Prognostic significance of CD26 in patients with colorectal cancer

Background: CD26, dipeptidyl peptidase IV, was discovered firstly as a membrane-associated peptidase on the surface of leukocyte. We previously demonstrated that a subpopulation of CD26+ cells were associated with the development of distant metastasis, enhanced invasiveness and chemoresistance in colorectal cancer (CRC). In order to understand the clinical impact of CD26, the expression was investigated in CRC patient's specimens. This study investigated the prognostic significance of tumour CD26 expression in patients with CRC. Examination of CD26+ cells has significant clinical impact for the prediction of distant metastasis development in colorectal cancer, and could be used as a selection criterion for further therapy. Methods: Tumour CD26 expression levels were studied by immunohistochemistry using Formalin-fixed paraffin embedded (FFPE) tissues in 143 patients with CRC. Tumour CD26 expression levels were correlated with clinicopathological features of the CRC patients. The prognostic significance of tumour tissue CD26 expression levels was assessed by univariate and multivariate analyses. Result: CD26 expression levels in CRC patients with distant metastasis were significantly higher than those in non-metastatic. High expression levels of CD26 were significantly associated with advanced tumour staging. Patients with a high CD26 expression level had significantly worse overall survival than those with a lower level (p<0.001). Conclusions: The expression of CD26 was positively associated with clinicopathological correlation such as TNM staging, degree of differentiation and development of metastasis. A high CD26 expression level is a predictor of poor outcome after resection of CRC. CD26 may be a useful prognostic marker in patients with CRC. © 2014 Lam et al.published_or_final_versio

A synopsis of current haemophilia care in Hong Kong

Objective To provide a synopsis of current haemophilia care in Hong Kong. Design Retrospective survey. Setting All haematology units of the Hospital Authority in Hong Kong. Patients All patients with haemophilia A and haemophilia B. Results To date, there were 222 mild-to-severe haemophilia patients (192 type A, 30 type B) under regular public care in Hong Kong (43% were considered severe, 33% moderate, and 24% mild), which gave a crude prevalence of 6.8/100 000 male inhabitants. A total of 12.8 million units of Factor VIII and 3 million units of Factor IX were prescribed annually. This amounts to 1.83 units of FVIII per capita of the population, which is comparable to that of other developed countries. Leading causes of mortality were human immunodefciency virus-related complications (10 cases) and cerebral bleeding (2 cases). The life expectancy of patients with severe haemophilia in Hong Kong is improving; currently the oldest patient is 60 years old. Such improved survival may be due to enhanced factor availability, prompt treatment of bleeding episodes at home, safer factor products, and better antiviral treatment. Primary prophylaxis is the accepted standard of care for severe and moderate cases, and "Factor First" has become hospital policy. However, 12 patients continue to present treatment challenges, due to the documented presence of factor inhibitors. In all, 28,100, and 14 cases respectively were positive for human immunodefciency virus, hepatitis C virus, and hepatitis B virus; the youngest patients with the corresponding infections being 28,13, and 22 years old. Comprehensive care with dedicated physiotherapy, surgical support, and radionucleotide synovectomy may reduce morbidity further. Conclusion A multidisciplinary approach can further improve the future care for haemophilia patients in Hong Kong.published_or_final_versio

A synopsis of current care of thalassaemia major patients in Hong Kong

OBJECTIVE: To provide a synopsis of current thalassaemia major patient care in Hong Kong. DESIGN: Retrospective study. SETTING: All haematology units of the Hospital Authority in Hong Kong. PATIENTS: All patients with thalassaemia major with regular transfusion. RESULTS: To date, there were 363 thalassaemia major patients under the care of the Hospital Authority. Prenatal diagnosis has helped to reduce the number of indigenous new cases, but in recent years immigrant cases are appearing. The patients have a mean age of 23 (range, 1-52) years, and 78% of them are adults. In 2009, they received 18 782 units of blood. This accounted for 9.5% of all blood consumption from the Hong Kong Red Cross. In the past, cardiac iron overload was the major cause of death (65%) and few patients survived beyond the age of 45 years. The availability of cardiac iron assessment by magnetic resonance imaging (T2 MRI) to direct the use of oral deferiprone chelation has reduced the prevalence of heart failure and cardiac haemosiderosis, which should reduce mortality and improve life expectancy. CONCLUSION: The future for thalassaemia care in Hong Kong is bright. With better transfusion and chelation, it should be possible to avoid growth and endocrine deficiencies in younger patients.published_or_final_versio

Heterotopic ossification after Total Knee Replacement. Is it an issue?

Concurrent Free Papers 9: Hips and Knees 2Conference Theme: Defying the Aging SpineIntroduction: Heterotopic ossification after total knee arthroplasty is a less frequently studied topic in contrast to after total hip arthroplasty. Its incidence in the western literature ranged from 1 to 42% but the incidence in a Chinese population is largely unknown. The significance and effects on the outcome of the surgery also remain controversial. Materials and Methods: We retrospectively reviewed all total knee arthroplasties performed in a local hospital from January 2009 to December 2010. Revision surgeries were excluded. The patients were assessed clinically on follow-up for range of motion of the knee and the most recent postoperative X-rays were studied for the presence of heterotopic ossification. Results: A total of 413 primary total knee arthroplasties were performed during the study period on 371 patients. The mean follow-up time was 44 months. The incidence of heterotopic ossification was 15.7%. The majority of which were located at the suprapatellar pouch (35%) or along the medial gutter (42%). Increase in size of the heterotopic ossification was not associated with reduced gains in the range of motion of the knee. Discussion and Conclusion: Heterotopic ossification after total knee arthroplasty is not an uncommon condition in the Chinese population. It was previously thought to occur mainly at the suprapatellar pouch, but our study showed that the medial gutter was the most common location. However, its presence did not appear to impact negatively on the range of motion of the knee on follow-up

Follow up of aerobic capacity in children affected by severe acute respiratory syndrome

Background and objective: The aim of this study was to investigate the aerobic capacity of children 3 years after they were diagnosed with severe acute respiratory syndrome (SARS). Methods: Twenty-seven patients who completed both pulmonary function and maximal aerobic capacity tests at 6 and 15 months after the acute illness were invited to return for reassessment. Results: Twenty-one patients (median age 18.2 years, interquartile range (IQR) 16.5-19.7) completed all investigations at 36 months. Pulmonary function was normal in all patients. Maximal aerobic capacity, peak oxygen pulse (peak VO 2) and ventilatory anaerobic threshold showed significant improvements compared with values measured at 6 months in both boys and girls. In girls, ventilatory efficiency (ventilatory equivalents for oxygen and carbon dioxide) and perfusion of the lungs (end-tidal partial carbon dioxide pressure) had not increased further compared with the values measured at 15 months. Although peak VO 2 improved further at 36 months in patients with or without persistent radiological abnormalities, the values were 68% (IQR 50-84) and 74% (IQR 60-99), respectively, of those for normal control subjects. Conclusions: There were improvements in aerobic capacity at 36 months in children affected by SARS; however, the measured values remained suboptimal. This long-term follow-up study demonstrated that the aerobic capacity of children improved three years after the diagnosis of severe acute respiratory syndrome, but the values remained suboptimal. © 2011 Asian Pacific Society of Respirology.link_to_OA_fulltex

Cardiac Magnetic Resonance Assessment of myocardial iron load and fibrosis in adult survivors of childhood leukaemias

Poster Presentatio