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Li MML, Chung KY, Ng AWH, Chiu KH. Progressive diaphyseal dysplasia: a rare bone disorder with alarming radiographs. Hong Kong Med J 2020; 26:538.e1-538.e3. [PMID: 33350969 DOI: 10.12809/hkmj208498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M M L Li
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong
| | - K Y Chung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong
| | - A W H Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
| | - K H Chiu
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong
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Versen-Höynck F, Chiu KH, Chi YY, Fleischmann RR, Zhang W, Winn VD, Conrad KP, Baker VL. Absence of the corpus luteum in early pregnancy increases the risk of preeclampsia – unvalued potential to improve maternal vascular health? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671289] [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: 10/28/2022] Open
Affiliation(s)
- F Versen-Höynck
- Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
- Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland
| | - KH Chiu
- Department of Biostatistics, University of Florida, Gainesville, Vereinigte Staaten von Amerika
| | - YY Chi
- Department of Biostatistics, University of Florida, Gainesville, Vereinigte Staaten von Amerika
| | - RR Fleischmann
- Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
| | - W Zhang
- Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
| | - VD Winn
- Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive, Stem Cell and Perinatal Biology, Stanford, Vereinigte Staaten von Amerika
| | - KP Conrad
- Departments of Physiology and Functional Genomics and Obstetrics and Gynecology, D. H. Barron Reproductive and Perinatal Biology Research Program, University of Florida College of Medicine, Gainesville, Vereinigte Staaten von Amerika
| | - VL Baker
- Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
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Chiu KH, Dong CD, Chen CF, Tsai ML, Ju YR, Chen TM, Chen CW. NMR-based metabolomics for the environmental assessment of Kaohsiung Harbor sediments exemplified by a marine amphipod (Hyalella azteca). Mar Pollut Bull 2017; 124:714-724. [PMID: 28267993 DOI: 10.1016/j.marpolbul.2017.02.067] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 05/08/2023]
Abstract
Inflow of wastewater from upstream causes a large flux of pollutants to enter Kaohsiung Harbor in Taiwan daily. To reveal the ecological risk posed by Kaohsiung Harbor sediments, an ecological metabolomic approach was employed to investigate environmental factors pertinent to the physiological regulation of the marine amphipod Hyalella azteca. The amphipods were exposed to sediments collected from different stream inlets of the Love River (LR), Canon River (CR), Jen-Gen River (JR), and Salt River (SR). Harbor entrance 1 (E1) was selected as a reference site. After 10-day exposure, metabolomic analysis of the Hyalella azteca revealed differences between two groups: {E1, LR, CR} and {JR, SR}. The metabolic pathways identified in the two groups of amphipods were significantly different. The results demonstrated that NMR-based metabolomics can be effectively used to characterize metabolic response related to sediment from polluted areas.
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Affiliation(s)
- K H Chiu
- Department and Graduate Institute of Aquaculture, National Kaohsiung Marine University, Kaohsiung, Taiwan
| | - C D Dong
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, Kaohsiung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - C F Chen
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, Kaohsiung, Taiwan
| | - M L Tsai
- Department of Seafood Science, National Kaohsiung Marine University, Kaohsiung, Taiwan
| | - Y R Ju
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, Kaohsiung, Taiwan
| | - T M Chen
- Department and Graduate Institute of Aquaculture, National Kaohsiung Marine University, Kaohsiung, Taiwan
| | - C W Chen
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, Kaohsiung, Taiwan.
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Lee HHL, Mak ASL, Kou KO, Poon CF, Wong WS, Chiu KH, Au PKC, Chan KYK, Kan ASY, Tang MHY, Leung KY. An Unusual Hydrops Fetalis Associated with Compound Heterozygosity for Krüppel-like Factor 1 mutations. Hemoglobin 2017; 40:431-434. [PMID: 28361594 DOI: 10.1080/03630269.2016.1267017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hydrops fetalis is commonly due to Hb Bart's (γ4) disease in South East Asia. Here, we report an unusual case of hydrops fetalis due to congenital dyserythropoietic anemia (CDA) associated with compound heterozygosity for Krüppel-like factor 1 (KLF1) gene mutations. Fetal cardiomegaly was first detected on routine mid-trimester scan in a pregnant woman with normal mean corpuscular volume (MCV) and Rhesus positive status. The fetus subsequently developed hydrops fetalis, and cordocentesis showed severe fetal anemia with a hemoglobin (Hb) level of 3.4 g/dL. Common causes of fetal anemia including Hb Bart's disease, parvovirus infection, and red cell antibodies were excluded. In view of the marked increase in erythroblasts at various stages of erythropoiesis, the diagnosis of CDA was suspected. We screened the couple for previously reported KLF1 gene mutations, showing that the mother was heterozygous for the c.525_526insCGGCGCC, p.Gly176Argfs*179 mutation, and her husband heterozygous for c.1012C>A, p.Pro338Thr mutation. The fetus was a compound heterozygote for these two KLF1 mutations. After counseling, repeated intrauterine transfusions were given at 27, 29, and 34 weeks' gestation; the hydrops fetalis was resolved. The baby was delivered at 34 weeks' gestation and required monthly blood transfusions but was otherwise thriving. Bone marrow aspiration at 10 months of age showed the features of ineffective erythropoiesis, compatible with CDA. In conclusion, hydrops fetalis can rarely be due to CDA associated with a compound heterozygous mutation for KLF1 gene mutations, and be managed by repeated intrauterine transfusions. Our present report adds to the wide clinical spectrum of KLF1 mutations.
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Affiliation(s)
- Helena H L Lee
- a Department of Obstetrics and Gynaecology , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
| | - Annisa S L Mak
- a Department of Obstetrics and Gynaecology , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
| | - K O Kou
- a Department of Obstetrics and Gynaecology , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
| | - C F Poon
- a Department of Obstetrics and Gynaecology , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
| | - W S Wong
- b Department of Clinical Pathology , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
| | - K H Chiu
- c Department of Paediatrics , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
| | - Patrick K C Au
- d Prenatal Diagnostic Laboratory, Department of Obstetrics and Gynaecology, Tsan Yuk Hospital , The University of Hong Kong , Hong Kong SAR , People's Republic of China
| | - Kelvin Y K Chan
- d Prenatal Diagnostic Laboratory, Department of Obstetrics and Gynaecology, Tsan Yuk Hospital , The University of Hong Kong , Hong Kong SAR , People's Republic of China
| | - Anita S Y Kan
- d Prenatal Diagnostic Laboratory, Department of Obstetrics and Gynaecology, Tsan Yuk Hospital , The University of Hong Kong , Hong Kong SAR , People's Republic of China
| | - Mary H Y Tang
- d Prenatal Diagnostic Laboratory, Department of Obstetrics and Gynaecology, Tsan Yuk Hospital , The University of Hong Kong , Hong Kong SAR , People's Republic of China
| | - K Y Leung
- a Department of Obstetrics and Gynaecology , Queen Elizabeth Hospital , Hong Kong SAR , People's Republic of China
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Sitt JCM, Griffith JF, Lai FM, Hui M, Chiu KH, Lee RKL, Ng AWH, Leung J. Ultrasound-guided synovial Tru-cut biopsy: indications, technique, and outcome in 111 cases. Eur Radiol 2016; 27:2002-2010. [PMID: 27553941 DOI: 10.1007/s00330-016-4545-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 06/07/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the diagnostic performance of ultrasound-guided synovial biopsy. METHODS Clinical notes, pathology and microbiology reports, ultrasound and other imaging studies of 100 patients who underwent 111 ultrasound-guided synovial biopsies were reviewed. Biopsies were compared with the final clinical diagnosis established after synovectomy (n = 43) or clinical/imaging follow-up (n = 57) (mean 30 months). RESULTS Other than a single vasovagal episode, no complication of synovial biopsy was encountered. One hundred and seven (96 %) of the 111 biopsies yielded synovium histologically. Pathology ± microbiology findings for these 107 conclusive biopsies comprised synovial tumour (n = 30, 28 %), synovial infection (n = 18, 17 %), synovial inflammation (n = 45, 42 %), including gouty arthritis (n = 3), and no abnormality (n = 14, 13 %). The accuracy, sensitivity, and specificity of synovial biopsy was 99 %, 97 %, and 100 % for synovial tumour; 100 %, 100 %, and 100 % for native joint infection; and 78 %, 45 %, and 100 % for prosthetic joint infection. False-negative synovial biopsy did not seem to be related to antibiotic therapy. CONCLUSION Ultrasound-guided Tru-cut synovial biopsy is a safe and reliable technique with a high diagnostic yield for diagnosing synovial tumour and also, most likely, for joint infection. Regarding joint infection, synovial biopsy of native joints seems to have a higher diagnostic yield than that for infected prosthetic joints. KEY POINTS • Ultrasound-guided Tru-cut synovial biopsy has high accuracy (99 %) for diagnosing synovial tumour. • It has good accuracy, sensitivity, and high specificity for diagnosis of joint infection. • Synovial biopsy of native joints works better than biopsy of prosthetic joints. • A negative synovial biopsy culture from a native joint largely excludes septic arthritis. • Ultrasound-guided Tru-cut synovial biopsy is a safe and well-tolerated procedure.
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Affiliation(s)
- Jacqueline C M Sitt
- Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - James F Griffith
- Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
| | - Fernand M Lai
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Mamie Hui
- Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K H Chiu
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ryan K L Lee
- Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Alex W H Ng
- Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong
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Cheung KW, Chung SL, Chung KY, Chiu KH. Patient perception and knowledge on total joint replacement surgery. Hong Kong Med J 2013; 19:33-37. [PMID: 23378352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVES To study patients' perceptions and knowledge about total joint replacement surgery. DESIGN; Cross-sectional survey. SETTING; University teaching hospital, Hong Kong. PATIENTS Three hundred consecutive patients with the diagnosis of osteoarthritis or inflammatory arthritis attending the out-patient clinic from June 2010 to May 2011. MAIN OUTCOME MEASURES Patients' knowledge and how they got the knowledge about total joint replacement surgery, and concerns about the outcome of such operations. RESULTS Whilst 94% of the patients knew about total joint replacement surgery, 77% obtained such knowledge from their friends and relatives. The three most common concerns related to this type of operation were whether they might: be wheelchair bound after surgery (64%), need to be taken care of by others for more than 3 months (61%), and have post-surgery complications (54%). Most of them recognised the advantages of the surgery, 82% knew about good pain relief after surgery, and 87% realised that total joint replacement surgery could improve their mobility. Patients did not have a realistic idea regarding the survival of the prosthesis; 41% thought the prosthesis might last for less than 10 years and 34% had no idea about its longevity. CONCLUSION; Patients did recognise the advantages of total joint replacement surgery in treating arthritis. However, they had many concerns about its outcome that warrant clarification. Public education on these aspects is necessary to address concerns, and may be achieved in cooperation with the media.
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Affiliation(s)
- K W Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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Chiu KH, Lin CR, Huang HW, Shiea J, Liu LL. Toxic effects of two brominated flame retardants BDE-47 and BDE-183 on the survival and protein expression of the tubificid Monopylephorus limosus. Ecotoxicol Environ Saf 2012; 84:46-53. [PMID: 22818847 DOI: 10.1016/j.ecoenv.2012.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 05/29/2012] [Accepted: 06/20/2012] [Indexed: 06/01/2023]
Abstract
The toxic effects of two brominated diphenyl ethers (BDE), BDE-47, and BDE-183, on a benthic oligochaete tubificid, Monopylephorus limosus were studied under laboratory conditions. Investigated responses included survival, growth, and protein expression profiles, at BDE concentrations of 1, 10, 100, and 700 ng/g on a dry soil weight basis, with isooctane as the carrier solvent. Body weight losses among treatments were insignificant after 8 weeks of exposure. The 8-wk LC(50) of BDE-47 and -183 were 2311 and 169 ng/g, respectively. By applying multivariate analysis techniques, protein expression patterns were compared and correlated with stressful sources of long-term culture, carrier solvent, BDE-47 and -183. The treatment of 8-wk 100 ng/g BDE-47 was most closely clustered to the 10 ng/g BDE-183 treatment, based on the 40 examined protein spots. This indicated that BDE-183 was more potent to M. limosus, than was BDE-47. The 2-wk and 8-wk controls clustered into different groups indicating the occurrence of physiological changes due to long-term laboratory culture. Additionally, solvent effect was shown by grouping the isooctane carrier to different clusters. With further characterization by principle component analysis, it was found that the separation was mainly contributed by the 2nd principal-component. And, the primarily inhibitory variation was at spots 2 (UMP-CMP kinase) and 40 (plasma retinol-binding protein precursor) in the 8-wk groups. On the contrary, protein spots 16 (cell division control protein 2 homolog) and 24 (mitochondrial DNA mismatch repair protein) showed stimulatory variation. In all, the observed proteomic responses suggest that BDEs disrupted metabolic function in M. limosus and multivariate analysis tool offers significant potential for the assessment of various stress sources at biochemical level.
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Affiliation(s)
- K H Chiu
- Department and Graduate Institute of Aquaculture, National Kaohsiung Marine University, Kaohsiung 811, Taiwan, ROC
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Cheung KW, Chiu KH. Imageless computer navigation in total knee arthroplasty. Hong Kong Med J 2009; 15:353-358. [PMID: 19801692] [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] Open
Abstract
OBJECTIVES To study the difference in clinical and radiological outcomes between imageless computer-navigated and the conventional technique for performing total knee arthroplasty. DESIGN Prospective case-control study. SETTING University teaching hospital, Hong Kong. PATIENTS Forty-seven patients with imageless computer-navigated total knee arthroplasty were matched with 47 patients with total knee arthroplasty using conventional technique over the period 2003 to 2007. MAIN OUTCOME MEASURES Postoperative radiological alignment, tourniquet time, Knee Society knee score and functional score, and range of motion. RESULTS The femoral anteroposterior, tibial anteroposterior, overall anteroposterior alignment of the lower limb, and lateral femoral lateral flexion angle had significantly less deviation from neutral alignment in those having computer-assisted total knee arthroplasty than conventional total knee arthroplasty. The former had significantly fewer outliers (>3 degrees from neutral alignment) than the latter, in both the coronal and sagittal planes of the femoral and tibial sides. The mean tourniquet time was significantly longer in the former (111 minutes) than in those having a conventional arthroplasty (98 minutes). There was no tracker/pin tract complication or wound infection in either group. CONCLUSION Computer-assisted navigation can give a better alignment than the conventional technique, but the tourniquet time was significantly longer. Computer-assisted navigation surgery can help the surgeon in determining limb alignment during the operation.
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Affiliation(s)
- K W Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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Abstract
PURPOSE To assess the accuracy of knee alignment after high tibial osteotomy (HTO) for varus knee deformity using arthroscopy-assisted computer navigation. METHODS Six men and 4 women aged 47 to 53 (mean, 49) years underwent medial open wedge HTO for varus knee deformity and medial unicompartmental osteoarthritis using arthroscopy-assisted computer navigation with fluoroscopy. Patients were followed up for a mean of 23 (range, 11-32) months. Intra- and post-operative leg alignments were compared. RESULTS The mean postoperative coronal plane alignment was 2.7 (range,1-4) degree valgus; the mean deviation from intra-operative computer images was one (range, 0.1-1.9) degree; 5 knees had less valgus in the postoperative radiographs than the intra-operative computer images. CONCLUSION Despite being more technically demanding, time consuming, and costly, arthroscopy-assisted computer navigation is safe, accurate, and reliable for HTO.
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Affiliation(s)
- W N Lo
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
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10
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Abstract
We report 2 cases of pseudoaneurysm of the geniculate artery after a total knee arthroplasty (TKA). The first one was located in the superomedial geniculate artery and resolved after compression dressing and warfarin cessation. The second one was located in the superolateral geniculate artery and was successfully treated with transarterial embolisation. There was no recurrence in both cases. The rare occurrence and delayed presentation of pseudoaneurysms pose a diagnostic challenge. A high index of suspicion is required to make the diagnosis. Early duplex Doppler ultrasonography is recommended when patients present with atypical knee pain and prolonged swelling after a TKA.
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Affiliation(s)
- K Y Law
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
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Abstract
The use of a navigation system in musculoskeletal tumour surgery enables the integration of pre-operative CT and MRI images to generate a precise three-dimensional anatomical model of the site and the extent of the tumour. We carried out six consecutive resections of musculoskeletal tumour in five patients using an existing commercial computer navigation system. There were three women and two men with a mean age of 41 years (24 to 47). Reconstruction was performed using a tumour prosthesis in three lesions and a vascularised fibular graft in one. No reconstruction was needed in two cases. The mean follow-up was 6.9 months (3.5 to 10). The mean duration of surgery was 28 minutes (13 to 50). Examination of the resected specimens showed clear margins in all the tumour lesions and a resection that was exactly as planned.
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Affiliation(s)
- K C Wong
- The Prince of Wales Hospital, Hong Kong, China.
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Abstract
PURPOSE To study the effect of drain suction pressure on drainage volume, decrease in haemoglobin level, blood transfusion, and wound complications following total knee arthroplasty. METHODS Primary total knee arthroplasty for degenerative osteoarthritis was performed in 60 (49 female and 11 male) patients. Patients were randomised for high-pressure (600 mm Hg) or low-pressure (350 mm Hg) postoperative suction drainage. Drain output was recorded daily and the drain removed after 48 hours. Postoperative haemoglobin level was measured on the evening of the operation day and on postoperative day 2. RESULTS The high-pressure group had a significantly higher drainage volume and decrease in haemogloblin level than the low-pressure group. However, there was no significant difference between groups in the transfusion rate, number of units of blood transfused, wound discharge, or Knee Society knee and function scores. No wound infection was detected in any patient. CONCLUSION. Low-pressure suction drainage results in less blood loss without a significant increase in wound complications.
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Affiliation(s)
- K W Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong.
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Abstract
Hemiarthroplasty of the hip for displaced fracture of the femoral neck (including Austin-Moore and Thompson arthroplasties) frequently is performed by orthopaedic surgeons. The posterior approach is used despite the slight increase in risk of postoperative dislocation. The outcome after dislocation can be disastrous. We tried to prevent this complication by repairing the posterior capsule and the short external rotators (piriformis, superior and inferior gemellus, obturator internus, and upper part of quadratus femoris) using locking loop stitch as described by Krackow. From January 1998 to April 1999, 205 hips were operated on and followed up for >3 months; no dislocation was found. Using the past records as the comparative group, 28 posterior dislocations (1.9%) were found in 1,483 hip hemiarthroplasties using the posterior approach (P <.05 using exact probability test). Enhanced soft tissue repair with locking loop stitch is an effective way to reduce the incidence of dislocation after hip hemiarthroplasty using the posterior approach.
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Affiliation(s)
- C K Ko
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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Abstract
We studied the seasonal variation of hip fracture admissions at three different latitudes: Scotland (56 degrees North; 54,399 admissions); Shatin, Hong Kong (22 degrees North; 4180 admissions); and Auckland, New Zealand (36 degrees South; 2257 admissions). We calculated the extent of seasonal variation (amplitude) and the time of year of the peak value (acrophase) by fitting a sine curve to monthly data using cosinor analysis. A significant seasonal variation was found in all three countries, at a high level in Scotland (p < 0.01) and Hong Kong (p < 0.001), but just significant in New Zealand (p < 0.05). The extent of the seasonal change was very similar in Scotland and New Zealand, but, as expected, the peak in New Zealand (early September) was approximately six months ahead of Scotland (mid February). In Hong Kong, the amplitude was three times greater than in Scotland and the peak occurred a month earlier. There is neither snow nor ice in Hong Kong, and this provides powerful evidence against a major influence of conditions underfoot causing extra falls in winter. In Scotland there was a significant increase in the proportion of deaths in winter as compared to summer. The Scotland/Hong Kong amplitude difference is striking, but it is unknown whether this has a genetic or environmental explanation. The cause of seasonal death difference to a given injury is also unknown. Possible mechanisms are discussed, but the purpose is to report two new epidemiological features, without wild speculative hypotheses. The findings should be viewed as leads to further epidemiological, clinical and more basic research.
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Affiliation(s)
- S Douglas
- Department of Medicine & Therapeutics, University of Aberdeen Medical School, Foresterhill, UK
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15
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Abstract
Primary cementless Porous Coated Anatomic total hip arthroplasty was carried out in 36 hips in 29 patients with osteonecrosis (ON) patients and in 36 hips in 33 patients without ON. The ON was alcohol related in 11. steroid induced in 5, post-traumatic in 4, and idiopathic in 16 patients. The average follow-up period was 6 years. Clinical evaluation demonstrated 77.8% excellent or good results in the patients with ON, with the average Harris hip scores improved from 36.8 to 83.5. No revision of a prosthesis has yet been performed in the patients with ON. The patients with alcohol-related and steroid-induced ON had inferior clinical results when compared with the patients without ON. There were no statistically significant differences in the clinical results between the patients with post-traumatic or idiopathic ON and the patients without ON.
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Affiliation(s)
- K H Chiu
- Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
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Chiu KH, Shen WY, Tsui HF, Chan KM. Experience with primary exeter total hip arthroplasty in patients with small femurs. Review at average follow-up period of 6 years. J Arthroplasty 1997; 12:267-72. [PMID: 9113540 DOI: 10.1016/s0883-5403(97)90022-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
One hundred twelve hips in 101 Chinese patients received a primary cemented Exeter total hip arthroplasty (Howmedica, Hong Kong). Average age was 65 years. The most common diagnosis was avascular necrosis. Average follow-up period was 6 years (range, 3 years to 9 years, 6 months). The Harris hip score improved from a preoperative average of 41.2 to 82.2 at the last follow-up visit. Stem subsidence within the cement mantle occurred in 9% of the cases, and none of these stems had other evidence of loosening. Three hips in two patients were revised because of loosening at 5 to 8 years after surgery. Because of the small size of the femurs, stem oversizing was common. Oversizing of the stem and an incomplete cement mantle might account for the early loosening. Stems of a smaller size should be made available to this population.
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Affiliation(s)
- K H Chiu
- Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
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Tsui HF, Chiu KH, Leung KS. Osteomyelitis of the spine due to Salmonella infection--conservative treatment with quinolone: a case report. Can J Surg 1997; 40:48-50. [PMID: 9030084 PMCID: PMC3949879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Although osteomyelitis due to Salmonella infection is known to be associated with sickle cell anemia, various hemoglobinopathies and immune suppressive states, it may also occur in normal hosts. A 16-year-old Chinese boy without sickle cell disease or any other condition that would compromise the immune system had osteomyelitis of the lumbar spine caused by Salmonella enteritidis. The condition was treated conservatively with ciprofloxacin (quinolone group). This may be the first reported case in which a patient with spinal osteomyelitis due to Salmonella infection, who was otherwise healthy, was successfully treated nonoperatively with quinolone.
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Affiliation(s)
- H F Tsui
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, NT, Hong Kong
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Du HS, Li GQ, Dong GZ, Chiu KH, Wai CM. A new method of uranium preseparation and concentration for neutron activation analysis. J Radioanal Nucl Chem 1996. [DOI: 10.1007/bf02039417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Primary uncemented Porous-Coated Anatomic total hip replacement was carried out in 72 hips in 62 Chinese patients. Their average age was 50 years and the average follow up was 3 1/2 years. The most common diagnosis was avascular necrosis. The average preoperative Harris score of 36.3 points improved to 83.2 at the last follow up. The pain score improved from 13.7 out of 44 to an average of 42. Seven of 8 hips with thigh pain had an inadequately fitting stem which had subsided. Only one cup was revised because of a technical error and one femoral component for loosening. Uncemented Porous-Coated Anatomic total hip replacement gave good early results in Chinese patients.
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Affiliation(s)
- K H Chiu
- Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Prince of Wales Hospital Shatin NT, Hong Kong
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Chen SL, Dzeng SR, Yang MH, Chiu KH, Shieh GM, Wai CM. Arsenic species in groundwaters of the blackfoot disease area, taiwan. Environ Sci Technol 1994; 28:877-81. [PMID: 22191829 DOI: 10.1021/es00054a019] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Abstract
One hundred cases of comminuted fracture of the distal radius were treated by a simple uniform method consisting of distraction by an external fixator for 3 weeks followed by functional bracing. During the application of the external fixator, autogenous cancellous bone chips were taken from the iliac crest and packed into the fracture site to realign the juxtaarticular fragments and to fill up the bone gap. Complications have been minimal. The results, after an average follow-up period of 20 months, taking into consideration subjective assessment of pain, objective measurement of wrist motion, and radiologic angles, have been excellent.
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Affiliation(s)
- K S Leung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin
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