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Boey JY, Kong U, Lee CK, Lim GK, Oo CW, Tan CK, Ng CY, Azniwati AA, Tay GS. The effect of spent coffee ground (SCG) loading, matrix ratio and biological treatment of SCG on poly(hydroxybutyrate) (PHB)/poly(lactic acid) (PLA) polymer blend. Int J Biol Macromol 2024; 266:131079. [PMID: 38537860 DOI: 10.1016/j.ijbiomac.2024.131079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
This study investigates the effects of SCG embedded into biodegradable polymer blends and aimed to formulate and characterise biomass-reinforced biocomposites using spent coffee ground (SCG) as reinforcement in PHB/PLA polymer blend. The effect of SCG filler loading and varying PHB/PLA ratios on the tensile properties and morphological characteristics of the biocomposites were examined. The results indicated that tensile properties reduction could be due to its incompatibility with the PHB/PLA matrixSCG aggregation at 40 wt% content resulted in higher void formation compared to lower content at 10 wt%. A PHB/PLA ratio of 50/50 with SCG loading 20 wt% was chosen for biocomposites with treated SCG. Biological treatment of SCG using Phanerochaete chrysosporium CK01 and Aspergillus niger DWA8 indicated P. chrysosporium CK01 necessitated a higher moisture content for optimum growth and enzyme production, whereas the optimal conditions for enzyme production (50-55 %, w/w) differed from those promoting A. niger DWA8 growth (40 %, w/w). SEM micrographs highlighted uniform distribution and effective wetting of treated SCG, resulting in improvements of tensile strength and modulus of biocomposites, respectively. The study demonstrated the effectiveness of sustainable fungal treatment in enhancing the interfacial adhesion between treated SCG and the PHB/PLA matrix.
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Affiliation(s)
- J Y Boey
- School of Industrial Technology, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - U Kong
- School of Industrial Technology, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - C K Lee
- School of Industrial Technology, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - G K Lim
- School of Chemical Sciences, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - C W Oo
- School of Chemical Sciences, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - C K Tan
- PMI Packaging Sdn. Bhd., Taman Perindustrian Senai, 81400 Senai, Johor, Malaysia
| | - C Y Ng
- CY Enterprise Sdn. Bhd., Taman Perindustrian Murni, 81400 Senai, Johor, Malaysia
| | - A A Azniwati
- School of Industrial Technology, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - G S Tay
- School of Industrial Technology, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia.
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Hur YJ, Kim J, Seong J, Lee CK, Kim BK, Kim DY. Combination of Radiotherapy and Atezolizumab plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma: A Pilot Study. Int J Radiat Oncol Biol Phys 2023; 117:e304-e305. [PMID: 37785109 DOI: 10.1016/j.ijrobp.2023.06.2325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Following the results of the IMbrave150 study, Atezolizumab plus bevacizumab (Atezo/beva) became the first-line treatment in patients with advanced hepatocellular carcinoma (HCC). However, its real-world efficacy has been less satisfied. In this study, we investigated the efficacy of radiotherapy (RT) combined with Atezo/beva in patients with advanced HCC. MATERIALS/METHODS Twenty patients received combination of RT and Atezo/beva between December 2021 and December 2022 at our institution. RT was administered in 10 fractions of 5 Gy between Atezo/beva cycles. Tumor response were evaluated on both imaging and tumor marker basis. The iRECIST guideline was used to assess treatment response after the combination treatment of RT and Atezo/beva. Primary endpoints were disease control rate (DCR) and overall response rate (ORR), and secondary endpoint was treatment related toxicity. RESULTS All patients were BCLC C with advanced tumors associated with lymph node metastasis (7, 35%) or distant metastasis (8, 40%). Patients received RT between cycles of Atezo/beva, mostly (14, 70%) between 2nd and 3rd cycles. After a median follow-up of 3.2 months, DCR was 65% and ORR was 20%. Significant decrease in tumor marker of over 2-fold was shown in 10 patients (50%). Regarding treatment related toxicity, only 1 patient (5%) showed grade 3 neutropenic fever, and no grade 4 or 5 toxicity was seen. CONCLUSION Combination of radiotherapy and Atezo/beva showed high response rate with tolerable treatment related toxicity in advanced HCC patients. Further prospective studies with larger patient cohort are warranted.
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Affiliation(s)
- Y J Hur
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J Seong
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - C K Lee
- Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - B K Kim
- Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - D Y Kim
- Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Mohd Suan MA, Ng YZ, Henry GF, Md Said R, Kollanthavelu S, Mustapha MI, Hoe CH, Lee CK, Rajamanickam P, Ismail I, Chan HK, Abu Hassan MR. Validation of Faecal Pyruvate Kinase Isoenzyme Type M2 (Faecal M2PK Quick) Test in Detection of Colorectal Adenoma and Adenocarcinoma Among High-Risk Malaysian Population. Asian Pac J Cancer Prev 2023; 24:3183-3186. [PMID: 37774070 PMCID: PMC10762739 DOI: 10.31557/apjcp.2023.24.9.3183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Colorectal neoplasia is a multistep process that can lead to the development of colorectal cancer. Colonoscopy is the gold standard for diagnosis and screening of colorectal cancer, but its uptake is often hindered by unpleasant experiences and logistic obstacles. Therefore, non-invasive biomarker tests such as the M2-pyruvate kinase (M2PK) test have been explored as a potential screening tool. OBJECTIVE This study aims to evaluate the efficacy of the M2PK Quick Stool Test (ScheBo®) in detecting colorectal adenoma and adenocarcinoma in high-risk Malaysian populations using colonoscopy as the comparison. METHODS A prospective, cross-sectional, multicenter study was conducted from December 2017 to December 2019 in four hospitals in Malaysia. Participants were eligible if they met any of the following criteria: personal or family history of colorectal polyps or cancer, inherited syndromes, altered bowel habits, rectal bleeding, unintended weight loss, loss of appetite, abdominal pain or cramps, or unexplained iron deficiency, or an Asia-Pacific Colorectal Screening score of 4-7. Participants provided a stool sample that was tested for M2PK using the M2PK Quick Test. Participants then underwent a colonoscopy, and any lesions found were biopsied and sent for histopathological examination. RESULTS A total of 562 participants were included in the study, of whom 89 had a positive M2PK test. Presence of adenoma and/or dysplastic lesions were confirmed in 14.4% and adenocarcinoma in 3.0% of the participants. The M2PK Quick Stool Test showed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 58.8%, 85.5%, 11.2% and 98.5%, respectively in detecting colorectal adenocarcinoma. For detection of colorectal adenoma, this test yielded a sensitivity, specificity, PPV and NPV of 27.3%, 86.3%, 27.0% and 86.5%, respectively. CONCLUSIONS The M2PK Quick Stool Test showed a moderate accuracy in detecting colorectal adenocarcinoma and adenomas in the studied population.
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Affiliation(s)
- Mohd Azri Mohd Suan
- Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
| | - Ying Zhuang Ng
- Gastroenterology unit, Medical Department, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
| | | | | | | | | | | | | | | | - Ibtisam Ismail
- Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
| | - Huan Keat Chan
- Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
| | - Muhammad Radzi Abu Hassan
- Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
- Gastroenterology unit, Medical Department, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
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Cheung SKF, Choi LCW, Chan YS, Ho JCY, Lee CK, Kwok JSY. Identification of 58 novel HLA alleles identified in Chinese individuals by next-generation sequencing. HLA 2023. [PMID: 37376846 DOI: 10.1111/tan.15127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023]
Abstract
HLA genes are the most polymorphic in the human genome. High resolution HLA typing from 13,870 bone marrow donors in Hong Kong was obtained using Next-generation sequencing (NGS) technology. Among the 67 novel alleles identified, official HLA allele names of 50 novel class I alleles (HLA-A, -B, -C) and 8 novel class II alleles (HLA-DRB1, -DQB1) were assigned by the World Health Organization (WHO) Nomenclature Committee for Factors of the HLA System.
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Affiliation(s)
- Stephen K F Cheung
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - Leo C W Choi
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - Y S Chan
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - Jenny C Y Ho
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Services, Hong Kong SAR, China
| | - Janette S Y Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
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Ng SC, Chu AWH, Chan WM, Yip CCY, Leung KH, So CK, Leung JNS, To KKW, Lee CK. Re-examine the transfusion transmitted risk of SARS-CoV-2 virus during a major COVID-19 outbreak in 2022. Transfus Med 2023. [PMID: 37286528 DOI: 10.1111/tme.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/16/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Although no case of COVID-19 transmission through transfusion has been reported, blood transfusion service (BTS) continues to implement pre-donation and post-donation measures to minimise the risk. In year 2022, when local healthcare system was badly impacted by a major outbreak, it opened an opportunity to re-examine the viraemia risk in these asymptomatic donors. MATERIALS AND METHODS Records were retrieved from blood donors who reported COVID-19 after donation and follow-up was also made for recipients who received their blood. Blood samples at donation were tested for SARS-CoV-2 viraemia by single-tube nested real-time RT-PCR assay designed to detect most SARS-CoV-2 variants including the prevailing delta and omicron variants. RESULTS From 1 January to 15 August 2022, the city with 7.4 M inhabitants recorded 1 187 844 COVID-19 positive cases and 125 936 successful blood donations were received. 781 donors reported to the BTS after donation with 701 being COVID-19 related (including close contact and symptoms respiratory tract infection). 525 COVID-19 were positive at the time of call back or follow-up. Of the 701 donations, they were processed into 1480 components with 1073 discarded upon donors' call back. For remaining 407 components, no recipient was found to have adverse event or COVID-19 positive. 510 samples from the above 525 COVID-19 positive donors were available and all tested negative for SARS-CoV-2 RNA. DISCUSSION With the negative SARS-CoV-2 RNA in blood donation samples and follow up data in transfusion recipients, the risk of transfusion transmitted COVID-19 appears negligible. However, current measures remains important in securing blood safety with ongoing surveillance of their effectiveness.
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Affiliation(s)
- S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - A W H Chu
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - W M Chan
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C C Y Yip
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - K H Leung
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C K So
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - K K W To
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
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Chan MY, Man SC, Lam M, Lai WH, Qin ZS, Ng MKR, Lee CK, Chen YHE, Lee HME, Liu LY, Wong HK, Zhang ZJ. Berberine for antipsychotic-induced metabolic syndrome in patients with schizophrenia spectrum disorders: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 3:4-7. [PMID: 37357582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Affiliation(s)
- M Y Chan
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - S C Man
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - M Lam
- Department of Adult Psychiatry, Castle Peak Hospital, Hong Kong SAR, China
| | - W H Lai
- Department of Adult Psychiatry, Castle Peak Hospital, Hong Kong SAR, China
| | - Z S Qin
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - M K R Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong SAR, China
| | - C K Lee
- Department of Psychiatry, Kowloon Hospital, Hong Kong SAR, China
| | - Y H E Chen
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - H M E Lee
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - L Y Liu
- Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - H K Wong
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Z J Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Yusof MR, Mohd Sharin MF, Aizat Sabri I, Jagwani AV, Lee FY, Ahmad Zaidi AI, Saiful Azli MZ, Rk Rishitra RR, Fahmey O, Lee CK, Khairul-Asri MG. [Iatrogenic hypospadias a preventable rare complication with two-stage repair with buccal mucosa graft: a case presen- tation]. Urologiia 2023:115-117. [PMID: 37401715] [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] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Urethral catheterization is a common procedure, but it is associated with a number of complications. Iatrogenic hypospadias can rarely occur. There is a limited literature dedicated to this condition. We report a young patient with COVID-19 with iatrogenic hypospadias of grade 3. He was undergone to a two-stage procedure with acceptable outcome. Surgical repair should be offered and performed for young patients to ensure good function with acceptable penile appearance. A surgical treatment will improve psychological, sexual and social outcomes.
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Affiliation(s)
- M R Yusof
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - M F Mohd Sharin
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - I Aizat Sabri
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - A V Jagwani
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - F Y Lee
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - A I Ahmad Zaidi
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - M Z Saiful Azli
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - Rk Rishitra Rk Rishitra
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - O Fahmey
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - C K Lee
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
| | - M G Khairul-Asri
- Department of Urology, Hospital Serdang, Serdang, Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Urology, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
- Plastic and Reconstructive Unit, Department of Surgery, Hospital Sultan Abdul Aziz Shah UPM, Malaysia
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Aizat Sabri I, Yusof MR, Jagwani AV, Fahmy O, Lee CK, Mg-Khairul Asri MKA, Wan Muhamad Mokhzani WM, Dharmendra G, Ahmad Zhariff H. [A rare case of bladder leiomyoma in pregnancy: a case report]. Urologiia 2022:118-121. [PMID: 36625624] [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] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We present a rare case of leiomyoma of the urinary bladder that was diagnosed during pregnancy. The case of a 29-year-old woman primigravida at 13 weeks of pregnancy who presented with 6 months history of abdominal swelling which was gradually increasing in size. Computed tomography done revealed a large heterogenous mass(enhancing) with an area of non-enhancing (necrosis) suggestive of malignant ovarian tumor. The histological findings of the surgical specimen confirmed a leiomyoma of the urinary bladder. The clinical presentation, imaging findings, and management of this relatively rare benign tumor are discussed in this case report.
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Affiliation(s)
- I Aizat Sabri
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - M R Yusof
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - A V Jagwani
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - O Fahmy
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - C K Lee
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Mg-Khairul Asri Mg-Khairul Asri
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - W M Wan Muhamad Mokhzani
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - G Dharmendra
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - H Ahmad Zhariff
- Department of Urology, Hospital Pengajar Universiti Pengajar, Universiti Putra Malaysia, Malaysia.,Urology Division, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Obstetric Department, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Kok PS, Antill YC, Scott CL, Lee CK. The impact of single agent PD-1 or PD-L1 inhibition on advanced endometrial cancers: meta-analysis. ESMO Open 2022; 7:100635. [PMID: 36410086 PMCID: PMC9808459 DOI: 10.1016/j.esmoop.2022.100635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/05/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitor (ICI) therapy is an emerging option for advanced endometrial cancer (EC). Mismatch repair (MMR) status is widely regarded as a biomarker predictive of response to ICIs. The predictive value of MMR based on small, single-arm trials, however, is conflicting. In this meta-analysis, we aimed to assess the activity of single-agent ICI in advanced EC, and compared the magnitude of treatment benefit in MMR deficient (dMMR) and MMR proficient (pMMR) EC. METHODS We carried out an electronic search to identify prospective trials of single-agent ICI in advanced EC. Data on objective response rate (ORR) and progression-free survival (PFS) were extracted and pooled. ORR was estimated using the inverse variance method and subgroup difference by MMR status was examined. PFS difference according to MMR status was summarized using the Kaplan-Meier approach. RESULTS From eight trials with 492 women, the pooled ORR was 19% [95% confidence interval (CI) 16% to 22%]. ORR was significantly greater in dMMR (n = 281) than pMMR EC (n = 211) (dMMR: 46%, pMMR: 8%; risk ratio 5.74, 95% CI 3.58-9.21; interaction P < 0.001). Complete response was 11% and 0.05% and median PFS was 8.3 and 2.1 months in dMMR and pMMR EC, respectively (hazard ratio PFS 0.58, 95% CI 0.38-0.89; P = 0.01). The 12-month PFS rates were 42.0% and 20.7%, respectively. CONCLUSION Single-agent ICI is associated with a 5.74 times greater objective response and 42% reduction in risk of disease progression or death in dMMR compared with pMMR EC. MMR status should be determined prospectively and be used as a stratification factor in future trials of advanced EC. Further translational analysis is urgently required to identify the cause of dMMR and allow subclassification of EC into different dMMR molecular subtypes.
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Affiliation(s)
- P-S Kok
- Australia New Zealand Gynaecological Oncology Group, Sydney, Australia; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia; Prince of Wales Hospital, Randwick, Australia.
| | - Y C Antill
- Australia New Zealand Gynaecological Oncology Group, Sydney, Australia; Faculty of Medicine, Dentistry and Health Sciences, Monash University, Melbourne, Australia
| | - C L Scott
- Australia New Zealand Gynaecological Oncology Group, Sydney, Australia; Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia; Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Australia
| | - C K Lee
- Australia New Zealand Gynaecological Oncology Group, Sydney, Australia; Cancer Care Centre, St George Hospital, Sydney, Australia
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Frenel JS, Kim JW, Aryal N, Asher R, Berton D, Vidal L, Pautier P, Ledermann JA, Penson RT, Oza AM, Korach J, Huzarski T, Pignata S, Colombo N, Park-Simon TW, Tamura K, Sonke GS, Freimund AE, Lee CK, Pujade-Lauraine E. Efficacy of subsequent chemotherapy for patients with BRCA1/2-mutated recurrent epithelial ovarian cancer progressing on olaparib versus placebo maintenance: post-hoc analyses of the SOLO2/ENGOT Ov-21 trial. Ann Oncol 2022; 33:1021-1028. [PMID: 35772665 DOI: 10.1016/j.annonc.2022.06.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In the SOLO2 trial (ENGOT Ov-21; NCT01874353), maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer (PSROC) and BRCA mutation significantly improved progression-free survival (PFS) and prolonged overall survival (OS). Following disease progression on olaparib, efficacy of subsequent chemotherapy remains unknown. PATIENTS AND METHODS We conducted a post-hoc hypothesis-generating analysis of SOLO2 data to determine the efficacy of different chemotherapy regimens following RECIST disease progression in patients who received olaparib or placebo. We evaluated time to second progression (TTSP) calculated from the date of RECIST progression to the next progression/death. RESULTS The study population comprised 147 patients who received chemotherapy as their first subsequent treatment after RECIST progression. Of these, 69 (47%) and 78 (53%) were originally randomized to placebo and olaparib arms, respectively. In the placebo-treated cohort, 27/69 and 42/69 received non-platinum and platinum-based chemotherapy, respectively, compared with 24/78 and 54/78, respectively, in the olaparib-treated cohort. Among patients treated with chemotherapy (N = 147), TTSP was significantly longer in the placebo than in the olaparib arm: 12.1 versus 6.9 months [hazard ratio (HR) 2.17, 95% confidence interval (CI) 1.47-3.19]. Similar result was obtained on multivariable analysis adjusting for prognostic factors at RECIST progression (HR 2.13, 95% CI 1.41-3.22). Among patients treated with platinum-based chemotherapy (n = 96), TTSP was significantly longer in the placebo arm: 14.3 versus 7.0 months (HR 2.89, 95% CI 1.73-4.82). Conversely, among patients treated with non-platinum-based chemotherapy (n = 51), the TTSP was comparable in the placebo and olaparib arms: 8.3 versus 6.0 months (HR 1.58, 95% CI 0.86-2.90). CONCLUSIONS Following progression from maintenance olaparib in the recurrent setting, the efficacy of platinum-based subsequent chemotherapy seems to be reduced in BRCA1/2-mutated patients with PSROC compared to patients not previously receiving poly (ADP-ribose) polymerase inhibitors (PARPi). The optimal strategy for patients who relapse after PARPi is an area of ongoing research.
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Affiliation(s)
- J S Frenel
- Institut de Cancerologie de l'Ouest, GINECO, GINEGEPS, Centre René Gauducheau, Saint-Herblain, France.
| | - J W Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - N Aryal
- NHMRC CTC Centre, University of Sydney, Camperdown, Sydney, Australia
| | - R Asher
- NHMRC CTC Centre, University of Sydney, Camperdown, Sydney, Australia
| | - D Berton
- Institut de Cancerologie de l'Ouest, GINECO, GINEGEPS, Centre René Gauducheau, Saint-Herblain, France
| | - L Vidal
- GEICO & H Clínic de Barcelona, Barcelona, Spain
| | - P Pautier
- GINECO & Gustave Roussy Cancer Center, Villejuif, France
| | | | - R T Penson
- Massachusetts General Hospital, Boston, USA
| | - A M Oza
- Princess Margaret Cancer Centre, Toronto, Canada
| | - J Korach
- ISGO & Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - T Huzarski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - S Pignata
- MITO & Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Napoli, Naples, Italy
| | - N Colombo
- MaNGO & European Institute of Oncology IRCCS and University of Milan-Bicocca, Milano, Italy
| | - T W Park-Simon
- AGO & Medical School, Department of Gynecologic Oncology, Hannover, Hannover, Germany
| | - K Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - G S Sonke
- DGOG & Netherlands Cancer Institute, Amsterdam, Netherlands
| | - A E Freimund
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - C K Lee
- NHMRC CTC Centre, University of Sydney, Camperdown, Sydney, Australia
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11
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Yusof MR, Fairuz MS, Lee FY, Arvind VJ, Fahmy O, Lee CK, Saiful Azli MZ, Arunasalam AP, Khairul-Asri MG. [The tale of two stones in an obstructed partial duplex kidney: case presentation]. Urologiia 2022:78-80. [PMID: 35274865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Duplex renal systems is a common anomalies. Incidence rate of 0.8% in healthy adult population and 2-4% in patients investigated for urinary tract symptoms. Urolithiasis management for patients with anomalies is complex and require proper imaging and planning. We have a patient with a partial duplex collecting system presented with a right renal calculus in a non-functioning lower moiety and multiple distal ureteric calculi. Preoperative planning done and surgery performed with good outcome without any early and late complications.
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Affiliation(s)
- M R Yusof
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - M S Fairuz
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - F Y Lee
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - V J Arvind
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - O Fahmy
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - C K Lee
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - M Z Saiful Azli
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - A P Arunasalam
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
| | - M G Khairul-Asri
- Department of Urology, Hospital Pengajar Universiti Putra Malaysia
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
- Department of Urology, Hospital Serdang
- Selangor, Malaysia
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12
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Lee JHM, Loo CH, Tan WC, Lee CK, Jamil A, Khor YH. Comparison of noninvasive screening tools for hepatic fibrosis, association with methotrexate cumulative dose, and risk factors in psoriasis patients. Dermatol Ther 2021; 35:e15203. [PMID: 34779102 DOI: 10.1111/dth.15203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
Methotrexate (MTX) is a first-line systemic psoriasis therapy with risk of liver fibrosis. Noninvasive tools for liver fibrosis screening are Fibroscan®, Fibrosis-4 (FIB-4) index, and aspartate aminotransferase-to-platelet ratio (APRI) index. To compare Fibroscan®, FIB-4, and APRI in detecting fibrosis, determine association of fibrosis with MTX cumulative dose, and explore risk factors for fibrosis. A case-control study involving psoriasis patients aged ≥18 years with MTX cumulative dose ≥1 g, with age and sex-matched MTX naïve psoriasis patients was performed. Noninvasive tools were used to assess liver fibrosis. Sixty-one patients on MTX and 54 controls participated. Fibroscan® detected fibrosis in 22 (36.1%) patients on MTX compared to 11 (19.6%) controls (p = 0.05). FIB-4 predicted fibrosis in 13 (21.3%) patients on MTX and in 10 (17.9%) controls (p = 0.64) while APRI diagnosed 7 (11.5%) versus 7 (12.5%), p = 0.65. No significant correlation between Fibroscan® assessed liver stiffness and MTX cumulative dose (p = 0.47). Independent risk factors for liver fibrosis were MTX use with raised alanine aminotransferase (OR = 68.56, 95% CI 8.26; 568.86, p < 0.001), diabetes mellitus (OR = 30.35, 95% CI 7.52; 122.42, p < 0.001), and raised BMI (obese patients OR = 8.26, 95% CI 1.73-39.43, p = 0.02; overweight patients OR = 6.29, 95% CI 1.28-30.99, p = 0.01). Liver fibrosis occurred in both MTX naïve and MTX-treated psoriasis patients. Fibroscan® detected higher prevalence of liver fibrosis compared to FIB-4 and APRI. Cumulative MTX does not correlate with fibrosis severity. Fibroscan® is recommended prior to MTX therapy and at regular intervals especially among patients with diabetes and increased BMI.
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Affiliation(s)
- Janet H M Lee
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia.,Department of Medicine, Dermatology Unit, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Chai Har Loo
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
| | - Wooi Chiang Tan
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
| | - Choon Kin Lee
- Department of Medicine, Gastroenterology Unit, Loh Guan Lye Specialists Centre, Penang, Malaysia
| | - Adawiyah Jamil
- Department of Medicine, Dermatology Unit, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Yek Huan Khor
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
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13
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Dayan I, Roth HR, Zhong A, Harouni A, Gentili A, Abidin AZ, Liu A, Costa AB, Wood BJ, Tsai CS, Wang CH, Hsu CN, Lee CK, Ruan P, Xu D, Wu D, Huang E, Kitamura FC, Lacey G, de Antônio Corradi GC, Nino G, Shin HH, Obinata H, Ren H, Crane JC, Tetreault J, Guan J, Garrett JW, Kaggie JD, Park JG, Dreyer K, Juluru K, Kersten K, Rockenbach MABC, Linguraru MG, Haider MA, AbdelMaseeh M, Rieke N, Damasceno PF, E Silva PMC, Wang P, Xu S, Kawano S, Sriswasdi S, Park SY, Grist TM, Buch V, Jantarabenjakul W, Wang W, Tak WY, Li X, Lin X, Kwon YJ, Quraini A, Feng A, Priest AN, Turkbey B, Glicksberg B, Bizzo B, Kim BS, Tor-Díez C, Lee CC, Hsu CJ, Lin C, Lai CL, Hess CP, Compas C, Bhatia D, Oermann EK, Leibovitz E, Sasaki H, Mori H, Yang I, Sohn JH, Murthy KNK, Fu LC, de Mendonça MRF, Fralick M, Kang MK, Adil M, Gangai N, Vateekul P, Elnajjar P, Hickman S, Majumdar S, McLeod SL, Reed S, Gräf S, Harmon S, Kodama T, Puthanakit T, Mazzulli T, de Lavor VL, Rakvongthai Y, Lee YR, Wen Y, Gilbert FJ, Flores MG, Li Q. Federated learning for predicting clinical outcomes in patients with COVID-19. Nat Med 2021; 27:1735-1743. [PMID: 34526699 PMCID: PMC9157510 DOI: 10.1038/s41591-021-01506-3] [Citation(s) in RCA: 152] [Impact Index Per Article: 50.7] [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] [Received: 12/21/2020] [Accepted: 08/13/2021] [Indexed: 02/08/2023]
Abstract
Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC) >0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site's data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare.
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Affiliation(s)
- Ittai Dayan
- MGH Radiology and Harvard Medical School, Boston, MA, USA
| | | | - Aoxiao Zhong
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | | | | | | | | | | | - Bradford J Wood
- Radiology & Imaging Sciences/Clinical Center, National Institutes of Health, Bethesda, MD, USA
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Chien-Sung Tsai
- Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Nan Hsu
- Center for Research in Biological Systems, University of California, San Diego, CA, USA
| | - C K Lee
- NVIDIA, Santa Clara, CA, USA
| | | | | | - Dufan Wu
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | - Gustavo Nino
- Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, Washington, DC, USA
| | - Hao-Hsin Shin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Hui Ren
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jason C Crane
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | | | - John W Garrett
- Departments of Radiology and Medical Physics, The University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Joshua D Kaggie
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge, Cambridge, UK
| | - Jung Gil Park
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Keith Dreyer
- MGH Radiology and Harvard Medical School, Boston, MA, USA
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA
| | - Krishna Juluru
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA
- Departments of Radiology and Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Masoom A Haider
- Joint Dept. of Medical Imaging, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
| | | | | | - Pablo F Damasceno
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Pochuan Wang
- MeDA Lab Institute of Applied Mathematical Sciences, National Taiwan University, Taipei, Taiwan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Sheng Xu
- Radiology & Imaging Sciences/Clinical Center, National Institutes of Health, Bethesda, MD, USA
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Sira Sriswasdi
- Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center for Artificial Intelligence in Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Soo Young Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Thomas M Grist
- Departments of Radiology, Medical Physics, and Biomedical Engineering, The University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Varun Buch
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA
| | - Watsamon Jantarabenjakul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Weichung Wang
- MeDA Lab Institute of Applied Mathematical Sciences, National Taiwan University, Taipei, Taiwan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Won Young Tak
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Xiang Li
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Xihong Lin
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Young Joon Kwon
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Andrew N Priest
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, Cambridge University Hospital, Cambridge, UK
| | - Baris Turkbey
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Benjamin Glicksberg
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bernardo Bizzo
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA
| | - Byung Seok Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Carlos Tor-Díez
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA
| | - Chia-Cheng Lee
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Jung Hsu
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chin Lin
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chiu-Ling Lai
- Medical Review and Pharmaceutical Benefits Division, National Health Insurance Administration, Taipei, Taiwan
| | - Christopher P Hess
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | | | - Eric K Oermann
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Evan Leibovitz
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA
| | | | - Hitoshi Mori
- Self-Defense Forces Central Hospital, Tokyo, Japan
| | | | - Jae Ho Sohn
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Li-Chen Fu
- MOST/NTU All Vista Healthcare Center, Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | | | - Mike Fralick
- Division of General Internal Medicine and Geriatrics (Fralick), Sinai Health System, Toronto, Ontario, Canada
| | - Min Kyu Kang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | | | - Natalie Gangai
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peerapon Vateekul
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | | | - Sarah Hickman
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge, Cambridge, UK
| | - Sharmila Majumdar
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Shelley L McLeod
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sheridan Reed
- Radiology & Imaging Sciences/Clinical Center, National Institutes of Health, Bethesda, MD, USA
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Stefan Gräf
- Department of Medicine and NIHR BioResource for Translational Research, NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Stephanie Harmon
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Clinical Research Directorate, Frederick National Laboratory for Cancer, National Cancer Institute, Frederick, MD, USA
| | | | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tony Mazzulli
- Department of Microbiology, Sinai Health/University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario Laboratories, Toronto, Ontario, Canada
| | | | - Yothin Rakvongthai
- Chulalongkorn University Biomedical Imaging Group and Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yu Rim Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | | | - Fiona J Gilbert
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge, Cambridge, UK
| | | | - Quanzheng Li
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Planchard D, Feng PH, Karaseva N, Kim SW, Kim TM, Lee CK, Poltoratskiy A, Yanagitani N, Marshall R, Huang X, Howarth P, Jänne PA, Kobayashi K. Osimertinib plus platinum-pemetrexed in newly diagnosed epidermal growth factor receptor mutation-positive advanced/metastatic non-small-cell lung cancer: safety run-in results from the FLAURA2 study. ESMO Open 2021; 6:100271. [PMID: 34543864 PMCID: PMC8453202 DOI: 10.1016/j.esmoop.2021.100271] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/11/2021] [Accepted: 08/21/2021] [Indexed: 11/25/2022] Open
Abstract
Background The phase III FLAURA2 (NCT04035486) study will evaluate efficacy and safety of first-line osimertinib with platinum–pemetrexed chemotherapy versus osimertinib monotherapy in epidermal growth factor receptor mutation-positive (EGFRm) advanced/metastatic non-small-cell lung cancer (NSCLC). The safety run-in, reported here, assessed the safety and tolerability of osimertinib with chemotherapy prior to the randomized phase III evaluation. Patients and methods Patients (≥18 years; Japan: ≥20 years) with EGFRm locally advanced/metastatic NSCLC received oral osimertinib 80 mg once daily (QD), with either intravenous (IV) cisplatin 75 mg/m2 or IV carboplatin target area under the curve 5, plus pemetrexed 500 mg/m2 every 3 weeks (Q3W) for four cycles. Maintenance was osimertinib 80 mg QD with pemetrexed 500 mg/m2 Q3W until progression/discontinuation. The primary objective was to evaluate safety and tolerability of the osimertinib–chemotherapy combination. Results Thirty patients (15 per group) received treatment [Asian, 73%; female, 63%; median age (range) 61 (45-84) years]. Adverse events (AEs) were reported by 27 patients (90%): osimertinib–carboplatin–pemetrexed, 100%; osimertinib–cisplatin–pemetrexed, 80%. Most common AEs were constipation (60%) with osimertinib–carboplatin–pemetrexed and nausea (60%) with osimertinib–cisplatin–pemetrexed. In both groups, 20% of patients reported serious AEs. No specific pattern of AEs leading to dose modifications/discontinuations was observed; one patient discontinued all study treatments including osimertinib due to pneumonitis (study-specific discontinuation criterion). Hematologic toxicities were as expected and manageable. Conclusions Osimertinib–chemotherapy combination had a manageable safety and tolerability profile in EGFRm advanced/metastatic NSCLC, supporting further assessment in the FLAURA2 randomized phase. FLAURA2 aims to assess efficacy and safety of first-line osimertinib with platinum–pemetrexed in EGFRm advanced NSCLC. In the FLAURA2 safety run-in period, 30 patients received osimertinib and pemetrexed with carboplatin or cisplatin. Most common AEs were constipation and nausea; no AE patterns leading to dose modifications/discontinuations were observed. The FLAURA2 safety run-in study showed that the safety profile of this combination was as expected and manageable.
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Affiliation(s)
- D Planchard
- Institut Gustave Roussy, Department of Medical Oncology, Thoracic Oncology Unit, Villejuif, France.
| | - P-H Feng
- Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - N Karaseva
- City Clinical Oncology Dispensary, St. Petersburg, Russia
| | - S-W Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - T M Kim
- Seoul National University Hospital, Seoul, Republic of Korea
| | - C K Lee
- Clinical Research Unit, Division of Cancer Services, St. George Hospital, Kogarah, Australia
| | - A Poltoratskiy
- Department of Clinical Trials, Petrov Research Institute of Oncology, St. Petersburg, Russia
| | - N Yanagitani
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | | | | | | | - P A Jänne
- Dana-Farber Cancer Institute, Boston, USA
| | - K Kobayashi
- Department of Respiratory Medicine, Saitama Medical School International Medical Center, Saitama, Japan
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15
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Wong MMC, Chung AKK, Yeung TMH, Wong DTW, Lee CK, Lai E, Chan GFY, Mak GKL, Wong JOY, Ng RMK, Tam KL, Mak KY. Consensus statements on the clinical usage and characteristics of aripiprazole for Hong Kong. Intern Med J 2021; 50 Suppl 3:6-14. [PMID: 32985093 DOI: 10.1111/imj.14896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Aripiprazole, a dopamine partial agonist, is a second-generation anti-psychotic that is widely used for the treatment of schizophrenia and other psychotic disorders. A group of psychiatric experts in Hong Kong developed a set of consensus statements, aiming to facilitate the understanding of clinical properties and usages of aripiprazole among local physicians. Of note, because aripiprazole long-acting injectable has been available locally not long before the establishment of the consensus panel, which limited the discussion on its use in the local context, the consensus statements were focused primarily on oral aripiprazole. To draft the consensus statements, the panellists discussed the published evidence and their clinical experience regarding aripiprazole in a series of meetings based on several areas. At the final meeting, each drafted statement was voted on anonymously by all panellists based on its practicability of recommendation in Hong Kong. A set of consensus statements on the characteristics and clinical use of aripiprazole was established and accepted by the panel. These statements serve to provide a practical reference for physicians in Hong Kong, and possibly other parts of the Asia-Pacific region, on the use of aripiprazole in people with schizophrenia spectrum disorders and other psychotic problems.
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Affiliation(s)
| | | | | | | | - C K Lee
- Asian Association of Neuropsychopharmacology
| | - Eric Lai
- Asian Association of Neuropsychopharmacology
| | | | | | | | | | - K L Tam
- Asian Association of Neuropsychopharmacology
| | - K Y Mak
- Asian Association of Neuropsychopharmacology
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16
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Flores M, Dayan I, Roth H, Zhong A, Harouni A, Gentili A, Abidin A, Liu A, Costa A, Wood B, Tsai CS, Wang CH, Hsu CN, Lee CK, Ruan C, Xu D, Wu D, Huang E, Kitamura F, Lacey G, César de Antônio Corradi G, Shin HH, Obinata H, Ren H, Crane J, Tetreault J, Guan J, Garrett J, Park JG, Dreyer K, Juluru K, Kersten K, Bezerra Cavalcanti Rockenbach MA, Linguraru M, Haider M, AbdelMaseeh M, Rieke N, Damasceno P, Cruz E Silva PM, Wang P, Xu S, Kawano S, Sriswasdi S, Park SY, Grist T, Buch V, Jantarabenjakul W, Wang W, Tak WY, Li X, Lin X, Kwon F, Gilbert F, Kaggie J, Li Q, Quraini A, Feng A, Priest A, Turkbey B, Glicksberg B, Bizzo B, Kim BS, Tor-Diez C, Lee CC, Hsu CJ, Lin C, Lai CL, Hess C, Compas C, Bhatia D, Oermann E, Leibovitz E, Sasaki H, Mori H, Yang I, Sohn JH, Keshava Murthy KN, Fu LC, Furtado de Mendonça MR, Fralick M, Kang MK, Adil M, Gangai N, Vateekul P, Elnajjar P, Hickman S, Majumdar S, McLeod S, Reed S, Graf S, Harmon S, Kodama T, Puthanakit T, Mazzulli T, de Lima Lavor V, Rakvongthai Y, Lee YR, Wen Y. Federated Learning used for predicting outcomes in SARS-COV-2 patients. Res Sq 2021:rs.3.rs-126892. [PMID: 33442676 PMCID: PMC7805458 DOI: 10.21203/rs.3.rs-126892/v1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
'Federated Learning' (FL) is a method to train Artificial Intelligence (AI) models with data from multiple sources while maintaining anonymity of the data thus removing many barriers to data sharing. During the SARS-COV-2 pandemic, 20 institutes collaborated on a healthcare FL study to predict future oxygen requirements of infected patients using inputs of vital signs, laboratory data, and chest x-rays, constituting the "EXAM" (EMR CXR AI Model) model. EXAM achieved an average Area Under the Curve (AUC) of over 0.92, an average improvement of 16%, and a 38% increase in generalisability over local models. The FL paradigm was successfully applied to facilitate a rapid data science collaboration without data exchange, resulting in a model that generalised across heterogeneous, unharmonized datasets. This provided the broader healthcare community with a validated model to respond to COVID-19 challenges, as well as set the stage for broader use of FL in healthcare.
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Affiliation(s)
| | | | | | - Aoxiao Zhong
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | | | | | | | - Bradford Wood
- Radiology & Imaging Sciences / Clinical Center, National Institutes of Health
| | - Chien-Sung Tsai
- Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chih-Hung Wang
- Tri-Service General Hospital, National Defense Medical Center
| | - Chun-Nan Hsu
- Center for Research in Biological Systems, University of California, San Diego
| | | | | | | | - Dufan Wu
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | - Hui Ren
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jason Crane
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | | | - John Garrett
- The University of Wisconsin-Madison School of Medicine and Public Health
| | | | - Keith Dreyer
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA
| | | | | | | | - Marius Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital and School of Medicine and Health Sciences, George Washington University, Washington, DC
| | - Masoom Haider
- Joint Dept. of Medical Imaging, Sinai Health System, University of Toronto, Toronto, Canada and Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
| | | | | | - Pablo Damasceno
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | - Pochuan Wang
- MeDA Lab and Institute of Applied Mathematical Sciences, National Taiwan University, Taipei, Taiwan
| | - Sheng Xu
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Soo Young Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | | | - Varun Buch
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA
| | - Watsamon Jantarabenjakul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand and Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital, Bang
| | | | - Won Young Tak
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Xiang Li
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Xihong Lin
- Harvard T.H. Chan School of Public Health
| | | | | | - Josh Kaggie
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge
| | - Quanzheng Li
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | - Andrew Priest
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, Cambridge University Hospital
| | | | | | - Bernardo Bizzo
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA
| | - Byung Seok Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Carlos Tor-Diez
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC
| | - Chia-Cheng Lee
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C. and Division of Colorectal Surgery, Department of Surgery, Tri-Service General H
| | - Chia-Jung Hsu
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chin Lin
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, R.O.C. and School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C. and Graduate Institute of Life Scienc
| | - Chiu-Ling Lai
- Medical Review and Pharmaceutical Benefits Division, National Health Insurance Administration, Taipei. Taiwan
| | | | | | | | | | - Evan Leibovitz
- The Center for Clinical Data Science, Mass General Brigham
| | | | | | | | - Jae Ho Sohn
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | - Li-Chen Fu
- MOST/NTU All Vista Healthcare Center, Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | | | - Mike Fralick
- Division of General Internal Medicine and Geriatrics (Fralick), Sinai Health System, Toronto, Canada
| | - Min Kyu Kang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | | | | | - Peerapon Vateekul
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University
| | | | - Sarah Hickman
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge
| | - Sharmila Majumdar
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Shelley McLeod
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, ON, Canada and Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Sheridan Reed
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Center of Excellence in Pediatric Infectious Diseases and Vaccine, Chulalongkorn University
| | - Tony Mazzulli
- Department of Microbiology, Sinai Health/University Health Network, Toronto, Canada and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto. Canada Public Health Ontar
| | | | - Yothin Rakvongthai
- Chulalongkorn University Biomedical Imaging Group and Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yu Rim Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
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17
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Lee CK, Leung JNS, Cheng P, Lung DC, To KKW, Tsang DNC. Absence of SARS-CoV-2 viraemia in a blood donor with COVID-19 post-donation. Transfus Med 2020; 31:223-224. [PMID: 33015920 PMCID: PMC7677860 DOI: 10.1111/tme.12724] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/22/2020] [Indexed: 12/01/2022]
Affiliation(s)
- C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, SAR, China
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, SAR, China
| | - P Cheng
- Public Health Laboratory Centre, Centre for Health Protection, Department of Health, Hong Kong, SAR, China
| | - D C Lung
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, SAR, China
| | - K K W To
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - D N C Tsang
- Public Health Laboratory Centre, Centre for Health Protection, Department of Health, Hong Kong, SAR, China
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18
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Chow YF, Cheng BCP, Cheng HK, Ho B, Lee CK, Ng SK, So R, Tse KC, Tsui C, Wan R, Wong S. Hong Kong Society of Clinical Blood Management recommendations for implementation of patient blood management. Hong Kong Med J 2020; 26:331-338. [PMID: 32807736 DOI: 10.12809/hkmj208397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Patient blood management (PBM) is a patient-centred, multidisciplinary approach to optimise red cell mass, minimise blood loss, and manage tolerance to anaemia in an effort to improve patient outcomes. Well-implemented PBM improves patient outcomes and reduces demand for blood products. The multidisciplinary approach of PBM can often allow patients to avoid blood transfusions, which are associated with less favourable clinical outcomes. In Hong Kong, there has been increasing demand for blood in the ageing population, and there are simultaneous blood safety and donor issues that are adversely affecting the blood supply. To address these challenges, the Hong Kong Society of Clinical Blood Management recommends implementation of a PBM programme in Hong Kong, including strategies such as optimising red blood cell mass, improving anaemia management, minimising blood loss, and rationalising the use of blood and blood products.
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Affiliation(s)
- Y F Chow
- Department of Anaesthesiology and OT Services, Queen Elizabeth Hospital, Hong Kong
| | - B C P Cheng
- Department of Anaesthesia and Operating Theatre Services, Tuen Mun Hospital, Hong Kong
| | - H K Cheng
- Department of Anaesthesia and Operating Theatre Services, Tseung Kwan O Hospital, Hong Kong
| | - B Ho
- Department of Anaesthesiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - S K Ng
- Private Practice, Hong Kong
| | - R So
- Department of Anaesthesia, Princess Margaret Hospital, Hong Kong
| | - K C Tse
- Department of Anaesthesia and Operating Theatre Services, Tseung Kwan O Hospital, Hong Kong
| | - C Tsui
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong Kong
| | - R Wan
- Private Practice, Hong Kong
| | - S Wong
- Department of Anaesthesiology and OT Services, Queen Elizabeth Hospital, Hong Kong
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19
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Tsan SEH, Kamalanathan A, Lee CK, Zakaria SA, Wang CY. A survey on burnout and depression risk among anaesthetists during COVID-19: the tip of an iceberg? Anaesthesia 2020; 76 Suppl 3:8-10. [PMID: 32776524 PMCID: PMC7436440 DOI: 10.1111/anae.15231] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Affiliation(s)
- S E H Tsan
- University of Malaysia Sarawak, Sarawak, Malaysia
| | | | - C K Lee
- Sungai Buloh Hospital, Ministry of Health, Malaysia
| | - S A Zakaria
- Sungai Buloh Hospital, Ministry of Health, Malaysia
| | - C Y Wang
- University of Malaya, Kuala Lumpur, Malaysia
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20
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Luen SJ, Asher R, Lee CK, Savas P, Kammler R, Dell'Orto P, Biasi OM, Demanse D, Hackl W, Thuerlimann B, Viale G, Di Leo A, Colleoni M, Regan MM, Loi S. Identifying oncogenic drivers associated with increased risk of late distant recurrence in postmenopausal, estrogen receptor-positive, HER2-negative early breast cancer: results from the BIG 1-98 study. Ann Oncol 2020; 31:1359-1365. [PMID: 32652112 DOI: 10.1016/j.annonc.2020.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/08/2020] [Accepted: 06/28/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In postmenopausal, estrogen receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer, the risk for distant recurrence can extend beyond 5 years of adjuvant endocrine therapy. This study aims to identify genomic driver alterations associated with late distant recurrence. PATIENTS AND METHODS Next generation sequencing was used to characterize driver alterations in primary tumors from a subset of 764 postmenopausal estrogen receptor-positive/HER2-negative patients from the BIG 1-98 randomized trial. Late distant recurrence events were defined as ≥5 years from time of randomization). The association of driver alterations with distant recurrence-free interval in early and late time periods was assessed using Cox regression models. Multivariable analyses were carried out to adjust for clinicopathological factors. Weighted analysis methods were used in order to correct for over-sampling of distant recurrences. RESULTS A total of 538 of 764 (70%) samples were successfully sequenced including 88 (63%) early and 52 (37%) late distant recurrence events after a median follow up of 8.1 years. In univariable analysis for late distant recurrence, PIK3CA mutations (58.8%) were significantly associated with reduced risk [hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.20-0.82, P = 0.012], whereas amplifications on chromosome 8p11 (10.9%) (HR 4.79, 95% CI 2.30-9.97, P < 0.001) and BRCA2 mutations (2.3%) (HR 5.39, 95% CI 1.51-19.29, P = 0.010) were significantly associated with an increased risk. In multivariable analysis, only amplifications on 8p11 (P = 0.002) and BRCA2 mutations (P = 0.013) remained significant predictors. CONCLUSIONS In estrogen receptor-positive/HER2-negative postmenopausal early breast cancer, PIK3CA mutations were associated with reduced risk of late distant recurrence, whereas amplifications on 8p11 and BRCA2 mutations were associated with increased risk of late distant recurrence. The characterization of oncogenic driver alterations may aid in refining treatment choices in the late disease setting, and help identify potential drug targets for testing in future trials.
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Affiliation(s)
- S J Luen
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - R Asher
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - C K Lee
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - P Savas
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - R Kammler
- International Breast Cancer Study Group, Coordinating Center, Central Pathology Office, Bern, Switzerland
| | - P Dell'Orto
- International Breast Cancer Study Group Central Pathology Office, Department of Pathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - O M Biasi
- Division of Pathology and Laboratory Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - D Demanse
- Novartis Pharma AG, Basel, Switzerland
| | - W Hackl
- OncogenomX Inc., Allschwil, Basel, Switzerland
| | - B Thuerlimann
- Breast Center, Cantonal Hospital, St Gallen, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - G Viale
- Department of Pathology, University of Milan, Milan, Italy; IEO European Institute of Oncology IRCCS, Milan, Italy
| | - A Di Leo
- Sandro Pitigliani Department of Medical Oncology, Hospital of Prato, Prato, Italy
| | - M Colleoni
- Division of Medical Senology, European Institute of Oncology, Milan, Italy
| | - M M Regan
- International Breast Cancer Study Group Statistical Center, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia.
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21
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Ng SC, Wong HK, So CK, Lau CW, Leung JNS, Tsoi WC, Lee CK. Streptococcus bovis bacteraemia should be investigated for early detection of colorectal pathology. Hong Kong Med J 2019; 25:414. [PMID: 31761757 DOI: 10.12809/hkmj198135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - H K Wong
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - C K So
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - C W Lau
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - W C Tsoi
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
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22
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Kwon HY, Kim NJ, Lee CK, Yoon HG, Choi JW, Won C. An innovative magnetic state generator using machine learning techniques. Sci Rep 2019; 9:16706. [PMID: 31723230 PMCID: PMC6853879 DOI: 10.1038/s41598-019-53411-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 10/28/2019] [Indexed: 12/02/2022] Open
Abstract
We propose a new efficient algorithm to simulate magnetic structures numerically. It contains a generative model using a complex-valued neural network to generate k-space information. The output information is hermitized and transformed into real-space spin configurations through an inverse fast Fourier transform. The Adam version of stochastic gradient descent is used to minimize the magnetic energy, which is the cost of our algorithm. The algorithm provides the proper ground spin configurations with outstanding performance. In model cases, the algorithm was successfully applied to solve the spin configurations of magnetic chiral structures. The results also showed that a magnetic long-range order could be obtained regardless of the total simulation system size.
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Affiliation(s)
- H Y Kwon
- Department of Physics, Kyung Hee University, Seoul, 02447, South Korea
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
| | - N J Kim
- Department of Physics, Kyung Hee University, Seoul, 02447, South Korea
| | - C K Lee
- Department of Physics, Kyung Hee University, Seoul, 02447, South Korea
| | - H G Yoon
- Department of Physics, Kyung Hee University, Seoul, 02447, South Korea
| | - J W Choi
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
| | - C Won
- Department of Physics, Kyung Hee University, Seoul, 02447, South Korea.
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23
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Park YM, Lee CK, Kim HJ. Gastrointestinal: Colon cast with segmental stricture following colonic ischemia. J Gastroenterol Hepatol 2019; 34:630. [PMID: 30592093 DOI: 10.1111/jgh.14550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/01/2018] [Accepted: 11/13/2018] [Indexed: 12/09/2022]
Affiliation(s)
- Y M Park
- Center for Crohn's and Colitis, Department of Gastroenterology, Kyung Hee University School of Medicine, Seoul, Korea
| | - C K Lee
- Center for Crohn's and Colitis, Department of Gastroenterology, Kyung Hee University School of Medicine, Seoul, Korea
| | - H J Kim
- Center for Crohn's and Colitis, Department of Gastroenterology, Kyung Hee University School of Medicine, Seoul, Korea
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24
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Mak LY, Lau CW, Hui YT, Ng C, Shan E, Li MK, Lau JY, Chiu PW, Leong HT, Ho J, Wu JC, Lee CK, Leung WK. Joint recommendations on management of anaemia in patients with gastrointestinal bleeding in Hong Kong. Hong Kong Med J 2018; 24:416-422. [PMID: 30100584 DOI: 10.12809/hkmj187348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The demand for blood products continues to grow in an unsustainable manner in Hong Kong. While anaemia associated with gastrointestinal bleeding (GIB) is the leading indication for transfusion, there is no local recommendation regarding best practices for transfusion. We aimed to provide evidence-based recommendations regarding management of anaemia in patients with acute and chronic GIB. We reviewed all original papers, meta-analyses, systematic reviews, or guidelines that were available in PubMed. For acute GIB, a restrictive transfusion strategy, targeting a haemoglobin threshold of 7 to 8 g/dL, should be adopted because overtransfusion is associated with significantly higher all-cause mortality and re-bleeding. A liberal transfusion strategy should only be considered in patients with co-existing symptomatic coronary artery disease, targeting a haemoglobin threshold of 9 to 10 g/dL. When acute GIB settles, patients should be prescribed iron supplements if iron deficiency is present. For chronic GIB, iron stores should be replenished aggressively via iron supplementation before consideration of blood transfusion, except in patients with symptoms of severe anaemia. Oral iron replacement is the preferred first-line therapy, while intravenous iron is indicated for patients with inflammatory bowel disease, poor response or poor tolerability to oral iron, and in whom a rapid correction of iron deficit is preferred. Intravenous iron is underutilised and the risk of anaphylactic reaction to current preparations is extremely low. These recommendations are provided to local clinicians to facilitate judicious and appropriate use of red cell products and iron replacement therapy in patients with GIB.
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Affiliation(s)
- L Y Mak
- Hong Kong Society of Gastroenterology.,Hong Kong IBD Society
| | - C W Lau
- Hong Kong Red Cross Blood Transfusion Service
| | | | | | | | | | - J Yw Lau
- Hong Kong Society of Digestive Endoscopy
| | - P Wy Chiu
- Hong Kong Society of Digestive Endoscopy
| | - H T Leong
- Hong Kong Society of Digestive Endoscopy
| | - J Ho
- Hong Kong Society of Gastroenterology
| | - J Cy Wu
- Hong Kong Society of Gastroenterology
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service
| | - W K Leung
- Hong Kong Society of Gastroenterology.,Hong Kong IBD Society
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25
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Mak WY, Mak OS, Lee CK, Tang W, Leung WK, Wong MTL, Sze ASF, Li M, Leung CM, Lo FH, Lam BCY, Chan KH, Shan EHS, Tsang SWC, Hui AJ, Chow WH, Chan FKL, Sung JJY, Ng SC. Significant Medical and Surgical Morbidity in Perianal Crohn's Disease: Results from a Territory-Wide Study. J Crohns Colitis 2018; 12:1392-1398. [PMID: 30165543 DOI: 10.1093/ecco-jcc/jjy120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The presence of perianal fistulas in Crohn's disease [CD] denotes increased disease aggressiveness. We studied the epidemiology and clinical outcomes of perianal CD [PCD] using the Hong Kong territory-wide IBD Registry [HKIBDR]. METHODS Consecutive patients with PCD were identified from the HKIBDR, and disease characteristics, treatments, and outcomes were analysed. The risks for medical and surgical therapies were assessed using Kaplan-Meier analysis. RESULTS Among 981 patients with CD with 10530 patient-years of follow-up, 283 [28.8%] had perianal involvement, of which 120 [42.4%] were as first presentation. The mean age at diagnosis of PCD was 29.1 years, and 78.8% were male. The median follow-up duration was 106 months (interquartile range [IQR]: 65-161 months]. Perianal fistula [84.8%] and perianal abscess [52.7%] were the two commonest forms. Male, younger age at diagnosis of CD, and penetrating phenotypes were associated with development of PCD in multivariate analysis. Of 242 patients with fistulizing PCD, 70 [29.2%] required ≥5 courses of antibiotics, and 98 [40.5%] had ≥2 surgical procedures. Nine patients required defunctioning surgery and 4 required proctectomy. Eighty-four patients [34.7%] received biologics. Cumulative probabilities for use of biologics were 4.7%, 5.8%, and 8.6% at 12 months, 36 months, and 96 months, respectively, while the probabilities for surgery were 67.2%, 71.6%, and 77.7%, respectively. Five mortalities were recorded, including 2 cases of anal cancer, 2 CD-related complications, and one case of pneumonia. CONCLUSION Over 40% of CD patients presented with perianal disease at diagnosis. Patients with PCD had poor outcome, with young age of onset, multiple antibiotic use, and repeated surgery.
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Affiliation(s)
- Wing Yan Mak
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Oi Sze Mak
- Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Choon Kin Lee
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong.,Gastroenterology Unit, Department of Medicine, Hospital Pulau Pinang, Pulau Pinang, Malaysia
| | - Whitney Tang
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Wai Keung Leung
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Marc T L Wong
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | | | - Michael Li
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong
| | - Chi Man Leung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Fu Hang Lo
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong
| | - Belsy C Y Lam
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong
| | - Kam Hon Chan
- Department of Medicine, North District Hospital, Hong Kong
| | | | | | - Aric J Hui
- Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - Wai Hung Chow
- Department of Medicine, Yan Chai Hospital, Hong Kong
| | - Francis K L Chan
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Joseph J Y Sung
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
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Mooi JK, Wirapati P, Asher R, Lee CK, Savas P, Price TJ, Townsend A, Hardingham J, Buchanan D, Williams D, Tejpar S, Mariadason JM, Tebbutt NC. The prognostic impact of consensus molecular subtypes (CMS) and its predictive effects for bevacizumab benefit in metastatic colorectal cancer: molecular analysis of the AGITG MAX clinical trial. Ann Oncol 2018; 29:2240-2246. [PMID: 30247524 DOI: 10.1093/annonc/mdy410] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [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: 02/07/2023] Open
Abstract
BACKGROUND The consensus molecular subtypes (CMS) is a transcriptome-based classification of colorectal cancer (CRC) initially described in early-stage cohorts, but the associations of CMS with treatment outcomes in the metastatic setting are yet to be established. This study aimed to evaluate the prognostic impact of CMS classification and its predictive effects for bevacizumab benefit in metastatic CRC by correlative analysis of the AGITG MAX trial. PATIENTS AND METHODS The MAX trial previously reported improved progression-free survival (PFS) for the addition of bevacizumab (B) to chemotherapy [capecitabine (C)±mitomycin (M)]. Archival primary tumours from 237 patients (50% of trial population) underwent gene expression profiling and classification into CMS groups. CMS groups were correlated to PFS and overall survival (OS). The interaction of CMS with treatment was assessed by proportional hazards model. RESULTS The distribution of CMS in MAX were CMS1 18%, CMS2 47%, CMS3 12%, CMS4 23%. CMS1 was the predominant subtype in right-sided primary tumours, while CMS2 was the predominant subtype in left-sided. CMS was prognostic of OS (P = 0.008), with CMS2 associated with the best outcome and CMS1 the worst. CMS remained an independent prognostic factor in a multivariate analysis. There was a significant interaction between CMS and treatment (P-interaction = 0.03), for PFS, with hazard ratios (95% CI) for CB+CBM versus C arms in CMS1, 2, 3 and 4: 0.83 (0.43-1.62), 0.50 (0.33-0.76), 0.31 (0.13-0.75) and 1.24 (0.68-2.25), respectively. CONCLUSIONS This exploratory study found that CMS stratified OS outcomes in metastatic CRC regardless of first-line treatment, with prognostic effects of CMS groups distinct from those previously reported in early-stage cohorts. In CMS associations with treatment, CMS2 and possibly CMS3 tumours may preferentially benefit from the addition of bevacizumab to first-line capecitabine-based chemotherapy, compared with other CMS groups. Validation of these findings in additional cohorts is warranted. CLINICAL TRIAL NUMBER This is a molecular sub-study of MAX clinical trial (NCT00294359).
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Affiliation(s)
- J K Mooi
- Olivia Newton-John Cancer Research Institute, Heidelberg; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - P Wirapati
- Bioinformatics Core Facility, Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - R Asher
- NHMRC Clinical Trials Centre, University of Sydney, Sydney
| | - C K Lee
- NHMRC Clinical Trials Centre, University of Sydney, Sydney
| | - P Savas
- Division of Research, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne
| | - T J Price
- Medical Oncology, The Queen Elizabeth Hospital, Woodville; School of Medicine, University of Adelaide, Adelaide
| | - A Townsend
- Medical Oncology, The Queen Elizabeth Hospital, Woodville; School of Medicine, University of Adelaide, Adelaide
| | - J Hardingham
- School of Medicine, University of Adelaide, Adelaide; The Basil Hetzel Institute, The Queen Elizabeth Hospital, Woodville
| | - D Buchanan
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Melbourne; University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville; Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville
| | - D Williams
- Olivia Newton-John Cancer Research Institute, Heidelberg; Department of Pathology, Austin Health, Heidelberg; Department of Pathology, University of Melbourne, Melbourne, Australia
| | - S Tejpar
- Oncology, University Hospital Leuven, Leuven, Belgium
| | - J M Mariadason
- Olivia Newton-John Cancer Research Institute, Heidelberg; School of Cancer Medicine, La Trobe University, Melbourne
| | - N C Tebbutt
- Medical Oncology, Austin Health, Heidelberg, Australia.
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Lee CK, Wong SHV, Lui G, Tang W, Tam LS, Ip M, Hung E, Chen M, Wu JC, Ng SC. A Prospective Study to Monitor for Tuberculosis During Anti-tumour Necrosis Factor Therapy in Patients With Inflammatory Bowel Disease and Immune-mediated Inflammatory Diseases. J Crohns Colitis 2018; 12:954-962. [PMID: 29757355 DOI: 10.1093/ecco-jcc/jjy057] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/09/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Biologic therapies have revolutionised the treatment of immune-mediated diseases including inflammatory bowel disease [IBD] and rheumatological disorders. However, biologic treatments are associated with an increased risk of reactivation of latent tuberculosis. Data from regular monitoring for latent tuberculosis infection [LTBI] during biologic treatment are lacking. METHODS Consecutive patients eligible for biologic therapies were screened for LTBI and prospectively followed up for 3 years. Incidence and risk factors of latent tuberculosis tests conversion (interferon gamma release assays [IGRA], tuberculin skin tests [TST], and chest radiography [CXR]) with clinical outcomes were studied. RESULTS A total of 108 patients [83 IBD; 25 rheumatological disorders] were included. At baseline, 18/108 [16.7%] patients [five IBD; 13 rheumatological disorders] were tested positive for LTBI. Of these, 14/18 [77.8%] patients received isoniazid monotherapy for 9 months. Of the remainder, 17/90 [18.9%] patients had LTBI test conversion while on biologic therapies and of these 14/17 [82.4%] received isoniazid monotherapy for 9 months. Age, sex, smoking status, alcohol use, travel history, disease type, and immunosuppressive therapy were not associated with LTBI test conversion. In subjects with IGRA conversion, serial IGRA levels normalised after completion of isoniazid except in one patient whose IGRA remained persistently elevated despite isoniazid and who subsequently developed active TB. CONCLUSIONS Conversion of LTBI is common and occurred early during biologic therapy in an area with intermediate TB burden. Subjects with latent TB tests conversion and persistently high IGRA levels may have an increased risk of TB reactivation or development of active TB, and they require close observation or intensive workup for active TB.
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Affiliation(s)
- Choon Kin Lee
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
| | - Sunny H V Wong
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
| | - Grace Lui
- Department of Medicine and Therapeutics, Division of Infectious Disease, Chinese University of Hong Kong, Hong Kong, China
| | - Whitney Tang
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
| | - Lai San Tam
- Department of Medicine and Therapeutics, Division of Rheumatology, Chinese University of Hong Kong, Hong Kong, China
| | - Margaret Ip
- Department of Microbiology, Chinese University of Hong Kong, Hong Kong, China
| | - Esther Hung
- Department of Radiology, Chinese University of Hong Kong, Hong Kong, China
| | - Minhu Chen
- Department of Gastroenterology and Hepatology, First Affliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Justin C Wu
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
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Roncolato FT, Gibbs E, Lee CK, Asher R, Davies LC, Gebski VJ, Friedlander M, Hilpert F, Wenzel L, Stockler MR, King M, Pujade-Lauraine E. Quality of life predicts overall survival in women with platinum-resistant ovarian cancer: an AURELIA substudy. Ann Oncol 2018; 28:1849-1855. [PMID: 28595285 DOI: 10.1093/annonc/mdx229] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Women with platinum-resistant ovarian cancer are a heterogeneous group whose median overall survival is 12 months. We hypothesized that their quality of life (QoL) scores would be prognostic. Patients and methods Data from AURELIA (n = 326), a randomized trial of chemotherapy with or without bevacizumab, were used to identify baseline QoL domains [EORTC (European Organisation for Research and Treatment of Cancer) QLQ-C30 and OV28] that were significantly associated with overall survival in multivariable Cox regression analyses. Patients were classified as having good, medium, or poor risk. Cutpoints were validated in an independent dataset, CARTAXHY (n = 136). Multivariable analyses of significant QoL domains on survival were adjusted for clinicopathological prognostic factors. The additional QoL information was assessed using C statistic. Results In AURELIA, all domains, except cognitive function, predicted overall survival in univariable analyses. Physical function (P < 0.001) and abdominal/gastrointestinal symptom (P < 0.001) scores remained significant in multivariable models. In high (score <67), medium (67-93), and low (>93) risk categories for physical function, median overall survival was 11.0, 14.7, and 19.3 months, respectively (P < 0.001). In CARTAXHY, median overall survival was 7.9, 16.2, and 23.9 months (P < 0.001), respectively. For high- (>44), medium- (13-44), and low- (<13) risk categories for abdominal/gastrointestinal symptoms, median overall survival was 11.9, 14.3, and 19.7 months in AURELIA (P < 0.001) and 10.5, 19.6, and 24.1 months in CARTAXHY (P = 0.02). Physical function (P = 0.02) and abdominal/gastrointestinal symptoms (P = 0.03) remained independent prognostic factors after adjustment for clinicopathological factors. The C statistic of the full model was 0.71. For QoL factors alone, patient factors alone and disease factors alone, the C statistics were 0.61, 0.61, and 0.67 respectively. Conclusions Physical function and abdominal/gastrointestinal symptom scores improved predictions of overall survival over clinicopathological factors alone in platinum-resistant ovarian cancer. This additional prognostic information could improve trial stratification, patient-doctor communication about prognosis, and clinical decision-making. Clinical trial registration NCT00976911.
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Affiliation(s)
- F T Roncolato
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
- Macarthur Cancer Therapy Centre, Campbelltown
| | - E Gibbs
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - C K Lee
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
- Medical Oncology, St George Hospital, Sydney
| | - R Asher
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - L C Davies
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - V J Gebski
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - M Friedlander
- Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - F Hilpert
- Gynecology & Obstetrics, University of Schleswig-Holstein, Kiel, Germany
| | - L Wenzel
- Public Health, University of California, Irvine, USA
| | - M R Stockler
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - M King
- Psycho-oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - E Pujade-Lauraine
- Hematology & Medical Oncology, Hopital Hôtel-Dieu de Paris, Paris, France
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Lee CK, Choi SK, Shin DA, Yi S, Kim KN, Kim I, Ha Y. Parkinson's disease and the risk of osteoporotic vertebral compression fracture: a nationwide population-based study. Osteoporos Int 2018; 29:1117-1124. [PMID: 29460103 DOI: 10.1007/s00198-018-4409-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/24/2018] [Indexed: 01/23/2023]
Abstract
UNLABELLED Patients with Parkinson's disease (PD) were at higher risk of osteoporotic vertebral compression fractures (OVCF) compared to controls and had elevated mortality rates. Compared to conservative treatment, surgical treatment for OVCF in PD patients seemed to be associated with better outcomes. INTRODUCTION The purpose of this study was to evaluate the risk of OVCF in patients with PD. METHODS Data from patients over the age of 60 years who were diagnosed with PD were collected between 2004 and 2013 from the Korean National Health Insurance Database (n = 3370). The comparison group (non-PD) consisted of randomly selected patients (five per patient with PD; n = 16,850) matched to the PD group, who were newly diagnosed annually according to age and sex. Cox proportional hazard regressions were used to examine the relationships between osteoporosis, OVCF, surgery for OVCF, and PD. Household income and residential area of patients were also assessed. Overall survival rates were calculated after adjusting for confounding factors, such as hypertension, diabetes mellitus, and chronic kidney disease. RESULTS OVCF was developed in 12.5% of patients in the PD group and in 7.4% of patients in the control group. PD was associated with increased risk of osteoporosis (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.21-1.43; p < 0.001), OVCF (HR 1.66; 95% CI, 1.47-1.87; p < 0.001), and surgery for OVCF (HR 2.69; 95% CI, 1.78-4.08; p < 0.001). Household income was not significantly related with development of osteoporosis, incidence of OVCF, or surgery for OVCF. Residential area was statistically associated with osteoporosis, OVCF, and surgery for OVCF. The mortality rate of the PD group was about 1.7 times higher than that of the non-PD group after adjusting for potential confounders, and the mortality rate of the PD with OVCF group was higher than that of the non-PD group, but not significantly (p = 0.09). The survival rate of the PD group with surgery for OVCF showed a trend toward a more positive prognosis compared with that of the PD group with conservative treatment. CONCLUSIONS Patients with PD had significantly increased risk of osteoporosis and OVCF. Surgical treatment for OVCF in PD patients was associated with a better prognosis than conservative treatment.
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Affiliation(s)
- C K Lee
- Department of Neurosurgery, Keimyung University Dongsan Medical Center, Daegu, South Korea
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - S K Choi
- Biostatistics and Epidemiology, Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea
| | - D A Shin
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - S Yi
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - K N Kim
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - I Kim
- Department of Neurosurgery, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Y Ha
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, South Korea.
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Kwok J, Guo M, Yang W, Ip P, Lee CK, Lu L, Chan GCF, Middleton D, van der Zanden HGM. Simulation of non-inherited maternal antigens acceptable HLA mismatches to increase the chance of matched cord blood units: Hong Kong's experience. Hum Immunol 2018; 79:539-544. [PMID: 29660452 DOI: 10.1016/j.humimm.2018.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 03/30/2018] [Accepted: 04/10/2018] [Indexed: 01/13/2023]
Abstract
In Cord blood transplantation (CBT), the non-inherited maternal antigen (NIMA) virtual six HLA matched CB is found to have similar outcomes to six HLA inherited matched CB. Such virtual HLA matched CB units can be generated by substituting the inherited alleles with one to three NIMAs. In Hong Kong Cord Blood Bank, CB units have no NIMA defined. 100 CB samples were collected with NIMA defined. Retrospective searches of Hong Kong patients (n = 520) were matched against the inherited and virtual HLA phenotypes of NIMA CB file. One to three NIMA matches was analyzed, virtual six HLA matches were identified for 31.7% patients, 29.4% from CB units with 5/6 HLA match with 1 NIMA match and 1.7% CB units with a 4/6 HLA match and 2 NIMA matches. However, searches in the 167,201 Bone Marrow Donors Worldwide CB units with defined NIMA did not yield similar increases, possibly due to the ethnicity differences between populations. The match performance rises from 26% to 60% after including the NIMA match. Comparing the match performance of 32% in a previous Dutch study, we calculated with 60% matching in this smaller size study. This provides a solid ground to considering NIMA in stem cell donor selection which was adopted in some centers, to be extended to Asian and local CB registries to increase the chance for matches and also to improve patient outcomes, increase the utilization of CB units, enhance clinical flexibility and signify economic intelligence.
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Affiliation(s)
- Janette Kwok
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong.
| | - Mengbiao Guo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong.
| | - Wanling Yang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Services, Hong Kong
| | - Liwei Lu
- Department of Pathology, The University of Hong Kong, Hong Kong
| | - Godfrey C F Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Derek Middleton
- Transplant Immunology, Royal Liverpool Hospital, Liverpool, UK
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Wong NS, Lee CK, Ng SC, Wong HK, Chan DPC, Lee SS. Prevalence of hepatitis C infection and its associated factors in healthy adults without identifiable route of transmission. J Viral Hepat 2018; 25:161-170. [PMID: 29032634 DOI: 10.1111/jvh.12804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 05/05/2017] [Accepted: 09/01/2017] [Indexed: 12/20/2022]
Abstract
While hepatitis C virus (HCV) infection is long known to be associated with parenteral exposure, the specific route of transmission is not identified in a proportion of infected patients. Taking blood donors as the surrogate of healthy adults in the community in Hong Kong, we identified 91 HCV-infected donors (≤0.02% positive rate) in 2014-2016, of whom 46 were recruited in a mixed-method study to examine their transmission routes. A majority (75%) of the recruited donors were HCV RNA positive, with the predominant subtypes being 1b and 6a. From the results of the structured self-administered questionnaire and in-depth interviews, only 14 (30%) recruited donors could be traced to past history of contaminated blood transfusion (n = 9) or injection drug use (n = 5). Case-control analyses with 3 different control groups were performed to examine factors associated with HCV infection in multivariable analyses. High-risk sexual behaviour, body piercing, intramuscular injection and vaccine inoculation abroad, having lived abroad for >3 months were significantly associated with HCV in donors with otherwise nonidentifiable source of infection. While the specific route of transmission cannot be established for each person, associations with multiple parenteral exposures outside Hong Kong were observed. The World Health Organization has advocated for the global elimination of HCV by 2030. With a high proportion of HCV-infected persons who are unaware of their infections, HCV elimination could be hard to achieve.
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Affiliation(s)
- N S Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - S C Ng
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - H K Wong
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Tam K, Tang I, Ho J, Yeung W, Lee CK, Ip P, Kwok J. A study of human neutrophil antigen genotype frequencies in Hong Kong. Transfus Med 2017; 28:310-318. [PMID: 29280200 DOI: 10.1111/tme.12494] [Citation(s) in RCA: 4] [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] [Received: 03/01/2016] [Revised: 07/07/2017] [Accepted: 11/19/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alloantibodies against human neutrophil antigens (HNA) are associated with a variety of clinical conditions. Over the past decade, the allelic and genotypic frequencies of the five HNA systems have been evaluated. Although the HNA system is less polymorphic than human leukocyte antigens (HLA), significant differences in the genotypic and allele frequencies still exist in different populations, even those living in close proximity. OBJECTIVES To delineate HNA genotypic and allele frequencies to provide vital information on estimating the risk of HNA-associated diseases for our local population. METHODS Using a validated, in-house-developed assay, genotyping for HNA-1, HNA-3, HLA-4 and HNA-5 was performed on 300 samples from Chinese blood donors from Hong Kong. In addition, the frequency of the HNA-2 c.843A > T allele was also determined. RESULTS The allele frequencies of HNA-1a, -1b and -1c alleles were 67·8, 31·5 and 0%, respectively, whereas the frequencies of HNA-3a and HNA-3b were 71·0 and 29·0%, respectively. The frequencies of HNA-4a and -4b alleles were 99·5 and 0·5%, respectively, and for HNA-5a and -5b, alleles were 85·2 and 14·8%, respectively. Homozygotes for the HNA-2 c.843 TT variant were absent in our population, whereas only <4% of the population were c.843AT heterozygote carriers. CONCLUSIONS This is the first study to define HNA genotype and allele frequencies using a validated modified in-house PCR-SSP method in the Hong Kong Chinese blood donor population. Our approach provides a cost-effective assay for conducting routine HNA typing and facilitates the incorporation of these assays into routine clinical service. Our results are comparable with those reported in the Guangzhou Chinese population, but the allele frequencies in our Hong Kong Chinese population are significantly different from the reported European frequencies, confirming that a geographical difference exists for HNA allele frequencies.
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Affiliation(s)
- K Tam
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - I Tang
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - J Ho
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - W Yeung
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong SAR, China
| | - P Ip
- Department of Paediatrics & Adolescent Medicine, University of Hong Kong, Hong Kong SAR, China
| | - J Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, China
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Lee CK, Rainer TH. Application of APACHE II in the Assessment, Classification of Severity and Predictive Ability of Chinese Patients Presenting to an Emergency Department Resuscitation Room. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790200900402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives To evaluate the use of APACHE II (Acute Physiology and Chronic Health Status Evaluation) in Chinese patients managed in the resuscitation room of an Accident & Emergency Department of one of the teaching hospitals in Hong Kong. Design Prospective study on Chinese patients. Setting Resuscitation Room in an Accident & Emergency Department of a university hospital in Hong Kong. Patients and measurements Consecutive patients managed in the resuscitation room between 14th August, 2000 and 20th August 2000 (excluding patients younger than 18 years old and patients who were not admitted to hospital after initial assessment and treatment). For each patient, demographic data, diagnosis, the chronic health points, and the worst physiological parameters in the A&E resuscitation room were recorded. The total APACHE II scores and the probability of death were calculated. The accuracy of APACHE II for predicting group mortality was assessed by receiver operating characteristic curve analysis and linear regression analysis. Results Of the 88 patients included in the study, 13 (15%) died and 75 (85%) survived. Significant factors associated with mortality included age, mean arterial pressure, heart rate, respiratory rate, arterial pH, serum sodium, Glasgow coma score, and chronic health points. For the three scoring subdivisions of APACHE II – total APS score, age points and chronic health points – higher mean values were found in those patients who died compared with patients who survived. Using logistic regression analysis, the APACHE II score determined in the emergency resuscitation room is a strong predictor of mortality (r2=0.712). At a cut off score of >28 the sensitivity is 100.0% (95% CI 100.0–100.0), specificity is 68.0% (95% CI 56.2–78.3), positive likelihood ratio is 3.13, positive predictive value is 35.1 and negative likelihood ratio is 100.0. Analysis of the ROC curve reveals an area under the curve of 0.910 (95% CI 0.829–0.960). In patients not admitted to ICU, there was a positive correlation between APACHE score and length of hospital stay in patient who survived (r=0.320, P=0.0075) and a negative correlation between APACHE score and length of hospital stay in patients who died (r=-0.760, P=0.0225). Conclusions The APACHE II scoring system may be usefully applied in emergency departments for predicting mortality, for classifying and assessing severity of disease, for evaluating performance and for planning departmental resource allocation.
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Affiliation(s)
| | - TH Rainer
- Prince of Wales Hospital, Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, 30–32 Ngan Shing Street, Shatin, N.T., Hong Kong
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Chan YC, Fung HT, Lee CK, Tsui SH, Ngan HK, Sy MY, Tse ML, Kam CW, Wong GCK, Tong HK, Lit ACH, Wong TW, Lau FL. A Prospective Epidemiological Study of Acute Poisoning in Hong Kong. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200305] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To update our epidemiological knowledge of acute poisoning in Hong Kong. Methods A multi-centred prospective study was conducted for six months in six major accident and emergency departments in Hong Kong. A specially designed form was used to collect demographic data, type of poison involved, cause of poisoning, management, disposal as well as final outcome of the poisoned patients. Results A total of 1,467 patients (male: 588, female: 879) were included in the study. Most of them were young adults (32% were between 20 and 40 years old). Suicidal attempt (64%) was the most common cause of poisoning. Notably, 379 (26%) patients took more than one poison. Among the 2,007 counts of poison taken, sleeping pills (24%) and analgesics (18%) were the most commonly used drugs and paracetamol was the commonest single ingredient involved in poisoning. Most patients were treated with supportive measures, and about 40% and 15% of the patients were given gastrointestinal decontamination and specific antidotes respectively in their management, in which activated charcoal and N-acetylcysteine were the most common. Concerning disposal from the emergency department, 91% of the poisoned cases required in-patient management. Most patients had an uneventful recovery but 5 (0.3%) had significant disability and 21 (1.4%) died. Suicidal carbon monoxide poisoning was the leading cause of mortality in our study. Conclusions Most acute poisonings in Hong Kong were suicidal in nature and paracetamol was the commonest agent. Activated charcoal was the most commonly used decontamination method and most patients had an uneventful recovery.
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Affiliation(s)
| | - HT Fung
- Tuen Mun Hospital, Accident & Emergency Department, Tsing Chung Koon Road, Tuen Mun, N.T., Hong Kong
| | - CK Lee
- Queen Elizabeth Hospital, Accident & Emergency Department, 30 Gascoigne Road, Kowloon, Hong Kong
| | - SH Tsui
- Queen Mary Hospital, Accident & Emergency Department, Pokfulam Road, Hong Kong
| | - HK Ngan
- Yan Chai Hospital, Accident & Emergency Department, Tsuen Wan, N.T., Hong Kong
| | - MY Sy
- Pamela Youde Nethersole Eastern Hospital, Accident & Emergency Department, 3 Lok Man Road, Chaiwan, Hong Kong
| | | | - CW Kam
- Tuen Mun Hospital, Accident & Emergency Department, Tsing Chung Koon Road, Tuen Mun, N.T., Hong Kong
| | - GCK Wong
- North District Hospital, Accident & Emergency Department, 9 Po Kin Road, Sheung Shui, N.T., Hong Kong
| | - HK Tong
- Queen Mary Hospital, Accident & Emergency Department, Pokfulam Road, Hong Kong
| | - ACH Lit
- Yan Chai Hospital, Accident & Emergency Department, Tsuen Wan, N.T., Hong Kong
| | - TW Wong
- Pamela Youde Nethersole Eastern Hospital, Accident & Emergency Department, 3 Lok Man Road, Chaiwan, Hong Kong
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Park SB, Kwok JB, Asher R, Lee CK, Beale P, Selle F, Friedlander M. Clinical and genetic predictors of paclitaxel neurotoxicity based on patient- versus clinician-reported incidence and severity of neurotoxicity in the ICON7 trial. Ann Oncol 2017; 28:2733-2740. [PMID: 29117336 DOI: 10.1093/annonc/mdx491] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of paclitaxel, with no reliable method to identify at-risk patients. We investigated the incidence and risk factors including genetic polymorphisms associated with the development of CIPN based on clinician and patient reporting of neuropathic symptoms. PATIENTS AND METHODS Risk factors for the development of CIPN were examined in 454 patients treated with paclitaxel/carboplatin from the International Collaboration on Ovarian Neoplasms 7 (ICON7) trial. Neuropathy was graded by clinicians by standard adverse event reporting and by patients utilising OV28 questionnaire. Genetic risk factors were examined by selecting six single nucleotide polymorphisms in genes associated with microtubule function. Risk factors were assessed via dose-to-event cox regression models. RESULTS Grade >2 neuropathy was reported by clinicians in 28% of patients, while 67% of patients reported 'quite a bit' or 'very much' tingling or numbness. Agreement between clinicians and patients was poor (κ = 0.236, 95% confidence interval, 0.177-0.296, P < 0.001). Older age, bevacizumab treatment and bowel resection were associated with clinician reported CIPN, while older age and volume of residual disease were associated with patient-reported neuropathy. There were no significant associations between clinician-reported neuropathy or patient-reported neuropathy and TUBB2, CEP72 or individual MAPT or GSK3B SNPs, however MAPT additive polymorphisms were associated with patient-reported neuropathy and GSK3B additive polymorphisms were associated with clinician reported CIPN. CONCLUSIONS There was significant discordance between patient- and clinician-reported neurotoxicity. The lack of consensus regarding optimal outcome measures and whose opinion with regard to CIPN takes precedence is a limitation in the investigation of risk factors for CIPN. Care must be taken to select and include patient-reported outcome measures in CIPN assessment to enable accurate identification of genetic and other risk factors for neuropathy.
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MESH Headings
- Adenocarcinoma, Clear Cell/complications
- Adenocarcinoma, Clear Cell/drug therapy
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Mucinous/complications
- Adenocarcinoma, Mucinous/drug therapy
- Adenocarcinoma, Mucinous/pathology
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Phytogenic/adverse effects
- Biomarkers, Tumor/genetics
- Cystadenocarcinoma, Serous/complications
- Cystadenocarcinoma, Serous/drug therapy
- Cystadenocarcinoma, Serous/pathology
- Endometrial Neoplasms/complications
- Endometrial Neoplasms/drug therapy
- Endometrial Neoplasms/pathology
- Female
- Follow-Up Studies
- Humans
- Incidence
- Middle Aged
- Neoplasm Invasiveness
- Neurotoxicity Syndromes/diagnosis
- Neurotoxicity Syndromes/epidemiology
- Neurotoxicity Syndromes/etiology
- Neurotoxicity Syndromes/genetics
- Outcome Assessment, Health Care
- Ovarian Neoplasms/complications
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Paclitaxel/adverse effects
- Patient Reported Outcome Measures
- Physicians
- Polymorphism, Single Nucleotide
- Prognosis
- Risk Factors
- Severity of Illness Index
- Surveys and Questionnaires
- Survival Rate
- Young Adult
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Affiliation(s)
- S B Park
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney; Prince of Wales Clinical School
| | - J B Kwok
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney; Neuroscience Research Australia, University of New South Wales, Sydney
| | - R Asher
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - C K Lee
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - P Beale
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney; Sydney Medical School, University of Sydney, Sydney, Australia
| | - F Selle
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens and Department of Medical Oncology, Alliance For Cancer Research, Hôpital Tenon, Paris, France
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Deepak AS, Ong JY, Choon D, Lee CK, Chiu CK, Chan C, Kwan MK. The Clinical Effectiveness of School Screening Programme for Idiopathic Scoliosis in Malaysia. Malays Orthop J 2017; 11:41-46. [PMID: 28435573 PMCID: PMC5393113 DOI: 10.5704/moj.1703.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction There is no large population size study on school screening for scoliosis in Malaysia. This study is aimed to determine the prevalence rate and positive predictive value (PPV) of screening programme for adolescent idiopathic scoliosis. Materials and Methods A total of 8966 voluntary school students aged 13-15 years old were recruited for scoliosis screening. Screening was done by measuring the angle of trunk rotation (ATR) on forward bending test (FBT) using a scoliometer. ATR of 5 degrees or more was considered positive. Positively screened students had standard radiographs done for measurement of the Cobb angle. Cobb angle of >10° was used to diagnose scoliosis. The percentage of radiological assessment referral, prevalence rate and PPV of scoliosis were then calculated. Results Percentage of radiological assessment referral (ATR >5°) was 4.2% (182/4381) for male and 5.0% (228/4585) for female. Only 38.0% of those with ATR >5° presented for further radiological assessment. The adjusted prevalence rate was 2.55% for Cobb angle >10°, 0.59% for >20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle >10°, 12.8% for >20° and 2.6% for > 40°. Conclusions This is the largest study of school scoliosis screening in Malaysia. The prevalence rate of scoliosis was 2.55%. The positive predictive value was 55.8%, which is adequate to suggest that the school scoliosis screening programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.
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Affiliation(s)
- A S Deepak
- Department of Orthopaedic Surgery, Prince Court Medical Center, Kuala Lumpur, Malaysia
| | - J Y Ong
- National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
| | - Dsk Choon
- National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
| | - C K Lee
- National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
| | - C K Chiu
- National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
| | - Cyw Chan
- National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
| | - M K Kwan
- National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia
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Lee SS, Cheung EKH, Leung JNS, Lee CK. Non-compliance to infectious disease deferral criteria among Hong Kong's blood donors. Vox Sang 2017; 112:425-433. [PMID: 28401619 DOI: 10.1111/vox.12520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/20/2017] [Accepted: 03/07/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Donor screening alone cannot eliminate the risk of transfusion-transmitted HIV infection. Donor deferral according to established criteria is a supplemental strategy, which has focused largely on men who have sex with men (MSM). A study was conducted to determine the compliance of non-MSM donors with such criteria and examine its implications on blood safety. MATERIALS AND METHODS Chinese donors who have just donated blood at blood donor centres in Hong Kong were recruited. Based on the contents of the routinely administered predonation Health Screening Questionnaires, participants were requested to complete a survey to assess their practice of deferrable risk behaviours and lifestyle encounters, using tablet computers. RESULTS Over an 8-week period in mid-2016, 1614 donors (male-to-female ratio 1·23) had enrolled in the survey, accounting for 40% of donors giving blood on the survey days. The proportion of respondents who gave blood despite having deferrable HIV risk was 5%: MSM 1·2% (of the male donors); non-MSM risk behaviours 2·6%; risky lifestyle encounters 2·1%. If inconsistent declaration and suspected risk behaviours were included, the total non-compliance rate became 10·8%. Male donors had a higher prevalence of deferrable behavioural risk, even after excluding MSM. Unawareness and non-acceptability were main reasons for non-compliance. CONCLUSION The non-compliance rate of donors to deferral was high, although the ultimate infection risk might be small in the presence of universal screening. Simplification of questionnaires, focus on time-limited deferral and a reduction of deferral items may improve the deferral mechanism without compromising blood safety.
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Affiliation(s)
- S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - E K H Cheung
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J N S Leung
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
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Kim W, Kim BG, Lee JS, Lee CK, Yeon JE, Chang MS, Kim JH, Kim H, Yi S, Lee J, Cho JY, Kim SG, Lee JH, Kim YJ. Randomised clinical trial: the efficacy and safety of oltipraz, a liver X receptor alpha-inhibitory dithiolethione in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2017; 45:1073-1083. [PMID: 28225186 DOI: 10.1111/apt.13981] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 05/31/2016] [Accepted: 01/22/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Oltipraz is a synthetic dithiolethione with an antisteatotic effect by inhibiting the activity of liver X receptor alpha (LXR-α). Recent studies demonstrated the disruptive role of oltipraz on LXR-α-dependent lipogenesis in hepatocytes and a high-fat diet mouse model. AIM To evaluate the efficacy and safety of oltipraz for reducing liver fat in subjects with non-alcoholic fatty liver disease (NAFLD). METHODS We performed a multicentre, double-blind, placebo-controlled, phase II study. Subjects with a liver fat >20% and hypertransaminasemia were randomised to the three groups: placebo (n = 22), 30 mg of oltipraz (n = 22) or 60 mg of oltipraz (n = 24) twice daily for 24 weeks. Changes in the liver fat from baseline to 24 weeks quantified using magnetic resonance spectroscopy were the primary outcome. RESULTS Compared with the placebo group (-3.2 ± 11.1%), absolute changes in the liver fat content increased in a dose-dependent manner: -7.7 ± 7.0% and -13.9 ± 10.7% for the low-dose and high-dose groups (P = 0.13 and P < 0.01). Per cent reduction in the liver fat content was also significantly greater in the high-dose group than in the placebo group (-34.6 ± 29.4% vs. -0.6 ± 62.9%, P = 0.046). Body mass indices (-1.0 ± 0.9% vs. -0.5 ± 1.4%, P = 0.04) significantly decreased in the high-dose group compared to the placebo group. However, absolute changes in insulin resistance, liver enzymes, lipids and cytokines were not significantly different among groups. The incidence of adverse events was comparable among groups. CONCLUSIONS Twenty-four-week oltipraz treatment significantly reduced the liver fat content in patients with NAFLD. Clinicaltrials.gov (NCT01373554).
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Ko SY, Im J, Lee CK, Cho Y. Identification of a novel HLA-B allele, HLA-B*55:81. HLA 2017; 89:166-167. [PMID: 28156057 DOI: 10.1111/tan.12972] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 01/16/2017] [Accepted: 01/16/2017] [Indexed: 11/28/2022]
Abstract
The new allele, B*55:81, differs from B*55:02:01:02 by 2 nucleotide substitutions in codon 116 (TTA → TAC).
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Affiliation(s)
- S-Y Ko
- Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - J Im
- Biowithus Life Science Institute, Seoul, Korea
| | - C K Lee
- Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Y Cho
- Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, South Korea
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Lee CK, Tan TS, Chan C, Kwan MK. Is C1 lateral mass screw placement safe for the Chinese, Indians, and Malays? An analysis of 180 computed tomography scans. J Orthop Surg (Hong Kong) 2017; 25:2309499017692683. [PMID: 28211302 DOI: 10.1177/2309499017692683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION C1 lateral mass (C1LM) screw is a common procedure in spine surgery. However, related studies are lacking in Asia. We aim to determine the safety of C1LM screw for the Chinese, Indians, and Malays. METHODS Three-dimensional computed tomographies of 180 subjects (60 from each ethnic) were analyzed. The length and angulations of C1LM screw and the location of internal carotid artery (ICA) in relation to C1LM were assessed and classified according to the classification by Murakami et al. The incidence of ponticulus posticus (PP) was determined and the differences among the population of these three ethnics were recorded. RESULTS The average base length was 8.5 ± 1.4 mm. The lengths within the lateral mass were between 14.7 ± 1.6 mm and 21.7 ± 2.3 mm. The prevalence of PP was 8.3%. 55.3% (199) of ICA were located in zone 0, 38.3% (138) in zone 1-1, 6.4% (23) in zone 1-2, and none in zone 1-3 and zone 2. The average angulation from the entry point to the ICA was 8.5° ± 6.4° laterally. The mean distance of ICA from C1 anterior cortex was 3.7 ± 1.7 mm (range: 0.6∼11.3). There was no difference in distribution of ICA in zone 1 among the three population (Chinese-47%, Indians-61%, and Malays-53%; p > 0.05). CONCLUSIONS No ICA is located medial to the entry point of C1LM screw. If bicortical purchase of C1LM screw is needed, screw protrusion of less than 3 mm or medially angulated is safe for ICA. The incidence of PP is 8.3% with higher prevalence among the Indian population.
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Affiliation(s)
- C K Lee
- 1 NOCERAL, Department of Orthopedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - T S Tan
- 1 NOCERAL, Department of Orthopedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Cyw Chan
- 1 NOCERAL, Department of Orthopedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - M K Kwan
- 1 NOCERAL, Department of Orthopedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Kwok J, Guo M, Yang W, Lee CK, Ho J, Tang WH, Chan YS, Middleton D, Lu LW, Chan GCF. HLA-A, -B, -C, and -DRB1 genotyping and haplotype frequencies for a Hong Kong Chinese population of 7595 individuals. Hum Immunol 2016; 77:1111-1112. [PMID: 27769748 DOI: 10.1016/j.humimm.2016.10.005] [Citation(s) in RCA: 11] [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: 08/25/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
Abstract
HLA-A, -B, -C and -DRB1 gene and haplotype frequencies have been calculated from 7595 southern Chinese unrelated donors in a Hong Kong Bone Marrow Donor Registry. This is the first large-scale paper to report the distribution of A-C-B-DRB1 alleles in Hong Kong Chinese. This information is important for phylogenetic, comparative studies and estimating the optimal and cost-effective donor size and likelihood of obtaining appropriately matched donors for Chinese patients awaiting haematopoietic stem cell transplantation. The allele and haplotype data are available in the Allele Frequencies Net Database under the population name ''Hong Kong Chinese BMDR'' and the identifier (AFND003357).
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Affiliation(s)
- Janette Kwok
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong.
| | - Mengbiao Guo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Wanling Yang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Services, Hong Kong
| | - Jenny Ho
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong
| | - W H Tang
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong
| | - Y S Chan
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong
| | - Derek Middleton
- Transplant Immunology, Royal Liverpool Hospital, Liverpool, UK
| | - L W Lu
- Department of Pathology, The University of Hong Kong, Hong Kong
| | - Godfrey C F Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
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Kwok J, Guo M, Yang W, Lee CK, Chan NK, Ho J, Tang WH, Chan YS, Middleton D, Lu LW, Chan GCF. HLA-A, -B and -DRB1 genotyping and haplotype frequencies of 3892 cord blood units in the Hong Kong Chinese Cord Blood Registry. Hum Immunol 2016; 77:1109-1110. [PMID: 27769747 DOI: 10.1016/j.humimm.2016.10.006] [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] [Received: 08/29/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022]
Abstract
HLA-A, -B and -DRB1 gene and haplotype frequencies have been calculated from 3892 southern Chinese unrelated cord blood units in a Hong Kong Cord Blood Registry. This is the first large-scale paper to report the distribution of A-B-DRB1 alleles in Hong Kong Chinese Cord Blood Units. This information is important for estimating the optimal and economically cost-effective donor size and likelihood of obtaining appropriately matched cord blood units for Chinese patients awaiting haematopoietic stem cell transplantation. The data are available in the Allele Frequencies Net Database under the population name ''Hong Kong Chinese Cord Blood Registry'' and the identifier (AFND003358).
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Affiliation(s)
- Janette Kwok
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong.
| | - Mengbiao Guo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Wanling Yang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - N K Chan
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - Jenny Ho
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong
| | - W H Tang
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong
| | - Y S Chan
- Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong
| | - Derek Middleton
- Transplant Immunology, Royal Liverpool Hospital, Liverpool, UK
| | - L W Lu
- Department of Pathology, The University of Hong Kong, Hong Kong
| | - Godfrey C F Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
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Park HJ, Lee JH, Kim SR, Kim SH, Park KH, Lee CK, Kang BD, Beom SH, Shin SJ, Jung M, Park JW. A New Practical Desensitization Protocol for Oxaliplatin-Induced Immediate Hypersensitivity Reactions: A Necessary and Useful Approach. J Investig Allergol Clin Immunol 2016; 26:168-76. [DOI: 10.18176/jiaci.0038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ou Y, Yau KKW, Poon CM, Hui YV, Lee SS, Lee CK. Donation frequency and its association with demographic characteristics--a 1-year observational study. Transfus Med 2016; 25:366-73. [PMID: 26729059 DOI: 10.1111/tme.12267] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 11/05/2015] [Accepted: 11/28/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study is to enhance the understanding of frequent blood donors' characteristics and devise strategies to achieve an optimal blood inventory. BACKGROUND Apart from donor recruitment and retention, an effective way to increase blood supply is to increase the donation frequency among donors. Understanding the characteristics of frequent donors will be helpful to impact their future donation pattern, which would in turn achieve a stable and adequate blood inventory to meet the changing demands of the society. METHODS AND MATERIALS Demographic information of blood donors for each donation in Hong Kong (HK) was routinely collected and stored in the database of Hong Kong Red Cross Blood Transfusion Service. Logistic regression models (by gender group) with interaction effects were constructed to analyse the differences in the likelihood of being frequent donors and the associations with their demographic characteristics. RESULTS A total of 158,666 blood donors in 2010 gave 227,634 donations during the study. In general, male donors were more likely to be frequent donors. Logistic regression models further identified the characteristics of frequent donors in HK: older, blood type Rh D-ve and repeat donors, although their extent of impact was different for different gender group. CONCLUSION To achieve an optimal blood inventory to meet the challenge of ageing in the society, donors who donate less often should be targeted to increase their donation frequency. More efforts in promotion should be made to recruit those non-donors to join the blood donation pool and motivate 'targeted' existing donors in the population to participate blood donation more regularly.
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Affiliation(s)
- Y Ou
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - K K W Yau
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - C M Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Y V Hui
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong.,Hang Seng Management College, New Territories, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong
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Tjokrowidjaja A, Lee CK, Houssami N, Lord S. Metastatic breast cancer in young women: a population-based cohort study to describe risk and prognosis. Intern Med J 2015; 44:764-70. [PMID: 24863750 DOI: 10.1111/imj.12481] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/22/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is limited information on the risk of metastatic breast cancer (MBC) to inform younger women, particularly those under 40 years. AIMS We conducted a retrospective analysis of a population-based cohort study to describe the risk, site and prognosis of MBC in young women under 40 years with an initial diagnosis of non-metastatic breast cancer and compared with older women. METHODS Data were extracted from the New South Wales Central Cancer Registry and the Admitted Patient Data Collection database between 2001-2007. Main outcome measures were 5-year cumulative incidence of MBC, prognostic factors for MBC and overall survival (OS) from the date of MBC diagnosis. RESULTS Three hundred and ninety-five (6%) of 6640 women with non-metastatic BC were <40 years. The 5-year cumulative incidence of MBC was 24% (95% CI 20-29%) for women <40 years with non-metastatic BC, compared with 9% (95% CI 9-10%) for women ≥40 years. Significant independent risk factors for MBC ≤ 5 years were age <40, regional disease at diagnosis, low socioeconomic status and the presence of other non-breast primary. At first record of MBC, visceral sites were more common for women <40 years than ≥40 (54% vs 43%; P = 0.03). Median survival for women with MBC within 5 years was not significantly different between young and older women (<40 years 18 months vs ≥40 years 14 months; log-rank P = 0.21). CONCLUSIONS Women with non-metastatic BC before age 40 have a higher 5-year risk of developing MBC than older women. There were no significant differences in median survival following MBC between young and older women.
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Affiliation(s)
- A Tjokrowidjaja
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia; School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Deotare PB, Chang W, Hontz E, Congreve DN, Shi L, Reusswig PD, Modtland B, Bahlke ME, Lee CK, Willard AP, Bulović V, Van Voorhis T, Baldo MA. Nanoscale transport of charge-transfer states in organic donor-acceptor blends. Nat Mater 2015; 14:1130-4. [PMID: 26413986 DOI: 10.1038/nmat4424] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/14/2015] [Indexed: 05/13/2023]
Abstract
Charge-transfer (CT) states, bound combinations of an electron and a hole on separate molecules, play a crucial role in organic optoelectronic devices. We report direct nanoscale imaging of the transport of long-lived CT states in molecular organic donor-acceptor blends, which demonstrates that the bound electron-hole pairs that form the CT states move geminately over distances of 5-10 nm, driven by energetic disorder and diffusion to lower energy sites. Magnetic field dependence reveals a fluctuating exchange splitting, indicative of a variation in electron-hole spacing during diffusion. The results suggest that the electron-hole pair of the CT state undergoes a stretching transport mechanism analogous to an 'inchworm' motion, in contrast to conventional transport of Frenkel excitons. Given the short exciton lifetimes characteristic of bulk heterojunction organic solar cells, this work confirms the potential importance of CT state transport, suggesting that CT states are likely to diffuse farther than Frenkel excitons in many donor-acceptor blends.
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Affiliation(s)
- P B Deotare
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - W Chang
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - E Hontz
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - D N Congreve
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - L Shi
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - P D Reusswig
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - B Modtland
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - M E Bahlke
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - C K Lee
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - A P Willard
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - V Bulović
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - T Van Voorhis
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - M A Baldo
- Center for Excitonics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
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Park JH, Cho SE, Lee SH, Lee CK, Shin HD. First Report of Postharvest Rot of Chestnuts Caused by Mucor racemosus f. sphaerosporus in Korea. Plant Dis 2014; 98:1742. [PMID: 30703917 DOI: 10.1094/pdis-05-14-0547-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Republic of Korea (South Korea) is the second largest chestnut producer in the world. Major cultivars planted in Korea, including cv. Daebo, Hyogo57, and Okkwang, are hybrids of Japanese chestnut (Castanea crenata) and Chinese chestnut (C. mollissima). Because of high perishability, most chestnuts harvested in September and October are preserved in cold rooms (0°C) for marketing. During a survey of postharvest diseases in April to August 2013, chestnut rots were continuously observed in cold rooms located in Buyeo County, Korea. Preliminary studies revealed that the most common agent of rot appeared to be a species of Mucor. When cut open, infected chestnuts showed partial interior discoloration varying from chalky white to dark brown. About 3 to 10% of chestnuts showed symptoms. Hyogo57 seemed to be the most susceptible variety with higher infection rates, up to 30% in some piles. Isolation was done by placing infected tissues on potato dextrose agar. A representative isolate was deposited in the Korean Agricultural Culture Collection (Accession No. KACC47727). Sporangiophores were mostly erect, branched sympodially, and hyaline. Sporangia were globose, pale yellow at first, then grayish brown at maturity. Columellae were obovoid to globose, subhyaline to pale brown, and usually with truncate base and collars. Sporangiospores were globose to irregular, and 4 to 10 μm in diameter. Chlamydospores were cylindrical to globose with oil drops. The fungus was identified as Mucor racemosus f. sphaerosporus (Hagem) Schipper based on the morphological characteristics and growth at low temperature (3). To conduct molecular analyses, genomic DNA was extracted with DNeasy Plant Mini Kits (Qiagen Inc., Valencia, CA). The primers ITS1/ITS4 and NL1/LR3 were used to amplify the internal transcribed spacer (ITS) region of rDNA and the D1/D2 region of the large subunit (4). The resulting 595-bp ITS sequences and 678 bp D1/D2 sequences were deposited in GenBank (Accession Nos. KJ769665 and KF769666). BLAST searches revealed that both the ITS sequences and D1/D2 sequences showed more than 99% similarity with those of M. racemosus f. sphaerosporus, respectively (JN939201 and AJ878775). To perform a pathogenicity test, a suspension of sporangiospores (1 × 105 spores/ml) was sprayed over 10 chestnuts cv. Hyogo57 wounded with a sewing needle and kept in plastic containers (0°C, 100% RH). Another 10 chestnuts wounded with a sewing needle and treated with sterile water served as controls. After 5 days, typical rots appeared on the inoculated chestnuts, whereas no symptoms were observed on controls. Koch's postulates were fulfilled with the re-isolation of M. racemosus from inoculated chestnuts. The pathogenicity test was carried out twice with similar results. M. hiemalis and M. mucedo have been recorded on chestnuts as postharvest pathogens in Switzerland (2) and Chile (1). To our knowledge, this is first report of postharvest rot of chestnut caused by M. racemosus f. sphaerosporus worldwide as well as in Korea. Further studies are necessary for control measures during cold storage of fresh chestnuts. References: (1) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., online publication, ARS, USDA, Retrieved May 23, 2014. (2) M. Jermini et al. J. Sci. Food Agric. 86:877, 2006. (3) M. A. A. Schipper. Stud. Mycol. 12:1, 1976. (4) G. Walther et al. Persoonia 30:11, 2013.
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Affiliation(s)
- J H Park
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
| | - S E Cho
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
| | - S H Lee
- Division of Forest Diseases and Insect Pests, Korea Forest Research Institute, Seoul 130-712, Korea
| | - C K Lee
- Department of Forest Resources, Gyeongnam National University of Science and Technology, Jinju 660-758, Korea
| | - H D Shin
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
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Park JH, Cho SE, Lee CK, Lee SH, Shin HD. First Report of Leaf Spot Caused by Phoma dictamnicola on Dictamnus dasycarpus in Korea. Plant Dis 2014; 98:1443. [PMID: 30703979 DOI: 10.1094/pdis-06-14-0658-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dictamnus dasycarpus Turcz, known as densefruit pittany, is a perennial herbal plant belonging to the Rutaceae. In Oriental medicine, this plant is used for treatment of various ailments (4). Since the white and purple striped flowers and glossy leaves are of aesthetic value, the plant is popular in gardens throughout Korea. In July 2012, a leaf spot was observed on hundreds of D. dasycarpus with nearly 100% incidence in a garden in Gapyeong County, Korea. Lesions on leaves reaching up to 20 mm in diameter were circular to irregular, brown to dark brown, then becoming zonate with age, and finally fading to grayish brown in the center with a reddish brown margin. The disease caused premature defoliation and reduced plant vigor as well as aesthetic value. In June 2014, the same symptoms were found on D. dasycarpus in a nursery in Jinju City, Korea. Representative samples were deposited in the Korea University Herbarium (KUS). Pycnidia on lesions were epiphyllous, immersed or semi-immersed in host tissue, light brown to olive brown, and 90 to 210 μm in diameter. Ostioles were 15 to 30 μm wide and surrounded by a ring of darker cells. Conidia were hyaline, smooth, ellipsoidal to nearly reniform, straight to mildly curved, aseptate or rarely medianly 1-septate with age, 5.5 to 9.6 × 1.8 to 3.6 μm, and contained small oil drops. These characteristics were consistent with the previous descriptions of Phoma dictamnicola Boerema, Gruyter & Noordel. (1,2). A monoconidial isolate was cultured on potato dextrose agar plates and deposited in the Korea Agricultural Culture Collection (Accession No. KACC46948). Morphological identification of the fungus was confirmed by molecular data. Genomic DNA was extracted using a DNeasy Plant Mini Kit (Qiagen Inc., Valencia, CA). The internal transcribed spacer (ITS) region of rDNA was amplified using the ITS1/ITS4 primers and sequenced. The resulting sequence of 505 bp was deposited in GenBank (Accession No. KM047023). A BLAST search showed that the ITS sequence shared >99% similarity with that of P. dictamnicola (GU237877). For the pathogenicity tests, inoculum was prepared by harvesting conidia from 30-day-old cultures of KACC46948 and a conidial suspension (2 × 106 conidia/ml) was sprayed onto leaves of five healthy seedlings. Five seedlings were sprayed with sterile distilled water, serving as controls. The plants were covered with transparent plastic bags for 48 h in a 25°C glasshouse with a 12-h photoperiod. After 10 days, typical leaf spot symptoms started to develop on the leaves of the inoculated plants. The fungus, P. dictamnicola, was re-isolated from those lesions, confirming Koch's postulates. No symptoms were observed on control plants. Previously, Phoma leaf spot on Dictamnus spp. has been reported in the Netherlands and North America (3) and recently in China (1). To our knowledge, this is the first report of leaf spot on D. dasycarpus caused by P. dictamnicola in Korea. Our observations suggest that low humidity with good ventilation as well as removal of infected leaves and plant debris might be main strategies for preventing this disease. References: (1) Q. Bai et al. Plant Dis. 95:771, 2011. (2) G. H. Boerema et al. Phoma Identification Manual: Differentiation of Specific and Infra-Specific Taxa in Culture. CABI Publishing. Wallingford, UK, 2004. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication, USDA ARS, Retrieved June 19, 2014. (4) J. L. Yang et al. Planta Med. 77:271, 2011.
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Affiliation(s)
- J H Park
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
| | - S E Cho
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
| | - C K Lee
- Department of Forest Resources, Gyeongnam National University of Science and Technology, Jinju 660-758, Korea
| | - S H Lee
- Division of Forest Diseases and Insect Pests, Korea Forest Research Institute, Seoul 130-712, Korea
| | - H D Shin
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
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Cho SE, Park JH, Lee SK, Lee SH, Lee CK, Shin HD. First Report of Powdery Mildew Caused by Phyllactinia actinidiae on Hardy Kiwi in Korea. Plant Dis 2014; 98:1436. [PMID: 30703999 DOI: 10.1094/pdis-04-14-0414-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Actinidia arguta (Siebold & Zucc.) Planch. ex Miq., known as hardy kiwi, is a perennial vine native to Japan, Korea, northern China, and Russian Siberia. It produces a small fruit resembling the kiwifruit. The fruits, referred to as hardy kiwifruit, are edible and often sweeter than kiwifruit. Picking of wild hardy kiwifruits in autumn is a popular ecotourism activity in Korea. In 2000, a powdery mildew disease on the abaxial surface of hardy kiwi leaves was found in Korea. Additional findings of the powdery mildew between 2000 and 2013 showed that the disease of hardy kiwi commonly occurs in Korea. The infected leaves were frequently distorted when young, then becoming prematurely chlorotic and defoliated. Chasmothecia were abundantly formed by September. Voucher specimens (n = 21) were deposited in the Korea University Herbarium (KUS). Mycelia were hypophyllous, thinly effuse, initially forming patches, finally covering the whole abaxial leaf surface. Hyphal appressoria were hook-shaped or often branched, and single or opposite in pairs. Conidiophores were erect, cylindrical, 160 to 300 × 5 to 7.5 μm with straight foot-cells (65 to 115 μm long), basal septum elevated up to 15 μm, and produced conidia singly. Conidia were obpyriform to clavate, papillate at the apex, 55 to 75 × 20 to 32 μm, and devoid of fibrosin bodies. Germ tubes were produced at the terminal and lateral positions of conidia. Chasmothecia were blackish brown, depressed globose, and 190 to 250 μm in diameter. Appendages arising around the equatorial zone of chasmothecia were 9 to 15 in number, acicular with a bulbose base, 1 to 1.3 times as long as the chasmothecial diameter, hyaline throughout, and aseptate. Penicillate cells crowded on the upper part of the chasmothecia were ampulliform, numerous, 50 to 87.8 μm long, and 12.5 to 17.5 μm wide. Asci were 13 to 20 in a chasmothecium, olivaceous brown, 60 to 90 × 22.5 to 40 μm, and short stalked. Ascospores were 2 in an ascus, ellipsoid-ovoid, pale olivaceous, and 32.5 to 40 × 16.5 to 20 μm. On the basis of the morphological characteristics, this fungus was identified as Phyllactinia actinidiae (Jacz.) Bunkina (1). To confirm the identification, the complete internal transcribed spacer (ITS) regions of rDNA of three specimens (KUS-F23673, F26240, and F26308) were amplified using primers ITS5/P3 and sequenced (4). The resulting sequences were deposited in GenBank (Accession Nos. KJ703014, KJ703015, and KJ703016). GenBank BLAST search with the three isolates showed >99% similarity with the results for P. actinidiae on hardy kiwi from Japan (AB080489, AB080500, and AB080508). Actinidia-Phyllactinia associations were recorded in China, Japan, Taiwan, Korea, Russia, and Turkey (2,3). However, P. actinidiae on A. arguta was known only from Japan (3). To our knowledge, this is the first record of P. actinidiae on hardy kiwi in Korea. There has been no finding of powdery mildews on commercial varieties of golden kiwi (A. chinensis) and fuzzy kiwi (A. deliciosa) in Korea. Common occurrence of Phyllactinia powdery mildew on hardy kiwi in Korea can be a potential threat to the commercial kiwi industry. References: (1) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No.11. CBS, Utrecht, 2012. (2) I. Erper et al. Scand. J. Forest Res. 27:432, 2012. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab., Online publication. ARS, USDA, March 10, 2014. (4) S. Takamatsu et al. Mycol. Res. 113:117, 2009.
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Affiliation(s)
- S E Cho
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
| | - J H Park
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
| | - S K Lee
- Division of Forest Diseases and Insect Pests, Korea Forest Research Institute, Seoul 130-712, Korea
| | - S H Lee
- Division of Forest Diseases and Insect Pests, Korea Forest Research Institute, Seoul 130-712, Korea
| | - C K Lee
- Department of Forest Resources, Gyeongnam National University of Science and Technology, Jinju 660-758, Korea
| | - H D Shin
- Division of Environmental Science and Ecological Engineering, Korea University, Seoul 136-701, Korea
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