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Biomedical subjects

W S Wong

Publications and source records attributed to W S Wong.

At least 19 recordsLinked to original sources
PubMed2006

Non-tuberculous mycobacterial infection in patients with systemic lupus erythematosus.

OBJECTIVES: Patients with systemic lupus erythematosus (SLE) are susceptible to opportunistic infections. To examine the clinical manifestations of non-tuberculous mycobacterial (NTM) infections with those of Mycobacterium tuberculosis (MTB) infections in SLE patients. METHODS: Medical records of a cohort of 725 SLE patients were reviewed for previous NTM infections. Demographic characteristics, predisposing factors and clinical outcomes were compared with patients who had previous MTB infections (n = 39). RESULTS: Eleven (nine female and two male) cases were identified (prevalence 1.5%). The mean +/- S.D. age at the time of infection was 42.8 +/- 13.9 yrs, 9.3 +/- 5.8 yrs after the onset of SLE. The mean +/- S.D. time taken from onset of symptoms to the diagnosis of NTM infection was 5.7 +/- 7.2 months. Sites of involvement included skin and soft tissue (n = 8), chest (n = 2) and disseminated infection (n = 1). NTM infections were more likely to involve extrapulmonary sites (P = 0.006), presented in patients with longer lupus disease duration (P < 0.001), occurred in older patients (P < 0.001) and in those who had a higher cumulative dose of prednisolone (P = 0.01) than MTB infections. Using a stepwise logistic regression, disease duration was found to be the only independent predictive factor (P = 0.005) for NTM infections. Ten (25.6%) patients with MTB infections but none of the patients with NTM infections presented concomitantly at the onset of SLE (P = 0.09). There were no differences in the recurrence rate (P = 0.64) and frequency of disseminated infections (P = 0.40) between NTM and MTB infections. CONCLUSIONS: NTM infections tended to develop in SLE patients later in their disease course than MTB infections. A high index of suspicion is required for its diagnosis.

Adult↗
PubMed2006

HLA-B67 may be a male-specific HLA marker of susceptibility to relapsed childhood ALL in Hong Kong Chinese and HLA-A33 or HLA-B17 signifies a higher presentation leukocytosis: A retrospective analysis on 53 transplant candidates (1989-2003).

We performed a retrospective analysis on the human leukocyte antigen (HLA) data of 53 consecutive Chinese patients with high-risk childhood acute lymphoblastic leukemia (ALL) diagnosed from 1989 to 2003. A significantly higher frequency of HLA-B67 in the male relapse group of patients [OR, 23.08; 95% CI, 5.31-100.36; p = 0.0042; for statistical significance after Bonferroni correction (Bc) p (Bc) < 0.0083] was identified after Bonferroni correction. Although not surviving the Bonferroni correction, gender effects on the association were also observed with HLA-A11, HLA-A32, HLA-A33, and HLA-B22, which were however more prevalent in the female patients and particularly those developing relapse. Two patients with HLA-A29 and HLA-B7 revealed significantly shortened survivals, suggestive of their potential prognostic impacts. Notably, for the first time, we found a significant correlation of leukocyte count with HLA types, where HLA-A33 (p = 0.006) or HLA-B17 (p < 0.001) signifies higher leukocytosis at presentation. Taken together, our findings support the involvement of HLA in Chinese high-risk childhood ALL.

Adolescent↗
PubMed2006

ECM overrides DNA damage-induced cell cycle arrest and apoptosis in small-cell lung cancer cells through beta1 integrin-dependent activation of PI3-kinase.

The emergence of resistance to chemotherapy remains a principle problem in the treatment of small-cell lung cancer (SCLC). We demonstrate that extracellular matrix (ECM) activates phosphatidyl inositol 3-kinase (PI3-kinase) signaling in SCLC cells and prevents etoposide-induced caspase-3 activation and subsequent apoptosis in a beta1 integrin/PI3-kinase-dependent manner. Crucially we show that etoposide and radiation induce G2/M cell cycle arrest in SCLC cells prior to apoptosis and that ECM prevents this by overriding the upregulation of p21(Cip1/WAF1) and p27(Kip1) and the downregulation of cyclins E, A and B. These effects are abrogated by pharmacological and genetic inhibition of PI3-kinase signaling. Importantly we show that chemoprotection is not mediated by altered SCLC cell proliferation or DNA repair. Thus, ECM via beta1 integrin-mediated PI3-kinase activation overrides treatment-induced cell cycle arrest and apoptosis, allowing SCLC cells to survive with persistent DNA damage, providing a model to account for the emergence of acquired drug resistance.

Antineoplastic Agents↗
PubMed2006

Necrotizing fasciitis in rheumatic diseases.

Necrotizing fasciitis is an uncommon but life-threatening complication in immunocompromised hosts. We reported four patients with rheumatic diseases complicated by necrotizing fasciitis and reviewed 14 others from literature search. Most patients were on corticosteroid treatment. Septic shock, disseminated intravascular coagulopathy and acute renal deterioration were common giving rise to an overall mortality rate of 27.8%. Septic arthritis may also complicate the condition. Statistical analysis on the series showed the lack of major surgical debridement as the only risk factor associated with increased mortality (RR 7.5, 95% CI 2.1-27.3, P = 0.01). Timely debridement of necrotic tissue is important for reducing mortality.

Adult↗
PubMed2005

Use of convalescent plasma therapy in SARS patients in Hong Kong.

In order to evaluate the efficacy of convalescent plasma therapy in the treatment of patients with severe acute respiratory syndrome (SARS), 80 SARS patients were given convalescent plasma at Prince of Wales Hospital, Hong Kong, between 20 March and 26 May 2003. Good outcome was defined as discharge by day 22 following the onset of SARS symptoms. Poor outcome was defined as death or hospitalization beyond 22 days. A higher day-22 discharge rate was observed among patients who were given convalescent plasma before day 14 of illness (58.3% vs 15.6%; P<0.001) and among those who were PCR positive and seronegative for coronavirus at the time of plasma infusion (66.7% vs 20%; P=0.001).

Blood Component Transfusion↗
PubMed2004

Childhood acute myeloid leukemia with CBFbeta-MYH11 rearrangement: study of incidence, morphology, cytogenetics, and clinical outcomes of Chinese in Hong Kong.

We analyzed 43 consecutive cases of pediatric acute myeloid leukemia (AML) for the presence of the CBFbeta-MYH11 rearrangement using molecular techniques in a regional hospital in Hong Kong. Five cases (11.6%), 3 girls and 2 boys, ranging in age from 8 months to 14 years old, were found positive for the CBFbeta-MYH11 rearrangement. Morphologically, they were FAB M2 or M4 with or without eosinophilia (Eo). Typical M4Eo was observed in only one case. The molecular findings were in complete concordance with cytogenetic data, which revealed inv(16)(p13q22) in all and also gains of chromosome 4, 8, 22, and Y in one patient. Clinically, all 5 patients achieved complete remission after chemotherapy with favorable outcomes except for the patient with infantile AML, who relapsed 11 months after diagnosis, underwent cord blood transplantation, and was in second remission. This is the first clinicopathological study and documentation of the incidence of CBFbeta-MYH11 in childhood AML of Chinese in Hong Kong.

Adolescent↗
PubMed2004

Primary granulocytic sarcoma of the mediastinum.

Primary granulocytic sarcoma (GS) is rare, and poses a diagnostic pitfall for both pathologists and oncologists. Previous literature showed that almost half of the patients with primary GS were misdiagnosed initially. We presented the clinico-pathological and radiological features of a patient with primary mediastinal GS, and discussed the differential diagnoses and clinical management.

Adult↗
PubMed2004

The importance of needs assessment in planning health promoting schools initiatives: comparison of youth risk behaviours of two districts in Hong Kong.

A needs assessment is recommended to be carried out before planning resource allocation in a community as it could help to identify the needs of the people. This study illustrated the importance of needs assessment in planning health promoting school initiatives by comparing the results of youth risk behaviours surveys conducted at two districts of Hong Kong, namely Tsuen Wan and North District. The findings indicated that the two districts should prioritize their resources in respect to their urgent needs. A higher proportion of students from Tsuen Wan participated in vigorous exercise regularly in comparison to students from North District. Students from North District consumed more vegetable per week and exhibited less depressive symptoms than students from Tsuen Wan. The availability of data on youth risk behaviours of the two districts would provide information for strategic planning and direct decision-making in youth health programmes.

Adolescent↗
PubMed2004

Significance of the Hygiene Charter towards different sectors in Hong Kong.

The occurrence of SARS in March 2003 has resulted in an increased interest, worldwide in emerging infectious diseases. The SARS experience provided us a lesson on the importance of promoting hygienic practices among individuals and different working sectors. In Hong Kong, a voluntary organization called the UNITE proposed a Hygiene Charter which aimed at taking hygiene to new levels. This action has been supported by individuals and different sectors including the Personal and Family, Management, Buildings, Catering, Education, Finance and Commercial, Industrial, Medical and Health, Public Transportation, Social Welfare, Sports and Culture and Tourism. As promotion and maintenance of environmental health requires input from different sectors, the signing of the Hygiene Charter provides an opportunity for individuals and the public to show their pledge and commitment to good hygiene practices. As a result, with environment improvement and good infectious disease control measures, prevention of epidemics of infectious diseases is deemed to be possible.

Adult↗
PubMed2003

Alterations of RAS signalling in Chinese multiple myeloma patients: absent BRAF and rare RAS mutations, but frequent inactivation of RASSF1A by transcriptional silencing or expression of a non-functional variant transcript.

The methylation status, mutation and expression of RASSF1A, and mutations of RAS and BRAF were studied in 52 patients with multiple myeloma (MM), one plasma cell leukaemia (PCL) patient and four MM-derived cell lines. Aberrant methylation of RASSF1A was found in nine of 32 MM patients and in one of four MM cell lines (U266), where the associated loss of transcription was reversible by demethylation treatment. RASSF1A transcription was further investigated on anti-CD138-sorted plasma cell-enriched bone marrow samples from 10 MM, one PCL and three reactive plasmacytosis patients. While the wild-type RASSF1A transcript was detected in all three reactive plasmacytosis and the PCL samples, we found no detectable wild-type transcripts in six of 10 MM samples studied. In two MM samples, only the non-functional variant transcript was detected, whereas the other four showed loss of transcription. In great contrast to western data, RAS mutations were identified in only four of 31 (13%) MM patients. While no RASSF1A or BRAF mutation (V599E) was detected in any of the primary MM studied (n = 21), the latter was found in the U266 cell line. Taken together, these data indicate that alterations of RAS signalling are critical in MM pathogenesis. In our current studies of Chinese MM patients, these alterations involved frequent RASSF1A inactivation (60%) as a result of transcriptional silencing or expression of a non-functional variant transcript.

Adult↗
PubMed2002

HIV antibody testing among male commercial sex networkers, men who have sex with men and the lower-risk male general population in Hong Kong.

The present study examined the prevalence and factors that were associated with HIV testing behaviour among the MSM population, the male clients of female sex workers (FSW) population and the lower-risk male population in Hong Kong. Results revealed that out of the 2,074 male respondents surveyed, 7.3% indicated that they had been tested for HIV antibody in the past six months. The prevalence of HIV antibody testing among those who had ever had sex with the same sex (MSM) and those who had visited one or more female sex workers in the past six months was 15.5% and 16.1%, respectively. Private clinics were found to be the most popular venue for testing. Factors associated with HIV testing included whether the respondent had had sexual intercourse with FSWs in the past six months, MSM behaviour and number of female sex partners in the past six months. Possible reasons for the low prevalence of HIV antibody testing in Hong Kong and implications of the findings are discussed.

AIDS Serodiagnosis↗
PubMed2002

An unusual case of a vesicovaginal stone.

We report a case of an unusual vesicovaginal stone. The dumb-bell-shaped stone created a ball valve effect in the fistula, therefore giving rise to only mild urinary leakage despite the large size of the fistula.

Calculi↗
PubMed2001

Pertussis toxin activates tyrosine kinase signaling cascade in myelomonocytic cells: a mechanism for cell adhesion.

Pertussis toxin (PTX) has recently been shown to specifically bind to CD14 to promote myelomonocytic cell adhesion to serum. The present study investigated the signaling mechanisms responsible for PTX-induced differentiated U937 cell adhesion. PTX-induced myelomonocytic cell adhesion was blocked by genistein or tyrphostin-47 (two protein tyrosine kinase inhibitors), LY294002 (a phosphatidylinositol 3-kinase (PI3K) inhibitor), or PD098059 (a mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) kinase (MEK) inhibitor). PTX induced a rapid tyrosine phosphorylation of several discrete cytoplasmic proteins, which could be inhibited by genistein or tyrphostin 47. In addition, PTX induced phosphorylation of Akt and of ERK2, which could be completely blocked by LY294002 and PD098059, respectively, and by genistein or tyrphostin 47 as well. All of these PTX-induced signaling events could be reproduced using purified PTX B-oligomer (PTX-B) alone. Our data show that PTX can activate tyrosine kinase signaling cascade, including the downstream PI3K and ERK/MAPK pathways, in myelomonocytic cells to induce cell adhesion to serum.

Cell Adhesion↗
PubMed2001

Seventy percent of the Mycobacterium tuberculosis isolates in Hong Kong represent the Beijing genotype.

We used spoligotyping to study 500 randomly selected pretreatment Mycobacterium tuberculosis (MTB) strains isolated in Hong Kong during the 2 year period 1998-9. It was found that amongst all MTB strains studied, the 'Beijing' genotype strains were highly prevalent in our geographic area, representing about 70% of the isolates. Unlike previous observations in Vietnam, no significant associations were found either between 'Beijing' genotype strains and all other anti-tuberculosis drug resistance phenotypes, or with particular patients' age groups, except for a weak association with isoniazid susceptibility. Eighteen of these strains exhibited spoligotype patterns that were similar but not identical to the 'Beijing' specific pattern. This is the first geographical area where genetic diversity among 'Beijing' genotype of MTB strains has been observed on this scale.

China↗
PubMed2001

AIDS-related discrimination in the workplace--the results of two evaluative surveys carried out during a three-year period in Hong Kong.

Two longitudinal surveys were carried out in 1996 and 1999 aimed at describing the situations of AIDS-related discrimination in the workplace and evaluating the effectiveness of some social interventions against discrimination towards HIV-positive employees. Two hundred and ninety-nine and 212 companies completed a questionnaire in 1996 and 1999, respectively. The results are mixed. Although most of the sampled companies had no HIV/AIDS-related policy, their awareness of related legislation increased over the three-year period. Over the three-year study period, more companies indicated they would disclose information of their HIV-positive employees if known to the company; however, fewer companies indicated they would dismiss an employee because of his or her HIV-positive status. Only a few companies indicated that they would provide counselling and support to an HIV-positive employee.

HIV Seropositivity↗