Early Bilateral Amniotic Membrane Transplantation in the Management of Severe Ocular Involvement from Acute Toxic Epidermal Necrolysis in a Chinese Pediatric Patient

Introduction: Toxic Epidermal Necrolysis (TEN) is a rare but potentially life-threatening muco-cutaneous condition associated with idiosyncratic hypersensitivity to certain drugs. Ophthalmic involvement is common, typically affecting the ocular surface and eyelids. Survivors often suffer from resulting bilateral blindness and ocular dryness or pain. Objective: To report the successful management of severe ocular surface disease during the acute stage of toxic epidermal necrolysis using early amniotic membrane transplantation on both eyes in a Chinese paediatric patient. Design: Interventional case report Case Report: A 15 year-old Chinese girl was transferred to the intensive care unit of Queen Mary Hospital, Hong Kong with TEN after taking oral cefuroxime and diclofenac. She developed bilateral keratoconjunctivitis, diffuse corneal epithelial defects (80-90% of cornea surface) and later bilateral symblephara. After initial treatment with daily rodding, topical lubricants, steroids and antibiotics, there was no improvement in her condition. Bilateral amniotic membrane transplantation (AMT) was performed over the cornea, fornix, tarsal and bulbar conjunctiva on day 10 of illness. On discharge from the hospital (post-operative week 7), the patient had pinhole visual acuity of 6/7.5 in the right eye and 6/6 the left eye. She was eventually weaned off all topical medication. Visual acuity eventually recovered to 6/6 in both eyes by week 20 after surgery. There was mild residual forniceal symblepharon and eyelid margin keratinization. She continues to require regular lubricants for her chronic ocular surface condition.published_or_final_versio

A community-based epidemiological study of acne vulgaris in Hong Kong

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Brain connectivity during the processing of nouns and verbs: a dynamic Bayesian network analysis

Dynamic Bayesian network was used to study the connections among the brain regions activated during processing of nouns and verbs. Under simplifying assumptions, we arrived at a dynamic Bayesian network learning algorithm with reduced time complexity, which allowed us to test all possible connectivity models exhaustively and choose the best model based on the Bayesian information criterion (BIC) score. We found a posterior to anterior flow of processing of both nouns and verbs. The left medial frontal gyrus was found to play an important role in the network. For verb processing, strong involvements of motor cortex and cerebellum were found.published_or_final_versio

Effects of culture on musical pitch perception.

The strong association between music and speech has been supported by recent research focusing on musicians' superior abilities in second language learning and neural encoding of foreign speech sounds. However, evidence for a double association--the influence of linguistic background on music pitch processing and disorders--remains elusive. Because languages differ in their usage of elements (e.g., pitch) that are also essential for music, a unique opportunity for examining such language-to-music associations comes from a cross-cultural (linguistic) comparison of congenital amusia, a neurogenetic disorder affecting the music (pitch and rhythm) processing of about 5% of the Western population. In the present study, two populations (Hong Kong and Canada) were compared. One spoke a tone language in which differences in voice pitch correspond to differences in word meaning (in Hong Kong Cantonese, /si/ means 'teacher' and 'to try' when spoken in a high and mid pitch pattern, respectively). Using the On-line Identification Test of Congenital Amusia, we found Cantonese speakers as a group tend to show enhanced pitch perception ability compared to speakers of Canadian French and English (non-tone languages). This enhanced ability occurs in the absence of differences in rhythmic perception and persists even after relevant factors such as musical background and age were controlled. Following a common definition of amusia (5% of the population), we found Hong Kong pitch amusics also show enhanced pitch abilities relative to their Canadian counterparts. These findings not only provide critical evidence for a double association of music and speech, but also argue for the reconceptualization of communicative disorders within a cultural framework. Along with recent studies documenting cultural differences in visual perception, our auditory evidence challenges the common assumption of universality of basic mental processes and speaks to the domain generality of culture-to-perception influences.published_or_final_versio

An increase in adenosine-5’-triphosphate (ATP) content in rostral ventrolateral medulla is engaged in the high fructose diet-induced hypertension

BACKGROUND: The increase in fructose ingestion has been linked to overdrive of sympathetic activity and hypertension associated with the metabolic syndrome. The premotor neurons for generation of sympathetic vasomotor activity reside in the rostral ventrolateral medulla (RVLM). Activation of RVLM results in sympathoexcitation and hypertension. Neurons in the central nervous system are able to utilize fructose as a carbon source of ATP production. We examined in this study whether fructose affects ATP content in RVLM and its significance in the increase in central sympathetic outflow and hypertension induced by the high fructose diet (HFD). RESULTS: In normotensive rats fed with high fructose diet (HFD) for 12 weeks, there was a significant increase in tissue ATP content in RVLM, accompanied by the increases in the sympathetic vasomotor activity and blood pressure. These changes were blunted by intracisternal infusion of an ATP synthase inhibitor, oligomycin, to the HFD-fed animals. In the catecholaminergic-containing N2a cells, fructose dose-dependently upregulated the expressions of glucose transporter 2 and 5 (GluT2, 5) and the rate-limiting enzyme of fructolysis, ketohexokinase (KHK), leading to the increases in pyruvate and ATP production, as well as the release of the neurotransmitter, dopamine. These cellular events were significantly prevented after the gene knocking down by lentiviral transfection of small hairpin RNA against KHK. CONCLUSION: These results suggest that increases in ATP content in RVLM may be engaged in the augmented sympathetic vasomotor activity and hypertension associated with the metabolic syndrome induced by the HFD. At cellular level, the increase in pyruvate levels via fructolysis is involved in the fructose-induced ATP production and the release of neurotransmitter

Problematic clinical features of powered wheelchair users with severely disabling multiple sclerosis

This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2014 Informa UK Ltd.Purpose: The aim of this study is to describe the clinical features of powered wheelchair users with severely disabling multiple sclerosis (MS) and explore the problematic clinical features influencing prescription. Method: Retrospective review of electronic and case note records of recipients of electric-powered indoor/outdoor powered wheelchairs (EPIOCs) attending a specialist wheelchair service between June 2007 and September 2008. Records were reviewed by a consultant in rehabilitation medicine, data systematically extracted and entered into a computer database. Further data were entered from clinical records. Data were extracted under three themes; demographic, diagnostic, clinical and wheelchair factors. Results: Records of 28 men mean age 57 (range 37–78, SD 12) years and 63 women mean age 57 (range 35–81, SD 11) years with MS were reviewed a mean of 64 (range 0–131) months after receiving their wheelchair. Twenty two comorbidities, 11 features of MS and 8 features of disability were thought to influence wheelchair prescription. Fifteen users were provided with specialised seating and 46 with tilt-in-space seats. Conclusions: Our findings suggest that people with severe MS requiring an EPIOC benefit from a holistic assessment to identify problematic clinical features that influence the prescription of the EPIOC and further medical and therapeutic interventions

The Diurnal Variation on Cardiovascular Endurance Performance of Secondary School Athlete Student

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Rationalizations and identity conflict following smoking relapse: a thematic analysis

Introduction: Little is known about how smokers respond cognitively and emotionally to the experience of “late” relapse after the acute withdrawal phase. This study assessed the kinds of thoughts and feelings that emerge in order to provide a basis for quantitative research assessing prevalence of different types of response and implications for future quit attempts. Methods: Face-to-face in-depth interviews were conducted among 14 people attending a quit smoking clinic in Malaysia who had relapsed after at least 6 weeks of abstinence. Transcripts were analyzed using thematic analysis to enable emergence of important aspects of the experience. Results: Following relapse, smokers often engaged in rationalizations and activities to minimize worry about the harmful effects of smoking by switching to a lower-tar cigarette, reducing the number of cigarette smoked, attempting to reduce cigarette smoke inhalation, comparing themselves with other smokers, and minimizing the health risks associated with smoking. In some cases, smokers retained a “non-smoker” identity despite having relapsed. Conclusion: Smoking relapsers rationalize their failure to quit and minimize their health risk in order to protect their image as non-smokers while it remains a source of identity conflict

Ambulatory intraocular pressure fluctuation recording with a novel wireless smart silicone contact lens sensor

The Conference program's website is located at http://apacrs2014.org/free_papers.htmlSession - FP1: General: no. FP1-03INTRODUCTION: Monitoring of treatment response in the management of glaucomatous optic neuropathy relies on single intraocular pressure (IOP) measurements during regular clinic hours at regular intervals. However IOP is a dynamic parameter with circadian rhythms as well as posture and exercise related fluctuations. The introduction of continuous 24 hour IOP monitoring technology has created a paradigm shift in glaucoma management. Our wireless smart contact lens sensor was previously validated in-vivo and ex-vivo in animal models. Here we describe the performance of the sensor in ...postprin