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Biomedical subjects

S Chan

Publications and source records attributed to S Chan.

At least 73 records · Page 4Linked to original sources

Molecular manifestations and molecular determinants of telomere capping.

Multiple interacting components of the telomere, together with telomerase (and sometimes recombination), determine whether a telomere will be functional, allowing cell proliferation. The various components reinforce each other, providing for a robust and resilient system of protection and replenishment of telomeres. A characteristic of a telomere is that its structural features elicit responses that allow it to be dynamically recapped. Eliciting a DNA damage response through uncapping of a telomere appears to be one way in which telomerase action at that telomere is stimulated. Thus, as long as a timely and appropriate recapping of the telomere is possible, regulated uncapping of a telomere appears to be not only normal, but even required for optimal telomere maintenance. Telomere length and the presence of telomerase provide an example of a pair of interacting components that determine telomere capping function. Telomerase is dispensable in cells with sufficiently long telomeres; but in cells with short telomeres lacking telomerase, cells lose the ability to proliferate, and in some cell types, telomere fusions are increased. However, expressing telomerase can make even very short telomeres functional. Many interesting questions remain as to the mechanisms of these biological effects.

Animals↗

Culturally sensitive mental health services through quality improvement.

An urban mental health service undertook a quality improvement programme to involve staff in the identification and resolution of cross-cultural issues. The programme involved clinical file audits, staff survey and workshops, and a focus group for consumers and their carers. It was found that non-English speaking patients received a different spectrum of services from English speaking patients. Non-English speaking patients were found to receive more pharmacological treatments and less cognitive behavioural therapy. In seeking to address these issues and improve their service delivery to all patients, the mental health service is now in the process of developing cross-cultural training; revising policies and procedures; and engaging bilingual mental health counsellors in a revision of their roles, particularly to increase their availability to staff as cultural consultants.

Australia↗

Trends in nursing education in China.

PURPOSE: To explore the current trends and development of nursing education in China. Nursing education in China has developed rapidly in alignment with economic growth of this vast country. DESIGN: Descriptive, using 345 manuscript abstracts from various regions of China, submitted for the 1996 Sino-Hong Kong Educational Conference. METHODS: Content analysis of manuscript abstracts was done to describe the trends. Codes were determined after several rounds of independent analysis. FINDINGS: Development of nursing education in China appears in line with global trends. The preparation of a pragmatic nurse was emphasized by nurse educators who also advocate total patient care and the integration of traditional Chinese medicine in nursing education. Areas seldom mentioned, however, were student-centered approaches to learning, advanced practice, and the evaluation of educational processes and outcomes. CONCLUSIONS: Nurse educators in mainland China appear aware of the dynamics and challenges in health care, and the need for preparing a new generation of nurses to face these challenges. Educators in China need to adopt new approaches in teaching and learning to prepare nurses to function in a wide range of health care settings, and to monitor and evaluate educational outcomes.

China↗

Detection of endocrine disrupting chemicals in samples of second trimester human amniotic fluid.

Man-made chemicals that have been shown to modulate endocrine function in animal models, so-called "endocrine disrupters", are suspected to play a role in the development of male reproductive tract abnormalities and neurobehaviroal deficits in children. However in utero exposure to environmental contaminants has not been documented previously. The present study was performed to test our hypothesis that man-made chemicals can be quantified in human amniotic fluid during the second trimester. Gas chromatographic/mass spectrometric (GC/MS) analysis was performed on amniotic fluid samples (n=53) from women (n=51) undergoing routine amniocentesis with a mean (+/- SEM) age of 36.5 +/- 0.5 years and between 15 and 23 weeks of gestation. Analytes included common PCB congeners, the DDT metabolites p,p'-DDE, and o,p'-DDE as well as the pesticides: hexachlorobenzene (HCB); and the three isomers of hexachlorocyclohexane (alpha,beta and gamma-HCH). The limit of quantitation (LOQ) for PCBs was 0.01 ng/ml and for the other organochlorines contaminants is was 0.1 ng/ml. The contaminants alpha-HCH with a mean (+/- SD) concentration of 0.15 +/- 0.06 (ng/ml) and p,p'-DDE with a mean (+/- SD) concentration of 0.21 +/- 0.18 ng/ml were detected in the amniotic fluid. PCB specific congeners were detected with a much lower frequency and levels were in the range of the LOQ. Overall one in three amniotic fluid samples tested positive for at least one environmental contaminant. Therefore, we conclude that approximately one in three fetuses in the Los Angeles area are exposed to endocrine modulatory environmental contaminants in utero the consequences of which remain unknown at this time.

Adult↗

Ribosomal protein L7a gene is up-regulated but not fused to the tyrosine kinase receptor as chimeric trk oncogene in human colorectal carcinoma.

Ribosomal protein L7a (rp L7a) was identified in a subtractive hybridization screen as a gene up-regulated in human colorectal cancer. Expression of rp L7a was greater than 2-fold higher in tumors compared to adjacent normal mucosa in 72% of the patients studied (n=36). rp L7a was also up-regulated in concomitant polyps. The number of patients with rp L7a T/N ratio of >2 was significantly higher in the female (16/18) than in the male (10/18). rp L7a expression was also significantly higher in females with lymph node involvement compared to males. These results indicate that rp L7a expression is related to tumor growth in colorectal cancer especially in females, where it may also be related to tumor spread. There was no correlation of rp L7a expression with tumor cell differentiation. We also show that rp L7a does not exist as a fusion oncogene (trk-2h) in colorectal cancer.

Artificial Gene Fusion↗

Fatal myocardial embolus after myectomy.

Coronary embolism is an infrequent phenomenon. A 56-year-old man with hypertrophic obstructive cardiomyopathy and severe mitral regurgitation who underwent left ventricular septal myectomy and mitral valve annular repair is presented. The patient had a cardiac arrest 36 h after surgery. Cardiac standstill, tamponade and a left ventricular rupture were noted when the chest was opened during attempted resuscitation. Autopsy revealed an occlusive embolus of myocardium in the proximal left anterior descending coronary artery. It showed pathological features of hypertrophic cardiomyopathy. There was an extensive acute transmural anteroseptal left ventricular myocardial infarction with rupture of the anterior free wall. Embolism of myocardium - to the coronary arteries, the systemic circulation or the pulmonary circulation - is a rare event, with only nine other cases reported in the literature in the past 30 years. This is the first reported case of myocardial embolus to a coronary artery in a patient with hypertrophic obstructive cardiomyopathy following septal myectomy.

Cardiomyopathy, Hypertrophic↗

When seconds are counted: tools for mobile, high-resolution time-motion studies.

Time-motion (TM) studies are often considered the gold-standard for measurements of the impact of computer systems on task flow and duration. However, in many clinical environments tasks occur too rapidly and have too short of a duration to be captured with conventional paper-based TM methods. Observers may also with to categorize caregiver activities along multiple axes simultaneously. This multi-axial characteristic of clinical activity has been modeled as multiple, parallel finite-state sets and implemented in three computerized data collection tools. Radiology reporting is a domain in which tasks can be characterized by multiple attributes. A radiologist may also switch among multiple tasks in a single minute. The use of these tools to measure the impact of an Automated Speech Recognition (ASR) system on Radiology reporting is presented.

Data Collection↗

Negative regulation of CD4 lineage development and responses by CD5.

CD5 deficiency results in a hyper-responsive phenotype to Ag receptor stimulation. Here we show that the development and responses of CD4 lineage T cells are regulated by the function of CD5. Thymocytes expressing the I-Ad-restricted DO11.10 TCR undergo abnormal selection without CD5. In H-2d mice, the absence of CD5 causes deletion of double-positive thymocytes, but allows for efficient selection of cells expressing high levels of the DO11.10 clonotype. By contrast, there is enhanced negative selection against the DO11.10 clonotype in the presence of I-Ab. T cell hybridomas and DO11.10 T cells are more responsive to TCR stimulation in the absence of CD5. Such hypersensitivity can be eliminated by expression of wild-type CD5, but not by a form of CD5 that lacks the cytoplasmic tail. Finally, CD5 deficiency partially suppresses the block of CD4 lineage development in CD4-deficient mice. Taken together, the data support a general role for CD5 as a negative regulator of Ag receptor signaling in the development and immune responses of CD4 lineage T cells.

Amino Acid Sequence↗

Truncated apolipoprotein E (ApoE) causes increased intracellular calcium and may mediate ApoE neurotoxicity.

Apolipoprotein E (apoE)-related synthetic peptides, the 22 kDa N-terminal thrombin-cleavage fragment of apoE (truncated apoE), and full-length apoE have all been shown to exhibit neurotoxic activity under certain culture conditions. In the present study, protease inhibitors reduced the neurotoxicity and proteolysis of full-length apoE but did not block the toxicity of truncated apoE or a synthetic apoE peptide, suggesting that fragments of apoE may account for its toxicity. Additional experiments demonstrated that both truncated apoE and the apoE peptide elicit an increase in intracellular calcium levels and subsequent death of embryonic rat hippocampal neurons in culture. Similar effects on calcium were found when the apoE peptide was applied to chick sympathetic neurons. The rise in intracellular calcium and the hippocampal cell death caused by the apoE peptide were significantly reduced by receptor-associated protein, removal of extracellular calcium, or administration of the specific NMDA glutamate receptor antagonist MK-801. These results suggest that apoE may be a source of both neurotoxicity and calcium influx that involves cell surface receptors. Such findings strengthen the hypothesis that apoE plays a direct role in the pathology of Alzheimer's disease.

Animals↗

Heparin/heparan sulfate interacting protein gene expression is up-regulated in human colorectal carcinoma and correlated with differentiation status and metastasis.

We applied a subtractive hybridization strategy to obtain genes that are differentially expressed in colorectal carcinoma. Heparin/heparan sulfate interacting protein (HIP) was shown to be up-regulated in colorectal carcinoma. A study of 53 patients with documented colorectal carcinoma showed that 70% of the tumors had HIP tumor-to-normal ratios (expression in tumor tissue compared to expression in normal mucosa) of >2. In six patients with concomitant polyps, HIP expression in the polyps was similar to the carcinoma, showing that up-regulation of HIP may be an early event in tumorigenesis. A significant inverse correlation between HIP levels and the presence of distant metastasis (Duke's stage D) was noted. Similarly, HIP expression was also related to differentiation status in human colorectal carcinoma cell lines. HIP expression was lower in the poorly differentiated COLO 205 cell line compared to the well-differentiated HT-29 cell line. The correlation was further strengthened by studies in COLO 205 cells that were induced to differentiate with herbimycin A treatment. HIP expression was significantly higher when the cells were induced to differentiate. Withdrawal of herbimycin A resulted in a reversal of morphological changes associated with differentiation and an associated decrease in HIP expression. These studies indicate that HIP is an important molecule for cell-cell and cell-extracellular matrix adhesion. The up-regulation of HIP may be an early event in tumorigenesis, and its increased expression may facilitate growth and local invasion. A lower expression of HIP in tumors results in decreased cell adhesion, favoring metastasis. HIP is a candidate marker of abnormal cell growth in the colon and a prognostic marker for colorectal carcinoma.

Blotting, Northern↗

An influence of CD5 on the selection of CD4-lineage T cells.

Combining CD5-null, MHC-deficient and lineage-specific reporter animals, we have investigated the influence of CD5 on positive selection and the choice of CD4- versus CD8-lineage commitment on broad populations of thymocytes. CD5 has no obvious quantitative effect in wild-type mice. In mice lacking MHC class II molecules, however, increased numbers of transitional, class I-selected CD4+ CD8(int) CD3(hi) cells were positively selected in the absence of CD5. Importantly, they were committed to the CD4 lineage. Our results indicate that CD5 negatively regulates the differentiation of CD4-committed cells in suboptimal conditions, thus perhaps serving to tighten the correlation between restriction of the TCR and lineage choice.

Animals↗

Development and application of a high-performance liquid chromatography screening method for aromatic compounds in invertebrate tissues

Contamination of marine invertebrates by aromatic compounds (ACs) can occur from a variety of environmental sources, both natural and anthropogenic. Invertebrate species bioaccumulate ACs because they metabolize and eliminate them at a much slower rate than do vertebrates, such as fish. We have developed a high-performance liquid chromatography (HPLC) UV fluorescence screening method that measures ACs in invertebrate tissues. Screening methods have proven to be useful in response to environmental emergencies (e.g., oil spills) and in environmental monitoring because they are more rapid and less expensive than detailed analyses. This method was validated using three species of bivalves and lobster hepatopancreas and tail muscle as test samples. The AC screening method at naphthalene, phenanthrene, and benzo[a]pyrene wavelength pairs showed good correlation to GC/MS results. The method was also used successfully in response to the North Cape oil spill, off Narragansett, Rhode Island.http://link.springer-ny. com/link/service/journals/00244/bibs/37n2p220.html

Journal Article↗

Complications associated with pegging hydroxyapatite orbital implants.

OBJECTIVE: Prior studies of hydroxyapatite orbital implant complications have primarily focused on complications of the implant itself with only occasional mention of the complications associated with the peg system. This in part may be because of a low rate of pegging and, thus, a small sample size to evaluate. Therefore, a full range of complications that can occur with pegging has not been presented. The objective of this study was to determine the complications associated with pegging and to discuss ways to manage them. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS/INTERVENTION: The authors analyzed all of the complications associated with pegging 165 of a possible 275 hydroxyapatite implants implanted by 2 surgeons over 7 years. MAIN OUTCOME MEASURES: The following data were recorded: type of surgery performed, size of implant used, type of hydroxyapatite used, peg system used, time of pegging, follow-up duration, problems encountered, and treatment. RESULTS: Sixty-two (37.5%) of the 165 patients who had pegged implants were found to have problems with their pegs. Twenty-one (33.8%) of the 62 patients with peg problems had more than 1 peg-related problem. Complications associated with pegging included discharge (37%; 23 of 62), pyogenic granulomas (30.6%; 19 of 62), peg falling out (29%; 18 of 62), poor transfer of movement (11.2%; 7 of 62), clicking (11.2%; 7 of 62), conjunctiva overgrowing peg (4.8%; 3 of 62), poor-fitting sleeve (4.8%; 3 of 62), part of sleeve shaft visible (4.8%; 3 of 62), peg drilled on an angle (4.8%; 3 of 62), hydroxyapatite visible around peg hole (3.2%; 2 of 62), peg drilled off-center (3.2%; 2 of 62), popping peg (3.2%; 2 of 62), and excess movement of peg (3.2%; 2 of 62). The most serious complication occurring in two individuals (3.2%) was implant infection requiring implant removal. CONCLUSION: There are several potential complications that can occur after pegging the hydroxyapatite implant. These problems are generally of a minor nature but often require additional patient visits that would not ordinarily have been required if the peg was not in place. The most serious peg problem is implant infection, which may necessitate implant removal. These potential peg problems should be reviewed with the patient before the procedure is performed.

Adolescent↗

Biochemical and immunologic mechanisms in atopic dermatitis: new targets for emerging therapies.

The immunologic and pharmacophysiologic features of atopic dermatitis have stimulated research seeking to identify relevant effector cells and mediators that characterize chronic skin inflammation. The theory that unifies the various abnormalities associated with atopic dermatitis suggests that hematopoietic cells carrying abnormal genetic expressions of atopy cause clinical disease once they infiltrate the skin and mucosa. The proposed underlying mechanism may be either abnormalities in cyclic nucleotide regulation of marrow-derived cells or allergenic overstimulation that causes secondary abnormalities. The primacy of one mechanism over the other remains unresolved, but this does not obviate their value in identifying two novel therapeutic targets: phosphodiesterase inhibition and immune-intervention alternatives to corticosteroids. New type IV phosphodiesterase inhibitors are proving promising in topical formulations, as are inhibitors of calcineurin, such as FK506 and SDZ ASM 981, an ascomycin macrolactam derivative that in early clinical research appears to offer the potency of a corticosteroid without its adverse side effects. The promising clinical trial profiles of these new topical agents may result in alternative therapies providing potent anti-inflammatory activity without the adverse effects that limit corticosteroid use.

Dermatitis, Atopic↗

Development of basic nursing education in China and Hong Kong.

Hong Kong returned to the sovereignty of the People's Republic of China in July 1997. In the past, Hong Kong has been greatly influenced by the British system of nurses' training, which was very different from that in mainland China. As Hong Kong is now a part of China again, there is an increased opportunity for the exchange of experience and ideas among nurse educators. The First China-Hong Kong Nursing Education Conference has provided opportunities for the authors to gain a deeper understanding of the development of nursing education in China and Hong Kong. The authors believe that it is also important for China and Hong Kong to increase networking with the international nursing community. This paper has been written largely based on the information gathered from papers presented in the Conference and the discussion with nurse educators who attended the Conference, together with a review of literature. This paper focuses on comparing the history and present development of basic nursing education in both places. The future direction for the development of nursing education in these two places will also be discussed.

China↗