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Wong KF, Fu N, Fan KYY, Cheng KY, Wong KL, Yung CY, Ho CKL, Au TWK. Implementing hybrid telerehabilitation following major cardiac surgery during COVID-19 pandemic in Hong Kong. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.162] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Department budget
Background
Aerobic exercise is a critical component of cardiac rehabilitation (CR) for patients (pts) who have undergone cardiac surgery. Exercise-based CR is ideally home-based and directly supervised by a trained physiotherapist. During COVID-19 pandemic in Hong Kong, there was increasing emphasis on social distancing and caregiving strategies to better reach pts outside hospital. As most cardiac surgeries were performed on urgent clinical needs including heart transplantation and aortic dissection, we implemented hybrid telerehabilitation (HTR) with transition to the use of remote care in order to continue comprehensive CR. We report the functional outcome of HTR group compared with usual care (UC) group.
Methods
From 7/2020 to10/2021, 36 pts ( 67% men, mean age 57±9.2 years) were enrolled into HTR (n=18) and UC (n=18) groups respectively for 12 weeks’ duration. Demographics in both groups were similar. Types of cardiac surgeries were heart transplant (n=5; 14%), CABG (n=6;17%), valvular surgery (n=17; 47%) and aorta operation (n=8; 22%). An individualized exercise prescription for HTR at home was determined based on initial standardized assessments in hospital and tailored to fit lifestyle and home environment. For HTR group, the goal is set at 150 minutes of low to moderate-intensity aerobic exercise per week at home. Exercise is progressed weekly based on daily metrics recorded by wearable device (exercise log and % target heart rate reserve (THRR) attained) and rate of perceived exertion (RPE). These were reported by pts through an online survey after each exercise session which were reviewed daily, with progress follow-up by phone calls or text messages on a weekly basis.
Functional capacity parameters were evaluated using symptom limited exercise treadmill test (ETT) and 6 minute walk test (6MWT). The advised level is based on the current activity level of the patient using a MET score list at intake by the physiotherapist. Handgrip and quadriceps strength were measured.
Results
All pts participated the programs. Both groups demonstrated significant improvement in MET scores and 6MWT after completion of CR programs.(Table ) Average exercise time at home was reported to be 379 ±98 minutes/ week (72% achieved >150 minutes/ week). Compared with UC, HTR showed significantly increased % change in MET score at baseline and upon completion of CR (22.1% vs 7%; p=0.02) and 6MWT (11.1% vs 5.3%; p=0.01). The effect muscle strength were similar in both groups with improving trend but no significant % change at baseline and end of CR.
Conclusion
Significant improvement in functional status can be demonstrated in comprehensive individualized HTR program in pts after major cardiac surgery. Adoption of digital technology with full integration into standard cardiac rehabilitation program should be recommended.
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Affiliation(s)
- K F Wong
- Grantham Hospital, Cardiac Medical Unit, Aberdeen, Hong Kong
| | - N Fu
- Grantham Hospital, Cardiac Medical Unit, Aberdeen, Hong Kong
| | - KYY Fan
- Grantham Hospital, Cardiac Medical Unit, Aberdeen, Hong Kong
| | - K Y Cheng
- Grantham Hospital, Cardiac Medical Unit, Aberdeen, Hong Kong
| | - K L Wong
- Grantham Hospital, Cardiac Medical Unit, Aberdeen, Hong Kong
| | - C Y Yung
- Grantham Hospital, Cardiac Medical Unit, Aberdeen, Hong Kong
| | - C K L Ho
- Queen Mary Hospital, Cardiothoracic Surgery Department, Hong Kong, Hong Kong
| | - TWK Au
- Queen Mary Hospital, Cardiothoracic Surgery Department, Hong Kong, Hong Kong
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Wong YT, Tai TF, Wong KF, Leung SK, Lam SM, Wong SY, Lo YY, Yan KM, Tam SK, Wong MF, Chan HL. The Study on Artificial Intelligence (AI) Colonoscopy in Affecting the Rate of Polyp Detection in Colonoscopy – A Single Center Retrospective Study. Surgical Practice 2022. [DOI: 10.1111/1744-1633.12559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Y. T. Wong
- Dept. of Surgery New Territories West Cluster, Hospital Authority
| | - T. F. Tai
- Dept. of Surgery New Territories West Cluster, Hospital Authority
| | - K. F. Wong
- Dept. of Surgery New Territories West Cluster, Hospital Authority
| | - S. K. Leung
- Dept. of Surgery New Territories West Cluster, Hospital Authority
| | - S. M. Lam
- Combined Endoscopy Unit, Tin Shui Wai Hospital
| | - S. Y. Wong
- Combined Endoscopy Unit, Tin Shui Wai Hospital
| | - Y. Y. Lo
- Combined Endoscopy Unit, Tin Shui Wai Hospital
| | - K. M. Yan
- Combined Endoscopy Unit, Tin Shui Wai Hospital
| | - S. K. Tam
- Combined Endoscopy Unit, Tin Shui Wai Hospital
| | - M. F. Wong
- Combined Endoscopy Unit, Tin Shui Wai Hospital
| | - H. L. Chan
- Combined Endoscopy Unit, Tin Shui Wai Hospital
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Wong KF, Perini F, Henderson SL, Teng J, Hassirim Z, Lin J, Leow Z, Fan Q, Ong J, Lo J, Ong JC, Doshi K, Lim J. 0519 Mindfulness Based Therapy for Insomnia Improves Objective Markers of Sleep in the Elderly: Preliminary Data from the Mindfulness Sleep Therapy (MIST) Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.516] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Mindfulness-based treatment for insomnia (MBTI) is a viable intervention for improving poor sleep. We report preliminary data from an ongoing pre-registered, randomized controlled trial which investigates the effect of MBTI on elderly adults.
Methods
Participants above 50 years old with PSQI ≥ 5 were recruited and randomised into either MBTI or an active control group (Sleep hygiene education and exercise program, SHEEP) in sequential cohorts with about 20 participants per cohort (10 per group). Before and after the intervention, 1 night of portable polysomnography (PSG) and 1 week of actigraphy (ACT) and sleep diary (DIARY) data were collected. We report the ACT and DIARY results of the first 3 cohorts (n = 46, male = 23, mean age = 62.3, std = 6.3) and PSG data of the first 2 cohorts (n = 29, male = 12, mean age = 62.5, std = 5.7). Time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were analysed with mixed-model repeated-measures ANOVA.
Results
We observed increases in TIBDIARY (F1,44 = 5.151, p < .05) and SEDIARY (F1,44 = 22.633, p < .0001), and significant reductions in SOLDIARY (F1,44 = 7.031, p < .05) and WASODIARY (F1,39 = 7.411, p < .05). In the actigraphy data, we found a significant interaction in SOLACT (F1,39 = 4.273, p < .05) with an increase in SHEEP SOLACT (t18= 2.36, p < .05). Significant reductions were also observed in WASOACT (F1,44 = 16.459, p < .0001) Finally, we observed a reduction in SOLPSG (F1,26 = 5.037, p <. 05). All other tests were non-significant.
Conclusion
Preliminary results suggest that both interventions lead to improvements in sleep with more pronounced effects in subjective sleep reports. Objective sleep data suggest that improvements in sleep is a result of improved sleep quality and not simply extending sleep opportunity. These preliminary data shows that MBTI may be a promising intervention for elderly individuals with sleep difficulties.
Support
This study was supported by an award from the 7th grant call of the Singapore Millennium Foundation Research Grant Programme
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Affiliation(s)
- K F Wong
- Duke NUS Medical School, Singapore, SINGAPORE
| | - F Perini
- Duke NUS Medical School, Singapore, SINGAPORE
| | | | - J Teng
- Duke NUS Medical School, Singapore, SINGAPORE
| | - Z Hassirim
- Duke NUS Medical School, Singapore, SINGAPORE
| | - J Lin
- Duke NUS Medical School, Singapore, SINGAPORE
| | - Z Leow
- Duke NUS Medical School, Singapore, SINGAPORE
| | - Q Fan
- Singapore General Hospital, Singapore, SINGAPORE
| | - J Ong
- Duke NUS Medical School, Singapore, SINGAPORE
| | - J Lo
- National University of Singapore, Singapore, SINGAPORE
| | - J C Ong
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - K Doshi
- Singapore General Hospital, Singapore, SINGAPORE
| | - J Lim
- Duke NUS Medical School, Singapore, SINGAPORE
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Venables ZC, Nijsten T, Wong KF, Autier P, Broggio J, Deas A, Harwood CA, Hollestein LM, Langan SM, Morgan E, Proby CM, Rashbass J, Leigh IM. Epidemiology of basal and cutaneous squamous cell carcinoma in the U.K. 2013-15: a cohort study. Br J Dermatol 2019; 181:474-482. [PMID: 30864158 PMCID: PMC7379277 DOI: 10.1111/bjd.17873] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), together known as keratinocyte cancers (KCs), are the commonest cancer in white ethnic populations. Recent improvements to registry data collection in England has allowed more accurate analysis of the epidemiology of BCC and cSCC and for the first time we are able to provide an accurate (representative) tumour burden for KC in the U.K. OBJECTIVES To estimate the incidence of BCC and cSCC in the U.K. METHODS A cohort of patients with KCs between 2013 and 2015 were identified using linkage to diagnostic codes derived from pathology reports collected into the national cancer registry. Data from England's cancer registry were combined with data from Scotland, Northern Ireland and Wales. European age-standardized incidence rates (EASRs) of the first BCC and cSCC per patient per annum (PPPA) were calculated. RESULTS In the U.K, the EASR of the first BCC and cSCC PPPA in 2013-15 were 285 and 77 per 100 000 person years, respectively (211 120 KCs total in 2015). The mean annual percentage increase was 5% between 2013 and 2015 for both BCC and cSCC. By counting the first KC PPPA, we include an additional 51% KCs compared with the previous reporting technique which counts only the first BCC and cSCC in a patient's lifetime, yet it represents a probable underestimation of 5-11% of the true tumour count. CONCLUSIONS Based on an improved methodology, a more representative incidence of KC is presented, which is essential to healthcare planning and will lead to improved understanding of the epidemiology of KC. What's already known about this topic? Keratinocyte cancers (KCs) are the most common cancers affecting white ethnic populations. The incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) is increasing worldwide including the U.K., most commonly in elderly male Caucasian patients. These cancers are traditionally substantially underreported and frequently excluded from national cancer statistics. What does this study add? Using improved data collection methods in England and validated tumour-reporting techniques, we report the most accurate BCC and cSCC incidence data for the U.K. ever published. Identifying the first BCC and cSCC per patient per annum, the incidence of BCC and cSCC in the U.K. (excluding Wales) was 285 and 77 per 100 000 person years, respectively, between 2013 and 2015, with more than 210 000 KCs in the U.K. in 2015.
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Affiliation(s)
- Z C Venables
- Department of Dermatology, Leicester Royal Infirmary, Leicester, U.K.,Public Health England London Region, London, U.K.,Barts and The London School of Medicine and Dentistry, London, U.K
| | - T Nijsten
- Department of Dermatology, Erasmus Medical Center, Burg Jacobsplein 51, Rotterdam, 3015CA, the Netherlands
| | - K F Wong
- Public Health England London Region, London, U.K
| | - P Autier
- International Prevention Research Institute, Lyon, France
| | - J Broggio
- Public Health England London Region, London, U.K
| | - A Deas
- Information Services Division, NHS National Services Scotland, Glasgow, U.K
| | - C A Harwood
- Blizard Institute, Barts and the London School of Medicine and Dentistry, London, U.K
| | - L M Hollestein
- Department of Dermatology, Erasmus Medical Center, Burg Jacobsplein 51, Rotterdam, 3015CA, the Netherlands
| | - S M Langan
- St John's Institute of Dermatology, Department of Dermatology, London, U.K
| | - E Morgan
- Northern Ireland Cancer Registry, Belfast, Northern Ireland, U.K
| | - C M Proby
- School of Medicine, University of Dundee, Dundee, Scotland, U.K
| | - J Rashbass
- Public Health England London Region, London, U.K
| | - I M Leigh
- Barts and The London School of Medicine and Dentistry, London, U.K
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Affiliation(s)
- K. F. Wong
- Department of Pathology Queen Elizabeth Hospital Hong Kong
| | - J. K. C. Chan
- Department of Pathology Queen Elizabeth Hospital Hong Kong
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Cher CY, Leung GMK, Au CH, Chan TL, Ma ESK, Sim JPY, Gill H, Lie AKW, Liang R, Wong KF, Siu LLP, Tsui CSP, So CC, Wong HWW, Yip SF, Lee HKK, Liu HSY, Lau JSM, Luk TH, Lau CK, Lin SY, Kwong YL, Leung AYH. Next-generation sequencing with a myeloid gene panel in core-binding factor AML showed KIT activation loop and TET2 mutations predictive of outcome. Blood Cancer J 2016; 6:e442. [PMID: 27391574 PMCID: PMC5030377 DOI: 10.1038/bcj.2016.51] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/16/2016] [Indexed: 12/21/2022] Open
Abstract
Clinical outcome and mutations of 96 core-binding factor acute myeloid leukemia (AML) patients 18–60 years old were examined. Complete remission (CR) after induction was 94.6%. There was no significant difference in CR, leukemia-free-survival (LFS) and overall survival (OS) between t(8;21) (N=67) and inv(16) patients (N=29). Univariate analysis showed hematopoietic stem cell transplantation at CR1 as the only clinical parameter associated with superior LFS. Next-generation sequencing based on a myeloid gene panel was performed in 72 patients. Mutations in genes involved in cell signaling were associated with inferior LFS and OS, whereas those in genes involved in DNA methylation were associated with inferior LFS. KIT activation loop (AL) mutations occurred in 25 patients, and were associated with inferior LFS (P=0.003) and OS (P=0.001). TET2 mutations occurred in 8 patients, and were associated with significantly shorter LFS (P=0.015) but not OS. Patients negative for KIT-AL and TET2 mutations (N=41) had significantly better LFS (P<0.001) and OS (P=0.012) than those positive for both or either mutation. Multivariate analysis showed that KIT-AL and TET2 mutations were associated with inferior LFS, whereas age ⩾40 years and marrow blast ⩾70% were associated with inferior OS. These observations provide new insights that may guide better treatment for this AML subtype.
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Affiliation(s)
- C Y Cher
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - G M K Leung
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - C H Au
- Department of Pathology, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - T L Chan
- Department of Pathology, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - E S K Ma
- Department of Pathology, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - J P Y Sim
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - H Gill
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - A K W Lie
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - R Liang
- Department of Medicine, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - L L P Siu
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - C S P Tsui
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - C C So
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - H W W Wong
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - S F Yip
- Department of Medicine, Tuen Mun Hospital, Hong Kong, China
| | - H K K Lee
- Department of Medicine, Princess Margaret Hospital, Hong Kong, China
| | - H S Y Liu
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - J S M Lau
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - T H Luk
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - C K Lau
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China
| | - S Y Lin
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China
| | - Y L Kwong
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - A Y H Leung
- Division of Haematology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
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Hau C, Reid KF, Wong KF, Chin RJ, Botto TJ, Eliasziw M, Bermudez OI, Fielding RA. Collaborative Evaluation of the Healthy Habits Program: An Effective Community Intervention to Improve Mobility and Cognition of Chinese Older Adults Living in the U.S. J Nutr Health Aging 2016; 20:391-7. [PMID: 26999238 DOI: 10.1007/s12603-015-0623-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES There is a growing demand to reduce ethnic health disparities. The Healthy Habits Program (HHP) was implemented to provide a community-based physical activity and education intervention for Chinese older adults living in Boston, Massachusetts. This study evaluated the HHP by assessing outcomes that are critical for maintaining independence of older persons. DESIGN, SETTING AND PARTICIPANTS Quantitative evaluation was performed on 50 Chinese older adults enrolled in the HHP. The community members were trained in data collection and management. MEASUREMENTS Cognition (Mini Mental State Examination (MMSE), Trail Making Test and Complex Walking Task), mobility (Short Physical Performance Battery (SPPB) and maximal gait speed), depressive symptoms (Patient Health Questionnaire-9), perceived disability (World Health Organization Disability Assessment 2.0), nutritional status (Mini Nutrition Assessment®), and strength (grip and leg strength) were assessed at baseline and at 6 months. All tests were translated into Chinese. RESULTS Of the 50 participants (mean age 68.4 years; 68% female), 78% achieved the goal of performing exercise ≥3 times/week. After 6 months, clinically meaningful improvements were observed in mobility (mean SPPB score changed from 10.3 to 11.1 points; p=0.01) and cognition (mean MMSE score changed from 26.0 to 27.8 points; p=0.001). There were also statistically significant improvements in executive function, depressive symptoms and perceived disability (p<0.05). CONCLUSION Culturally sensitive community interventions, such as the HHP, are effective for improving mobility and cognition of Chinese older adults. This reveals the potential of promoting successful aging in minority populations through community settings, and should be advocated to reduce ethnic health disparities in the U.S.
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Affiliation(s)
- C Hau
- Roger A. Fielding, PhD, Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111, USA, Phone: +1-617-556-3016, Fax: +1-617-556-3083, E-mail:
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Chan AOK, But WM, Lee CY, Lam YY, Ng KL, Loung PY, Lam A, Cheng CW, Shek CC, Wong WS, Wong KF, Wong MY, Tse WY. Aetiological bases of 46,XY disorders of sex development in the Hong Kong Chinese population. Hong Kong Med J 2015; 21:499-510. [PMID: 26492835 DOI: 10.12809/hkmj144402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Disorders of sex development are due to congenital defects in chromosomal, gonadal, or anatomical sex development. The objective of this study was to determine the aetiology of this group of disorders in the Hong Kong Chinese population. SETTING Five public hospitals in Hong Kong. PATIENTS Patients with 46,XY disorders of sex development under the care of paediatric endocrinologists between July 2009 and June 2011. MAIN OUTCOME MEASURES Measurement of serum gonadotropins, adrenal and testicular hormones, and urinary steroid profiling. Mutational analysis of genes involved in sexual differentiation by direct DNA sequencing and multiplex ligation-dependent probe amplification. RESULTS Overall, 64 patients were recruited for the study. Their age at presentation ranged from birth to 17 years. The majority presented with ambiguous external genitalia including micropenis and severe hypospadias. A few presented with delayed puberty and primary amenorrhea. Baseline and post-human chorionic gonadotropin-stimulated testosterone and dihydrotestosterone levels were not discriminatory in patients with or without AR gene mutations. Of the patients, 22 had a confirmed genetic disease, with 11 having 5α-reductase 2 deficiency, seven with androgen insensitivity syndrome, one each with cholesterol side-chain cleavage enzyme deficiency, Frasier syndrome, NR5A1-related sex reversal, and persistent Müllerian duct syndrome. CONCLUSIONS Our findings suggest that 5α-reductase 2 deficiency and androgen insensitivity syndrome are possibly the two most common causes of 46,XY disorders of sex development in the Hong Kong Chinese population. Since hormonal findings can be unreliable, mutational analysis of the SRD5A2 and AR genes should be considered the first-line tests for these patients.
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Affiliation(s)
- Angel O K Chan
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - W M But
- Department of Paediatrics, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - C Y Lee
- Department of Paediatrics and Adolescent Medicine, Caritas Medical Centre, Shamshuipo, Hong Kong
| | - Y Y Lam
- Department of Paediatrics and Adolescent Medicine, Kwong Wah Hospital, Yaumatei, Hong Kong
| | - K L Ng
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong
| | - P Y Loung
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Aimen Lam
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong
| | - C W Cheng
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - C C Shek
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - W S Wong
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - M Y Wong
- Department of Paediatrics, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - W Y Tse
- Department of Paediatrics, Queen Elizabeth Hospital, Jordan, Hong Kong
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Pan HB, Wong KF, Hsu GC, Liang HL. The type of digital mammography is an influencing factor for the performance of national screening. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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McOwat L, Wong KF, Varughese GI, Nayak AU. Splenic abscess as a potential initial manifestation of quiescent infective endocarditis in a patient with bronchopneumonia. Case Reports 2015; 2015:bcr-2014-206794. [DOI: 10.1136/bcr-2014-206794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Wong KF, Siu LLP, Wong WS. Double minutes and MYC amplification: a combined May-Grunwald Giemsa and fluorescence in situ hybridization study. Am J Clin Pathol 2014; 141:280-4. [PMID: 24436278 DOI: 10.1309/ajcpwubgt7c0lhin] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To report the demonstration of double minutes with MYC amplification in a case of myeloproliferative neoplasm with monocytosis in transformation by a combination of standard karyotyping and interphase and metaphase fluorescence in situ hybridization (FISH). METHODS To determine the lineage involvement, we applied combined morphology and an interphase FISH study using dual-color break-apart probes for MYC on peripheral blood film. RESULTS MYC amplification was demonstrated in both myeloid and monocytic cells but not lymphocytes. The MYC amplification was not associated with loss of MYC signals at the homologous 8q24 regions where the genes were located. Furthermore, the extent of MYC amplification has been shown to diminish as the granulocytes mature. CONCLUSIONS Combined morphology and FISH study has shown a pluripotent myeloid disorder and also an inverse relationship between cell maturity and MYC amplification.
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Affiliation(s)
- K. F. Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - Lisa L. P. Siu
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - W. S. Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
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12
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Wong KF, Siu LLP, Ainsbury E, Moquet J. Cytogenetic biodosimetry: what it is and how we do it. Hong Kong Med J 2013; 19:168-173. [PMID: 23535678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Dicentric assay is the international gold standard for cytogenetic biodosimetry after radiation exposure, despite being very labour-intensive, time-consuming, and highly expertise-dependent. It involves the identification of centromeres and structure of solid-stained chromosomes and the enumeration of dicentric chromosomes in a large number of first-division metaphases of cultured T lymphocytes. The dicentric yield is used to estimate the radiation exposure dosage according to a statistically derived and predetermined dose-response curve. It can be used for population triage after large-scale accidental over-exposure to ionising radiation or with a view to making clinical decisions for individual patients receiving substantial radiation. In this report, we describe our experience in the establishment of a cytogenetic biodosimetry laboratory in Queen Elizabeth Hospital, Hong Kong. This was part of the contingency plan for emergency measures against radiation accidents at nuclear power stations.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong.
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13
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Wong KF, Kwan AMY, Wong MLG, Lam CCK, Yip SC. Virtual blood banking in Hong Kong. Hong Kong Med J 2012; 18:304-309. [PMID: 22865174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE. To review our experience in virtual blood banking for intra-operative transfusion in Hong Kong. DESIGN. Retrospective study. SETTING. Three major acute hospitals and a specialised centre for joint replacement surgery with installation of an Operating Theatre Blood Transaction System. PATIENTS. Patients undergoing surgery under anaesthesia and requiring intra-operative transfusion for the period from the implementation of the system in individual institutes (Queen Elizabeth Hospital: June 1997; Princess Margaret Hospital: May 2001; Queen Mary Hospital: October 2009; and Hong Kong Buddhist Hospital: December 2010) till September 2011. RESULTS. Under the system, 58 923 units of red cells were released intra-operatively for 18 264 patients (11% of the total number of blood units issued by the blood banks in these institutes during the study period). About 1% of them (613 units) entailed unmatched red cells given to 183 patients for emergency transfusions during surgery. The mean time required for the issue of the first unit of red cells was less than 1 minute. A total of 1231 units of red cells were returned unused after being released. Among them, 95 units were deemed unfit for re-issue because they had left the temperature-monitored blood storage refrigerators in the operating theatres for more than 30 minutes. There was no delay in transfusion or postponement of surgery due to problems or downtime of the Operating Theatre Blood Transaction System. CONCLUSION. Our experience has shown that our virtual blood banking system was efficient and effective, and helped ensure that the right patient received the right amount of the right blood at the right time. The system can be implemented either locally in the same hospital with a central blood bank, or in a more remote and networked site without a nearby supporting blood bank.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong.
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Srivastava S, Wong KF, Ong CW, Huak CY, Yeoh KG, Teh M, Luk JM, Salto-Tellez M. A morpho-molecular prognostic model for hepatocellular carcinoma. Br J Cancer 2012; 107:334-9. [PMID: 22713659 PMCID: PMC3394972 DOI: 10.1038/bjc.2012.230] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Hepatocellular carcinoma (HCC) is the third common cause of cancer-related deaths and its prognostication is still suboptimal. The aim of this study was to establish a new prognostication algorithm for HCC. Methods: In all, 13 biomarkers related to the etiopathogenesis of HCC were evaluated by immunohistochemistry using tissue microarrays containing 121 primary HCC resection cases, and validated in subsequent cohort of 85 HCC cases. The results were compared with Affymetrix Gene Chip Human Genome U133Plus microarray data in a separate cohort of 228 HCC patients. Results: On immunohistochemical evaluation and multivariate Cox regression analysis p53, alpha fetaprotein (AFP), CD44 and CD31, tumour size and vascular invasion, were significant predictors for worse survival in HCC patients. A morpho-molecular prognostic model (MMPM) was constructed and it was a significant independent predictor for overall survival (OS) and relapse-free survival (RFS) (P<0.000). The OS and RFS of HCClow was higher (104 and 78 months) as compared with HCChigh (73 and 43 months) (P<0.0001for OS and RFS). Hepatocellular carcinoma patients with higher stage (III+IV), >5 cm tumour size, positive vascular invasion and satellitosis belonged to HCChigh group. The validation group reproduced the same findings. Gene expression analysis confirmed that 7 of the 12 biomarkers were overexpressed in >50% of tumour samples and significant overexpression in tumour samples was observed in AFP, CD31, CD117 and Ki-67 genes. Conclusion: The MMPM, based on the expression of selected proteins and clinicopathological parameters, can be used to classify HCC patients between good vs poor prognosis and high vs low risk of recurrence following hepatic resection.
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Affiliation(s)
- S Srivastava
- Cancer Science Institute, National University of Singapore, Singapore
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15
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Wong KF, Wong KHF. Acute myeloid leukaemia with inv(3)(q21q26). Br J Haematol 2012; 157:158. [PMID: 22329694 DOI: 10.1111/j.1365-2141.2012.09062.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China.
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17
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Abstract
Penicillium marneffei is a dimorphic fungus which is endemic in Southeast Asia. It is an opportunistic pathogen which has emerged to become an AIDS-defining illness in the endemic areas. Early diagnosis with prompt initiation of treatment is crucial for its management. Prompt diagnosis can often be established through careful cytological and histological examination of clinical specimens although microbiological culture remains the gold standard for its diagnosis. Standard antifungal treatment for AIDS patients with penicilliosis is well established. Highly active antiretroviral therapy should be started early together with the antifungal treatment. Special attention should be paid to potential drug interaction between antiretroviral and antifungal treatments. Secondary prophylaxis may be discontinued with a low risk of relapse of the infection once the immune dysfunction has improved.
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Affiliation(s)
- Stephenie Y N Wong
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong
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Abstract
AIM This paper details the experience of establishing an integrated skills training centre for use in undergraduate nursing education in The Open University of Hong Kong. BACKGROUND Skills training is an essential element in undergraduate nursing education. Owing to the increasing complexity of the health-care system and patient health needs, undergraduate nursing students should be well prepared for integrated skills competency, critical thinking and rapid decision-making. To achieve this goal, the use of simulation as a skills training tool is being recommended. CONCLUSION The Clinical Nursing Education Centre is established. It adopts simulation as a teaching and learning tool. It has four specific education units, namely: (1) clinical simulation education unit, (2) virtual reality education unit, (3) nursing skills education unit, and (4) Chinese medicinal education unit. These units are specifically designed for the teaching and learning of nursing skills related to general, mental and Chinese medicinal nursing from elementary to advanced level. Experiences pertaining to the conceptualization, exploration and actualization phases of the establishment are presented. Details of the structure and specific functions of the centre are also illustrated. Finally, there is discussion on the challenges encountered during the establishment process and how they were overcome.
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Affiliation(s)
- L Y K Lee
- The Open University of Hong Kong, Kowloon, Hong Kong, China.
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Affiliation(s)
- K F Wong
- School of Science & Technology, The Open University of Hong Kong, Hong Kong, China
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21
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Abstract
Penicillium marneffei is a dimorphic fungus that causes one of the most common opportunistic infections in Asian patients with AIDS. The diagnosis is established by microbiologic culture, requiring at least several days. A presumptive diagnosis can be made by cytologic or histologic examination of biopsied or aspirated tissue. Bone marrow biopsy is often performed in the workup of patients with AIDS who have fever or hematologic abnormalities and can provide prompt diagnosis of opportunistic infection. We report the bone marrow findings in the largest series of patients with culture-proven P marneffei infection. In the bone marrow, the histiocytes can occur in large numbers and be easily recognized or may be extremely subtle. P marneffei infection is sometimes not accompanied by granuloma formation despite marked histiocytic proliferation. The histiocytes contain a few to many intracellular yeast-form cells that resemble cellular debris because of their small size and staining pattern. The characteristic septate forms and the absence of budding help distinguish the condition from histoplasmosis and toxoplasmosis. Routine performance of silver methenamine stain for fungi in marrow biopsy specimens of febrile patients with AIDS is recommended to detect a subtle infection.
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Abstract
JAK2 V617F mutation is mostly seen in BCR-ABLI negative myeloproliferative neoplasms. Among other myeloid neoplasms, it occurs with remarkably high frequency in refractory anemia with ring sideroblasts associated with marked thrombocytosis, a group of myeloid neoplasms with both dysplastic and proliferative features. It has also been reported in occasional cases of myelodysplastic syndrome with isolated del(5q), often with a diagnosis of refractory cytopenia with multilineage dysplasia. We performed a retrospective analysis of JAK2 V617F mutation in Chinese patients with myeloid neoplasms and isolated del(5q), and were able to demonstrate the frequent occurrence of JAK2 V617F mutation in 5q- syndrome.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China.
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26
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Wong KF, Wong WW, Li BX, Song YZ. The first case of Silver-Russell syndrome accompanied by linea alba hernia in China. Singapore Med J 2010; 51:e9-e11. [PMID: 20200765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 10-month-old Chinese boy presented with delayed motor development for seven months. Blood and biochemistry investigations revealed no abnormalities. The physical examination showed poor postnatal growth (below -2 standard deviation from the mean at diagnosis), preservation of the occipitofrontal head circumference with delayed closure of the anterior fontanel, a classical triangular facial phenotype, asymmetry of the lower extremities and other characteristic features that fulfil the diagnostic criteria of Silver-Russell syndrome clinically. As PubMed and web searches revealed no similar findings, we believe that this may be the first case of Silver-Russell syndrome with linea alba hernia and pes varus reported in China, and possibly the world. The genetic deficit responsible for this case is still under investigation.
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Affiliation(s)
- K F Wong
- Department of Pediatrics, First Affiliated Hospital, Jinan University, West 613, Huangpu Dadao Xi, Guangzhou 510632, Guangdong Province, China.
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Wong KF, Wong WS, Siu LLP. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue presenting with cryoglobulinemia and subtle marrow infiltrate. Leuk Lymphoma 2009; 51:543-5. [PMID: 20038228 DOI: 10.3109/10428190903503420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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28
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Ma SK, Wong KF, Siu L. Hemoglobinemia and hemoglobinuria complicating concomitant use of a white cell filter and a pressure infusion device. Transfusion 2009. [DOI: 10.1111/j.1537-2995.1995.tb03389.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Au WY, Fung A, Wong KF, Chan CH, Liang R. Tumor necrosis factor alpha promoter polymorphism and the risk of chronic lymphocytic leukemia and myeloma in the Chinese population. Leuk Lymphoma 2009; 47:2189-93. [PMID: 17071494 DOI: 10.1080/10428190600758645] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The -308 GA promoter polymorphism of tumor necrosis factor alpha (TNFalpha) has been reported to be associated with an increased risk of lymphoid malignancies in Caucasians. We studied the incidence and prognostic significance of this polymorphism in Chinese patients with plasma cell myeloma (PCM), chronic lymphocytic leukemia (CLL) and lymphomas. Despite a far lower incidence of PCM and CLL in the Chinese population compared with Caucasians, the rates of TNFalpha-308A were similar to those in Caucasians, both in the study and control populations. Similarly, there was no increased rate of TNFalpha-308A in all the lymphomas studied, irrespective of lineage. However, TNFalpha-308A is significantly associated with female CLL cases and confers a strong negative prognostic impact for Chinese CLL. These argue for a possible biological role for increased TNFalpha production in CLL progression in low-risk individuals.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Cell Lineage
- China
- Disease Progression
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Multiple Myeloma/genetics
- Multiple Myeloma/metabolism
- Multiple Myeloma/pathology
- Polymorphism, Genetic
- Prognosis
- Promoter Regions, Genetic
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/physiology
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Affiliation(s)
- W Y Au
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
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Wong KF, Wong WS, Siu LLP, Lau TC. JAK2 V617F mutation in myeloid neoplasms with 3q21 and 3q26 abnormalities in Chinese patients. Leuk Lymphoma 2009; 50:1386-8. [PMID: 19562620 DOI: 10.1080/10428190903040022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wong KF, Siu LLP, Wong WS. Fluorescence in situ hybridisation in chronic lymphocytic leukemia in Hong Kong Chinese. Leuk Lymphoma 2009; 50:859-60. [PMID: 19337936 DOI: 10.1080/10428190902856816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China.
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34
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35
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Affiliation(s)
- K F Wong
- Institute of Pathology, Queen Elizabeth Hospital, Hong Kong
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Affiliation(s)
- K F Wong
- Institute of Pathology, Queen Elizabeth Hospital, Hong Kong
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Wong WS, Chung JYS, Wong KF. Images in haematology. Human babesiosis. Br J Haematol 2007; 140:364. [PMID: 18042268 DOI: 10.1111/j.1365-2141.2007.06889.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- W S Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China
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38
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Affiliation(s)
- Y K Lam
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China
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39
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Affiliation(s)
- Edmond S K Ma
- Department of Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong.
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40
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Wong KF. Transformed follicular lymphoma with concurrent t(2;3), t(8;14) and t(14;18). ACTA ACUST UNITED AC 2007; 173:68-70. [PMID: 17284373 DOI: 10.1016/j.cancergencyto.2006.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 08/08/2006] [Accepted: 08/15/2006] [Indexed: 10/23/2022]
Abstract
An elderly Chinese man who had an 8-year history of follicular lymphoma presented with large B-cell lymphoma. The disease ran a rapidly fatal course with a terminal leukemic phase. Cytogenetic analysis of the transformed follicular lymphoma showed a complex karyotype of 48,Y,t(X;19)(q26;p13.3),t(2;3)(p12;q27),t(8;14)(q24.1;q32),+12,t(14;18)(q32;q21),+21. To my knowledge, this is the first reported case of simultaneous occurrence of t(2;3), t(8;14), and t(14;18) in transformed follicular lymphoma.
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MESH Headings
- Aged
- Chromosome Banding
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- Chromosomes, Human, Pair 2
- Chromosomes, Human, Pair 3
- Chromosomes, Human, Pair 8
- Fatal Outcome
- Humans
- Karyotyping
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/genetics
- Male
- Translocation, Genetic/genetics
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong SAR, China.
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41
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Tang JW, Lau JSM, Wong SYN, Cheung JLK, Chan CH, Wong KF, Wong A, Chan PKS. Dose-by-dose virological and hematological responses to intravenous immunoglobulin in an immunocompromised patient with persistent parvovirus B19 infection. J Med Virol 2007; 79:1401-5. [PMID: 17607784 DOI: 10.1002/jmv.20870] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 42-year-old male with stage IV mantle cell lymphoma received chemotherapy and autologous peripheral blood stem cell transplantation. He developed pancytopaenia, and bone marrow examination indicated a parvovirus B19 (PVB 19)-induced red cell aplasia, confirmed by virological tests. Multiple doses of intravenous immunoglobulin (IVIG) were given over the following months, with blood samples being taken after each dose for quantitative PVB 19 DNA and hematological testing to assess the response. Each dose of IVIG produced a 1-3 log(10) drop in PVB 19 DNA levels. Eventually, after the fifth dose of IVIG, the PVB 19 DNA was reduced to <10 copies/ml serum, with a gradual improvement in his hematological parameters. This report demonstrates how close monitoring of the virological and hematological response to IVIG therapy for persistent PVB 19 infection in an immunocompromised patient can optimize the usage of this relatively expensive, and sometimes scarce intervention.
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Affiliation(s)
- Julian W Tang
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
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Chim CS, Lau JS, Wong KF, Kwong YL. CDKN2B methylation is an independent poor prognostic factor in newly diagnosed acute promyelocytic leukemia. Leukemia 2006; 20:149-51. [PMID: 16307009 DOI: 10.1038/sj.leu.2404052] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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43
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Chim CS, Fung TK, Wong KF, Lau JS, Liang R. Frequent DAP kinase but not p14 or Apaf-1 hypermethylation in B-cell chronic lymphocytic leukemia. J Hum Genet 2006; 51:832-838. [PMID: 16897188 DOI: 10.1007/s10038-006-0029-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Accepted: 06/06/2006] [Indexed: 10/24/2022]
Abstract
Dysregulation of apoptosis, and thus the p14/DAP kinase/HDM2/p53/Apaf-1 pathway, is potentially important in carcinogenesis. Chronic lymphocytic leukemia (CLL), uncommon in the Chinese, is a disease characterized by impaired apoptosis, of the neoplastic lymphocytes. Hypermethylation of p14, DAP kinase and Apaf-1 was studied by methylation-specific polymerase chain reaction (MSP) with primers for methylated (M-MSP) and unmethylated (U-MSP) alleles in 50 diagnostic marrow samples from patients with CLL. Chinese CLL patients had an indolent course similar to Caucasians with median overall survival (OS) of 96 months, which was adversely affected by advanced Rai stage (projected 5-year OS = 72% and 39% for Rai < or = 2 and Rai > 2; P = 0.01). DAP kinase was methylated in 18 (36%) patients while p14 and Apaf-1 were completely unmethylated in all the primary CLL samples. There was no correlation between DAP kinase hypermethylation and age, sex, poor-risk karyotype, lymphocyte count and Rai stage at diagnosis. Projected OS for patients with and without DAP kinase hypermethylation were 59 and 57% (P = 0.91). DAP kinase, but not p14 and Apaf-1, of the DAP kinase/p14/HDM2/p53/Apaf-1 pathway is frequently hypermethylated in CLL, but not of prognostic significance. Moreover Chinese patients with CLL share a similarly indolent clinical course, and this is the first comprehensive study on p14, DAP kinase and Apaf-1 hypermethylation in CLL.
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Affiliation(s)
- C S Chim
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong, China.
| | - T K Fung
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - J S Lau
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - R Liang
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong, China
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China.
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45
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Abstract
Osteosarcoma is the most common primary malignant bone tumor of children and adolescents. It often presents as a solitary lesion; multicentric osteosarcoma with synchronous lesions occurring at multiple skeletal sites is very rare. We report a 9-year-old boy with multicentric osteosarcoma who presented with a left retrobulbar non-sclerotic mass. The multiple lesions in bone were mostly non-sclerotic on radiological examination except for a single lesion in the left tibia. Biopsy of the retrobulbar mass showed an unclassifiable poorly differentiated malignant tumor. Marrow aspiration smears showed many large, often segregated, round cells that expressed NB84a. However, trephine biopsy showed the formation of tumoral osteoid by the malignant cells, finally permitting the definitive diagnosis of osteosarcoma to be made. A hypertetraploid clone with complex structural abnormalities was demonstrated by cytogenetic study.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong.
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Wong KF, Wong MLG, Tu SP. Dup(1)(p31.2p36.2) in acute myelomonocytic leukemia. ACTA ACUST UNITED AC 2006; 165:83-4. [PMID: 16490603 DOI: 10.1016/j.cancergencyto.2005.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2005] [Revised: 09/16/2005] [Accepted: 09/23/2005] [Indexed: 10/25/2022]
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Chim CS, Fung TK, Wong KF, Lau JS, Law M, Liang R. Methylation of INK4 and CIP/KIP families of cyclin-dependent kinase inhibitor in chronic lymphocytic leukaemia in Chinese patients. J Clin Pathol 2006; 59:921-6. [PMID: 16565223 PMCID: PMC1860467 DOI: 10.1136/jcp.2005.035089] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND INK4 (p15, p16, p18 and p19) and CIP/KIP (p21, p27 and p57) are two families of cyclin-dependent kinase inhibitors (CKI) targeting CDK4/6 and CDK2, respectively. AIM To study the role of methylation in the inactivation of CKI in chronic lymphocytic leukaemia (CLL). MATERIALS AND METHODS Methylation-specific polymerase chain reaction was carried out on DNA obtained from the bone marrow of 56 newly diagnosed patients with CLL. RESULTS Similar demographic features and clinical outcome were observed in our patients when compared with Caucasian patients, including an indolent clinical course (10-year overall survival 51%) and advanced Rai stage (p = 0.006), and a high-risk karyotype such as trisomy 12 and complex aberrations (p = 0.03). In the INK4 family, methylation in p15 and p16 occurred in 20 (35.7%) and 8 (14.3%) patients, respectively. In all, 5 (8.9%) CLL samples harboured concurrent methylation of both p15 and p16. Apart from an association of p16 methylation with higher presenting leucocyte count (64.5 x 10(9)/l in methylated p16 and 16.0 x 10(9)/l in unmethylated p16 patients; p = 0.016), there was no association between p15 and p16 methylation and age, sex and Rai stage. No difference was observed in the overall survival for patients with and without p15 and p16 methylation. By contrast, p18 and Rb were unmethylated in all samples. In the CIP/KIP family, apart from infrequent methylation of p57 in 4 (7.1%) patients, methylation of p21 and p27 was uniformly absent. CONCLUSION p15 and, less frequently, p16 of the INK4 family of CKI, instead of the CIP or KIP family, were targeted by methylation in CLL. p16 methylation was associated with a higher lymphocyte count at presentation. This is the first comprehensive study of the epigenetic dysregulation of the INK4 and CIP/KIP families of CKI in Chinese patients with CLL.
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Affiliation(s)
- C S Chim
- Department of Medicine, Queen Mary Hospital, Hong Kong.
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48
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Chim CS, Fung TK, Wong KF, Lau JS, Liang R. Infrequent Wnt inhibitory factor-1 (Wif-1) methylation in chronic lymphocytic leukemia. Leuk Res 2006; 30:1135-9. [PMID: 16427695 DOI: 10.1016/j.leukres.2005.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2005] [Revised: 12/11/2005] [Accepted: 12/14/2005] [Indexed: 10/25/2022]
Abstract
The Wnt pathway has been shown recently, to be activated in patients with chronic lymphocytic leukemia (CLL). This is the first study to examine the role of Wnt inhibitory factor-1 (Wif-1) methylation in the pathogenesis of haematolymphoid malignancies. Wif-1, a putative tumor suppressor, is a soluble negative regulator of the Wnt pathway activated in CLL. We studied the role of methylation of Wif-1 in 43 Chinese patients with CLL. At diagnosis, Wif-1 methylation was detected in 5/43 (11.6%) CLL marrow samples. Wif-1 methylation occurred more frequently in patients with advanced age (p = 0.059) but there was no correlation between Wif-1 methylation and sex, lymphocyte count and Rai stage at diagnosis. In conclusion, Wif-1 is infrequently methylated in CLL. Other factors leading to activation of the Wnt pathway warrant further study.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Adult
- Aged
- Aged, 80 and over
- Asian People
- Carrier Proteins/genetics
- China
- DNA Methylation
- Female
- Genes, Tumor Suppressor
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/physiopathology
- Male
- Middle Aged
- Repressor Proteins/genetics
- Wnt Proteins/genetics
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Affiliation(s)
- C S Chim
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong.
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49
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Abstract
Isochromosome 7q is not an uncommon chromosomal abnormality. It has been reported in association with Shwachman-Diamond syndrome, Wilms tumor, and hepatosplenic T-cell lymphoma. In other hematolymphoid malignancies, it occurs almost invariably as a secondary change. A notable example is its association with t(4;11)(q21;q23) in acute lymphoblastic leukemia. It has rarely been described in myelodysplastic syndrome and acute myeloid leukemia. We report the occurrence of i(7q) as the primary abnormality in a 2-year-old boy with Down syndrome and minimally differentiated acute myeloid leukemia.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong SAR, China.
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50
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Abstract
The operating theater blood transaction system (OTBTS) is a virtual blood banking system that allows computer crossmatch-compatible blood ordering and delivery in the operating theater remote from the hospital blood bank. It was developed and implemented in our hospital in 1997 and was expanded in 2002 to include an unmatched blood module that allows ordering and issuing unmatched RBCs for intraoperative transfusion. During the past 7 years, the system has handled 6,333 crossmatch requests for intraoperative transfusion and issued 20,073 units of RBCs, including 100 units of unmatched RBCs (group O, 72 units; group-identical, 28 units). The OTBTS has proven to be efficient (with a turnaround time for blood ordering and issuing < 30 seconds), effective (with a reduced crossmatch/transfusion ratio and blood wastage), and error free (no delay or error in transfusion or postponement of operation). Furthermore, our experience with the unmatched blood module has attested to the safety and efficacy of computer-controlled, online ordering and real-time, on-site delivery of unmatched RBCs for emergency transfusion.
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Affiliation(s)
- K F Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
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