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Chan NH, Lee SY, Cheng NHY, Wong HY, Lo WK, Lung DC. Hospital infection control best practice: Five essential elements to successfully minimize healthcare-associated COVID-19. Infect Prev Pract 2020; 3:100110. [PMID: 34316572 PMCID: PMC7837126 DOI: 10.1016/j.infpip.2020.100110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/10/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- N H Chan
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - S Y Lee
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - N H Y Cheng
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - H Y Wong
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - W K Lo
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - D C Lung
- Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.,Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
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So MH, Lo WK. Giant perivascular spaces: an uncommon cause of obstructive hydrocephalus. Hong Kong Med J 2020; 25:491.e1-491.e2. [PMID: 32127504 DOI: 10.12809/hkmj197964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M H So
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yaumatei, Hong Kong
| | - W K Lo
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Yaumatei, Hong Kong
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Lo WK, Mahboobani NR, Siu Y. Gastrointestinal: Phlebosclerotic colitis: A rare but increasingly recognized cause of ischemic colitis with telltale imaging features. J Gastroenterol Hepatol 2017; 32:1792. [PMID: 29024011 DOI: 10.1111/jgh.13741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- W K Lo
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
| | - N R Mahboobani
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - Ywd Siu
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong
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Chen JY, Choi EPH, Wan EYF, Chan AKC, Tsang JPY, Chan KHY, Lo WK, Lui SL, Chu WL, Lam CLK. Validation of the Disease-Specific Components of the Kidney Disease Quality of Life-36 (KDQOL-36) in Chinese Patients Undergoing Maintenance Dialysis. PLoS One 2016; 11:e0155188. [PMID: 27148742 PMCID: PMC4858254 DOI: 10.1371/journal.pone.0155188] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 04/25/2016] [Indexed: 01/22/2023] Open
Abstract
AIM The aim of this study was to evaluate the validity, reliability and sensitivity of the disease-specific items of the Kidney Disease Quality of Life-36 (KDQOL-36) in Chinese patients undergoing maintenance dialysis. METHODS The content validity was assessed by content validity index (CVI) in ten subjects. 356 subjects were recruited for pilot psychometric testing. The internal construct validity was assessed by corrected item-subscale total correlation. Confirmatory factor analysis (CFA) was used to confirm the factor structure. The convergent validity was assessed by Pearson's correlation test between the disease specific subscale scores and SF-12 version 2 Health Survey (SF-12 v2) scores. The reliability was assessed by the internal consistency (Cronbach's Alpha coefficient) and 2-week test-retest reliability (intraclass correlation coefficient (ICC)). The sensitivity was determined by performing known group comparisons by independent t-test. RESULTS The CVI on clarity and relevance was ≥ 0.9 for all items. Corrected item- total correlation scores were ≥0.4 for all, except an item related to problems with access site. CFA confirmed the 3-factor structure of the disease-specific component of the KDQOL-36. The correlation coefficients between the disease-specific domain scores and the SF-12 v2 physical and mental component summary scores ranged from 0.328 to 0.492. The reliability was good (Cronbach's alpha coefficients ranged from 0.810 to 0.931, ICC ranged from 0.792 to 0.924). Only the effect subscale was sensitive in detecting differences in HRQOL between haemodialysis and peritoneal dialysis patients, with effect size = 0.68. CONCLUSION The disease-specific items of the KDQOL-36 are a valid, reliable and sensitive measure to assess the health-related quality of life of Chinese patients on maintenance dialysis.
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Affiliation(s)
- Julie Y. Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong
| | - Edmond P. H. Choi
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Eric Y. F. Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong
| | - Anca K. C. Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong
| | - Joyce P. Y. Tsang
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong
| | - Karina H. Y. Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong
| | - W. K. Lo
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - S. L. Lui
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - W. L. Chu
- Renal Unit, Tung Wah Hospital, Pokfulam, Sheung Wan, Hong Kong
| | - Cindy L. K. Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong
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Cheuk YY, Lo WK, Chan SK, Wong CW. Pancreatic Neuroendocrine Tumour Causing Chronic Diarrhoea: Radiological-Pathological Correlations. Hong Kong J Radiol 2014. [DOI: 10.12809/hkjr1412150] [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
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Ma MKM, Yap DYH, Yip TPS, Lui SL, Lo WK. Staphylococcus aureus peritonitis in two peritoneal dialysis patients: an uncommon complication of peripheral intravenous catheter infection. Perit Dial Int 2012; 32:573-4. [PMID: 22991021 DOI: 10.3747/pdi.2011.00293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Liu J, Liu J, Liu Y, Xu Y, Zhao X, Qian J, Sun B, Xing C, Kanda R, Hamada C, Nakano T, Wakabayashi K, Io H, Horikoshi S, Tomino Y, Ishimatsu N, Miyamoto T, Morimoto H, Nakamata J, Baba R, Kanegae K, Serino R, Kabashima N, Otsuji Y, Doi Y, Tamura M, Nakamata J, Morimoto H, Baba R, Ishimatsu N, Miyamoto T, Kanegae K, Serino R, Kabashima N, Otsuji Y, Doi Y, Tamura M, Kusumoto T, Fukami K, Yamagishi SI, Ueda S, Kaida Y, Hazama T, Nakayama Y, Ando R, Obara N, Okuda S, Tamura M, Matsumoto M, Miyamoto T, Kanegae K, Furuno Y, Serino R, Kabashima N, Otsuji Y, Bang-Gee H, Mazzotta L, Rosati A, Carlini A, Henriques VT, Zangiacomi Martinez E, Divino-Filho JC, Pecoits-Filho R, Cardeal Da Costa JA, Henriques VT, Henriques VT, Gama Axelsson T, Lindholm B, Carrero JJ, Heimburger O, Stenvinkel P, Qureshi AR, Akazawa M, Uno T, Kanda E, Maeda Y, Aktsiali M, Aktsiali M, Antonopoulou S, Tsiolaki K, Bakirtzi N, Patrinou A, Georgopoulou M, Liaveri P, Afentakis N, Tsirpanlis G, Hasegawa T, Nishiwaki H, Hirose M, Komukai D, Tayama H, Koiwa F, Yoshimura A, Lui SL, Lui S, Yung S, Tang C, Ng F, Lo WK, Chan TM, Koo HM, Doh FM, Yoo DE, Oh HJ, Yoo TH, Choi KH, Kang SW, Han DS, Han SH, Fernandes N, Fernandes N, Bastos MG, Gianotti Franco MR, Chaoubah A, Gloria Lima MD, Pecoits-Filho R, Divino-Filho JC, Qureshi AR, Kang S, Do J, Cho K, Park J, Yoon K, Chen JB, Cheng BC, Chen TC, Su YJ, Wu CH, Park Y, Jeon J, Tsikeloudi M, Pateinakis P, Patsatsi K, Manou E, Sotiriadis D, Tsakiris D, Teixeira L, Rodrigues A, Carvalho MJ, Cabrita A, Mendonca D, Kang S, Do J, Park J, Cho K, Yoon K, Bruschi M, Candiano G, Santucci L, Luzio S, Cannavo R, Ghiggeri GM, Verrina E, Varadarajan Y, Raju B, Cho KH, Do J, Kang S, Park JW, Yoon KW, Kim TW, Kimmel M, Braun N, Latus J, Alscher MD, Struijk D, Van Esch S, Krediet RT, Fernandes N, Van den Beukel T, Hoekstra T, Tirapani L, De Andrade Bastos K, Pecoits-Filho R, Qureshi AR, Bastos M, Dekker F, Divino-Filho JC, Yasuhisa T, Kanai H, Harada K, Kawai Y, Sugiyama H, Ito Y, Tsuruya K, Yoshida H, Maruyama H, Goto S, Nakayama M, Nakamoto H, Morinaga H, Matsuo S, Makino H, DI Gioia MC, Gallar P, Laso N, Rodriguez I, Cobo G, Oliet A, Hynostroza J, Herrero JC, Mon C, Ortiz M, Vigil A, Tomo T, Portoles J, Uta S, Uta S, Tato AM, Lopez-Sanchez P, Rivera M, Rodriguez-Pena R, Del Peso G, Ortega M, Felipe C, Tsampikaki E, Aperis G, Kaikis A, Paliouras C, Karvouniaris N, Maragaki M, Alivanis P, Kortus-Gotze B, Hoferhusch T, Hoyer J, Martino F, Kaushik M, Rodighiero MP, Creapldi C, Ronco C, Lacquaniti A, Lacquaniti A, Donato V, Fazio MR, Lucisano S, Cernaro V, Lupica R, Buemi M, Aloisi C, Uno T, Akazawa M, Kanda E, Maeda Y, Bavbek Ruzgaresen N, Secilmis S, Yilmaz H, Akcay A, Duranay M, Akalin N, Akalin N, Altiparmak MR, Trabulus S, Yalin AS, Ataman R, Serdengecti K, Schneider K, Bator B, Niko B, Braun N, Peter F, Ulmer C, Joerg L, Martin K, Dagmar B, German O, Fabian R, Juergen D, Stephan S, Dominik A, Latus J, Latus J, Ulmer C, Fritz P, Rettenmaier B, Hirschburger S, Segerer S, Biegger D, Lang T, Ott G, Kimmel M, Alscher MD, Braun N, Habib M, Korte M, Hagen M, Dor F, Betjes M, Habib M, Hagen M, Korte M, Zietse R, Dor F, Betjes M, Latus J, Latus J, Ulmer C, Fritz P, Rettenmaier B, Biegger D, Lang T, Ott G, Scharpf C, Kimmel M, Alscher MD, Braun N, Habib M, Korte M, Zietse R, Betjes M, Chang TI, Shin DH, Oh HJ, Kang SW, Han DS, Yoo TH, Han SH, Choi HY, Lee YK, Kim BS, Han SH, Yoo TH, Park HC, Lee HY, Horimoto N, Tuji K, Kitamura S, Sugiyama H, Makino H, Isshiki R, Isshiki R, Iwagami M, Tsutsumi D, Mochida Y, Ishioka K, Oka M, Maesato K, Moriya H, Ohtake T, Hidaka S, Kobayashi S, Higuchi C, Tanihata Y, Ishii M, Sugimoto H, Sato N, Kyono A, Ogawa T, Nishimura H, Otsuka K, Cho KH, Do JY, Kang S, Park JW, Yoon KW, Kim TW, Du Halgouet C, Latifa A, Anne Sophie V, Emmanuel D, Christine R, Francois V, Grzelak T, Czyzewska-Majchrzak L, Kramkowska M, Witmanowski H, Czyzewska K, Janda K, Krzanowski M, Dumnicka P, Sulowicz W, Rroji M, Seferi S, Barbullushi M, Likaj E, Petrela E, Thereska N, Cabiddu G, Dessi E, Arceri A, Laura P, Manca E, Conti M, Cao R, Pani A, Liao CT, Vega Vega O, Mendoza de la Garza A, Correa-Rotter R, Ueda A, Nagai K, Morimoto M, Hirayama A, Owada S, Tonozuka Y, Saito C, Saito C, Yamagata K, Matsuda A, Tayama Y, Ogawa T, Iwanaga M, Noiri C, Hatano M, Kiba T, Kanozawa K, Katou H, Hasegawa H, Mitarai T, Ros-Ruiz S, Ros-Ruiz S, Fuentes-Sanchez L, Jironda-Gallegos C, Gutierrez-Vilches E, Garcia-Frias P, Hernandez-Marrero D, Kang S, Lee S, Cho K, Park J, Yoon K, Do J, Lai X, Chen W, Guo Z, Braide M, Cristina V, Popa SG, Maria M, Eugen M, Martino F, DI Loreto P, DI Loreto P, Ronco C, Rroji M, Seferi S, Barbullushi M, Petrela E, Spahia N, Likaj E, Thereska N, Sanchez Macias LO, Sanchez Macias LO, Lares Castellanos KI, Hernandez Pacheco JA, Vega Vega O, Correa Rotter R, Pedro Ventura A, Olivia S, Teixeira L, Joana V, Francisco F, Maria Joao C, Antonio C, Rodrigues AS, Atas N, Erten Y, Erten Y, Onec K, Inal S, Topal S, Akyel A, Celik B, Okyay GU, Tavil Y, Zeiler M, Monteburini T, Agostinelli RM, Marinelli R, Santarelli S, Erten Y, Erten Y, Inal S, Onec K, Atas N, Okyay GU, Yaylaci C, Sahin G, Tavil Y, Guz G, Sindel S, Pinho A, Cabrita A, Malho Guedes A, Fragoso A, Carreira H, Pinto I, Bernardo I, Leao P, Janda K, Janda K, Krzanowski M, Kusnierz-Cabala B, Dumnicka P, Krasniak A, Chowaniec E, Tabor-Ciepiela B, Sulowicz W, Turkmen K, Ozbek O, Kayrak M, Samur C, Guler I, Tonbul HZ, Rusai K, Herzog R, Kratochwill K, Kuster L, Aufricht C, Meier CM, Fliser D, Schilling MK, Klingele M, Fukasawa M, Fukasawa M, Takeda M, Kamiyama M, Song YR, Kim HJ, Kim SG, Kim JK, Noh JW, Lee YK, Yoon JW, Koo JR. Peritoneal dialysis. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs243] [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: 11/14/2022] Open
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Lee JSW, Kwok T, Chui PY, Ko FWS, Lo WK, Kam WC, Mok HLF, Lo R, Woo J. Can continuous pump feeding reduce the incidence of pneumonia in nasogastric tube-fed patients? A randomized controlled trial. Clin Nutr 2009; 29:453-8. [PMID: 19910085 DOI: 10.1016/j.clnu.2009.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Revised: 10/12/2009] [Accepted: 10/20/2009] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS Continuous pump feeding is often used to reduce aspiration risk in older patients on tube feeding, but its effectiveness in preventing aspiration pneumonia is unproven. A randomized controlled trial was therefore performed to examine the effectiveness of continuous pump feeding in decreasing the incidence of pneumonia in tube-fed older hospital patients. METHODS One hundred and seventy eight elderly patients from three convalescence hospitals and one infirmary, on nasogastric tube feeding, were randomly assigned to have intermittent bolus (bolus) or continuous pump (pump) feeding for 4weeks. The primary outcome was the incidence of pneumonia. The secondary outcome was mortality. RESULTS Eighty five subjects were randomized into the pump group and 93 in the bolus group. The groups were comparable in age, nutritional and functional status, co-morbidities and history of pneumonia, except that there were more women in the pump group. Within 4weeks, 15 subjects (17.6%) in the pump group and 18 (19.4%) in the bolus group developed pneumonia. Seven subjects (8.2%) in pump group and 13 subjects (14.0%) in bolus group died. There was no significant difference in either pneumonia or death rates between the two groups. CONCLUSION Continuous pump feeding did not significantly affect the rates of pneumonia or mortality in tube-fed older hospital patients when compared with intermittent bolus feeding.
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Affiliation(s)
- J S W Lee
- Department of Medicine & Geriatrics, Shatin Hospital, Hong Kong SAR, China
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Wan SH, Lau H, Patil NG, Lo WK, Lui SL. Peritoneal computed tomography: a diagnostic tool for genital oedema in patients on peritoneal dialysis. Hong Kong Med J 2007; 13:82-3. [PMID: 17277399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Affiliation(s)
- S H Wan
- Department of Medicine, Queen Mary Hospital and Tung Wah Hospital, University of Hong Kong, Pokfulam, Hong Kong
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Lam MF, Lo WK, Tang C, Lui SL, Chan TM, Lai KN. Transport of Small Solutes in Peritonitis-free PD Patients. Int J Organ Transplant Med 2005. [DOI: 10.1016/s1561-5413(09)60198-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Lam MF, Leung JCK, Tam S, Tse KC, Lui SL, Lo WK, Chan TM, Lai KN. Increased Serum Leptin Levels During PD-related Peritonitis Associated with Prolonged Inflammation and Loss of Lean Body Mass. Int J Organ Transplant Med 2005. [DOI: 10.1016/s1561-5413(09)60197-6] [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: 11/16/2022] Open
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Hung IFN, Cheng VCC, Lo WK, Lui SL. Paradoxical deterioration during anti-tubercular treatment in a dialysis patient on maintenance steroid therapy. Hong Kong Med J 2005; 11:210-2. [PMID: 15951588] [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: 05/02/2023] Open
Abstract
We report a 38-year-old Chinese woman with lupus nephritis on peritoneal dialysis and long-term maintenance steroid therapy. This patient developed paradoxical deterioration during anti-tubercular therapy for tuberculous lymphadenitis. The deterioration resolved spontaneously without change to pharmacotherapy. Paradoxical deterioration that may spontaneously resolve is a potential complication of anti-tubercular treatment in patients on long-term renal replacement therapy.
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Affiliation(s)
- I F N Hung
- Division of Nephrology, Department of Medicine, Tung Wah Hospital, Hong Kong
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Lui SL, Lo WK. Agrobacterium radiobacter peritonitis in a Chinese patient on CAPD. Perit Dial Int 2005; 25:95. [PMID: 15770935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
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Lui SL, Li FK, Choy BY, Chan TM, Lo WK, Lai KN. Long-term outcome of isoniazid prophylaxis against tuberculosis in Chinese renal transplant recipients. Transpl Infect Dis 2004; 6:55-6. [PMID: 15225230 DOI: 10.1111/j.1399-3062.2004.00050.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cheung TH, Lo WK, Yu MY, Yang WT, Ho S. Extended experience in the use of laparoscopic ultrasound to detect pelvic nodal metastasis in patients with cervical carcinoma. Gynecol Oncol 2004; 92:784-8. [PMID: 14984941 DOI: 10.1016/j.ygyno.2003.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 03/05/2003] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the use of laparoscopic ultrasound (USG) to detect pelvic nodal metastasis in patients with early stage cervical carcinoma. METHODS Laparoscopic USG was used to search for pelvic lymph node metastasis in stage Ia2 to IIa cervical carcinoma patients before radical hysterectomy. Suspicious lymph nodes identified by laparoscopic USG were removed laparoscopically for pathological confirmation by frozen section. If nodal metastasis was diagnosed, radical hysterectomy would be cancelled but enlarged lymph nodes were removed preferably by laparoscopic approach before closing the abdomen. These patients were treated with radiotherapy after recovering from the surgery. By comparing the laparoscopic USG and pathological findings of lymph nodes removed with or without radical hysterectomy, diagnostic accuracy of laparoscopic USG was determined. RESULTS Ninety-three patients were recruited and the final analysis included 90 patients. Laparoscopic USG found suspicious lymph nodes in 17 patients and nodal metastases were confirmed pathologically in 14 of them. Three patients with macroscopic and five patients with microscopic pelvic nodal metastases were missed by laparoscopic USG. The accuracy, sensitivity, specificity, positive and negative predictive value of laparoscopic USG in detecting pelvic lymph node metastasis were 87.8%, 63.6%, 95.6%, 82.4%, and 89%, respectively. Macroscopic metastatic nodes were successfully removed laparoscopically in 11 out of 14 patients and laparotomy was required for the other three patients. CONCLUSIONS Laparoscopic USG can be performed with no major morbidity. This technique is sensitive in detecting macroscopic but not microscopic metastatic pelvic lymph nodes. Removal of macroscopic metastatic nodes identified via laparoscopic USG via laparoscopic approach could be accomplished in majority of patients.
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Affiliation(s)
- T H Cheung
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hongkong, China.
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Lui SL, Chan TM, Lo WK, Lai KN. Chronic Inflammatory Demyelinating Polyneuropathy after Initiation of Peritoneal Dialysis – a Distinct Clinical Entity? Int J Artif Organs 2003; 26:969-71. [PMID: 14708824 DOI: 10.1177/039139880302601101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Choy BY, Chan TM, Li FK, Lui SL, Lo WK, Yip T, Tse KC, Lai KN. IL2-receptor antagonist (basiliximab) induction therapy is associated with lower morbidity and mortality in renal transplant recipients. Transplant Proc 2003; 35:195. [PMID: 12591363 DOI: 10.1016/s0041-1345(02)03980-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- B Y Choy
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, Hong Kong, China.
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Leong WM, Lo WK, Chiu JW. Analgesic efficacy of continuous delivery of bupivacaine by an elastomeric balloon infusor after abdominal hysterectomy: a prospective randomised controlled trial. Aust N Z J Obstet Gynaecol 2002; 42:515-8. [PMID: 12495098 DOI: 10.1111/j.0004-8666.2002.00515.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the analgesic efficacy and morphine-sparing effect of continuous bupivacaine wound infiltration after abdominal hysterectomy. DESIGN Prospective, randomised controlled trial. SAMPLE Fifty-two female ASA I or II patients were enrolled with 26 patients in each of the study and control groups. METHODS The study group received 0.5% bupivacaine infusion into the incisional (Pfannenstiel) wound via an elastomeric infusor at 2 mL/hr for 48 hours postoperatively plus morphine via a patient controlled analgesia (PCA) pump. The control group had only PCA morphine. RESULTS There were no significant differences in the visual analogue scores (VAS) for pain nor PCA morphine usage for 48 hours postoperatively CONCLUSION That continuous infusion of the incisional wound with 0.5% bupivacaine did not confer additional analgesia over PCA morphine after abdominal hysterectomy
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Affiliation(s)
- W M Leong
- Department of Anaesthesia, Changi General Hospital, Singapore, Singapore
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Abstract
The disease activity of patients suffering from lupus nephritis usually becomes quiescent after the onset of end stage renal failure. Reactivation of lupus activity, especially after a long period of dialysis, is uncommon. Factors that might trigger off lupus reactivation after dialysis have not been well defined. We report a case of a 43-year-old Chinese woman on long-term peritoneal dialysis, who developed lupus reactivation with cerebral involvement 2 weeks after she was diagnosed to have tuberculous peritonitis. The close temporal relationship between the tuberculous peritonitis and the lupus reactivation raise the possibility that the tuberculous infection might have triggered off the lupus reactivation.
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Affiliation(s)
- S L Lui
- Division of Nephrology, University Department of Medicine, Tung Wah Hospital, Hong Kong, People's Republic of China.
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Lo WK, Li FK, Choy CB, Cheng SW, Chu WL, Ng SY, Lo CY, Lui SL. A retrospective survey of attitudes toward acceptance of peritoneal dialysis in Chinese end-stage renal failure patients in Hong Kong--from a cultural point of view. Perit Dial Int 2002; 21 Suppl 3:S318-21. [PMID: 11887844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE We undertook to study the attitudes toward dialysis of patients approaching end-stage renal failure and to analyze those attitudes from a cultural perspective. SETTING The study was performed in the pre-dialysis clinic of a tertiary referral renal center. PATIENTS All patients of Chinese ethnic origin seen in the pre-dialysis clinic from 1995 to 2000 for assessment of dialysis therapy were included. METHOD We performed a retrospective analysis of patient records with regard to attitudes of the patients toward dialysis, reasons for those attitudes, and factors that could lead to a subsequent change in attitude. RESULTS We assessed 462 patients over the 6-year period. Their mean age was 65.5 +/- 13.3 years, and 43.9% of the patients had diabetes. Peritoneal dialysis (PD) was offered to 74% of the patients, and hemodialysis (HD) to 3.9%. Among the patients offered PD, only 44% accepted dialysis. After counselling, 54% of the patients who originally declined PD ultimately accepted it. The major reasons for refusing PD were the ideas of "having lived long enough" and "lack of family support." Most other reasons could be overcome by counselling. Only a minority of patients demanded hemodialysis. CONCLUSIONS Declining an offer of dialysis was common. Counselling helped patients to accept PD. Certain cultural elements that hindered acceptance of dialysis were involved in the ideas of "having lived long enough" and "lack of family support." Those cultural elements should be tackled more specifically during counselling.
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Affiliation(s)
- W K Lo
- Department of Medicine, Tung Wah Hospital, The University of Hong Kong, Hong Kong SAR, China.
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Abstract
Insufficient apoptosis is implicated in many human cancers, including cervical carcinoma. The objectives of this study were to explore changes of apoptosis-regulating gene expression and their clinical significance in cervical cancer. The expression of apoptosis-regulating genes, including five Bcl-2 family and two caspase family members, was evaluated in 43 cervical invasive squamous cell carcinomas, using immunohistochemistry. Specimens in which >or=10% of the neoplastic cells showed cytosolic immunoreactivity were considered to be immunopositive. Results were correlated with clinico-pathologic characteristics of the subjects. All seven apoptotic regulators examined were positive in a proportion of the tumors. The percentage of cases expressing Bax was higher in the patients without evidence of disease after treatment than in the patients alive with disease or who died of disease (P<0.05). A significant difference in disease-free survival was detected between Bax-positive and -negative groups (P<0.05), and in overall survival between Mcl-1-positive and -negative groups (P<0.05). Significant association between the seven markers tested was only found for caspase 3 and Bak immunoreactivity in cervical carcinoma (P<0.05). The results demonstrate expression of multiple apoptosis-modulating proteins in cervical cancer. There appears to be complex regulation of apoptosis protein levels in association with clinical behavior of cervical squamous cell carcinoma.
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Affiliation(s)
- T K H Chung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
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Abstract
Awareness among parturients during general anaesthesia for caesarean section, though now uncommon, remains a concern for obstetric anaesthetists. We examined the adequacy of our general anaesthetic technique for avoiding explicit awareness by determining the depth of anaesthesia using Bispectral Index (BIS) monitoring. Twenty ASA1 parturients having general anaesthesia for lower segment caesarean section were studied. The drugs and doses used for each anaesthetic were similar Intraoperative Bispectral Index, haemodynamic parameters, end-tidal isoflurane concentration and inspired nitrous oxide fraction were measured and the postoperative incidence of explicit awareness was assessed. All anaesthetists were blinded to the Bispectral Index value throughout the operation. The depth of anaesthesia at various stages of the operation was evaluated by recording the Bispectral Index. Patients were interviewed for any intraoperative recall or awareness at the end of operation. A median BIS of 70 or below was recorded on most occasions during surgery. The range was 52 to 70, with values reaching 60 and below at intubation, uterine incision and delivery. Haemodynamic stability was satisfactory and there was no case of uterine atony, fetal compromise or postpartum haemorrhage. No patient experienced intraoperative dreams, recall or awareness. Our current general anaesthetic technique appeared inadequate to reliably produce BIS values of less than 60 that are associated with a low risk of awareness. However, no patients experienced explicit awareness.
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Affiliation(s)
- S N Yeo
- Department of Anaesthesiology, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore
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Lui SL, Tang S, Li FK, Choy BY, Chan TM, Lo WK, Lai KN. Tuberculosis infection in Chinese patients undergoing continuous ambulatory peritoneal dialysis. Am J Kidney Dis 2001; 38:1055-60. [PMID: 11684559 DOI: 10.1053/ajkd.2001.28599] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A retrospective study of the prevalence and pattern of tuberculosis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) was performed. Thirty-eight cases of tuberculosis were diagnosed among 790 patients (18 men, 20 women; mean age, 58 +/- 12.6 years) between July 1994 and June 2000. The interval between the initiation of CAPD and onset of tuberculosis ranged from 1 to 168 months (median, 22 months). There were 18 cases of pulmonary tuberculosis, 14 cases of tuberculous peritonitis, 5 cases of tuberculous lymphadenitis, and 1 case of tuberculous synovitis. Patients with pulmonary tuberculosis usually presented with fever, constitutional symptoms, and pleural effusion or pulmonary infiltrates on chest radiograph. Abdominal pain and turbid dialysate were the main presenting symptoms in patients with tuberculous peritonitis. Diagnosis was established by positive culture in 20 patients, typical histological characteristics on a tissue biopsy specimen in 10 patients, and response to empirical antituberculous treatment in 8 patients. The duration of symptoms before the diagnosis of tuberculosis and initiation of antituberculous treatment ranged from 7 to 57 days (median, 30 days). Antituberculous treatment consisted of isoniazid, rifampicin, pyrazinamide, and ofloxacin for 9 to 15 months. Antituberculous treatment generally was well tolerated. Twenty-seven patients (71%) completed antituberculous treatment. No recurrence of tuberculosis was observed after a mean follow-up of 19.8 months. Eleven patients (29%) died while on antituberculous treatment; none of the deaths appeared to be directly caused by tuberculosis. We conclude that: (1) tuberculosis is prevalent among CAPD patients in our locality; (2) extrapulmonary tuberculosis, particularly tuberculous peritonitis, is common; and (3) a high index of suspicion for tuberculosis among CAPD patients is warranted to ensure early diagnosis and prompt initiation of treatment.
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MESH Headings
- Aged
- Antitubercular Agents/therapeutic use
- Female
- Hong Kong
- Humans
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/therapy
- Male
- Middle Aged
- Mycobacterium tuberculosis/drug effects
- Mycobacterium tuberculosis/isolation & purification
- Peritoneal Dialysis, Continuous Ambulatory
- Peritonitis, Tuberculous/complications
- Peritonitis, Tuberculous/drug therapy
- Peritonitis, Tuberculous/mortality
- Survival Rate
- Treatment Outcome
- Tuberculosis/complications
- Tuberculosis/drug therapy
- Tuberculosis/mortality
- Tuberculosis, Lymph Node/complications
- Tuberculosis, Lymph Node/drug therapy
- Tuberculosis, Lymph Node/mortality
- Tuberculosis, Pulmonary/complications
- Tuberculosis, Pulmonary/drug therapy
- Tuberculosis, Pulmonary/mortality
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Affiliation(s)
- S L Lui
- Division of Nephrology, University Department of Medicine, Tung Wah Hospital, Sheung Wan, Hong Kong.
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26
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Lui SL, Hui CK, Chan TM, Lo WK, Lai KN. Progressive demyelinating neuropathy after initiation of continuous ambulatory peritoneal dialysis--report of two cases. Clin Nephrol 2001; 56:407-10. [PMID: 11758015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
We report on two patients who developed rapidly progressive demyelinating neuropathy within 6 to 10 weeks after the initiation of continuous ambulatory peritoneal dialysis. The neuropathy in one patient resolved after kidney transplantation while that of the other patient improved with immunosuppressive therapy. The close temporal relationship between the initiation of peritoneal dialysis and the onset of neuropathy suggests that these two events may be causally related.
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Affiliation(s)
- S L Lui
- University Department of Medicine, Tung Wah Hospital, Hong Kong.
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27
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Lo WK, Tong KL, Li CS, Chan TM, Wong AK, Ho YW, Cheung KO, Kwan TH, Wong KS, Ng FS, Cheng IK. Relationship between adequacy of dialysis and nutritional status, and their impact on patient survival on CAPD in Hong Kong. Perit Dial Int 2001; 21:441-7. [PMID: 11757826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE Superior patient survival on continuous ambulatory peritoneal dialysis (CAPD) with 3 x 2-L exchanges has been reported from Hong Kong. This study examined the relationship between indices of dialysis adequacy and nutrition and patient survival on CAPD in Hong Kong. DESIGN A cross-sectional study on prevalent CAPD patients. Patients were assessed for indices of dialysis adequacy and nutritional status with a composite nutritional index (CNI). Patients were then followed for 24 months. Survival data were analyzed according to adequacy indices and nutritional status. SETTING All prevalent CAPD patients in nine dialysis centers in Hong Kong as of 1 April 1996. MAIN OUTCOME MEASURE Mortality. RESULTS 937 patients were assessed: 68.2% were using 3 x 2-L exchanges per day; mean age was 54.6 +/- 13 years. Mean total Kt/V was 1.83 +/- 0.42 and total creatinine clearance was 55.6 +/- 19.5 L/week/1.73 m2. 19% of patients were moderately to severely malnourished according to the CNI. There was no significant correlation between indices of adequacy and serum albumin or CNI. The 1- and 2-year patient survival from the time of assessment was 90.9% and 79.8%. There was a trend toward better survival in patients with Kt/V greater than 2.0, but it was not statistically significant. Peritoneal Kt/V did not impact survival in anuric patients. Malnourished patients had poorer survival than patients who were better nourished (p = 0.0259). After adjusting for age and diabetes, CNI was predictive of mortality but Kt/V and creatinine clearance were not. CONCLUSIONS This study demonstrates the importance of nutritional status over adequacy indices in predicting patient survival. There was a lack of correlation between nutritional status and conventional indices of dialysis adequacy.
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Affiliation(s)
- W K Lo
- Renal Unit of Tung Wah Hospital, University of Hong Kong, Hong Kong.
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28
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Cheng VC, Lo WK, Woo PC, Chan SB, Cheng SW, Ho M, Yuen KY. Polymicrobial outbreak of intermittent peritoneal dialysis peritonitis during external wall renovation at a dialysis center. Perit Dial Int 2001; 21:296-301. [PMID: 11475346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVE To investigate an outbreak of peritonitis in intermittent peritoneal dialysis (IPD) patients. DESIGN An outbreak investigation was performed to identify the etiology of the polymicrobial outbreak, and a retrospective case-control study was conducted to assess the risk factors for development of peritonitis. SETTING Renal dialysis center. PATIENTS Ten episodes of peritonitis occurred in 8 of 61 patients over a 6-month period in which 669 IPD procedures were analyzed. INTERVENTIONS Field visit to renal dialysis center to examine the entire IPD procedure, inspect the hospital environment, and perform air bacterial count. MAIN OUTCOME MEASURES The environmental factors and risk factors contributing to the polymicrobial peritonitis outbreak in IPD patients. The incidence of IPD peritonitis was determined before and after interventions. RESULTS The causative organisms included Acinetobacter baumanii (6), Stenotrophomonas maltophilia (2), Pseudomonas aeruginosa (1), Candida albicans (1), C. tropicalis (1), Enterococcus (3), and Enterobacteriaceae (2). Four episodes of peritonitis involved infection by more than one organism. Air sampling of the environment detected a median of 110 colony forming units of bacteria per cubic meter of air, 10% of which were found to be Acinetobacter baumanii. The source of this polymicrobial outbreak was attributed to the bamboo scaffolding structure covering the external wall of the hospital during renovation. A retrospective case-control study indicated that the absence of the flush-before-fill step was a risk factor for development of peritonitis. CONCLUSION In addition to invasive aspergillosis in transplant or oncology patients, Acinetobacter peritonitis in dialysis patients should be considered another microbial cause of outbreak associated with hospital renovation.
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Affiliation(s)
- V C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong
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29
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Abstract
PURPOSE To assess the analgesic efficacy of administering, immediately after surgery, a single dose of diclofenac (100 mg suppository) to women who had undergone lower segment Cesarean section (LSCS) under combined spinal-epidural anesthesia, and received post-operative patient-controlled epidural analgesia (PCEA) with ropivacaine 0.2% and fentanyl 2 microg x ml(-1). METHODS Forty-eight ASA physical status I or II term parturients scheduled for elective LSCS under regional anesthesia were enrolled into this randomised double-blind study. The patient-controlled epidural analgesia device was programmed to deliver a bolus of 4 ml of local anesthetic mixture with a lockout period of ten minutes and an hourly limit of 12 ml. There was no baseline infusion. The study commenced upon the patient's first demand for analgesia post-operatively and the patients were assessed at one, six, 12 and 24 hr post-operatively for pain scores on movement, dermatomal level of sensory blockade, degree of motor blockade and volume of local anesthetic used. At conclusion of the study, patients' satisfaction scores were recorded. RESULTS The two groups of patients were similar demographically. Patients who received a diclofenac suppository used 52.8 +/- 17.8 ml of local anesthetic mixture while those who did not, used 74 +/- 25 ml (P <0.005). Pain scores and satisfaction scores did not differ significantly between the groups. CONCLUSION A single administration of 100 mg diclofenac suppository is effective in reducing post-Cesarean epidural local anesthetic/opioid requirements by 33% for the first 24 hr post-operatively.
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Affiliation(s)
- N L Lim
- Department of Anaesthesia and Surgical Intensive Care, Kandang Kerbau Women's and Children's Hospital, Singapore.
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30
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Lui SL, Li FK, Lo CY, Lo WK. Simultaneous removal and reinsertion of Tenckhoff catheters for the treatment of refractory exit-site infection. Adv Perit Dial 2001; 16:195-7. [PMID: 11045292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Exit-site infection (ESI) refractory to medical therapy is an important complication of continuous ambulatory peritoneal dialysis (CAPD). Between July 1994 and June 1998, 28 patients in our hospital underwent simultaneous removal and reinsertion of Tenckhoff catheters for the treatment of refractory ESI. The ESI was caused by Pseudomonas aeruginosa in 22 patients (78%), methicillin-resistant Staphylococcus aureus in 5 patients (18%), and diphtheroid bacilli in 1 patient (4%). The patients had received antibiotic treatment for a mean duration of 11.6 +/- 5.8 weeks (range: 3-28 weeks) before their operations. During each operation, the old Tenckhoff catheter was removed and a new catheter was inserted in the opposite side of the abdomen. CAPD was resumed after two weeks of intermittent peritoneal dialysis. All patients received intravenous antibiotic cover for seven days after the operation. Early post-operative complications were uncommon. At one year after the operation, 22 patients (78%) were free of ESI. Six patients (22%) had a recurrence of ESI 21.3 +/- 6 weeks (range: 16-32 weeks) after their operation. All new infections were treated successfully with antibiotics. Seven patients (25%) had one episode of peritonitis each, all of which resolved with intraperitoneal antibiotic treatment. We conclude that simultaneous removal and reinsertion of Tenckhoff catheters is a safe and effective method for the treatment of refractory ESI. The procedure alleviates the need for temporary hemodialysis and allows an early return to CAPD.
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Affiliation(s)
- S L Lui
- University Department of Medicine, Tung Wah Hospital, Hong Kong, China
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31
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Affiliation(s)
- S Tang
- Division of Renal Medicine, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, People's Republic of China
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32
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Siu CW, Chan TM, Li FK, Choy BY, Lui SL, Lo CY, Tang S, Lo WK, Lai KN. Association between anti-thymocyte globulin administration and cytomegalic virus infection and/or CMV disease in cadaveric renal allograft recipients. Transplant Proc 2000; 32:1932-4. [PMID: 11120007 DOI: 10.1016/s0041-1345(00)01499-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C W Siu
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Room 411, Professional Block, Queen Mary Hospital, Pokfulam Road, Hong Kong, Hong Kong
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33
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Lam MF, Li FK, Choy BY, Tang S, Lo WK, Lui SL, Chu SM, Tam PC, Chan TM, Lai KN. The impact of the establishment of a multiorgan transplantation program on cold ischemia time and delayed graft function in renal transplantation. Transplant Proc 2000; 32:1611-2. [PMID: 11119859 DOI: 10.1016/s0041-1345(00)01451-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M F Lam
- Departments of Medicine and Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People's Republic of China
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Abstract
SPARC (secreted protein acidic and rich in cysteine) is a matricellular protein involved in cell-matrix interactions. We have shown previously that mice deficient in SPARC develop posterior cortical cataract early in life that progresses to a mature opacity and capsule rupture. To evaluate the primary effects of SPARC deficiency in the lens, we examined the lenses of SPARC-null and wild-type mice by electron microscopy and immunohistochemistry to investigate whether ultrastructural abnormalities occur at the basement membrane (capsule)-lens cell interface in SPARC-null mice. The most notable feature in the lenses of SPARC-null mice, relative to wild-type animals, was the modification of the basal surface of the lens epithelial and fiber cells at the basement membrane (capsule) interface. Electron microscopy revealed numerous filopodial projections of the basal surface of the lens epithelial and fiber cells into the extracellular matrix of the anterior, posterior, and equatorial regions of the lens capsule. In 1 week old precataractous lenses, basal invasive filopodia projecting into the capsule were small and infrequent. Both the size and frequency of these filopodia increased in precataractous 3-4 week old lenses and were prominent in the cataractous 5-6 week old lenses. By rhodamine-phalloidin labeling, we confirmed the presence of basal invasive filopodia projecting into the lens capsule and demonstrated that the projections contained actin filaments. In contrast to the obvious abnormal projections at the interface between the basal surface of the lens epithelial and fiber cells and the lens capsule, the apical and lateral plasma membranes of lens epithelial cells and lens fibers in SPARC-null mice were as smooth as those of wild-type mice. We conclude that the absence of SPARC in the murine lens is associated with a filopodial protrusion of the basal surface of the lens epithelium and differentiating fiber cells into the lens capsule. The altered structures appear prior to the opacification of the lens in the SPARC-null model. These observations are consistent with one or more functions previously proposed for SPARC as a modulator of cell shape and cell-matrix interactions.
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Affiliation(s)
- K Norose
- Wistar Institute, Philadelphia, Pennsylvania 19104, USA
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35
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Lo WK, Wen XJ, Zhou C. Regional differences in actin stability in the rat lens as visualized by immunofluorescence labeling under the influence of pH. Exp Eye Res 2000; 71:323-7. [PMID: 10973741 DOI: 10.1006/exer.2000.0881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lo WK, Shaw AP, Paulsen DF, Mills A. Spatiotemporal distribution of zonulae adherens and associated actin bundles in both epithelium and fiber cells during chicken lens development. Exp Eye Res 2000; 71:45-55. [PMID: 10880275 DOI: 10.1006/exer.2000.0848] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Zonulae adherens and associated actin bundles (ZA/AB) are believed to play a major role in epithelial folding and invagination during morphogenesis of neural tube and other vesicular structures. The lens morphogenesis is associated with the formation of the lens vesicle in which ZA/AB would be needed during the formation process. However, the existence of ZA/AB in the lens has never been established. In this study we report for the first time the existence of ZA/AB in both lens epithelium and fiber cells during embryonic development of chicken lens from E4 to E20. Light microscopy revealed contacts between the lens epithelium and primary fiber cells, and between the lens epithelium and secondary fiber cells at E4 and E11, respectively. Thin-section electron microscopy consistently revealed ZA/AB near both the apical ends of lens epithelial cells and primary fiber cells at E4. This arrangement manifests as a parallel pair of belt-like ZA/AB along the epithelium-fiber interface. In semi-tangential sections, a continuous belt-like ZA/AB was also evidenced in individual epithelial cells and fiber cells. Furthermore, the same ZA/AB arrangement was observed near both the apical ends of epithelial cells and secondary fiber cells at E11. Besides ZA/AB, macular-type fasciae adherens were distributed regularly between epithelial cells, between primary fibers, between secondary fibers, and between epithelium and both primary and secondary fibers. Immunofluorescence strongly and preferentially labeled N-cadherin at both the apical ends of lens epithelium and primary or secondary fibers at the corresponding ages, suggesting a direct association with the zonulae adherens. Also punctate N-cadherin labeling was commonly seen along various regions of primary and secondary fiber cells at different ages, and to a larger extent in the mature fibers of older lenses. This study suggests that: (1) ZA/AB located at the apices of lens epithelial cells may play a crucial role in the early stages of lens morphogenesis (e.g. lens vesicle formation); (2) ZA/AB of primary and secondary fiber cells originate from the epithelial cells during their elongation and differentiation; (3) owing to the restricted distribution of ZA/AB, abundant fasciae adherens are needed to maintain the structural stability of the epithelium and fiber cells during development and maturation; and (4) N-cadherin is the principle adhesion protein for both the zonulae adherens and fasciae adherens in the lens.
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Affiliation(s)
- W K Lo
- Department of Anatomy, Morehouse School of Medicine, 720 Westview Dr. SW, Atlanta, Georgia, 30310, USA.
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Chung TK, Cheung TH, Lo WK, Yu MY, Hampton GM, Wong HK, Wong YF. Loss of heterozygosity at the short arm of chromosome 3 in microdissected cervical intraepithelial neoplasia. Cancer Lett 2000; 154:189-94. [PMID: 10806307 DOI: 10.1016/s0304-3835(00)00398-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Loss of heterozygosity (LOH) is a common genetic finding in many human neoplasms, including cervical cancer. The detection of LOH at specific loci in the precursor of cervical cancer, cervical intraepithelial neoplasia (CIN) may help in elucidating the evolution of this cancer, which has a clearly defined histological premalignant phase. However, molecular genetic investigation of CIN is difficult because many of the lesions are very small and sometimes ill defined topographically. In this study we analyzed eighteen polymorphic microsatellite repeats on chromosome 3p in CINs using a method of primer extension pre-amplification (PEP) for whole genome amplification combined with microdissection. These markers encompass chromosome region 3pter-3p12. LOH at one or more loci was detected in five (33%) out of the 15 informative cases with low grade CIN (CIN 1), while 22 (92%) out of 24 cases with high grade CIN (CIN 2 and 3) (P<0.01). The highest incidence (41%) of LOH was detected at locus D3S1038 (3p26.1-3p25.2). Frequent LOH (more than 20%) was also found at other loci including D3S1110 (3p25.3-3p25.1) (31%), D3S656 (3p25.1) (24%), D3S1076 (3p21.2-3p21.1) (29%), D3S1300 (3p21.1-3p14.2) (24%), D3S1600 (3p14.2-3p14.1) (24%), and D3S1079 (3p13) (25%). The results from this study taken together with others indicate that the genetic alterations on chromosome 3p are common in high grade of CIN and are probably early events in cervical carcinogenesis. Tumor suppressor gene(s) that play a role in cervical neoplasm may be located on the short arm of chromosome 3, likely at or near 3p26.1-25.1, 3p21.2-21.1, and 3p14.2-13.
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Affiliation(s)
- T K Chung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Steele EC, Wang JH, Lo WK, Saperstein DA, Li X, Church RL. Lim2(To3) transgenic mice establish a causative relationship between the mutation identified in the lim2 gene and cataractogenesis in the To3 mouse mutant. Mol Vis 2000; 6:85-94. [PMID: 10851259] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
PURPOSE Lim2 is the gene encoding the ocular lens-specific intrinsic membrane protein MP19. We previously reported finding a single nonconservative G->T transversion in exon two of the Lim2 gene. This mutation was linked to the cataract in the To3 (Total opacity number 3) mouse mutant, confirming Lim2 as an ideal candidate gene for the To3 cataract. The aim of the present study was to substantiate a causative relationship between the mutation in the Lim2 gene and cataractogenesis in the To3 mouse mutant. To this end a Lim2To3 transgene cassette was engineered and introduced into fertilized normal mouse embryos to test its ability to induce cataractogenic lens development. METHODS A Lim2 genomic clone was isolated and purified from a murine 129/SvJ genomic library. A restriction endonuclease map of the gene was generated using classical Southern techniques. The murine Lim2 promoter was characterized by transfecting primary chicken lens epithelial cells with Lim2 promoter-CAT reporter constructs and assaying promoter activity and specificity. This genomic clone was then used in conjunction with PCR to generate a Lim2To3 transgene cassette. After sequencing of the PCR engineered portion, the Lim2To3 transgene was then used to generate Lim2To3 transgenic mice via pronuclear injection. Founder mice and their offspring from outcrosses and intercrosses were characterized by ophthalmic examination, PCR and Southern DNA analysis, RT-PCR mRNA analysis, and histology of lens sections. RESULTS Two mice, from independent microinjections, were identified as positive for presence of the Lim2To3 transgene cassette as well as presence of bilateral congenital cataracts and reduced eye size and mass. One of these founders was incapable of germline transmission of the transgene to offspring and was not characterized further. The other was capable of germline transmission and was characterized as described above. PCR DNA analysis revealed a perfect concordance between presence of the Lim2To3 transgene cassette and congenital cataract in offspring of this founder. Transgenic hemizygotes exhibited cataract and a reduction in eye and lens size and mass, while transgenic "homozygotes" presented with a more severe cataract and microphthalmic reduction in eye and lens size and mass. Southern analysis revealed approximately 2 copies of the transgene cassette integrated into a single chromosomal site in the founder and all hemizygous offspring. RT-PCR analysis revealed a very low ratio of Lim2To3 transgenic mRNA compared to endogenous normal Lim2. Finally, histology revealed that lens development was abnormal in mutant transgenic animals by embryonic day E15. By E19, just prior to birth, gross disorganization of secondary fibers was observed in mutants. CONCLUSIONS These transgenic experiments firmly establish a causative relationship between the previously identified mutation in the Lim2 gene and cataractogenesis in the To3 mouse mutant. The low levels of mutant mRNA produced by the transgene cassette as compared to endogenous levels of normal Lim2 mRNA provides evidence that this dominant mutation results in a mutant MP19 protein with altered function rather than simply loss of function.
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Affiliation(s)
- E C Steele
- Emory Eye Center, Emory University School of Medicine, Department of Ophthalmology, Atlanta, GA 30322, USA
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Abstract
OBJECTIVE To assess whether transcervical intrauterine instillation of local anaesthetic agent reduces pain during diagnostic outpatient hysteroscopy and endometrial biopsy. DESIGN Prospective, randomised, double blind, placebo-controlled trial. SETTING Outpatient hysteroscopy clinic in a university teaching hospital. POPULATION Ninety women undergoing outpatient diagnostic hysteroscopy with or without endometrial biopsy. METHODS Transcervical intrauterine instillation of 5 mL of 2% lignocaine into the uterine cavity before performing the procedure. MAIN OUTCOME MEASURES Evaluation of pain at different stages of the procedure using a visual analogue scale and changes in blood pressure and heart rate. RESULTS The use of local anaesthetic did not alleviate pain experienced during hysteroscopy and endometrial biopsy. It did not prevent the occurrence of vaso-vagal reactions; however the incidence of these was low. CONCLUSIONS Transcervical instillation of local anaesthesia neither reduced pain nor prevented vaso-vagal reaction during hysteroscopy and endometrial biopsy.
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Affiliation(s)
- W C Lau
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong
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40
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Ramaswami RA, Lo WK. Use of hyperbaric oxygen therapy in Hong Kong. Hong Kong Med J 2000; 6:108-12. [PMID: 10793411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
The Recompression Treatment Centre on Stonecutters Island has been operating in Hong Kong for more than 5 years and has been used to treat a variety of diving-related and other conditions by means of hyperbaric oxygen therapy. Up to the end of December 1997, 295 treatment sessions had been conducted for 39 patients. This article reviews the usefulness of and indications for hyperbaric oxygen therapy.
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Affiliation(s)
- R A Ramaswami
- Recompression Treatment Centre, Swift Block 505, Government Dockyard, Stonecutters Island, Hong Kong
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Wong K, Chong JL, Lo WK, Sia AT. A comparison of patient-controlled epidural analgesia following gynaecological surgery with and without a background infusion. Anaesthesia 2000; 55:212-6. [PMID: 10671837 DOI: 10.1046/j.1365-2044.2000.01204.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We conducted a randomised, controlled study to investigate the effect of adding a background infusion to patient-controlled epidural analgesia for postoperative pain relief. Forty-two patients scheduled for elective lower abdominal gynaecological surgery received patient-controlled epidural analgesia postoperatively using a mixture of 0.2% ropivacaine and 2.0 microg x ml-1 fentanyl. Patients in group B (n = 20) were given a background infusion of 5 ml x h-1, whereas those in group N (n = 21) were not. There was no difference in pain scores or patient satisfaction scores between the two groups. Patients in group B had a higher total drug consumption (156.8 +/- 34.8 ml vs. 89.5 +/- 41.0 ml; p < 0.0001) and incidence of side-effects (71.4% vs. 30.0%; p = 0.007). Motor blockade during the 24-h study period was also greater in group B (median [range] area under the curve 7.5 [0.0-39.0] h vs. 3.0 [0.0-36.0] h; p = 0.035). We conclude that the addition of a background infusion to patient-controlled epidural anaesthesia is not recommended as it confers no additional benefits.
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Affiliation(s)
- K Wong
- Department of Anaesthesia (Obstetrics & Gynaecology), KK Hospital, Singapore
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42
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Lo WK, Chong JL, Chen LH. Combined spinal epidural for labour analgesia--duration, efficacy and side effects of adding sufentanil or fentanyl to bupivacaine intrathecally vs plain bupivacaine. Singapore Med J 1999; 40:639-43. [PMID: 10741192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AIM OF STUDY The aim of the study was to evaluate the efficacy and side effects of adding sufentanil 10 micrograms, fentanyl 10 micrograms or a control of 1 mL saline to 2.5 mg bupivacaine given intrathecally via combined spinal epidural (CSE) for labour pain relief in the first stage. METHOD Sixty ASA I or II patients who requested for epidural analgesia were randomised to three groups. CSE was performed with a 16G Touhy needle and 27G Whitacre needle. RESULTS Patients in the sufentanil/bupivacaine group had a significantly longer duration of analgesia (162.9 min +/- 63.4) compared with fentanyl/bupivacaine (110.0 min +/- 44.6) compared with plain bupivacaine (70.0 min +/- 32.1). Pruritus was significant in patients with sufentanil (80%) and fentanyl (47.4%) but did not occur with plain bupivacaine. There was no significant difference in the incidence of nausea or vomiting, hypotension and motor blockade although blood pressures in the sufentanil group were consistently lower than the other two groups. Pain scores were lowest in the sufentanil group. Fetal heart rate changes and Apgar scores were not significantly different between the groups. CONCLUSION In combined spinal epidural for labour analgesia, adding sufentanil 10 micrograms to intrathecal bupivacaine 2.5 mg provided fast onset and good analgesia for a longer duration compared with adding fentanyl 10 micrograms and with plain bupivacaine. The main side effect was pruritus. Neonatal outcome was similar.
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Affiliation(s)
- W K Lo
- Department of Anaesthesia, KK Women's and Children's Hospital, Singapore
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43
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Lai KN, Lo WK. Optimal peritoneal dialysis for patients from Hong Kong. Perit Dial Int 1999; 19 Suppl 3:S26-31; discussion S32-4. [PMID: 10433549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
The socioeconomic statuses of Asian countries are diverse and government reimbursement policies for renal replacement programs vary greatly from one country to another. Both factors affect not only the availability of treatment but also the choice of dialysis modality. Despite the economic growth of Hong Kong over the past three decades, the resources spent by our government on health services are less than other developed countries. The National Health Service, which is run on a tight budget, supports almost 95% of the patients on renal replacement programs. Due to the cost-effectiveness and reimbursement from the government, 79% of patients with end-stage renal failure in Hong Kong are treated with continuous ambulatory peritoneal dialysis (CAPD). All new patients entering the renal replacement program run by the National Health Service are offered CAPD as the first-line dialytic treatment. Due to budgetary constraint, over the past 10 years dialysis centers in Hong Kong have adopted a small-volume regime of 3 x 2-L daily exchanges as the initial dialysis prescription. This dialysis prescription will be considered to be suboptimal by Western standards, but the survival of these patients was comparable to, or even better than, other areas despite a lower Kt/V. These preliminary studies suggest small-volume dialysis may be an acceptable compromise in Asian populations with their smaller body size, given the financial constraints. These issues are especially important in Asia, where financial resources for renal replacement therapy are still limited in most countries and many patients have to continue working to pay for their renal replacement treatment. Using this small-volume dialytic regime, more patients may be treated with the limited financial resources. Furthermore, our experience raises the question of the importance of nutritional status in patient survival.
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Affiliation(s)
- K N Lai
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam
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Lo WK, Chan TM, Lui SL, Li FK, Cheng IK. Fungal peritonitis--current status 1998. Perit Dial Int 1999; 19 Suppl 2:S286-90. [PMID: 10406534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Affiliation(s)
- W K Lo
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, PR China
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Lo WK, Cheng IK, Lui SL, Chan TM, Li FK, Lai KN. Is target Kt/V and patient survival different between Asian and Western continuous ambulatory peritoneal dialysis (CAPD) patients? Perit Dial Int 1999; 19 Suppl 2:S27-31. [PMID: 10406490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Affiliation(s)
- W K Lo
- Queen Mary Hospital, Department of Medicine, The University of Hong Kong, Hong Kong
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Lau WC, Lo WK, Tam WH, Yuen PM. Paracervical anaesthesia in outpatient hysteroscopy: a randomised double-blind placebo-controlled trial. Br J Obstet Gynaecol 1999; 106:356-9. [PMID: 10426243 DOI: 10.1111/j.1471-0528.1999.tb08274.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of paracervical anaesthesia in reducing pain during outpatient hysteroscopy and endometrial biopsy. DESIGN Prospective, randomised, placebo-controlled, double-blind study. POPULATION One hundred women undergoing outpatient hysteroscopy and endometrial biopsy for abnormal uterine bleeding. INTERVENTIONS Paracervical block using 10 mL of either 2% lignocaine or normal saline before the procedure. MAIN OUTCOME MEASURES Evaluation of pain at different stages of hysteroscopy using a visual analogue scale together with blood pressure and heart rate monitoring. RESULTS Compared with placebo, paracervical anaesthesia significantly reduced the pain only at the time of insertion of the hysteroscope, but not at the subsequent stages of the procedure. However, paracervical injection of lignocaine resulted in a higher incidence of bradycardia and hypotension. CONCLUSIONS Paracervical anaesthesia not only fails to reduce pain during outpatient hysteroscopy and endometrial biopsy, but also carries a risk of inducing bradycardia and hypotension, which is probably a result of inadvertent intravascular injection.
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Affiliation(s)
- W C Lau
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories
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47
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Tang S, Lui SL, Li FK, Lo WK, Chan TM, Lai KN. Long-term renal allograft recipients from South-east Asia in the pre-cyclosporin era. Int J Artif Organs 1999; 22:131-7. [PMID: 10357240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The clinical outcome of long-term renal allograft recipients in the Chinese population has not been reported previously. We analysed patients from the pre-cyclosporin era who had grafts that functioned for > 10 years. Forty-five patients (31 men, 14 women; mean age 30, follow-up duration 13.3 years), representing a 10-year graft survival of 53%, were included. Thirty-six patients (80%) received living-related allografts and 9 (20%) received cadaveric or living-unrelated renal transplantation. The mean serum creatinine at last follow-up was 1.36 mg/dl (range, 0.83-4.08). Major posttransplantation complications included: hypertension in 25 (56%), infection in 16 (36%), acute rejection in 15 (33%), lipid disorder in 13 (29%), liver disease in 7 (16%), osteonecrosis in 5 (11%), malignancy in 4 (9%), coronary artery disease in 3 (7%), and diabetes mellitus in 3 (7%). Five grafts were lost: 3 to chronic rejection, and 2 to patients with stable function who died of non-renal causes. Proteinuria correlated strongly with graft function and survival, and marginally with hypertension. In hepatitis B carriers, serum alpha-feto protein is useful in the early detection of hepatocellular carcinoma. We conclude that while patients in the pre-cyclosporin era can survive with excellent graft function beyond the first decade, the risk of complications leading to significant morbidity still remains even when patients are receiving minimal doses of immunosuppression in the second decade.
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Affiliation(s)
- S Tang
- University Department of Medicine, Queen Mary Hospital, Hong Kong, China
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48
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Lo WK, Cheng IK. Who is going to benefit from nystatin prophylaxis for fungal peritonitis complicating CAPD? Perit Dial Int 1999; 19:185. [PMID: 10357198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Lo CY, Li L, Lo WK, Chan ML, So E, Tang S, Yuen MC, Cheng IK, Chan TM. Benefits of exercise training in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1998; 32:1011-8. [PMID: 9856517 DOI: 10.1016/s0272-6386(98)70076-9] [Citation(s) in RCA: 44] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We examined the effects of a 12-week exercise program on the exercise tolerance, blood biochemistry, blood pressure (BP) control, cardiac function, and quality-of-life (QOL) scores in 13 patients undergoing continuous ambulatory peritoneal dialysis (CAPD; six men, seven women; mean age, 46.5+/-12.8 years; mean duration on dialysis, 4.8+/-3.8 years). The patients underwent exercise training on treadmill, bike, and arm ergometers thrice weekly. Seven CAPD patients matched for age, sex, and duration on dialysis served as controls. The mean peak aerobic capacity (VO2peak) of the exercisers increased by 16.2% after training (pre- and postexercise, 17.2+/-5.2 v 20.0+/-6.4 mL/kg/min; P=0.004). Although there were no significant changes in serum urea, creatinine, albumin, and hematocrit levels; left ventricular diastolic/systolic diameters; and ejection fraction, an increasing trend of high-density lipoproteins (HDLs) was observed in the exercisers (baseline v postexercise, 33+/-11 v 40+/-14 mg/dL; P=0.06). Twenty-four-hour ambulatory BP monitoring showed a significant increase in daytime systolic BP in the exercisers (pre- and postexercise, 142+/-26 v 157+/-22 mm Hg; P=0.003), but no significant changes could be found in the ambulatory daytime diastolic BP, nocturnal BP, and resting clinic BP. The patients' QOL improved after training, with better scores in two Kidney Disease Quality of Life scales (KDQOL): burden of kidney disease and physical functioning. Two mild and uncomplicated hypotensive episodes were reported in two patients immediately after training. No changes occurred in exercise capacity, blood biochemistry, BP profile, and QOL scores in the controls. We conclude that structured aerobic exercise is safe and can improve the exercise tolerance and QOL outcomes in CAPD patients.
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Affiliation(s)
- C Y Lo
- Department of Medicine, Tung Wah Hospital, Hong Kong, The People's Republic of China.
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50
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Choy BY, Cheng IK, Chan TM, Li FK, Lui SL, Lo WK, Lo CY, Lai KN. Comparison of clinical outcomes among renal allograft recipients in Hong Kong in relation to the place of transplant operation. Transplant Proc 1998; 30:3633-4. [PMID: 9838592 DOI: 10.1016/s0041-1345(98)01168-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- B Y Choy
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, People's Republic of China
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