The pathology of bone marrow transplantation in Hong Kong Chinese

The pathological lesions found in 68 successfully engrafted patients with human leucocyte antigen-matched sibling-related bone marrow transplants werereviewed retrospectively. Twenty-six (38%) patients had acute graft-versus-host disease, which was slightly less than that reported in Caucasians. Skin was a constant site of involvement (100%), followed by the gastrointestinal tract (74%) and liver (59%). There was a 74% correlation between the clinical and histological grading of cutaneous graft-versus-host disease, while that of the gastrointestinal tract was lower at 60%. Cytomegalovirus colitis was found on histological examination of two patients clinically thought to have graft-versus-host disease. Histological evidence of infection, which included viral hepatitis (n=5), disseminated cytomegalovirus infection (n=3), disseminated aspergillosis (n=2), systemic candidiasis (n=2), Pneumocystis carinii pneumonia (n=1), and bacterial pneumonia (n=1), was present in 14 patients. In addition to graft-versus-host disease and infections, there was a case of veno-occlusive disease of the liver. Histological examination is important in distinguishing graft-versus-host disease from infection and other complications in bone marrow transplantation.published_or_final_versio

Patient complexity and genotype-phenotype correlations in biliary atresia: a cross-sectional analysis

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Stage-specific manifestation of mold infections in bone marrow transplant recipients: Risk factors and clinical significance of positive concentrated smears

Potassium hydroxide-concentrated smears, prepared from sedimented remains of clinical specimens, were used to distinguish between mold infection and exogenous contamination in fungal culture-positive specimens. This method was applied in the study of 3,857 clinical specimens from 230 bone marrow transplant recipients who were followed up prospectively for infectious complications. Concentrated smears of only 86 (from 21 infected patients) of 149 fungal culture-positive specimens were positive for hyphae; 82 of the strains were Aspergillus species. Concentrated smears of the remaining 63 fungal culture-positive specimens were negative; the strains identified by culture were considered as exogenous contaminants (87% of which were Penicillium species). A stage-specific manifestation of mold infection was observed: 67% of mold infections occurred during acute graft-vs.-host disease (GVHD) a median of 47 days after transplantation, whereas 9% of mold infections occurred as rapidly fatal invasive disease before engraftment. Overall, of the 21 patients with mold infection, 17 (81%) had invasive mold disease, and four (19%) had mold colonization of airways secondary to chronic GVHD after day 100. The significant risk factors for mold infection were total-body irradiation and grade 2-4 acute GVHD. Because of our high mortality rate (82%), the consideration of antimold prophylaxis for such patients may be warranted.published_or_final_versio

Role of RET and PHOX2B gene polymorphisms in risk of Hirschsprung's disease in Chinese population [9]

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Haemoglobin H disease due to (--SEA) α-globin gene deletion and α2-codon 30 (ΔGAG) mutation: A family study

A Chinese family in which two siblings suffer from haemogloblin (Hb) H disease due to (--SEA) α-globin gene deletion and α2-codon 30 (ΔGAG) mutation is described. Both siblings are transfusion-independent and have survived to adulthood. In contrast to previous report of hydrops fetalis associated with ζ-α-thal-1 and α2-codon 30 (ΔGAG) mutation, the ζ-globin genes are intact in the two siblings, which most probably alleviates the γ-chain excess and protects the fetus from severe anaemia. Correlation of genotype with phenotype in Hb H disease is important for genetic counselling, especially in the antenatal setting.link_to_subscribed_fulltex

Contribution of adult aquatic insects to riparian prey availability along tropical forest streams

The contribution of adult aquatic insects to riparian prey availability at four sites along three hillstreams in Hong Kong was estimated during 2004-2006 dry and wet seasons using light traps deployed at different distances from the banks. The number and biomass of aquatic and terrestrial insects collected were markedly higher during the wet season. Numerically, aquatic insects (especially Chironomidae and Philopotamidae) remained a major catch component along banks throughout the year comprising 77% (range: 61-85%) of total insects. Their contribution to total biomass was higher in the wet season (mean: 50%, range: 33-62%) than during the dry season (mean: 21%, range: 8-45%). Aquatic insect abundance decreased with increasing distance from streams during both seasons: numbers at 10-20 m distance were less than 45% of those at the banks, declining to less than 13% at 80 m distance. No such decline with distance was observed for terrestrial insects, but the limited dispersal of aquatic insects meant total insect catches were highest along stream banks. Changes in biomass with distance from streams were similar to those for abundance. Adult aquatic insects may represent an important water-to-land energy subsidy for riparian predators in Hong Kong, but the magnitude varied seasonally and fell sharply with increasing distance from streams. © CSIRO 2007.link_to_subscribed_fulltex

Simultaneous laparoscopic totally extraperitoneal repair for concurrent ipsilateral spigelian and indirect inguinal hernia

Simultaneous unilateral spigelian and inguinal hernia is uncommon. Majority of the approaches to repair of spigelian hernia is open surgery. We report our technique of a simultaneous repair of both spigelian and inguinal hernia using the totally extraperitoneal laparoscopic mesh repair. © 2008 by Lippincott Williams & Wilkins.link_to_subscribed_fulltex

Arthropod 'rain' into tropical streams: The importance of intact riparian forest and influences on fish diets

Terrestrial arthropods might represent an important energy source for stream predators, but these trophic linkages have seldom been studied in the tropics. Terrestrial arthropod inputs (essentially, arthropod 'rain') into four streams with different riparian vegetation (two draining shrublands and two draining forests) were measured over three consecutive seasons (dry, wet, dry) from 2005 to 2007 in monsoonal Hong Kong. Predatory minnows, Parazacco spilurus (Cyprinidae), were collected and their consumption of terrestrial arthropods was estimated. Inputs of arthropods were dominated by Diptera, Collembola, Formicidae and aerial Hymenoptera, accounting for ≥73% of the arthropod abundance. Seasonal variation was marked: numbers in the dry seasons were approximately half (47-57%) those in the wet season, and biomass fell to one-third (33-37%) of the wet-season value. Shrubland streams received 19-43% fewer individuals and 6-34% less biomass than shaded forest streams. An analysis of fish diets in three of the four streams showed that terrestrial insects and spiders were more important prey in the two forest streams, accounting for 35-43% of prey abundance (39-43% by volume) v. 28% (27%) in the shrubland stream. Because riparian vegetation is the source of terrestrial arthropod inputs to streams, degradation of streamside forests that reduce these inputs will have consequences for the diets of stream fishes. © CSIRO 2008.link_to_subscribed_fulltex

Essential thrombocythemia with BCR/ABL rearrangement

Essential thrombocythemia (ET) was diagnosed clinically in three patients. Karyotypic analysis and reverse transcription polymerase chain reaction for the bcr-abl chimeric transcript showed that two were Philadelphia chromosome (Ph) positive, bcr-abl positive, whereas the third was Ph negative, bcr-abl positive. The first patient received on allogeneic bone marrow transplantation but relapsed as localized blastic transformation, thus behaving similarly to chronic myeloid leukemia (CML). However, the other patients showed clinical courses more in keeping with ET. Essential thrombocythemia with BCR rearrangements may resemble CML but there are clinical differences. These may be due to genetic changes in addition to the BCR rearrangement.link_to_subscribed_fulltex