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Wu HJ, Lau WL, Chan TYC, Chen SPL, Ko CH. Differentiating episodic ataxia type 2 from migraine: a case report. Hong Kong Med J 2020; 26:526-527. [PMID: 33350965 DOI: 10.12809/hkmj198306] [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)
- H J Wu
- Department of Paediatrics, Caritas Medical Centre, Hong Kong
| | - W L Lau
- Department of Paediatrics, Caritas Medical Centre, Hong Kong
| | - T Y C Chan
- Department of Chemical Pathology, Princess Margaret Hospital, Hong Kong
| | - S P L Chen
- Department of Chemical Pathology, Princess Margaret Hospital, Hong Kong
| | - C H Ko
- Department of Paediatrics, Caritas Medical Centre, Hong Kong
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Chong CSY, Lo WTL, Mak CM, Chen SPL, Lau KK, Sheng B. Prevalence of neuronal membrane target antibodies in first-episode psychosis: abridged secondary publication. Hong Kong Med J 2020; 26 Suppl 8:4-6. [PMID: 33504669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Affiliation(s)
- C S Y Chong
- Department of Psychiatry, Kwai Chung Hospital
| | - W T L Lo
- Department of Psychiatry, Kwai Chung Hospital
| | - C M Mak
- Department of Pathology, Princess Margaret Hospital
| | - S P L Chen
- Department of Pathology, Princess Margaret Hospital
| | - K K Lau
- Department of Medicine and Geriatrics, Princess Margaret Hospital
| | - B Sheng
- Department of Medicine and Geriatrics, Princess Margaret Hospital
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Chan TCH, Mak CM, Chen SPL, Leung MT, Cheung HN, Leung DCW, Lee HK, Koo EC, Lo YC. Survey on common reference intervals for general chemistry analytes in Hong Kong. Hong Kong Med J 2019; 25:295-304. [PMID: 31402339 DOI: 10.12809/hkmj197943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Reference intervals (RIs) are essential tool for proper interpretation of results. There is a global trend towards implementing common RIs to avoid confusion and enhance patient management across different laboratories. However, local practices with respect to RIs lack harmonisation. METHODS We have conducted the first local survey regarding RIs for 14 general chemistry analytes in 10 chemical pathology laboratories that employ four different analytical platforms (Abbott Architect, Beckman Coulter AU, Roche Cobas, and Siemens Dimension EXL). Analytical bias was assessed by an inter-laboratory results comparison of external quality assurance programmes. RESULTS Sufficient inter-laboratory and inter-platform agreement regarding the 10 analytes (albumin, alanine aminotransferase, aspartate aminotransferase, chloride, gamma-glutamyl transferase, phosphate, potassium, sodium, total protein, and urea) were demonstrated. However, the RIs were heterogeneous across all laboratories, with percentage differences of the upper RI value of up to 47% for aspartate aminotransferase (absolute difference of 16 U/L), 29% for urea (1.8 mmol/L), and 18% for potassium (0.8 mmol/L). The percentage difference between lower RI values was up to 24% for urea (0.6 mmol/L), 22% for phosphate (0.16 mmol/L), and 8% for total protein (5 g/L). The coefficients of variation of the upper RI values of potassium and sodium were 1.2 times and 1.0 times of their corresponding between-subject biological variation, respectively, representing unnecessary variations that are overlooked and unchecked in current practice. CONCLUSIONS We recommend the use of common RIs for general chemistry analytes in Hong Kong to prevent interpreter confusion, improve electronic data transfer, and unite laboratory practice. This is the first local study on this topic, and our data can lay the groundwork for increasing harmonisation of RIs across more laboratory tests.
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Affiliation(s)
- T C H Chan
- Chemical Pathology Laboratory, Department of Pathology, Hong Kong Children's Hospital, Kowloon Bay, Hong Kong.,Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - C M Mak
- Chemical Pathology Laboratory, Department of Pathology, Hong Kong Children's Hospital, Kowloon Bay, Hong Kong.,Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - S P L Chen
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong.,Chemical Pathology Laboratory, Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - M T Leung
- Chemical Pathology Laboratory, Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - H N Cheung
- Chemical Pathology Laboratory, Department of Pathology, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - D C W Leung
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - H K Lee
- Chemical Pathology Laboratory, Department of Pathology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - E C Koo
- Clinical Pathology Laboratory, Grantham Hospital, Wong Chuk Hang, Hong Kong
| | - Y C Lo
- Chemical Pathology Laboratory, Department of Pathology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
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Mak CM, Mok NS, Shum HC, Siu WK, Chong YK, Lee HHC, Fong NC, Tong SF, Lee KW, Ching CK, Chen SPL, Cheung WL, Tso CB, Poon WM, Lau CL, Lo YK, Tsui PT, Shum SF, Lee KC. Sudden arrhythmia death syndrome in young victims: a five-year retrospective review and two-year prospective molecular autopsy study by next-generation sequencing and clinical evaluation of their first-degree relatives. Hong Kong Med J 2019; 25:21-9. [PMID: 30670673 DOI: 10.12809/hkmj187256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Sudden arrhythmia death syndrome (SADS) accounts for about 30% of causes of sudden cardiac death (SCD) in young people. In Hong Kong, there are scarce data on SADS and a lack of experience in molecular autopsy. We aimed to investigate the value of molecular autopsy techniques for detecting SADS in an East Asian population. METHODS This was a two-part study. First, we conducted a retrospective 5-year review of autopsies performed in public mortuaries on young SCD victims. Second, we conducted a prospective 2-year study combining conventional autopsy investigations, molecular autopsy, and cardiac evaluation of the first-degree relatives of SCD victims. A panel of 35 genes implicated in SADS was analysed by next-generation sequencing. RESULTS There were 289 SCD victims included in the 5-year review. Coronary artery disease was the major cause of death (35%); 40% were structural heart diseases and 25% were unexplained. These unexplained cases could include SADS-related conditions. In the 2-year prospective study, 21 SCD victims were examined: 10% had arrhythmogenic right ventricular cardiomyopathy, 5% had hypertrophic cardiomyopathy, and 85% had negative autopsy. Genetic analysis showed 29% with positive heterozygous genetic variants; six variants were novel. One third of victims had history of syncope, and 14% had family history of SCD. More than half of the 11 first-degree relatives who underwent genetic testing carried related genetic variants, and 10% had SADS-related clinical features. CONCLUSION This pilot feasibility study shows the value of incorporating cardiac evaluation of surviving relatives and next-generation sequencing molecular autopsy into conventional forensic investigations in diagnosing young SCD victims in East Asian populations. The interpretation of genetic variants in the context of SCD is complicated and we recommend its analysis and reporting by qualified pathologists.
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Affiliation(s)
- C M Mak
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - N S Mok
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - H C Shum
- Forensic Pathology Service, Department of Health, Hong Kong
| | - W K Siu
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - Y K Chong
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - H H C Lee
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - N C Fong
- Department of Paediatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S F Tong
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - K W Lee
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - C K Ching
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S P L Chen
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - W L Cheung
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - C B Tso
- Forensic Pathology Service, Department of Health, Hong Kong
| | - W M Poon
- Forensic Pathology Service, Department of Health, Hong Kong
| | - C L Lau
- Forensic Pathology Service, Department of Health, Hong Kong
| | - Y K Lo
- Forensic Pathology Service, Department of Health, Hong Kong
| | - P T Tsui
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S F Shum
- Forensic Pathology Service, Department of Health, Hong Kong
| | - K C Lee
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
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Lee CH, Cheung CYY, Chow WS, Woo YC, Yeung CY, Lang BHH, Fong CHY, Kwok KHM, Chen SPL, Mak CM, Tan KCB, Lam KSL. Genetics of Apparently Sporadic Pheochromocytoma and Paraganglioma in a Chinese Population. Horm Metab Res 2015; 47:833-8. [PMID: 26267327 DOI: 10.1055/s-0035-1555955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Identification of germline mutation in patients with apparently sporadic pheochromocytomas and paragangliomas is crucial. Clinical indicators, which include young age, bilateral or multifocal, extra-adrenal, malignant, or recurrent tumors, predict the likelihood of harboring germline mutation in Caucasian subjects. However, data on the prevalence of germline mutation, as well as the applicability of these clinical indicators in Chinese, are lacking. We conducted a cross-sectional study at a single endocrine tertiary referral center in Hong Kong. Subjects with pheochromocytomas and paragangliomas were evaluated for the presence of germline mutations involving 10 susceptibility genes, which included NF1, RET, VHL, SDHA, SDHB, SDHC, SDHD, TMEM 127, MAX, and FH genes. Clinical indicators were assessed for their association with the presence of germline mutations. Germline mutations, 2 being novel, were found in 24.4% of the 41 Chinese subjects recruited and 11.4% among those with apparently sporadic presentation. The increasing number of the afore-mentioned clinical indicators significantly correlated with the likelihood of harboring germline mutation in one of the 10 susceptibility genes. (r=0.757, p=0.026). The presence of 2 or more clinical indicators should prompt genetic testing for germline mutations in Chinese subjects. In conclusion, our study confirmed that a significant proportion of Chinese subjects with apparently sporadic pheochromocytoma and paraganglioma harbored germline mutations and these clinical indicators identified from Caucasians series were also applicable in Chinese subjects. This information will be of clinical relevance in the design of appropriate genetic screening strategies in Chinese populations.
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Affiliation(s)
- C H Lee
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - C Y Y Cheung
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - W S Chow
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - Y C Woo
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - C Y Yeung
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - B H H Lang
- Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China
| | - C H Y Fong
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - K H M Kwok
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - S P L Chen
- Kowloon West Cluster Laboratory Genetic Service, Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, China
| | - C M Mak
- Kowloon West Cluster Laboratory Genetic Service, Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, China
| | - K C B Tan
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - K S L Lam
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
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Chong YK, Ng WY, Chen SPL, Mak CM. Authors' reply. Hong Kong Med J 2015; 21:380. [PMID: 26251852 DOI: 10.12809/hkmj154583] [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)
- Y K Chong
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W Y Ng
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Sammy P L Chen
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - C M Mak
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
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Chong YK, Ng WY, Chen SPL, Mak CM. Effects of a plasma heating procedure for inactivating Ebola virus on common chemical pathology tests. Hong Kong Med J 2015; 21:201-7. [PMID: 25904476 DOI: 10.12809/hkmj144373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The recent declaration of Ebola virus disease as epidemic by the World Health Organization indicates urgency for affected countries and their laboratories to evaluate and provide treatment to patients potentially infected by the Ebola virus. A heat inactivation procedure involving treating specimens at 60°C for 60 minutes has been suggested for inactivation of the Ebola virus. This study aimed at evaluating the effect of plasma heating on common biochemical tests. DESIGN Comparative experimental study. SETTING A regional chemical pathology laboratory in Hong Kong. METHODS Forty consecutive plasma specimens for general chemistry analytes on Beckman Coulter AU5822 and another 40 plasma specimens for troponin I analysis on Access 2 Immunoassay System were obtained, anonymised, and divided into two aliquots. One aliquot was analysed directly and the other was analysed after heating at 60°C for 60 minutes. RESULTS A total of 20 chemical pathology tests were evaluated. Nine tests (sodium, potassium, chloride, urea, creatinine, total calcium, phosphate, total protein, and glucose) were not significantly affected by the heat inactivation procedure and remained clinically interpretable. Results for magnesium (15% mean increase), albumin (41% mean increase), bilirubin (8% mean decrease), amylase (27% mean decrease), and troponin I (76% mean decrease) were still interpretable using regression estimation with proportional bias. However, all enzymes studied except amylase (alanine transaminase, aspartate transaminase, alkaline phosphatase, gamma-glutamyltransferase, creatine kinase, and lactate dehydrogenase) were inactivated to a significant degree. Their Pearson r or Spearman rho values ranged from no significant correlation (P≥0.05) to 0.767, and most normality was rejected. CONCLUSION Heat inactivation results in no significant change in electrolytes, glucose, and renal function tests, but causes a significant bias for many analytes. Recognition of the relationship between pre- and post-heat inactivation specimens allows clinical interpretation of affected values and contributes to patient care. For safety and diagnostic accuracy, we recommend use of a point-of-care device for blood gases, electrolytes, troponin, and liver and renal function tests within a class 2 or above biosafety cabinet with level 3 or above biosafety laboratory practice.
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Affiliation(s)
- Y K Chong
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W Y Ng
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Sammy P L Chen
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Chloe M Mak
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
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Tam VHK, Chen SPL, Mak CM, Fung LM, Lee CY, Chan AYW. A novel mutation in pseudohypoparathyroidism type 1a in a Chinese woman and her son with hypocalcaemia. Hong Kong Med J 2015; 20:258-60. [PMID: 24914079 DOI: 10.12809/hkmj134025] [Citation(s) in RCA: 8] [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: 01/27/2023] Open
Abstract
Pseudohypoparathyroidism is a rare genetic disorder characterised by end-organ resistance to parathyroid hormone due to a defect of the guanine nucleotide-binding protein alpha that simulates activity of the polypeptide 1 (GNAS) gene. Patients with type 1a pseudohypoparathyroidism display different features of Albright's hereditary osteodystrophy as well as multi-hormone resistance. We describe a Chinese woman and her son, who presented with different symptoms of pseudohypoparathyroidism and clinically manifested different degree of Albright's hereditary osteodystrophy. Genetic study detected a mutation [NM_000516.4(GNAS):c682C>T (p.Arg228Cys)] in the GNAS gene.
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Affiliation(s)
- Vicki H K Tam
- Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo, Hong Kong
| | - Sammy P L Chen
- Kowloon West Cluster Laboratory Genetic Service, Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Chole M Mak
- Kowloon West Cluster Laboratory Genetic Service, Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - L M Fung
- Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo, Hong Kong
| | - C Y Lee
- Department of Paediatrics and Adolescent Medicine, Caritas Medical Centre, Shamshuipo, Hong Kong
| | - Albert Y W Chan
- Kowloon West Cluster Laboratory Genetic Service, Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
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Mak CM, Chan KY, Yau EKC, Chen SPL, Siu WK, Law CY, Lam CW, Chan AYW. Genetic diagnosis of severe myoclonic epilepsy of infancy (Dravet syndrome) with SCN1A mutations in the Hong Kong Chinese patients. Hong Kong Med J 2011; 17:500-502. [PMID: 22147323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Epilepsy is a clinically and genetically heterogeneous group of disorders. The advent of molecular genetics brings unprecedented advancement in diagnostic molecular pathology and reduces over-reliance on traditional clinical classification. Severe myoclonic epilepsy of infancy or Dravet syndrome is a catastrophic infantile-onset epilepsy. We report two unrelated Hong Kong Chinese patients with this condition presenting with febrile seizures, epilepsy with different semiologies, psychomotor retardation, and recurrent status epilepticus. Two different mutations were characterised, viz NM_001165963.1: c.680T>G; NP_001159435.1: p.I227S and NM_001165963.1: c.3953T>G; NP_001159435.1: p.L1318R (novel). Genetic characterisation conveys a definitive diagnosis and is important from the perspective of selecting anti-epileptic drug therapy and genetic counselling.
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Affiliation(s)
- Chloe M Mak
- Kowloon West Cluster Laboratory Genetic Service, Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong.
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Tang MHY, Chen SPL, Ng SW, Chan AYW, Mak TWL. Case series on a diversity of illicit weight-reducing agents: from the well known to the unexpected. Br J Clin Pharmacol 2011; 71:250-3. [PMID: 21219406 DOI: 10.1111/j.1365-2125.2010.03822.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS To provide an overview of illicit weight-reducing agents found in over-the-counter slimming products ingested by poisoned patients. METHODS The clinical details and analytical findings of slimming products involved in poisoning cases between 2004 and 2009 were reviewed. RESULTS Sixty-six (including one fatal) poisoning cases were encountered. Eighty-one products were analysed and found to contain undeclared prescription weight-loss drugs, drug analogues, banned drugs, drugs used for an inappropriate indication or animal thyroid tissue, with up to six illicit agents within the same product. Many products were readily available from shops or the Internet. CONCLUSIONS A rich diversity of illicit, potentially harmful weight-reducing agents was found in over-the-counter slimming products.
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Affiliation(s)
- Magdalene H Y Tang
- Hospital Authority Toxicology Reference Laboratory, Block P, Princess Margaret Hospital, Laichikok, Hong Kong, China
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Chan B, Chen SPL, Wong WC, Mak CM, Wong S, Chan KY, Chan AYW. RYR1-related central core myopathy in a Chinese adolescent boy. Hong Kong Med J 2011; 17:67-70. [PMID: 21282829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Central core myopathy is a rare, inherited neuromuscular disorder with a wide spectrum of phenotypic presentations. It is also considered an allelic disease of malignant hyperthermia. We report a case of central core myopathy in a Chinese adolescent boy presenting with atypical clinical features and a moderately elevated serum creatine kinase level. The diagnosis was made from the histopathological findings of central cores on muscle biopsy, and confirmed by the molecular genetic testing for the RYR1 gene mutation. This is the first case of central core myopathy confirmed by molecular study in our locality.
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Affiliation(s)
- B Chan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Kowloon, Hong Kong
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12
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Abstract
Genetic variation in the microsomal triglyceride transfer protein (MTP) affects the secretion pattern and plasma concentration of apolipoprotein (aopB)-containing lipoproteins and a common functional -493 G/T polymorphism has been reported to influence plasma lipids levels. Recent data suggest that carriers of the T allele might be more sensitive to detrimental factors such as features of the insulin resistance syndrome. Since type 2 diabetes is associated with obesity and insulin resistance, the present study investigated the effect of this polymorphism on plasma lipids, apoB and LDL subfractions in 281 Chinese type 2 diabetic subjects and 364 non-diabetic controls. The frequency of the rare T allele was 0.162 and 0.126 in subjects with and without diabetes respectively. There were no differences in the effect of the polymorphism on plasma lipids and apoB in the two groups. However, the TT genotype was associated with a higher concentration of small dense LDL-III than the GT or GG variants in the diabetic subjects (P=0.01) whereas no such effect was observed in the controls. In the diabetic patients, age, plasma triglyceride and the MTP genotype were independent determinants of LDL-III concentrations in linear regression analysis (R(2)=10%, P=0.04) whereas in the controls, only plasma triglyceride and age were important determinants (R(2)=15%, P=0.01). In conclusion, the -493 G/T polymorphism only has a minor effect on LDL subfraction pattern in Chinese and the effect is only apparent in the presence of type 2 diabetes.
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Affiliation(s)
- S P L Chen
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
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