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Biomedical subjects

K K Leung

Publications and source records attributed to K K Leung.

At least 19 recordsLinked to original sources
PubMed2000

Needs of Chinese families of critically ill patients.

Critical illness and subsequent hospitalization are stressful for patients and their family members. The purpose of this descriptive study was to identify the family members' perceptions of their immediate needs within 48 to 96 hours following admission of a relative to a critical care unit in Hong Kong and to compare their perceptions with the critical care nurses' perceptions of the family needs. A convenience sample of 37 Chinese family members and 45 registered nurses completed a self-report Chinese version of the Critical Care Family Need Inventory. The 10 most important and 10 least important family needs were identified by family members and by nurses and the results were compared. Conclusions were drawn about the implications for nurses in planning and implementing quality family-centered care for critically ill patients.

Adult↗
PubMed1999

Development of a Chinese chronic illness-related stress inventory for primary care.

This study evaluates the construct validity and internal consistency of a Chronic Illness-Related Stress Inventory (CRSI) for primary care Chinese patients and studies the relationship between chronic illness-related stress and sociodemographic characteristics and indices of disease severity. A total of 301 patients were interviewed using a structured questionnaire. The responses to the CRSI were divided into a frequency scale and a severity scale. Six factors including physical integrity and discomfort, psychosocial function and economic burdens, self-fulfillment and daily life, sexual function, self-esteem, and diet limitations were obtained for each CRSI scale. Except for the last factor, all other factors and the scale as a whole for both scales have a Cronbach alpha of > 0.90. The results of the convergent and discriminant validity analysis were promising. In addition, chronic illness-related stress was related to insurance status and the self-perceived severity of disease.

Adult↗
PubMed1999

Mortality trends of elderly people in Taiwan from 1974 to 1994.

BACKGROUND: the hypothesis that disability and death will eventually be compressed to a period late in life needs empirical confirmation. OBJECTIVES: we have examined the secular trends of life expectancy and common causes of death in the aged population of Taiwan. METHOD: we compared the life expectancy, causes of death and probability of death for people at birth, at age 65 and at age 85 for both sexes from 1974 to 1994 using data from Taiwan government statistics. RESULTS: there has been a substantial gain in life expectancy, especially for men age 85 and over, in the past 20 years. . Mortality due to stroke, ischaemic heart disease, hypertension and chronic pulmonary disease has declined. There has been a steep increase in cancer deaths and deaths associated with diabetes mellitus. Tuberculosis and injury-related deaths have declined but pneumonia deaths have increased. For elderly people, the probability of dying from cancer and ischaemic heart disease increased with time. However, the probability of dying from stroke decreased. Although there was a decrease in probability of deaths associated with falls, there was an increase of deaths due to 'frailty' (as judged by falls, pneumonia and septicaemia). CONCLUSIONS: cancer is a major cause of death in the elderly population of Taiwan. This rapidly expanding elderly population seemed to suffer from poorer health in the later period of their life.

Aged↗
PubMed1999

Differences in diagnostic approach between family physicians and other specialists in patients with unintentional body weight loss.

BACKGROUND: Unintentional weight loss is a diagnostic dilemma with diverse diagnostic possibilities for physicians. OBJECTIVES: Our study focused on the evaluation of differences in diagnostic approach between family physicians and physicians in other specialties. METHODS: Outpatients who visited National Taiwan University Hospital from January 1996 to December 1996 with unintentional weight loss of 5% or more within 6 months were recruited by a computer search. All data were obtained from a structured medical record audit. RESULTS: There was no significant difference in the utilization of common diagnostic laboratory tests between the two groups. However, other specialists ordered more carcinoembryonic antigen tests (P < 0.01) and hepatitis B antigen tests (P < 0.05), but fewer upper gastrointestinal tract barium studies (P < 0.05) than family physicians. For patients without a definite final diagnosis, the diagnostic total costs for laboratory tests and imaging studies were lower for family physicians than other specialists (P < 0.01). For patients with biomedical disorders, the diagnostic cost was not significantly different between the two groups. For patients with psychological disorders, the costs for imaging studies were lower for family physicians than for other specialists (P < 0.05) but there was no significant difference in the total costs between these two groups. CONCLUSIONS: We conclude that the different approaches between the two groups are due to different training backgrounds and characteristics of practice. The patient-centred concepts of family physicians might be more cost-effective in dealing with undifferentiated problems.

Adolescent↗
PubMed1999

The needs of the family of critically ill neurosurgical patients: a comparison of nurses' and family members' perceptions.

In this study, researchers identified the important needs of family members of critically ill neurosurgical patients and explored the relationship between needs and unmet needs as perceived by nurses and family members. A total of 52 family members and 36 nurses in three neurosurgical special care units in Hong Kong were asked to complete the Chinese version of the 45-item Critical Care Family Needs Inventory. The rank order of most important needs reported by family members indicates that the majority of needs are related to assurance; needs for support and comfort were much less important. When rating needs, nurses underrated most of the needs considered important by family members. Needs for proximity were also underrated in importance by nurses when compared to family ratings, and needs for support were heavily overrated by nurses. The needs for proximity were least met. An inverse relationship between nurses' ratings of importance and the frequency of unmet needs was demonstrated. The most important need that was also largely unmet was having a specific person call when unable to visit. The findings of this study indicate areas of unmet need that require additional nursing interventions.

Adolescent↗
PubMed1998

Different cis-regulatory DNA elements mediate developmental stage- and tissue-specific expression of the human COL2A1 gene in transgenic mice.

Expression of the type II collagen gene (human COL2A1, mouse Col2a1) heralds the differentiation of chondrocytes. It is also expressed in progenitor cells of some nonchondrogenic tissues during embryogenesis. DNA sequences in the 5' flanking region and intron 1 are known to control tissue-specific expression in vitro, but the regulation of COL2A1 expression in vivo is not clearly understood. We have tested the regulatory activity of DNA sequences from COL2A1 on the expression of a lacZ reporter gene in transgenic mice. We have found that type II collagen characteristic expression of the transgene requires the enhancer activity of a 309-bp fragment (+2, 388 to +2,696) in intron 1 in conjunction with 6.1-kb 5' sequences. Different regulatory elements were found in the 1.6-kb region (+701 to +2,387) of intron 1 which only needs 90-bp 5' sequences for tissue-specific expression in different components of the developing cartilaginous skeleton. Distinct positive and negative regulatory elements act together to control tissue-specific transgene expression in the developing midbrain neuroepithelium. Positive elements affecting expression in the midbrain were found in the region from -90 to -1,500 and from +701 to +2,387, whereas negatively acting elements were detected in the regions from -1,500 to -6,100 and +2,388 to +2,855.

Animals↗
PubMed1998

Screening of depression in patients with chronic medical diseases in a primary care setting.

BACKGROUND: Patients with chronic medical diseases may have depression that is not recognized by their primary care physicians. OBJECTIVES: We aimed to examine the application of Zung's Self-Rating Depression Scale (SDS) in the screening of depression in primary care patients with chronic medical diseases in a Chinese population. METHODS: We studied 268 patients with chronic medical diseases in the Family Medicine Outpatient Clinic using a structured questionnaire including basic demographic data, a Chinese version of the SDS and a rating for the self-perceived severity of physical condition. The severity of chronic medical diseases was assessed by the authors using the Duke University Severity of Illness Scale from a chart audit. Fifty patients were randomly selected for a diagnostic interview according to the DSM-IV criteria. The construct validity and internal consistency reliability, sensitivity and specificity of the SDS were examined. RESULTS: The results revealed that the SDS has good construct validity and internal consistent reliability in the evaluation of depression in Chinese patients with chronic medical diseases. A cut-off point of 55 had a sensitivity of 66.7% and a specificity of 90.0%. Depressed patients reported more cognitive symptoms than depressed affect and physical symptoms. Female patients had more severe depressed affect than male patients, but males had more prominent diurnal variation of mood than females. CONCLUSIONS: We concluded that SDS can be a good screening tool for depression in Chinese patients with chronic medical diseases. Owing to constraints in the expression of sexual desire in the Chinese, elderly subjects tended to report loss of libido in the response to the SDS.

Adult↗
PubMed1997

Self-rated health and mortality in Chinese institutional elderly persons.

The relationship between self-rated health (SRH) and subsequent mortality was examined in a cohort of 411 Chinese elderly individuals living in institutions. SRH was assessed by a global health rating, by comparing health with others of the same age, and by perception of recent physical condition. Covariates including age, sex, daily activity function, instrumental daily activity function, cognitive function, self-reported visual acuity, urinary function, number of chronic conditions, number of medications, and history of falls were controlled by the Cox proportional hazard model. Elderly people who rated their global health as "fair or poor" had increased mortality compared to those in the "good" category (RR = 6.00; 95% CI 1.39-25.1) and a borderline significant increase in mortality risk for those who rated themselves in the "average" category (RR = 4.05; 95% CI 0.93-17.70). Elderly people who compared their health with others of the same age as "worse or worst" and "similar" had an RR of 2.75; 95% CI of 0.64-11.83 and RR of 2.40; 95% CI of 0.64-8.96, respectively. Elderly people who rated their physical symptoms as "moderate or severe" and "slight" had an RR of 2.54; 95% CI 0.65-9.80 and RR of 1.05; 95% CI 0.32-3.41, respectively. Age, institutional factors, and history of multiple falls were associated with an increased risk of mortality. We concluded that only the global health rating has direct predictive power for mortality in institutionalized elderly people.

Activities of Daily Living↗
PubMed1997

SOX9 directly regulates the type-II collagen gene.

Mutations in human SOX9 are associated with campomelic dysplasia (CD), characterised by skeletal malformation and XY sex reversal. During chondrogenesis in the mouse, Sox9 is co-expressed with Col2a1, the gene encoding type-II collagen, the major cartilage matrix protein. Col2a1 is therefore a candidate regulatory target of SOX9. Regulatory sequences required for chondrocyte-specific expression of the type-II collagen gene have been localized to conserved sequences in the first intron in rats, mice and humans. We show here that SOX9 protein binds specifically to sequences in the first intron of human COL2A1. Mutation of these sequences abolishes SOX9 binding and chondrocyte-specific expression of a COL2A1-driven reporter gene (COL2A1-lacZ) in transgenic mice. Furthermore, ectopic expression of Sox9 trans-activates both a COL2A1-driven reporter gene and the endogenous Col2a1 gene in transgenic mice. These results demonstrate that COL2A1 expression is directly regulated by SOX9 protein in vivo and implicate abnormal regulation of COL2A1 during, chondrogenesis as a cause of the skeletal abnormalities associated with campomelic dysplasia.

Animals↗
PubMed1996

Evaluating the CELL-DYN 3500 haematology analyser in an acute general hospital.

The CELL-DYN 3500 (CD3500) (Abbott Diagnostics Division, Santa Clara, CA, USA) is a multiparameter, automated haematology analyser system capable of producing 22 haematological parameters including a screening five-part differential. The evaluation was performed in a recently expanded acute care general hospital. Studies of linearity, carryover and precision were acceptable and within manufacturer's stated limits. Correlation of CD3500 with manual differential counts were good except for the basophil count. The white cell flagging system had a sensitivity of 83.6% and specificity of 88.9% with 85.6% agreement. The platelet flagging system also had comparable sensitivity and specificity rate of 88.4% and 94.5% and agreement rate of 92.2%. The overall false positive rate and false negative rate for both the white cell and platelet flags combined were 8.6% and 10.3%. All samples provided a differential with no rejection experienced. The MAPSS technology, together with the extended lyse mode and the investigational nine-part differential provides potential for future development in WBC differential.

Blood Cell Count↗
PubMed1995

Human COL2A1-directed SV40 T antigen expression in transgenic and chimeric mice results in abnormal skeletal development.

The ability of SV40 T antigen to cause abnormalities in cartilage development in transgenic mice and chimeras has been tested. The cis-regulatory elements of the COL2A1 gene were used to target expression of SV40 T antigen to differentiating chondrocytes in transgenic mice and chimeras derived from embryonal stem (ES) cells bearing the same transgene. The major phenotypic consequences of transgenic (pAL21) expression are malformed skeleton, disproportionate dwarfism, and perinatal/neonatal death. Expression of T antigen was tissue specific and in the main characteristic of the mouse alpha 1(II) collagen gene. Chondrocyte densities and levels of alpha 1(II) collagen mRNAs were reduced in the transgenic mice. Islands of cells which express cartilage characteristic genes such as type IIB procollagen, long form alpha 1(IX) collagen, alpha 2(XI) collagen, and aggrecan were found in the articular and growth cartilages of pAL21 chimeric fetuses and neonates. But these cells, which were expressing T antigen, were not properly organized into columns of proliferating chondrocytes. Levels of alpha 1(II) collagen mRNA were reduced in these chondrocytes. In addition, these cells did not express type X collagen, a marker for hypertrophic chondrocytes. The skeletal abnormality in pAL21 mice may therefore be due to a retardation of chondrocyte maturation or an impaired ability of chondrocytes to complete terminal differentiation and an associated paucity of some cartilage matrix components.

Animals↗
PubMed1993

Multi-adjustable post-operative orthosis for congenital muscular torticollis.

A multi-adjustable torticollis orthosis is described for the post-operative bracing of patients after surgical correction of congenital muscular torticollis. The orthosis can be put on in the early post-operative period and the head and neck position can be maintained in the corrected, and later over-corrected position by the built-in multi-adjustable joint-mechanism. The details of the manufacturing are described. Twenty-five patients (13 girls and 12 boys) from age 1 to 22 with congenital muscular torticollis were fitted with the orthosis post-operatively for an average duration of 10 weeks. Satisfactory compliance with the orthosis was found in 23 cases. Complications were minimal (3 cases) and were related to scalp irritation which improved after minor adjustments of the halo.

Adolescent↗
PubMed1990

[Clinical evaluation of psychiatric disorders among first-visit patients to a primary care unit].

It is important for a primary care physician to know the most common psychiatric diagnoses, criteria for these diagnoses, and proper treatment. During a 4-month period from December 1987 to March 1988, the authors conducted this prospective study in a rural group practice center and investigated 189 first-visit patients aged from 16 to 60 years. Among them, 55 cases (29.1%) were diagnosed as having psychiatric disorders which included: psychological factors affecting physical condition, 29 cases; generalized anxiety disorder, 12 cases; adjustment disorder, 10 cases; and others, 4 cases. There were no significant differences in marital status, social class, or family structure between patients with and without psychiatric disorders. However, the patients with psychiatric disorders tended to have a longer duration of illness, to exhibit more salient features of introversion and neuroticism in their personalities, to show poorer family function and to experience more stressful life events. Although all the psychiatric patients presented somatic symptoms as their primary complaints, we also found that they reported significantly higher scores for psychiatric symptoms on a self-rating scale. This study demonstrates that in order to promote comprehensive primary health care, psychiatry and behavioral science are essential training curricula for family physicians.

Adolescent↗
PubMed1977

Uridine and cytidine transport in Escherichia coli B and transport-deficient mutants.

Three mutants of Escherichia coli B which are defective in components of the transport system for uridine and uracil were isolated and utilized to study the mechanism of uridine transport. Mutant U- was isolated from a culture resistant to 77 micronM 5-fluorouracil. Mutant U-UR-, isolated from a culture of mutant U-, is resistant to 770 micronM 5-fluorouracil and 750 micronM adenosine. Mutant NUC- is resistant to 80 micronM showdomycin and has been reported previously. The characteristics of uridine transport by E. coli B and the mutants provide data supporting the following conclusions. The transport of adenosine, deoxyadenosine, guanosine, deoxyguanosine, adenine, or guanine by mutant U- and mutant U-UR- is identical with that in the parental strain. Uridine is transported by E. coli B as intact uridine. In addition, extracellular uridine is also rapidly cleaved to uracil and the ribose moiety. The latter is transported into the cells, whereas uracil appears in the medium and is transported by a separate uracil transport system. The entry of the ribose moiety of uridine is fast relative to the uracil and uridine transport processes. The Km values and the inhibitory effects of heterologous nucleosides for the transport of uridine and the ribose moiety of uridine are similar. Studies of cytidine uptake in the parental and mutant strains provide evidence that cytidine is transported by two independent systems, one of which is the same as that involved in the transport of intact uridine. Uridine inhibits but is not transported by the other system for cytidine transport. Evidence for the above conclusions was based on comparisons of the characteristics of [2-14C]uridine, [U-14C]uridine, and [2-14C]cytidine transport using E. coli B and the three transport mutants under conditions which measure initial rates. The nature of the inhibitory effects of heterologous nucleosides on the uridine transport processes and identification of extracellular components from radioactive uridine provides supportive data for the conclusions.

Adenosine↗