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Biomedical subjects

L Y Chan

Publications and source records attributed to L Y Chan.

At least 73 records · Page 4Linked to original sources

A frequent activated smoothened mutation in sporadic basal cell carcinomas.

Basal-cell carcinomas (BCCs) are the most common cancer in Caucasians. It has been reported that the patched gene is inactivated in 30-40% sporadic BCCs and 20% sporadic medulloblastomas via loss of heterozygosity and nonsense mutations. Recently, two activating smoothened mutations have been found in the sporadic basal cell carcinomas. One, at base pair 1604 (G-to-T transversion) of exon 9, changes codon 535 from tryptophan to leucine, and the other, at base pair 1685 (G-to-A transition) of exon 10, changes codon 562 from arginine to glutamine (Xie et al., 1998). In our study, 1604G-->T was found in 20 out of 97 (20.6%) sporadic BCCs. The high prevalence indicates that 1604G is the mutation hot spot in our tumor samples. This mutation was detected in all three histological subtypes of BCCs, suggesting that smoothened mutation is an early event during the development of the tumor. Our finding of a high smoothened mutation rate, together with high frequent patched gene mutations reported recently, indicates that activation of the hedgehog signal transduction pathway is the most common and early event in the development of sporadic BCCs. Additionally, to determine whether smoothened, like patched, is also involved in the carcinogenesis of medulloblastomas, we screened medulloblastoma samples for these two mutations by restriction analysis. We have found the 1604G-->T mutation in 1 out of 21 medulloblastomas. This result confirmed smoothened gene involvement in the carcinogenesis of medulloblastoma.

Basal Cell Carcinoma↗

Apolipoprotein E genotype and its pathological correlation in Chinese Alzheimer's disease with late onset.

In this study, we attempted to find a relationship between apoliprotein E (ApoE) genotypes and Alzheimer's disease (AD) pathology in different areas of the brain in Chinese. We also studied the borderline group of possible AD (Poss). There were 34 definite or probable AD (Ad), 18 Poss, and 123 brains from age-matched normal subjects (N). ApoE genotype was determined by nested polymerase chain reaction on genomic DNA extracted from archival paraffin-embedded materials. Hippocampus (including entorhinal cortex), amygdala, superior temporal lobe, middle frontal gyrus, and inferior parietal lobule of the brains of Ad and Poss were examined with beta amyloid (A beta) immunostaining, and the same regions plus medial occipital lobe were examined with tau immunostaining. The percentage of plaque area stained for A beta in each brain region was obtained by an image analyzer, and the average number of neurofibrillary tangles stained for tau was counted with an eyepiece graticule. ApoE epsilon4 frequency was increased in both Ad (22.1%, chi2, df = 1, P = .00005), and Poss (33.3%, P = .000005) compared with N (5.3%). A beta load was significantly increased in the neocortex in Ad examined with at least 1 copy of epsilon4 compared with subjects without epsilon4 (Mann-Whitney, P = .014). The same trend, though not statistically significant, occurred in Poss (P = .15). Tau expression was associated with ApoE epsilon4 in neither Ad nor Poss. Poss is genetically and histologically similar to Ad, although the overall A beta load is significantly increased in the latter. These findings support the recent Consensus Report's findings that all Alzheimer-type pathology may be significant.

Age of Onset↗

Surgical pearl: fine gauze is a useful carrier for epidermal graft in the treatment of vitiligo by means of the suction blister method.

Conventional treatments of vitiligo include topical steroids and PUVA, which necessitate prolonged application and frequent clinic visits; response to such treatments also varies. During the past few years, we have used autologous suction-blister-derived epidermal grafts in more than 150 patients with stable localized vitiligo who did not respond to topical steroids and PUVA. Up to now results are promising. In this method, spreading of the epidermal graft to its maximum size and its accurate transferral onto the recipient area are important steps. However, the graft produced by this method is so thin and soft that it wrinkles and curls frequently, making spreading and transportation to the recipient site cumbersome. In our experience with more than 700 grafts, we found that the use of plain fine gauze makes harvesting and transportation of donor grafts technically simple and effective.

Humans↗

Hepatitis B carrier and perinatal outcome in singleton pregnancy.

The objective of this article is to evaluate the effect of hepatitis B antigenemia on perinatal outcome. Perinatal outcome of 824 women with hepatitis B surface antigen (HbsAg) was compared with 6281 women without hepatitis B surface antigen (control) from June 1996 to September 1998. The maternal characteristics were comparable between the two groups. Perinatal outcome was comparable between groups. The incidences of preterm birth, premature prelabor rupture of membranes, prelabor rupture of membranes, small for gestational age, neonatal jaundice, fetal distress, perinatal asphyxia, congenital abnormality, gastrointestinal tract abnormality, and perinatal mortality were similar among the two groups. We conclude that the presence of hepatitis B surface antigen in pregnant women does not pose additional risk for the pregnancy.

Adult↗

Evaluation on the antipruritic role of transcutaneous electrical nerve stimulation in the treatment of pruritic dermatoses.

BACKGROUND: Pruritus is a common and sometimes distressing symptom in many dermatological conditions. Response to conventional pharmaceutical agents may not be satisfactory, and adverse effects are real problems. OBJECTIVE: To evaluate the short-term efficacy and adverse effects of transcutaneous electrical nerve stimulation (TENS) for ameliorating pruritus in patients with dermatoses. METHODS: A prospective 1-week study using TENS given once daily for treating pruritic dermatoses in 5 patients. RESULTS: Significant amelioration of pruritus was obtained without adverse effect referable to TENS treatment, and a subjective reduced use of conventional topical drugs was also reported by all patients. CONCLUSIONS: TENS is a useful aramentarium for short-term amelioration of pruritus in pruritic dermatoses. Long-term efficacy and safety await further studies.

Adolescent↗

Treatment of palmar hyperhidrosis using tap water iontophoresis: local experience.

To evaluate the efficacy and safety of tap water iontophoresis in the treatment of severe idiopathic palmar hyperhidrosis, nine Chinese patients with severe palmar hyperhidrosis that had failed to respond to topical aluminium chloride were given 6 weeks' treatment with tap water iontophoresis at the Social Hygiene Service, Department of Health, Hong Kong. The reduction in sweat output was assessed objectively and subjectively. The mean objective reduction in sweat output was 49%, 51%, 26%, and 22% at week 3, 6, 10, and 12, respectively, since the start of treatment with tap water iontophoresis The mean subjective improvements were 43%, 59%, 30%, and 12% at week 3, 6,10, and 12, respectively. The side effects reported were all mild and transient. We conclude that tap water iontophoresis is a safe and useful treatment modality for palmar hyperhidrosis.

Journal Article↗

Tissue injury of Injection Gold Probe.

BACKGROUND: The Injection Gold Probe, which incorporates an injection needle and a bipolar electrocoagulation probe, potentially offers better anchoring of the probe for electrocoagulation. This study compares the tissue injury caused by the Injection Gold Probe with or without protrusion of the needle. METHODS: A 10F Injection Gold Probe was applied perpendicularly on the antrum of porcine stomach. At each site of testing, one pulse of treatment at 12 W was given for 10 seconds. The extent of tissue injury was studied under different forces of application (light touch or maximal force) and different probe conditions (needle-in, needle-out, needle-out plus 1 mL saline solution injection). Each maneuver was repeated 8 times. The depth and width of tissue injury were assessed histologically by a pathologist blinded to the treatment. RESULTS: The depth and width of tissue injury did not differ significantly with needle-in, needle-out, or needle-out plus 1 mL saline solution injection on both light touch. But the tissue injury was significantly deeper and wider with maximal force applications than with light touch under the same probe condition. CONCLUSION: The extent of tissue injury inflicted by electrocoagulation using the Injection Gold Probe is not affected by the position of the injection needle.

Analysis of Variance↗

Clinical evaluation of ceftibuten in gonorrhea. A pilot study in Hong Kong.

BACKGROUND: The escalating rates of gonococcal resistance to quinolone in Hong Kong have prompted a search for an alternative first-line antimicrobial agent for use in treating uncomplicated gonococcal urethritis. Ceftibuten is an orally active third-generation cephalosporin with potent in vitro activity against Neisseria gonorrhoeae. Its pharmacokinetic properties allow single-dose administration. OBJECTIVE: To evaluate the efficacy, safety, and tolerability of ceftibuten in the treatment of uncomplicated gonorrhea in men. STUDY DESIGN: Ceftibuten was evaluated in an open-label, noncomparative, multicenter study. Eligible men with uncomplicated gonococcal urethritis were treated with a single 400-mg oral dose of ceftibuten and reassessed 1 week and 3 weeks after treatment. The main outcome measures were the isolation of N. gonorrhoeae, patient-reported side effects, and other safety parameters (e.g., blood counts and renal and hepatic function tests). RESULTS: One hundred twenty-five men were enrolled in the study. The overall cure rate was 98.2% (110 of 112 evaluable patients). Adverse events, which occurred in 4.5% of patients, were all mild, well tolerated, and of short duration. No significant changes in laboratory test results were noted. Of the 125 isolates, 4.8% were -lactamase positive. Susceptibility to ofloxacin was found to be low in 59.2% of isolates (MIC 0.1 to < 1g/mL) and 25.6% of isolates were resistant (MIC1g/mL) to ofloxacin. CONCLUSIONS: A single 400-mg oral dose of ceftibuten is highly effective and well tolerated in the treatment of uncomplicated gonococcal urethritis in men.

Adolescent↗

Treatment of vitiligo with autologous epidermal transplantation using the roofs of suction blisters.

We report our experience of autologous epidermal transplantation for three patients with vitiligo. The vitiligo in two patients was stable whereas that in the third was active. Autologous epidermal transplantation using suction blister roofs from normally pigmented skin was performed following the failure to repigment skin using topical steroid and/or psoralen-ultraviolet A treatment. Grafts were well taken in all three patients. Satisfactory repigmentation was noted in the two patients who had stable vitiligo; there were no complications except for mild hyperpigmentation at the donor areas. For the patient who had active vitiligo, depigmentation of the graft and concomitant Koebner's phenomenon at the donor site were observed 3 weeks after the procedure. We conclude that autologous epidermal transplantation using the roofs of suction blisters is an excellent and safe repigmenting procedure for stable, localised vitiligo and that active disease precludes transplantation.

Journal Article↗

Cure of malignant ascites and generation of protective immunity by monoclonal antibody-targeted activation of a glucuronide prodrug in rats.

We examined the in vivo efficacy of targeting beta-glucuronidase (betaG) to activate a glucuronide prodrug (BHAMG) of p-hydroxyaniline mustard (pHAM) at hepatoma ascites in Sprague-Dawley rats. Injection i.p. of 500 microg RH1-betaG, a conjugate formed between recombinant betaG and monoclonal antibody RH1 with specificity for an antigen expressed on AS-30D rat hepatoma cells, into rats bearing AS-30D ascites resulted in the accumulation of 54 microg conjugate per 10(9) tumor cells after 2 hr. Ascites fluid and serum contained 0.53 and 0 microg/ml, respectively, RH1-betaG 2 hr after injection of the conjugate. Conjugate binding to AS-30D cells was heterogeneous and non-saturated, as determined by flow cytometry. BHAMG was less toxic than pHAM to SD rats based on measures of animal mortality, weight loss and hematological toxicity. Treatment of rats bearing established hepatoma ascites with 500 microg RH1-betaG followed 2 hr later with a single i.p. injection of 30 mg/kg BHAMG or 3 i.p. injections of 10 mg/kg BHAMG 2, 3 and 4 hr later resulted in the cure of 6/8 and 8/8 animals, respectively. Treatment with BHAMG or pHAM alone did not produce cures, whereas treatment with a control antibody-betaG conjugate and BHAMG produced significantly greater hematological toxicity compared to treatment with RH1-betaG and BHAMG. All cured rats were completely protected from rechallenge with 2 x 10(7) AS-30D cells, indicating that successful treatment of animals induced protective immunity.

Aniline Mustard↗

Poly(ethylene glycol) modification of beta-glucuronidase-antibody conjugates for solid-tumor therapy by targeted activation of glucuronide prodrugs.

Methoxypoly(ethylene glycol) (PEG) modification of Escherichia coli beta-glucuronidase (betaG) was examined as a method to improve the stability and pharmacokinetics of antibody-betaG conjugates for the targeted activation of glucuronide prodrugs at tumor cells. Introduction of 3 PEG molecules did not affect betaG activity whereas higher degrees of PEG modification produced progressively greater loss of enzymatic activity. The enzyme was found to be stable in serum regardless of PEG modification. PEG-modified betaG was coupled via a thioether bond to mAb RH1, an IgG2a antibody that binds to the surface of AS-30D hepatoma cells, to produce conjugates with 3 (RH1-betaG-3PEG), 5.2 (RH1-betaG-5PEG) or 9.8 (RH1-betaG-10PEG) PEG molecules per betaG with retention of 75%, 45% and 40% of the combined antigen-binding and enzymatic activity of the unmodified conjugate RH1-betaG. In contrast to the rapid serum clearance of RH1-betaG observed in mice, the PEG-modified conjugates displayed extended serum half-lives. RH1-betaG-3PEG and RH1-betaG-5PEG also exhibited reduced spleen uptake and greater tumor accumulation than RH1-betaG. BHAMG, the glucuronide prodrug of p-hydroxyaniline mustard (pHAM), was relatively nontoxic in vivo. Injection of 6 mg/kg or 12 mg/kg pHAM i.v. depressed white blood cell numbers by 46% and 71% whereas 80 mg/kg BHAMG reduced these levels by 22%. Although the tumor/blood ratio of RH1-betaG-5PEG was adversely affected by slow clearance from serum, combined therapy of small solid hepatoma tumors with this conjugate, followed 4 and 5 days later with i.v. injections of BHAMG, cured all of seven mice with severe combined immunodeficiency. Combined treatment with a control antibody-betaG conjugate and BHAMG delayed tumor growth and cured two of six mice while treatment with pHAM or BHAMG alone was ineffective.

Aniline Mustard↗

Review article: the role of pharmaco-therapy for acute variceal haemorrhage in the era of endoscopic haemostasis.

In the last decade, endoscopic haemostasis, including injection sclerotherapy and variceal ligation has become the standard method for the treatment of variceal haemorrhage. While the use of vasopressin has been hampered by severe side effects, the development of new vasoactive agents such as terlipressin, somatostatin and octreotide has opened new indications for these pharmacological therapies. These agents are effective, safe and easy to use. They could be recommended as stop-gap treatment before endoscopy can be arranged. They can also be used as adjunct therapy for endoscopic haemostasis in acute variceal haemorrhage.

Combined Modality Therapy↗

Does smoking predispose to peptic ulcer relapse after eradication of Helicobacter pylori?

OBJECTIVES: To investigate whether smoking would increase ulcer recurrence after eradication of Helicobacter pylori (H. pylori) without maintenance acid-suppression therapy. METHODS: A total of 287 patients, 256 patients with duodenal ulcers and 31 patients with gastric ulcers, were followed-up for up to 18 months after ulcer healing and successful eradication of H. pylori. There were 83 smokers (defined as smoking > or = 10 cigarettes/day) and 204 patients who never smoked or stopped smoking after the diagnosis of peptic ulcer disease. None were taking nonsteroidal anti-inflammatory drugs or receiving maintenance acid suppression therapy. Endoscopy was repeated either at the end of the follow-up period or when ulcer symptoms recurred. RESULTS: Of the 83 smokers, 3 (3.6%) had ulcer recurrence, which included two duodenal ulcers and one gastric ulcer. Of the 204 nonsmokers, 4 (2.0%) had ulcer relapse, and all being recurrent duodenal ulcers. Four smokers (4.8%) and nine nonsmokers (4.4%) had recurrence of H. pylori infection after 10-18 months. There was no significant difference in ulcer relapse or recurrence of H. pylori infection between smokers and nonsmokers. CONCLUSIONS: Cigarette smoking did not increase the recurrence of peptic ulcers after eradication of H. pylori.

Adolescent↗

Neurotoxicity following the ingestion of a Chinese medicinal plant, Alocasia macrorrhiza.

1. A case of poisoning due to the raw root tuber of a Chinese medicinal plant, Alocasia macrorrhiza is presented. 2. The patient developed neurological (severe pain and numbness in the perioral area and throat) and gastrointestinal (nausea, vomiting, abdominal pain) symptoms immediately after eating the root tuber. 3. A macrorrhiza has properties and morphology very similar to another medical plant. A. odora. The root tuber of the latter is known to contain a neurotoxin sapotoxin.

Adult↗

A practical evaluation of five dose-volume histogram reduction algorithms.

A unifying approach to cumulative dose-volume histogram (CDVH) reduction analysis is presented, utilising two weighted linear interpolation models (VWD, DWV), two weighted probability models (VWP, DWP) and a novel integral probability model (IPM). As a test of their predictive value these algorithms were applied to CDVH data generated from lung doses, measured by TLD arrays in a female anthropomorphic phantom. Three arbitrary configurations of breast size and location of "target volume" within the breast were "treated", using an appropriate electron field (Varian Clinac 1800) or double-plane iridium-192 implant. Calculated effective doses from each of the reduction algorithms showed the iridium implant to be dosimetrically the most favourable in two the three configurations. Likewise, complication probabilities, based on a logistic dose-volume response function showed lung complication probabilities to be lower for the interstitial technique in the same situations. All algorithms tested showed reasonable consistency, with the exception of the VWD. The rationale and value of comparative rather than absolute dose-volume histogram analyses are discussed.

Algorithms↗