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Biomedical subjects

Derek Wong

Publications and source records attributed to Derek Wong.

6 recordsLinked to original sources
PubMed2006

Prognostic significance of the Epstein-Barr virus, p53, Bcl-2, and survivin in nasopharyngeal cancer.

PURPOSE: Nasopharyngeal cancer (NPC) is a malignant epithelial carcinoma which is intimately associated with EBV. The latent presence of EBV affects the function of p53, Bcl-2, and survivin. We thus investigated the relationship between EBV status, p53, Bcl-2, and survivin in biopsy specimens from patients with primary NPC. EXPERIMENTAL DESIGN: Archival formalin-fixed, paraffin-embedded NPC biopsies were evaluated in 80 patients treated with curative radiation from a single institution. The presence of EBV was determined using EBER in situ hybridization, whereas p53, Bcl-2, and survivin were assessed using immunohistochemistry. RESULTS: The majority of NPC specimens in this patient cohort were EBER-positive (64 of 78, or 82%), which in turn, was significantly associated with ethnicity (P = 0.0007), and WHO subtype 2A/2B (P = 0.04). EBER-positive tumors were also associated with p53 (P = 0.002), Bcl-2 (P = 0.04), and nuclear survivin (P = 0.03) expression. Patients with EBER-positive NPC fared better, with a 10-year overall survival of 68% versus 48% for EBER-negative patients (P = 0.03). For nuclear survivin, patients with either low or high nuclear survivin fared worse than patients with intermediate survivin expression (P = 0.05), suggesting that there is an optimal proportion of survivin-expressing cells for best function and clinical outcome. CONCLUSIONS: With an extended median follow-up time of 11.4 years, EBV status remains a strong predictor for overall survival in NPC. EBV-positive NPC has strong molecular associations with p53, Bcl-2, and survivin expression. Furthermore, we provide clinical data revealing the potentially dual nature of survivin in predicting clinical outcome.

Carcinoma, Squamous Cell↗
PubMed2005

Kawasaki disease, myocardial infarction and coronary artery revascularization.

Kawasaki disease (KD) is the leading cause of acquired pediatric heart disease in North America and Japan. Cardiac sequelae, such as coronary artery aneurysms and myocardial infarction, are the major causes of the morbidity and mortality associated with KD. Three case scenarios are described illustrating the wide range of clinical presentations of myocardial ischemia in children after acute KD, varying from asymptomatic to fatal myocardial infarction. In addition, the present paper provides a review of the literature on myocardial infarction in association with KD and various modalities of coronary artery revascularization in children with myocardial ischemia secondary to KD.

Alberta↗
PubMed2004

Impaired fibrinolytic activity is present in children with dyslipidemias.

Dyslipidemias are major risk factors for atherosclerosis and cardiovascular disease. Abnormalities of fibrinolytic and coagulation components are considered useful predictors of cardiovascular morbidity and mortality in adults. This study examined whether fibrinolytic and coagulation components are abnormal in children with dyslipidemia. Thirty-six children with asymptomatic dyslipidemia, and 26 control subjects underwent venous occlusion stress testing with collection of preocclusion and postocclusion blood samples. All samples were assayed for tissue plasminogen activator, plasminogen, plasminogen activator inhibitor-1, alpha(2)-antiplasmin, alpha(2)-macroglobulin, D-dimer, fibrinogen, and von Willebrand factor. Children with dyslipidemia had significantly decreased levels of tissue plasminogen activator in both preocclusion and postocclusion samples compared with control subjects, reflecting decreased fibrinolytic activity. Children with dyslipidemia also had significantly increased levels of plasminogen, alpha(2)-macroglobulin, and fibrinogen in preocclusion and postocclusion samples compared with control subjects. In conclusion, decreased fibrinolytic activity is present in asymptomatic children with dyslipidemias, potentially reflecting endothelial dysfunction and increased risk of cardiovascular disease in early adult life. Further studies are required to determine the usefulness of this marker in predicting disease progression or response to therapy.

Adolescent↗
PubMed2004

Kawasaki disease and scald injuries: a possible association.

The cause of Kawasaki disease (KD) is still unknown. Evidence is available to support both a conventional infection, as well as a superantigen-mediated illness. The cases of two children who were hospitalized with scald injuries are presented. Both patients became febrile without an infectious source and subsequently developed typical KD, that responded to treatment with intravenous immunoglobulin, without cardiac sequelae. The temporal association between the thermal injury and the onset of KD could be explained by the entry of an infectious agent(s), toxin or superantigen through the compromised skin barrier, leading to an inflammatory vasculitis and the clinical manifestations of KD.

Anti-Bacterial Agents↗
PubMed2003

Fibrinolytic response to venous occlusion is decreased in patients after Kawasaki disease.

Impaired fibrinolysis is considered a sensitive marker of endothelial dysfunction. Persistent endothelial dysfunction occurs in some patients following Kawasaki disease. The aim of the present study was to assess whether impaired fibrinolysis is present in long-term survivors of Kawasaki disease. The study included 42 children with a documented history of Kawasaki disease presenting with or without coronary lesions, and 26 healthy controls. Blood samples were collected from patients and controls prior to and following venous occlusion stress testing. Significantly decreased fibrinolytic response to venous occlusion was detected in patients compared with controls due to decreased tissue plasminogen activator. In addition, patients had significantly increased plasma concentrations of plasminogen and fibrinogen, which were related to similar increases of alpha2 -macroglobulin. Decreased fibrinolytic response was found in patients with coronary aneurysms but also in those without coronary lesions. In summary, a decreased fibrinolytic response to venous occlusion may reflect persistent endothelial damage following acute Kawasaki disease, potentially predisposing these patients to accelerated atherosclerosis and cardiovascular disease in early adult life.

Adolescent↗