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Biomedical subjects

Kai Ming Chan

Publications and source records attributed to Kai Ming Chan.

5 recordsLinked to original sources

Socioeconomic impact of osteoarthritis in Hong Kong: utilization of health and social services, and direct and indirect costs.

OBJECTIVE: To determine the direct and indirect cost of osteoarthritis (OA) according to disease severity, and to estimate the total cost of the disease in Hong Kong. METHODS: This study is a retrospective, cross-sectional, nonrandom, cohort design, with subjects stratified according to disease severity based on functional limitation and the presence or absence of joint prosthesis. Subjects were recruited from primary care, geriatric medicine, rheumatology, and orthopedic clinics. There were 219 patients in the mild disease category, 290 patients in the severe category, and 65 patients with joint replacement. A questionnaire gathered information on demographic and socioeconomic characteristics, function limitation, use of health and social services, and effect on occupation and living arrangements over the previous 12 months. Costs were calculated as direct and indirect. RESULTS: Low education and socioeconomic class were associated with more severe disease. OA affected family or close relationships in 44%. The average cost incurred as a result of side effects of medication is similar to the average cost of medication itself. Excluding joint replacement, the direct costs ranged from Hong Kong (HK) dollar $11,690 to $40,180 per person per year and indirect costs, HK $3,300-$6,640. The direct costs are comparable to those reported in Western countries; however, the ratio of direct to indirect costs is much higher than 1, in contrast to the greater indirect versus direct costs reported in whites. The total cost expressed as a percentage of gross national product is also much lower in Hong Kong. CONCLUSIONS: The socioeconomic impact of OA in the Hong Kong population is comparable to Western countries, but the economic burden is largely placed on the government, with patients having relatively low out-of-pocket expenditures.

Costs and Cost Analysis↗

Healing of bone-tendon junction in a bone trough: a goat partial patellectomy model.

Bone-tendon junction healing in a bone trough was investigated in a goat partial patellectomy model. Histologic evaluation and biomechanical tests were done at 6, 12, and 24 weeks. Irregular fibrous tissue seen at the healing bone-tendon junction at 6 weeks gradually assumed longitudinal alignment and remodeled toward a direct bone-tendon junction. Type III collagen deposition was diffuse at 6 weeks, but became localized to the healing interface at 12 weeks. Thickness of newly formed bone increased progressively with time. Bridging collagen fibers were formed at the junction, with fibrochondrocytic cells and a basophilic tidemark detected at 24 weeks. The trabecular line remained discontinuous and there was no safranin O uptake. Most specimens failed at the junctions under tensile loads. The ultimate failure stress increased from 4.78 +/- 0.50 N/mm2 at 6 weeks to 7.99 +/- 0.33 N/mm2 at 24 weeks (mean +/- standard error of the mean), only reaching 15% of normal. Cartilage from the articular cut surface extended into the healing interface, later forming an area of fibrocartilage with densely packed collagen fibers aligned along the direction of force, containing proteoglycans. Cartilage may enhance restoration of a transition zone in bone-tendon junction healing. The sequence of events outlined formed a basis to guide clinical practice regarding bone-tendon junction reattachment.

Animals↗

Regular moderate exercise training prevents decrease of CD4+ T-lymphocytes induced by a single bout of strenuous exercise in mice.

The biphasic effects of exercise training on the immune system have been studied extensively and represented by the well-known J-shaped curve with respect to training intensity. However, the relationship and interactions between "beneficial" exercise training and "harmful" strenuous exercise have not been researched. This study was designed to determine whether regular moderate exercise training could affect the changes of percentage of T-lymphocytes induced by a single bout of strenuous exercise. A protocol to run uphill on a 10 degrees tilted treadmill for 4 weeks was employed as moderate exercise training in mice, while a sedentary control group of mice was exposed to the same handling stress without training. The trained and untrained mice were then exposed to a single bout of strenuous exercise until exhaustion. Total leukocytes were collected from spleen and peripheral blood at 0 hr, 3 hrs, and 24 hrs postexhaustion, as well as from the control groups. Flow cytometric analyses were conducted to determine the percentages of selected leukocyte populations. It was demonstrated that moderate exercise training prevented the decrease of CD4+ but stimulated the increase of CD25+ CD8+ T-lymphocytes induced by a single bout of strenuous exercise, indicating an adaptive response that can affect changes of leukocyte subpopulations.

Animals↗

Increased expression of transforming growth factor-beta1 in patellar tendinosis.

Patellar tendinosis is characterized by longstanding localized and activity-related pain, swelling and tenderness on palpation, and characteristic features on magnetic resonance imaging and ultrasonography and during surgical excision. Histologic examination of tendinosis tissues shows disrupted collagen matrix, increased cellularity, and increased proteoglycan stainability, but lack of inflammatory cell infiltration despite the clinical signs resembling inflammation. Disturbances in inflammatory response may be associated with the development of tendinosis. Expression of cyclooxygenase-2 and transforming growth factor-beta1 were detected in tendinosis, and the in vitro production of prostaglandin E2 by tendinosis and healthy tendon fibroblast cultures also was observed. Eleven patients with patellar tendinosis and 12 control subjects with healthy patellar tendons, but deficient anterior cruciate ligaments, were included in the current study. The percentages of immunopositive cells in tendinosis samples for cyclooxygenase-2 and transforming growth factor-beta1 were 66.75 and 56.40, respectively, which were significantly higher than those of the control subjects (25.15 and 23.06 respectively). Tendinosis fibroblast culture also produced more prostaglandin E2 and active transforming growth factor-beta1. These findings indicate the involvement of prostaglandins and cytokines that may explain the clinical symptoms and nonhealing features of tendinosis.

Adolescent↗

Immobilization-induced changes in erythrocyte membrane fluidity in rabbits: a spin-label electron spin resonance study.

It has been shown that many diseases are linked to abnormalities of the erythrocyte membrane. This study observed the changes in erythrocyte membrane fluidity during an immobilization period of 21 days. The right hindlimbs of male adult New Zealand white rabbits were immobilized for 21 days. Blood samples were collected and heparinized prior to immobilization and on days 1, 3, 7, 14, and 21 of immobilization. The membrane fluidity of erythrocytes was measured by spin-label electron spin resonance (ESR). The membrane fluidity was expressed by the value of order parameter (S). The results showed a significant increase of S on days 7 and 14 of immobilization (p <0.01). The highest value of S was found on day 7 of immobilization; thereafter, S gradually declined. Compared with the value measured before immobilization, there was no significant difference in the value of S on day 21. The results show that immobilization significantly affected erythrocyte membrane fluidity, indicating a systemic and temporal response ofthe immobilized body. This study is the first to document the time-course of changes in erythrocyte membrane fluidity in rabbits with single hindlimb immobilization during 21 days. These results may be helpful in studying the pathophysiology of immobilization.

Animals↗