Advances in immunomodulating therapy of HBV infection

Patients with chronic hepatitis B virus (HBV) infection have a higher risk of developing liver cirrhosis and hepatocellular carcinoma. Interferon-α, lamivudine and adefovir dipivoxil are the three approved treatment for chronic HBV infection and offers the only means of preventing the development of these complications. However, the efficacy of these agents, in terms of loss of Hepatitis B e antigen with or without seroconversion to Hepatitis B e antibody, normalization of serum alanine transaminase levels, loss of serum HBV DNA, and improvement in liver histology can only be achieved in 20-30% of those treated. Long-term treatment with either lamivudine or adefovir dipivoxil can result in the development of drug resistant mutants leading to an increased length of treatment with additional nucleoside analogues. These limitations of the current antiviral therapies underline the need for alternative therapies. Specific and nonspecific immunotherapeutic strategies to restore effective virus-specific T cell responses in those with chronic HBV infection offers an interesting alternative approach. These immunotherapeutic therapies include the adoptive transfer of HBV immunity, pegylated interferon and therapeutic vaccine therapies.published_or_final_versio

Curricula 2001: a brief summary

Model curricula are important resources for curricula planning and design. A joint task force between IEEE-CS and ACM was formed to undertake the responsibility of revising the 1991 model curricula. The effort is now underway, and the result will be known as Curricula 2001.published_or_final_versio

Comparison of three approaches on DSP based digital controlled 2-wheeler forward converter

This paper presents the design of digital controls of PWM DC-DC converters on a digital signal processor (DSP) based platform. Three digital control approaches are being investigated: discretisation of analog control, digital proportional-integral-derivative (PID) control, and deadbeat control. Simulation results of the three types of control are shown. Experimental results of a 25W 2-wheeler forward converter prototype are presented to verify the design.published_or_final_versio

A patient with non-Q wave acute inferior myocardial infarction

The occurrences of atrioventricular (AV) nodal blockade or right ventricular (RV) infarction in acute inferior myocardial infarction (MI) had been well recognised and signified a proximal right coronary artery (RCA) occlusion. However, they did not point out the extent of the RCA territory involved. We recently managed a patient with incomplete inferior MI in which ECG on presentation already showed (he infarct-related RCA as the dominant vessel having proximal occlusion. Various aggressive treatments have been taken subsequently.published_or_final_versio

Performance analysis of the doubly-linked list protocol family for distributed shared memory systems

The 2nd International Conference on Algorithms and Architectures for Parallel Processing, Singapore, 11-13 June 1996The doubly-linked list (DLL) protocol provides a memory efficient, scalable, high-performance and yet easy to implement method to maintain memory coherence in distributed shared memory (DSM) systems. In this paper, the performance analysis of the DLL family of protocols is presented. Theoretically, the DLL protocol with stable owners has the shortest remote memory access latency among the DLL protocol family. According to the simulated performance evaluation, the DLL-S protocol is 65.7% faster than the DDM algorithm for the linear equation solver; and is 16.5% faster for the matrix multiplier. From the trend of the performance figures, it is predicted that the improvement in performance due to the DLL-S protocol will be considerably greater when a larger number of processors are used, indicating that the DLL-S protocol is also the most scalable of the protocols tested.published_or_final_versio

From zero to one : integrating engineering and non-engineering students in a service-learning engineering project

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Unilateral epistaxis after swimming in a stream

A 55-year-old Chinese woman presented with a 3-week history of unilateral left-sided epistaxis and nasal obstruction. She had swum in a freshwater stream 1 month prior to the onset of symptoms. Endoscopic examination revealed a live leech at the left middle meatus with a large part of its body inside the left maxillary antrum. Local anaesthetic was applied to anaesthetise the leech and facilitate removal. Magnetic resonance imaging performed following removal confirmed that no other leeches were present in the sinonasal area. The endoparasitism might have persisted because of the inconspicuous site of infestation and the absence of pain. This form of leech infestation has not been previously reported.published_or_final_versio

Predicting future blood demand from thalassemia major patients in Hong Kong

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Outcomes of interferon alpha and ribavirin treatment for chronic hepatitis C in patients with normal serum aminotransaminases

INTRODUCTION: Information on treatment outcomes with interferon plus ribavirin combination therapy in chronic hepatitis C patients with normal alanine aminotransaminase (ALT) levels is limited. AIM: The aims of this study were to assess outcomes of treatment with interferon plus ribavirin in patients with normal ALT levels (normal ALT group, n=52) compared with those with elevated ALT levels (raised ALT group, n=53), and to document the rate at which patients with normal ALT levels have an apparent worsening of disease, as shown by increases in ALT levels. RESULTS: At the end of treatment (week 48), 31 patients (59.6%) in the normal ALT group and 30 patients (56.6%) in the raised ALT group had undetectable hepatitis C virus (HCV) RNA (p=0.75). A sustained virological response (SVR) was achieved in 20 patients (38.5%) in the normal ALT group and in 21 patients (39.6%) in the raised ALT group (p=0.90). Patients were subsequently followed up for a median of 29.8 (interquartile range 25th-75th percentile (IQR) 20.8-36.2) months in the normal ALT group and for a median of 26.1 (IQR 17.7-36.3) months in the raised group (p=0.20) after week 72 of treatment. Among patients without SVR in the normal ALT group, only three patients (9.4%) developed persistently raised ALT levels following therapy. CONCLUSIONS: Combination therapy with interferon plus ribavirin is associated with a similar SVR in patients with normal ALT levels compared with those with elevated ALT levels. In patients with normal ALT levels, virological non-response to therapy results in new elevations in serum ALT levels in a small minority only.published_or_final_versio