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Biomedical subjects

K K Pun

Publications and source records attributed to K K Pun.

At least 37 records · Page 2Linked to original sources
PubMed1990

Vitamin D status among patients with fractured neck of femur in Hong Kong.

Vitamin D deficiency leads to secondary hyperparathyroidism initially and then to mild osteomalacia, both of which conditions may be aymptomatic and may predispose to bone fracture. To assess the importance of vitamin D deficiency in predisposing to fractured neck of femur, we studied the vitamin D status, dietary intake and socio-economic characteristics in 69 patients with fractured neck of femur (group A), 28 normal subjects with age above 60 (group B), and 101 normal volunteers (group C). Patients with fractured neck of femor had significantly lower levels of serum 25-hydroxy-cholecalciferol compared with subjects of groups B and C. There is no statistically significant difference in other biochemical parameters, including calcium, phosphate, and alkaline phosphatase. Patients with fractured neck of femur and with 25-hydroxycholecalciferol below 20 ng/mL were characterized by a home-bound and/or institutionalized life-style, smaller living place, and limited access to open space. To conclude, hypovitaminosis D is a common problem among elderly patients with fractured neck of femur in Hong Kong. The fact that such vitamin D deficiency is associated with muscle weakness may contribute to falls, and thus indirectly account for an increased rate of hip fractures over the normal control.

Aged↗
PubMed1990

25-Hydroxycholecalciferol and insulin-like growth factor I are determinants of serum concentration of osteocalcin in elderly subjects with and without spinal fractures.

Osteocalcin is one of the major proteins in the osseous matrix. To evaluate the determinants and thus the physiological control of osteocalcin production in normal and osteoporotic subjects, the serum levels of osteocalcin, 25-hydroxycholecalciferol (25-OH-D3), and insulin-like growth factor I (IGFI) were measured by radioimmunoassay in 44 subjects over 60 years old. Circulating osteocalcin, 25-OH-D3, and IGFI were 0.28 +/- 0.10 nmol/L (1.65 +/- 0.96 ng/mL), 70.5 +/- 25.1 nmol/L (28.3 +/- 10.1 ng/mL), and 23.8 +/- 12.0 nmol/L in 27 healthy controls respectively, as compared with 0.09 +/- 0.09 nmol/L (0.52 +/- 0.52 ng/mL), 48.2 +/- 19.9 nmol/L (19.35 +/- 7.91 ng/mL), and 16.56 +/- 6.96 nmol/L in 17 patients with spinal fractures. Significant correlation was found between osteocalcin and 25-OH-D3 level, as well as between osteocalcin and IGFI. The results show that IGFI and 25-OH-D3 are important determinants for serum concentration of osteocalcin in elderly subjects with and without spinal fractures.

Aged↗
PubMed1990

Discriminant factors affecting early outcome of radioiodine treatment for Graves' disease.

Pretreatment clinical, biochemical, iodine-131 (131I) scan and tracer-kinetic parameters were studied in 827 Chinese patients with Graves' disease treated with radioactive iodine. One year after 131I therapy, 56.7% were euthyroid, 33.9% were still thyrotoxic and 9.4% were hypothyroid. Discriminant analysis of all pretreatment variables identified thyroid mass, presenting free thyroxine index and 4 h 131I uptake as the three variables most helpful in discriminating the early outcome group of 131I therapy. The findings suggest that patients with large goitres and severe disease may require higher doses of 131I for treatment of Graves' disease.

Adult↗
PubMed1990

Effects of aluminum on the parathyroid hormone receptors of bone and kidney.

Aluminum intoxication is associated with low osseous remodeling rate and peripheral resistance to parathyroid hormone (PTH). The pathophysiological mechanism of these aluminum induced changes was investigated using cultured clonal osteoblastic UMR-106 cells as well as dog renal cortical membrane. Both systems possess high-affinity PTH receptors that are coupled to adenylate cyclase. The UMR-106 cells have typical osteoblastic features, including receptors for the tissue-specific hormones, formation and mineralization of a bone-like ground substance and exclusive synthesis of type 1 collagen. The results show that aluminum at a concentration of 4 microM and 40 microM significantly inhibits the cyclic AMP responses to PTH challenge in UMR-106 cells, and this is associated with significant decrease in the binding to the PTH receptor. At 200 microM, no PTH-responsive adenylate cyclase or binding to receptor can be demonstrated. The effect of aluminum on UMR-106 rat osteosarcoma cells is not due to changes in cell number, cell viability or rate of mitogenesis. Similar results are obtained with dog kidney membrane. At a concentration of 10 microM and 400 microM, there is significant inhibition of the binding of PTH to kidney membrane and proportional decrease in PTH-stimulated adenylate cyclase. With higher concentration of aluminum, no response or binding can be demonstrated. In conclusion, aluminum at concentrations of 4 to 400 microM is associated with a decrease in affinity of PTH receptor and concomitant suppression of PTH-stimulated adenylate cyclase.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMed1990

Extraction of nucleic acids from agarose gel--a quantitative and qualitative comparison of four different methods.

Agarose gel electrophoresis is commonly used to separate different species of nucleic acids. We compare four different methods of extraction which are commonly used. These methods include buffer extraction, electroelution, glass bead extraction and extraction of DNA from low-melting agarose. The results show that DNA extracted by these four methods is comparable in their ligability to the PMT 21 vectors and the plasmids with insert can be used for subsequent transfections of competent bacteria. There is a higher yield for buffer extraction and electroelution when compared with glass bead extraction and low melting agarose (p less than 0.05). To conclude, the four commonly used methods for DNA isolation are comparable qualitatively. But the simplest method, namely buffer extraction, has the highest yield.

Bacteriophages↗
PubMed1990

Pyoderma gangrenosum associated with erythroid hypoplasia.

Pyoderma gangrenosum is most commonly associated with inflammatory bowel disease and rheumatoid arthritis, but it has been associated with various haematological malignancies. We describe its association with primary erythroid hypoplasia without thymoma in an 80 year old woman who presented with septicaemia complicating urinary tract infection. Spontaneous healing of an extensive lesion was observed.

Aged↗
PubMed1990

Hypocalcemic heart failure in end-stage renal disease.

A 37-year-old woman presented with hypocalcemic heart failure complicating end-stage renal disease. Heart failure persisted despite conventional therapy but improved after correction of hypocalcemia. Continuous monitoring of left ventricular function by radionuclide study during calcium replacement showed dramatic improvement. Our case showed that hypocalcemia could be a rare but reversible cause of frank heart failure in uremic patients.

Adult↗
PubMed1990

Eight-month longitudinal study of urinary excretion of albumin and tubular proteins in diabetic subjects.

To evaluate the importance of tubular proteinuria in diabetic nephropathy, we studied the serial changes of micro-albuminuria, microproteinuria and protein patterns by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) in 38 diabetic patients over 8 months. There was a significant correlation between the amount of micro-albuminuria measured by radio-immunoassay and the amount of microproteinuria quantitated by the Coomassie brilliant blue dye binding method (r = 0.976; p less than 0.0001). Micro-albuminuria of 50 mg/day was equivalent to microproteinuria of 190 mg/day. Among the 38 diabetic patients, 26 had micro-albuminuria above 50 mg/day, while 12 had micro-albuminuria below this level. There was a significant correlation between the amount of microproteinuria and haemoglobin A1, showing that the quantity of microproteinuria was affected by metabolic control. Diabetic patients with micro-albuminuria of above 50 mg/day have a significantly higher diastolic blood pressure than those below this level. Among the diabetic patients with micro-albuminuria of less than 50 mg/day, the amount of micro-albuminuria and microproteinuria remained constant, whereas progressive increases in micro-albuminuria and microproteinuria were observed among the 12 diabetic subjects with micro-albuminuria above 50 mg/day. These support the prognostic importance of this quantity of micro-albuminuria. The protein patterns as revealed by SDS-PAGE with Coomassie blue staining show a significant loss of low-molecular-weight proteins in 7 patients, which may therefore suggest tubular damage. The loss of tubular proteins persisted over a period of 8 months in all 7 subjects, and the amount gradually increased over this period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Long-term results following 131I treatment for Graves' disease in Hong Kong Chinese--discriminant factors predicting hypothyroidism.

The clinical outcome of 1028 Hong Kong Chinese patients with Graves' disease treated with radioiodine therapy and followed for a mean of 9.85 +/- 4.84 years (range 2-20) was analysed. Retreatment was required by 413 patients (40.2 per cent), with 134 patients (13.0 per cent) requiring more than two 131I doses. One hundred and eighty-nine patients received carbimazole after 131I until euthyroidism was achieved. The cumulative incidence of hypothyroidism at one, five, 10 and 15 years was 9.6 per cent, 31.4 per cent, 53.8 per cent and 65.8 per cent, respectively. The average incidence of hypothyroidism after the first two years was 3.3 per cent per annum. Stepwise logistic regression analysis of pretreatment variables suggested that a combination of adjunctive carbimazole therapy, absence of ophthalmopathy and longer effective half-lives of 131I were of value in predicting which patients were less likely to develop permanent hypothyroidism. However, the probability of accurately predicting permanent hypothyroidism based on the present model was only 60 per cent. We believe that no single pretreatment variable, or combination of variables, predicts long-term hypothyroidism with sufficient confidence to justify the use of a 'formula' approach for prescribing 131I therapy for Graves' disease.

Adolescent↗
PubMed1990

Importance of measurement of bone density in the management of osteoporosis.

Bone mass is the primary, although not the only, determinant of fracture. Over the past few years a number of noninvasive techniques have been developed to more sensitively quantitate bone mass. These include radiogrammetry (RG) and radiographic photodensitometry (RD), single and dual photon absorptiometry (SPA and DPA), quantitative computed tomography (QCT), and single and dual-energy X-ray absorptiometry (SEXA and DEXA). These techniques provide bone mass quantitation at the spine, wrist, hip and total body skeletal sites that are the principal areas usually involved in osteoporosis. The evaluation of the aetiology, progression, and treatment of osteoporosis has been clearly improved with the use of these methods. It is the intent of this review to discuss the pros and cons of these techniques, in particular their applications to the detection and management of osteoporosis.

Absorptiometry, Photon↗
PubMed1989

Increased serum levels of a parathyroid hormone-like protein in malignancy-associated hypercalcemia.

STUDY OBJECTIVE: To measure the serum levels of a newly described parathyroid hormone-like protein (PLP) which was isolated from malignant tumors associated with hypercalcemia, and determine whether PLP is a humoral factor in malignancy-associated hypercalcemia. DESIGN: A cross-sectional study of serum levels of PLP using a newly developed radioimmunoassay. SETTING: A university-affiliated Veterans Administration hospital in San Francisco, California, a University hospital in Hong Kong, and a private hospital in Danville, Pennsylvania. PATIENTS: Patients with hypercalcemia (calcium greater than 2.65 mmol/L) and a diagnosis of malignancy were studied. Control groups included normocalcemic patients with malignancy, patients with hyperparathyroidism, and normal subjects. MEASUREMENTS AND MAIN RESULTS: Serum immunoreactive PLP (iPLP) levels in normal subjects were less than 2.5 pmol eq/L (10 pg/mL), and 68% of subjects had undetectable levels. The serum concentration of iPLP was normal in 15 of 16 hypercalcemic patients with hyperparathyroidism. Serum iPLP was increased (greater than 2.5 pmol eq/L) in 36 of 65 (55%) patients with malignancy-associated hypercalcemia, with a mean value of 6.1 +/- 0.9 pmol eq/L (24 pg/mL). In a subgroup of patients with solid tumors serum iPLP was increased in 30 (71%) of 42 hypercalcemic patients, with a mean value of 6.5 +/- 0.9 pmol eq/L. Serum iPLP was elevated in only 3 of 23 normocalcemic patients with cancer. In patients with solid malignancies (n = 59), levels of iPLP were positively correlated with the total serum calcium (r = 0.43, P less than 0.01). CONCLUSION: The data indicate a relation between the serum concentration of iPLP and the presence of hypercalcemia in solid malignancies. The results support a role for PLP as a humoral mediator of hypercalcemia in most patients with solid tumors. Measurement of iPLP should be useful in the differential diagnosis of hypercalcemia.

Bone Neoplasms↗
PubMed1989

Subclinical hyponatremia, hyperkalemia and hypomagnesemia in patients with poorly controlled diabetes mellitus.

Diabetes mellitus is associated with disturbances in electrolyte metabolism. We studied 68 patients with insulin-requiring diabetes mellitus followed up in the Home Monitoring Clinic in order to assess the relationship between electrolyte disturbances and severity of diabetes. There is a significant correlation of serum sodium (r = -0.323, P less than 0.01), potassium (r = 0.416, P less than 0.001), magnesium (r = -0.292, P less than 0.02) with fasting glucose. Thus, in patients with high fasting blood glucose, sodium and magnesium tend to be lower while potassium is higher. Among the three parameters, only serum magnesium significantly correlates with the level of hemoglobin A1 (r = -0.356, P less than 0.001) and thus may be related to the long-term control of diabetes. On the other hand, the hyponatremia and hyperkalemia are more likely to be related to short-term metabolic control as reflected by fasting blood glucose. To conclude, minor changes in electrolytes have been found in a group of 68 Chinese patients receiving insulin. There is a remote possibility that these electrolyte changes may influence the chemical events responsible for long-term diabetic complications.

Blood Glucose↗
PubMed1989

Identification and characterization of parathyroid hormone receptors on dog kidney, human kidney, chick bone and human dermal fibroblast. A comparative study of functional and structural properties.

To evaluate the functional and structural characteristics of the parathyroid hormone (PTH) receptors on different tissues and the possible heterogeneity in structure and function, PTH receptors on dog kidney membrane, human kidney membrane, chick bone cell membrane and human dermal fibroblast membrane were evaluated. The results showed that human kidney plasma membrane, canine kidney plasma membrane and chick bone cell membrane possess one single class of PTH receptor with a Kd (dissociation constant) of 1-5 nM and an IC50 also of 1-5 nM. The number of binding sites was 800 fmol per mg of protein for chick bone cell particulate membrane, 1-5 pmol per mg of protein for human kidney plasma membrane and 2.2 pmol per mg of protein for dog kidney plasma membrane. Photoaffinity labelling identified a major binding component with a molecular mass of 70 kDa in all three types of membrane. The plasma membrane fraction from human dermal fibroblast contained two different binding sites for PTH with high (Kd = 2 nM) and low (Kd = 580 nM) affinities respectively. The IC50 for the adenylate cyclase is about 2 nM, which is similar to the Kd of the high-affinity site. Photoaffinity labelling also demonstrated a major binding component with a molecular weight of 70 kDa. We conclude that structural and functional similarity exists among the PTH receptors present on chick bone cell membrane, dog kidney membrane and human kidney membrane. The human dermal fibroblast possesses two different binding sites, one of which is coupled to adenylate cyclase.

Adenylyl Cyclases↗
PubMed1989

The characterization, regulation, and function of insulin receptors on osteoblast-like clonal osteosarcoma cell line.

The properties and regulation of insulin receptors on monolayers of cultured clonal osteoblastic rat osteosarcoma UMR-106 cells and human osteosarcoma U20S cells were studied. Confluent cultures of UMR-106 cells bound lactoperoxidase-labeled, HPLC-purified [125I]A-14-monoiodinated insulin in a reversible, saturable, and specific manner. Binding was related inversely to the incubation temperature. Prolonged period of steady-state binding was achieved at all temperatures studied. Competition curves demonstrated half-maximal inhibition of [125I]insulin binding at an unlabeled insulin concentration of about 1 nM. Scatchard analysis of the binding data was curvilinear, suggesting negative cooperativity, and revealed that UMR-106 osteoblasts contained about 87,000 receptor sites per cell according to a two-site model. Bound [125I]insulin dissociated from osteoblasts with a t1/2 of about 15 minutes at 22 degrees C. The dissociation curve was multiexponential, and the addition of native insulin accelerated the dissociation of intact but not degraded [125I]insulin. Preincubation with 125 nM insulin for 1 h induced 70% loss of binding sites and reduced total insulin bound by 30%. When monolayers were treated with the lysosomotropic agent chloroquine, a 40% increase in cell-associated radioactivity that could not be dissociable in fresh buffer was observed. The use of an energy depleter, sodium fluoride, completely inhibited the effects of chloroquine. Similar results were obtained for human osteosarcoma U20S cells except that the number of receptor sites was far less than that of UMR-106 cells. Insulin increased collagen synthesis at a half-maximal concentration of 1 nM. To conclude, cultured rat and human osteoblasts possess insulin receptors that exhibit kinetic properties and specificity similar to those of other insulin target cells. Receptor-bound insulin is internalized and degraded by a chloroquine-sensitive, energy-requiring reaction. Insulin receptor on bone cells modulates the synthesis of collagen and this role may be important in bone homeostasis.

Animals↗