Fungi and the indoor environment: their impact on human health.
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Air Microbiology↗
Biomedical subjects
W C Wong
Publications and source records attributed to W C Wong.
Perioperative and rehabilitation outcome after lower-limb amputation in elderly Chinese patients in Hong Kong.
PURPOSE: Major amputation of the lower limb is considered the last resort when limb salvage is impossible. The aim of this study is to determine the morbidity, mortality, and rehabilitation outcome of patients that underwent a lower-limb amputation. METHODS: A retrospective cohort study was conducted among 100 elderly patients who underwent a total of 120 lower-limb amputations in a regional hospital in Hong Kong from 1996 to 2001. RESULTS: The mean age of the amputees was 77.9 years; 58 were female. 95% of the amputations were performed because of infection with or without vascular compromise; 55 transfemoral and 60 transtibial amputations contributed 96% of the case mix. Some 43% of patients experienced early complications and 12% required re-amputation. The early (30-day) mortality rate was 15%. Only 55% of the amputees survived after 4 years. A 44% return-home rate was achieved. However, only 11% of the amputees could walk without help from other people. Although prostheses were issued to 42% of the survivors, compliance was only 53%; 24% of the survivors lost their remaining leg within 2 years. CONCLUSION: The outcome of major lower-extremity amputation remains poor. Efforts should be made to retain these limbs. When it is proven impossible, one should strive to preserve the knee joint whenever feasible.
Aged↗
Correlation between magnetic resonance imaging and radiographic measurement of cervical spine in cervical myelopathic patients.
PURPOSE: To correlate the radiographic measurement, cord diameter shown on magnetic resonance imaging (MRI), and clinical hand sign of cervical myelopathic patients. METHODS: Patients with clinical cervical myelopathy who had had MRI in Kwong Wah Hospital between January 2001 and December 2002 were enlisted. Their cervical spine radiographs and clinical records were reviewed. RESULTS: Of 36 patients with a complete set of MRI films, cervical spine radiographs, and clinical notes; 18% did not have Hoffman's sign, 47% had normal supinator reflex, 39% had unimpaired 10-second test, and 45% showed no finger escape sign. The presence of myelopathic hand signs was not correlated to any radiological assessment, cord diameter, or presence of myelomalacia at any level. CONCLUSION: Cervical spine radiography cannot predict the level and degree of cervical spinal cord compression. Myelopathic hand signs are not diagnostically fail-safe and cannot predict the level and degree of cord compression.
Adult↗
Laparoscopic management of large ovarian cysts: more than cosmetic considerations.
Laparoscopic management of three cases, each with a large ovarian cyst, is reported. Appropriate preoperative assessment, patient counselling, and good laparoscopic skills are the cornerstones of successful laparoscopic management in such patients.
Adolescent↗
Arterial embolisation in intractable primary post-partum haemorrhage: case series.
OBJECTIVE: To evaluate the efficacy and safety of arterial embolisation in the management of intractable primary post-partum haemorrhage. DESIGN. Retrospective case series. SETTING: Regional hospital, Hong Kong. PATIENTS: Nine patients aged 28 to 39 years who were treated for severe primary post-partum haemorrhage between October 2000 and January 2003. INTERVENTION: Emergency transcatheter arterial embolisation. MAIN OUTCOME MEASURES: Clinical outcome and complications. RESULTS: All nine arterial embolisations successfully arrested the haemorrhage. The main cause of primary post-partum haemorrhage was uterine atony. No serious complication arose, although one patient experienced slight numbness of the right leg. Normal menstruation resumed in all patients, except for the one who had had a hysterectomy as initial treatment. One patient became pregnant 1 year after embolisation. Patients were followed up for 10 months. CONCLUSION: In our experience, arterial embolisation is safe and efficacious, and is the treatment of choice for patients with intractable primary post-partum haemorrhage.
Adult↗
Improved diagnosis of a temporal lobe abscess in a post-irradiated nasopharyngeal carcinoma patient using diffusion-weighted magnetic resonance imaging.
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Brain Abscess↗
Airborne microbial flora in a cattle feedlot.
A total of 1,408 cattle held in eight commercial feedlot pens were used to examine the quantity and diversity of microorganisms in cattle feedlot air. The effect of two feeding patterns on the generation of airborne dust and the total numbers of microorganisms was also examined (four feedlot pens/treatment). Microbial samples were collected, and dust particles that were 2.5 microm or less in diameter were measured with a Dustrak monitor during the evening dust peak for 4 days at sites both upwind and downwind of the feedlot pens. An Andersen biological cascade sampler was employed with different medium and incubation combinations for the capture and identification of bacteria and fungi. The results showed that when bacteria were considered, only nonpathogenic gram-positive organisms were recovered. However, gram-negative bacteria may have been present in a viable but nonculturable state. Fungi were recovered in smaller numbers than bacteria, and none of the fungi were pathogenic. The Dustrak results showed that one feeding pattern resulted in cattle behavior that generated levels of downwind dust lower (P = 0.04) than the levels generated by the behavior resulting from the other feeding pattern. However, the Andersen sampler results showed that there were no differences between feeding patterns with regard to the total number or diversity of microorganisms. The disparity may have been due to the different operating principles of the two systems. The overall numbers of microorganisms recovered were lower than those reported in studies of intensively housed farm animals in which similar recovery techniques were used.
Air Microbiology↗
Irreducible dislocation of the hallucal interphalangeal joint.
Irreducible dislocation of the hallucal interphalangeal joint is a rare condition, with only 41 cases reported in the literature. We present a patient with a Miki type 2 irreducible dislocation of the hallucal interphalangeal joint and review literature pertinent to this condition.
Adolescent↗
[Changes of chemical and biological properties during composting sewage sludge by using forced aerated static pile model].
Municipal sewage sludge was composted for 53 days with Chinese medical herb residues as bulking agent through forced aerated static pile model. The temperature of the pile could quickly rise to more than 55 degrees C after the second day after composting. Furthermore, the temperature of more than 55 degrees C maintained as long as 8 days, which was helpful in inactivation of pathogens in compost. The cress seed germination index (GI) and the ratio of water-soluble organic carbon to organic nitrogen (soluble C/N-organic), used as indicators of phytotoxicity and maturation of compost, exhibited that the sludge compost was almost stabilized and matured near the 40th day of composting, when 80% of GI and 6.4 of soluble C/N-organic were obtained. The content of total N, P, Cu, Zn and Cd in compost increased as the composting time elapsed, while volatile solids, solid and water soluble organic carbons, pH, and NH4(+)-N decreased. F. coli, as a common indicator of pathogens in sludge, was reduced greatly from 1.41 x 10(5) to 2.32 x 10(1) in the final examination of the compost.
Aerobiosis↗
MRI appearance of synovial chondromatosis in the temporomandibular joint.
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Adult↗
Diabetic foot ulcers in the Hong Kong Chinese population: retrospective study.
OBJECTIVE: To assess the predictive power of various parameters on the final outcome of ulcerated diabetic feet among the Hong Kong Chinese population. DESIGN: Retrospective cohort study. SETTING: Regional public hospital, Hong Kong. PATIENTS: Medical records of 340 diabetic patients with foot ulcers (535) who were referred to the Diabetic Foot Clinic between July 1995 and June 2000 were reviewed. MAIN OUTCOME MEASURES: Demographic and clinical data, including assessment of the foot and blood parameters. RESULTS: Increasing age, wound depth, the presence of ischaemia, a low albumin level, and the lack of simultaneous ulceration were determined by stepwise logistic regression analysis to be the most significant independent predictors of an unfavourable outcome. CONCLUSIONS: Major amputation is more likely to occur in elderly patients, with progressive wound depth, and in the presence of ischaemia. A low albumin level was also noted to be an independent predictor of major amputation in the population studied.
Adult↗
Limb salvage in extensive diabetic foot ulceration-a preliminary clinical study using simple debridement and herbal drinks.
Diabetic patients frequently suffer from foot ulcer. In spite of the advances in treating many complicated diseases, amputation is usually the 'cure' for diabetic foot ulcer. Diabetic foot ulcer was treated in this study using Chinese herbal medicine and simple debridement as an alternative to amputation. Limb salvage was successful in 35 of 40 legs. These results encourage continuing research into the treatment of diabetic ulcer using Chinese herbal medicine.
Aged↗
In vitro studies on L-771,688 (SNAP 6383), a new potent and selective alpha1A-adrenoceptor antagonist.
L-771,688 (SNAP 6383, methyl(4S)-4-(3, 4-difluorophenyl)-6-[(methyloxy)methyl]-2-oxo-3-[(¿3-[4-(2-pyridin yl)-1-piperidinyl]propyl¿amino)carbonyl]-1,2,3, 4-tetrahydro-5-pyrimidine carboxylate) had high affinity (Ki less than or = 1 nM) for [3H]prazosin binding to cloned human, rat and dog alpha1A-adrenoceptors and high selectivity (>500-fold) over alpha1B and alpha1D-adrenoceptors. [3H]Prazosin / (+/-)-beta-[125I]-4-hydroxy-phenyl)-ethyl-aminomethylteralone ([125I]HEAT) binding studies in human and animal tissues known to contain alpha1A and non-alpha1A-adrenoceptors further demonstrated the potency and alpha1A-subtype selectivity of L-771,688. [3H]L-771,688 binding studies at the cloned human alpha1A-adrenoceptors and in rat tissues indicated that specific [3H]L-771,688 binding was saturable and of high affinity (Kd=43-90 pM) and represented binding to the pharmacologically relevant alpha1A-adrenoceptors. L-771,688 antagonized norepinephrine-induced inositol-phosphate responses in cloned human alpha1A-adrenoceptors, as well as phenylephrine or A-61603 (N-[5-4,5-dihydro-1H-imidazol-2yl)-2-hydroxy-5,6,7, 8-terahydro-naphthlen-1-yl] methanesulfonamide hydrobromide) induced contraction in isolated rat, dog and human prostate, human and monkey bladder neck and rat caudal artery with apparent Kb values of 0.02-0.28 nM. In contrast, the contraction of rat aorta induced by norepinephrine was resistant to L-771,688. These data indicate that L-771,688 is a highly selective alpha1A-adrenoceptor antagonist.
Adrenergic alpha-1 Receptor Antagonists↗
2-amino-2-oxazolines as subtype selective alpha(2) adrenoceptor agonists.
Cyclohexylamino oxazoline 1 (AGN 190837), an analogue of 2 (Bay a6781), is a potent alpha(2) adrenoceptor agonist. On the basis of a design generated by receptor-ligand modeling, a number of cyclohexyl and norbornyl analogues were synthesized wherein the propyl group of 1 was replaced by phenylalkyl subsituents. This resulted in compound 6 being an alpha(2c) selective agonist, as well as 7 and 9 being alpha(2a)/alpha(2c) selective.
Adrenergic alpha-2 Receptor Agonists↗
An animal model for allergic penicilliosis induced by the intranasal instillation of viable Penicillium chrysogenum conidia.
BACKGROUND: A study was undertaken to determine the consequences of long term intranasal instillation of Penicillium chrysogenum propagules in a mouse model. METHODS: C57 Black/6 mice were inoculated intranasally each week for six weeks with 10(4) viable and non-viable P chrysogenum conidia. Cytokine levels and cellular responses in these animals were then measured. RESULTS: Compared with controls, mice inoculated intranasally each week for six weeks with 10(4) P chrysogenum conidia (average viability 25%) produced significantly more total serum IgE (mean difference 1823.11, lower and upper 95% confidence intervals (CI) 539.09 to 3107.13), peripheral eosinophils (mean difference 5.11, 95% CI 2.24 to 7.99), and airway eosinophilia (rank difference 11.33, 95% CI 9.0 to 20.0). With the exception of airway neutrophilia (mean difference 20.89, 95% CI 3.72 to 38.06), mice inoculated intranasally with 10(4) non-viable conidia did not show significant changes in total serum IgE, peripheral or airway eosinophils. However, when compared with controls, this group (10(4) non-viable) had a significant increase in total serum IgG(2a) (mean difference 1990.56, 95% CI 790.48 to 3190.63) and bronchoalveolar lavage (BAL) fluid levels of interferon (IFN)-gamma (mean difference 274.72, 95% CI 245.26 to 304.19). In addition, lung lavages from mice inoculated intranasally with 10(4) viable P chrysogenum conidia had significantly increased levels of interleukin (IL)-4 (mean difference 285.28, 95% CI 108.73 to 461.82) and IL-5 (mean difference 16.61, 95% CI 11.23 to 21.99). The IgG(2a)/IgE ratio and the IFN-gamma/IL-4 ratio was lower in the group of mice inoculated intranasally with 10(4) viable conidia than in the 10(4) non-viable conidia group and the controls. When proteins were extracted from P chrysogenum conidia, attached to microtitre plates and incubated with serum from the 10(4) viable group, significant increases in conidia-specific IgE and IgG(1) were observed compared with controls, while serum from the 10(4) non-viable group was similar to controls. CONCLUSIONS: These data suggest that long term inhalation of viable P chrysogenum propagules induces type 2 T helper cell mediated (Th2) inflammatory responses such as increases in total and conidia-specific serum IgE and IgG(1), together with BAL fluid levels of IL-4 and IL-5 and peripheral and airway eosinophilia, which are mediators of allergic reactions.
Administration, Intranasal↗
A case-controlled MRI/MRA study of neurovascular contact in hemifacial spasm.
BACKGROUND: Neurovascular contact (NVC) with the root exit zone (REZ) of the ipsilateral facial nerve is associated with hemifacial spasm (HFS), but unresolved issues remain. OBJECTIVES: To 1) determine the frequency of symptomatic and nonsymptomatic NVC, 2) determine the features of NVC associated with HFS, and 3) correlate severity of HFS to these features. METHODS: Two independent, blinded, prospective assessments of high-resolution MR and MR angiography (MRA) images were performed on Chinese cases (HFS: n = 44; age-matched control subjects: n = 20). RESULTS: Over 88% of 44 symptomatic sides in patients with HFS had NVC of the ipsilateral facial nerve. At least 80% of symptomatic sides involved NVC at the anterior aspect of the REZ [REZ(ant.)]. Although NVC was observed in approximately half of nonsymptomatic sides, at least 70% of them were not at REZ(ant.). NVC at the cisternal and intracanalicular portions of the facial nerve were not associated with HFS. Half of our patients with HFS had bilateral NVC, but none had bilateral symptoms. Most of our MR/MRA images showed that the size and position of the arterial branches of the vertebrobasilar system were markedly asymmetric. Of patients with bilateral NVC, over 83% had asymmetric NVC sites. The anterior inferior cerebellar artery was the most common vessel involved in NVC, but was not significantly associated with HFS. Most of the NVC involved one vessel at one contact point with no indentation. The development of HFS was significantly associated with nerve indentation in NVC. The development and severity of HFS were not associated with multiple contact points in NVC. No significant interobserver variability existed between the blinded assessments. CONCLUSIONS: MRI/MR angiography are accurate, fast, and safe in characterizing neurovascular contact (NVC) at the brainstem. The site of NVC and ipsilateral facial nerve indentation in NVC are significant determinants for the development of hemifacial spasm (HFS). The lack of bilateral NVC at the anterior aspect of the root exit zone of the facial nerve could explain in part the lack of bilateral symptoms. The development and severity of HFS are not associated with a specific blood vessel or multiple contact points in NVC.
Adult↗
Design and synthesis of novel alpha(1)(a) adrenoceptor-selective antagonists. 1. Structure-activity relationship in dihydropyrimidinones.
Dihydropyrimidinones such as compound 12 exhibited high binding affinity and subtype selectivity for the cloned human alpha(1a) receptor. Systematic modifications of 12 led to identification of highly potent and subtype-selective compounds such as (+)-30 and (+)-103, with high binding affinity (K(i) = 0.2 nM) for alpha(1a) receptor and greater than 1500-fold selectivity over alpha(1b) and alpha(1d) adrenoceptors. The compounds were found to be functional antagonists in human, rat, and dog prostate tissues. Compound (+)-103 exhibited excellent selectively to inhibit intraurethral pressure (IUP) as compared to lowering diastolic blood pressure (DBP) in mongrel dogs (K(b)(DBP)/K(b)(IUP) = 40) suggesting uroselectivity for alpha(1a)-selective compounds.
Adrenergic alpha-1 Receptor Antagonists↗
Design and synthesis of novel alpha(1)(a) adrenoceptor-selective antagonists. 2. Approaches to eliminate opioid agonist metabolites via modification of linker and 4-methoxycarbonyl-4-phenylpiperidine moiety.
We have previously described compound 1a as a high-affinity subtype selective alpha(1a) antagonist. In vitro and in vivo evaluation of compound 1a showed its major metabolite to be a mu-opioid agonist, 4-methoxycarbonyl-4-phenylpiperidine (3). Several dihydropyrimidinone analogues were synthesized with the goal of either minimizing the formation of 3 by modification of the linker or finding alternative piperidine moieties which when cleaved as a consequence of metabolism would not give rise to mu-opioid activity. Modification of the linker gave several compounds with good alpha(1a) binding affinity (K(i) = < 1 nM) and selectivity (>300-fold over alpha(1b) and alpha(1d)). In vitro analysis in the microsomal assay revealed these modifications did not significantly affect N-dealkylation and the formation of the piperidine 3. The second approach, however, yielded several piperidine replacements for 3, which did not show significant mu-opioid activity. Several of these compounds maintained good affinity at the alpha(1a) adrenoceptor and selectivity over alpha(1b) and alpha(1d). For example, the piperidine fragments of (+)-73 and (+)-83, viz. 4-cyano-4-phenylpiperidine and 4-methyl-4-phenylpiperidine, were essentially inactive at the mu-opioid receptor (IC(50) > 30 microM vs 3 microM for 3). Compounds (+)-73 and (+)-83 were subjected to detailed in vitro and in vivo characterization. Both these compounds, in addition to their excellent selectivity (>880-fold) over alpha(1b) and alpha(1d), also showed good selectivity over several other recombinant human G-protein coupled receptors. Compounds (+)-73 and (+)-83 showed good functional potency in isolated human prostate tissues, with K(b)s comparable to their in vitro alpha(1a) binding data. In addition, compound (+)-73 also exhibited good uroselectivity (DBP K(b)/IUP K(b) > 20-fold) in the in vivo experiments in dogs, similar to 1a.
Adrenergic alpha-1 Receptor Antagonists↗