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Misdiagnosis of Sexually Transmitted Diseases in Hong Kong Outpatient Private Healthcare

Open Journal of Medical Microbiology 2023年第1期13卷 31-42页

作者： Andes lau David W. y. Ho Clinical Laboratory Service Unit Pangenia Life Sciences Ltd. Hong Kong China

Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impose adverse effects on patient treatment. Sexually transmitted disease (STD) is one of the most common infectious diseases, and more than one million of STD cases are acquired every day globally. Misdiagnosis of STD inevitably exists, therefore should not be overlooked. Being a medical diagnostic laboratory providing various STDs diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of STDs and investigate the possible underlying cause. Methods: Specimens were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20 October 2021 from different clinics and hospitals were included in the study. DNA extraction was performed using magnetic bead based method;then the extracted DNA was tested using the DiagCor GenoFlowTM STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period, with 643 specimens found to be positive with at least one targeted STD pathogen. 494 of these were found to be aligned with test ordered by physicians, and the remaining 149 positive cases had at least one pathogen detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was determined to be 23.2% (149/643), with high frequency of misdiagnosis occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion: The findings suggested incorrect test selection made by physicians was one of the major reasons of STDs misdiagnosis in outpatient settings. To reduce diagnostic errors in STD diagnosis, physicians are encouraged to select and request test that allow detection o

关键词： Sexually Transmitted Diseases (STDs) Diagnostic Error Misdiagnosis Incorrect Decision

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Classification of iatrogenic bile duct injury

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Hepatobiliary & Pancreatic Diseases International 2007年第5期6卷 459-463页

作者： Wan-yee lau Eric C.H.Lai Department of Surgery the Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina

BACKGROUND: Iatrogenic bile duct injury continues to be an important clinical problem, resulting in serious morbidity, and occasional mortality, to patients. The ease of management, operative risk, and outcome of bile duct injuries vary considerably, and are highly dependent on the type of injury and its location. This article reviews the various classification systems of bile duct injury. DATA SOURCES: A Medline, PubMed database search was performed to identify relevant articles using the keywords 'bile duct injury', 'cholecystectomy', and 'classification'. Additional papers were identified by a manual search of the references from the key articles. RESULTS: Traditionally, biliary injuries have been classified using the Bismuth's classification. This classification, which originated from the era of open surgery, is intended to help the surgeons to choose the appropriate technique for the repair, and it has a good correlation with the final outcome after surgical repair. However, the Bismuth's classification does not encompass the whole spectrum of injuries that are possible. Bile duct injury during laparoscopic cholecystectomy tends to be more severe than those with open cholecystectomy. Strasberg's classification made Bismuth's classification much more comprehensive by including various other types of extrahepatic bile duct injuries. Our group, Bergman et al, Neuhaus et al, Csendes et al, and Stewart et al have also proposed other classification systems to complement the Bismuth's classification. CONCLUSIONS: None of the classification system is universally accepted as each has its own limitation. Hopefully, a universally accepted comprehensive classification system will be published in the near future.

关键词： laparoscopic cholecystectomy bile duct injury bile duct stricture bile leak classification

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Tumor cyclooxygenase-2 levels correlate with tumor invasiveness in human hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第13期11卷 1896-1902页

作者： TerenceC.Tang RonnieT.Poon CeciliaP.lau Danxie SheungTatFan CentrefortheStudyofLiverDisease andDepartmentofSurgerytheUniversityofHongKongPokfulamHongKongChina DepartmentofClinicalOncology theUniversityofHongKongPokfulamHongKongChina

ABM: Recent studies suggested that cyclooxygenase-2 (COX-2) enhances tumor angiogenesis via upregulation of vascular endothelial growth factor (VEGF). Although COX-2 expression has been demonstrated in hepatocellular carcinoma (HCC), the significance of COX-2 in progression of HCC remains unclear. This study evaluated the clinico-pathological correlation of COX-2 level and its relationship with VEGF level in HCC. METHODS: Fresh tumor tissues were obtained from 100 patients who underwent resection of HCC. COX-2 protein expression was examined by immunohistochemistry, and quantitatively by an enzyme immunometric assay (EIA) of tumor cytosolic COX-2 levels. Tumor cytosolic VEGF levels were measured by an ELISA. RESULTS: Immunostaining showed expression of COX-2 in tumor cells. Tumor cytosolic COX-2 levels correlated with VEGF levels (r = 0.469,Py higher tumor cytosolic COX-2 levels in the presence of multiple tumors (P = 0.027), venous invasion (P = 0.030), microsatellite lesions (P=0.037) and advanced tumor stage (P = 0.008). Higher tumor cytosolic COX-2 levels were associated with worse patient survival. CONCLUSION: This study shows that elevated tumor COX-2 levels correlate with elevated VEGF levels and invasiveness in HCC, suggesting that COX-2 plays a significant role in the progression of HCC.

关键词： Cyclooxygenase-2 Vascular endothelial growth factor Hepatocellular carcinoma

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Predicting scour beneath subsea pipelines from existing small free span depths under steady currents

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Journal of Ocean Engineering and Science 2017年第2期2卷 61-75页

作者： Jun y.Lee Jasmin McInerney Remo Cossu Zhi Q.Leong alexander L.Forrest National Centre for Maritime Engineering and Hydrodynamics Australian Maritime CollegeUniversity of Tasmania1 Maritime WayNewnham Tasmania 7248Australia Department of Civil and Environmental Engineering University of California–Davis1 Shields AvenueDavisCA 95616United States of America School of Civil Engineering University of QueenslandSt Lucia Queensland 4072Australia

An equation was developed to predict current-induced scour beneath subsea pipelines in areas with small span depths,*** equations for scour prediction are only applicable to partially buried *** existence of small span depths(i.e.S/Dy for scour is higher at smaller span ***,it is impractical to perform rectification works,such as installing grout bags,under a pipeline with a small S/***-scale two-dimensional computational fluid dynamics(CFD)simulations were performed using the Reynolds-averaged Navier-Stokes approach and the Shear stress transport k-ωturbulence *** predict the occurrence of scour,the computed maximum bed shear stress beneath the pipe was converted to the dimensionless Shields parameter,and compared with the critical Shields parameter based on the mean sediment grain *** numerical setup was verified,and a good agreement was found between model-scale CFD data and experimental *** data were obtained to determine the mean grain size,far field current velocity and to measure the span depths along the surveyed pipe length.A trend line equation was fitted to the full-scale CFD data,whereby the maximum Shields parameter beneath the pipe can be calculated based on the undisturbed Shields parameter and S/D.

关键词： Sediment scour Subsea pipelines Small span depths Steady currents

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The new molecular diagnostics in cancer treatment and early diagnosis

The new molecular diagnostics in cancer treatment and early ...

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中华医学会第八次全国检验医学学术会议暨中华医学会检验分会成立30周年庆典大会

作者： Pauline y.lau President Suntec MedicalInc.USAPh.D.

Molecular diagnostics,the child of the human genome research,is the fastest developing segment among the in-vitro diagnostic *** is fueled by the public demand of a better, more predictive *** markers enables the clin...

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Expression of the human TSPy gene in the brains of transgenic mice suggests a potential role of this y chromosome gene in neural functions

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Journal of Genetics and Genomics 2011年第5期38卷 181-191页

作者： Tatsuo Kido Stephanie Schubert Jrg Schmidtke yun-Fai Chris lau Division of Cell and Developmental Genetics Department of MedicineVA Medical Centerand Institute for Human GeneticsUniversity of California Institute of Human Genetics Hannover Medical School

The testis specific protein y-encoded （TSPy） is a member of TSPy/SET/NAP1 superfamily, encoded within the gonadoblastoma locus on the y chromosome. TSPy shares a highly conserved SET/NAP-domain responsible for protein--protein interaction among TSPy/SET/NAP 1 proteins. Accumulating data, so far, support the role of TSPyas the gonadoblastoma gene, involved in germ cell tumorigenesis. The X-chromosome homolog of TSPy, TSPX is expressed in various tissues at both fetal and adult stages, including the brain, and is capable of interacting with the multi-domain adapter protein CASK, thereby influencing the synaptic and transcriptional functions and developmental regulation of CASK in the brain and other neural tissues. Similar to TSPX, we demonstrated that TSPy could interact with CASK at its SET/NAP-domain in cultured cells. Transgenic mice harboring a human TSPygene and flanking sequences showed specific expression of the human TSPytransgene in both testis and brain. The neural expression pattern of the human TSPygene overlapped with those of the endogenous mouse Cask and Tspx gene. Similarly with TSPX, TSPy was co-localized with CASK in neuronal axon fibers in the brain, suggesting a potential role（s） of TSPy in development and/or physiology of the nervous system.

关键词： TSPy TSPX CASK y chromosome Neuron Testis

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The interaction of stem cells and vascularity in peripheral nerve regeneration

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Neural Regeneration Research 2021年第8期16卷 1510-1517页

作者： Sara Saffari Tiam M.Saffari Dietmar J.O.Ulrich Steven E.R.Hovius alexander y.Shin Division of Hand and Microvascular Surgery Department of Orthopedic SurgeryMayo ClinicRochesterMNUSA Department of Plastic and Reconstructive Surgery Radboud University Medical CenterNijmegenthe Netherlands

The degree of nerve regeneration after peripheral nerve injury can be altered by the microenvironment at the site of injury. Stem cells and vascularity are postulated to be a part of a complex pathway that enhances peripheral nerve regeneration;however, their interaction remains unexplored. This review aims to summarize current knowledge on this interaction, including various mechanisms through which trophic factors are promoted by stem cells and angiogenesis. Angiogenesis after nerve injury is stimulated by hypoxia, mediated by vascular endothelial growth factor, resulting in the growth of preexisting vessels into new areas. Modulation of distinct signaling pathways in stem cells can promote angiogenesis by the secretion of various angiogenic factors. Simultaneously, the importance of stem cells in peripheral nerve regeneration relies on their ability to promote myelin formation and their capacity to be influenced by the microenvironment to differentiate into Schwann-like cells. Stem cells can be acquired through various sources that correlate to their differentiation potential, including embryonic stem cells, neural stem cells, and mesenchymal stem cells. Each source of stem cells serves its particular differentiation potential and properties associated with the promotion of revascularization and nerve regeneration. Exosomes are a subtype of extracellular vesicles released from cell types and play an important role in cell-to-cell communication. Exosomes hold promise for future transplantation applications, as these vesicles contain fewer membrane-bound proteins, resulting in lower immunogenicity. This review presents pre-clinical and clinical studies that focus on selecting the ideal type of stem cell and optimizing stem cell delivery methods for potential translation to clinical practice. Future studies integrating stem cell-based therapies with the promotion of angiogenesis may elucidate the synergistic pathways and ultimately enhance nerve regeneration.

关键词： angiogenesis exosomes nerve graft nerve regeneration peripheral nerve injury revascularization Schwann cells stem cells stem cell delivery vascularity

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纳米二氧化硅填料量对LDPE复合材料局部放电特性的影响(英文)

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高电压技术 2011年第11期37卷 2629-2635页

作者： Z.Abdul-Malek A.M.Azzin y.Z.Arief Aulia K.y.lau M.Jaafar UTM Institute of High Voltage & High Current Universiti Teknologi MalaysiaMalaysia School of Materials & Mineral Resources Engineering Universiti Sains MalaysiaMalaysia

Partial discharges(PDs) due to artificial void in samples of LDPE nanocomposite sheet have been investigated in this *** may cause the degradation of insulating materials and may affect the lifetime of high-voltage apparatus. An experimental work using sphere ball-plane electrode system(CIGRE MethodⅡ) and a 1.0 mm LDPE composite sheet was carried *** weight percentages of nanosilica(0%,2%,4%,6%and 8%) were used. PD experimental results,such as PD magnitude and PD number(both PD pulse polarities),as functions of the applied stress duration at a specified applied voltage were *** surface morphology of specimens was also presented and this conforms to the PD *** experimental results show that the PD characteristics of the LDPE generally improve with the introduction of nanosilica,the composite with the highest content of filler,namely the 8%(wt) nanosilica sample has the least partial discharge activities.

关键词： LDPE nanocomposite nanosilica partial discharges

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Combating an invisible enemy: The American military response to global pandemics

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Military Medical Research 2021年第3期8卷 326-335页

作者： lauren K.Dutton Peter C.Rhee alexander y.Shin Richard J.Ehrlichman Richard J.Shemin Department of Orthopedic Surgery Mayo Clinic2001st Street SWRochesterMN 55905USA Navy Medicine Professional Development Center BethesdaMD 20889USA United States Air Force Reserve the 60th Ops SquadronTravis AFBCA 94535USA Division of Plastic and Reconstructive Surgery Massachusetts General HospitalBostonMA 02114USA Massachusetts National Guard United States ArmyHanscom AFBMA 01731USA Division of Cardiac Surgery Department of SurgeryCardiovascular Center at UCLADavid Geffen School of Medicine at UCLALos AngelesCA 90095USA

The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped enable the spread of influenza in the fall of 1918 during World War I such that an estimated 20%–40% of U.S. military members were infected. While the coronavirus disease 2019(COVID-19) pandemic is unparalleled for most of today's population, it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten. This article provides a historical perspective on the effect of the most notable antecedent pandemic, the Spanish Influenza epidemic, on American forces with the goal of understanding the interrelationship of global pandemics and the military, highlighting the unique challenges of the current pandemic, and examining how the American military has fought back against pandemics both at home and abroad, both 100 years ago and today.

关键词： Pandemic Spanish influenza COVID-19 Military Influenza

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Transient bone resorption following finger replantation： a report of 3 cases

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Chinese Journal of Traumatology 2011年第3期14卷 178-182页

作者： Stefano Lucchina Hillary A. Becker Cesare Fusetti alexander y. Shin Hand Unit EOC Surgical Department Locarno's Re- gional Hospital 6600 Locarno Switzerland Division of Hand and Microvascular Surgery Department of Orthopaedic Surgery Mayo Clinic Rochester MN 55905 USA

Radiographic changes consisting of al- terations in mineral content, osteopaenia or destructive neuropathy that occur following successful finger replantation have already been described. We report our experience about four fingers in three individuals in whom bone changes developed in the first three months postoperatively with complete ＂restitution ad integrum＂. Three patients, 21-49 years old （average 36 years） sustained a clean-cut amputation of four fingers. The first patient had an amputation at the base of the middle phalanx of the index finger and the second patient at the base of the proximal phalanx of the ring finger. The third had an amputation at the base of the first metacarpal bone and the proxi- mal phalanx of the small finger in a five finger amputation. In the first case, two dorsal veins and two palmar digital arteries and nerves were repaired. In the second case, one pal- mar artery and one dorsal vein were reanastomosed. In the third case at the thumb, two dorsal veins and two palmar digital arteries and nerves were reconstructed. At the small finger, one dorsal vein, one palmar digital artery and twodigital nerves were reconstructed. Bone fixation was achieved with two and three K-wires or tension-band wiring. Replantation was successful in all cases. Three weeks after replantation, the X-rays showed rapid development of osteopaenia in the juxtaarticular region and metaphyses of the bone. These changes were followed by subperiosteal, intracortical and endosteal bone resorption. No further surgical procedures or splintage were needed and hand therapy was not discontinued. At 10-13 weeks （average 12 weeks） postoperatively, the X-rays showed a complete recovery with new periosteal bone formation. We suggest that the radiographic changes after finger replantation are transient, first evident subperiosteally and progressing centrally. They may reflect small-vessel compromise and microinfarction and transient hyperemia secondary to neurovascular da

关键词： Fingers Replantation Bone resorption

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