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Biomedical subjects

W K Chan

Publications and source records attributed to W K Chan.

At least 19 recordsLinked to original sources

Defects in ZnO nanorods prepared by a hydrothermal method.

ZnO nanorod arrays were fabricated using a hydrothermal method. The nanorods were studied by scanning electron microscopy, photoluminescence (PL), time-resolved PL, X-ray photoelectron spectroscopy, and positron annihilation spectroscopy before and after annealing in different environments and at different temperatures. Annealing atmosphere and temperature had significant effects on the PL spectrum, while in all cases the positron diffusion length and PL decay times were increased. We found that, while the defect emission can be significantly reduced by annealing at 200 degrees C, the rods still have large defect concentrations as confirmed by their low positron diffusion length and short PL decay time constants.

Journal Article↗

Metal phthalocyanine nanoribbons and nanowires.

Nanoribbons and nanowires of different metal phthalocyanines (copper, nickel, iron, cobalt, and zinc), as well as copper hexadecafluorophthalocyanine (F(16)CuPc), have been grown by organic vapor-phase deposition. Their properties, as a function of substrate type, source-to-substrate distance, and substrate temperature, were studied by scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and absorption measurements. The size and morphology of the nanostructures were found to be mainly determined by the substrate temperature. The crystal structure was dependent on the substrate temperature as well. At substrate temperatures below 200 degrees C, in addition to straight nanoribbons, twisted nanoribbons were found for all investigated materials except F(16)CuPc, which formed helical nanoribbons upon exposure to an electron beam. The formation of different nanostructures (nanoribbons, twisted nanoribbons, and helical nanoribbons) is discussed.

Journal Article↗

Management of hypertension by private doctors in Hong Kong.

OBJECTIVE: To investigate the management of hypertension by private doctors in Hong Kong. DESIGN: Self-administered questionnaire survey. SETTING: Hong Kong. PARTICIPANTS: Private doctors from all districts in Hong Kong selected by simple random sampling from the website of "The Hong Kong Doctors Homepage" from March to June 2005. MAIN OUTCOME MEASURES: Practice of blood pressure measurement and the treatment prescribed to hypertensive patients. RESULTS: A total of 225 (46%) completed questionnaires were analysed. Only 24.4% of the respondents measured blood pressure in all new patients aged above 18 years. A total of 28.0% of doctors reported that hypertensive status was unknown in over 30% of their patients prior to their first clinic visit when it was consequently diagnosed. Calcium channel blockers (31%), angiotensin-converting enzyme inhibitors (28.5%), diuretics (27.5%), and beta-blockers (21.2%) were the most commonly prescribed antihypertensive medication. Drug efficacy was the reason cited by more than half (56.9%) of doctors for selecting a given drug. Public education about hypertension was considered insufficient by 66.2% of doctors and 32% believed that self-medication would have a very significant effect on drug compliance. CONCLUSIONS: In private clinics, blood pressure measurement should become a routine procedure. There is a need to raise public awareness of hypertension.

Adult↗

Vertebroplasty by use of a strontium-containing bioactive bone cement.

STUDY DESIGN: A review of the laboratory and clinical data for a new strontium-containing hydroxyapatite bioactive bone cement. OBJECTIVES: To compare the properties of the strontium-containing bioactive bone cement with those of polymethyl methacrylate (PMMA) and hydroxyapatite (HA) bone cements. SUMMARY OF BACKGROUND DATA: Vertebroplasty and kyphoplasty using conventional PMMA bone cements have been effectively used to treat osteoporotic spine fractures with good short- and medium-term results. However, PMMA has some undesirable properties, including its high setting temperature, lack of osseointegration, and large stiffness mismatch with osteoporotic bone. These properties are responsible for some postoperative complications. METHODS: Strontium-containing hydroxyapatite (Sr-HA) bioactive bone cement consists of a filler blend of strontium-containing hydroxyapatite, fumed silica and benzoyl peroxide; and a resin blend of bisphenol A diglycidylether methacrylate, triethylene glycol dimethacrylate, poly(ethylene glycol) methacrylate, and N, N-dimethyl-p-toluidine. Its properties, including mechanical strength, setting temperature, biocompatibility, and osseoinduction, were compared with other cements in vitro and in vivo. Early clinical results are presented. RESULTS: The Sr-HA cement has a setting time of 15 to 18 minutes, a maximum setting temperature of 58 degrees C, a compressive strength of 40.9 MPa, bending strength of 31.3 MPa, and a bending modulus of 1,408 MPa. The bending strength and modulus are closer to human cancellous bone. Sr-HA cement promotes osteoblast attachment and mineralization in vitro and bone growth and osseointegration in vivo. In a pilot study, 23 cases of osteoporotic fractures treated with this cement with a mean follow-up of 18 months suggest that it is as effective as PMMA in relieving pain. DISCUSSIONS: Oral strontium has been shown to induce new bone formation and is effective in reducing fracture risk in osteoporosis. Our data suggest that strontium delivered locally has the same effect; thus, the combination of strontium with HA in a cement with a low setting temperature, adequate stiffness, and low viscosity makes this a good bioactive cement for vertebroplasty and kyphoplasty.

Animals↗

Chromosomal abnormalities and FMR1 gene premutation in Chinese women with premature menopause.

OBJECTIVE: To study the prevalence of chromosomal abnormalities and FMR1 gene premutation in Chinese women with premature menopause in Hong Kong. DESIGN: Retrospective study. SETTING: Clinical Genetic Service, Hong Kong. PARTICIPANTS: Chinese women with premature menopause referred for cytogenetic study from January 1983 to November 2003. MAIN OUTCOME MEASURES: Chromosomal abnormalities, FMR1 gene premutation. RESULTS: Chromosomal abnormalities were present in 15.6% of Chinese women who suffered premature menopause. X-chromosome abnormality was involved in over 80% of cases. FMR1 gene premutation was present in 0.86% of 116 cases screened for this abnormality. The predominance of X-chromosome abnormality accounted for the shorter stature, younger menopausal age, and higher prevalence of dysmorphic features among the cytogenetically abnormal patients. However, on logistic regression, no clinical feature was significantly correlated with cytogenetic abnormality. CONCLUSIONS: The prevalence of chromosomal abnormalities among Hong Kong Chinese women who suffer premature menopause was comparable with that of Caucasian and Chinese populations elsewhere. Because clinical features are poor predictors of cytogenetic abnormality, a pragmatic approach to screening is advocated. The carrier rate of fragile X premutation in these women appeared lower than that of Caucasians. Nevertheless, a search for FMR1 gene premutation, in addition to conventional chromosomal study, has important implication for prenatal diagnosis and fertility management for the extended family.

Adult↗

Clopidogrel-induced hepatotoxicity after percutaneous coronary stenting.

Clopidogrel, an adenosine diphosphate receptor blocker, is widely used as an adjunctive antiplatelet therapy in acute coronary syndrome and percutaneous coronary stenting. The occurrence of hepatotoxicity is rare. We describe the occurrence of symptomatic liver disease in a 74-year-old man 5 weeks following commencement of therapy with clopidogrel. The reported cases of clopidogrel-induced hepatotoxicity are reviewed and the clinical significance of this event are discussed.

Aged↗

Barriers to participation in a phase II cardiac rehabilitation programme.

OBJECTIVES: To identify barriers to participation in a phase II cardiac rehabilitation programme and measures that may enhance participation. DESIGN: Prospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Cardiac patients recruited for a phase I cardiac rehabilitation programme from July 2002 to January 2003. MAIN OUTCOME MEASURES: Reasons for not participating in a phase II cardiac rehabilitation programme. RESULTS: Of the 193 patients recruited for a phase I cardiac rehabilitation programme, 152 (79%) patients, with a mean age of 70.3 years (standard deviation, 11.9 years), did not proceed to phase II programme. Eleven (7%) deaths occurred before commencement of phase II and 74 (49%) patients were considered physically unfit. Reasons for the latter included fractures, pain, or degenerative changes in the lower limbs (24%), and co-morbidities such as cerebrovascular accident (19%), chronic renal failure (11%), congestive heart failure (9%), and unstable angina (8%). Phase II rehabilitation was postponed until after completion of scheduled cardiac interventions in 13% of patients. Failure of physicians to arrange the pre-phase II exercise stress test as per protocol was reported in 7% of patients. Other reasons were reported: work or time conflicts (16%), non-compliance with cardiac treatment (5%), financial constraints (4%), self-exercise (3%), fear after exercise stress testing (3%), and patients returning to their original cardiologists for treatment (3%). CONCLUSIONS: A significant (79%) proportion of patients did not proceed to a phase II cardiac rehabilitation programme for a variety of reasons. These included physical unfitness, work or time conflicts, and need to attend scheduled cardiac interventions. Further studies are required to determine how to overcome obstacles to cardiac rehabilitation.

Adult↗

Ultrastructural study of mineralization of a strontium-containing hydroxyapatite (Sr-HA) cement in vivo.

The purpose of this study was to investigate the mineralization leading to osseointegration of strontium-containing hydroxyapatite (Sr-HA) bioactive bone cement injected into cancellous bone in vivo. Sr-HA cement was injected into the ilium of rabbits for 1, 3, and 6 months. The bone mineralization area was found to be largest at 3 months, then at 1 month, and smallest at 6 months (p < 0.01) measured with tetracycline labeling. Osseointegration of Sr-HA cement was achieved at 3 months as observed by scanning electron microscopy. A high calcium and phosphorus area was observed at the interface of bone-Sr-HA cement determined by energy-dispersive X-ray analysis. Transmission electron microscopy gave evidence of the mechanism of bone formation. Dissolution of Sr-HA into debris by the bone remodeling process was thought to increase the concentration of calcium and phosphorus at the interface of bone-Sr-HA cement and stimulate bone formation. Crystalline Sr-HA formed an amorphous layer and dissolved into the surrounding solution, then apatite crystallites were precipitated and formed new bone at 3 months. This young bone then becomes mature bone, which bonds tightly to the Sr-HA cement with collagen fibers inserted perpendicularly after 6 months.

Animals↗

In vivo cancellous bone remodeling on a strontium-containing hydroxyapatite (sr-HA) bioactive cement.

The purpose of this study was to investigate the in vivo bone response to the strontium-containing hydroxyapatite (Sr-HA) bioactive bone cement injected into the cancellous bone. Sr-HA cement was injected into the iliac crest of rabbits for 1, 3, and 6 months. Active bone formation and remodeling were observed after 1 month. Newly formed bone was observed to grow onto the bone cement after 3 months. Thick osteoid layer with osteoblasts formed along the bone and guided over the bone cement surface reflected the stimulating effect of Sr-HA. From scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) analysis, high calcium and phosphorus levels were detected at the interface with a thick layer of 70 microm in width, and fusion of Sr-HA with the bone was observed. Blood vessels were found developing in remodeling sites. The affinity of bone on Sr-HA cement was increased from 73.55 +/- 3.50% after 3 months up to 85.15 +/- 2.74% after 6 months (p < 0.01). In contrast to Sr-HA cement, poly(methyl methacrylate) (PMMA) bone cement was neither osteoconductive nor bioresorbable. Results show that the Sr-HA cement is biocompatible and osteoconductive, which is suitable for use in treating osteoporotic vertebral fractures.

Animals↗

Clinical profile and genetic basis of Brugada syndrome in the Chinese population.

OBJECTIVE: To study the clinical profile and genetic basis of Brugada syndrome in Chinese patients. DESIGN: Prospective observational study. SETTING: Seven regional public hospitals, Hong Kong. MAIN OUTCOME MEASURES: The clinical and follow-up data of 50 patients (47 men, 3 women; mean age, 53 years) were collected, and genetic data of 36 probands and eight family members of three genotyped probands were analysed. RESULTS: Eight patients survived sudden cardiac death (group A), 12 had syncope of unknown origin but no sudden death (group B), and 30 were asymptomatic before recognition of Brugada syndrome (group C). Programmed electrical stimulation induced sustained ventricular arrhythmias in 88% (7/8), 82% (9/11), and 27% (3/11) of patients in group A, group B, and group C, respectively. New arrhythmic events occurred in 50% (4/8) of patients in group A and 17% (2/12) of patients in group B after a mean follow-up period of 30 (standard deviation, 13) months and 25 (7) months, respectively. All group C patients remained asymptomatic during a mean follow-up period of 25 (standard deviation, 11) months. Five of 36 probands and three of eight family members who underwent genetic testing were found to have a mutation in their SCN5A gene. CONCLUSIONS: Chinese patients with Brugada syndrome who are symptomatic have a high likelihood of arrhythmia recurrence, whereas asymptomatic patients enjoy a good short-term prognosis. The prevalence of SCN5A mutation among probands is 14%. Thus, Chinese patients with Brugada syndrome share with their western counterparts similar clinical and genetic heterogeneity.

Adult↗

Rapid manufacturing techniques in the development of an axial blood pump impeller.

This paper presents a comparison of manufacturing techniques used in the development of an axial blood pump impeller. In this development process the impeller was designed and its performance was evaluated with the aid of computational fluid dynamics (CFD). Prototypes of those designs where the CFD results show promise were needed in sufficient quantities at a low cost for experimental validation of the CFD results. As the impeller is less than 16 mm in diameter with a maximum blade thickness of about 1.5 mm, innovative manufacturing techniques are explored in this paper to determine the best process for quick fabrication of prototypes that are dimensionally accurate, structurally robust and low in cost. Four rapid prototyping techniques were explored. The completed parts were compared on the basis of manufacturing time, quality and strength of parts obtained, manufacturing cost and also in vitro performances. Based on these studies, it was concluded that selective laser sintering (SLS) is the most appropriate method for the quick production of prototype parts for evaluation of pump performance.

Blood Flow Velocity↗

A computational study of the effects of inlet guide vanes on the performance of a centrifugal blood pump.

This article presents computational studies on the effects of inlet guide vanes (IGVs) on the flow pattern and shear stress in a centrifugal blood pump. The effect of IGVs is to introduce a pre-swirl to fluid particles entering the impeller with the intention that the fluid particles will travel along the blade profile. Currently, most commercial centrifugal blood pumps employ straight radial impeller blades that are not hydrodynamically ideal for a good flow pattern within the blade passage. Flow separation and formation of vortices within the blade passage are believed to increase the degree of hemolysis and thrombosis. These are causes for blood clotting that will lead to malfunctioning of ventricular assist devices. Four IGVs of different geometrical profiles have been numerically investigated using a commercial software program CFX-Tascflow. The pump is operated at 2,000 rpm, and the results revealed that the relative flow patterns in the blade passage have been dramatically altered. The size of the vortices was reduced, and the pressure contours indicated a gradual rise from the impeller leading edge to the trailing edge. However, inclusion of IGV causes a drop in the pressure head generated. Higher frictional losses are incurred as fluid particles passed through the IGV. In addition, the IGV modifies the inlet velocity triangles, and this also contributes to a drop in the pressure head generated that is consistent with Euler's pump theory. The change in the flow patterns and the gradual variation of the pressure contours have led to lower shear stress within the blade passages as compared to the case without IGVs.

Blood Flow Velocity↗

Numerical investigation of the effect of blade geometry on blood trauma in a centrifugal blood pump.

Fluid dynamic forces in centrifugal blood pump impellers are of key importance in destruction of red blood cells (RBCs) because high rotational speed leads to strong interaction between the impeller and the RBCs. In this paper, three-dimensional models of five different blade geometries are investigated numerically using the commercial software CFX-TASCflow, and the streaklines of RBCs are obtained using the Lagrangian particle tracking method. In reality, RBCs pass through the pump along complicated paths resulting in a highly irregular loading condition for each RBC. In order to enable the prediction of blood damage under the action of these complex-loading conditions, a cumulative damage model for RBCs was adopted in this paper. The numerically simulated percent hemoglobin (%HB) released as RBCs traversed the impeller and volute was examined. It was observed that the residence time of particles in the blade passage is a critical factor in determining hemolytic effects. This, in turn, is a function of the blade geometry. In addition, it was observed that the volute profile is an important influence on the computed HB% released.

Computer Simulation↗

The role of ruthenium and rhenium diimine complexes in conjugated polymers that exhibit interesting opto-electronic properties.

This paper reports the synthesis and opto-electronic properties of different conjugated polymers that contain the diimine complexes of ruthenium or rhenium. Conjugated poly(phenylene vinylene)s that contain aromatic 1,3,4-oxadiazole and 2,2'-bipyridine units on the main chain were synthesized by the palladium catalyzed olefinic coupling reaction. Other types of polymers based on 1,10-phenanthroline bis(2,2-bipyridyl) ruthenium(II) or chlorotricarbonyl rhenium(I) complexes were also synthesized by the same reaction. In general, these polymers exhibit two absorption bands due to the pi - pi transition of the conjugated main chain and the d-pi* metal-to-ligand charge-transfer transition of the metal complex. As a result, the photosensitivity of the polymers beyond 500 nm was enhanced. Charge-carrier mobility measurements showed that the presence of metal complexes could facilitate the charge-transport process, and the enhancement in carrier mobility was dependent on the metal content in the polymer. In addition, we have also demonstrated that the ruthenium complex could act as both photosensitizer and light emitter. Photovoltaic cells were constructed, and they were subjected to irradiation with a xenon arc lamp. Under illumination, the short circuit current and the open circuit voltage were measured to be 0.05 mAcm(-2) and 0.35 V, respectively. The polymers were fabricated into single-layer emitting devices, and light emission was observed when the device was subjected to forward bias. The maximum luminance was determined to be 300 cdm(-2), and the external quantum efficiency was approximately 0.05 to 0.2%. Although the efficiency was relatively low when compared with other devices based on organic materials, we have demonstrated the first examples of using transition metal complexes for both photovoltaic and light-emitting applications.

Journal Article↗

Neurofilaments consist of distinct populations that can be distinguished by C-terminal phosphorylation, bundling, and axonal transport rate in growing axonal neurites.

We examined the steady-state distribution and axonal transport of neurofilament (NF) subunits within growing axonal neurites of NB2a/d1 cells. Ultrastructural analyses demonstrated a longitudinally oriented "bundle" of closely apposed NFs that was surrounded by more widely spaced individual NFs. NF bundles were recovered during fractionation and could be isolated from individual NFs by sedimentation through sucrose. Immunoreactivity toward the restrictive C-terminal phospho-dependent antibody RT97 was significantly more prominent on bundled than on individual NFs. Microinjected biotinylated NF subunits, GFP-tagged NF subunits expressed after transfection, and radiolabeled endogenous subunits all associated with individual NFs before they associated with bundled NFs. Biotinylated and GFP-tagged NF subunits did not accumulate uniformly along bundled NFs; they initially appeared within the proximal portion of the NF bundle and only subsequently were observed along the entire length of bundled NFs. These findings demonstrate that axonal NFs are not homogeneous but, rather, consist of distinct populations. One of these is characterized by less extensive C-terminal phosphorylation and a relative lack of NF-NF interactions. The other is characterized by more extensive C-terminal NF phosphorylation and increased NF-NF interactions and either undergoes markedly slower axonal transport or does not transport and undergoes turnover via subunit and/or filament exchange with individual NFs. Inhibition of phosphatase activities increased NF-NF interactions within living cells. These findings collectively suggest that C-terminal phosphorylation and NF-NF interactions are responsible for slowing NF axonal transport.

Amoxicillin-Potassium Clavulanate Combination↗

The predominant form in which neurofilament subunits undergo axonal transport varies during axonal initiation, elongation, and maturation.

The forms in which neurofilament (NF) subunits undergo axonal transport is controversial. Recent studies from have provided real-time visualization of the slow axonal transport of NF subunits by transfecting neuronal cultures with constructs encoding green fluorescent protein (GFP)-conjugated NF-M subunits. In our studies in differentiated NB2a/d1 cells, the majority NF subunits underwent transport in the form of punctate NF precursors, while studies in cultured neurons have demonstrated transport of NF subunits in predominantly filamentous form. Although different constructs were used in these studies, transfection of the same cultured neurons with our construct yielded the filamentous pattern observed by others, while transfection of our cultures with their construct generated punctate structures, confirming that the observed differences did not reflect variances in assembly-competence among the constructs. Manipulation of intracellular kinase, phosphatase, and protease activities shifted the predominant form of GFP-conjugated subunits between punctate and filamentous, confirming, as shown previously for vimentin, that punctate structures represent precursors for intermediate filament formation. Since these prior studies were conducted at markedly differing neuronal differentiation states, we tested the alternate hypothesis that these differing results reflected developmental alterations in NF dynamics that accompany various stages of neuritogenesis. We conducted time-course analyses of transfected NB2a/d1 cells, including monitoring of transfected cells over several days, as well as transfecting cells at varying intervals prior to and following induction of differentiation and axonal neurite outgrowth. GFP-conjugated subunits were predominantly filamentous during the period of most robust axonal outgrowth and NF accumulation, and presented a mixed profile of punctate and filamentous forms prior to neuritogenesis and following the developmental slowing of neurite outgrowth. These analyses demonstrate that NF subunits are capable of undergoing axonal transport in multiple forms, and that the predominant form in which NF subunits undergo axonal transport varies in accord with the rate of axonal elongation and accumulation of NFs within developing axons.

Animals↗

Ontogeny of alpha-amylase gene expression in sea bass larvae (Lates calcarifer).

The enzymatic activities of alpha-amylase and its corresponding messenger RNA levels in developing sea bass (Lates calcarifer) larvae were studied from hatching until 27 days post hatching (dph). An increasing activity of amylase enzyme was measured until 5 dph, and the activity gradually decreased thereafter and reached a constant level by 12 dph. To achieve a better understanding of the molecular mechanisms underlying amylase expression, we have cloned and sequenced a 318-bp fragment of alpha-amylase complementary DNA. Based on this sequence, a real-time reverse transcriptase polymerase chain reaction technique to monitor the changes in the mRNA levels in the larvae was developed. A correlation between enzymatic activity and mRNA level of alpha-amylase could be demonstrated during the early development of sea bass larvae. This suggests that the changes in alpha-amylase are controlled at least at the transcriptional level during early larval development of sea bass.

Journal Article↗