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Biomedical subjects

Ting-fan Leung

Publications and source records attributed to Ting-fan Leung.

7 recordsLinked to original sources
PubMed2006

A malignant itch.

We report an unusual presentation of a previously healthy three-year-old Chinese girl with a four-week history of apparently unexplained generalized intense itch. She had no past history of atopy or xerosis. Despite the severe itch, she had only minimal scratch marks on her right gluteal region but no flexural involvement. The girl was treated as having scabies and eczema and with oral antihistamines by various dermatologists without much improvement. She subsequently presented to a regional hospital with right hip pain and fever. Radiological and histopathological investigations confirmed that she had a peripheral T-cell lymphoma. The itch pattern prior to and following chemotherapy, as documented by the DigiTrac wrist-held movement monitor, showed a dramatic reduction of her nocturnal itch. The pattern was also very different from that of atopic dermatitis in that the scratching was of much higher intensity but lower frequency. Intractable pruritus associated with a peripheral T-cell lymphoma has not been previously reported in the pediatric literature. This report serves to alert clinicians of the gold paradigm that in a patient with an unexplained generalized itch, lymphoma and other malignancies must be considered.

Child, Preschool↗
PubMed2005

Oral sildenafil for treatment of severe pulmonary hypertension in an infant.

We report the use of oral sildenafil in a 5-month-old preterm infant with severe bronchopulmonary dysplasia and pulmonary arterial hypertension refractory to inhaled nitric oxide treatment, maximal ventilatory support and conventional vasodilator therapy. Sildenafil was prepared as a liquid suspension by the method of trituration and administered via an orogastric tube to the patient. Forty-eight hours after sildenafil treatment, echocardiography revealed that the tricuspid incompetence was substantially diminished and the contractility of both ventricles improved, indicating a marked reduction in pulmonary arterial pressure. Oral sildenafil treatment was continued for 6 months until complete resolution of pulmonary arterial hypertension, and oxygen supplement was weaned off. There was no adverse effect during the treatment period. Oral sildenafil may be useful in reducing pulmonary vascular resistance and can be considered for treatment of severe pulmonary arterial hypertension secondary to bronchopulmonary dysplasia.

Administration, Oral↗
PubMed2005

Hyperventilation at referring hospitals is common before transport in intubated children with neurological diseases.

OBJECTIVE: To assess if cardiopulmonary complications and abnormal carbon dioxide tension are more likely in intubated children with neurological diseases undergoing transport. METHODS: We reviewed the transport records of all ventilated children retrieved to a pediatric teaching hospital in the United States within a 12-month period. RESULTS: Twenty-seven children were transported by ground (n = 11), helicopter (n = 10), and fixed-wing aircraft (n = 6). Adjustments of ventilator settings were made in 17 (63%). There were no pneumothoraces, endotracheal tube complications, arrhythmias, or cardiopulmonary resuscitation en route. Twelve patients (44%) had a primary neurological condition. In the neurological category, the pretransport blood gases revealed 7 patients with hyperventilation (Pco2, 20-29 mm Hg), and the posttransport blood gases showed 4 patients with hyperventilation (Pco2, 15-28 mm Hg). In the nonneurological category, hyperventilation occurred only in one patient before and another after transport. No significant difference between the mode of transport, stabilization time, return time, and the occurrence of hypercapnia and hypocapnia was identified. Patients who had a neurological condition were more likely to be hyperventilated at the referring hospitals (P = 0.007). Additional maneuvers were considered necessary in 3 of the 6 neurological patients and 2 of the 5 nonneurological patients with DeltapH greater than +/-0.1, whereas the management of all but one patient with DeltapH less than +/-0.1 was considered appropriate (DeltapH defined as the difference between posttransport and pretransport pH values). CONCLUSION: There is no cardiopulmonary disaster in the various modes of pediatric transport. When compared with ground transport, there is no significant increase in the risk for cardiopulmonary complications or abnormal CO2 tension in air transport of intubated children. DeltapH, in conjunction with clinical data and PCO2 values, may be a simple index for evaluation of cardiopulmonary management during transport.

Adolescent↗
PubMed2005

A survey of attitudes toward homosexuality in Hong Kong chinese medical students.

BACKGROUND: Homosexuality is now considered an alternative lifestyle occurring with some regularity as a variant of human sexuality, rather than a pathological disorder. It is important to understand the attitudes of medical professionals toward homosexuality, as their attitudes may influence their approach to gay men and lesbians as patients. It is also important to understand the current attitudes of medical students who will be the future generation of health care providers. PURPOSE: To study Chinese medical students' attitudes toward and personal experiences with homosexuality. METHODS: A cross-sectional study was conducted at a university medical school. Medical students were asked 16 questions according to an anonymous survey questionnaire. RESULTS: Of the 780 medical students (42% male, 49% female, 10% sex anonymous) who received the questionnaire, 627 (80%) returned it. Of these students, 72% were age 18 to 22 years; 38% reported that they had homosexual friends. Only 16 students described themselves as homosexuals and 20 as bisexuals. A total of 249 students (40%) reported that they had a religion; 542 (86%) reported that they would accept their friends to be homosexuals. Two thirds thought that homosexual and heterosexual partners should have equal legal rights in terms of marriage, whereas slightly less than half (46%) thought they should have equal legal rights in adopting children. With regard to learning or working abilities, 93% thought homosexuals are not any different from heterosexuals. Two thirds thought homosexuals are not different from heterosexuals in terms of sexual behaviour such as promiscuity or loyalty. One fourth thought homosexuality is a psychological disorder that requires therapy. These findings did not differ significantly with seniority, but students with a religion held different attitudes than those without, and were more likely to believe that homosexuality is a psychological disorder, odds ratio (OR) = 2.33, 95% confidence interval (CI) = 1.59 .43, p < .001. Female students were more likely to have homosexual friends, OR = 1.72, 95% CI = 1.20 .48, p = .003, and more accepting attitudes, OR = 1.78, 95% CI = 1.24 .57, p = .002. CONCLUSIONS: The attitudes and experiences do not vary significantly between the 5 classes of medical students, but religious beliefs and gender might influence these attitudes. These findings can help medical teachers to be more sensitive in terms of educating their students.

Adolescent↗
PubMed2002

Inhalant allergens as risk factors for the development and severity of mild-to-moderate asthma in Hong Kong Chinese children.

Sensitization to aeroallergens has been found to be a dominant risk factor for asthma in population-based studies. Similar results in asthmatic children being managed in hospital-affiliated outpatient clinic have not been established. We therefore conducted a case-control study on asthmatic children attending a university hospital-based outpatient clinic to investigate the pattern of aeroallergen sensitization and to assess the correlation between asthma control and the presence of allergen-specific IgE-s. Asthmatic patients underwent a questionnaire assessment of their asthma control, skin prick tests (SPT) for allergen sensitization, and spirometric evaluation. Peripheral blood was collected from all subjects for in vitro serum specific IgE assay (RAST) to common aeroallergens. One hundred and seventy asthmatics (aged 9.8 +/- 3.7 years) and 57 age-matched control subjects were enrolled. Our patients had a median of two asthmatic attacks within 6 months prior to evaluation, and their median Disease Severity Score was 13. The median FEV1 in our asthmatic children was 98%, whereas serum logarithmic total IgE concentrations in patients and controls were 2.57 and 2.09, respectively (p < 0.0001). More than 85% of our asthmatic children were sensitized to house-dust mite (HDM), and sensitization to HDM and cat, as well as elevated serum total IgE concentration, was a significant risk factor for the development of asthma in this cohort. Several objective measures of asthma severity, as well as FEV1, correlated significantly with sensitization to HDM, pets, and cockroaches. In conclusion, indoor aeroallergens are one of the risk factors for the development and severity of mild-to-moderate asthma in Chinese children in Hong Kong.

Adolescent↗
PubMed2002

Sensitization to common food allergens is a risk factor for asthma in young Chinese children in Hong Kong.

Sensitization to aeroallergens is a major risk factor for asthma. Although patients frequently consider food ingestion as an asthma trigger, the relationship between serum food-specific IgE antibodies and childhood asthma in China remains unclear. We therefore conducted a case-control study on asthmatic children attending a university hospital-based outpatient clinic to investigate their pattern of food sensitization. Asthmatic patients underwent spirometric assessment, and peripheral blood was collected for serum-specific IgE antibodies to common food and inhalant allergens. Two hundred and thirty-one asthmatics (aged 9.3+/-4.3 years) and 79 age- and sex-matched controls were enrolled. The serum logarithmic total IgE concentrations in patients and controls were 2.49 and 1.92, respectively (p < 0.0001). Subjects with increased serum total IgE level were significantly more likely to have food sensitization than those with normal values (33% vs. 16%; p = 0.001). Twenty-nine (52%) of 56 asthmatics younger than 6 years old and seven (27%) of 26 age-matched controls hadfood-specific IgE in their sera (p = 0.035). Asthmatics with food-specific IgE also used more doses of as-needed bronchodilator weekly (p = 0.005). Nonetheless, no association was found between asthma diagnosis and sensitization to individual food allergens. Significant food sensitization, with food-specific IgE level above 95% predictive values for clinical food allergy as proposed by Sampson, was only found in two patients for peanut and three subjects for egg white. In conclusion, a significant association was found between asthma and the presence of food-specific IgE antibodies in young Chinese children. Significant sensitization to common foods is rare in this cohort.

Administration, Inhalation↗