Ten-year experience with liver transplantation at Queen Mary Hospital: retrospective study.

OBJECTIVE: To report the experience with liver transplantation at the Queen Mary Hospital from 1991 to 2000. DESIGN: Retrospective study. SETTING: Liver transplant centre of a University teaching hospital, Hong Kong. PATIENTS: One hundred and forty-eight patients (127 adults and 21 children) who underwent a total of 155 liver transplants using 75 cadaver grafts (full-size, 67; reduced-size, 5; split, 3) and 80 living donor grafts (left lateral segment, 15; left lobe, 6; right lobe, 59) from October 1991 to December 2000 were reviewed. MAIN OUTCOME MEASURES: Graft and patient survival rate. RESULTS: The most common disease indications for liver transplantation were chronic hepatitis B-related liver disease (n=74) in adults and biliary atresia (n=14) in children. Eighteen patients had hepatocellular carcinoma. Forty-eight (31%) liver transplants (three ABO-incompatible) were performed in high-urgency situations for patients requiring intensive care. The proportion of living donor liver transplants was 47.7% in adults and 73.9% in children. The overall 1-year and 5-year patient survival rates were 82% and 77%, respectively. The survival of high-risk recipients, such as those with fulminant hepatic failure (80%), chronic hepatitis B (81%), or hepatocellular carcinoma (94%), was not inferior to that of other patients. CONCLUSION: Over the last decade, the promotion of (cadaver) organ donation through public education coupled with innovative techniques in living donor liver transplantation have enabled a liver transplantation programme to be established in Hong Kong with gratifying results.published_or_final_versio

Alterations of lipid-related genes during anti-tuberculosis treatment: insights into host immune responses and potential transcriptional biomarkers

BackgroundThe optimal diagnosis and treatment of tuberculosis (TB) are challenging due to underdiagnosis and inadequate treatment monitoring. Lipid-related genes are crucial components of the host immune response in TB. However, their dynamic expression and potential usefulness for monitoring response to anti-TB treatment are unclear. MethodologyIn the present study, we used a targeted, knowledge-based approach to investigate the expression of lipid-related genes during anti-TB treatment and their potential use as biomarkers of treatment response. Results and discussionThe expression levels of 10 genes (ARPC5, ACSL4, PLD4, LIPA, CHMP2B, RAB5A, GABARAPL2, PLA2G4A, MBOAT2, and MBOAT1) were significantly altered during standard anti-TB treatment. We evaluated the potential usefulness of this 10-lipid-gene signature for TB diagnosis and treatment monitoring in various clinical scenarios across multiple populations. We also compared this signature with other transcriptomic signatures. The 10-lipid-gene signature could distinguish patients with TB from those with latent tuberculosis infection and non-TB controls (area under the receiver operating characteristic curve > 0.7 for most cases); it could also be useful for monitoring response to anti-TB treatment. Although the performance of the new signature was not better than that of previous signatures (i.e., RISK6, Sambarey10, Long10), our results suggest the usefulness of metabolism-centric biomarkersConclusionsLipid-related genes play significant roles in TB pathophysiology and host immune responses. Furthermore, transcriptomic signatures related to the immune response and lipid-related gene may be useful for TB diagnosis and treatment monitoring

Adjunctive mood stabilizer treatment for hospitalized schizophrenia patients: Asia psychotropic prescripton study (2001-2008)

Recent studies indicate relatively high international rates of adjunctive psychotropic medication, including mood stabilizers, for patients with schizophrenia. Since such treatments are little studied in Asia, we examined the frequency of mood-stabilizer use and its clinical correlates among hospitalized Asian patients diagnosed with schizophrenia in 2001-2008. We evaluated usage rates of mood stabilizers with antipsychotic drugs, and associated factors, for in-patients diagnosed with DSM-IV schizophrenia in 2001, 2004 and 2008 in nine Asian regions: China, Hong Kong, India, Korea, Japan, Malaysia, Taiwan, Thailand, and Singapore. Overall, mood stabilizers were given to 20.4% (n=1377/6761) of hospitalized schizophrenia patients, with increased usage over time. Mood-stabilizer use was significantly and independently associated in multivariate logistic modeling with: aggressive behaviour, disorganized speech, year sampled (2008 vs. earlier), multiple hospitalizations, less negative symptoms, younger age, with regional variation (Japan, Hong Kong, Singapore>Taiwan or China). Co-prescription of adjunctive mood stabilizers with antipsychotics for hospitalized Asian schizophrenia patients increased over the past decade, and was associated with specific clinical characteristics. This practice parallels findings in other countries and illustrates ongoing tension between evidence-based practice vs. individualized, empirical treatment of psychotic disorders.published_or_final_versio

Evaluation of immunomodulatory effect: selection of the correct targets for immunostimulation study

Problem statement: Numerous plants or remedies that are traditionally used for various diseases had been claimed to maintain general good health, particularly the immune system. With the advanced understanding on immunology and ethnopharmacology, study on the interaction of this herb with the immune system is critical to understand the safety and its efficacy as a potent immunomodulatory agent. Approach: Selecting proper immune cells from a suitable immune organ allowed for the understanding on the mode of immunomodulation. Lymphocytes isolated from mammalian thymus, spleen and bone marrow represented great candidates for this immunomodulatory study. Results: A number of herbal extracts including that of Rhaphidophora korthalsii and compounds isolated from this plant, namely lectin and zerumbone, had been identified as potent immunostimulators. Conclusion/Recommendations: Future studies are needed to elucidate the mechanism underlaying activites of these immunomodulatory agents

Traditional practice, bioactivities and commercialization potential of Elephantopus scaber Linn

Elephantopus scaber Linn. is known as Prickly-leaves elephant’s foot or di dan tou in Chinese. It has been used in traditional medicine to stimulate diuresis, reduce fever and eliminate bladder stones, as well as to treat nephritis, edema, dampness, chest pain, pneumonia, scabies, arthralgia and leukemia. A number of phytochemicals have also been isolated from this plant, such as deoxyelephantopin, 11,13, dihydrodeoxyelephantopin, lupeol, epifriedelinol and stigmasterol. Most of the major studies only involved the bioactivities of the compounds especially deoxyelephantopin. The effects of the plant extract which can benefit a broad mass of people are still lacking. This paper briefly reviews the traditional usage and scientifically proven bioactivities of E. scaber which contributed its commercialization potential

Traditional practice, bioactivities and commercialization potential of Elephantopus scaber Linn.

Elephantopus scaber Linn. is known as Prickly-leaves elephant’s foot or di dan tou in Chinese. It has been used in traditional medicine to stimulate diuresis, reduce fever and eliminate bladder stones, as well as to treat nephritis, edema, dampness, chest pain, pneumonia, scabies, arthralgia and leukemia. A number of phytochemicals have also been isolated from this plant, such as deoxyelephantopin, 11,13, dihydrodeoxyelephantopin, lupeol, epifriedelinol and stigmasterol. Most of the major studies only involved the bioactivities of the compounds especially deoxyelephantopin. The effects of the plant extract which can benefit a broad mass of people are still lacking. This paper briefly reviews the traditional usage and scientifically proven bioactivities of E. scaber which contributed its commercialization potential

Coconut water vinegar ameliorates recovery of acetaminophen induced liver damage in mice

Background: Coconut water has been commonly consumed as a beverage for its multiple health benefits while vinegar has been used as common seasoning and a traditional Chinese medicine. The present study investigates the potential of coconut water vinegar in promoting recovery on acetaminophen induced liver damage. Methods: Mice were injected with 250 mg/kg body weight acetaminophen for 7 days and were treated with distilled water (untreated), Silybin (positive control) and coconut water vinegar (0.08 mL/kg and 2 mL/kg body weight). Level of oxidation stress and inflammation among treated and untreated mice were compared. Results: Untreated mice oral administrated with acetaminophen were observed with elevation of serum liver profiles, liver histological changes, high level of cytochrome P450 2E1, reduced level of liver antioxidant and increased level of inflammatory related markers indicating liver damage. On the other hand, acetaminophen challenged mice treated with 14 days of coconut water vinegar were recorded with reduction of serum liver profiles, improved liver histology, restored liver antioxidant, reduction of liver inflammation and decreased level of liver cytochrome P450 2E1 in dosage dependent level. Conclusion: Coconut water vinegar has helped to attenuate acetaminophen-induced liver damage by restoring antioxidant activity and suppression of inflammation

16S metagenomic microbial composition analysis of kefir grain using MEGAN and BaseSpace

Kefir is a unique cultured product traditionally made from the fermentation of milk with kefir grains. Metagenomics analysis of kefir grain is essential to understand the composition of microbial populations in the kefir grain. Many microbial populations have been reported in kefir grains from different parts of the world. Although the kefir from Malaysian kefir grain is regularly consumed locally, no report has been made on the kefir grain microbial profile. The present study used kefir grain obtained locally and the microbial composition in the kefir grain was determined using Next Generation Sequencing (NGS). The taxonomic results analysis obtained when using BaseSpace (Illumina) and MEGAN were compared. The software agreed that Lactobacillus genus dominated the samples and the predominant species was L. kefiranofaciens (81.45–91.93%) while L. kefiri (2.01–2.47%) was the second in abundance. The results suggested that Malaysian kefir grain contained the same top two predominant species using both software methods and the microbial composition between both software did not vary significantly

Antioxidant and hepatoprotective effects of the food seasoning curry leaves Murraya koenigii (L.) Spreng. (Rutaceae)

Murraya koenigii (L.) Spreng. (Rutaceae), a common spice, has been traditionally used to reduce inflammation and hepatitis. The present study aimed to reveal the antioxidant and anti-inflammatory activity as well as the regulation of cytochrome P450 levels elicited by aqueous extracts of M. koenigii leaves in response to paracetamol-induced liver toxicity in BALB/c mice. Liver toxicity was induced by an overdose of paracetamol followed by treatment with a M. koenigii leaf aqueous extract. The levels of serum liver markers, liver antioxidants, inflammatory markers and liver cytochrome P450 2E1 were quantified after 14 days of treatment. Histopathological analysis of the liver was also carried out. In vitro antioxidant levels and phenolic acid characterization were also performed. The extracts (50 and 200 mg kg-1 body weight) effectively restored the serum liver profiles (alanine transaminase, aspartate transaminase and alkaline phosphatase), liver antioxidant levels (superoxide dismutase, glutathione and ferric reducing ability of plasma) and inflammatory markers (tumor necrosis factor alpha, inducible nitric oxide synthase, nuclear factor kappa-light-chain-enhancer of activated B cells and nitric oxide) to healthy levels in a dosage dependent manner. The level of liver cytochrome P450 2E1 was also lowered in the extract treated groups. Histopathological assessment showed that treatment with 200 mg kg-1 of the M. koenigii aqueous extract was able to reduce liver necrosis in mice fed paracetamol. Gallic acid concentration was the highest among all the phenolic acids detected in the extract. These results suggested that the M. koenigii aqueous extract, which possessed antioxidant and anti-inflammatory effects, can be used as a potential treatment for liver diseases caused by oxidative stress