1
|
Chow EMW, Lau JKY, Liyeung LLC, Chau WW, Mak MCK, Tse WL, Ho PC. Functional Outcome for Arthroscopic Treatment of Septic Arthritis of the Wrist. J Wrist Surg 2020; 9:190-196. [PMID: 32509421 PMCID: PMC7263864 DOI: 10.1055/s-0039-3402423] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
Background Septic arthritis is a potentially joint-destructing condition if not treated properly. Septic wrist accounts for ∼5% of all septic arthritis. Arthroscopic lavage is a well-documented treatment for septic arthritis of the knee, hip, or shoulder only. Previous studies on septic wrist were limited to case reports or retrospective studies focusing on open treatment, and functional outcome was seldom documented. Our study aims to evaluate the effectiveness of arthroscopic treatment and to investigate the functional outcome. Materials and Methods Patients were retrospectively reviewed over a period of 10 years. Parameters including age, gender, history of prior injury, duration of symptoms, joint aspirates and intraoperative tissue culture, radiological and arthroscopic findings, antibiotics used, number of operations, and hospital stay were reviewed. Functional outcomes were evaluated with QuickDASH (disabilities of the arm, shoulder, and hand) score. Results From 2007 to 2016, 14 patients (15 septic wrists) underwent arthroscopic surgery. One patient had bilateral involvement. The average age was 63.9 years and the average duration of symptoms was 6.08 days. Average follow-up time was 10 months. All except two patients (85.7%) responded to single arthroscopic treatment. Two required subsequent operations for concomitant tenosynovitis. There were no major complications. The most common isolated organism was Staphylococcus aureus . Only one case had severe joint erosion during follow-up. The average QuickDASH score was 19.7. Duration of symptoms 5 days or more before admission was associated with higher QuickDASH score ( p = 0.04). Conclusion Early arthroscopic treatment should be considered for all patients admitted for septic arthritis of the wrist if not contraindicated. Level of Evidence This is a Level III, retrospective review.
Collapse
Affiliation(s)
- Esther M. W. Chow
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| | - Jimmy K. Y. Lau
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| | - Lucci L. C. Liyeung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| | - W. W. Chau
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| | - Michael C. K. Mak
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| | - W. L. Tse
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| | - P. C. Ho
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, HKSAR, China
| |
Collapse
|
2
|
Kakar S, Burnier M, Atzei A, Ho PC, Herzberg G, Del Piñal F. Dry Wrist Arthroscopy for Radial-Sided Wrist Disorders. J Hand Surg Am 2020; 45:341-353. [PMID: 32122689 DOI: 10.1016/j.jhsa.2020.01.012] [Citation(s) in RCA: 13] [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] [Received: 07/19/2019] [Revised: 01/20/2020] [Accepted: 01/24/2020] [Indexed: 02/02/2023]
Abstract
The development of wrist arthroscopy has been useful in diagnosis, prognosis, and treatment of both ligament and osseous injuries. As the treatment indications and techniques become more refined, this article explores the role of dry arthroscopy to treat radial-sided disorders of the wrist.
Collapse
Affiliation(s)
- Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
| | - Marion Burnier
- Service Chirurgie Orthopédique Membre Supérieur, Hôpital Edouard Herriot, Lyon, France
| | - Andrea Atzei
- Hand Surgery Unit, Policlinico G.B. Rossi, Verona, Italy
| | - P C Ho
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Guillaume Herzberg
- Service Chirurgie Orthopédique Membre Supérieur, Hôpital Edouard Herriot, Lyon, France
| | | |
Collapse
|
3
|
Ng AWH, Griffith JF, Tong CSL, Law EKC, Tse WL, Wong CWY, Ho PC. MRI criteria for diagnosis and predicting severity of carpal tunnel syndrome. Skeletal Radiol 2020; 49:397-405. [PMID: 31396669 DOI: 10.1007/s00256-019-03291-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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] [Received: 06/08/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To study MRI criteria for diagnosing and predicting severity of carpal tunnel syndrome (CTS). METHODS Sixty-nine wrists in 41 symptomatic CTS patients and 32 wrists in 28 asymptomatic subjects were evaluated by MRI. Circumferential surface area (CSA), flattening ratio, relative median nerve signal intensity, and retinacular bowing were measured. CTS severity was classified as mild, moderate, or severe. Parameters for patients with and without CTS and for the three severity groups were compared. ROC curves were plotted to assess accuracy for CTS diagnosis and severity prediction. RESULTS Significant differences were found between CTS and control wrists for median nerve CSA, flattening ratio at inlet, relative median nerve signal intensity, and retinacular bowing. ROC curve analysis revealed a sensitivity, specificity, and accuracy of median nerve CSA > 15 mm2 proximal to the tunnel (CSAp) of 85.5, 100, and 90.1%. Using either CSAp or CSAd > 15 mm2 as a diagnostic criterion, MRI could achieve a sensitivity of 100% and specificity of 94% for diagnosis of CTS while overall accuracy was 98%. Significant differences were found among the three severity groups. Sensitivity, specificity, and accuracy of prediction of severe CTS using for CSAp > 19 mm2 were 75.0, 65.9, and 69.6%, respectively. CONCLUSIONS MRI is highly accurate at diagnosing CTS and moderately accurate at determining CTS severity. We recommend using CSA > 15 mm2 either proximal to or distal to the tunnel as a diagnostic criterion for CTS and CSA > 19 mm2 proximal to the tunnel as a marker for severe CTS.
Collapse
Affiliation(s)
- Alex W H Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong.
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong
| | - Cina S L Tong
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong
| | - Eric K C Law
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong
| | - W L Tse
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong
| | - Clara W Y Wong
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong
| | - P C Ho
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong
| |
Collapse
|
4
|
Li HWR, Ko JKY, Lee VCY, Yung SSF, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Comparison of antral follicle count and serum anti Müllerian hormone level for determination of gonadotropin dosing in in-vitro fertilization: randomized trial. Ultrasound Obstet Gynecol 2020; 55:303-309. [PMID: 31325336 DOI: 10.1002/uog.20402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/06/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To compare the proportion of women achieving a desired ovarian response following ovarian stimulation when gonadotropin dosing was determined based on antral follicle count (AFC) vs serum anti-Müllerian hormone (AMH) level, in women undergoing in-vitro fertilization (IVF) using the gonadotropin-releasing hormone (GnRH) antagonist protocol. METHODS This was a randomized double-blind trial carried out in a university-affiliated assisted reproduction unit. A total of 200 women undergoing their first IVF cycle using the GnRH-antagonist protocol between April 2016 and February 2018 were randomized to determination of gonadotropin dosing based on either AFC or serum AMH level measured in the pretreatment cycle 1 month before the IVF cycle. Patients underwent IVF as per our center's standard protocol. The proportion of subjects achieving a desired ovarian response, defined as retrieval of six to 14 oocytes, was compared between the two study arms. Subgroup analysis of patients with baseline AFC > 5 and those with baseline AFC ≤ 5 was performed. Concordance in AFC and AMH categorization between the pretreatment cycle and the ovarian-stimulation cycle was assessed using Cohen's kappa (κ). RESULTS There was no significant difference in the proportion of patients achieving a desired ovarian response between the AFC (54%) and AMH (49%) groups (P = 0.479). The median number of oocytes retrieved was nine vs seven (P = 0.070), and the median follicular output rate was 0.54 vs 0.55 (P = 0.764) in the AFC and AMH groups, respectively. Similar findings were observed on subgroup analysis of subjects with AFC ≤ 5 and AFC > 5 at the start of ovarian stimulation (P > 0.05 for all comparisons). There was moderate concordance between AFC and AMH measured in the pretreatment cycle and the stimulation cycle (κ = 0.478 and 0.587, respectively). CONCLUSION The proportion of women achieving a desired ovarian response following ovarian stimulation using the GnRH-antagonist protocol is similar when the gonadotropin-dosing algorithm used is based on AFC or serum AMH level. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- H W R Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Shenzhen Key Laboratory on Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong, Shenzhen Hospital, Shenzhen, People's Republic of China
| | - J K Y Ko
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - V C Y Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S S F Yung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Shenzhen Key Laboratory on Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong, Shenzhen Hospital, Shenzhen, People's Republic of China
| | - E Y L Lau
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - W S B Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Shenzhen Key Laboratory on Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong, Shenzhen Hospital, Shenzhen, People's Republic of China
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Shenzhen Key Laboratory on Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong, Shenzhen Hospital, Shenzhen, People's Republic of China
| | - E H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Shenzhen Key Laboratory on Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong, Shenzhen Hospital, Shenzhen, People's Republic of China
| |
Collapse
|
5
|
Li H, He YL, Li R, Wong C, Sy B, Lam CW, Lam K, Peng HM, Mu S, Schooling M, Yeung W, Ho PC, Ng E. Age-specific reference ranges of serum anti-müllerian hormone in healthy women and its application in diagnosis of polycystic ovary syndrome: a population study. BJOG 2020; 127:720-728. [PMID: 32009280 DOI: 10.1111/1471-0528.16147] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To establish the age-specific centiles of serum anti-müllerian hormone (AMH) levels in Chinese women, and to explore the use of multiples of median (MoM) AMH levels for the diagnosis of polycystic ovary syndrome (PCOS). DESIGN An observational study. SETTING University-affiliated hospitals and community clinics. POPULATION We included 3137 healthy women aged 20-44 years recruited prospectively or who had archived serum samples from previous research projects. Another validation cohort of 751 women with PCOS as well as ovulatory controls, which was a convenient sample of women attending for infertility or menstrual disorders, was also studied. METHODS The serum samples were assayed for AMH by the automated Access AMH assay. MAIN OUTCOME MEASURES Age-specific reference ranges were constructed on the primary cohort with the Lambda-Mu-Sigma method. The MoM AMH of each subject in the validation cohort was calculated. RESULTS Centile curves of serum AMH level against age were established. MoM AMH was significantly higher in women with PCOS than in controls (P < 0.05). The area under the ROC curve was 0.852 (95% confidence interval [CI] 0.825-0.877) (P < 0.0001) for discriminating women with PCOS from ovulatory controls by MoM AMH. CONCLUSIONS We established a set of year-by-year age-specific reference ranges of serum AMH levels in Chinese women. The MoM AMH derived from this set of reference ranges is a promising tool to replace antral follicle count in the diagnosis of PCOS. TWEETABLE ABSTRACT A set of age-specific reference ranges of AMH levels was established in Chinese women. Multiples of median AMH may be used to diagnose PCOS.
Collapse
Affiliation(s)
- Hwr Li
- Key Laboratory of Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong.,The Family Planning Association of Hong Kong, Hong Kong, Hong Kong
| | - Y-L He
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - R Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Cyg Wong
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong.,The Family Planning Association of Hong Kong, Hong Kong, Hong Kong
| | - B Sy
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, Hong Kong
| | - C W Lam
- Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Ksl Lam
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - H-M Peng
- Reproductive Medicine Center, People's Liberation Army General Hospital, Beijing, China
| | - S Mu
- Reproductive Medicine Center, People's Liberation Army General Hospital, Beijing, China
| | - M Schooling
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wsb Yeung
- Key Laboratory of Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - P C Ho
- Key Laboratory of Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Ehy Ng
- Key Laboratory of Fertility Regulation, Department of Obstetrics and Gynaecology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.,Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
6
|
Lui MW, Yeung WSB, Ho PC, Ng EHY. In vitro fertilisation in Hong Kong: the situation in 2019. Hong Kong Med J 2019; 25:468-472. [PMID: 31796641 DOI: 10.12809/hkmj198057] [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: 11/05/2022] Open
Abstract
The popularity of in vitro fertilisation has continuously increased throughout the past 40 years owing to an increased incidence of infertility and delayed planning for pregnancy. The aim of this paper is to review the current situation of in vitro fertilisation in Hong Kong. In Hong Kong, in 2018, 7995 women underwent 5055 fresh and 5050 frozen-thawed embryo in vitro fertilisation cycles, resulting in an ongoing pregnancy rate of 33.7% per transfer. However, in vitro fertilisation is associated with several problems, including a high rate of multiple pregnancies and risks associated with cross-border reproductive care. Single embryo transfer is a simple strategy to reduce multiple pregnancies without compromising the cumulative live birth rate.
Collapse
Affiliation(s)
- M W Lui
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - W S B Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - E H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
7
|
Ng AWH, Tong CSL, Hung EHY, Griffith JF, Tse WL, Wong CWY, Mak MCK, Ho PC. Top-Ten Tips for Imaging the Triangular Fibrocartilaginous Complex. Semin Musculoskelet Radiol 2019; 23:436-443. [PMID: 31170740 DOI: 10.1055/s-0039-1688715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The triangular fibrocartilage complex (TFCC) is a crucial structure for both maintaining the stability of the distal radioulnar joint (DRUJ) and acting as a cushion for axial loading of the ulnocarpal joint. Injury to the TFCC can lead to early degeneration of the DRUJ and ulnocarpal joint, with resultant chronic wrist pain and weakness. The TFCC is a moderately complex structure with several attachments to the adjacent bony and cartilaginous structures. Familiarity with the anatomy of the TFCC is a prerequisite for identification of TFCC tears. Several pitfalls can occur while assessing the TFCC on magnetic resonance imaging (MRI) if one is not familiar with the MRI appearances. This article illustrates key tips for diagnosing TFCC tears on MRI.
Collapse
Affiliation(s)
- Alex W H Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Cina S L Tong
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Esther H Y Hung
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - W L Tse
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Clara W Y Wong
- Hand, Wrist, Elbow and Microsurgery Clinic, Chinese University of Hong Kong
| | - Michael C K Mak
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - P C Ho
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
8
|
Yung SSF, Cheng MMC, Ma PWS, Ho PC. Candida glabrata chorioamnionitis and fungaemia complicating pregnancy following intrauterine insemination. Hong Kong Med J 2018. [DOI: 10.12809/hkmj164800] [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: 11/05/2022] Open
|
9
|
Abstract
The synthesis of mifepristone, an antiprogestin blocking the action of progesterone at the receptor level, started a new era of medical termination of pregnancy (MTOP). The initial results of MTOP with mifepristone alone were disappointing; however, mifepristone can sensitise the myometrium to the action of prostaglandins. Clinical trials have shown that the sequential administration of mifepristone followed 1-2 days later by a prostaglandin analogue is a safe, effective, and acceptable method for MTOP. This article will review the events and challenges leading to the development of the current evidence-based and yet off-label regimen for first-trimester MTOP. TWEETABLE ABSTRACT This article reviews the events and challenges in the development of medical termination of pregnancy.
Collapse
Affiliation(s)
- P C Ho
- Centre of Reproductive Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
10
|
Chow JF, Yeung WS, Lee VC, Lau EY, Ho PC, Ng EH. Preimplantation genetic diagnosis and screening by array comparative genomic hybridisation: experience of more than 100 cases in a single centre. Hong Kong Med J 2017; 23:129-33. [PMID: 28211357 DOI: 10.12809/hkmj164883] [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: 11/05/2022] Open
Abstract
INTRODUCTION Preimplantation genetic screening has been proposed to improve the in-vitro fertilisation outcome by screening for aneuploid embryos or blastocysts. This study aimed to report the outcome of 133 cycles of preimplantation genetic diagnosis and screening by array comparative genomic hybridisation. METHODS This study of case series was conducted in a tertiary assisted reproductive centre in Hong Kong. Patients who underwent preimplantation genetic diagnosis for chromosomal abnormalities or preimplantation genetic screening between 1 April 2012 and 30 June 2015 were included. They underwent in-vitro fertilisation and intracytoplasmic sperm injection. An embryo biopsy was performed on day-3 embryos and the blastomere was subject to array comparative genomic hybridisation. Embryos with normal copy numbers were replaced. The ongoing pregnancy rate, implantation rate, and miscarriage rate were studied. RESULTS During the study period, 133 cycles of preimplantation genetic diagnosis for chromosomal abnormalities or preimplantation genetic screening were initiated in 94 patients. Overall, 112 cycles proceeded to embryo biopsy and 65 cycles had embryo transfer. The ongoing pregnancy rate per transfer cycle after preimplantation genetic screening was 50.0% and that after preimplantation genetic diagnosis was 34.9%. The implantation rates after preimplantation genetic screening and diagnosis were 45.7% and 41.1%, respectively and the miscarriage rates were 8.3% and 28.6%, respectively. There were 26 frozen-thawed embryo transfer cycles, in which vitrified and biopsied genetically transferrable embryos were replaced, resulting in an ongoing pregnancy rate of 36.4% in the screening group and 60.0% in the diagnosis group. CONCLUSIONS The clinical outcomes of preimplantation genetic diagnosis and screening using comparative genomic hybridisation in our unit were comparable to those reported internationally. Genetically transferrable embryos replaced in a natural cycle may improve the ongoing pregnancy rate and implantation rate when compared with transfer in a stimulated cycle.
Collapse
Affiliation(s)
- J Fc Chow
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - W Sb Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - V Cy Lee
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - E Yl Lau
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - E Hy Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| |
Collapse
|
11
|
Ko JK, Chai J, Lee VC, Li RH, Lau E, Ho KL, Tam PC, Yeung WS, Ho PC, Ng EH. Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia in Hong Kong. Hong Kong Med J 2016; 22:556-62. [PMID: 27687508 DOI: 10.12809/hkmj154710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE There are currently no local data on the sperm retrieval and pregnancy rates in in-vitro fertilisation and testicular sperm extraction cycles, especially with regard to the presence of genetic abnormalities. This study aimed to determine the sperm retrieval and pregnancy rates in infertile couples who underwent in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia. METHODS This retrospective case series was conducted at a tertiary assisted reproduction unit in Hong Kong. Men with non-obstructive azoospermia who underwent in-vitro fertilisation and testicular sperm extraction between January 2001 and December 2013 were included. The main outcome measures were sperm retrieval and pregnancy rates. RESULTS During the study period, 89 men with non-obstructive azoospermia underwent in-vitro fertilisation and testicular sperm extraction. Sperm was successfully retrieved in 40 (44.9%) men. There was no statistically significant difference in the sperm retrieval rate of those with karyotypic abnormalities (2/5, 40.0% vs 28/61, 45.9%; P=1.000) and AZFc microdeletion (3/6, 50.0% vs 28/61, 45.9%; P=1.000) compared with those without. Sperms were successfully retrieved in patients who had mosaic Klinefelter syndrome (2/3, 66.7%) but not in the patient with non-mosaic Klinefelter syndrome. No sperms were found in men with AZFa or AZFb microdeletions. Pregnancy test was positive in 15 (16.9%) patients and the clinical pregnancy rate was 13.5% (12/89) per cycle. The clinical pregnancy rate per transfer was 34.3% (12/35). CONCLUSIONS The sperm retrieval rate and clinical pregnancy rate per initiated cycle in men undergoing in-vitro fertilisation and testicular sperm extraction in our unit were 44.9% and 13.5%, respectively. No sperms could be retrieved in the presence of AZFa and AZFb microdeletions, but karyotype and AZFc microdeletion abnormalities otherwise did not predict the success of sperm retrieval in couples undergoing in-vitro fertilisation and testicular sperm extraction. Genetic tests are important prior to testicular sperm extraction for patient selection and genetic counselling.
Collapse
Affiliation(s)
- J Ky Ko
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - J Chai
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - V Cy Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - R Hw Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - E Lau
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - K L Ho
- Division of Urology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.,Private practice
| | - P C Tam
- Division of Urology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.,Private practice
| | - W Sb Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - E Hy Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| |
Collapse
|
12
|
Lee RKL, Griffith JF, Ng AWH, Law EKC, Tse WL, Wong CWY, Ho PC. Intrinsic carpal ligaments on MR and multidetector CT arthrography: comparison of axial and axial oblique planes. Eur Radiol 2016; 27:1277-1285. [DOI: 10.1007/s00330-016-4436-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 02/29/2016] [Accepted: 05/23/2016] [Indexed: 11/29/2022]
|
13
|
Lee VC, Chow JF, Lau EY, Kwong A, Leung SY, Yeung WS, Ho PC, Ng EH. Preimplantation genetic diagnosis for hereditary cancer syndrome: local experience. Hong Kong Med J 2016; 22:289-91. [PMID: 27305697 DOI: 10.12809/hkmj144499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- V Cy Lee
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - J Fc Chow
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - E Yl Lau
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - A Kwong
- Hong Kong Hereditary Breast Cancer Family Registry; Division of Breast Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - S Y Leung
- Hereditary Gastrointestinal Cancer Genetic Diagnosis Laboratory, Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - W Sb Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - E Hy Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
14
|
Yung SSF, Lai SF, Lam MT, Lee VCY, Li RHW, Ho PC, Ng EHY. Randomized, controlled, double-blind trial of topical lidocaine gel and intrauterine lidocaine infusion for pain relief during saline contrast sonohysterography. Ultrasound Obstet Gynecol 2016; 47:17-21. [PMID: 26434382 DOI: 10.1002/uog.15775] [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: 07/15/2015] [Revised: 09/24/2015] [Accepted: 09/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To evaluate the efficacy of topical lidocaine gel and intrauterine lidocaine infusion administered prior to saline contrast sonohysterography (SCSH) in reducing pain level during the procedure. METHODS This was a randomized, double-blind, placebo controlled trial. We recruited 120 women scheduled to undergo SCSH and randomized them into one of three groups according to administration of gel and intrauterine infusion immediately prior to the procedure: (1) the 'lidocaine gel' group received 3 mL 2% lidocaine gel applied to the cervix and intrauterine infusion, using an infant feeding tube without balloon, of 5 mL normal saline; (2) the 'lidocaine infusion' group received 3 mL gel lubricant applied to the cervix and intrauterine infusion of 5 mL 2% lidocaine; (3) the placebo group received 3 mL gel lubricant applied to the cervix and intrauterine infusion of 5 mL normal saline. The tube was left in place for the SCSH procedure. The primary outcome measure was the overall pain level (on a scale of 0-100) reported by the women during the SCSH procedure. Women also rated their pain levels at various other time points and an observer assessed visible signs of the women's discomfort during the procedure, producing a distress score. RESULTS There were no significant differences among the three groups in baseline characteristics, volume of saline solution infused, tenaculum use and duration and difficulty level of the SCSH procedure. The median (range) pain scores during normal saline infusion for the SCSH procedure were 0 (0-65) in the placebo group, 2.5 (0-80) in the lidocaine gel group, and 0 (0-70) in the lidocaine infusion group. The pain scores at other time points, the overall pain score and the distress score were also comparable for the three groups. No significant adverse events were reported. CONCLUSIONS SCSH performed with an infant feeding tube without balloon is associated with very low pain levels. Topical lidocaine gel application and intrauterine lidocaine infusion do not further reduce pain levels during SCSH.
Collapse
Affiliation(s)
- S S F Yung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - S F Lai
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - M T Lam
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - V C Y Lee
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - R H W Li
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - P C Ho
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - E H Y Ng
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| |
Collapse
|
15
|
Abstract
CpFe(CO)2 complexes kill cancer cells while leaving normal cells unharmed.
Collapse
Affiliation(s)
- H. T. Poh
- Department of Chemistry
- National University of Singapore
- Kent Ridge
- Singapore 117543
| | - P. C. Ho
- Department of Pharmacy
- National University of Singapore
- Kent Ridge
- Singapore 117543
| | - W. Y. Fan
- Department of Chemistry
- National University of Singapore
- Kent Ridge
- Singapore 117543
| |
Collapse
|
16
|
Yeung T, Chai J, Li R, Lee V, Ho PC, Ng E. A double-blind randomised controlled trial on the effect of dehydroepiandrosterone on ovarian reserve markers, ovarian response and number of oocytes in anticipated normal ovarian responders. BJOG 2015; 123:1097-105. [PMID: 26663817 DOI: 10.1111/1471-0528.13808] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the effect of dehydroepiandrosterone (DHEA) on antral follicle count (AFC), ovarian response to a standard low dose of gonadotrophin stimulation and number of oocytes in anticipated normal responders undergoing in vitro fertilisation (IVF). DESIGN Randomised, double-blind, placebo-controlled study. SETTING Tertiary reproductive unit. POPULATION Seventy-two subfertile women with AFC of 5-15 scheduled for IVF. METHODS Eligible women were randomised into the DHEA group (n = 36), who received DHEA (GNC(®) , 25 mg three times a day), or the placebo group (n = 36), who received placebo, starting from 12 weeks before the scheduled IVF treatment according to a computer-generated randomisation list. Monthly assessment of AFC, serum anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) levels, ovarian response to a standard dose of gonadotrophin stimulation at week 8 and the number of oocytes obtained were compared. MAIN OUTCOME MEASURES The primary outcome was AFC after 12 weeks of DHEA or placebo. RESULTS DHEA for 12 weeks prior to IVF treatment in anticipated normal responders leads to significantly higher serum and follicular DHEA-S and testosterone relative to placebo. However, no significant differences in AFC, AMH and FSH, ovarian response to standard-dose ovarian stimulation and IVF cycle outcomes can be detected. CONCLUSION No significant differences in AFC, ovarian response to a standard low dose of gonadotrophin stimulation and number of oocytes obtained were detected in anticipated normal responders receiving 12 weeks of DHEA prior to IVF treatment relative to placebo. TWEETABLE ABSTRACT No difference in ovarian response markers in normal responders receiving 12 weeks of DHEA.
Collapse
Affiliation(s)
- Twy Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - J Chai
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Rhw Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Vcy Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Ehy Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
17
|
|
18
|
Li HWR, Lam KSL, Tam S, Lee VCY, Yeung TWY, Cheung PT, Yeung WSB, Ho PC, Ng EHY. Screening for dysglycaemia by oral glucose tolerance test should be recommended in all women with polycystic ovary syndrome. Hum Reprod 2015. [PMID: 26202923 DOI: 10.1093/humrep/dev166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/31/2022] Open
Abstract
STUDY QUESTION Should fasting glucose (FG) or an oral glucose tolerance test (OGTT) be used to screen for dysglycaemia in women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER A full OGTT should be recommended as the screening method for dysglycaemia in women with PCOS, regardless of BMI or family history of diabetes mellitus (DM). STUDY DESIGN, SIZE, DURATION A cross-sectional study on 467 Chinese women diagnosed with PCOS by the Rotterdam criteria between January 2010 to December 2013. PARTICIPANTS, SETTING, METHODS The study was done at a university hospital in Hong Kong. All subjects underwent a 75 g OGTT after overnight fasting. We evaluated the performance of FG alone, when compared with the full OGTT, in identifying subjects with dysglycaemia (prediabetes or DM, according to the 2010 diagnostic criteria of the American Diabetes Association). MAIN RESULTS AND THE ROLE OF CHANCE Of the 467 subjects, 58 (12.4%) had dysglycaemia, among which 46 (9.8%) had prediabetes and 12 (2.6%) had DM, including 4 with known DM. Of the 46 subjects with prediabetes, 25 (54.3%) had normal FG and of the 8 subjects with screened DM in this study, 1 (12.5%) had normal FG. The sensitivity of FG alone in screening for prediabetes, DM and overall dysglycaemia were 45.7, 87.5 and 48.1%, respectively, i.e. missing 54.3% of prediabetes and 12.5% of DM cases as defined by the OGTT. Among the 54 subjects with screened dysglycaemia, 20 (37.0%) had BMI < 25 kg/m(2) and 35 (64.8%) had no family history of DM. LIMITATIONS, REASONS FOR CAUTION We only reported on the biochemical diagnosis of DM based on a single time point. In clinical practice, confirmatory results at another time point is required for definitive diagnosis in asymptomatic subjects. WIDER IMPLICATIONS OF THE FINDINGS There is an ongoing debate as to whether FG or an OGTT should be used as a screening method for dysglycaemia in women with PCOS. Some guidelines also recommend glucose screening only in those who are overweight and/or having family history of diabetes (DM). There have been scarce data on this issue in the Chinese population, which the current study aims at addressing. STUDY FUNDING/COMPETING INTERESTS The study was supported by a research grant from the Hong Kong Obstetrical and Gynaecological Trust Fund, as well as internal research funding of the Department of Obstetrics and Gynaecology, The University of Hong Kong. All authors have no competing interests.
Collapse
Affiliation(s)
- H W R Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - K S L Lam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - V C Y Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong
| | - T W Y Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong
| | - P T Cheung
- Department of Paediatric and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - W S B Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - E H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
19
|
Chow JFC, Yeung WSB, Lee VCY, Lau EYL, Ho PC, Ng EHY. Experience of more than 100 preimplantation genetic diagnosis cycles for monogenetic diseases using whole genome amplification and linkage analysis in a single centre. Hong Kong Med J 2015; 21:299-303. [PMID: 26044869 DOI: 10.12809/hkmj144436] [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
OBJECTIVE To report the outcomes of more than 100 cycles of preimplantation genetic diagnosis for monogenetic diseases. DESIGN Case series. SETTING Tertiary assisted reproductive centre in Hong Kong, where patients needed to pay for the cost of preimplantation genetic diagnosis on top of standard in-vitro fertilisation charges. PATIENTS Patients undergoing preimplantation genetic diagnosis for monogenetic diseases at the Centre of Assisted Reproduction and Embryology, Queen Mary Hospital-The University of Hong Kong between 1 August 2007 and 30 April 2014 were included. INTERVENTIONS In-vitro fertilisation, intracytoplasmic sperm injection, embryo biopsy, and preimplantation genetic diagnosis. MAIN OUTCOME MEASURES Ongoing pregnancy rate and implantation rate. RESULTS Overall, 124 cycles of preimplantation genetic diagnosis were initiated in 76 patients, 101 cycles proceeded to preimplantation genetic diagnosis, and 92 cycles had embryo transfer. The ongoing pregnancy rate was 28.2% per initiated cycle and 38.0% per embryo transfer, giving an implantation rate of 35.2%. There were 16 frozen-thawed embryo transfer cycles in which, following preimplantation genetic diagnosis, cryopreserved embryos were replaced resulting in an ongoing pregnancy rate of 37.5% and implantation rate of 30.0%. The cumulative ongoing pregnancy rate was 33.1%. The most frequent indication for preimplantation genetic diagnosis was thalassaemia, followed by neurodegenerative disorder and cancer predisposition. There was no misdiagnosis. CONCLUSIONS Preimplantation genetic diagnosis is a reliable method to prevent couples conceiving fetuses severely affected by known genetic disorders, with ongoing pregnancy and implantation rates similar to those for in-vitro fertilisation for routine infertility treatment.
Collapse
Affiliation(s)
- Judy F C Chow
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - William S B Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Vivian C Y Lee
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - Estella Y L Lau
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Ernest H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| |
Collapse
|
20
|
Li W, Yang J, Zhu XS, Li SC, Ho PC. Correlation between tea consumption and prevalence of hypertension among Singaporean Chinese residents aged ⩾40 years. J Hum Hypertens 2015; 30:11-7. [PMID: 26016594 DOI: 10.1038/jhh.2015.45] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/20/2015] [Accepted: 04/16/2015] [Indexed: 02/07/2023]
Abstract
By a cross-sectional epidemiology study, we attempted to correlate the consumption of tea and/or health supplements, living habits and socio-demographic factors to the prevalence of hypertension among Singaporean Chinese residents. Singaporean Chinese residents aged ⩾40 years were randomly selected and interviewed face-to-face by clinical research assistants. Hypertension was defined as measured systolic blood pressure at least 140 mm Hg and/or diastolic blood pressure at least 90 mmHg or self-reported history/treatment for hypertension. The prevalence of hypertension among the whole investigated population (N=1184, 58.27% females) was 49.73% and the prevalence increased to 66.47% in the sub-population aged ⩾60 years. High risk of hypertension was associated with age ⩾60 years (odds ratio (OR): 4.15-4.19, P<0.01), obesity (body mass index >25 kg m(-2), OR: 2.10-2.11, P<0.01), family history of hypertension (OR: 2.69-2.76, P<0.01), diabetes history (OR: 2.29-2.33, P<0.01), hyperlipidemia history (OR: 1.79-1.80, P<0.01), male (OR: 1.56-1.59, P<0.01) and coffee intake (OR: 1.44-1.46, P<0.05). In contrast, drinking green tea at least 150 ml per week was associated with lower hypertension risk (OR: 0.63, 95% confidence interval (CI): 0.43-0.91, P<0.05). Drinking combination of green tea and British tea was associated with higher reduction in the risk of hypertension (OR: 0.58, 95% CI: 0.39-0.85, P<0.05). This cross-sectional study suggests that consumption of tea, especially green tea and British tea, was associated with lowering the risk of hypertension. On the other hand, consumption of coffee could be a risk factor of hypertension. These findings may provide useful information for health promotion to reduce risk of hypertension and warrant further study to confirm and elucidate such association.
Collapse
Affiliation(s)
- W Li
- Singapore College of Traditional Chinese Medicine, Singapore, Singapore.,Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - J Yang
- National University Hospital of Singapore, Singapore, Singapore
| | - X S Zhu
- Centre for Complementary Medicine Research, University of Western Sydney, Sydney, New South Wales, Australia
| | - S C Li
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
| | - P C Ho
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| |
Collapse
|
21
|
Liu WH, Lok J, Lau MS, Hung YW, Wong CWY, Tse WL, Ho PC. Mechanism and epidemiology of paediatric finger injuries at Prince of Wales Hospital in Hong Kong. Hong Kong Med J 2015; 21:237-42. [PMID: 25953929 DOI: 10.12809/hkmj144344] [Citation(s) in RCA: 7] [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] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To determine the mechanism and epidemiology of paediatric finger injuries in Hong Kong during 2003-2005 and 2010-2012. DESIGN Comparison of two case series. SETTING University-affiliated teaching hospital, Hong Kong. PATIENTS This was a retrospective study of two cohorts of children (age, 0 to 16 years) admitted to Prince of Wales Hospital with finger injuries during two 3-year periods. Comparisons were made between the two groups for age, involved finger(s), mechanism of injury, treatment, and outcome. Telephone interviews were conducted for parents of children who sustained a crushing injury of finger(s) by door. RESULTS A total of 137 children (group A) were admitted from 1 January 2003 to 31 December 2005, and 109 children (group B) were admitted from 1 January 2010 to 31 December 2012. Overall, the mechanisms and epidemiology of paediatric finger injuries were similar between groups A and B. Most finger injuries occurred in children younger than 5 years (group A, 56%; group B, 76%) and in their home (group A, 67%; group B, 69%). The most common mechanism was crushing injury of finger by door (group A, 33%; group B, 41%) on the hinge side (group A, 63%; group B, 64%). The right hand was most commonly involved. The door was often closed by another child (group A, 37%; group B, 23%) and the injury often occurred in the presence of adults (group A, 60%; group B, 56%). Nailbed injury was the commonest type of injury (group A, 31%; group B, 39%). Fractures occurred in 24% and 23% in groups A and B, respectively. Traumatic finger amputation requiring replantation or revascularisation occurred in 12% and 10% in groups A and B, respectively. CONCLUSIONS Crushing injury of finger by door is the most common mechanism of injury among younger children and accounts for a large number of hospital admissions. Serious injuries, such as amputations leading to considerable morbidity, can result. Crushing injury of finger by door occurs even in the presence of adults. There has been no significant decrease in the number of crushing injuries of finger by door in the 5 years between the two studies despite easily available and affordable preventive measures. It is the authors' view that measures aimed at promoting public awareness and education, and safety precautions are needed.
Collapse
Affiliation(s)
- W H Liu
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Johann Lok
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M S Lau
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Y W Hung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Clara W Y Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - W L Tse
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - P C Ho
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
22
|
Kwok SK, Ho PC, Leung SF, Sonal KF. Surgical result of radiation-induced cataract in Chinese patients with nasopharyngeal carcinoma. Dev Ophthalmol 2015; 26:14-8. [PMID: 7895876 DOI: 10.1159/000423757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S K Kwok
- Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital
| | | | | | | |
Collapse
|
23
|
Hung YW, Ko WS, Liu WH, Chow CS, Kwok YY, Wong CWY, Tse WL, Ho PC. Local review of treatment of hand enchondroma (artificial bone substitute versus autologous bone graft) in a tertiary referral centre: 13 years' experience. Hong Kong Med J 2015; 21:217-23. [PMID: 25810024 DOI: 10.12809/hkmj144325] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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
OBJECTIVE To evaluate the treatment outcomes of enchondroma of the hand with artificial bone substitute versus autologous (iliac) bone graft. DESIGN Historical cohort study. SETTING Tertiary referral centre, Hong Kong. PATIENTS A total of 24 patients with hand enchondroma from January 2001 to December 2013 who underwent operation at the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong were reviewed. Thorough curettage of the tumour was performed in all patients, followed by either autologous bone graft impaction under general anaesthesia in 13 patients, or artificial bone substitute in 11 patients (10 procedures were performed under local or regional anaesthesia and 1 was done under general anaesthesia). The functional outcomes and bone incorporation were measured by QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire) scores and radiological appearance, respectively. The mean follow-up period was 59 months. RESULTS There were eight men and 16 women, with a mean age of 40 years. Overall, 17 cases involved phalangeal bones and seven involved metacarpal bones. Among both groups of patients, most of the affected digits had good range of motion and function after surgery. One patient in each study group had complications of local soft tissue inflammation. One patient in the artificial bone substitute group was suspected to have recurrence 8 years after operation. Among the autologous bone graft group, four patients had persistent donor site morbidity at the last follow-up. In all patients, radiographs showed satisfactory bone incorporation. CONCLUSIONS Artificial bone substitute is a safe and effective treatment option for hand enchondroma, with satisfactory functional and radiographic outcomes. Artificial bone substitute offers the additional benefits of enabling the procedure to be done under local anaesthesia on a day-case basis with minimal complications.
Collapse
Affiliation(s)
- Y W Hung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - W S Ko
- Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - W H Liu
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong
| | - C S Chow
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - Y Y Kwok
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong
| | - Clara W Y Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - W L Tse
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - P C Ho
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.,Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| |
Collapse
|
24
|
Yeung TW, Chai J, Li RH, Lee VC, Ho PC, Ng EH. Reply: Endometrial injury and reproductive outcomes: there's more to this story than meets the horse's blind eye. Hum Reprod 2015; 30:749-50. [PMID: 25605702 DOI: 10.1093/humrep/deu366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- T W Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - J Chai
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - R H Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - V C Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| | - E H Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
25
|
Lee VCY, Chow JFC, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Comparison between fluorescent in-situ hybridisation and array comparative genomic hybridisation in preimplantation genetic diagnosis in translocation carriers. Hong Kong Med J 2014; 21:16-22. [PMID: 25345996 DOI: 10.12809/hkmj144222] [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: 11/05/2022] Open
Abstract
OBJECTIVES To compare the pregnancy outcome of the fluorescent in-situ hybridisation and array comparative genomic hybridisation in preimplantation genetic diagnosis of translocation carriers. DESIGN Historical cohort. SETTING A teaching hospital in Hong Kong. PATIENTS All preimplantation genetic diagnosis treatment cycles performed for translocation carriers from 2001 to 2013. RESULTS Overall, 101 treatment cycles for preimplantation genetic diagnosis in translocation were included: 77 cycles for reciprocal translocation and 24 cycles for Robertsonian translocation. Fluorescent in-situ hybridisation and array comparative genomic hybridisation were used in 78 and 11 cycles, respectively. The ongoing pregnancy rate per initiated cycle after array comparative genomic hybridisation was significantly higher than that after fluorescent in-situ hybridisation in all translocation carriers (36.4% vs 9.0%; P=0.010). The miscarriage rate was comparable with both techniques. The testing method (array comparative genomic hybridisation or fluorescent in-situ hybridisation) was the only significant factor affecting the ongoing pregnancy rate after controlling for the women's age, type of translocation, and clinical information of the preimplantation genetic diagnosis cycles by logistic regression (odds ratio=1.875; P=0.023; 95% confidence interval, 1.090-3.226). CONCLUSION This local retrospective study confirmed that comparative genomic hybridisation is associated with significantly higher pregnancy rates versus fluorescent in-situ hybridisation in translocation carriers. Array comparative genomic hybridisation should be the technique of choice in preimplantation genetic diagnosis cycles in translocation carriers.
Collapse
Affiliation(s)
- Vivian C Y Lee
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Judy F C Chow
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Estella Y L Lau
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - William S B Yeung
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Ernest H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| |
Collapse
|
26
|
Lam SC, Hung YW, Chow ECS, Wong CWY, Tse WL, Ho PC. Digital ischaemia: a rare but severe complication of jellyfish sting. Hong Kong Med J 2014; 20:460-3. [DOI: 10.12809/hkmj134155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
27
|
Yeung TWY, Chai J, Li RHW, Lee VCY, Ho PC, Ng EHY. The effect of endometrial injury on ongoing pregnancy rate in unselected subfertile women undergoing in vitro fertilization: a randomized controlled trial. Hum Reprod 2014; 29:2474-81. [DOI: 10.1093/humrep/deu213] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
28
|
Ko JKY, Huang VW, Li RHW, Yeung WSB, Ho PC, Chiu PCN. An in vitro study of the effect of mifepristone and ulipristal acetate on human sperm functions. Andrology 2014; 2:868-74. [PMID: 25168311 DOI: 10.1111/j.2047-2927.2014.00261.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 05/19/2014] [Revised: 07/13/2014] [Accepted: 07/25/2014] [Indexed: 01/11/2023]
Abstract
Ulipristal acetate (UPA) and mifepristone are currently well-established agents for emergency contraception. Both drugs are selective progestogen receptor modulators which have been shown to have better efficacy than the widely used levonorgestrel in prevention of pregnancy. However, there is only limited information on the action of UPA on sperm function. The present study compared the in vitro biological effects of mifepristone and UPA on human sperm functions. Spermatozoa from semen samples with normal semen parameters were isolated. Capacitated spermatozoa were pre-incubated with 0.04, 0.4, 4 and 40 μM mifepristone or UPA for 1 h. Sperm motility, viability, DNA integrity, capacitation, spontaneous acrosome reaction, spontaneous hyperactivation, zona pellucida (ZP) binding capability and intracellular calcium concentration ([Ca(2+)]i) were determined. The effects of mifepristone and UPA on progesterone-induced acrosome reaction, hyperactivation and [Ca(2+)]i were also studied. Our results showed that mifepristone and UPA dose-dependently suppressed progesterone-induced acrosome reaction, hyperactivation and [Ca(2+)]i at concentrations ≥0.4 μM in human spermatozoa. Both compounds did not affect sperm motility, viability, DNA integrity, capacitation, spontaneous acrosome reaction, spontaneous hyperactivation, ZP binding capability and [Ca(2+)]i. This study demonstrated that UPA and mifepristone modulate human sperm functions by acting as progesterone antagonists. The results enable us to gain a better understanding of the mechanisms by which mifepristone and UPA work for emergency contraception, and provide a scientific basis for their clinical application.
Collapse
Affiliation(s)
- J K Y Ko
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | | | | | | | | | | |
Collapse
|
29
|
Chai J, Yeung TWY, Lee VCY, Li RHW, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Live birth rate, multiple pregnancy rate, and obstetric outcomes of elective single and double embryo transfers: Hong Kong experience. Hong Kong Med J 2014; 20:102-6. [PMID: 24531501 DOI: 10.12809/hkmj134065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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
OBJECTIVE To compare the live birth rate, multiple pregnancy rate, and obstetric outcomes of elective single and double embryo transfers. DESIGN Case series with internal comparisons. SETTING University affiliated hospital, Hong Kong. PARTICIPANTS Between October 2009 and December 2011, 206 women underwent their first in-vitro fertilisation cycle. Elective single embryo transfer was offered to women who were aged 35 years or below, and had endometrial thickness of 8 mm or more and at least two embryos of good quality. MAIN OUTCOME MEASURES Live birth rate, multiple birth rate, and obstetric outcomes. RESULTS Among the 206 eligible women, 74 underwent an elective single embryo transfer and 132 a double embryo transfer. The live birth rate was comparable in the two groups, being 39.2% in the elective single embryo transfer group and 43.2% in the double embryo transfer group, while the multiple pregnancy rate was significantly lower in the elective single embryo transfer group than the double embryo transfer group (6.9% vs 40.4%; P<0.001). Gestational ages and birth weights were comparable in the two groups. There was no significant difference between the two groups with respect to the rate of preterm delivery and antenatal complications (27.6% vs 43.9%, respectively; P>0.05). CONCLUSION In this selected population, an elective single embryo transfer policy decreases the multiple pregnancy rate without compromising the live birth rate. The non-significant difference in antenatal complications may be related to the small sample size.
Collapse
Affiliation(s)
- Joyce Chai
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tracy W Y Yeung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Vivian C Y Lee
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Raymond H W Li
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Estella Y L Lau
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - William S B Yeung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - P C Ho
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ernest H Y Ng
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
30
|
Ng AWH, Griffith JF, Taljanovic MS, Li A, Tse WL, Ho PC. Is dynamic contrast-enhanced MRI useful for assessing proximal fragment vascularity in scaphoid fracture delayed and non-union? Skeletal Radiol 2013; 42:983-92. [PMID: 23653220 DOI: 10.1007/s00256-013-1627-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) as a measure of vascularity in scaphoid delayed-union or non-union. MATERIALS AND METHODS Thirty-five patients (34 male, one female; mean age, 27.4 ± 9.4 years; range, 16-51 years) with scaphoid delayed-union and non-union who underwent DCE MRI of the scaphoid between September 2002 and October 2012 were retrospectively reviewed. Proximal fragment vascularity was classified as good, fair, or poor on unenhanced MRI, contrast-enhanced MRI, and DCE MRI. For DCE MRI, enhancement slope, Eslope comparison of proximal and distal fragments was used to classify the proximal fragment as good, fair, or poor vascularity. Proximal fragment vascularity was similarly graded at surgery in all patients. Paired t test and McNemar test were used for data comparison. Kappa value was used to assess level of agreement between MRI findings and surgical findings. RESULTS Twenty-five (71 %) of 35 patients had good vascularity, four (11 %) had fair vascularity, and six (17 %) had poor vascularity of the proximal scaphoid fragment at surgery. DCE MRI parameters had the highest correlation with surgical findings (kappa = 0.57). Proximal scaphoid fragments with surgical poor vascularity had a significantly lower Emax and Eslope than those with good vascularity (p = 0.0043 and 0.027). The sensitivity, specificity, positive and negative predictive value and accuracy of DCE MRI in predicting impaired vascularity was 67, 86, 67, 86, and 80 %, respectively, which was better than that seen with unenhanced and post-contrast MRI. Flattened time intensity curves in both proximal and distal fragments were a feature of protracted non-union with a mean time interval of 101.6 ± 95.5 months between injury and MRI. CONCLUSIONS DCE MRI has a higher diagnostic accuracy than either non-enhanced MRI or contrast enhanced MRI for assessing proximal fragment vascularity in scaphoid delayed-union and non-union. For proper interpretation of contrast-enhanced studies in scaphoid vascularity, one needs to incorporate the time frame between injury and MRI.
Collapse
Affiliation(s)
- Alex W H Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong, SAR, People's Republic of China.
| | | | | | | | | | | |
Collapse
|
31
|
Nazzaro A, Salerno A, Di Iorio L, Landino G, Marino S, Pastore E, Fabregues F, Iraola A, Casals G, Creus M, Peralta S, Penarrubia J, Manau D, Civico S, Balasch J, Lindgren I, Giwercman YL, Celik E, Turkcuoglu I, Ata B, Karaer A, Kirici P, Berker B, Park J, Kim J, Rhee J, Krishnan M, Rustamov O, Russel R, Fitzgerald C, Roberts S, Hapuarachi S, Tan BK, Mathur RS, van de Vijver A, Blockeel C, Camus M, Polyzos N, Van Landuyt L, Tournaye H, Turhan NO, Hizli D, Kamalak Z, Kosus A, Kosus N, Kafali H, Lukaszuk A, Kunicki M, Liss J, Bednarowska A, Jakiel G, Lukaszuk K, Lukaszuk M, Olszak-Sokolowska B, Lukaszuk K, Kunicki M, Liss J, Jakiel G, Bednarowska A, Wasniewski T, Neuberg M, Lukaszuk M, Cavalcanti V, Peluso C, Lechado BL, Cordts EB, Christofolini DM, Barbosa CP, Bianco B, Venetis CA, Kolibianakis EM, Bosdou J, Tarlatzis BC, Onal M, Gungor DN, Acet M, Kahraman S, Kuijper E, Twisk J, Caanen M, Korsen T, Hompes P, Kushnir M, Rockwood A, Meikle W, Lambalk CB, Hizli D, Kamalak Z, Kosus A, Kosus N, Turhan NO, Kafali H, Yan X, Dai X, Wang J, Zhao N, Cui Y, Liu J, Yarde F, Maas AHEM, Franx A, Eijkemans MJC, Drost JT, van Rijn BB, van Eyck J, van der Schouw YT, Broekmans FJM, Martyn F, Anglim B, Wingfield M, Fang T, Yan GJ, Sun HX, Hu YL, Chrudimska J, Krenkova P, Macek M, Macek M, Teixeira da Silva J, Cunha M, Silva J, Viana P, Goncalves A, Barros N, Oliveira C, Sousa M, Barros A, Nelson SM, Lloyd SM, McConnachie A, Khader A, Fleming R, Lawlor DA, Thuesen L, Andersen AN, Loft A, Smitz J, Abdel-Rahman M, Ismail S, Silk J, Abdellah M, Abdellah AH, Ruiz F, Cruz M, Piro M, Collado D, Garcia-Velasco JA, Requena A, Kollmann Z, Bersinger NA, McKinnon B, Schneider S, Mueller MD, von Wolff M, Vaucher A, Kollmann Z, Bersinger NA, Weiss B, Stute P, Marti U, von Wolff M, Chai J, Yeung WYT, Lee CYV, Li WHR, Ho PC, Ng HYE, Kim SM, Kim SH, Jee BC, Ku S, Suh CS, Choi YM, Kim JG, Moon SY, Lee JH, Kim SG, Kim YY, Kim HJ, Lee KH, Park IH, Sun HG, Hwang YI, Sung NY, Choi MH, Cha SH, Park CW, Kim JY, Yang KM, Song IO, Koong MK, Kang IS, Kim HO, Haines C, Wong WY, Kong WS, Cheung LP, Choy TK, Leung PC, Fadini R, Coticchio G, Renzini MM, Guglielmo MC, Brambillasca F, Hourvitz A, Albertini DF, Novara P, Merola M, Dal Canto M, Iza JAA, DePablo JL, Anarte C, Domingo A, Abanto E, Barrenetxea G, Kato R, Kawachiya S, Bodri D, Kondo M, Matsumoto T, Maldonado LGL, Setti AS, Braga DPAF, Iaconelli A, Borges E, Iaconelli C, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Kitaya K, Taguchi S, Funabiki M, Tada Y, Hayashi T, Nakamura Y, Snajderova M, Zemkova D, Lanska V, Teslik L, Calonge RN, Ortega L, Garcia A, Cortes S, Guijarro A, Peregrin PC, Bellavia M, Pesant MH, Wirthner D, Portman L, de Ziegler D, Wunder D, Chen X, Chen SHL, Liu YD, Tao T, Xu LJ, Tian XL, Ye DSH, He YX, Carby A, Barsoum E, El-Shawarby S, Trew G, Lavery S, Mishieva N, Barkalina N, Korneeva I, Ivanets T, Abubakirov A, Chavoshinejad R, Hartshorne GM, Marei W, Fouladi-nashta AA, Kyrkou G, Trakakis E, Chrelias CH, Alexiou E, Lykeridou K, Mastorakos G, Bersinger N, Kollmann Z, Mueller MD, Vaucher A, von Wolff M, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Pellicer A, Turienzo A, Lledo B, Guerrero J, Ortiz JA, Morales R, Ten J, Llacer J, Bernabeu R, De Leo V, Focarelli R, Capaldo A, Stendardi A, Gambera L, Marca AL, Piomboni P, Kim JJ, Choi YM, Kang JH, Hwang KR, Chae SJ, Kim SM, Yoon SH, Ku SY, Kim SH, Kim JG, Moon SY, Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM, Lee HJ, Weghofer A, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Barad DH, Gleicher NN, Shavit T, Shalom-Paz E, Fainaru O, Michaeli M, Kartchovsky E, Ellenbogen A, Gerris J, Vandekerckhove F, Delvigne A, Dhont N, Madoc B, Neyskens J, Buyle M, Vansteenkiste E, De Schepper E, Pil L, Van Keirsbilck N, Verpoest W, Debacquer D, Annemans L, De Sutter P, Von Wolff M, Kollmann Z, Vaucher A, Weiss B, Bersinger NA, Verit FF, Keskin S, Sargin AK, Karahuseyinoglu S, Yucel O, Yalcinkaya S, Comninos AN, Jayasena CN, Nijher GMK, Abbara A, De Silva A, Veldhuis JD, Ratnasabapathy R, Izzi-Engbeaya C, Lim A, Patel DA, Ghatei MA, Bloom SR, Dhillo WS, Colodron M, Guillen JJ, Garcia D, Coll O, Vassena R, Vernaeve V, Pazoki H, Bolouri G, Farokhi F, Azarbayjani MA, Alebic MS, Stojanovic N, Abali R, Yuksel A, Aktas C, Celik C, Guzel S, Erfan G, Sahin O, Zhongying H, Shangwei L, Qianhong M, Wei F, Lei L, Zhun X, Yan W, Vandekerckhove F, De Baerdemaeker A, Gerris J, Tilleman K, Vansteelandt S, De Sutter P, Oliveira JBA, Baruffi RLR, Petersen CG, Mauri AL, Nascimento AM, Vagnini L, Ricci J, Cavagna M, Massaro FC, Pontes A, Franco JG, El-khayat W, Elsadek M, Foroozanfard F, Saberi H, Moravvegi A, Kazemi M, Gidoni YS, Raziel A, Friedler S, Strassburger D, Hadari D, Kasterstein E, Ben-Ami I, Komarovsky D, Maslansky B, Bern O, Ron-El R, Izquierdo MP, Ten J, Guerrero J, Araico F, Llacer J, Bernabeu R, Somova O, Feskov O, Feskova I, Bezpechnaya I, Zhylkova I, Tishchenko O, Oguic SK, Baldani DP, Skrgatic L, Simunic V, Vrcic H, Rogic D, Juras J, Goldstein MS, Garcia De Miguel L, Campo MC, Gurria A, Alonso J, Serrano A, Marban E, Peregrin PC, Hourvitz A, Shalev L, Yung Y, Yerushalmi G, Giovanni C, Dal Canto M, Fadini R, Has J, Maman E, Monterde M, Gomez R, Marzal A, Vega O, Rubio JM, Diaz-Garcia C, Pellicer A, Eapen A, Datta A, Kurinchi-selvan A, Birch H, Lockwood GM, Ornek MC, Ates U, Usta T, Goksedef CP, Bruszczynska A, Glowacka J, Kunicki M, Jakiel G, Wasniewski T, Jaguszewska K, Liss J, Lukaszuk K, Oehninger S, Nelson S, Verweij P, Stegmann B, Ando H, Takayanagi T, Minamoto H, Suzuki N, Maman E, Rubinshtein N, Yung Y, Shalev L, Yerushalmi G, Hourvitz A, Saltek S, Demir B, Dilbaz B, Demirtas C, Kutteh W, Shapiro B, Witjes H, Gordon K, Lauritsen MP, Loft A, Pinborg A, Freiesleben NL, Mikkelsen AL, Bjerge MR, Andersen AN, Chakraborty P, Goswami SK, Chakravarty BN, Mittal M, Bajoria R, Narvekar N, Chatterjee R, Bentzen JG, Johannsen TH, Scheike T, Andersen AN, Friis-Hansen L, Sunkara S, Coomarasamy A, Faris R, Braude P, Khalaf Y, Makedos A, Kolibianakis EM, Venetis CA, Masouridou S, Chatzimeletiou K, Zepiridis L, Mitsoli A, Lainas G, Sfontouris I, Tzamtzoglou A, Kyrou D, Lainas T, Tarlatzis BC, Fermin A, Crisol L, Exposito A, Prieto B, Mendoza R, Matorras R, Louwers Y, Lao O, Kayser M, Palumbo A, Sanabria V, Rouleau JP, Puopolo M, Hernandez MJ, Diaz-Garcia C, Monterde M, Marzal A, Vega O, Rubio JM, Gomez R, Pellicer A, Ozturk S, Sozen B, Yaba-Ucar A, Mutlu D, Demir N, Olsson H, Sandstrom R, Grundemar L, Papaleo E, Corti L, Rabellotti E, Vanni VS, Potenza M, Molgora M, Vigano P, Candiani M, Andersen AN, Fernandez-Sanchez M, Bosch E, Visnova H, Barri P, Garcia-Velasco JA, De Sutter P, Fauser BJCM, Arce JC, Sandstrom R, Olsson H, Grundemar L, Peluso P, Trevisan CM, Cordts EB, Cavalcanti V, Christofolini DM, Fonseca FA, Barbosa CP, Bianco B, Bakas P, Vlahos N, Hassiakos D, Tzanakaki D, Gregoriou O, Liapis A, Creatsas G, Adda-Herzog E, Steffann J, Sebag-Peyrelevade S, Poulain M, Benachi A, Fanchin R, Gordon K, Zhang D, Andersen AN, Aybar F, Temel S, Kahraman S, Hamdine O, Macklon NS, Eijkemans MJC, Laven JS, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom CAG, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Broekmans FJ, Bhattacharya J, Mitra A, Dutta GB, Kundu A, Bhattacharya M, Kundu S, Pigny P, Dassonneville A, Catteau-Jonard S, Decanter C, Dewailly D, Pouly J, Olivennes F, Massin N, Celle M, Caizergues N, Fleming R, Gaudoin M, Messow M, McConnachie A, Nelson SM, Dewailly D, Vanhove L, Peigne M, Thomas P, Robin G, Catteau-Jonard S. Reproductive endocrinology. Hum Reprod 2013. [DOI: 10.1093/humrep/det221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
32
|
Chan CHY, Chan CLW, Ng EHY, Ho PC, Chan THY, Lee GL, Hui WHC. Incorporating spirituality in psychosocial group intervention for women undergoing in vitro fertilization: a prospective randomized controlled study. Psychol Psychother 2012; 85:356-73. [PMID: 23080528 DOI: 10.1111/j.2044-8341.2011.02040.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [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: 11/30/2022]
Abstract
OBJECTIVES This study examined the efficacy of a group intervention, the Integrative Body-Mind-Spirit (I-BMS) intervention, which aims at improving the psychosocial and spiritual well-being of Chinese women undergoing their first IVF treatment cycle. DESIGN The I-BMS intervention facilitates the search of meaning of life in the context of family and childbearing, as well as the letting go of high IVF expectations. A randomized controlled study of 339 women undergoing first IVF treatment cycle in a local Hong Kong hospital was conducted (intervention: n= 172; no-intervention control: n= 167). METHODS Assessments of anxiety, perceived importance of childbearing, and spiritual well-being were made at randomization (T(0) ), on the day starting ovarian stimulations (T(1)), and on the day undertaking embryo transfer (T(2)). RESULTS Comparing T(0) and T(2), interaction analyses showed women who had received the intervention reported lower levels of physical distress, anxiety, and disorientation. They reported being more tranquil and satisfied with their marriage, and saw childbearing as less important compared to women in the control group. CONCLUSIONS These findings suggest that I-BMS intervention was successful at improving the psychosocial and spiritual well-being of women undergoing their first IVF treatment cycle. This study highlights the importance of providing integrative fertility treatment that incorporates psychosocial and spiritual dimensions.
Collapse
Affiliation(s)
- Celia H Y Chan
- Department of Social Work and Social Administration, University of Hong Kong, China.
| | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
UNLABELLED Purpose wrist arthroscopy is typically performed under general or regional anesthesia with the aid of a tourniquet to maintain a bloodless field. We have been using portal site local anesthesia (PSLA) for wrist arthroscopy without a tourniquet since 1998. The aim of the study was to assess the efficacy, safety, and complications of PSLA and whether this can be recommended for routine wrist arthroscopy. Method We conducted a retrospective study, identifying 111 consecutive cases of wrist arthroscopies performed from January 2007 to December 2009. All cases were performed under PSLA. The effectiveness of PSLA was assessed by analyzing whether the procedure required adjuvant forms of anesthesia. The subjective effectiveness was assessed via phone questionnaires. Results Sixty-eight male and 43 female patients were identified. The average age was 43.2 (range 16-77). The indications included chronic wrist pain of unknown origin (30), posttraumatic arthritis (27), rheumatoid arthritis (5), ganglion (30), triangular fibrocartilage complex (TFCC) injury (14), infectious (1), and carpal instability (4). The average duration of the procedures was 73 minutes (range 20-255 minutes). Therapeutic procedures were performed in all 111 cases in addition to a routine diagnostic assessment. These included arthroscopic debridement (82) synovectomy (6), ganglionectomy (30), TFCC repair (3), TFCC debridement (11), radial styloidectomy (2), wafer procedure (4), thermal shrinkage (2), distal scaphoidectomy (1), and synovial biopsy (4). All procedures could be completed uneventfully. Most patients tolerated the procedure well throughout the operation, and the satisfaction level was high. No complication was encountered. Discussions We concluded that PSLA technique is a feasible mode of anesthesia in selected patients. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Michael T. Y. Ong
- Department of Orthopaedic and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin SAR, Hong Kong
| | - P. C. Ho
- Department of Orthopaedic and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin SAR, Hong Kong
| | - Clara W. Y. Wong
- Department of Orthopaedic and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin SAR, Hong Kong
| | - Sally H. S. Cheng
- Department of Orthopaedic and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin SAR, Hong Kong
| | - Wing- Lim Tse
- Department of Orthopaedic and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin SAR, Hong Kong
| |
Collapse
|
34
|
Lee VCY, Yeung TWY, Tang OS, Ng EHY, Yeung WSB, Ho PC. Effect of letrozole on uterine artery Doppler flow indices prior to first-trimester termination of pregnancy: a randomized controlled trial. Ultrasound Obstet Gynecol 2012; 40:392-397. [PMID: 22302719 DOI: 10.1002/uog.11115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE We previously demonstrated that a sequential regimen of letrozole and misoprostol resulted in a marked reduction in the serum estradiol concentration and in a higher efficacy of first-trimester termination of pregnancy than misoprostol alone. The aim of this study was to evaluate the effect of letrozole on uterine artery Doppler flow indices during early pregnancy. METHODS This was a randomized controlled trial. Thirty women requesting termination of pregnancy up to 63 days' gestation were randomized into two groups: a letrozole group receiving 10 mg of letrozole, daily, for 3 days, and a control group receiving a placebo for 3 days. Serum estradiol, progesterone and human chorionic gonadotropin (hCG) concentrations were measured before drug administration and then daily for 6 days. Ultrasound scanning for fetal viability and measurement of the pulsatility (PI) and resistance (RI) indices of the uterine arteries was performed before drug administration, and then on day 3 and day 7 after starting letrozole or placebo. All pregnancies were terminated by surgical evacuation on day 7 or day 8. RESULTS Uterine artery PI and RI decreased significantly in the letrozole group, but not in the control group. Serum estradiol concentrations were significantly lower in the letrozole group than in the control group from day 2 onwards. Serum progesterone and hCG concentrations were comparable for the two groups throughout the 7 days. There were significantly more women in the letrozole group with vaginal bleeding. CONCLUSION We have demonstrated that the use of letrozole in the first trimester of pregnancy suppresses serum estradiol levels but results in an increase in blood flow to the uterus. Further studies should be carried out to elucidate the mechanism of letrozole pretreatment in medical abortion.
Collapse
Affiliation(s)
- V C Y Lee
- Department of Obstetrics & Gynecology, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
The treatment of hypoplastic thumb (modified Blauth's type IIIb and IV) by pollicization is culturally unfavourable in the Chinese population and digit preservation is preferred. An innovative reconstruction method using a nonvascularized hemi-longitudinal metatarsal graft was performed in six cases with an average follow-up of 87.7 months. Overall hand function was good, as assessed using the Jebsen hand function test. Grip strength and pinch power were significantly weaker than the normal contralateral hand. There was no neurovascular or wound complication. The only donor site complication was a metatarsal fracture, which healed uneventfully with casting. There had been no permanent morbidity to the donor site, as all donor metatarsals hypertrophied and regained normal growth potentials. Linear growth of the transferred metatarsals was evident radiologically (average 1.5 mm/year). Free hemi-longitudinal metatarsal transfer is a feasible method with good functional outcome in the attainment of a 5-digit hand in patients with type IIIb/IV hypoplastic thumb.
Collapse
Affiliation(s)
- C S Chow
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong SAR.
| | | | | | | |
Collapse
|
36
|
Chen ACH, Lee YL, Hou DYC, Fong SW, Peng Q, Pang RTK, Chiu PCN, Ho PC, Lee KF, Yeung WSB. Study of transforming growth factor alpha for the maintenance of human embryonic stem cells. Cell Tissue Res 2012; 350:289-303. [PMID: 22864984 PMCID: PMC3480587 DOI: 10.1007/s00441-012-1476-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 12/15/2011] [Accepted: 06/25/2012] [Indexed: 11/28/2022]
Abstract
Human embryonic stem cells (hESCs) have great potential for regenerative medicine as they have self-regenerative and pluripotent properties. Feeder cells or their conditioned medium are required for the maintenance of hESC in the undifferentiated state. Feeder cells have been postulated to produce growth factors and extracellular molecules for maintaining hESC in culture. The present study has aimed at identifying these molecules. The gene expression of supportive feeder cells, namely human foreskin fibroblast (hFF-1) and non-supportive human lung fibroblast (WI-38) was analyzed by microarray and 445 genes were found to be differentially expressed. Gene ontology analysis showed that 20.9% and 15.5% of the products of these genes belonged to the extracellular region and regulation of transcription activity, respectively. After validation of selected differentially expressed genes in both human and mouse feeder cells, transforming growth factor α (TGFα) was chosen for functional study. The results demonstrated that knockdown or protein neutralization of TGFα in hFF-1 led to increased expression of early differentiation markers and lower attachment rates of hESC. More importantly, TGFα maintained pluripotent gene expression levels, attachment rates and pluripotency by the in vitro differentiation of H9 under non-supportive conditions. TGFα treatment activated the p44/42 MAPK pathway but not the PI3K/Akt pathway. In addition, TGFα treatment increased the expression of pluripotent markers, NANOG and SSEA-3 but had no effects on the proliferation of hESCs. This study of the functional role of TGFα provides insights for the development of clinical grade hESCs for therapeutic applications.
Collapse
Affiliation(s)
- Andy C H Chen
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Lo SST, Ho PC. The profile of women who seek emergency contraception from the family planning service. Hong Kong Med J 2012; 18:299-303. [PMID: 22865173] [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. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were satisfactory.
Collapse
Affiliation(s)
- Sue S T Lo
- The Family Planning Association of Hong Kong, 10/F, 130 Hennessy Road, Wanchai, Hong Kong.
| | | |
Collapse
|
38
|
Chow CS, Hung LK, Chiu CP, Lai KL, Lam LN, Ng ML, Tam KC, Wong KC, Ho PC. IS SYMPTOMATOLOGY USEFUL IN DISTINGUISHING BETWEEN CARPAL TUNNEL SYNDROME AND CERVICAL SPONDYLOSIS? ACTA ACUST UNITED AC 2012; 10:1-5. [PMID: 16106494 DOI: 10.1142/s0218810405002425] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2004] [Accepted: 01/25/2005] [Indexed: 11/18/2022]
Abstract
Hand paraesthesia is a common symptom found in patients either with carpal tunnel syndrome or cervical spondylosis. To differentiate between the two conditions, it is important to identify additional diagnostic symptoms. Ninety-two patients with operated carpal tunnel syndrome and 138 patients with spinal surgery for cervical spondylosis were reviewed. After exclusion of cases co-morbid with both cervical spondylosis and carpal tunnel syndrome or other neurological disorders, 44 patients with carpal tunnel syndrome and 41 patients with cervical spondylosis were compared. There were significant differences in the symptomatology between the two groups. In carpal tunnel syndrome, 84% had nocturnal paraesthesia, 82% hand paraesthesia were aggravated by hand activity, and hand pain occurred in 64%. The incidences were only 10%, 7% and 10%, respectively in cervical spondylosis. Neck pain was present in 76% of cervical spondylosis but only in 14% of carpal tunnel syndrome, and lower limb symptoms were present in 44% of cervical spondylosis and only 9% in carpal tunnel syndrome.
Collapse
Affiliation(s)
- C S Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Ray PF, Pierre V, Martinez G, Coutton C, Delaroche J, Novella C, Pernet-Gallay K, Hennebicq S, Arnoult C, Rivera R, Meseguer M, Romany L, Pellicer A, Remohi J, Garrido N, Ozturk S, Kayisli-Guzeloglu O, Sozen B, Demir N, Ilbay O, Lalioti DM, Seli E, Chiu PCN, Lee CL, Zhao W, Huang VWX, Lam KKW, Ho PC, Yeung WSB, Subramani E, Basu H, Chattopadhyay R, Mathur D, Chakravarty BN, Chaudhury K, Alhalabi M, Samawi S, Khalaf M, Khatib A, Sharif J, Hamad W, Othman A, Breznik B, Kovacic B, Vlaisavljevic B. SESSION 72: CLINICAL AND BASIC ANDROLOGY 2. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.70] [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: 11/13/2022] Open
|
40
|
Li RHW, Gebbie AE, Wong RWS, Ng EHY, Glasier AF, Ho PC. The use of sex hormones in women with rheumatological diseases. Hong Kong Med J 2011; 17:487-491. [PMID: 22147320] [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: 05/31/2023] Open
Abstract
A number of rheumatological diseases predominantly affect women of reproductive age. There has always been concern that the use of oestrogen-containing agents such as combined hormonal contraception and hormone therapy might aggravate these conditions. This article reviews the up-to-date evidence regarding the safety of using these agents in women with various rheumatological diseases, with emphasis on systemic lupus erythematosus and rheumatoid arthritis. In the absence of antiphospholipid antibody or other prothrombotic risk factors, combined hormonal contraception is not contra-indicated in most rheumatological conditions including inactive systemic lupus erythematosus. Moreover, hormone therapy is generally not contra-indicated except for women with active systemic lupus erythematosus disease where its effect on disease flare is less clear and individual judgement is required.
Collapse
Affiliation(s)
- Raymond H W Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
| | | | | | | | | | | |
Collapse
|
41
|
Cheng HS, Hung LK, Ho PC, Wong J. AN ANALYSIS OF CAUSES AND TREATMENT OUTCOME OF CHRONIC WRIST PAIN AFTER DISTAL RADIAL FRACTURES. ACTA ACUST UNITED AC 2011; 13:1-10. [PMID: 18711777 DOI: 10.1142/s0218810408003748] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 02/28/2008] [Indexed: 11/18/2022]
Abstract
Healed distal radial fractures are frequently complicated by chronic wrist pain which is multifactorial and can be debilitating. An accurate delineation of the pathoanatomy is the key for successful treatment. This study reviewed 22 patients who had surgical treatment between 1997 and 2001 for chronic wrist pain after distal radial fracture. Four patterns of pathoanatomy were identified: (1) ulnar impaction caused by radial malunion and shortening; (2) ulnar styloid non-union; (3) triangular fibrocartilage complex (TFCC) tears with or without distal radioulnar joint (DRUJ) instability; and (4) intercarpal ligament injuries and chondral lesions. Surgical treatment directed towards identified abnormalities gave satisfactory outcome. At six months after surgery the mean functional score improved 36%, mean pain score decreased 50%, mean grip strength improved 25%, and 64% of patients returned to work.
Collapse
Affiliation(s)
- H. S. Cheng
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, P. R. China
| | - L. K. Hung
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, P. R. China
| | - P. C. Ho
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, P. R. China
| | - J. Wong
- Department of Occupational Therapy, Prince of Wales Hospital, The Chinese University of Hong Kong, P. R. China
| |
Collapse
|
42
|
Chan WL, Hung LK, Griffith JF, Louis TCC, Ho PC. TENOSYNOVIAL OSTEOCHONDROMATOSIS OF BOTH FLEXOR AND EXTENSOR TENDONS. ACTA ACUST UNITED AC 2011; 9:89-95. [PMID: 15368633 DOI: 10.1142/s0218810404001991] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2003] [Accepted: 12/02/2003] [Indexed: 11/18/2022]
Abstract
An unusual case of a 52-year-old woman with tenosynovial osteochondromatosis involving both of the wrist flexor and extensor tendons is reported.
Collapse
Affiliation(s)
- W L Chan
- Department of Orthopaedic and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | | | | |
Collapse
|
43
|
Abstract
We report a rare case of self-injection of mercury into the subcutaneous tissue of the upper limb. A multi-disciplinary management approach was adopted including cooperation between toxicologists, orthopaedic surgeons, radiologists and environment safety personnel. Surgical removal of mercury under radiological screening and systemic intoxication treated by chelating agents, namely dimercaprol and succimer. Serial serum and urine mercury levels showed an initial rise despite surgical removal and returned to normal after a prolonged period of time. Safety precautions were taken during surgery to avoid inadvertent intoxication of staff. Contamination of the operation theatre was monitored by the amount of mercury vapour released into the air. All personnels involved in the management of the patient did not show any evidence of mercury intoxication.
Collapse
Affiliation(s)
- F Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | | | | | | |
Collapse
|
44
|
Hung YT, Hung LK, Griffith JF, Wong CH, Ho PC. ULTRASOUND FOR THE DETECTION OF VEGETATIVE FOREIGN BODY IN HAND — A CASE REPORT. Hand Surg 2011; 9:83-7. [PMID: 15368632 DOI: 10.1142/s021881040400198x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2003] [Accepted: 12/02/2003] [Indexed: 11/18/2022]
Abstract
Foreign bodies in soft tissues are commonly encountered in daily orthopaedic practice. While most of the metals and glass foreign bodies can be detected by plain radiograph, organic substances such as wood and vegetative materials are radiolucent. Unfortunately, these radiolucent foreign bodies are usually more prone to cause an inflammatory reaction and infection. The detection can be even more difficult in cases of multiple foreign bodies and in penetrating injuries with small innocuous skin wounds. Ultrasonography is a sensitive and reliable investigation for detection of foreign bodies in soft tissue. We present a case of penetration injury to thumb with residual radiolucent foreign bodies and demonstrate the proper role of ultrasonography in the management of foreign bodies in soft tissues.
Collapse
Affiliation(s)
- Y T Hung
- Department of Orthopaedic and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | | | | | | | | |
Collapse
|
45
|
Lee VCY, Yung SSF, Li RHW, Watzer B, Schweer H, Ng EHY, Ho PC. A randomized comparison of pharmacokinetics of a single vaginal dose of dry misoprostol or misoprostol moistened with normal saline or with acetic acid. Hum Reprod 2011; 26:2981-7. [DOI: 10.1093/humrep/der303] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
46
|
Nema T, Chan ECY, Ho PC. Efficiency of a miniaturized silica monolithic cartridge in reducing matrix ions as demonstrated in the simultaneous extraction of morphine and codeine from urine samples for quantification with liquid chromatography-tandem mass spectrometry (LC-MS/MS). J Mass Spectrom 2011; 46:891-900. [PMID: 21915953 DOI: 10.1002/jms.1966] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Presence of matrix ions could negatively affect the sensitivity and selectivity of liquid chromatography-tandem mass spectrometer (LC-MS/MS). In this study, the efficiency of a miniaturized silica monolithic cartridge in reducing matrix ions was demonstrated in the simultaneous extraction of morphine and codeine from urine samples for quantification with LC-MS. The miniaturized silica monolith with hydroxyl groups present on the largely exposed surface area function as a weak cation exchanger for solid phase extraction (SPE). The miniaturized silica cartridge in 1 cm diameter and 0.5 cm length was housed in a 2-ml syringe fixed over a SPE vacuum manifold for extraction. The cleaning effectiveness of the cartridge was confirmed by osmometer, atomic absorption spectrometer, LC-MS and GC-TOFMS. The drugs were efficiently extracted from urine samples with recoveries ranging from 86% to 114%. The extracted analytes, after concentration and reconstitution, were quantified using LC-MS/MS. The limits of detection for morphine and codeine were 2 ng/ml and 1 ng/mL, respectively. The relative standard deviations of measurements ranged from 3% to 12%. The monolithic sorbent offered good linearity with correlation coefficients > 0.99, over a concentration range of 50-500 ng/ml. The silica monolithic cartridge was found to be more robust than the particle-based packed sorbent and also the commercial cartridge with regards to its recyclability and repeated usage with minimal loss in efficiency. Our study demonstrated the efficiency of the miniaturized silica monolith for removal of matrix ions and extraction of drugs of abuse in urinary screening.
Collapse
Affiliation(s)
- T Nema
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543
| | | | | |
Collapse
|
47
|
Abstract
The peculiar shape of scaphoid hinders a precise evaluation of its fracture configuration, displacement and accuracy of screw placement. Its tenuous vascular supply risks the complications of delayed union, nonunion and avascular necrosis. Scaphoid is the focus of ligamentous attachment governing carpal kinematics. Preservation of its anatomy and vascularity is critical for normal wrist function. A new fracture classification clearly denoting every fracture type and guiding the management is introduced. The minimal invasive management of different scaphoid fracture conditions, including acute non-displaced and displaced fracture, delayed presentation, and nonunion are discussed. Role of arthroscopy is emphasized. Detailed surgical techniques are shared here.
Collapse
Affiliation(s)
- W Y Clara Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong
| | | |
Collapse
|
48
|
Abstract
Arthroscopic surgery has become the gold standard for the diagnosis and treatment of major joint disorders. With advancement in arthroscopic technique, arthroscopy has become feasible in most human joints, even those as small as the finger joints. The metacarpophalangeal joint (MCPJ) can become spacious with simple traction, the intra-articular anatomy is simple, and its major structures can be easily visualized and identified. However, MCPJ arthroscopy has never been popular. This article describes our experience with MCPJ arthroscopy and seeks to establish its role in clinical practice.
Collapse
Affiliation(s)
- Alexander K Y Choi
- Department of Orthopaedics & Traumatology, Tuen Mun Hospital, 23 Tsing Tsun Koon Road, Tuen Mun, NT, Hong Kong SAR, China.
| | | | | | | |
Collapse
|
49
|
Yeung YK, Ho ST, Yen CH, Ho PC, Tse WL, Lau YK, Choi KY, Choi ST, Lam MMY, Cheng SHS, Wong TC. Factors affecting mortality in Hong Kong patients with upper limb necrotising fasciitis. Hong Kong Med J 2011; 17:96-104. [PMID: 21471588] [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: 05/30/2023] Open
Abstract
OBJECTIVE To identify predictive factors for mortality of patients with upper limb necrotising fasciitis. DESIGN Retrospective study. SETTING Six hospitals in Hong Kong. PATIENTS Clinical records of 29 patients treated in the hospitals were traced and analysed. MAIN OUTCOME MEASURES Possible predictive factors for mortality as evaluated by application of Fisher's test. RESULTS Overall mortality was 28%. Digital infections conferred a lower mortality, but progressive necrosis necessitated amputation. Vibrio vulnificus was the commonest organism identified in association with marine injury and in patients with cirrhosis. Prognostic indicators with decreasing significance include deranged renal and liver function, thrombocytopaenia, proximal involvement (elbow or above) initially, and presence of hypotension upon admission. CONCLUSION With a P value of less than 0.05, deranged renal and liver function, thrombocytopaenia, initial proximal involvement, and hypotension on admission were predictors of mortality in necrotising fasciitis affecting the upper limbs. The ALERTS (Abnormal Liver function, Extent of infection, Renal impairment, Thrombocytopenia, and Shock) score with a cutoff of 3 appeared to predict mortality.
Collapse
Affiliation(s)
- Y K Yeung
- Department of Orthopaedics, Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
The concept of temporary aortic valves has been suggested in the clinical settings of acute aortic regurgitation and transcatheter aortic valve replacement procedure (TAVR). In TAVR, suggestions have been made to pre-treat or remove the diseased aortic valve prior to implantation of the replacement valve. A successful temporary aortic valve must demonstrate the ability to prevent life-threatening haemodynamics of massive aortic regurgitation. A novel temporary aortic valve (TAV) design, comprised of inflatable balloon elements as a check-valve, can readily be deployed and retrieved via a catheter-system. A simple flow model is set up to test the TAV's performance in severe aortic regurgitation. With induced aortic regurgitation, placement of the TAV is found to increase the distal aortic diastolic pressure, to reduce the widened pulse pressure, to protect proximal aorta-left ventricle from diastolic pressure elevation and to reduce the aortic regurgitant volume. In conclusion, continued development of the TAV system can lead to a successful temporary aortic valve to be used in various appropriate clinical settings.
Collapse
Affiliation(s)
- P C Ho
- HOCOR Cardiovascular Technologies, LLC, 88 Piikoi Street, Suite 3903, Honolulu, HI 96814, USA.
| |
Collapse
|