seven known NHEJ factors are therefore immunodeficient. Nevertheless, DSB repair is not eliminated entirely in these animals: evidence of a third mechanism, 'alternative NHEJ', appears in the form of extremely rare V(D)J junctions and a higher rate of chromosomal translocations. The paucity of these V(D)J events has suggested that alternative NHEJ contributes little to a cell's overall repair capacity, being operative only (and inefficiently) when classical NHEJ fails. Here we find that removing certain portions of murine Rag proteins reveals robust alternative NHEJ activity in NHEJ-deficient cells and some alternative joining activity even in wild-type cells. We propose a two-tier model in which the Rag proteins collaborate with NHEJ factors to preserve genomic integrity during V(D)J recombination.
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Affiliation(s)
- Barbara Corneo
- The Kimmel Center for Biology and Medicine of the Skirball Institute and Department of Pathology, New York University School of Medicine, New York, New York 10016, USA
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Abstract
In the 40 years since Harvard medical student Gilbert Omenn first described a rare, inherited disorder producing a paradoxical combination of immunodeficiency and immune dysregulation, the pathogenesis of Omenn syndrome (OS) has remained mysterious. In separate studies reported in this issue of the JCI, two mouse models bearing mutations in the V(D)J recombinase analogous to those causing human OS have been shown to recapitulate the disease and provide insight into the genesis of immunodeficiency combined with autoimmunity and atopy in OS and other disease settings (see the related articles beginning on pages 1260 and 1270).
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Affiliation(s)
- Serre-Yu Wong
- Program in Molecular Pathogenesis, Skirball Institute of Biomolecular Medicine, and Department of Pathology, New York University School of Medicine, 540 First Avenue, New York, NY 10016, USA
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Chiu TW, Lam CK, Wong SY, Lau YK, Ying SY, Burd A. A simple practical model for planning tissue-expanded flaps. J Plast Reconstr Aesthet Surg 2007; 60:686-7. [PMID: 17485060 DOI: 10.1016/j.bjps.2006.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2006] [Accepted: 11/30/2006] [Indexed: 11/16/2022]
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Abstract
Necrotizing fasciitis is an uncommon but life-threatening complication in immunocompromised hosts. We reported four patients with rheumatic diseases complicated by necrotizing fasciitis and reviewed 14 others from literature search. Most patients were on corticosteroid treatment. Septic shock, disseminated intravascular coagulopathy and acute renal deterioration were common giving rise to an overall mortality rate of 27.8%. Septic arthritis may also complicate the condition. Statistical analysis on the series showed the lack of major surgical debridement as the only risk factor associated with increased mortality (RR 7.5, 95% CI 2.1-27.3, P = 0.01). Timely debridement of necrotic tissue is important for reducing mortality.
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MESH Headings
- Adult
- Aeromonas/isolation & purification
- Animals
- Anti-Bacterial Agents/therapeutic use
- Arthritis, Infectious/etiology
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/drug therapy
- Arthroplasty, Replacement, Hip
- Combined Modality Therapy
- Cyclophosphamide/adverse effects
- Cyclophosphamide/therapeutic use
- Debridement
- Disseminated Intravascular Coagulation/etiology
- Fasciitis, Necrotizing/drug therapy
- Fasciitis, Necrotizing/etiology
- Fasciitis, Necrotizing/surgery
- Fatal Outcome
- Female
- Femur Head Necrosis/chemically induced
- Femur Head Necrosis/surgery
- Fishes/microbiology
- Gram-Negative Bacterial Infections/drug therapy
- Gram-Negative Bacterial Infections/etiology
- Gram-Negative Bacterial Infections/surgery
- Humans
- Immunocompromised Host
- Immunosuppressive Agents/adverse effects
- Immunosuppressive Agents/therapeutic use
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/drug therapy
- Middle Aged
- Prednisolone/adverse effects
- Prednisolone/therapeutic use
- Pseudomonas Infections/drug therapy
- Pseudomonas Infections/etiology
- Pseudomonas Infections/surgery
- Scleroderma, Diffuse/complications
- Scleroderma, Diffuse/drug therapy
- Shock, Septic/etiology
- Skin/injuries
- Skin Transplantation
- Streptococcal Infections/drug therapy
- Streptococcal Infections/etiology
- Streptococcal Infections/surgery
- Surgical Wound Infection/etiology
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Affiliation(s)
- M Y Mok
- University Department of Medicine, Queen Mary Hospital, Hong Kong.
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Wong SY, Lai AC, Martinson I, Wong TKS. Effects of an education programme on family participation in the rehabilitation of children with developmental disability. J Intellect Disabil 2006; 10:165-89. [PMID: 16682391 DOI: 10.1177/1744629506064012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The growth and development of children with developmental disability depend very much on the parents. The present study was designed to examine whether family-focused education could enhance parental skills, knowledge and competency. The enhancement would in turn result in greater parental participation in the rehabilitation process of these children. The parental needs of Chinese parents were reviewed for the formulation of the Family-Focused Education Programme, which was then implemented, and evaluated using a pre-test/post-test control group design. Forty parents were invited to participate in the study using a convenience sampling technique. The mean scores of these variables were in the direction of increasing after the programme, though repeated measures ANOVA did not indicate any statistically significant changes in parenting knowledge, attitude and stress. It was apparent that the Family-Focused Education Programme enhanced parental competence. Undoubtedly, the family-focused approach is crucial for enhancing parenting competency, and education is fundamental to enabling parents.
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Affiliation(s)
- S Y Wong
- Siu Lam Hospital, and Hong Kong Polytechnic University, China.
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