An update on hepatocarcinogenesis

Hepatocellular carcinoma is the most common cancer occurring in males in the world and has an annual incidence worldwide of 1 million. There are variations in its geographical distribution. It is the second most common cancer in Southeast Asia, including Hong Kong and ranks third among males in China.published_or_final_versio

The natural history of chronic hepatitis B infection

Chronic hepatitis B infection is a global health problem that affects about 300 million people. Of these, 75% are Chinese. Most Chinese who become chronic carriers, contract the virus during the perinatal period. The natural history of these chronic hepatitis B carriers includes an initial immune tolerance phase, followed by immune clearance and an inactive hepatitis B non-replicative phase with the development of cirrhosis that may be complicated by hepatocellular carcinoma. The classification of hepato-cellular carcinoma has recently been revised. Based on immunohistochemical studies, it has been found that patients with hepatocellular carcinoma and biliary markers have a poorer survival than patients with hepatocellular carcinoma but who have negative biliary markers. Sometimes, a fourth phase, a hepatitis B envelope-negative hepatitis B virus replicative phase, reflecting the emergence of a pre-core mutant strain, may follow. Our improved understanding of the natural history of chronic hepatitis B infection has led to more effective approaches towards the control of this viral infection and its sequelae. Most importantly, immunisation against hepatitis B virus in the perinatal setting has been shown to prevent chronic infection.published_or_final_versio

Pre-implantation genetic diagnosis in Hong Kong

This paper presents the first two successful cases of pre-implantation genetic diagnosis in Hong Kong and discusses the indications and the advantages over prenatal diagnosis. Patients should be informed about the procedure and extensively counselled about the possibility of misdiagnosis and the need for conventional prenatal diagnosis during pregnancy.published_or_final_versio

Assessment of regional systolic and diastolic impairment of left ventricular function: a study with tissue doppler imaging on right ventricular pacing

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Assessment of regional systolic and diastolic impairment on left ventricular function: a study with tissue Doppler imaging on right ventricular pacing

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Viral loads in clinical specimens and SARS manifestations.

1. A high viral load in nasopharyngeal aspirate (with or without a high viral load in serum) is a useful prognostic indicator of respiratory failure or mortality. The presence of viral RNA in multiple body sites is also indicative of poor prognosis. 2. Early treatment with an effective antiviral agent before day 10 may decrease the peak viral load, and thus ameliorate the clinical symptoms and mortality, and reduce viral shedding and the risk of transmissionpublished_or_final_versio

The effect of ageing on female fertility in an assisted reproduction programme in Hong Kong: retrospective study.

OBJECTIVE: To analyse the effect of ageing on female fertility in an in vitro fertilisation programme in Hong Kong. DESIGN: Retrospective study. SETTING: University teaching hospital, Hong Kong. PATIENTS: Seven hundred and seventy-one women in whom 1336 cycles of in vitro fertilisation were initiated between 1 January 1986 and 31 December 1995. MAIN OUTCOME MEASURES: Patient age and indications for treatment; hormonal response; and the number of cancelled cycles, oocytes retrieved, oocytes fertilised, cleaving embryos, embryos transferred, and clinical pregnancies. RESULTS: Compared with women aged or =36 years (n=398) had a significantly higher cycle cancellation rate (19.3% versus 10.4%), fewer oocytes retrieved per retrieval cycle (6.6 versus 9.0), fewer oocytes fertilised per retrieval cycle (5.0 versus 7.0), fewer cleaving embryos per retrieval cycle (4.8 versus 6.8), and lower serum oestradiol level (9735 [standard deviation, 5681] pmol/L versus 10 708 [5916] pmol/L) despite a larger amount of human menopausal gonadotrophin having been used (all variables, P<0.01; Chi squared test). The clinical pregnancy rate per initiated cycle (range, 7.5%-13.0%) decreased with advancing age (P<0.01; Chi squared test). CONCLUSION: Ageing has a significant deleterious effect on women's reproductive capability. Women should be encouraged to seek early medical advice and treatment for subfertility.published_or_final_versio

Acupuncture transmitted infections.

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Coronavirus HKU15 in respiratory tract of pigs and first discovery of coronavirus quasispecies in 5′-untranslated region

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Persistence of hepatic hepatitis B virus after serological clearance of HBsAG with autologous peripheral stem cell transplantation

Delayed clearance of hepatitis B surface antigen was previously reported in a 38 year old woman after high dose chemotherapy with autologous peripheral blood stem cell rescue. Sixteen months later, this patient remained hepatitis B surface antigen negative, hepatitis B surface anti-body positive, and serum hepatitis B DNA negative by polymerase chain reaction. Serial liver biopsies (one at hepatitis B e antigen positive stage, one at hepatitis B e antibody positive stage, and one at hepatitis B surface antigen negative and hepatitis B surface antibody positive stage) showed a gradual resolution of the inflammatory activity with loss of hepatitis B e antigen and then hepatitis B surface antigen in the serum. However, the degree of fibrosis, though mild, remained the same. With the serological clearance of hepatitis B surface antigen, a small amount of hepatitis B virus DNA was still detectable in the nuclei of liver cells.published_or_final_versio