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Cheng CS, Tan HY, Zhang C, Chan YT, Zhang ZJ, Man K, Yuen MF, Wang N, Feng Y. Berberine suppresses metastasis and recurrence of hepatocellular carcinoma by targeting circulating tumour cells: abridged secondary publication. Hong Kong Med J 2022; 28 Suppl 6:10-11. [PMID: 36535791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- C S Cheng
- School of Chinese Medicine, The University of Hong Kong
| | - H Y Tan
- School of Chinese Medicine, The University of Hong Kong
| | - C Zhang
- School of Chinese Medicine, The University of Hong Kong
| | - Y T Chan
- School of Chinese Medicine, The University of Hong Kong
| | - Z J Zhang
- School of Chinese Medicine, The University of Hong Kong
| | - K Man
- Department of Surgery, The University of Hong Kong
| | - M F Yuen
- Department of Medicine, The University of Hong Kong
| | - N Wang
- School of Chinese Medicine, The University of Hong Kong
| | - Y Feng
- School of Chinese Medicine, The University of Hong Kong
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Lin ZX, Chan NHT, Kwan YK, Zhang H, Chan YT, Tam KYS. Effectiveness and safety of acupuncture for overactive bladder: a randomised controlled trial (abridged secondary publication). Hong Kong Med J 2022; 28 Suppl 3:45-47. [PMID: 35701233] [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: 06/15/2023] Open
Affiliation(s)
- Z X Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong
| | - N H T Chan
- Department of Medicine and Geriatrics, Tuen Mun Hospital
| | - Y K Kwan
- Department of Medicine and Geriatrics, Tuen Mun Hospital
| | - H Zhang
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong
| | - Y T Chan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong
| | - K Y S Tam
- Yan Oi Tong - The Chinese University of Hong Kong Chinese Medicine Centre for Training and Research
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Bradshaw D, Bibby DF, Manso CF, Piorkowska R, Mohamed H, Ledesma J, Bubba L, Chan YT, Ngui SL, Carne S, Mbisa JL. Clinical evaluation of a Hepatitis C Virus whole-genome sequencing pipeline for genotyping and resistance testing. Clin Microbiol Infect 2021; 28:405-409. [PMID: 34245902 DOI: 10.1016/j.cmi.2021.06.042] [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] [Received: 03/03/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We sought to evaluate clinically a hepatitis C virus (HCV) whole-genome, next-generation sequencing (NGS) pipeline that is agnostic to viral genotype. METHODS Performance of the NGS pipeline was assessed through comparison of results with Sanger sequencing (SS) of partial HCV genomes. RESULTS There was 98.7% (376/381) concordance for viral subtype between SS and NGS. The positive and negative per cent agreements for determination of resistance-associated substitutions were 97.8% (95% CI 92.5-99.4%) and 99.9% (95% CI 99.5-100.0%), respectively. The NGS pipeline was also able to detect novel subtypes, mixtures, recombinants, transiently occurring resistance mutations and distinguish re-infection with the same subtype from relapse. DISCUSSION Particular scenarios where NGS may be used include settings without universal access to pan-genotypic antiviral regimens, those infected with a 'rare' subtype or who have been failed by first-line therapy, and in cases of suspected re-infection.
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Affiliation(s)
- Daniel Bradshaw
- National Infection Service, Public Health England, London, UK.
| | - David F Bibby
- National Infection Service, Public Health England, London, UK
| | - Carmen F Manso
- National Infection Service, Public Health England, London, UK
| | | | - Hodan Mohamed
- National Infection Service, Public Health England, London, UK
| | - Juan Ledesma
- National Infection Service, Public Health England, London, UK
| | - Laura Bubba
- National Infection Service, Public Health England, London, UK
| | - Yuen T Chan
- National Infection Service, Public Health England, London, UK
| | - Siew Lin Ngui
- National Infection Service, Public Health England, London, UK
| | - Simon Carne
- National Infection Service, Public Health England, London, UK
| | - Jean L Mbisa
- National Infection Service, Public Health England, London, UK
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- National Infection Service, Public Health England, London, UK
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Manso CF, Bibby DF, Lythgow K, Mohamed H, Myers R, Williams D, Piorkowska R, Chan YT, Bowden R, Ansari MA, Ip CLC, Barnes E, Bradshaw D, Mbisa JL. Technical Validation of a Hepatitis C Virus Whole Genome Sequencing Assay for Detection of Genotype and Antiviral Resistance in the Clinical Pathway. Front Microbiol 2020; 11:576572. [PMID: 33162957 PMCID: PMC7583327 DOI: 10.3389/fmicb.2020.576572] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/14/2020] [Indexed: 01/05/2023] Open
Abstract
Choice of direct acting antiviral (DAA) therapy for Hepatitis C Virus (HCV) in the United Kingdom and similar settings usually requires knowledge of the genotype and, in some cases, antiviral resistance (AVR) profile of the infecting virus. To determine these, most laboratories currently use Sanger technology, but next-generation sequencing (NGS) offers potential advantages in throughput and accuracy. However, NGS poses unique technical challenges, which require idiosyncratic development and technical validation approaches. This applies particularly to virology, where sequence diversity is high and the amount of starting genetic material is low, making it difficult to distinguish real data from artifacts. We describe the development and technical validation of a sequence capture-based HCV whole genome sequencing (WGS) assay to determine viral genotype and AVR profile. We use clinical samples of known subtypes and viral loads, and simulated FASTQ datasets to validate the analytical performances of both the wet laboratory and bioinformatic pipeline procedures. We show high concordance of the WGS assay compared to current "gold standard" Sanger assays. Specificity was 92.3 and 96.1% for AVR and genotyping, respectively. Discordances were due to the inability of Sanger assays to assign the correct subtype or accurately call mixed drug-resistant variants. We show high repeatability and reproducibility with >99.8% sequence similarity between sequence runs as well as high precision for variant frequency detection at >98.8% in the 95th percentile. Post-sequencing bioinformatics quality control workflows allow the accurate distinction between mixed infections, cross-contaminants and recombinant viruses at a threshold of >5% for the minority population. The sequence capture-based HCV WGS assay is more accurate than legacy AVR and genotyping assays. The assay has now been implemented in the clinical pathway of England's National Health Service HCV treatment programs, representing the first validated HCV WGS pipeline in clinical service. The data generated will additionally provide granular national-level genomic information for public health policy making and support the WHO HCV elimination strategy.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Rory Bowden
- The Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - M. Azim Ansari
- The Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Peter Medawar Building for Pathogen Research and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Camilla L. C. Ip
- The Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | | | - Jean L. Mbisa
- Public Health England, London, United Kingdom
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, London, United Kingdom
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Kinsella FAM, Inman CF, Gudger A, Chan YT, Murray DJ, Zuo J, McIlroy G, Nagra S, Nunnick J, Holder K, Wall K, Griffiths M, Craddock C, Nikolousis E, Moss P, Malladi R. Very early lineage-specific chimerism after reduced intensity stem cell transplantation is highly predictive of clinical outcome for patients with myeloid disease. Leuk Res 2019; 83:106173. [PMID: 31276965 DOI: 10.1016/j.leukres.2019.106173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The importance of chimerism status in the very early period after hematopoietic stem cell transplantation is unclear. We determined PBMC and T-cell donor chimerism 50 days after transplantation and related this to disease relapse and overall survival. METHODS 144 sequential patients underwent transplantation of which 90 had AML/MDS and 54 had lymphoma. 'Full donor chimerism' was defined as ≥99% donor cells and three patient groups were defined: 40% with full donor chimerism (FC) in both PBMC and T-cells; 25% with mixed chimerism (MC) within both compartments and 35% with 'split' chimerism (SC) characterised by full donor chimerism within PBMC and mixed chimerism within T-cells. RESULTS In patients with myeloid disease a pattern of mixed chimerism (MC) was associated with a one year relapse rate of 45% and a five year overall survival of 40% compared to values of 8% and 75%, and 17% and 60%, for those with SC or FC respectively. The pattern of chimerism had no impact on clinical outcome for lymphoma. CONCLUSION The pattern of lineage-specific chimerism at 50 days after transplantation is highly predictive of clinical outcome for patients with myeloid malignancy and may help to guide subsequent clinical management.
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Affiliation(s)
- Francesca A M Kinsella
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | | | - Amy Gudger
- Heartlands Hospital, Heart of England NHS Foundation trust, Birmingham, UK
| | - Yuen T Chan
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Duncan J Murray
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Jianmin Zuo
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Graham McIlroy
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - Sandeep Nagra
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - Jane Nunnick
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - Kathy Holder
- Heartlands Hospital, Heart of England NHS Foundation trust, Birmingham, UK
| | - Kerry Wall
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Mike Griffiths
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Charles Craddock
- Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | | | - Paul Moss
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK.
| | - Ram Malladi
- School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
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Au EY, Ip WK, Lau CS, Chan YT. Evaluation of a multiplex flow immunoassay versus conventional assays in detecting autoantibodies in systemic lupus erythematosus. Hong Kong Med J 2018; 24:261-269. [PMID: 29807953 DOI: 10.12809/hkmj177007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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 Conventional diagnostic assays are being replaced with automated multiplex assays, but their performance needs to be evaluated. We compared a multiplex flow immunoassay with conventional techniques in the detection of antinuclear antibodies (ANAs) and antibodies to specific extractable nuclear antigens (ENAs) in serum samples from patients with systemic lupus erythematosus. METHODS A total of 140 consecutive Chinese patients with systemic lupus erythematosus and 41 healthy controls were included. The automated BioPlex 2200 ANA Screen assay (Bio-Rad Laboratories, Hercules [CA], US) was compared with indirect immunofluorescence. In addition, use of BioPlex 2200 to detect anti-ENA antibodies was compared with in-house assays of countercurrent immunoelectrophoresis (CIEP), enzyme-linked immunosorbent assay (ELISA), and line blot. RESULTS The sensitivity and specificity of BioPlex in detecting ANAs (91.4% and 95.1%, respectively) were comparable to those of indirect immunofluorescence (90.7% and 85.4%, respectively). Overall, BioPlex achieved the best agreement with ELISA in detecting anti-ENA antibodies: agreement was >90% for most antibody types (κ=0.79-0.94). In contrast, agreement was poorest with CIEP, ranging from 85.6% (κ=0.33) for anti-Sm antibodies to 93.9% (κ=0.88) for anti-Ro antibodies. Overall, BioPlex and ELISA had the highest sensitivity, whereas CIEP had the highest specificity. In terms of disease association, anti-Sm detected by CIEP had the best positive predictive value and specificity for lupus nephritis. CONCLUSIONS In a local lupus cohort, BioPlex showed comparable sensitivity to indirect immunofluorescence in detecting ANAs and comparable performance to ELISA in detecting anti-ENA antibodies. However, CIEP was the best method in terms of disease specificity.
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Affiliation(s)
- E Y Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - W K Ip
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - C S Lau
- Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Y T Chan
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong
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Chan YT, Liu YT, Tzou YM, Kuan WH, Chang RR, Wang MK. Kinetics and equilibrium adsorption study of selenium oxyanions onto Al/Si and Fe/Si coprecipitates. Chemosphere 2018; 198:59-67. [PMID: 29421761 DOI: 10.1016/j.chemosphere.2018.01.110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/01/2017] [Revised: 01/07/2018] [Accepted: 01/22/2018] [Indexed: 05/26/2023]
Abstract
Inappropriate treatments for the effluents from semiconductor plants might cause the releases and wide distributions of selenium (Se) into the ecosystems. In this study, Al/Si and Fe/Si coprecipitates were selected as model adsorbents as they often formed during the wastewater coagulation process, and the removal efficiency of selenite (SeO3) and selenate (SeO4) onto the coprecipitates were systematically examined. The removal efficiency of SeO3 and SeO4 was highly related to surface properties of Al/Si and Fe/Si coprecipitates. The surface-attached Al shell of Al/Si coprecipitates shielded a portion of negative charges from the core SiO2, resulting in a higher point of zero charge than that of Fe/Si coprecipitates. Thus, adsorption of SeO3/SeO4 was favorable on the Al/Si coprecipitates. Adsorptions of both SeO3 and SeO4 on Al/Si coprecipitates were exothermic reactions. On Fe/Si coprecipitates, while SeO3 adsorption also showed the exothermic behavior, SeO4 adsorption occurred as an endothermic reaction. The kinetic adsorption data of SeO3/SeO4 on Al/Si and Fe/Si coprecipitates were described well by the pseudo-second-order kinetic model. SeO4 and SeO3 adsorption on Fe/Si or Al/Si were greatly inhibited by the strong PO4 ligand, whereas the weak ligand such as SO4 only significantly affected SeO4 adsorption. The weakest complex between SeO4 and Al was implied by the essentially SeO4 desorption as SeO4/PO4 molar ratios decreased from 0.5 to 0.2. These results were further confirmed by the less SeO4 desorption (41%) from Fe/Si coprecipitates than that from Al/Si coprecipitates (78%) while PO4 was added sequentially.
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Affiliation(s)
- Y T Chan
- Department of Soil and Environmental Sciences, National Chung Hsing University, Taichung, 40227, Taiwan, ROC
| | - Y T Liu
- Department of Soil and Environmental Sciences, National Chung Hsing University, Taichung, 40227, Taiwan, ROC.
| | - Y M Tzou
- Department of Soil and Environmental Sciences, National Chung Hsing University, Taichung, 40227, Taiwan, ROC.
| | - W H Kuan
- Department of Safety, Health and Environmental Engineering, Ming-Chi University of Technology, New Taipei City, 24301, Taiwan, ROC
| | - R R Chang
- Department of Agricultural Chemistry, National Taiwan University, Taipei, 10617, Taiwan, ROC
| | - M K Wang
- Department of Agricultural Chemistry, National Taiwan University, Taipei, 10617, Taiwan, ROC
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Judd A, Zangerle R, Touloumi G, Warszawski J, Meyer L, Dabis F, Mary Krause M, Ghosn J, Leport C, Wittkop L, Reiss P, Wit F, Prins M, Bucher H, Gibb D, Fätkenheuer G, Julia DA, Obel N, Thorne C, Mocroft A, Kirk O, Stephan C, Pérez-Hoyos S, Hamouda O, Bartmeyer B, Chkhartishvili N, Noguera-Julian A, Antinori A, d’Arminio Monforte A, Brockmeyer N, Prieto L, Rojo Conejo P, Soriano-Arandes A, Battegay M, Kouyos R, Mussini C, Tookey P, Casabona J, Miró JM, Castagna A, Konopnick D, Goetghebuer T, Sönnerborg A, Quiros-Roldan E, Sabin C, Teira R, Garrido M, Haerry D, de Wit S, Miró JM, Costagliola D, d’Arminio-Monforte A, Castagna A, del Amo J, Mocroft A, Raben D, Chêne G, Judd A, Pablo Rojo C, Barger D, Schwimmer C, Termote M, Wittkop L, Campbell M, Frederiksen CM, Friis-Møller N, Kjaer J, Raben D, Salbøl Brandt R, Berenguer J, Bohlius J, Bouteloup V, Bucher H, Cozzi-Lepri A, Dabis F, d’Arminio Monforte A, Davies MA, del Amo J, Dorrucci M, Dunn D, Egger M, Furrer H, Grabar S, Guiguet M, Judd A, Kirk O, Lambotte O, Leroy V, Lodi S, Matheron S, Meyer L, Miro JM, Mocroft A, Monge S, Nakagawa F, Paredes R, Phillips A, Puoti M, Rohner E, Schomaker M, Smit C, Sterne J, Thiebaut R, Thorne C, Torti C, van der Valk M, Wittkop L, Tanser F, Vinikoor M, Macete E, Wood R, Stinson K, Garone D, Fatti G, Giddy J, Malisita K, Eley B, Fritz C, Hobbins M, Kamenova K, Fox M, Prozesky H, Technau K, Sawry S, Benson CA, Bosch RJ, Kirk GD, Boswell S, Mayer KH, Grasso C, Hogg RS, Richard Harrigan P, Montaner JSG, Yip B, Zhu J, Salters K, Gabler K, Buchacz K, Brooks JT, Gebo KA, Moore RD, Moore RD, Rodriguez B, Horberg MA, Silverberg MJ, Thorne JE, Rabkin C, Margolick JB, Jacobson LP, D’Souza G, Klein MB, Rourke SB, Rachlis AR, Cupido P, Hunter-Mellado RF, Mayor AM, John Gill M, Deeks SG, Martin JN, Patel P, Brooks JT, Saag MS, Mugavero MJ, Willig J, Eron JJ, Napravnik S, Kitahata MM, Crane HM, Drozd DR, Sterling TR, Haas D, Rebeiro P, Turner M, Bebawy S, Rogers B, Justice AC, Dubrow R, Fiellin D, Gange SJ, Anastos K, Moore RD, Saag MS, Gange SJ, Kitahata MM, Althoff KN, Horberg MA, Klein MB, McKaig RG, Freeman AM, Moore RD, Freeman AM, Lent C, Kitahata MM, Van Rompaey SE, Crane HM, Drozd DR, Morton L, McReynolds J, Lober WB, Gange SJ, Althoff KN, Abraham AG, Lau B, Zhang J, Jing J, Modur S, Wong C, Hogan B, Desir F, Liu B, You B, Cahn P, Cesar C, Fink V, Sued O, Dell’Isola E, Perez H, Valiente J, Yamamoto C, Grinsztejn B, Veloso V, Luz P, de Boni R, Cardoso Wagner S, Friedman R, Moreira R, Pinto J, Ferreira F, Maia M, Célia de Menezes Succi R, Maria Machado D, de Fátima Barbosa Gouvêa A, Wolff M, Cortes C, Fernanda Rodriguez M, Allendes G, William Pape J, Rouzier V, Marcelin A, Perodin C, Tulio Luque M, Padgett D, Sierra Madero J, Crabtree Ramirez B, Belaunzaran P, Caro Vega Y, Gotuzzo E, Mejia F, Carriquiry G, McGowan CC, Shepherd BE, Sterling T, Jayathilake K, Person AK, Rebeiro PF, Giganti M, Castilho J, Duda SN, Maruri F, Vansell H, Ly PS, Khol V, Zhang FJ, Zhao HX, Han N, Lee MP, Li PCK, Lam W, Chan YT, Kumarasamy N, Saghayam S, Ezhilarasi C, Pujari S, Joshi K, Gaikwad S, Chitalikar A, Merati TP, Wirawan DN, Yuliana F, Yunihastuti E, Imran D, Widhani A, Tanuma J, Oka S, Nishijima T, Na S, Choi JY, Kim JM, Sim BLH, Gani YM, David R, Kamarulzaman A, Syed Omar SF, Ponnampalavanar S, Azwa I, Ditangco R, Uy E, Bantique R, Wong WW, Ku WW, Wu PC, Ng OT, Lim PL, Lee LS, Ohnmar PS, Avihingsanon A, Gatechompol S, Phanuphak P, Phadungphon C, Kiertiburanakul S, Sungkanuparph S, Chumla L, Sanmeema N, Chaiwarith R, Sirisanthana T, Kotarathititum W, Praparattanapan J, Kantipong P, Kambua P, Ratanasuwan W, Sriondee R, Nguyen KV, Bui HV, Nguyen DTH, Nguyen DT, Cuong DD, An NV, Luan NT, Sohn AH, Ross JL, Petersen B, Cooper DA, Law MG, Jiamsakul A, Boettiger DC, Ellis D, Bloch M, Agrawal S, Vincent T, Allen D, Smith D, Rankin A, Baker D, Templeton DJ, O’Connor CC, Thackeray O, Jackson E, McCallum K, Ryder N, Sweeney G, Cooper D, Carr A, Macrae K, Hesse K, Finlayson R, Gupta S, Langton-Lockton J, Shakeshaft J, Brown K, Idle S, Arvela N, Varma R, Lu H, Couldwell D, Eswarappa S, Smith DE, Furner V, Smith D, Cabrera G, Fernando S, Cogle A, Lawrence C, Mulhall B, Boyd M, Law M, Petoumenos K, Puhr R, Huang R, Han A, Gunathilake M, Payne R, O’Sullivan M, Croydon A, Russell D, Cashman C, Roberts C, Sowden D, Taing K, Marshall P, Orth D, Youds D, Rowling D, Latch N, Warzywoda E, Dickson B, Donohue W, Moore R, Edwards S, Boyd S, Roth NJ, Lau H, Read T, Silvers J, Zeng W, Hoy J, Watson K, Bryant M, Price S, Woolley I, Giles M, Korman T, Williams J, Nolan D, Allen A, Guelfi G, Mills G, Wharry C, Raymond N, Bargh K, Templeton D, Giles M, Brown K, Hoy J. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study. Clin Infect Dis 2017; 65:1316-1326. [PMID: 28531260 PMCID: PMC5850623 DOI: 10.1093/cid/cix480] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). RESULTS We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. CONCLUSIONS Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.
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Chan YT, Ho HK, Lai CKW, Lau CS, Lau YL, Lee TH, Leung TF, Wong GWK, Wu YY. Allergy in Hong Kong: an unmet need in service provision and training. Hong Kong Med J 2015; 21:52-60. [PMID: 25554794 DOI: 10.12809/hkmj144410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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
Many children in Hong Kong have allergic diseases and epidemiological data support a rising trend. Only a minority of children will grow out of their allergic diseases, so the heavy clinical burden will persist into adulthood. In an otherwise high-quality health care landscape in Hong Kong, allergy services and training are a seriously unmet need. There is one allergy specialist for 1.5 million people, which is low not only compared with international figures, but also compared with most other specialties in Hong Kong. The ratio of paediatric and adult allergists per person is around 1:460 000 and 1:2.8 million, respectively, so there is a severe lack of adult allergists, while the paediatric allergists only spend a fraction of their time working with allergy. There are no allergists and no dedicated allergy services in adult medicine in public hospitals. Laboratory support for allergy and immunology is not comprehensive and there is only one laboratory in the public sector supervised by accredited immunologists. These findings clearly have profound implications for the profession and the community of Hong Kong and should be remedied without delay. Key recommendations are proposed that could help bridge the gaps, including the creation of two new pilot allergy centres in a hub-and-spoke model in the public sector. This could require recruitment of specialists from overseas to develop the process if there are no accredited allergy specialists in Hong Kong who could fulfil this role.
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Affiliation(s)
- Y T Chan
- Division of Clinical Immunology, Department of Pathology and Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - H K Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - C S Lau
- Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - T H Lee
- Allergy Centre, Hong Kong Sanatorium and Hospital, Hong Kong
| | - T F Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Gary W K Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y Y Wu
- Private practice, Hong Kong
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Yung WK, Hui W, Chan YT, Lo TK, Tai SM, Sing C, Lam YY, Lo CM, Lau WL, Leung WC. Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong. Hong Kong Med J 2014; 20:213-21. [PMID: 24812199 DOI: 10.12809/hkmj134181] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To review the pregnancy outcomes of non-booked, non-local pregnant women delivering in Kwong Wah Hospital via admission to the Accident and Emergency Department 1 year after the announcement by the Hospital Authority to stop antenatal booking for non-eligible persons; and to perform a literature review of local studies about non-eligible person deliveries over the last decade. DESIGN Case series. SETTING A public hospital in Hong Kong. PARTICIPANTS All women who held the People's Republic of China passport or the two-way permit and those non-eligible persons whose spouses were Hong Kong Identity Card holders, who delivered in Kwong Wah Hospital from 1 April 2011 to 31 March 2012. RESULTS Overall, 219 women who were non-eligible persons delivered 221 live births during the study period. Compared with the annual statistics of Kwong Wah Hospital in 2011, non-local mothers were of higher parity; more likely to have hypertensive disease (including pre-eclamptic toxaemia), preterm deliveries (ie at <37 weeks), babies needing admission to the special care baby unit, and macrosomic babies (ie weighing >4.0 kg). The rates of induction of labour and caesarean section were lower in this group. There was no significant difference in the maternal and neonatal outcomes between women who had no booking and those who had a booking in another Hospital Authority or private hospital. There were many incidents of near-miss obstetric complications or suboptimally managed obstetric conditions due to lack of well-structured and continuous antenatal care in this group of non-eligible persons. CONCLUSION Non-eligible person delivering babies in Hong Kong has become a social obstetrics phenomenon. Despite the introduction of policies, reduction in the number of deliveries (quantity) did not improve the obstetric outcomes (quality). Health care professionals should continue to be prepared for managing the potential near-miss clinical complications in this group of 'travelling mothers'.
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Affiliation(s)
- W K Yung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - Winnie Hui
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - Y T Chan
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - T K Lo
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - S M Tai
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - C Sing
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - Y Y Lam
- Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - C M Lo
- Department of Accident and Emergency, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - W L Lau
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
| | - W C Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
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Li WY, Chiu LCM, Lam WS, Wong WY, Chan YT, Ho YP, Wong EYL, Wong YS, Ooi VEC. Ethyl acetate extract of Chinese medicinal herb Sarcandra glabra induces growth inhibition on human leukemic HL-60 cells, associated with cell cycle arrest and up-regulation of pro-apoptotic Bax/Bcl-2 ratio. Oncol Rep 2007; 17:425-31. [PMID: 17203183] [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: 05/13/2023] Open
Abstract
Sarcandra glabra (Thunb.) Nakai, colloquially known as Caoshanhu, is a Chinese medicinal herb with reported anti-tumor, anti-inflammatory, anti-viral and non-specific immunoenhancing properties. Although the plant has been clinically used for treating a variety of diseases, its bioactive ingredients are largely unknown and its mode of action has never been investigated. In this study, the anti-tumor property of ethyl acetate (EA) extract of S. glabra was investigated by determining its in vitro growth-inhibitory effects on a panel of human cancer cell lines of different histotypes. Growth inhibition of the EA extract on the cancer cells seemed to be selective, and the leukemic HL-60 was found to be the most responsive after 48 h of treatment (IC50=58 microg/ml). Flow cytometric studies further illustrated that the extract might interfere with DNA replication and thus arrested the cell cycle at S phase in the leukemic cells, followed by DNA fragmentation and loss of phospholipid asymmetry in the plasma membrane after 72 h of treatment. Concurrently, the pro-apoptotic Bax/Bcl-2 ratio was also up-regulated by more than 178% of the control level. All these findings suggested that the extract had initiated apoptosis to kill the leukemic cells. Results from this pioneer study help to establish a scientific foundation for future research and development of the bioactive ingredients in EA extract of S. glabra as efficacious anti-cancer agents.
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Affiliation(s)
- W Y Li
- Department of Biology, The Chinese University of Hong Kong, Hong Kong, P.R. China
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12
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Affiliation(s)
- W D Ng
- Princess Margaret Hospital, Kowlon, Hong Kong
| | - Y T Chan
- Princess Margaret Hospital, Kowlon, Hong Kong
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13
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Abstract
OBJECTIVE To introduce the Spaso technique for reducing anterior shoulder dislocation by reporting the success rate of the Spaso technique performed by junior emergency medicine residents. DESIGN Retrospective case series. SETTING Urban accident and emergency department. PARTICIPANTS Patients with anterior shoulder dislocations. INTERVENTIONS The Spaso technique was applied by the emergency medicine residents to reduce anterior shoulder dislocation. RESULTS The emergency medicine residents applied the Spaso technique to reduce 16 cases of anterior dislocated shoulder during the study period. The Spaso technique was successful in 14 of 16 cases. The overall success rate was 87.5% (95% CI 60.4, 97.8%). No complications were noted. CONCLUSION A new method has been introduced for reduction of anterior shoulder dislocation by reporting the experience of junior residents. The Spaso technique is simple, effective and able to be performed by single operator. Although the sample size was small, the result of the study could provide background information for planning a properly designed randomised controlled trial to evaluate the Spaso technique.
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Affiliation(s)
- M C Yuen
- Accident and Emergency Department, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong Special Administrative Region.
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14
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Lam CW, Chan KY, Tong SF, Chan BY, Chan YT, Chan YW. A novel missense mutation (P191L) in the glucose-6-phosphate translocase gene identified in a Chinese family with glycogen storage disease 1b. Hum Mutat 2000; 16:94. [PMID: 10874322 DOI: 10.1002/1098-1004(200007)16:1<94::aid-humu26>3.0.co;2-q] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C W Lam
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
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Hawkins BR, Chan P, Chan YT, Cheng IK, Cheung KO, Fenn J, Ho KK, Lai KN, Li CS, Lui SF, Opelz G, Tong MK. Highly successful long-term outcome of kidney transplantation in Chinese recipients: an enhancing race effect? Clin Transplant 1997; 11:178-84. [PMID: 9193839] [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: 02/04/2023]
Abstract
We report on 352 cadaveric kidney transplants and 294 living related transplants performed over a 25-yr period among the Chinese population of Hong Kong. There is a marked preference for transplanting male patients, especially from living donors, and we argue that this represents a cultural phenomenon within the Chinese population. The 10-yr graft survivals for related and cadaveric transplants are 86.2% and 67.4%, respectively. These figures are appreciably higher than corresponding figures in Caucasian populations. We show beneficial effects of using cyclosporin A, minimizing the cold ischemia time and avoiding very young and very old donors. There is a clear benefit of transplanting kidneys with zero or one mismatched HLA antigen against the recipient but no stepwise decrease in outcome as the number of mismatched antigens increases. There is close concordance between the outcome of living related grafts with zero, one, and two mismatched haplotypes against the recipient and no observable benefit of haplotype matching. We show that Chinese renal transplant recipients in other centers also have better long-term graft outcome than Caucasians, both for cadaveric and living related transplants. We draw attention to the existence of a detrimental "race effect" in other studies when Black recipients are compared with Caucasians and consider whether an enhancing race effect exists for Chinese or whether the better outcome reflects different underlying diseases in Chinese.
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Affiliation(s)
- B R Hawkins
- Department of Pathology, University of Hong Kong, Hong Kong
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16
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Abstract
Thirty-nine consecutive patients with acute lymphoblastic leukemia were treated with an intensive chemotherapy protocol. There were 23 males and 16 females with a median age of 37 years (range: 15-65). Eighteen patients had common ALL, seven had pre-B ALL, three early-precursor B ALL, seven T-ALL and four had aberrant expression of myeloid antigens (c-ALL in three and pre-B ALL in one). The median initial leukocyte count was 11.8 x 10(9)/l (range: 0.65-295). Cytogenetic result of the marrow was available in 16 of 39 patients (41 per cent) and showed Philadelphia positivity in six, a normal result in six and one each of t(4,11), t(1,19), hyperdiploidy and del 12p. Hepatosplenomegaly was present in about 20 per cent of the patients. L-Asparaginase-related hepatic toxicity was the commonest toxicity (48.7 per cent) during phase I of induction. Prolonged pancytopenia and hypoplastic death were common during phase II. With the use of growth factors during the neutropenic period of phase II induction, the rate of hypoplastic death was reduced from 40 per cent to 3 per cent. Common causes of treatment failure included early hypoplastic death (27.8 per cent) and leukemia relapses (50 per cent) while primary refractory leukemia, hepatic failure and perforated peptic ulcer contributed to 11.1, 5.5 and 5.5 per cent of the other deaths. A high complete remission (CR) rate (87.4 per cent) was achieved after phase I induction. The median event-free survival (EFS) was 8 months and the 3-year event-free survival was 43 per cent. This result compared favourably to the other regimens previously employed in our institution. In conclusion, satisfactory survival can be achieved with this intensive regimen. Good supportive care was however, essential to minimize toxicities.
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Affiliation(s)
- C S Chim
- Department of Medicine, Queen Mary Hospital, Hong Kong
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17
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Ng WT, Book KS, Chan YT. Pelvi-ureteric junction obstruction in an incomplete duplex system. Br J Urol 1996; 78:138-9. [PMID: 8795422] [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] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- W T Ng
- Department of Surgery, Yan Chai Hospital, Tsuen Wan, Hong Kong
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Davidson NG, Chick JB, Perren TJ, Campbell N, Thompson JM, Chan YT. A phase II study of single agent paclitaxel in patients at first relapse following initial chemotherapy for breast cancer. Clin Oncol (R Coll Radiol) 1996; 8:358-62. [PMID: 8973850 DOI: 10.1016/s0936-6555(96)80077-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study was initiated to evaluate the safety and efficacy of 3-weekly paclitaxel given at 225 mg/m2 over 3 hours without colony stimulating factor support in patients at their first relapse following adjuvant therapy for breast cancer. Thirty patients were entered into the study; all were assessable for response and toxicity. All patients had received adjuvant/neo-adjuvant chemotherapy; 22 patients had had prior hormonal therapy and 26 previous adjuvant radiotherapy. The group was characterized by a short time to first relapse (median 7.5 months (range 2-43)) and widespread disease, with 22 patients having multiple disease sites including: nodes (43%), skin and soft tissue (43%), liver (40%), lung (37%) and bone (50%). A total of 219 cycles of paclitaxel were given, with a median of eight per patient. The major non-haematological toxicities were: grade 3 alopecia (82% cycles), grade 2/3 arthralgia/myalgia (26%), grade 2/3 fatigue (16%) and grade 2/3 peripheral nervous system toxicity (12%). Haematological toxicity was mainly neutropenia of short duration, with grade 4 counts documented in 16% of cycles. Thrombocytopenia was minimal and there were no significant hypersensitivity reactions. The objective response rate was 60% (95% CI 42.5-77.5) with one complete response and 17 partial responses. The median duration of overall response was 30 weeks (range 15-75+ (95% CI 25-33)) with a median survival time for all patients of 42 weeks (range 1-124+). This study demonstrates that paclitaxel 225 mg/m2 is well tolerated as a 3-hour infusion and can be given safely in an outpatient setting without routine use of granulocyte colony stimulating factor. The response rate is encouraging and shows that this regimen is effective in this poor prognosis patient population.
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Ng JW, Kong CK, Book KS, Cheung CH, Wong YW, Chan YT, Lee K, Liu K. Pancreatitis and anomalous union of the pancreaticobiliary ductal system in childhood. J Pediatr Surg 1993; 28:1523-4. [PMID: 8301477 DOI: 10.1016/0022-3468(93)90493-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 01/29/2023]
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20
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Bento RF, Mazza CDC, Motti EF, Chan YT, Guimarães JR, Miniti A. Human lagochilascariasis treated successfully with ivermectin: a case report. Rev Inst Med Trop Sao Paulo 1993; 35:373-5. [PMID: 8115799 DOI: 10.1590/s0036-46651993000400012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A 15 year old male patient was diagnosed as being infected with the nematode Lagochilascaris minor, presenting as abscesses over the left mastoid region, and invading the temporal bone, mastoid sinuses and possibly the CNS. Surgical drainage and administration of cambendazole and levamisole led to improvement, followed by an early relapse and poor tolerance to the antihelminthic drugs. Repeated doses of ivermectin (an animal preparation) were used for the first time to treat this condition and resulted in complete remission of signs of infection, maintained for 15 months after the end of drug therapy, indicating cure of the disease.
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Affiliation(s)
- R F Bento
- University of São Paulo School of Medicine, Brasil
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21
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Ng WT, Yiu MK, Wong MK, Wong YT, Kong CK, Chan YT. Use of skin staples for fixation of T tubes and drains. Surg Gynecol Obstet 1993; 177:93-5. [PMID: 8322163] [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: 01/29/2023]
Abstract
Stapled anchorage is safe and effective for T tubes and drains and is preferred to the conventional technique. Significant bile leaks never occur. Three and two staples are recommended for anchoring T tubes and drains, respectively.
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Affiliation(s)
- W T Ng
- Surgical B Unit, Princess Margaret Hospital, Hong Kong
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22
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Ng WT, Wong MK, Kong CK, Cheung CH, Chan YT. Meconium ileus: a review 1972-1990. Br J Surg 1993; 80:129. [PMID: 8428276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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23
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Ng WT, Wong MK, Chan YT, Liu K. The common bilio-pancreatic channel syndrome in childhood. ANZ J Surg 1992; 62:901-2; author reply 902. [PMID: 20169711 DOI: 10.1111/j.1445-2197.1992.tb06947.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Ng WT, Wong MK, Chan YT. Re: Cavernous haemangioma of the glans penis. Br J Urol 1992; 70:340. [PMID: 1422704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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25
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Ng WT, Wong MK, Chan YT, Liu K. Clinical application of the study on sphincter of Oddi motor activity in patients with anomalous pancreaticobiliary junction. Am J Gastroenterol 1992; 87:926-7. [PMID: 1615956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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27
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Ng WD, Liu K, Wong MK, Kong CK, Lee K, Chan YT, Leung JW. Endoscopic sphincterotomy in young patients with choledochal dilatation and a long common channel: a preliminary report. Br J Surg 1992; 79:550-2. [PMID: 1611450 DOI: 10.1002/bjs.1800790625] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
An anomalous elongated pancreaticobiliary common channel encourages reflux up both the biliary tree and the pancreatic ductal system, resulting in progressive choledochal dilatation, cholangitis with ductal calculi, relapsing pancreatitis and malignant change. Transduodenal sphincteroplasty has been used to improve drainage from the abnormal channel. The use of endoscopic sphincterotomy (ES) to establish drainage and minimize the surgical risks is reported in six symptomatic patients with mild choledochal dilatation (common bile duct diameter less than 15 mm), a common channel less than 15 mm in length and a distal stenosis. This was successful in five patients, who have no further symptoms. ES failed in the only patient with an undilated common channel and this patient went on to have open surgery. We believe ES to be safe and effective in the treatment of selected cases of long common channel.
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Affiliation(s)
- W D Ng
- Surgical B Unit, Princess Margaret Hospital, Lai King Hill, Hong Kong
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Ng JW, Chan YT, Wong MK. Intestinal obstruction due to axial twisting of bowel in transmesenteric hernia. Aust N Z J Surg 1992; 62:408-11. [PMID: 1575666 DOI: 10.1111/j.1445-2197.1992.tb07215.x] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A baby, born with gastroschisis, had an unrepaired large aperture in the mesocolon close to a short segment of colon. One day, the entire length of bowel proximal to the defect traversed the rent. The free segment of colon was affected by the resulting twist along the long axis of the bowel and became obstructed. A large mesenteric defect, albeit too wide to strangulate the bowel, is not totally innocuous and should always be closed.
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Affiliation(s)
- J W Ng
- Surgical B Unit, Princess Margaret Hospital, Hong Kong
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30
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Ng WT, Chan YT. Recurrent pyogenic cholangitis: current management: a word of caution. World J Surg 1992; 16:150. [PMID: 1290257 DOI: 10.1007/bf02067134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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32
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Cheng IK, Lai KN, Au TC, Chan PS, Poon GP, Chan YT. Comparison of the mortality and morbidity rate between proper and unconventional renal transplantation using organs from executed prisoners. Transplant Proc 1991; 23:2533-6. [PMID: 1926466] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- I K Cheng
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam
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Ng WD, Chan YT. Double linear stapling technique for oesophagojejunal anastomosis following total gastrectomy. Br J Surg 1991; 78:760-1. [PMID: 2070249 DOI: 10.1002/bjs.1800780635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Ng WD, Chan YT, Ho KK. Stapled bypass for nonresectable carcinoma located in the upper part of the stomach. Surg Gynecol Obstet 1991; 172:234-5. [PMID: 1704643] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- W D Ng
- Surgical B Unit, Princess Margaret Hospital, Hong Kong
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35
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Affiliation(s)
- Y T Chan
- Surgical B Unit, Princess Margaret Hospital, Hong Kong
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36
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Affiliation(s)
- W D Ng
- Surgical "B" Unit, Princess Margaret Hospital, Hong Kong
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37
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Ng WD, Chan YT, Fung H. Primary anoplasty with skin flaps in posterior sagittal anorectoplasty. Br J Surg 1988; 75:795. [PMID: 3167532 DOI: 10.1002/bjs.1800750824] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- W D Ng
- Surgical B Unit, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong
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Abstract
A rare case of presacral myelolipoma in an otherwise healthy 53 year old man is described. His only complaint was lower abdominal discomfort. Full investigation including computed tomography and angiography revealed a well-delineated, heavily calcified, avascular retrorectal mass adhering to the presacral fascia. Histologically the mass showed a mixture of haemopoietic tissue and mature fat cells. Clinically the absence of symptoms and bone involvement served to distinguish this condition from other more sinister presacral lesions, particularly a chordoma.
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Affiliation(s)
- Y F Chan
- Clinical Pathology Unit, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong
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Chan YT, Chan FL, Ho KK, Ng WD. Non-operative diagnosis of renal sinus lipomatosis simulating tumour of the renal pelvis. Br J Urol 1988; 61:265-6. [PMID: 3359136 DOI: 10.1111/j.1464-410x.1988.tb06397.x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Y T Chan
- Surgical "B" Unit, Princess Margaret Hospital, Hong Kong
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41
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Abstract
We report three cases of choledochal cyst. The calibre of the common bile duct in each of them was demonstrated by ultrasonogram, CT scan, radiography and laparotomy to be almost normal before recurrent attacks of pancreatitis, following which the common bile duct was shown to become grossly dilated. This observation leads us to surmise that recurrent pancreatitis contributes to the formation of choledochal cysts.
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Chan YT, Yip SK, Ng WD. Hepatorenal revascularization in non-specific aorto-arteritis. Br J Surg 1986; 73:209. [PMID: 2868772 DOI: 10.1002/bjs.1800730318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
The study is based on a prospective survey of 200 necropsies, to determine the prevalence of colonic polyps and diverticula in Hong Kong. Adenomatous polyps were found in 34% of men and 19% of women. The corresponding figures for hyperplastic polyps were 22% and 15%. When compared with European countries having similar rates for colorectal cancer, the polyp pattern by type, prevalence, and distribution is very similar. For diverticula the prevalence rate in this study was only 5%; most of these were situated in the caecum. This is at marked variance to the European pattern.
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Abstract
The renal capsule long has been suggested to be the origin of leiomyosarcoma of the kidney but this speculation has never been proved. We describe a case of leiomyosarcoma lying with the renal capsule. The radiographic, as well as the macroscopic and microscopic appearances provide convincing evidence of capsular origin.
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Abstract
Intrarenal scarring with stricture formation is common in late cases of renal tuberculosis and has caused more loss of renal function than direct involvement by tuberculosis. The classical treatment of this condition is heminephrectomy for early cases and total nephrectomy for late cases. However, these destructive procedures are far from satisfactory. We describe a new operation, pan-caliceal ileoneocystostomy, that aims at draining the entire caliceal system into an ileal ureter, which thereby relieves the obstruction. Good results were obtained in 2 cases. This procedure also is applicable to cases of intrarenal scarring with stricture formation owing to other causes.
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