1
|
Yu WC, Liu XD, Han JX, Chen N, Liu Y, Sun Y. [Analysis of work stress and its influencing factors among nursing staff in Tianjin City]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:424-428. [PMID: 37400402 DOI: 10.3760/cma.j.cn121094-20221018-00501] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Objective: To explore the current situation of work stress among nursing staff in Tianjin City and analyze its influencing factors. Methods: From August to October 2020, 26002 nursing staff from tertiary hospitals, secondary public hospitals, secondary private hospitals, primary hospitals, and other medical institutions in Tianjin City were selected as objects, and their general situation and working stress situation were surveyed by the general information questionnaire and the Nurse's Work Stressor Scale. Single factor analysis and multiple linear regression analysis were used to explore the influencing factors of work stress among nursing staff. Results: The average age of 26002 nursing staff was (33.86±8.28) years old, and the average working years were (11.84±9.12) years. There were 24874 women (95.66%) and 1128 men (4.34%). The total score of work stress was (79.82±21.69), and the average score of workload and time allocation dimension was the highest (2.55±0.79). The results of multiple linear regression analysis showed that marital status (β=-0.015, P=0.014), employment form as contract system (β=0.022, P=0.001), post as clinical nursing (β=0.048, P<0.001), education level (β=0.024, P<0.001), age (β=0.050, P<0.001), working years (β=0.075, P<0.001), and professional title (β=0.036, P<0.001) were the influencing factors of work stress, which explained 22.8% of the total variation in work stress of nursing staff (F=24.25, P<0.001) . Conclusion: The work stress among nursing staff in Tianjin City is high, the corresponding departments and nursing managers should adopt scientific management methods to reduce the workload of nursing staff according to the influencing factors of work stress, so as to create a good atmosphere for further promoting the healthy development of nursing career and nursing industry in the new era.
Collapse
Affiliation(s)
- W C Yu
- Tianjin Health Commission, Tianjin 300070, China
| | - X D Liu
- Tianjin Health Commission, Tianjin 300070, China
| | - J X Han
- Department of Nursing, Tianjin Union Medical Center, Tianjin 300121, China
| | - N Chen
- Department of Nursing, Tianjin Third Central Hospital, Tianjin 300170, China
| | - Y Liu
- Department of Nursing, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Y Sun
- Department of Nursing, Tianjin Union Medical Center, Tianjin 300121, China
| |
Collapse
|
2
|
Chang HC, Kuo L, Niu DM, Yu WC. Left ventricular apical aneurysm in Fabry disease: implications for clinical significance and risk stratification. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.435] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
More than 50% of patients with Fabry disease (FD) present with cardiac phenotype, and left ventricular hypertrophy (LVH) is the most frequent manifestation. Among FD patients with LVH, a rare and novel presentation of left ventricular apical aneurysm (LVAA) has been reported.
Purpose
This study aimed to investigate the clinical incidence of LVAA and its impacts on prognosis among FD patients.
Methods
We retrospectively analyzed 268 FD patients at a tertiary medical center between January 2003 to September 2020. Two patients with ischemic LVAA were excluded. LVH and LVAA were confirmed either by echocardiography (Figure 1A) or cardiovascular magnetic resonance imaging (Figure 1B). The primary endpoints were a composite of heart failure (HF) hospitalization, sustained ventricular tachycardia (VT), stroke, and death.
Results
Of 266 FD patients, there were 105 (39.5%) patients had LVH, and 11 (10.3%) of them had LVAAs (age 67.5 ± 9.5 years, 8 males [72.7%]). After a mean follow-up of 49.3 ± 34.8 months, 8 patients experienced primary endpoints, including 5 (45.5%) HF hospitalizations, 3 (27.3%) VT, 1 (9.1%) stroke, and 4 (36.4%) deaths. The risk for composite adverse events was significantly higher in patients with LVAA compared with those without (8 [72.7%] vs 17 [18.1%]), leading to significantly lower event-free survival in patients with LVAA (Log-Rank P < 0.001, Figure 2). The presence of LVAA was independently associated with an increased risk of composite adverse events (hazard ratio: 3.59; confidence interval: 1.30-9.91, P = 0.01) after adjusting for age, gender, advanced HF, renal function, dyslipidemia, atrial fibrillation, left ventricular ejection fraction of <40%, average E/e’, and LV mass index.
Conclusions
LVAA presents in around 10% of patients with Fabry cardiomyopathy and is strongly associated with an increased risk of adverse events. The identification of this phenotype would be useful to identify high-risk patients with Fabry cardiomyopathy, among whom more aggressive treatments may be considered. Abstract Figure. Apical aneurysm in Fabry cardiomyopathy Abstract Figure. KM curve of composite adverse events
Collapse
Affiliation(s)
- HC Chang
- Taipei Veterans General Hospital, Division of Cardiology, Department of Medicine, Taipei, Taiwan
| | - L Kuo
- Taipei Veterans General Hospital, Division of Cardiology, Department of Medicine, Taipei, Taiwan
| | - DM Niu
- Taipei Veterans General Hospital, Department of Pediatrics, Taipei, Taiwan
| | - WC Yu
- Taipei Veterans General Hospital, Division of Cardiology, Department of Medicine, Taipei, Taiwan
| |
Collapse
|
3
|
Chan YH, Yu ELM, Kwok HC, Yeung YC, Yu WC. Clamping of chest drain before removal in spontaneous pneumothorax. J Cardiothorac Surg 2021; 16:24. [PMID: 33731180 PMCID: PMC7968250 DOI: 10.1186/s13019-021-01398-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In spontaneous pneumothorax, clamping the chest drain before its removal may avoid reinsertion in case of early recurrence, but may be unsafe and may prolong hospital stay. The objective of this study was to examine the incidence of early recurrence in both clamped and unclamped pneumothorax episodes, and factors associated with it. METHODS Retrospective chart review of primary and secondary spontaneous pneumothorax episodes in which chest drain was inserted during the period April 2012 to March 2014. RESULTS Data of 122 episodes were analysed. There were 36 primary pneumothorax and 86 secondary pneumothorax episodes. Mean age was 59 years with 92% males. Clamping of the chest drain was done in 68 episodes (55.7%), and not done in 54. The clamping group was significantly younger, had more primary pneumothorax, and had shorter time from cessation of air leak to clamp/removal. Recurrence within 24 h were seen in 12 (17.6%) clamped episodes and 4 (7.4%) non-clamped episodes, although in only eight episodes were reinsertion of chest drain saved. Significantly more previous pneumothorax episodes were seen in the early recurrence group. We observed no new onset of tension pneumothorax or subcutaneous emphysema associated with clamping. CONCLUSION The practice of clamping the chest drain before removal in spontaneous pneumothorax appear safe. Clamping saved chest drain reinsertion in 11.8% of cases, and has the potential to save more if clamped for up to 24 h. However, clamping may result in more early recurrences. Prospective randomised studies are needed.
Collapse
Affiliation(s)
- Yu-Hong Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, nil, Hong Kong, China.
| | - Ellen Lok-Man Yu
- Clinical Research Centre, Princess Margaret Hospital, Hong Kong, China
| | - Hau-Chung Kwok
- Department of Medicine and Geriatrics, Princess Margaret Hospital, nil, Hong Kong, China
| | - Yiu-Cheong Yeung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, nil, Hong Kong, China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, nil, Hong Kong, China
| |
Collapse
|
4
|
Hu YJ, Yu WC, Lai KT, Sun D, Balakirev FF, Zhang W, Xie JY, Yip KY, Aulestia EIP, Jha R, Higashinaka R, Matsuda TD, Yanase Y, Aoki Y, Goh SK. Detection of Hole Pockets in the Candidate Type-II Weyl Semimetal MoTe_{2} from Shubnikov-de Haas Quantum Oscillations. Phys Rev Lett 2020; 124:076402. [PMID: 32142308 DOI: 10.1103/physrevlett.124.076402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/08/2019] [Accepted: 01/24/2020] [Indexed: 06/10/2023]
Abstract
The bulk electronic structure of T_{d}-MoTe_{2} features large hole Fermi pockets at the Brillouin zone center (Γ) and two electron Fermi surfaces along the Γ-X direction. However, the large hole pockets, whose existence has important implications for the Weyl physics of T_{d}-MoTe_{2}, has never been conclusively detected in quantum oscillations. This raises doubt about the realizability of Majorana states in T_{d}-MoTe_{2}, because these exotic states rely on the existence of Weyl points, which originated from the same band structure predicted by density functional theory (DFT). Here, we report an unambiguous detection of these elusive hole pockets via Shubnikov-de Haas (SdH) quantum oscillations. At ambient pressure, the quantum oscillation frequencies for these pockets are 988 and 1513 T, when the magnetic field is applied along the c axis. The quasiparticle effective masses m^{*} associated with these frequencies are 1.50 and 2.77 m_{e}, respectively, indicating the importance of Coulomb interactions in this system. We further measure the SdH oscillations under pressure. At 13 kbar, we detected a peak at 1798 T with m^{*}=2.86m_{e}. Relative to the oscillation data at a lower pressure, the amplitude of this peak experienced an enhancement, which can be attributed to the reduced curvature of the hole pockets under pressure. Combining our experimental data with DFT+U calculations, where U is the Hubbard parameter, our results shed light on why these important hole pockets have not been detected until now.
Collapse
Affiliation(s)
- Y J Hu
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - W C Yu
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
- Department of Physics, City University of Hong Kong, Kowloon, Hong Kong
| | - Kwing To Lai
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - D Sun
- National High Magnetic Field Laboratory, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - F F Balakirev
- National High Magnetic Field Laboratory, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - W Zhang
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Y Xie
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K Y Yip
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Rajveer Jha
- Department of Physics, Tokyo Metropolitan University, Hachioji, Tokyo 192-0397, Japan
| | - Ryuji Higashinaka
- Department of Physics, Tokyo Metropolitan University, Hachioji, Tokyo 192-0397, Japan
| | - Tatsuma D Matsuda
- Department of Physics, Tokyo Metropolitan University, Hachioji, Tokyo 192-0397, Japan
| | - Y Yanase
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - Yuji Aoki
- Department of Physics, Tokyo Metropolitan University, Hachioji, Tokyo 192-0397, Japan
| | - Swee K Goh
- Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
5
|
Fu SN, Dao MC, Wong CKH, Yu WC. SF-6D utility scores of smokers and ex-smokers with or without respiratory symptoms attending primary care clinics. Health Qual Life Outcomes 2019; 17:48. [PMID: 30876466 PMCID: PMC6419835 DOI: 10.1186/s12955-019-1115-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 02/27/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction The aim of this paper is to find out generic preference-based Short-Form 6 Dimensions (SF-6D) utility scores of smokers and ex-smokers with varying cigarette exposure, with and without respiratory symptoms. Methods Seven hundred thirty one people aged ≥30 with a history of smoking who attended 5 public primary care clinics completed a cross-sectional survey using SF-6D utility score, Breathlessness, Cough, and Sputum Scale (BCSS©) and office spirometry. Results Most of the subjects were men (92.5%) in an older age group (mean age 62.2 ± 11.7 years). About half of them (48.3%) were current smokers while the other half (51.7%) were ex-smokers. More than half of them (54.2%) reported mild respiratory symptoms (mean BCSS score 0.95 ± 1.12). The most common symptoms were sputum (45.1%), followed by cough (34.2%) and breathlessness (6.0%). The SF-6D overall utility score was 0.850 ± 0.106. The subjects reported significantly lower SF-6D scores when they had breathlessness (0.752 ± 0.138; p = < 0.001), cough (0.836 ± 0.107; p = 0.007), sputum (0.838 ± 0.115; p = 0.004) or any of the above symptom (0.837 ± 0.113; p < 0.001). In both groups of current smokers and ex-smokers, there was no statistically significant difference in the scores among light, moderate or heavy smokers. In the Tobit regression model of factors affecting SF-6D utility score, subjects who reported more respiratory symptoms (i.e. higher BCSS©) had lower SF-6D scores (B = − 0.018 ± 0.007, p < 0.001), while men had higher SF-6D scores than women (B = 0.037 ± 0.031, p = 0.019). Subjects who attended middle or high school had higher SF-6D score than those attended the University or above. The presence of airflow obstruction was not associated with the score. Conclusions The study yielded SF-6D utility scores of smokers and ex-smokers with different reported cigarette exposure, which could be useful in future clinical studies and cost-effectiveness analysis.
Collapse
Affiliation(s)
- Sau-Nga Fu
- Department of Family Medicine & Primary Health Care, Kowloon West Cluster, Hospital Authority, Hong Kong Special Administration Region, China. .,Present Address: G/F, Ha Kwai Chung General Outpatient Department, 77 Lai Cho Road, Kwai Chung, N.T., Hong Kong Special Administration Region, China.
| | - Man-Chi Dao
- Department of Family Medicine & Primary Health Care, Kowloon West Cluster, Hospital Authority, Hong Kong Special Administration Region, China
| | - Carlos King-Ho Wong
- Department of Family Medicine & Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administration Region, China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administration Region, China
| |
Collapse
|
6
|
Lu DY, Wang WT, Huang WM, Sung SH, Cheng HM, Chen CH, Yu WC. P1255Disease stage-dependent changes of cardiac contractile performance in patients with fabry cardiomyopathf. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1255] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Y Lu
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - W T Wang
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - W M Huang
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - S H Sung
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - H M Cheng
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - C H Chen
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - W C Yu
- Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| |
Collapse
|
7
|
Yu WC, Yu EL, Kwok HC, She HL, Kwong KK, Chan YH, Tsang YL, Yeung YC. Endobronchial valve for treatment of persistent air leak complicating spontaneous pneumothorax. Hong Kong Med J 2018; 24:158-165. [PMID: 29622759 DOI: 10.12809/hkmj176823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Endobronchial one-way valves have been proposed as treatment for persistent air leak complicating spontaneous pneumothorax in which surgical intervention is not feasible. However, published data on efficacy, safety, and factors associated with success are scanty. METHODS This is a retrospective study of 37 patients at a general hospital from 2008 to 2016. The impact of endobronchial valve implantation on the time to air-leak cessation after bronchoscopy was evaluated. RESULTS The median patient age was 71 years. The majority of patients were males (92%), were ever-smokers (83%), had at least one co-morbidity (97%), and had secondary spontaneous pneumothorax (89%). Nineteen patients (51%) had a mean of 2.6 endobronchial valves implanted (range, 1-6). The air leak ceased within 72 hours for only eight patients (22% of the complete cohort), with immediate air-leak cessation after completion of endobronchial valve implantation. All six successful cases that had computed tomographic data of the thorax were shown to have bilateral intact interlobar fissures. The median (interquartile range) Charlson co-morbidity index was 1 (0.25-1) and 2 (1-3) for the success group and failure group, respectively (P=0.029). All patients in the no-endobronchial valve group survived, whereas three patients in the endobronchial valve group died within 30 days of endobronchial valve implantation. CONCLUSION Only a small proportion of cases of endobronchial valve implantation for air leak complicating pneumothorax had unequivocal success. Intact bilateral interlobar fissures appear to be a necessary, though not sufficient, condition for success. Patients with fewer medical co-morbidities and immediate air-leak cessation after endobronchial valve implantation have a higher likelihood of success.
Collapse
Affiliation(s)
- W C Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| | - E Lm Yu
- Clinical Research Centre, Princess Margaret Hospital, Laichikok, Hong Kong
| | - H C Kwok
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| | - H L She
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - K K Kwong
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Y H Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Y L Tsang
- Central Endoscopy Unit, Princess Margaret Hospital, Laichikok, Hong Kong
| | - Y C Yeung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| |
Collapse
|
8
|
Lam DCL, Kwok HH, Yu WC, Ko FWS, Tam CY, Lau ACW, Fong DYT, Ip MSM. CC16 levels correlate with cigarette smoke exposure in bronchial epithelial cells and with lung function decline in smokers. BMC Pulm Med 2018; 18:47. [PMID: 29548305 PMCID: PMC5857103 DOI: 10.1186/s12890-018-0607-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/01/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Club cell protein-16 (CC16) expression has been associated with smoking-related lung function decline. The study hypothesis was that CC16 expression in both serum and bronchial epithelium is associated with lung function decline in smokers, and exposure to cigarette smoke will lead to reduction in CC16 expression in bronchial epithelial cells. METHODS In a cohort of community-based male Chinese subjects recruited for lung function test in 2000, we reassessed their lung function ten years later and measured serum levels of CC16. CC16 expression was further assayed in bronchial epithelium from endobronchial biopsies taken from an independent cohort of subjects undergoing autofluorescence bronchoscopy, and tested for correlation between CC16 immunostaining intensity and lung function. In an in-vitro model, bronchial epithelial cells were exposed to cigarette smoke extract (CSE), and the expression levels of CC16 were measured in bronchial epithelial cells before and after exposure to CSE. RESULTS There was a significant association between FEV1 decline and serum CC16 levels in smokers. Expression of CC16 in bronchial epithelium showed significant correlation with FEV1/FVC. Bronchial epithelial cells showed significant decrease in CC16 expression after exposure to CSE, followed by a subsequent rise in CC16 expression upon removal of CSE. CONCLUSIONS Results of these clinical and laboratory investigations suggested that low serum CC16 was associated with smoking-related decline in lung function, demonstrated the first time in a Chinese cohort. The data also lend support to the putative role of CC16 in protection against smoking-related bronchial epithelial damage. (Abstract word count: 243) US CLINICAL TRIAL REGISTRY: NCT01185652 , first posted 20 August, 2010.
Collapse
Affiliation(s)
- David Chi-Leung Lam
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| | - Hoi-Hin Kwok
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai King, HK China
| | - Fanny Wai-San Ko
- Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Shatin, HK China
| | - Cheuk-Yin Tam
- Department of Medicine and Geriatrics, Tuen Mun Hospital, 23, Tsing Chung Koon Rd, Tuen Mun, HK China
| | - Arthur Chun-Wing Lau
- Department of Intensive Care, Pamela Youde Nethersole Hospital, 3, Lok Man Rd, Chai Wan, HK China
| | - Daniel Yee-Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| | - Mary Sau-Man Ip
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, HK China
| |
Collapse
|
9
|
Chang KC, Chan MC, Leung WM, Kong FY, Mak CM, Chen SP, Yu WC. Optimising the utility of pleural fluid adenosine deaminase for the diagnosis of adult tuberculous pleural effusion in Hong Kong. Hong Kong Med J 2017; 24:38-47. [PMID: 29269590 DOI: 10.12809/hkmj176238] [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: 11/05/2022] Open
Abstract
INTRODUCTION Pleural fluid adenosine deaminase level can be applied to rapidly detect tuberculous pleural effusion. We aimed to establish a local diagnostic cut-off value for pleural fluid adenosine deaminase to identify patients with tuberculous pleural effusion, and optimise its utility. METHODS We retrospectively reviewed the medical records of consecutive adults with pleural fluid adenosine deaminase level measured by the Diazyme commercial kit (Diazyme Laboratories, San Diego [CA], United States) during 1 January to 31 December 2011 in a cluster of public hospitals in Hong Kong. We considered its level alongside early (within 2 weeks) findings in pleural fluid and pleural biopsy, with and without applying Light's criteria in multiple scenarios. For each scenario, we used the receiver operating characteristic curve to identify a diagnostic cut-off value for pleural fluid adenosine deaminase, and estimated its positive and negative predictive values. RESULTS A total of 860 medical records were reviewed. Pleural effusion was caused by congestive heart failure, chronic renal failure, or hypoalbuminaemia caused by liver or kidney diseases in 246 (28.6%) patients, malignancy in 198 (23.0%), non-tuberculous infection in 168 (19.5%), tuberculous pleural effusion in 157 (18.3%), and miscellaneous causes in 91 (10.6%). All those with tuberculous pleural effusion had a pleural fluid adenosine deaminase level of ≤100 U/L. When analysis was restricted to 689 patients with pleural fluid adenosine deaminase level of ≤100 U/L and early negative findings for malignancy and non-tuberculous infection in pleural fluid, the positive predictive value was significantly increased and the negative predictive value non-significantly reduced. Using this approach, neither additionally restricting analysis to exudates by Light's criteria nor adding closed pleural biopsy would further enhance predictive values. As such, the diagnostic cut-off value for pleural fluid adenosine deaminase is 26.5 U/L, with a sensitivity of 87.3%, specificity of 93.2%, positive predictive value of 79.2%, negative predictive value of 96.1%, and accuracy of 91.9%. Sex, age, and co-morbidity did not significantly affect prediction of tuberculous pleural effusion using the cut-off value. CONCLUSION We have established a diagnostic cut-off level for pleural fluid adenosine deaminase in the diagnosis of tuberculous pleural effusion by restricting analysis to a level of ≤100 U/L, and considering early pleural fluid findings for malignancy and non-tuberculous infection, but not Light's criteria.
Collapse
Affiliation(s)
- K C Chang
- Tuberculosis and Chest Service, Department of Health, Hong Kong
| | - M C Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W M Leung
- Tuberculosis and Chest Service, Department of Health, Hong Kong
| | - F Y Kong
- Department of Medicine and Geriatrics, Yan Chai Hospital, Tsuen Wan, Hong Kong
| | - C M Mak
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - S Pl Chen
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W C Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| |
Collapse
|
10
|
Lin JT, Zhang YM, Zhou X, Wang CZ, Huang M, Liu CT, Wu CG, Wan HY, Yu WC, Dai YR. [Chinese expert consensus for non-antiinfective effects and clinical use of macrolides]. Zhonghua Nei Ke Za Zhi 2017; 56:546-557. [PMID: 28693067 DOI: 10.3760/cma.j.issn.0578-1426.2017.07.015] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions, 10 experts examined important data and drafted this consensus related to macrolides: (1) mechanism of non-antiinfective effects; (2) clinical use in chronic respiratory diseases; (3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect, modifying airway secretion, immune-regulation related to antibacterial effect, corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis, chronic rhinosinusitis. It is considerably used in bronchiectasia, cystic fibrosis, severe asthma and chronic obstructive pulmonary disease. Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection. It should be paid attention to its possible adverse effects (including drug interactions, cardiac toxicity, ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time, which aims to expand their rational use and the further research.
Collapse
Affiliation(s)
- J T Lin
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Niu Q, Yu WC, Yip KY, Lim ZL, Kotegawa H, Matsuoka E, Sugawara H, Tou H, Yanase Y, Goh SK. Quasilinear quantum magnetoresistance in pressure-induced nonsymmorphic superconductor chromium arsenide. Nat Commun 2017; 8:15358. [PMID: 28580936 PMCID: PMC5465317 DOI: 10.1038/ncomms15358] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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: 09/23/2016] [Accepted: 03/15/2017] [Indexed: 11/29/2022] Open
Abstract
In conventional metals, modification of electron trajectories under magnetic field gives rise to a magnetoresistance that varies quadratically at low field, followed by a saturation at high field for closed orbits on the Fermi surface. Deviations from the conventional behaviour, for example, the observation of a linear magnetoresistance, or a non-saturating magnetoresistance, have been attributed to exotic electron scattering mechanisms. Recently, linear magnetoresistance has been observed in many Dirac materials, in which the electron–electron correlation is relatively weak. The strongly correlated helimagnet CrAs undergoes a quantum phase transition to a nonmagnetic superconductor under pressure. Here we observe, near the magnetic instability, a large and non-saturating quasilinear magnetoresistance from the upper critical field to 14 T at low temperatures. We show that the quasilinear magnetoresistance may arise from an intricate interplay between a nontrivial band crossing protected by nonsymmorphic crystal symmetry and strong magnetic fluctuations. The electronic structure of the helimagnet CrAs is unusual due to its nonsymmorphic crystal symmetry. Here, the authors observe quasilinear magnetoresistance close to a pressure-driven superconducting transition, which may arise from the interaction of the band structure and magnetic fluctuations.
Collapse
Affiliation(s)
- Q Niu
- Department of Physics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong 999077, China
| | - W C Yu
- Department of Physics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong 999077, China
| | - K Y Yip
- Department of Physics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong 999077, China
| | - Z L Lim
- Department of Physics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong 999077, China
| | - H Kotegawa
- Department of Physics, Kobe University, Kobe 658-8530, Japan
| | - E Matsuoka
- Department of Physics, Kobe University, Kobe 658-8530, Japan
| | - H Sugawara
- Department of Physics, Kobe University, Kobe 658-8530, Japan
| | - H Tou
- Department of Physics, Kobe University, Kobe 658-8530, Japan
| | - Y Yanase
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - Swee K Goh
- Department of Physics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong 999077, China
| |
Collapse
|
12
|
Wang F, Tse LA, Chan WC, Kwok CCH, Leung SL, Wu C, Mang OWK, Ngan RKC, Li M, Yu WC, Tsang KH, Law SH, Miao X, Wu C, Zheng Y, Wu F, Yang XR, Yu ITS. Disparities of time trends and birth cohort effects on invasive breast cancer incidence in Shanghai and Hong Kong pre- and post-menopausal women. BMC Cancer 2017; 17:362. [PMID: 28535760 PMCID: PMC5442698 DOI: 10.1186/s12885-017-3359-5] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 05/15/2017] [Indexed: 12/29/2022] Open
Abstract
Background Breast cancer is the leading cause of cancer morbidity among Shanghai and Hong Kong women, which contributes to 20–25% of new female cancer incidents. This study aimed to describe the temporal trend of breast cancer and interpret the potential effects on the observed secular trends. Methods Cancer incident data were obtained from the cancer registries. Age-standardized incidence rate was computed by the direct method using the World population of 2000. Average annual percentage change (AAPC) in incidence rate was estimated by the Joinpoint regression. Age, period and cohort effects were assessed by using a log-linear model with Poisson regression. Results During 1976–2009, an increasing trend of breast cancer incidence was observed, with an AAPC of 1.73 [95% confidence interval (CI): 1.54–1.92)] for women in Hong Kong and 2.83 (95% CI, 2.26–3.40) in Shanghai. Greater upward trends were revealed in Shanghai women aged 50 years old or above (AAPC = 3.09; 95% CI, 1.48–4.73). Using age at 50 years old as cut-point, strong birth cohort effects were shown in both pre- and post-menopausal women, though a more remarkable effect was suggested in Shanghai post-menopausal women. No evidence for a period effect was indicated. Conclusions Incidence rate of breast cancer has been more speedy in Shanghai post-menopausal women than that of the Hong Kong women over the past 30 years. Decreased birth rate and increasing environmental exposures (e.g., light-at-night) over successive generations may have constituted major impacts on the birth cohort effects, especially for the post-menopausal breast cancer; further analytic studies are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3359-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Feng Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China.
| | - Wing-Cheong Chan
- Department of Surgery, North District Hospital, Sheung Shui, Hong Kong SAR, China
| | - Carol Chi-Hei Kwok
- Department of Oncology, Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Siu-Lan Leung
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China
| | - Cherry Wu
- Department of Pathology, North District Hospital, Sheung Shui, Hong Kong SAR, China
| | - Oscar Wai-Kong Mang
- Hong Kong Cancer Registry, Hospital Authority, Yau Ma Tei, Hong Kong SAR, China
| | | | - Mengjie Li
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Koon-Ho Tsang
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong SAR, China
| | - Sze-Hong Law
- Department of Surgery, Yan Chai Hospital, Tsuen Wan, Hong Kong SAR, China
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics, Tongji School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Chunxiao Wu
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Ying Zheng
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Fan Wu
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Xiaohong R Yang
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ignatius Tak-Sun Yu
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| |
Collapse
|
13
|
Li M, Tse LA, Chan WC, Kwok CH, Leung SL, Wu C, Yu WC, Lee PMY, Tsang KH, Law SH, Vermeulen R, Gu F, Caporaso NE, Yu ITS, Wang F, Yang XR. Nighttime eating and breast cancer among Chinese women in Hong Kong. Breast Cancer Res 2017; 19:31. [PMID: 28302140 PMCID: PMC5356318 DOI: 10.1186/s13058-017-0821-x] [Citation(s) in RCA: 16] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/01/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A novel line of research suggests that eating at nighttime may have several metabolic consequences that are highly relevant to breast cancer. We investigated the association between nighttime eating habits after 10 p.m. and breast cancer in Hong Kong women. METHODS A hospital-based case-control study was conducted during 2012-2015. A total of 922 patients with incident breast cancer (cases) and 913 hospital controls were recruited and interviewed using a standard questionnaire including information on eating behavior during both daytime and nighttime. We collected the timing, duration, types and frequencies of food intake of eating at nighttime. Odds ratios (ORs) for the risk of breast cancer in relation to nighttime eating-related variables were calculated by unconditional multivariable logistic regression. RESULTS Eating at night after 10 pm was significantly associated with breast cancer with an adjusted OR of 1.50 (95% confidence interval (CI) 1.06-2.12, P = 0.02), and the associations were stronger in women who had the longest duration of nighttime eating (≥20 years) (adjusted OR = 2.28 (95% CI 1.13-4.61, P = 0.02) and who ate late (midnight to 2 a.m.) (adjusted OR = 2.73, 95% CI 1.01-6.99, P = 0.04). Interestingly, nighttime eating was only associated with breast cancer among women who consumed staple foods (OR = 2.16, 95% CI 1.42-3.29, P < 0.001) but not those who ate vegetables or fruits as nighttime meals. The significant association between nighttime eating and breast cancer was observed among women with body mass index (BMI) <25 (OR = 2.29, 95% CI 1.48-3.52, P < 0.001) but not among women with BMI ≥25. CONCLUSIONS Results from this study suggest a possible association between nighttime eating behavior and breast cancer. These findings need to be confirmed by independent large studies.
Collapse
Affiliation(s)
- Mengjie Li
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Wing-Cheong Chan
- Department of Surgery, North District Hospital, Hong Kong SAR, China
| | - Chi-Hei Kwok
- Department of Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Siu-Lan Leung
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Cherry Wu
- Department of Pathology, North District Hospital, Hong Kong SAR, China
| | - Wai-Cho Yu
- Department of Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - Priscilla Ming-Yi Lee
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Koon-Ho Tsang
- Department of Pathology, Yan Chai Hospital, Hong Kong SAR, China
| | - Sze-Hong Law
- Department of Surgery, Yan Chai Hospital, Hong Kong SAR, China
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Fangyi Gu
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Neil E Caporaso
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Ignatius Tak-Sun Yu
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Feng Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaohong Rose Yang
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| |
Collapse
|
14
|
Abstract
Background This study aimed to determine the associations of various sociodemographic factors with the level of disease-specific knowledge among Hong Kong Chinese patients with COPD. Methods A cross-sectional survey of 100 Chinese adults with COPD recruited from outpatient clinics was conducted from September 2009 to September 2010. Data on the knowledge specific to COPD and patients’ sociodemographics were collected from face-to-face interviews. Primary outcome of disease-specific knowledge was measured using 65-item Bristol COPD Knowledge Questionnaire (BCKQ), summing up the 65 items as the BCKQ overall score. Associations of sociodemographic factors with the BCKQ overall score were evaluated using the linear regression model. Results The mean BCKQ overall score of our patients was 41.01 (SD: 10.64). The knowledge in topics of “Smoking” and “Phlegm” achieved the first (3.97, SD: 0.82) and second (3.91, SD: 1.17) highest mean scores, respectively, while the topic of “Oral steroids” returned the lowest mean score of 1.89 (SD: 1.64). The BCKQ overall score progressively declined (P<0.001) with increase in education level, with the highest BCKQ overall score of 46.71 at no formal education among all subgroups. Compared to nondrinkers, current drinkers were associated with lower total BCKQ score. Conclusion We found that among COPD patients in outpatient clinics, impairments in the level of COPD knowledge were evident in patients who were current drinkers or had higher level of education.
Collapse
Affiliation(s)
- Carlos Kh Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong
| | - W C Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, Special Administrative Region
| |
Collapse
|
15
|
Chen J, Wong CKH, McGhee SM, Pang PKP, Yu WC. A comparison between the EQ-5D and the SF-6D in patients with chronic obstructive pulmonary disease (COPD). PLoS One 2014; 9:e112389. [PMID: 25379673 PMCID: PMC4224433 DOI: 10.1371/journal.pone.0112389] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/15/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The appropriate use of generic preference-based measures determines the accuracy of disease assessment and further decision on healthcare policy using quality adjusted life years. The discriminative capacity of different instruments would differ across disease groups. Our study was to examine the difference in utility scores for COPD patients measured by EQ-5D and SF-6D and to assist the choice of a proper instrument in this disease group. METHODS Differences of mean utility scores of EQ-5D and SF-6D in groups defined by socio-demographic characteristics, comorbidities, health service utilisation and severity of illness were tested using Mann-Whitney test, t-test, Kruskal-Wallis test, Pearson's correlation coefficient and ANOVA, as appropriate. The discriminative properties of the two instruments were compared against indicators of quality of life using receiver operating characteristic curves. The statistical significance of the area under the curves (AUC) was tested by ANOVA and F-statistics used to compare the efficiency with which each instrument discriminated between disease severity groups. RESULTS Mean utility scores of EQ-5D and SF-6D were 0.644 and 0.629 respectively in the 154 subjects included in the analysis. EQ-5D scores were significantly higher than SF-6D in groups less severe and these differences corresponded to a minimally important difference of greater than 0.03 (p<0.001). EQ-5D and SF-6D scores were strongly correlated across the whole sample (r = 0.677, p<0.001) and in pre-defined groups (r>0.5 and p<0.05 for all correlation coefficients). AUCs were above 0.5 against the indicators of health-related quality of life for both instruments. F-ratios suggested SF-6D was more efficient in discriminating cases of different disease severity than EQ-5D. CONCLUSIONS Both EQ-5D and SF-6D appeared to be valid preference-based measures in Chinese COPD patients. SF-6D was more efficient in detecting differences among subgroups with differing health status. EQ-5D and SF-6D measured different things and might not be used interchangeably in COPD patients.
Collapse
Affiliation(s)
- Jing Chen
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Carlos K. H. Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Sarah M. McGhee
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Polly K. P. Pang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| |
Collapse
|
16
|
Lam CT, Yang ZF, Lau JC, Ng MN, Yu WC, Ho DW, Fan ST. Abstract 5346: Identification of essential genes for the development of hepatitis B virus-associated hepatocellular carcinoma. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-5346] [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: 11/16/2022]
Abstract
Abstract
Background and Aim: Hepatocellular carcinoma (HCC) is a highly lethal and prevalent cancer, posing a grave threat to human health globally. Hepatitis B virus (HBV) infection is considered as a major risk factor for this cancer, especially in the Asia-Pacific region. Unfortunately, the molecular mechanisms of hepatocarcinogenesis remain obscure, which hinders the development of effective therapies for the disease. In the present study, we attempted to elucidate the molecular details of HBV-induced hepatocarcinogenesis by investigating differentially regulated genes at multiple developmental stages of HCC in a HBV transgenic mouse model. Materials and Methods: The transgenic mice which overproduced HBV large envelope polypeptide in hepatocytes and developed liver tumors spontaneously were used in this study. To unravel transcriptomics dynamics underlying hepatocarcinogenesis, RNA prepared from livers of both transgenic and wild type mice of different ages (at months 2, 12, 18 and 19) were subjected to RNA sequencing. Selected target genes were first validated by quantitative PCR (qPCR) using a larger set of mouse liver tissues (n=96) collected from 8 time points. Clinical implications of the selected genes were then explored in a set of human liver samples comprising 18 normal, 29 cirrhosis and 96 pairs of HCC. RNA and protein expression levels were determined by qPCR, immunohistochemical staining and Western blotting, respectively. Results: Upon analysis of 20,209 gene transcripts, 2574 and 1035 transcripts were found to be up-regulated (≥2 folds) and down-regulated (≤2 folds) in tumors, respectively, when compared with the wild type controls. Among these, 133 most prominent genes that exhibited concordant differential expression throughout the stages of tumor progression were chosen for validation in mouse liver tissues. Correlation analysis showed a high correlation between RNA sequencing and qPCR data (r=0.7495; P<0.0001), indicating a high validity of the data. Forty-six biologically informative genes were further validated in human liver samples. By Gene Ontology analysis, the target genes were revealed to play roles in a variety of biological processes including stress and inflammation responses, metabolic and apoptotic processes. Immunohistochemical staining and Western blotting demonstrated significant differential expression of these genes between HCC and non-tumorous livers. Statistical analyses revealed their significant correlation with clinicopathological parameters including venous infiltration, tumor size and overall survival, implicating their roles in hepatocarcinogenesis. Conclusion: This study has demonstrated a systematic strategy for identifying crucial genes for HBV-associated HCC, which may have profound implications in combating this deadly cancer.
Citation Format: CT Lam, ZF Yang, JC Lau, MN Ng, WC Yu, DW Ho, ST Fan. Identification of essential genes for the development of hepatitis B virus-associated hepatocellular carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5346. doi:10.1158/1538-7445.AM2014-5346
Collapse
Affiliation(s)
- CT Lam
- University of Hong Kong, Pokfulam, Hong Kong
| | - ZF Yang
- University of Hong Kong, Pokfulam, Hong Kong
| | - JC Lau
- University of Hong Kong, Pokfulam, Hong Kong
| | - MN Ng
- University of Hong Kong, Pokfulam, Hong Kong
| | - WC Yu
- University of Hong Kong, Pokfulam, Hong Kong
| | - DW Ho
- University of Hong Kong, Pokfulam, Hong Kong
| | - ST Fan
- University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
17
|
Tang WM, Tong CK, Yu WC, Tong KL, Buckley TA. Outcome of adult critically ill patients mechanically ventilated on general medical wards. Hong Kong Med J 2012; 18:284-290. [PMID: 22865171] [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. A significant number of critically ill mechanically ventilated patients are not admitted to the Intensive Care Unit but are cared for on general wards. This study looked at the outcome of these patients. DESIGN. Case series. SETTING. A 1100-bed tertiary hospital in Hong Kong. PATIENTS. All adult patients admitted in a 2.5-year period who received invasive mechanical ventilation on general medical wards without admission to Intensive Care Unit or other special care areas. INTERVENTIONS. Invasive mechanical ventilation. MAIN OUTCOME MEASURES. The observed number of deaths, the expected number of deaths as derived from the Mortality Probability Model II system admission model, and other morbidity measures. RESULTS. Among 755 patients studied, the observed number of deaths was 673, which amounts to a mortality of 89.1%. The expected number of deaths was 570. The risk-standardised mortality ratio was 1.18 (95% confidence interval, 1.09-1.28; P<0.0005). Patients with chronic obstructive pulmonary disease had the lowest mortality rate of 70.8% (P<0.005). The post-cardiac arrest subgroup had the highest mortality of 99.0%. CONCLUSIONS. There was a worse-than-predicted survival in the absence of Intensive Care Unit care for the critically ill patients who received mechanical ventilation on general wards. Patients with chronic obstructive pulmonary disease warranted more Intensive Care Unit admissions. Early discontinuation of invasive support should be seriously considered in the post-cardiac arrest patients.
Collapse
Affiliation(s)
- W M Tang
- Intensive Care Unit, Princess Margaret Hospital, Laichikok, Kowloon, Hong Kong.
| | | | | | | | | |
Collapse
|
18
|
Chau JPC, Lee DTF, Yu DSF, Chow AYM, Yu WC, Chair SY, Lai ASF, Chick YL. A feasibility study to investigate the acceptability and potential effectiveness of a telecare service for older people with chronic obstructive pulmonary disease. Int J Med Inform 2012; 81:674-82. [PMID: 22789911 DOI: 10.1016/j.ijmedinf.2012.06.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 03/09/2012] [Accepted: 06/14/2012] [Indexed: 10/28/2022]
Abstract
AIMS To investigate the feasibility, acceptance and potential effectiveness of delivering a telecare service on the health outcomes and hospital service utilization of community-dwelling patients with chronic obstructive pulmonary disease. METHODS Eligible participants were older people, with moderate or severe chronic obstructive pulmonary disease, and who had been admitted to hospital at least once for exacerbation during the previous year. The participants were randomly assigned to the intervention or control group. Participants in the intervention group received a telecare device kit and they were asked to monitor their oxygen saturation, pulse rate and respiration rate using the device and to transmit the data to an online network platform. A medication and purse-lip breathing reminder with a feedback function is also provided in the device kit. A community nurse monitors changes in the physiological parameters and takes immediate action to address the patients' needs. Participants in the control group received no other extra care. Study outcomes include user satisfaction, health-related quality of life, pulmonary function, hospital re-admission and use of emergency room services. RESULTS Twenty-two participants in the intervention group and 18 in the control group were included in the analysis. The mean age of all 40 participants was 72.93 years. Overall, the participants in the intervention group expressed satisfaction with the telecare service. Some patients reported difficulty in reading the screen of the mobile phone and manipulating the tiny key-in buttons. No significant differences were found between the two time points (baseline and post-test period) with regard to health-related quality of life. No significant differences in pulmonary function and in the number of emergency department visits and hospital re-admissions between the study groups were found. CONCLUSION The high level of user satisfaction indicated the feasibility of conducting a large-scale randomized control trial to evaluate the effects of a telecare service on health outcomes of patients with chronic obstructive pulmonary disease.
Collapse
Affiliation(s)
- Janita Pak-Chun Chau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Yu WC, Tai EL, Fu SN, Kwong KC, Yeung YC, Chang Y, Yiu YK, Tam CM. Treatment of patients with chronic obstructive pulmonary disease as practised in a defined Hong Kong community: a cross-sectional pilot survey. Hong Kong Med J 2011; 17:306-314. [PMID: 21813900] [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
OBJECTIVES To examine the characteristics of chronic obstructive pulmonary disease patients of the Kwai-Tsing area, Hong Kong, and the chronic treatments they received. DESIGN. Cross-sectional survey. SETTING Four clinic settings in Hong Kong: Respiratory Specialist Clinic, Princess Margaret Hospital (group 1); Medical Specialist Clinics, Princess Margaret Hospital (group 2); General Outpatient Clinics, Princess Margaret Hospital (group 3); South Kwai Chung Chest Clinic, Department of Health (group 4). PATIENTS Thirty physician-diagnosed chronic obstructive pulmonary disease patients in each of the above groups with post-bronchodilator 1-second forced expiratory volume/forced vital capacity ratios of less than 70% predicted values, who had been followed up at any of the participating clinics for at least 6 months. RESULTS There were 111 male and nine female patients. The median age was 72.5 years and 79% had at least one medical co-morbidity. The mean duration of their chronic obstructive pulmonary disease was 9.8 years, and their mean post-bronchodilator 1-second forced expiratory volumes were 45% (for males) and 58% (for females) of predicted values. There were significantly fewer stage I and more stage IV patients in group 1. Influenza vaccination coverage within the previous 1 year was 54% and did not differ significantly between groups. Chronic obstructive pulmonary disease education was given significantly more often to group 1 patients. Short-acting beta agonists were used to treat all patients but long-acting bronchodilators and pulmonary rehabilitation were used almost exclusively in group 1. Overall, long-acting bronchodilators and pulmonary rehabilitation were offered to 16% and 5%, respectively, of those for whom these were indicated (according to international guidelines). CONCLUSION In general there was insufficient education and under-treatment for chronic obstructive pulmonary disease patients. Management of such patients warrants improvements by way of increased accessibility to structured education programmes, pulmonary rehabilitation programmes, long-acting bronchodilator drugs, and respiratory specialist care.
Collapse
Affiliation(s)
- W C Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Chan JW, Ko FW, Ng CK, Yeung A, Yee WKS, So LKY, Lam B, Wong MML, Choo KL, Ho ASS, Tse PY, Fung SL, Lo CK, Yu WC. Management and prevention of spontaneous pneumothorax using pleurodesis in Hong Kong. Int J Tuberc Lung Dis 2011; 15:385-390. [PMID: 21333108] [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
BACKGROUND The practice of pleurodesis for the management and prevention of spontaneous pneumothorax (SP) is uncertain. DESIGN A retrospective multicentre analysis of patients admitted to 12 hospitals in Hong Kong with SP in 2004 and who subsequently underwent pleurodesis for the same episode. RESULTS Pleurodesis was performed in 394 episodes. Initial medical chemical pleurodesis was performed for 258 (65.5%) patients ('initial medical group'), while 136 (34.5%) underwent initial surgical pleurodesis ('initial surgical group'). Secondary spontaneous pneumothorax (SSP; 237 episodes, 60.2%) was the most common indication for pleurodesis; it was also performed after a first episode of primary spontaneous pneumothorax (PSP) in 22 episodes (5.6%). Tetracycline derivatives (172 episodes, 66.7%) were the most popular sclerosing agents in the initial medical group. Those in the initial medical group were older and were more likely to be males, have SSP, chronic obstructive pulmonary disease and a history of past pleurodesis (P < 0.05) compared to the initial surgical group. Compared to the tetracycline group, more patients who initially received talc slurry had the procedure performed by surgeons, had larger (≥2 cm) pneumothorax or required suction during initial drainage (P < 0.05). CONCLUSIONS Despite the availability of international guidelines, there is considerable variation in pleurodesis for SP.
Collapse
Affiliation(s)
- J W Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, SAR China.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Ng CK, Ko FW, Chan JW, Yeung A, Yee WKS, So LKY, Lam B, Wong MML, Choo KL, Ho ASS, Tse PY, Fung SL, Lo CK, Yu WC. Minocycline and talc slurry pleurodesis for patients with secondary spontaneous pneumothorax. Int J Tuberc Lung Dis 2010; 14:1342-1346. [PMID: 20843428] [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: 05/29/2023] Open
Abstract
SETTING Few studies have evaluated the sclerosing efficacy of minocycline, and none have specifically compared its sclerosing efficacy and safety profiles with talc slurry in secondary spontaneous pneumothorax (SSP). DESIGN A retrospective analysis was conducted in patients with SSP who underwent chemical pleurodesis from January to December 2004 with minocycline or talc slurry in 12 public hospitals of Hong Kong. RESULT There were 121 episodes of minocycline pleurodesis and 64 episodes of talc slurry pleurodesis. Immediate procedural failure were similar in the minocycline and talc slurry groups (21.5% vs. 28.1%, P = 0.31). Presence of interstitial lung disease, ≥ 2 previous episodes of pneumothorax, requiring mechanical ventilation during pleurodesis and persistent air leak before pleurodesis were independently associated with procedural failure. Pain was experienced in respectively 44.6% and 37.5% of the minocycline and the talc slurry groups. Pain was more common in patients receiving high doses of talc (≥ 5 g; P = 0.03). Respiratory distress was found in respectively 1.7% and 1.6% of the minocycline and talc slurry groups. CONCLUSION Minocycline and talc slurry had comparable sclerosing efficacy in SSP, with immediate success rates of >70%. Pain was the most common adverse effect and respiratory distress was uncommon. Both appeared to be effective and safe for chemical pleurodesis in SSP.
Collapse
Affiliation(s)
- C K Ng
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR, China.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Chan JWM, Ko FWS, Ng CK, Yeung AWT, Yee WKS, So LKY, Lam B, Wong MML, Choo KL, Ho ASS, Tse PY, Fung SL, Lo CK, Yu WC. Management of patients admitted with pneumothorax: a multi-centre study of the practice and outcomes in Hong Kong. Hong Kong Med J 2009; 15:427-433. [PMID: 19966346] [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
OBJECTIVE To examine the management practice of pneumothorax in hospitalised patients in Hong Kong, especially the choice of drainage options and their success rates, as well as the factors associated with procedural failures. DESIGN Retrospective study. SETTING Multi-centre study involving 12 public hospitals in Hong Kong. PATIENTS All adult patients admitted as an emergency in the year 2004 with a discharge diagnosis of 'pneumothorax' were included. Data on the management and outcomes of the various types of pneumothoraces were collected from their case records. RESULTS Altogether these patients had 1091 episodes (476 primary spontaneous pneumothoraces, 483 secondary spontaneous pneumothoraces, 87 iatrogenic pneumothoraces, and 45 traumatic pneumothoraces). Conservative treatment was offered in 182 (17%) episodes, which were more common among patients with small primary spontaneous pneumothoraces (71%). Simple aspiration was performed to treat 122 (11%) of such episodes, and had a success rate of 15%. Aspiration failure was associated with having a pneumothorax of size 2 cm or larger (odds ratio=3.7; 95% confidence interval, 1.2-11.5; P=0.03) and a smoking history (4.1; 1.2-14.3; P=0.03). Intercostal tube drainage was employed in 890 (82%) episodes, with a success rate of 77%. Failure of intercostal tube drainage was associated with application of suction (odds ratio=4.1; 95% confidence interval, 2.8-5.9; P<0.001) and presence of any tube complications (1.55; 1.0-2.3; P=0.03). Small-bore catheters (<14 French) were used in 12 (1%) of the episodes only. Tube complications were encountered in 214 (24%) episodes. CONCLUSION Notwithstanding recommendations from international guidelines, simple aspiration and intercostal tube drainage with small-bore catheters were not commonly employed in the management of hospitalised patients with the various types of pneumothoraces in Hong Kong.
Collapse
|
23
|
Mak JCW, Ho SP, Yu WC, Choo KL, Chu CM, Yew WW, Lam WK, Chan-Yeung M. Polymorphisms and functional activity in superoxide dismutase and catalase genes in smokers with COPD. Eur Respir J 2007; 30:684-90. [PMID: 17567676 DOI: 10.1183/09031936.00015207] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Increased oxidative stress has been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). This study investigated the risk of COPD and the substitution of alanine 16 with valine (Ala16Val) polymorphism of manganese-superoxide dismutase (Mn-SOD) and the cytosine to thymidine transition of nucleotide -262 (-262C>T) polymorphism of the catalase gene, and the activity of erythrocyte SOD and catalase. The subjects were stable COPD patient ever smokers (n = 165) and healthy controls, matched for age and cigarette consumption. Genotyping of Mn-SOD at Ala16Val and the catalase gene at -262C>T was performed, and the functional activity of SOD and catalase in erythrocytes determined. There were no significant differences in the distribution of the different genotypes or allele frequencies between patients and controls for both the Mn-SOD and catalase genes. Among healthy controls or COPD patients, no differences were observed in erythrocyte SOD and catalase activity, irrespective of genotype. Significantly higher erythrocyte catalase activity was found in COPD patients than in healthy controls. The T/T catalase genotype and Ala/Ala Mn-SOD genotype were uncommon in the present Chinese population. The increase in erythrocyte catalase activity in Chinese patients with chronic obstructive pulmonary disease probably indicates dysfunction of the oxidant/antioxidant defence system, but it is unclear whether this increase is compensatory or a pathogenic factor.
Collapse
Affiliation(s)
- J C W Mak
- Division of Respiratory Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Jones AYM, Yu WC, Mok NS, Yeung OYY, Cheng HCW, Dean E. Exercise-induced desaturation and electrocardiogram changes in people with severe lung disease: An exploratory investigation of 25 serial cases. Heart Lung 2006; 35:397-404. [PMID: 17137941 DOI: 10.1016/j.hrtlng.2006.05.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2005] [Revised: 04/11/2006] [Accepted: 05/08/2006] [Indexed: 11/24/2022]
Abstract
BACKGROUND Arterial desaturation is a commonly accepted clinical basis for discontinuing physical activity in people with chronic obstructive pulmonary disease. OBJECTIVE The purpose of this exploratory study was to examine the electrocardiograms of people with severe chronic obstructive pulmonary disease recovering from exercise-induced arterial desaturation. SUBJECTS Subjects (n = 25) walked for 6 minutes while oxygen saturation was monitored. METHODS When the Spo2 decreased below 90%, subjects were asked to sit and rest while the electrocardiograms were recorded. For all patients, Spo2 decreased 11.6% on average below baseline during walking. Four patients developed dysrhythmias during desaturation, with a mean lowest Spo2 of 85%. The Spo2 in six other patients continued to decrease below 80% despite rest, yet these patients did not develop new dysrhythmias. CONCLUSIONS Our findings suggest that a decrease in Spo2 during exercise does not necessarily correlate with cardiac rhythm.
Collapse
Affiliation(s)
- Alice Y M Jones
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | | | | | | | | | | |
Collapse
|
25
|
Ng WF, Wong SF, Lam A, Mak YF, Yao H, Lee KC, Chow KM, Yu WC, Ho LC. The placentas of patients with severe acute respiratory syndrome: a pathophysiological evaluation. Pathology 2006; 38:210-8. [PMID: 16753741 PMCID: PMC7131423 DOI: 10.1080/00313020600696280] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aims The pathology of the placentas delivered from pregnant women who had severe acute respiratory syndrome (SARS) in Hong Kong was studied. Methods The pathology of the placentas was retrospectively studied in detail and compared with control sets. The clinical data of the women and neonates were also reviewed. Results A total of seven placentas were studied. The placentas from two women convalescent from SARS in the first trimester were normal. In three placentas delivered in the acute stage of SARS, there were increases in intervillous or subchorionic fibrin which might be related to disturbances in maternal placental blood flow due to the hypoxic respiratory disease. Extensive fetal thrombotic vasculopathy (FTV) with sharply demarcated zones of avascular fibrotic villi was noted in the placentas of two patients convalescent from SARS in the third trimester. Both pregnancies had intrauterine growth retardation, oligohydramnios and newborns small for gestation. The aetiology of the FTV might be related to thrombotic tendency due to SARS or placental hypoxia. Conclusions This report highlights placental pathology that was probably the result of pathophysiological alteration of the maternal fetal unit during SARS. Further studies are required to delineate the relationship between severe maternal respiratory disease, placental pathology and pregnancy outcome.
Collapse
Affiliation(s)
- W F Ng
- Department of Pathology, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Wang CR, Qiu JH, Zhao JP, Xu LM, Yu WC, Zhu XQ. Prevalence of helminthes in adult dogs in Heilongjiang Province, the People’s Republic of China. Parasitol Res 2006; 99:627-30. [PMID: 16715234 DOI: 10.1007/s00436-006-0219-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2006] [Accepted: 04/20/2006] [Indexed: 10/24/2022]
Abstract
The prevalence of helminthes in adult dogs was investigated in Heilongjiang Province, the People's Republic of China, between 1996 and 2004. A total of 178 adult farm dogs from representative geographical locations in Heilongjiang Province were killed and examined for the presence of helminthes using a helminthological approach. The worms were examined, counted, and identified to species according to existing keys and descriptions. A total of 17 species of helminthes were found to infect dogs, and they represented two phyla, three orders, 13 families, and 15 genera. All dogs were infected by more than one helminth species. Clonorchis sinensis (26.4%), Paragonimus westermani (7.9%), and Metagonimus yokogawai (6.2%) were the most common trematode species; Mesocestoides lineatus (20.2%), Taenia hydatigena (19.7%), and Dipylidium caninum (14.6%) were the most common cestodes species; and Ancylostoma caninum (66.3%), Toxocara canis (36.5%), and Trichinella nativa (21.9%) were the most common nematode species. The results of the present investigation provide relevant "base-line" data for assessing the effectiveness of future control strategies against helminth infection in dogs in Heilongjiang Province, China.
Collapse
Affiliation(s)
- C R Wang
- College of Animal Science and Technology, Heilongjiang August-First Land Reclamation University, Daqing, Heilongjiang Province 163319, People' Republic of China
| | | | | | | | | | | |
Collapse
|
27
|
Ip MSM, Ko FWS, Lau ACW, Yu WC, Tang KS, Choo K, Chan-Yeung MMW. Updated spirometric reference values for adult Chinese in Hong Kong and implications on clinical utilization. Chest 2006; 129:384-392. [PMID: 16478856 DOI: 10.1378/chest.129.2.384] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [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: 11/01/2022] Open
Abstract
STUDY OBJECTIVES The accuracy of reference values of lung function is important for assessment of severity and functional impairment of respiratory diseases. The aim of the study was to establish updated prediction formulae of spirometric parameters for Hong Kong Chinese and to compare the reference values with those derived from other studies in white and Chinese subjects. DESIGN Cross-sectional multicenter study. SETTING Lung function laboratories of eight regional hospitals in Hong Kong. PARTICIPANTS Subjects were recruited by random-digit dialing. One thousand one hundred seventy-six subjects who fulfilled recruitment criteria underwent spirometry. MEASUREMENTS Spirometry was performed according to American Thoracic Society recommendations, and the technique was standardized among the eight participating lung function laboratories. RESULTS Evaluable data of 1,089 (494 men and 595 women) healthy nonsmokers aged 18 to 80 years were analyzed. Age and height were found to be the major determinants of FEV1 and FVC, with a linear decline of height-adjusted values with age in both sexes. Spirometric values of this population have increased compared to Chinese populations of similar sex, age, and height two decades ago. Reference values derived from white populations were higher than our values by 5 to 19%, and the degree of overestimation varied with age, sex, and lung function parameter. We also demonstrated that the blanket application of correction factors for Asian populations may not be appropriate. In this study cohort, the distribution-free estimation of age-related centiles was more appropriate for the determination of lower limits of normal. CONCLUSIONS Our findings underscore the need to use reference values based on updated data derived from local populations or those matched for ethnicity and other sociodemographic characteristics.
Collapse
Affiliation(s)
- Mary Sau-Man Ip
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital.
| | - Fanny Wai-San Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital
| | | | - Wai-Cho Yu
- Department of Medicine, Princess Margaret Hospital
| | | | - Kahlin Choo
- Department of Medicine, Northern District Hospital, Hong Kong SAR, China
| | | |
Collapse
|
28
|
Lau ST, Yu WC, Mok NS, Tsui PT, Tong WL, Cheng S. Tachycardia amongst subjects recovering from severe acute respiratory syndrome (SARS). Int J Cardiol 2005; 100:167-9. [PMID: 15820302 PMCID: PMC7132412 DOI: 10.1016/j.ijcard.2004.06.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2004] [Accepted: 06/19/2004] [Indexed: 11/22/2022]
Abstract
SARS is a new infection in human. Patients recovering from SARS had palpitation in the form of sinus tachycardia. This study to identify the possible causes for the tachycardia excluded active disease, thyroid dysfunction, haematological, cardiac, autonomic and significant pulmonary defect at 2 months from onset of disease. The symptomatology was attributed to physical deconditioning and anxiety state. Physical and psychological fitness should be restored with rehabilitation.
Collapse
Affiliation(s)
- Suet-Ting Lau
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China
- Corresponding author. Tel.: +86 852 29903581; fax: +86 852 29903148.
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China
| | - Ngai-Shing Mok
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China
| | - Ping-Tim Tsui
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China
| | - Wing-Lok Tong
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China
| | - Stella,W.C. Cheng
- Occupational Therapy Department, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
| |
Collapse
|
29
|
Chan KCA, Tang NLS, Hui DSC, Chung GTY, Wu AKL, Chim SSC, Chiu RWK, Lee N, Choi KW, Sung YM, Chan PKS, Tong YK, Lai ST, Yu WC, Tsang O, Lo YMD. Absence of association between angiotensin converting enzyme polymorphism and development of adult respiratory distress syndrome in patients with severe acute respiratory syndrome: a case control study. BMC Infect Dis 2005; 5:26. [PMID: 15819995 PMCID: PMC1090578 DOI: 10.1186/1471-2334-5-26] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Accepted: 04/09/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been postulated that genetic predisposition may influence the susceptibility to SARS-coronavirus infection and disease outcomes. A recent study has suggested that the deletion allele (D allele) of the angiotensin converting enzyme (ACE) gene is associated with hypoxemia in SARS patients. Moreover, the ACE D allele has been shown to be more prevalent in patients suffering from adult respiratory distress syndrome (ARDS) in a previous study. Thus, we have investigated the association between ACE insertion/deletion (I/D) polymorphism and the progression to ARDS or requirement of intensive care in SARS patients. METHOD One hundred and forty genetically unrelated Chinese SARS patients and 326 healthy volunteers were recruited. The ACE I/D genotypes were determined by polymerase chain reaction and agarose gel electrophoresis. RESULTS There is no significant difference in the genotypic distributions and the allelic frequencies of the ACE I/D polymorphism between the SARS patients and the healthy control subjects. Moreover, there is also no evidence that ACE I/D polymorphism is associated with the progression to ARDS or the requirement of intensive care in the SARS patients. In multivariate logistic analysis, age is the only factor associated with the development of ARDS while age and male sex are independent factors associated with the requirement of intensive care. CONCLUSION The ACE I/D polymorphism is not directly related to increased susceptibility to SARS-coronavirus infection and is not associated with poor outcomes after SARS-coronavirus infection.
Collapse
Affiliation(s)
- KC Allen Chan
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Nelson LS Tang
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - David SC Hui
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Grace TY Chung
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Alan KL Wu
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Stephen SC Chim
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Rossa WK Chiu
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Nelson Lee
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - KW Choi
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - YM Sung
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Paul KS Chan
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - YK Tong
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - ST Lai
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - WC Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - Owen Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - YM Dennis Lo
- The Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| |
Collapse
|
30
|
Abstract
BACKGROUND Severe acute respiratory syndrome (SARS) is an emerging infectious disease and diarrhea has been reported in up to 76% of cases. The purpose of the present paper was to carry out a retrospective study of the clinical and demographic data of SARS patients with diarrhea in Princess Margaret Hospital. METHODS From 1 to 31 March 2003, hospital records from 240 patients with confirmed SARS were studied. Patients with watery stool of >/=3 times/day for at least 3 consecutive days were defined as the diarrhea group. Clinical and demographic data were compared between the diarrhea and non-diarrhea groups. Chest X-ray (CXR) scores during the peak of diarrhea period were recorded by a respiratory physician. These CXR scores were correlated with the peak frequency of diarrhea by Spearman's correlation coefficient. RESULTS Diarrhea occurred in 20.4% of patients after admission. Female patients were predominant with a female to male ratio of 6:1 (P < 0.001) and 69.4% of patients were living in Amoy Gardens Estate (P = 0.01). The proportions of patients requiring ventilatory care and mortality in the diarrhea group were 8.2% and 2%, respectively, which were significantly lower than those in the non-diarrhea group (27.6% and 16.2%, P < 0.005). The CXR scores during the peak of diarrhea were not correlated with the maximum frequency of diarrhea (r = -0.09, P = 0.5). CONCLUSIONS A total of 20.4% of SARS patients had the complication of diarrhea after hospital admission. Both female sex and being a resident of Amoy Gardens Estate were associated with diarrhea. The diarrhea group had a better prognosis.
Collapse
|
31
|
Abstract
BACKGROUND Severe acute respiratory syndrome (SARS) is an emerging infectious disease and diarrhea has been reported in up to 76% of cases. The purpose of the present paper was to carry out a retrospective study of the clinical and demographic data of SARS patients with diarrhea in Princess Margaret Hospital. METHODS From 1 to 31 March 2003, hospital records from 240 patients with confirmed SARS were studied. Patients with watery stool of >/=3 times/day for at least 3 consecutive days were defined as the diarrhea group. Clinical and demographic data were compared between the diarrhea and non-diarrhea groups. Chest X-ray (CXR) scores during the peak of diarrhea period were recorded by a respiratory physician. These CXR scores were correlated with the peak frequency of diarrhea by Spearman's correlation coefficient. RESULTS Diarrhea occurred in 20.4% of patients after admission. Female patients were predominant with a female to male ratio of 6:1 (P < 0.001) and 69.4% of patients were living in Amoy Gardens Estate (P = 0.01). The proportions of patients requiring ventilatory care and mortality in the diarrhea group were 8.2% and 2%, respectively, which were significantly lower than those in the non-diarrhea group (27.6% and 16.2%, P < 0.005). The CXR scores during the peak of diarrhea were not correlated with the maximum frequency of diarrhea (r = -0.09, P = 0.5). CONCLUSIONS A total of 20.4% of SARS patients had the complication of diarrhea after hospital admission. Both female sex and being a resident of Amoy Gardens Estate were associated with diarrhea. The diarrhea group had a better prognosis.
Collapse
|
32
|
|
33
|
Chan PKS, To WK, Ng KC, Lam RKY, Ng TK, Chan RCW, Wu A, Yu WC, Lee N, Hui DSC, Lai ST, Hon EKL, Li CK, Sung JJY, Tam JS. Laboratory diagnosis of SARS. Emerg Infect Dis 2004; 10:825-31. [PMID: 15200815 PMCID: PMC3323215 DOI: 10.3201/eid1005.030682] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The virologic test results of 415 patients with severe acute respiratory syndrome (SARS) were examined. The peak detection rate for SARS-associated coronavirus occurred at week 2 after illness onset for respiratory specimens, at weeks 2 to 3 for stool or rectal swab specimens, and at week 4 for urine specimens. The latest stool sample that was positive by reverse transcription–polymerase chain reaction (RT-PCR) was collected on day 75 while the patient was receiving intensive care. Tracheal aspirate and stool samples had a higher diagnostic yield (RT-PCR average positive rate for first 2 weeks: 66.7% and 56.5%, respectively). Pooled throat and nasal swabs, rectal swab, nasal swab, throat swab, and nasopharyngeal aspirate specimens provided a moderate yield (29.7%–40.0%), whereas throat washing and urine specimens showed a lower yield (17.3% and 4.5%). The collection procedures for stool and pooled nasal and throat swab specimens were the least likely to transmit infection, and the combination gave the highest yield for coronavirus detection by RT-PCR. Positive virologic test results in patient groups were associated with mechanical ventilation or death (p < 0.001), suggesting a correlation between viral load and disease severity.
Collapse
Affiliation(s)
- Paul K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, China.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Chau TN, Lee PO, Choi KW, Lee CM, Ma KF, Tsang TY, Tso YK, Chiu MC, Tong WL, Yu WC, Lai ST. Value of initial chest radiographs for predicting clinical outcomes in patients with severe acute respiratory syndrome. Am J Med 2004; 117:249-54. [PMID: 15308434 PMCID: PMC7093886 DOI: 10.1016/j.amjmed.2004.03.020] [Citation(s) in RCA: 26] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2003] [Revised: 03/15/2004] [Accepted: 03/15/2004] [Indexed: 02/04/2023]
Abstract
PURPOSE To determine whether the initial chest radiograph is helpful in predicting the clinical outcome of patients with severe acute respiratory syndrome (SARS). METHODS Of 343 patients who met the World Health Organization's case definition of probable SARS and who had been admitted to a regional hospital in Hong Kong, 201 patients had laboratory evidence of SARS coronavirus infection. The initial frontal chest radiographs of these 201 patients were assessed in a blinded fashion by 3 radiologists; individual findings were accepted if at least 2 of the radiologists concurred. Independent predictors of an adverse outcome, defined as the need for assisted ventilation, death, or both, were identified by multivariate analysis. RESULTS Bilateral disease and involvement of more than two zones on the initial chest radiograph were associated with a higher risk of liver impairment and poor clinical outcome. Forty-two patients (21%) developed an adverse outcome. Multivariate analysis showed that lung involvement of more than two zones (odds ratio [OR] = 7.0; 95% confidence interval [CI]: 2.7 to 17.9), older age (OR for each decade of life = 1.5; 95% CI: 1.1 to 2.0), and shortness of breath on admission (OR = 2.8; 95% CI: 1.1 to 7.4) were independent predictors of an adverse outcome. CONCLUSION Frontal chest radiographs on presentation may have prognostic value in patients with SARS.
Collapse
Affiliation(s)
- Tai-Nin Chau
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Hong Kong Special Administrative Region.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
On day 22 of illness, generalized tonic-clonic convulsion developed in a 32-year-old woman with severe acute respiratory syndrome (SARS). Cerebrospinal fluid tested positive for SARS coronavirus (SARS-CoV) by reverse transcriptase–polymerase chain reaction. SARS-CoV may have caused an infection in the central nervous system in this patient.
Collapse
Affiliation(s)
- Kwok-Kwong Lau
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong Special Administrative Region, China.
| | | | | | | | | | | |
Collapse
|
36
|
Wong ATY, Tsang OTY, Wong MYF, Lim WL, Zheng BJ, Lee SS, Lai ST, Yuen KY, Choi KW, Tso EYK, Chau TN, Tong WL, Chiu MC, Yu WC. Coronavirus infection in an AIDS patient. AIDS 2004; 18:829-30. [PMID: 15075525 DOI: 10.1097/00002030-200403260-00021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Chen ML, Yu WC, Lam CW, Au KM, Kong FY, Chan AYW. Diagnostic value of pleural fluid adenosine deaminase activity in tuberculous pleurisy. Clin Chim Acta 2004; 341:101-7. [PMID: 14967164 DOI: 10.1016/j.cccn.2003.11.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2003] [Revised: 11/17/2003] [Accepted: 11/18/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Diagnosis of tuberculous pleuritis is difficult because of its nonspecific clinical presentation and insufficient efficiency of traditional diagnostic methods. We investigated the use of adenosine deaminase (ADA) activity in tuberculous pleuritis diagnosis. METHODS We optimized a kinetic assay and retrospectively analysed 210 patients with exudative pleural effusions. Using the ROC curve, we determined the optimal cutoff for TB pleurisy. RESULTS One hundred forty-seven exudative samples were nontuberculous (non-TB) and 63 were tuberculous (TB). There was statistically significant difference (p<0.0001) between the means of pleural fluid ADA levels among the TB and non-TB populations. The disease prevalence of TB pleurisy in the studied population was 30%. The cutoff value for diagnosing TB effusions was >55.8 U/L, with a sensitivity of 87.3% (95% CI: 76.5-94.3%) and specificity of 91.8% (95% CI: 86.2-95.7%). The positive predictive value (PPV) was 82.1% and the negative predictive value (NPV) was 94.4%. A pleural fluid ADA value <16.81 IU/L suggests that a tuberculous effusion is highly unlikely (100% sensitive with 100% NPV and 0% negative likelihood ratio for a pleural fluid ADA level>/=16.81 U/L). In addition, the area under the ROC curve was 0.933 (S.E.=0.0230, 95% CI: 0.890-0.963). CONCLUSION Pleural fluid total ADA assay is a sensitive and specific test suitable for rapid diagnosis of TB pleurisy.
Collapse
Affiliation(s)
- Mo-Lung Chen
- Department of Pathology, Princess Margaret Hospital, Lai King Hill Road, Hong Kong, China.
| | | | | | | | | | | |
Collapse
|
38
|
Peiris JSM, Yu WC, Leung CW, Cheung CY, Ng WF, Nicholls JM, Ng TK, Chan KH, Lai ST, Lim WL, Yuen KY, Guan Y. Re-emergence of fatal human influenza A subtype H5N1 disease. Lancet 2004; 363:617-9. [PMID: 14987888 PMCID: PMC7112424 DOI: 10.1016/s0140-6736(04)15595-5] [Citation(s) in RCA: 589] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Human disease associated with influenza A subtype H5N1 re-emerged in January, 2003, for the first time since an outbreak in Hong Kong in 1997. Patients with H5N1 disease had unusually high serum concentrations of chemokines (eg, interferon induced protein-10 [IP-10] and monokine induced by interferon gamma [MIG]). Taken together with a previous report that H5N1 influenza viruses induce large amounts of proinflammatory cytokines from macrophage cultures in vitro, our findings suggest that cytokine dysfunction contributes to the pathogenesis of H5N1 disease. Development of vaccines against influenza A (H5N1) virus should be made a priority.
Collapse
Affiliation(s)
- J S M Peiris
- Department of Microbiology and Pathology, University of Hong Kong and Queen Mary Hospital, Pokfulam, Hong Kong SAR, People's Republic of China.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Tsang OTY, Chau TN, Choi KW, Tso EYK, Lim W, Chiu MC, Tong WL, Lee PO, Lam BHS, Ng TK, Lai JY, Yu WC, Lai ST. Coronavirus-positive nasopharyngeal aspirate as predictor for severe acute respiratory syndrome mortality. Emerg Infect Dis 2004; 9:1381-7. [PMID: 14718079 PMCID: PMC3035547 DOI: 10.3201/eid0911.030400] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Severe acute respiratory syndrome (SARS) has caused a major epidemic worldwide. A novel coronavirus is deemed to be the causative agent. Early diagnosis can be made with reverse transcriptase-polymerase chain reaction (RT-PCR) of nasopharyngeal aspirate samples. We compared symptoms of 156 SARS-positive and 62 SARS-negative patients in Hong Kong; SARS was confirmed by RT-PCR. The RT-PCR-positive patients had significantly more shortness of breath, a lower lymphocyte count, and a lower lactate dehydrogenase level; they were also more likely to have bilateral and multifocal chest radiograph involvement, to be admitted to intensive care, to need mechanical ventilation, and to have higher mortality rates. By multivariate analysis, positive RT-PCR on nasopharyngeal aspirate samples was an independent predictor of death within 30 days.
Collapse
|
40
|
Abstract
Home mechanical ventilation (HMV) is increasingly used to treat chronic respiratory failure. This present study was aimed to examine the trend, the disease categories treated and the outcomes of HMV use in Hong Kong. In the year 2002, all adult respiratory units in Hong Kong were invited to report to a multicentre retrospective survey of HMV use. A total of 249 patients (156 males, mean age 62.7 +/- 13.8 yrs) were treated since 1980, with 197 (79%) continuing with HMV at the time of the survey. Cumulative number of HMV grew as a cubic function of time since 1980. Currently, there are 2.9 users per 100,000 population. The predominant mode of HMV was noninvasive ventilation by bilevel pressure support ventilators (n=236). Chronic obstructive pulmonary disease accounted for 48.6% of all cases. The overall 3-yr HMV continuation rate was 66.2%. Death was the main reason for discontinuation. A rapidly rising trend of home mechanical ventilation use is observed in Hong Kong. In contrast to other series, chronic obstructive pulmonary disease was the major group treated and bilevel pressure support ventilation was the predominant mode chosen. Most patients tolerate home mechanical ventilation reasonably well, with approximately two-thirds continuing with its use at 36 months.
Collapse
Affiliation(s)
- C M Chu
- Division of Respiratory Medicine, Dept of Medicine, United Christian Hospital, Hong Kong SAR, China.
| | | | | | | | | | | |
Collapse
|
41
|
Tsang OTY, Chau TN, Choi KW, Tso EYK, Lim W, Chiu MC, Tong WL, Lee PO, Lam BHS, Ng TK, Lai JY, Yu WC, Lai ST. Severe acute respiratory syndrome: Relapse? Hospital infection? Emerg Infect Dis 2003; 9:1180-1. [PMID: 14531379 PMCID: PMC3016786 DOI: 10.3201/eid0909.030395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
42
|
Abstract
OBJECTIVE To describe the outbreak of severe acute respiratory syndrome in Hong Kong. DESIGN Descriptive case series. SETTING Hong Kong, Special Administrative Region, China RESULTS The outbreak started with a visitor from southern China on 21 February. At the hospitals where the first cases were treated the disease spread quickly among healthcare workers, and then out into the community as family members became infected. By 1 April, 685 cases had been reported with 16 deaths. Symptoms include high fever and one or more respiratory symptoms (including cough, shortness of breath, and difficulty breathing). Changes in lung tissue suggest that part of the lung damage is due to cytokines induced by the microbial agent, which has led to empirical treatment with corticosteroids, broad spectrum antiviral agent, and antibacterial cover. There is strong evidence that a novel coronavirus is the pathogen. Precautions for droplet infection should be instituted, including the wearing of masks and rigorous disinfection and hygiene procedures. On 27 March the Department of Health announced drastic measures, including vigorous contact tracing and examination, quarantine of contacts in their homes, and closure of all schools and universities. CONCLUSION The rapidity of the spread of the disease and the morbidity indicate that the agent responsible is highly infectious and virulent. Strict infection control measures for droplet and contact transmission by healthcare workers, a vigilant healthcare profession, and public education are essential for disease prevention.
Collapse
Affiliation(s)
- Moira Chan-Yeung
- Division of Respiratory and Critical Care Medicine, 4/F, Professorial Block, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China.
| | | |
Collapse
|
43
|
Lee PC, Chen SA, Chiang CE, Tai CT, Yu WC, Hwang B. Clinical and electrophysiological characteristics in children with atrioventricular nodal reentrant tachycardia. Pediatr Cardiol 2003; 24:6-9. [PMID: 12574975 DOI: 10.1007/s00246-002-0145-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 10/27/2022]
Abstract
Atrioventricular (AV) nodal reentrant tachycardia is one of the most common supraventricular tachycardias in childhood. However, information about AV nodal reentrant tachycardia in childhood is limited, especially about the variant and multiple forms. The purpose of this retrospective study was to investigate the clinical and electrophysiological characteristics in pediatric patients with AV nodal reentrant tachycardia. Forty-eight pediatric patients with AV nodal reentrant tachycardia were included (ages 11-18 years; 25 males and 23 females). The age of onset and duration of symptoms were significantly younger and shorter in pediatric patients, respectively. A higher incidence of antegrade dual AV nodal pathways was found in adult patients than pediatric patients (72.9 vs 52.1% p = 0.003). Both antegrade and retrograde slow pathway functions were better in pediatric than adult patients. There was no significant difference between children and adults in the occurrence of variant and multiple forms of AV nodal reentrant tachycardia. This study demonstrated that pediatric patients have different electrophysiologic characteristics from those of adult patients.
Collapse
Affiliation(s)
- P C Lee
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
44
|
Chang KC, Mak YF, Yu WC, Lau KK, Yan WW, Chow TC. Respiratory insufficiency in a Chinese adult with mitochondrial myopathy. Hong Kong Med J 2002; 8:137-40. [PMID: 11937669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Mitochondrial myopathy is an important but uncommon cause of respiratory insufficiency in adults. We report the first case of respiratory insufficiency associated with adult-onset mitochondrial myopathy seen in a Chinese adult in Hong Kong. The patient presented with peripheral oedema and shortness of breath over 2 to 3 days. There was a history of gradual progressive limb weakness over approximately 2 years, hypertrophic cardiomyopathy, intermittent diarrhoea, and weight loss. The diagnosis was made by skeletal muscle biopsy and molecular study, which revealed the A3243G point mutation.
Collapse
Affiliation(s)
- K C Chang
- Yaumatei Chest Clinic, Yaumatei Jockey Club Polyclinic, 145 Battery Street, Kowloon, Hong Kong
| | | | | | | | | | | |
Collapse
|
45
|
Tsao HM, Wu MH, Yu WC, Tai CT, Lin YK, Hsieh MH, Ding YA, Chang MS, Chen SA. Role of right middle pulmonary vein in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 2001; 12:1353-7. [PMID: 11797991 DOI: 10.1046/j.1540-8167.2001.01353.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [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: 11/20/2022]
Abstract
INTRODUCTION Elimination of the ectopic foci from pulmonary veins (PVs) has proved to be a curative therapy for focal atrial fibrillation (AF). However, information about the importance of the right middle PV (RMPV) in initiation of AF and radiofrequency ablation of AF is limited. METHOD AND RESULTS Forty-three patients (34 men and 9 women; age 65+/-12 years) with drug-refractory paroxysmal AF underwent electrophysiologic study and catheter ablation for treatment of AF. Three-dimensional magnetic resonance angiography (MRA) of the PVs and left atrium (LA) was performed to determine the anatomic patterns of RMPV. Diameter of PV ostium was measured at the junction of the LA and each PV. MRA findings showed the following: (1) 36 (84%) of 43 patients had a discrete RMPV; (2) there are three drainage patterns of RMPV, including joining the proximal part (<1 cm from the ostium) of the right superior PV (RSPV), joining the right inferior PV (RIPV), and a separate RMPV ostium in the LA wall; and (3) the ostial diameter of RMPV was significantly smaller than RSPV and RIPV (P < 0.01). Electrophysiologic studies demonstrated that five AF foci arose from RMPV. The coupling interval between the ectopic beat of AF and sinus beat was longer in RMPV than RSPV (262+/-45 msec vs 212+/-47 msec; P = 0.043). All AFs from RMPV were ablated successfully. PV stenosis or AF recurrence from RMPV was not found during follow-up of 10+/-4 months. CONCLUSION RMPV was detected by MRA in >80% of paroxysmal AF patients. Ectopy from RMPV can initiate AF, and radiofrequency ablation of RMPV foci is feasible and safe.
Collapse
Affiliation(s)
- H M Tsao
- Department of Medicine, National Yang-Ming University, School of Medicine, Taiwan, Republic of China
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Kuo JY, Tai CT, Chiang CE, Yu WC, Chen YJ, Tsai CF, Hsieh MH, Chen CC, Lin WS, Lin YK, Tsao HM, Ding YA, Chang MS, Chen SA. Mechanisms of transition between double paroxysmal supraventricular tachycardias. J Cardiovasc Electrophysiol 2001; 12:1339-45. [PMID: 11797988 DOI: 10.1046/j.1540-8167.2001.01339.x] [Citation(s) in RCA: 31] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Coexistence of double tachycardias in one patient has been infrequently reported. Furthermore, the mechanisms of transition between double paroxysmal supraventricular tachycardias have not been well studied. METHODS AND RESULTS Thirty-five patients with two paroxysmal supraventricular tachycardias were studied. Group IA consisted of 3 patients with spontaneous transition between AV reciprocating tachycardia (AVRT) and AV nodal reentrant tachycardia (AVNRT). Group IB consisted of 13 patients without spontaneous transition between AVRT and AVNRT. Group IIA consisted of 5 patients with spontaneous transition between AVNRT and atrial tachycardia (AT). Group IIB consisted of 14 patients without spontaneous transition between AVNRT and AT. The absolute values of differences between the two tachycardia cycle lengths were significantly smaller in patients with than in those without transition between the two tachycardias (25+/-8 msec vs 90+/-46 msec, P < 0.05, IA vs IB; 21+/-25 msec vs 99+/-57 msec, P < 0.01, IIA vs IIB). The cutoff point of 25 msec had 80% positive predictive value for transition between the two tachycardias. Transition between two tachycardias occurred due to a spontaneous premature atrial complex (30%), conduction block at one limb of tachycardia (20%), or tachycardia-induced tachycardia (50%). Absence of transition between two tachycardias might be explained by the absence of a spontaneous premature atrial complex, longer cycle length of the first tachycardia, larger difference between two tachycardia cycle lengths, or induction of each tachycardia under different situations. CONCLUSION Double supraventricular tachycardias with similar tachycardia cycle lengths are vulnerable to transition between different tachycardias.
Collapse
Affiliation(s)
- J Y Kuo
- Department of Medicine, National Yang-Ming University, School of Medicine, and Veterans General Hospital-Taipei, Taiwan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
|
48
|
Tai CT, Tsai CF, Hsieh MH, Lin WS, Lin YK, Lee SH, Yu WC, Ding YA, Chang MS, Chen SA. Effects of cavotricuspid isthmus ablation on atrioventricular node electrophysiology in patients with typical atrial flutter. Circulation 2001; 104:1501-5. [PMID: 11571243 DOI: 10.1161/hc3801.078813] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/16/2022]
Abstract
BACKGROUND The atrial musculature in the cavotricuspid isthmus is a part of posterior inputs to the AV node. In patients with typical atrial flutter, effects of radiofrequency ablation of this isthmus on AV node conduction are still unknown. METHODS AND RESULTS This study included 16 patients with clinically documented typical atrial flutter. Group 1 had 8 patients without and group 2 had 8 patients with dual AV nodal pathway physiology. Electrical pacing from the interatrial septum and low right atrium was performed to evaluate antegrade AV node function before and after ablation of the cavotricuspid isthmus. In group 1, the AV node conduction properties were similar before and after ablation. In group 2, the AV node Wenckebach cycle length and maximal AH interval during low right atrium (356+/-58 versus 399+/-49 ms, P=0.008; 303+/-57 versus 376+/-50 ms, P=0.008) and interatrial septum (365+/-62 versus 393+/-59 ms, P=0.008; 324+/-52 versus 390+/-60 ms, P=0.008) pacing were significantly longer after ablation. Elimination of the slow pathway after ablation was noted in 2 patients, including 1 with AV nodal reentrant echo beats. CONCLUSIONS Radiofrequency ablation of the cavotricuspid isthmus was effective in eliminating typical atrial flutter without injury of antegrade fast AV node conduction. The atrial musculature in the cavotricuspid isthmus significantly contributed to the slow AV node conduction.
Collapse
Affiliation(s)
- C T Tai
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, and Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Hu CC, Chen WK, Liao PH, Yu WC, Lee YJ. Synergistic effect of cadmium chloride and acetaldehyde on cytotoxicity and its prevention by quercetin and glycyrrhizin. Mutat Res 2001; 496:117-27. [PMID: 11551487 DOI: 10.1016/s1383-5718(01)00214-5] [Citation(s) in RCA: 23] [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] [Indexed: 11/30/2022]
Abstract
Cadmium chloride at concentrations of 10-50mM and acetaldehyde (AA) at 1-5mM showed synergistic toxic effects on V79 cells in vitro. Furthermore, synergistic effects of these chemicals were also observed in mutagenicities of the Hprt gene within certain dose ranges (cadmium chloride 5-10mM, and AA 1-2.5mM). Moreover, lipid peroxide formation, malondialdehyde (MDA) formation, detected by 2-thiobarbituric acid (TBA) reaction and the mitochondrial membrane potentials detected by rhodamine 123 uptake were significantly increased with the combined effect of cadmium and AA in V79. Thus, the cytotoxicity and genotoxicity displayed by combination of these chemicals can be considered to be associated with oxidative stress. Further, these effects were efficiently reduced by quercetin and less efficiently with glycyrrhizin.
Collapse
Affiliation(s)
- C C Hu
- Institute of Biochemistry, Chung Shan Medical and Dental College, Taichung, Taiwan, ROC
| | | | | | | | | |
Collapse
|
50
|
Affiliation(s)
- J Y Kuo
- Division of Cardiology, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | | | | | | | | |
Collapse
|