Search PubMed⌕ Search

Biomedical subjects

H K Ma

Publications and source records attributed to H K Ma.

At least 109 records · Page 6Linked to original sources
PubMed1986

Cervical intraepithelial neoplasia treated by perilesional injection of interferon.

Twelve patients with cervical intraepithelial neoplasia (CIN) were studied by colposcopy and cervical smears to elucidate the local response to interferon alpha and beta given by perilesional injections and to assess long-term disease remission. In all patients, local inflammatory response was seen and persisted throughout the treatment period. Selective toxic effect was evident by exfoliation of increasing proportion of degenerate to viable dyskaryotic cells, while the normal epithelial cells appeared unaffected, and by the progressive regression of the lesion. Interferon alpha induced complete remission in six of seven (85.7%) patients but three had recurrence 12 to 24 months later, while interferon beta induced complete remission in only two of five (40%) patients.

Colposcopy↗
PubMed1985

Return of ovulation after evacuation of hydatidiform moles.

Plasma levels of progesterone, 17 beta-estradiol and prolactin and serum levels of the beta-subunit of human chorionic gonadotropin were measured by radioimmunoassay before evacuation and then weekly after evacuation in 52 patients with complete moles and 15 patients with partial moles. The first menstrual cycle was ovulatory in 20 patients (29.9%) and anovulatory in 36 patients (53.7%). In 11 patients (16.4%) it was uncertain whether they ovulated in the first cycle. There was no difference in the ovulation rate between patients with complete moles and those with partial moles. The ovulation rate in patients with theca-lutein cysts was lower than that in patients without theca-lutein cysts. The preevacuation serum level of the beta-subunit of human chorionic gonadotropin in patients who ovulated in the first cycle was significantly lower than that in patients who did not ovulate, but there was no significant difference in the other hormones. By the sixth week, 12 patients already had the first ovulatory menstrual period and 40% of patients ovulated when the serum level of the beta-subunit of human chorionic gonadotropin was still above 10 mlU/ml. It is recommended that an effective method of contraception be instituted immediately after evacuation of hydatidiform moles.

Abortion, Therapeutic↗
PubMed1985

Ovarian dysfunction in patients with gestational trophoblastic neoplasia treated with short intensive courses of etoposide (VP-16-213).

The effect of oral Etoposide (VP-16-213) on the ovarian function in 22 patients with residual gestational trophoblastic disease was studied by serial weekly measurement of serum follicle stimulating hormone (FSH), 17 beta-estradiol (E2), progesterone (P) and prolactin (PRL), and monitoring of the menstrual patterns during and after drug treatment. Multiple courses of VP-16-213 at a dosage of 200 mg/m2 X 5 days were given 1 week apart. Following an average dose of 5.0 gm, five young patients developed transient ovarian failure for a mean period of 2.4 months and two elderly patients developed permanent ovarian failure (total incidence, 7/22, 31.8%) as evidenced by hypergonadotropic, hypoestrogenic amenorrhea. In addition, two patients each developed anovulatory cycles and hypomenorrhea. VP-16-213 should therefore be regarded a potent gonadotoxic drug and these hitherto unreported side effects should be recognized when the drug is used in menstruating females.

Adult↗
PubMed1985

Methotrexate with citrovorum factor rescue in gestational trophoblastic disease.

Thirty-three patients with gestational trophoblastic disease treated with methotrexate alone and 68 similar patients treated with methotrexate and citrovorum factor rescue were analyzed. Both groups showed a comparable sustained biochemical remission rate. The group treated with methotrexate and citrovorum factor however showed a shorter interval to induction of remission (p less than 0.05). Contrary to previous reports, the methotrexate and citrovorum factor regimen failed to protect the patients against the development of hepatic toxicity, the incidence of hepatic toxicity being significantly higher in the group treated with methotrexate and citrovorum factor.

Adult↗
PubMed1985

Pregnancy in patients with mitral valve prolapse.

The obstetrical performances and outcomes of 37 pregnancies in women with mitral valve prolapse between 1979 and 1982 are reviewed. Thirteen patients were diagnosed before pregnancy and 24 patients were detected at antenatal examinations. Three ended in cesarean sections for obstetrical complications and 34 in uneventful vaginal deliveries at term. No cardiac complications occurred in these patients. There was no maternal mortality. Thirty-six babies were born without congenital abnormalities. One baby was hydropic due to haemoglobinopathy and died. Prophylactic antibiotics is recommended in selected cases. Early detection and treatment of cardiac arrhythmias is mandatory.

Adult↗
PubMed1985

Cross-sectional study of semen parameters in a large group of normal Chinese men.

Testicular size, semen characteristics and serum reproductive hormone levels were studied in 1239 normal Chinese men. The mean testicular size of 17 ml in this group of subjects was similar to other reports in Orientals but was smaller than that reported in Caucasians. Semen volume, and the sperm count, motility and morphology were comparable to those described for Caucasian subjects. The cervical mucus penetration test (Kremer's test) and the zona-free hamster egg penetration test were also studied in some of the subjects. Age showed a positive correlation with the serum levels of FSH and LH, which were highly correlated with each other. Sperm concentration and the total sperm count were positively correlated with testicular volume, the length of abstinence, the % of sperm with an oval head, and the zona-free hamster egg penetration test, but were negatively correlated with serum FSH. Sperm motility was negatively correlated with the duration of abstinence but was positively correlated with the % normal sperm. The results constitute a normal data base from Chinese men for comparison with studies in male infertility and fertility regulation.

Adult↗
PubMed1985

Homozygous alpha-thalassaemia: clinical presentation, diagnosis and management. A review of 46 cases.

Forty-six hydropic infants with homozygous alpha-thalassaemia born during a period of 10 years have been reviewed. The incidence was 1:1550 total births, and accounted for 81% of all non-immune hydrops. The male to female ratio was 1:1.4. There was increased incidence of anaemia, pregnancy induced hypertension, antepartum haemorrhage, malpresentation, prematurity, fetal distress, difficult vaginal delivery, caesarean section, retained placenta, postpartum haemorrhage and congenital abnormalities. Antenatal diagnosis by DNA hybridization with subsequent abortion of the affected fetuses is the best method to decrease maternal morbidity and to reduce the incidence of hydrops fetalis in couples at risk. For those with no previous history, but with early onset hypertension and/or polyhydramnios, sonography is useful in making an earlier diagnosis, and in reducing avoidable morbidity, because DNA analysis can be done before caesarean section and aggressive neonatal management is instituted.

Adolescent↗
PubMed1985

Factor VIII related antigen in gestational trophoblastic disease.

Serum factor VIII related antigen (factor VIII R:Ag) levels were determined in 34 patients with hydatidiform mole at diagnosis and at 2, 4 and 6 weeks after evacuation of uterus and in 272 normal pregnant women. Serum factor VIII R:Ag levels in molar pregnancies before evacuation of the uterus were significantly higher than those in normal pregnancies of the same gestation age. Serum factor VIII R:Ag levels in the group of patients with residual trophoblastic disease were significantly higher than those in the group without residual trophoblastic disease before evacuation and at 6 weeks after evacuation of uterus, but there is considerable overlap in the levels of factor VIII R:Ag between the two groups of patients especially before evacuation of uterus. Factor VIII R:Ag level does not appear to be an useful marker in predicting the outcome of hydatidiform mole.

Antigens↗
PubMed1985

Sonographic patterns of pelvic and hepatic lesions in persistent trophoblastic disease.

The sonographic findings of the pelvic lesions in persistent trophoblastic disease were evaluated prospectively in 57 patients. The appearance ranged from minimal lesions in the myometrium to complex lesions extending into the parametrium. A grading system was devised based upon the extent of the disease in the pelvis. The different grades correlated well with the plasma human chorionic gonadotrophin level at the time of the ultrasound examination. Findings of the hepatic lesions were evaluated in 69 patients managed during the same period. Thirteen were diagnosed to have metastatic disease on hepatic arteriography, of which 11 were correctly diagnosed by ultrasonography. The sensitivity and specificity of sonography in detecting metastasis in the liver from trophoblastic disease were 86.7 and 91.8 per cent, respectively. Two sonographic patterns were observed: a) the discrete hyperechoic lesions in three patients and b) the diffuse hyperechoic lesions in eight patients. In addition, ultrasonography could depict the size and internal structure of the pelvic and hepatic lesions much better than arteriography. Therefore, it is concluded that sonography is a very useful tool in the assessment of these lesions in persistent trophoblastic disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Postmenopausal uterine bleeding of nonorganic cause.

Eighty-nine patients with postmenopausal uterine bleeding were studied focusing on the nonorganic causes of bleeding. Atrophic endometrium was found in 82%, proliferative endometrium in 7%, and secretory endometrium in 1% of patients. Carcinoma was uncommon, found in only 7% of patients. Hysteroscopy was an invaluable adjunct to dilatation and curettage in diagnosing bleeding due to atrophic endometrium as 42% of such cases yielded no tissue on curettage. The clinical entity of bleeding atrophic endometrium is discussed.

Aged↗
PubMed1985

Concurrent radiochemotherapy in the treatment of gynaecologic neoplasms.

Chemotherapy with adriamycin and/or cisplatinum in standard dosages concurrent with full radiation produced an accelerated local-regional tumour control leading to complete response in 12 of 14 patients who had advanced primary or recurrent gynaecologic neoplasms. The continuation of chemotherapy thereafter did not however prevent the development nor arrest progression of metastases outside the irradiated field. Epidermitis and myelosupression were the enhanced side effects but were tolerable and manageable. Radiochemotherapy can be applicable in situations where rapid shrinkage of the tumour bulk is required. Its other useful potentials deserve further evaluation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Combined treatment in adenocarcinoma of cervix.

From January 1976 - end of 1979, 427 patients with cervical cancer were treated in the Department of Gynaecology, University of Hong Kong. Twenty-seven (6%) had primary adenocarcinoma of cervix. Eighteen patients with stage I and early stage II were treated by preoperative irradiation and Wertheim hysterectomy. Serial cervical biopsies were taken to assess the response to radiotherapy. All the cervical biopsies as well as the surgical specimens were read by the same pathologist. 83% showed residual dividing tumour cells in the surgical specimens. One hundred and forty-five patients with early squamous cervical cancer were similarly treated during the same period; only 13% had residual tumour in the specimens (chi square test p is less than 0.001). All the patients are being followed up regularly. Fifteen patients with early cervical adenocarcinoma are free from disease. The shortest period of follow-up is 5 1/4 years.

Adenocarcinoma↗
PubMed1984

Use of oral VP16-213 as primary chemotherapeutic agent in treatment of gestational trophoblastic disease.

Thirty-seven patients with persistent or metastatic gestational trophoblastic disease were treated with oral etoposide (VP16-213). All responded well and achieved permanent remission. The hematologic toxicity was mild. Alopecia was present in all patients. Etoposide is an effective drug against trophoblastic disease. In patients who have received chemotherapy for long periods oral etoposide would eliminate the problem of venous access.

Administration, Oral↗
PubMed1984

Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study.

Newborn infants of Chinese HBeAg-carrier mothers in Hong Kong were randomly assigned to one of four study groups. Group I was treated with 3 micrograms heat-inactivated hepatitis B (HB) vaccine at birth and at 1, 2, and 6 months thereafter, in conjunction with seven monthly HBIg injections; group II was treated according to the same vaccine schedule but received only one HBIg injection at birth; group III received only the vaccine, at months 0, 1, 2, and 6; and group IV received placebos for both vaccine and HBIg. The first set of injections was given within 1 h after birth. Comparisons were made in the 140 children who were at least six months old at the close of the trial (495 days). In all three treatment groups development of the persistent carrier state was significantly (p less than or equal to 0.0001) less frequent than in controls (2.9%, 6.8%, and 21.0% versus 73.2%). Although vaccination alone was significantly less protective than vaccination plus multiple HBIg injections (p = 0.03), the degree of protection was still remarkable. 12 months after the first set of injections 96-100% of the infants in the three treatment groups were anti-HBs positive; the geometric mean titres of anti-HBs in the three groups did not differ significantly. This indicates that even high doses of HBIg do not interfere with the anti-HBs response to the vaccine. Probable intra-uterine HB infections were observed in 3 infants. No serious side-effects were observed from the interventions, even in the babies with intra-uterine infections who had received HBIg and HB-vaccine at birth. To prevent development of the persistent HBsAg carrier state, and thereby the consequent chronic liver disease and/or primary carcinoma of the liver, HB vaccine and HBIg should be administered as soon as possible after birth to all newborn infants at risk of perinatal hepatitis B infection.

Carrier State↗
PubMed1984

The syndrome of partial mole.

One hundred and six patients with complete mole and 35 patients with partial mole were analysed. The clinical behaviour of complete mole was more florid. The clinical diagnosis of partial mole was more difficult. 20.7% of the complete mole patients and 11.4% of the partial mole patients required chemotherapy because of persistent or metastatic trophoblastic disease. The response to chemotherapy was more favourable in the partial moles. All patients with either partial or complete mole needed hCG assay monitor because of the risk of malignant sequelae.

Adolescent↗