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Biomedical subjects

E Mok

Publications and source records attributed to E Mok.

At least 19 recordsLinked to original sources
PubMed2003

Attitudes of Hong Kong Chinese to traditional Chinese medicine and Western medicine: survey and cluster analysis.

OBJECTIVES: To determine whether within a cohort of Hong Kong out-patients definable subtypes exist based on their attitudes to traditional Chinese medicine and Western medicine. DESIGN: Data were collected using a structured questionnaire. SETTING: The sample of 503 subjects was recruited at two local outpatient clinics in Hong Kong. MAIN OUTCOME MEASURES: The study employs demographic variables, illness status, the Chinese-Western Medical Belief Scale, trust of physicians and subjects' preferences on consultation fees, attitude of health care professional, efficacy of service and waiting time during consultation. RESULTS: A cluster analysis yielded three clusters based on their attitudes towards traditional Chinese and Western medicine. One cluster, 24% of the sample, is noted for being older, poorer, more likely to be female and to have chronic conditions; they are sceptical of western physicians. The second cluster (63% of the sample) is younger and have considerably more belief in Western than traditional Chinese medicine. The third group (14%) is intermediate in age and is noted for a marked faith in both forms of medicine. CONCLUSIONS: A clear profile of these attitudes of Hong Kong Chinese may benefit health care professionals in making appropriate patient-doctor relationships and planning patient care.

Adolescent↗
PubMed2001

Acquisition of texture-cued fasting-anticipatory meal-size change in rats with adequate energy intake.

To determine if an increase in intake at a meal before a long fast can be conditioned to food texture cues, male Sprague-Dawley rats were given a high- or low-fat diet in one texture (powder or pellet) for 1 h prior to a 12.5-h fast and in the other texture before a 3-h fast. Each group (N = 9) went through a pseudorandom sequence of four duplicates of each texture-fast pairing over 4 experimental days in each of three training trials, followed by one 4-day trial under extinction, i.e. without the difference in fast lengths between textures. Neither the high-fat group nor the low-fat group as a whole gave a clear indication of a learnt texture-cued increase in meal size before the longer fast relative to the shorter fast. However, the rats trained on the high-fat diet that had the highest intakes on the first 4 days of training showed a relative increase in the amount eaten of the texture predicting the longer fast during the third training trial, and this effect also approached statistical significance in the extinction test. These results provide some support for the conclusion that anticipatory hunger/satiety can be differentially conditioned to dietary texture cues, but only if sufficient food is eaten before a short fast to prevent the rise in hunger during longer fasts that reinforces the discriminative increase in meal size.

Animals↗
PubMed2001

Stressors and coping methods among chronic haemodialysis patients in Hong Kong.

The purpose of the study was to determine the stressors and coping methods of chronic haemodialysis patients in Hong Kong. Relationships among treatment-related stressors, coping methods and length of time on haemodialysis were explored. Fifty subjects completed the Haemodialysis Stressor Scale (HSS) and Jalowiec Coping Scale (JCS). Results revealed that limitation of fluid was the most frequently identified stressor, followed by limitation of food, itching, fatigue and cost. The most common coping methods are 'accepted the situation because very little could be done', followed by 'told oneself not to worry because everything would work out fine' and 'told oneself that the problem was really not that important.' It was found that the traditional philosophies of the Chinese--Confucianism, Buddhism, and Taoism--share an approach to the understanding and management of life stressors as different from that adopted by Western philosophies. The findings of this study can further facilitate nurse practitioners in providing support, information, and alternative solutions when assisting patients in coping with long-term haemodialysis.

Activities of Daily Living↗
PubMed2001

Educating nurses to care for the dying in Hong Kong: a problem-based learning approach.

Caring for dying patients is an essential and major aspect of nursing care. However, previous studies have revealed that nurses felt uncomfortable and inadequate in dealing with the dying patients and their families. This study reports the effectiveness of a problem-based learning approach in death education among a group of registered nurses in Hong Kong. Three problems, with three segmented scenarios related to cancer nursing, were used. Students went through the problem-based learning process and documented their learning throughout the course in journals. A total of 72 sets of journals were collected and analyzed. The strategies of within case and cross-case analysis were employed. The within case analysis explored the learning development of students for each problem. The cross-case analysis compared and contrasted findings of the within case analysis. Three themes have been derived from the findings. They were: nurses acknowledging their emotions in facing death and dying, a need for the nurses to be better equipped in communication and counseling, and a holistic and family-centered approach to care. This study provides evidence showing that problem-based learning is an effective strategy to enhance nurses' self-awareness of death and dying issues, and to stimulate nurses to formulate a plan that addresses the physical, psychological, and social aspects of care. Findings also reveal that nurses need to take into account the particular reactions of death and dying in the Chinese culture when planning care.

Adult↗
PubMed2001

Empowerment of cancer patients: from a Chinese perspective.

The philosophy of empowerment, which is based on the premises that clients must be active, equal and collaborative participants, who are aware and committed to change, has guided research in empowerment interventions. This article reports on a small part of a research study that sought to understand Chinese cancer patients' conceptualization of empowerment. Qualitative delineation of the concept of empowerment by means of in-depth interviews was carried out with 12 Chinese patients with cancer. The findings showed that empowerment is a process whereby patients develop a sense of inner strength through connection with others, including families, friends and health care professionals. It is also a process of transformation through which they actively develop new perspectives by reframing and reinterpreting their illness. Acceptance of illness was shown to result from a realization of a lack of control in the situation, which is then enhanced by the beliefs of Confucianism and Taoism. In the cancer context, personal control comprises both primary and secondary processes. Active involvement, awareness of the situation, partnership, self-determination and self-reliance are important values in empowerment. The concept and therapeutic foundations of empowerment provide ample legitimacy for its vigorous pursuit in nursing.

Adult↗
PubMed2000

Effect of quipazine, a selective 5-HT3 agonist, on dietary self-selection of different macronutrient diets in male and female rats.

Macronutrient intakes, 2h and 12h, following administration of a selective 5-HT3 agonist, quipazine, N methyl, dimaleate (QUIPAZINE; 2.5, 5.0 and 7.5 mg/kg, i.p.) at dark onset were examined in three groups of adult male and female Wistar rats fed different sources of the three macronutrients: Group 1 (casein, corn starch, safflower oil), Group 2 (egg protein, corn starch/sucrose, lard) and Group S (casein hydrolysate, maltose dextrin, butter). QUIPAZINE decreased total food intake only in female rats from Group 1 (2 h) at a dose of 7.5 mg/kg and Group 2 (2h and 12h) with doses of 2.5 and 7.5 mg/kg. Intakes from corn starch and corn starch/sucrose diet (12h) were reduced in male and female rats, respectively, with doses of 2.5 and 7.5 mg/kg of QUIPAZINE. In conclusion, when provided with different sources of the three macronutrients, quipazine injection reduces specifically carbohydrate ingestion from corn starch-containing diets in male and female rats. Thus, the nature of the macronutrient source is of major importance to assess the effect of a drug on nutrient-specific selection.

Analysis of Variance↗
PubMed2000

Validation of a Monte Carlo dose calculation tool for radiotherapy treatment planning.

A new EGS4/PRESTA Monte Carlo user code, MCDOSE, has been developed as a routine dose calculation tool for radiotherapy treatment planning. It is suitable for both conventional and intensity modulated radiation therapy. Two important features of MCDOSE are the inclusion of beam modifiers in the patient simulation and the implementation of several variance reduction techniques. Before this tool can be used reliably for clinical dose calculation, it must be properly validated. The validation for beam modifiers has been performed by comparing the dose distributions calculated by MCDOSE and the well-benchmarked EGS4 user codes BEAM and DOSXYZ. Various beam modifiers were simulated. Good agreement in the dose distributions was observed. The differences in electron cutout factors between the results of MCDOSE and measurements were within 2%. The accuracy of MCDOSE with various variance reduction techniques was tested by comparing the dose distributions in different inhomogeneous phantoms with those calculated by DOSXYZ without variance reduction. The agreement was within 1.0%. Our results demonstrate that MCDOSE is accurate and efficient for routine dose calculation in radiotherapy treatment planning, with or without beam modifiers.

Bone and Bones↗
PubMed2000

Energy- and intensity-modulated electron beams for radiotherapy.

This work investigates the feasibility of optimizing energy- and intensity-modulated electron beams for radiation therapy. A multileaf collimator (MLC) specially designed for modulated electron radiotherapy (MERT) was investigated both experimentally and by Monte Carlo simulations. An inverse-planning system based on Monte Carlo dose calculations was developed to optimize electron beam energy and intensity to achieve dose conformity for target volumes near the surface. The results showed that an MLC with 5 mm leaf widths could produce complex field shapes for MERT. Electron intra- and inter-leaf leakage had negligible effects on the dose distributions delivered with the MLC, even at shallow depths. Focused leaf ends reduced the electron scattering contributions to the dose compared with straight leaf ends. As anticipated, moving the MLC position toward the patient surface reduced the penumbra significantly. There were significant differences in the beamlet distributions calculated by an analytic 3-D pencil beam algorithm and the Monte Carlo method. The Monte Carlo calculated beamlet distributions were essential to the accuracy of the MERT dose distribution in cases involving large air gaps, oblique incidence and heterogeneous treatment targets (at the tissue-bone and bone-lung interfaces). To demonstrate the potential of MERT for target dose coverage and normal tissue sparing for treatment of superficial targets, treatment plans for a hypothetical treatment were compared using photon beams and MERT.

Algorithms↗
PubMed2000

Monte Carlo verification of IMRT dose distributions from a commercial treatment planning optimization system.

The purpose of this work was to use Monte Carlo simulations to verify the accuracy of the dose distributions from a commercial treatment planning optimization system (Corvus, Nomos Corp., Sewickley, PA) for intensity-modulated radiotherapy (IMRT). A Monte Carlo treatment planning system has been implemented clinically to improve and verify the accuracy of radiotherapy dose calculations. Further modifications to the system were made to compute the dose in a patient for multiple fixed-gantry IMRT fields. The dose distributions in the experimental phantoms and in the patients were calculated and used to verify the optimized treatment plans generated by the Corvus system. The Monte Carlo calculated IMRT dose distributions agreed with the measurements to within 2% of the maximum dose for all the beam energies and field sizes for both the homogeneous and heterogeneous phantoms. The dose distributions predicted by the Corvus system, which employs a finite-size pencil beam (FSPB) algorithm, agreed with the Monte Carlo simulations and measurements to within 4% in a cylindrical water phantom with various hypothetical target shapes. Discrepancies of more than 5% (relative to the prescribed target dose) in the target region and over 20% in the critical structures were found in some IMRT patient calculations. The FSPB algorithm as implemented in the Corvus system is adequate for homogeneous phantoms (such as prostate) but may result in significant under or over-estimation of the dose in some cases involving heterogeneities such as the air-tissue, lung-tissue and tissue-bone interfaces.

Computer Simulation↗
PubMed2000

Empowerment of Chinese patients with cancer through self-help groups in Hong Kong.

This study was conducted to identify the process and outcomes of empowerment as experienced by Hong Kong Chinese patients with cancer through participation in cancer self-help groups. The study involved in-depth individual interviews of self-help group members (n = 12) and participant observation of the group meetings over a period of 6 months. The empowered outcomes at a personal level included interconnectedness, confidence and hope, support and affirmation, and a feeling of usefulness. At a social level, expanded social network and opportunities to participate in more activities were reported. Collective efficacy also was demonstrated, although this happened only occasionally through participation in the group. One main theme that runs through the process of participation is empowerment among the members. On the basis of the efficacy demonstrated by self-help groups in this study, nurses should strongly consider referral of patients to such groups. Self-help groups serve as an important resource for patients with cancer in the Hong Kong Chinese community.

Adaptation, Psychological↗
PubMed1999

Clinical implementation of a Monte Carlo treatment planning system.

The purpose of this study was to implement the Monte Carlo method for clinical radiotherapy dose calculations. We used the EGS4/BEAM code to obtain the phase-space data for 6-20 MeV electron beams and 4, 6, and 15 MV photon beams for Varian Clinac 1800, 2100C, and 2300CD accelerators. A multiple-source model was used to reconstruct the phase-space data for both electron and photon beams, which retained the accuracy of the Monte Carlo beam data. The multiple-source model reduced the phase-space data storage requirement by a factor of 1000 and the accelerator simulation time by a factor of 10 or more. Agreement within 2% was achieved between the Monte Carlo calculations and measurements of the dose distributions in homogeneous and heterogeneous phantoms for various field sizes, source-surface distances, and beam modulations. The Monte Carlo calculated electron output factors were within 2% of the measured values for various treatment fields while the heterogeneity correction factors for various lung and bone phantoms were within 1% for photon beams and within 2% for electron beams. The EGS4/DOSXYZ Monte Carlo code was used for phantom and patient dose calculations. The results were compared to the dose distributions produced by a conventional treatment planning system and an intensity-modulated radiotherapy inverse-planning system. Significant differences (>5% in dose and >5 mm shift in isodose lines) were found between Monte Carlo calculations and the analytical calculations implemented in the commercial systems. Treatment sites showing the largest dose differences were for head and neck, lung, and breast cases.

Algorithms↗
PubMed1998

Application of a video-optical beam imaging system for quality assurance of medical accelerators.

Method validation techniques were developed and experiments were carried out using a beam imaging system (BIS, Wellhöfer Dosimetrie, Schwarzenbruck, Germany) for routine quality assurance of medical accelerators. The routine quality assurance tasks include x-ray beam flatness and symmetry check, light/radiation field congruence test, beam energy constancy for electrons and mechanical checks for couch and collimator rotations. Comparisons were made between the BIS application and conventional quality assurance methods that use radiographic films or detector arrays. In this work, we have demonstrated efficiency and accuracy of the BIS to perform some of the routine quality assurance tasks for medical linear accelerators.

Electrons↗
PubMed1992

A mouse mammary tumor virus mammary gland enhancer confers tissue-specific but not lactation-dependent expression in transgenic mice.

The long terminal repeat (LTR) of mouse mammary tumor virus (MMTV) is known to contain a number of transcriptional regulatory elements, including glucocorticoid response elements. In this study, we showed that a mammary gland/salivary gland enhancer found in the LTR of this virus directs expression of a heterologous promoter to both virgin and lactating mammary glands in transgenic mice. Using transgenic mice containing hybrid gene constructs with various deletions of the LTR sequences linked to marker genes, we also showed that the dramatic increase in MMTV expression that occurs during lactation is due to the glucocorticoid response elements. Thus, the MMTV LTR encodes two distinct elements, both of which are required for a high level of expression in lactating mammary glands.

Animals↗
PubMed1990

Negative regulation in correct tissue-specific expression of mouse mammary tumor virus in transgenic mice.

Mouse mammary tumor virus (MMTV) is an endogenous murine retrovirus that is expressed in the epithelial cells of the mammary and salivary glands, lungs, kidneys, and seminal vesicles and in the lymphoid cells of the spleen and thymus. Several studies have shown that the long terminal repeat (LTR) of this virus can direct the expression of reporter genes to the same tissues in transgenic mice. To determine whether multiple regulatory elements within the LTR are involved in this tissue-specific expression, we have established lines of transgenic mice containing transgenes that have deletions in the MMTV LTR. Deletions of all LTR sequences upstream of -364 or of LTR sequences from -165 to -665 both result in the expression of linked reporter genes such as the simian virus 40 early region or the bacterial enzyme chloramphenicol acetyltransferase in novel sites, such as the heart, brain, and skeletal muscle; expression of endogenous MMTV and transgenes containing the full-length LTR is not detected in these organs. Negative regulation appears to involve more than one region, since deletion of sequences between either -201 and -471 or -201 and -344, as well as sequences upstream of -364, results in inappropriate expression in heart, brain, and skeletal muscle. Therefore, a negative regulatory element(s) in the MMTV LTR can suppress transcription from the viral promoter in several different organs. This represents the first example of generalized negative regulatory elements that act in many different tissues in transgenic mice to prevent inappropriate expression of a gene.

Animals↗
PubMed1989

Quantitative and qualitative fat analysis in human leg muscle of neuromuscular diseases by 1H MR spectroscopy in vivo.

1H MR spectra were recorded from human gastrocnemius muscle at 63.86 MHz using the body coil of the Signa scanner as transmitter and a 3-in. surface coil as receiver. The fat content of the muscle was quantified relative to that of water in a selected volume or slice. The fat/water ratio was 0.05-0.07 for normal muscle but increased to 0.5-6.0 in primary and secondary muscular disorders such as Duchenne and myotonic dystrophy, Charcot-Marie-Tooth and polio muscular atrophy, cerebral palsy, and spina bifida. In Werdnig-Hoffmann spinal atrophy the ratio was above 10. Water-suppressed and slice-selective 1H spectroscopy was used for qualitative analysis of fat. The 1H profile of gastrocnemius muscles between healthy individuals and patients with neuromuscular diseases showed two major differences. In the normal muscle spectra, the resonance from the -(CH2)n- protons at 1.6 ppm was the most pronounced, whereas in the diseased muscle spectra resonances also appeared between 1.1 and 1.4 ppm. Some diseased muscle spectra showed multiple resonances from -CH = CH- in polyunsaturated fatty acids between 5.5 and 7.0 ppm. The corresponding resonances from = CH-CH2-, 1.9-2.0 ppm, and = CH-CH2-CH =, 2.7-2.9 ppm, were also seen. These peaks are usually not detected in normal muscle.

Adipose Tissue↗
PubMed1989

Human leg neuromuscular diseases: P-31 MR spectroscopy.

Phosphorus-31 magnetic resonance (MR) spectra of leg muscles in patients with the neuromuscular diseases Duchenne dystrophy, myotonic dystrophy, postpoliomyelitis, Werdnig-Hoffmann disease, and pedal dystonia were recorded. Ratios of beta-adenosine triphosphate (ATP), inorganic phosphate (Pi), alpha-glycerophosphorylcholine (GPC), and phosphomonoesters to phosphocreatine (PCr) were calculated from peak integrals and compared with normal muscle ratios. In all diseases studied, beta-ATP/PCr and Pi/PCr values showed an increase from normal values. The extent of increase in beta-ATP/PCr was related to the clinical severity of the disease, suggesting that this could be a useful noninvasive means of monitoring effectiveness of therapy for neuromuscular disorders. In myotonic dystrophy and Werdnig-Hoffmann disease, GPC/PCr values increased greatly. The intracellular pH in Duchenne and postpoliomyelitis muscles was slightly elevated compared with that in normal muscles. Hydrogen-1 MR images of muscles showed fat infiltration in all patients, more in weaker muscles and less in stronger muscles.

Adenosine Triphosphate↗
PubMed1987

Surface coil holder for Signa.

A surface coil holder is described for the General Electric Signa spectrometer. This allows for accurate positioning of the 31P coil relative to that of the 1H coil used for tissue slice localization.

Arterial Occlusive Diseases↗