Search PubMed⌕ Search

Biomedical subjects

W K Chan

Publications and source records attributed to W K Chan.

At least 91 records · Page 5Linked to original sources
PubMed1996

Corneal pannus associated with contact lens wear.

PURPOSE: To determine whether contact lens, related corneal pannus regressed when eyes were refitted with rigid gas-permeable contact lenses and to investigate the role of hypoxia as the putative origin of this complication. METHODS: Twenty-three eyes of 14 patients with corneal pannus were identified retrospectively from a referral practice population and were separated into two subgroups. One subgroup accepted refitting with rigid gas-permeable contact lenses or discontinued contact lens wear, and the other elected to continue wearing hydrogel or polymethylmethacrylate contact lenses. The response of pannus was observed by slit-lamp biomicroscopy and photographs and was compared between the two subgroups. One eye of each of six patients identified with bilateral corneal pannus secondary to daily wear of hydrogel contact lenses was selected at random. Duplicates of the hydrogel contact lenses worn by these eyes were obtained, and their peripheral oxygen transmissibility (Dk/Lp) values were compared with those of a control group of hydrogel contact lenses identical to those worn by another group of patients, matched by age, gender, and laterality to the study group, but who did not have corneal vascularization. RESULTS: Vascularization regressed in 14 eyes of nine patients refitted with rigid gas-permeable contact lenses and also in both eyes of one patient who discontinued contact lens wear. All seven eyes of five patients who declined refitting showed persistence or increase of pannus. The mean Dk/Lp of the hydrogel contact lenses for six eyes with pannus was 3.8 X 10(-9) cm ml O2/s ml mm Hg; mean Dk/Lp was 8.6 X 10(-9) cm ml O2/s ml mm Hg for the lens of the control eyes. This difference was found to be statistically significant (P = .028). CONCLUSION: Peripheral, contact lens-induced hypoxia is a risk factor for corneal pannus, and conversion from hydrogel or polymethylmethacrylate contact lenses to daily wear rigid gas-permeable contact lenses in these eyes successfully reversed this complication.

Adolescent↗
PubMed1996

Corneal scarring after photorefractive keratectomy in a penetrating keratoplasty.

PURPOSE: To report severe scarring in a corneal graft after excimer laser photorefractive keratectomy. METHODS: A 35-year-old man underwent photorefractive keratectomy twice for severe compound myopic astigmatism and anisometropia after penetrating keratoplasty. RESULTS: Corneal opacity corresponded to areas of irregular epithelial thickness, focal absence of the basement membrane, loss of Bowman's layer, and stromal scarring in the ablation zone. CONCLUSION: There may be an increased risk of severe corneal stromal scarring from photorefractive keratectomy in eyes that have had previous penetrating keratoplasty.

Adult↗
PubMed1996

Notational analysis on game strategy used by the world's top male squash players in international competition.

The purpose of this study was to provide a profile of the competition strategy used by the world's top squash players at the international level and provide recommendations for other players to improve their playing strategy. A total of 10 matches including three in round one, the four quarter finals, the two semi-finals, and the final of the 1993 Hong Kong Squash Open were filmed using a 3-CDD video camera. The tournament was played under the North American scoring system. Notational analysis which is based on frame by frame video analysis was used to categorize a player's motion. The frequency of each stroke, and the success or failure rate of each stroke were recorded. Shots were classified as "effective", "ineffective", "winning" and "losing" shots and the analysis demonstrated that 70.28% were "effective", 19.86% were "ineffective", 5.37% were "winning" and 4.48% were "losing" shots. The mean number of shots per game was 252.09. The order of priority using different kinds of strokes in matches were as follows: drive (length) (60.79%), drop (17.91%), volley (11.79%), boast (4.80%), and lob (4.72%). The results of this study show that the "pressure and attack game" was the most important strategy for the world's top squash players in producing winning performances. Also identified are the strokes and the strategies which should be practiced to improve performance. This method of notational analysis can be utilized to evaluate the strengths and weaknesses of players at all levels of competition.

Competitive Behavior↗
PubMed1996

Case reports and mini review of bee stings of the cornea.

Bee stings of the eye are not uncommon. Quite a few clinical case reports have documented the various ocular reactions to the venom of the bee stings, which may range from mild conjunctivitis to sudden loss of vision. This report presents 2 patients who suffered bee stings to the cornea and their different outcomes. The properties of bee venom as well as the treatment of various possible complications are also discussed.

Adult↗
PubMed1996

Fusarium keratitis following the use of topical antibiotic-corticosteroid therapy in traumatised eyes.

Keratomycosis is a rare sight-threatening infection of the cornea. Important predisposing factors in its pathogenesis include corneal trauma and use of topical corticosteroid or antibiotic-corticosteroid therapy. Some family physicians are unaware of the dangers of unmonitored topical corticosteroid therapy for traumatised eyes. Three cases of Fusarium keratitis following the use of topical antibiotic-corticosteroid therapy in traumatised eyes are reported. Despite aggressive anti-fungal therapy, one eye required a therapeutic penetrating keratoplasty for impending corneal perforation, another eye progressed to corneal perforation and required evisceration while the third eye developed endophthalmitis which also required evisceration. The potential danger of fungal infections of the cornea following the unmonitored use of topical antibiotic-corticosteroids in traumatised eyes is highlighted.

Adrenal Cortex Hormones↗
PubMed1996

Problems of refraction after photorefractive keratectomy.

BACKGROUND: Excimer laser photorefractive keratectomy (PRK) is a refractive procedure to correct myopia that is gaining worldwide acceptance. PRK has been performed as an open-ended clinical trial since January 1992, and specific problems have been encountered in refracting PRK patients. METHODS: A review of all cases of PRK performed with at least 1-year follow-up was conducted. Nine hundred and seventy-one eyes with myopia ranging from -2.00 to -15.00 diopters had preoperative manifest and cycloplegic refraction, and postoperative refraction at 3 months after treatment. RESULTS: Refractive difficulty due to degradation of the retinoscopic reflex was encountered in patients who developed moderate to severe haze (seven eyes). Small ablation zones (5 mm) and decentered ablations also contributed to confusion in interpretation of the retinoscopic reflex. In addition, excessive accommodation, profound early myopic and hypermetropic shifts, postoperative irregular astigmatism and inaccurate autorefractometer readings contributed to difficulty in refraction. CONCLUSIONS: Laser ablation of the central cornea produces alterations in optical homogeneity of the cornea that may cause significant refractive difficulties. Refracting PRK patients requires careful and consistent refraction by an experienced refractionist, both before and after laser treatment.

Accommodation, Ocular↗
PubMed1995

Elimination of dose limiting toxicities of cisplatin, 5-fluorouracil, and leucovorin using a weekly 24-hour infusion schedule for the treatment of patients with nasopharyngeal carcinoma.

BACKGROUND: Cisplatin, 5-flourouracil (5-FU), and leucovorin (PFL) chemotherapy has been reported to be effective in the treatment of cancers but severe mucositis or neutropenia are dose limiting toxicities. This Phase II study evaluated the anticancer effect and the toxicities of a new weekly 24-hour infusional PFL chemotherapy in patients with nasopharyngeal carcinoma (NPC). METHODS: Forty-two patients with stage IV NPC were studied. Cisplatin 25 mg/m2/d, 5-FU 2200 mg/m2/d, and leucovorin 120 mg/m2/d were adminstered weekly by 24-hour intravenous continuous infusion in an outpatient setting. Clinical response and toxicity were evaluated weekly. RESULTS: The complete response rate (CR) was 30% and the partial response (PR) rate 60% in the localized previously untreated group. The CR rate was 22.7% and PR rate 45.5% in local recurrent/metastatic group. The overall response rate was 79%. Eighty-one percent of patients who had no previous chemotherapy and 67% of patients who had previous chemotherapy responded to weekly PFL. There were no dose limiting toxicities. No patient had grade 3 or 4 mucositis or neutropenia. Thirty-two patients (76%) had no oral mucositis. Seven patients (17%) had grade 1 mucositis and 3 patients (7%) had grade 2 mucositis. CONCLUSIONS: Elimination of dose limiting toxicities is possible using a weekly 24-hour infusion schedule of PFL chemotherapy while retaining significant anticancer activity as demonstrated in these patients with advanced NPC. To discover whether this schedule is superior to cisplatin and 5-FU or other PFL chemotherapy regimens requires further investigation.

Adult↗
PubMed1995

DNA binding specificities and pairing rules of the Ah receptor, ARNT, and SIM proteins.

The Ah receptor (AHR), the Ah receptor nuclear translocator protein (ARNT), and single-minded protein (SIM) are members of the basic helix-loop-helix-PAS (bHLH-PAS) family of regulatory proteins. In this study, we examine the DNA half-site recognition and pairing rules for these proteins using oligonucleotide selection-amplification and coprecipitation protocols. Oligonucleotide selection-amplification revealed that a variety of bHLH-PAS protein combinations could interact, with each generating a unique DNA binding specificity. To validate the selection-amplification protocol, we demonstrated the preference of the AHR.ARNT complex for the sequence commonly found in dioxin-responsive enhancers in vivo (TNGCGTG). We then demonstrated that the ARNT protein is capable of forming a homodimer with a binding preference for the palindromic E-box sequence, CACGTG. Further examination indicated that ARNT may have a relaxed partner specificity, since it was also capable of forming a heterodimer with SIM and recognizing the sequence GT(G/A)CGTG. Coprecipitation experiments using various PAS proteins and ARNT were consistent with the idea that the ARNT protein has a broad range of interactions among the bHLH-PAS proteins, while the other members appear more restricted in their interactions. Comparison of this in vitro data with sites known to be bound in vivo suggests that the high affinity half-site recognition sequences for the AHR, SIM, and ARNT are T(C/T)GC, GT(G/A)C (5'-half-sites), and GTG (3'-half-sites), respectively.

Amino Acid Sequence↗
PubMed1995

Determination of anticancer drug vitamin K3 in plasma by high-performance liquid chromatography.

Synthetic vitamin K3 (VK3, 2-methyl-1,4-naphthoquinone, or menadione) has been found to exhibit antitumor activity against various human cancer cells at relative high dose. Parallel to our study on the mechanism of VK3 action and for future clinical trials in Taiwan, we developed a simple, sensitive and accurate high-performance liquid chromatographic method for the determination of VK3 in biological fluids. VK3 was extracted from the plasma samples with n-hexane. The chromatographic separation employed an ODS analytical column (5 microns, 250 x 4.6 mm I.D.) with a mobile phase of methanol-water (70:30, v/v) and UV detection at 265 nm. On completely drying of the extraction solution, n-hexane, by a stream of nitrogen, menadione was lost to a great extent. Methanol (70%, 200 microliters) was added to the extraction solvent after extraction and centrifugation to prevent the loss of menadione. The absolute recovery was 82.4 +/- 7.69% (n = 7). The within-day and between-day calibration curves of VK3 in plasma in the ranges of interest (0.01-10.00 micrograms/ml; 0.01-5.00 micrograms/ml) showed good linearity (r > 0.999) and acceptable precision. The limit of quantitation of VK3 was 10 ng/ml in plasma. This method has been successfully applied to a pilot pharmacokinetic study of VK3 in rabbits receiving an intravenous high-dose bolus injection of 75 mg menadiol sodium diphosphate (Synkayvite). The pharmacokinetic properties of menadione could be described adequately by an open two-compartment model. The mean half-life of menadiol (transformation to menadione) was 2.60 +/- 0.12 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Nuclear and cytoplasmic bcl-2 expression in endometrial hyperplasia and adenocarcinoma.

The bcl-2 proto-oncogene, which inhibits programmed cell death (apoptosis), has recently been found to be cyclically expressed in human endometrium. In order to investigate its role in endometrial hyperplasia and neoplasia, bcl-2 expression was studied in 25 cases of endometrial carcinoma and 20 cases of endometrial hyperplasia (eight simple, two complex, and ten atypical hyperplasias). Uniform intense cytoplasmic bcl-2 expression was found in all cases of non-atypical hyperplasia, and less strong positivity in eight out of ten cases of atypical hyperplasia. In well-differentiated carcinomas, nine out of ten showed weak to moderate bcl-2 expression, whereas six out of seven poorly differentiated carcinomas were bcl-2-negative. Moderately differentiated tumours were an intermediate group, with six out of eight being positive. Widespread localization of bcl-2 protein to the chromosomes of dividing cells was also demonstrated, regardless of cytoplasmic bcl-2 expression, with rare staining of interphase nuclei. Our findings suggest a role for bcl-2 in the natural history of endometrial neoplasia and studies are needed to determine its usefulness as a prognostic marker. The finding of bcl-2 localization to chromosomes has important implications for its mode and site of action.

Adenocarcinoma↗
PubMed1995

Inhaled nitric oxide improves oxygenation in piglets with meconium aspiration.

We hypothesized that nitric oxide (NO) inhalation in a model of meconium aspiration in newborn piglets would decrease pulmonary vascular resistance. Seven neonatal piglets were obtained at less than 48 hr of age and instrumented under fentanyl anesthesia. Inhaled NO (40 parts per million) was administered during normoxia and again after hypoxia was induced by reducing FiO2 to 0.13. During normoxia NO inhalation caused a fall in pulmonary artery pressure from a mean of 3.15 (SD 0.8) kPa to 2.84 (SD 0.7) kPa (P < 0.01). Hypoxia (mean arterial O2 saturation 35%) increased PA pressures to a mean of 5.4 (SD 1.6) kPa and NO administration during hypoxia decreased PA pressures to 3.6 (SD 1.2) kPa (P < 0.001). In order to determine the effects of NO in a model of meconium aspiration, 6 to 7 mL/kg of 20% human meconium in normal saline was instilled into the trachea. This procedure induced hypoxemia (mean SaO2 43.4%, SD 19), respiratory acidosis, (mean PaCO2 12.1 kPa, SD 0.5; mean pH 7.04, SD 0.03), and pulmonary arterial hypertension (mean pulmonary artery pressure 6.0 kPa, SD 1.3) despite ventilation with 90% oxygen. Inhaled NO was then administered in concentrations of 5, 10, 20, 30, 40, 60, and 80 parts per million in random order according to a Latin square design.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1995

Lipiodol uptake and retention by human hepatoma cells.

Lipodol has important diagnostic and therapeutic uses in hepatoma. However, the mechanisms of its selective, prolonged retention in hepatoma cells is not well understood. Therefore, using oil-red O, light and electron microscopy and neutron activation analysis we have determined that HepG2 cells are characterized by lipiodol deposition and emulsification on the cell surface, action uptake of lipodol by endocytosis, and prolonged intracellular retention. These findings may have major clinical significance in the development of a new treatment for hepatoma patients.

Carcinoma, Hepatocellular↗
PubMed1995

A multicenter trial of photorefractive keratectomy for residual myopia after previous ocular surgery. Summit Therapeutic Refractive Study Group.

PURPOSE: The Summit Therapeutic Refractive Clinical Trial is a nine-center prospective, nonrandomized, self-controlled trial to assess the efficacy, stability, and safety of using a standardized technique of excimer laser photorefractive keratectomy (PRK) to correct residual myopia in eyes with previous refractive surgery or cataract surgery. PATIENTS AND METHODS: Eligible eyes with a mean residual myopia of -3.7 +/- 1.8 diopters (D) (range, -0.63 to -11.00 D) underwent PRK with a 193-nm excimer laser for myopic corrections between -1.50 and -7.50 D. Standardized settings were used for the ablation zone, ablation rate, repetition rate, and fluence. One hundred seven of the first 114 treated eyes were examined 1 year after PRK, with 98% of eyes having had refractive keratotomy and 2% having had cataract surgery. RESULTS: One year postoperatively, the mean manifest spherical equivalent refraction was -0.6 +/- 1.4 D (range, -6.50 to 2.50 D); 63% of eyes were within +/-1.00 D of the attempted correction; and uncorrected visual acuity was 20/40 or better in 74% of eyes. Twenty-nine percent of eyes lost two or more Snellen lines of best-corrected visual acuity, and central corneal haze was moderate or severe in 8% of eyes. CONCLUSIONS: Excimer laser PRK is effective in reducing residual myopia after previous refractive and cataract surgery. However, it is less accurate than PRK in eyes that did not undergo surgery and is more likely to cause a loss of best-corrected visual acuity 1 year after treatment.

Adult↗
PubMed1995

A blind, randomized comparison of the circulatory effects of dopamine and epinephrine infusions in the newborn piglet during normoxia and hypoxia.

OBJECTIVE: To determine the hemodynamic responses to dopamine and epinephrine infusions in newborn piglets during normoxia and hypoxia. DESIGN: Prospective, randomized, blind cross-over study. SUBJECTS: Newborn piglets (n = 7). INTERVENTIONS: Animals were acutely instrumented for measurements of cardiac output, pulmonary and systemic pressures, carotid and coronary artery blood flow, and coronary artery oxygen consumption. Dopamine at infusion rates of 2 to 16 micrograms/kg/min and epinephrine 0.2 to 1.6 micrograms/kg/min were administered during normoxia. Six piglets were similarly prepared and were then made hypoxic to an arterial O2 saturation of 45% to 50%. Epinephrine at infusion rates of 0.2 to 3.2 micrograms/kg/min and dopamine at rates of 2 to 32 micrograms/kg/min were administered in random order during hypoxia. MEASUREMENTS AND MAIN RESULTS: During normoxia, cardiac output increased similarly with both drugs and was significantly increased by > or = 0.2 micrograms/kg/min of epinephrine and significantly increased by 8 or 16 micrograms/kg/min of dopamine. Mean arterial blood pressure was not affected by dopamine but was significantly increased by epinephrine at a rate of 1.6 micrograms/kg/min. The relative effects of the drugs on pulmonary and systemic vascular resistance differed, the pulmonary/systemic vascular resistance ratio was reduced at the higher doses of epinephrine (i.e., 0.8 and 1.6 micrograms/kg/min) and was unaffected by dopamine. Coronary artery oxygen consumption and coronary blood flow increased significantly with both medications at rates > 0.4 and 4 micrograms/kg/min, respectively. Increases of both variables were greater with epinephrine than with dopamine. Myocardial extraction ratio was unaffected by dopamine and reduced at 0.2 and 1.6 micrograms/kg/min of epinephrine. Hypoxia caused significant increases in cardiac index, systemic blood pressure, pulmonary arterial pressure, carotid artery blood flow, coronary artery blood flow, coronary oxygen consumption, coronary oxygen extraction ratio, and the pulmonary/systemic vascular resistance ratio. Mean systemic arterial blood pressure increased significantly with 1.6 and 3.2 micrograms/kg/min of epinephrine, but was not significantly affected by dopamine at any infusion rate. Cardiac index was not affected significantly by either of the medications. Thus, there was a significant increase in the calculated systemic vascular resistance index with the highest dose of epinephrine, in contrast to the slight, statistically significant, decrease in calculated systemic vascular resistance index with the highest dose of dopamine. Epinephrine significantly reduced pulmonary arterial pressures at 0.2, 0.4, and 0.8 microgram/kg/min. Dopamine had no effect on this variable. The pulmonary/systemic vascular resistance ratio was significantly reduced by epinephrine at doses of 0.2 and 3.2 micrograms/kg/min, whereas the highest dose of dopamine caused a significant increase in the pulmonary/systemic vascular resistance ratio. CONCLUSIONS: Epinephrine infusion during normoxia increases systemic pressure more than pulmonary arterial pressure at doses > or = 8 micrograms/kg/min, and furthermore, produces a more appropriate hemodynamic profile in the presence of hypoxic pulmonary hypertension than dopamine infusion, in the acutely operated anesthetized piglet.

Animals↗
PubMed1995

Nonischemic ventricular tachycardia: surgical or medical treatment?

Fifty-two consecutive patients with nonischemic ventricular tachycardia (VT) were seen between 1985 and 1991. Twenty-two patients underwent surgery, while in the remaining 30, the VT was well controlled on medication. In the surgical group, arrhythmogenic right ventricular dysplasia (ARVD) was the cause of VT in 12 patients, cardiomyopathy (CM) in 6, posttetralogy of Fallot repair in 2, myocarditis in 1, and myocardial hamartoma in 1. The mean number of drugs tried and found ineffective was 5.5. There were three early deaths; 13 patients are symptom-free without taking any medication. In the medical group, the pathology associated with the VT was myocarditis in 2 patients, CM in 11, and ARVD in 2. In ten patients, VT appeared idiopathic, 1 was exercise-induced, 3 were catecholamine sensitive, and 1 presented with long QT syndrome. Beta blockers controlled the symptoms in 43% of the patients, amiodarone in 20%, and flecainide in 17%. The mortality was higher in the surgical group, but 95% of them are VT-free, compared with those on medical treatment (55%) over the last 8 years' follow-up. In conclusion, the nonischemic VT is a serious condition. Medical therapy is usually effective, but if it fails, VT surgery should be considered.

Adolescent↗
PubMed1995

Effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients after cisplatin, fluorouracil, and leucovorin chemotherapy.

PURPOSE: To evaluate prospectively the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) in the reduction of chemotherapy-induced oral mucositis. PATIENTS AND METHODS: Twenty patients with stage IV squamous cell carcinoma of head and neck were studied. Two-cycles (periods) of identical doses of cisplatin, fluorouracil (5-FU), and leucovorin (PFL) chemotherapy with cisplatin 20 mg/m2/d, 5-FU 800 mg/m2/d, leucovorin 90 mg/m2/d by 96-hour continuous intravenous infusion every 3 weeks were given to each patient. After PFL chemotherapy, GM-CSF 4 micrograms/kg subcutaneously from days 5 to 14 or no therapy was given by a randomized self-controlled crossover study design. Oral mucositis was graded with modified Radiation Therapy Oncology Group criteria. RESULTS: In the first cycle of PFL chemotherapy, GM-CSF significantly reduced the incidence, mean duration, and mean area under the curve (AUC) of severe oral gross mucositis (grade > or = 3) compared with no therapy. These beneficial effects continued into the second cycle of PFL chemotherapy after crossover to no GM-CSF. The incidence of severe mucositis was reduced when GM-CSF was given in the second cycle of PFL. Analysis of variance indicated significant direct GM-CSF treatment effects on the mean AUC of gross/functional scores and duration of moderate gross mucositis (grade > or = 2) over both periods. There was a significant period effect in favor of giving GM-CSF in the first cycle of chemotherapy. CONCLUSION: GM-CSF can significantly reduce the severity and duration of chemotherapy-induced oral mucositis after PFL chemotherapy.

Adult↗