From nine species of small mammals collected during the 12 month study period, nine species of fleas were recovered. Of the fleas, Ctenophthamus congeneroides congeneroides were obtained from seven host species, were recovered every month but January, comprised greater than 60% of the freas recovered each month except Noverber, December and January, accounted for more than 60% of all fleas and were collected from 15 of 17 localities visited. During November, December and January more than 50% of all fleas recovered were Stenoponia sidimi. Too, the greatest variety of flea species were recovered during November and December. Among the hosts, all nine flea species were recovered from Apodemus agrarius, six species were obtained from Microtus fortis and four from both Eothenomys regulus and Crocidura laciura. The highest rates of infested individuals, highest to lowest E. regulus, M.fortis, C.lasiura and A. agrarius. The highest general and specific indices were found in M.agrarius occurred in April and May and the highest monthly specific indices were noted for January, April and May. Ctenophthalmus congeneroides was the most abundant flea, had the widest host range, seasonal occurrence and the widest habitat distribution of the flea collected during this study. These fleas exhibited a decline in abundance in midwinter and an increase in numbers in the early spring. Among the small mammals, Apodemus agrairus yielded the greatest number of fleas species and was most heavily infested with during April and May.
parasitology-arthropoda-flea ; hemorrhagic fever ; epidemiology ; Ctenophthamus congeneroides congeneroides ; Stenoponia sidimi ; rat ; Apodemus agrarius ; Microtus fortis ; Eothenomys regulus ; Crocidura laciura ; Microtus agrarius ; Xenopsylla cheopsis ; Hystricopsylla microti ; Neopsylla bidentatiformis ; Rhadinopsylla insolita ; Peromiscopsylla hamifer cuneata ; Monopsylla anisus

OBJECTIVEEpidemiologic studies in Caucasian populations suggested that symptomatic obstructive sleep apnea (OSA) occurred at a prevalence of 1-10%. The condition has been increasingly recognised among the Chinese in Hong Kong. We therefore, summarize our experience with OSA at the Department of Medicine, The University of Hong Kong at Queen Mary Hospital from 1985-1996.

METHODSAll clinic records concerning demographic data, anthropometric data, clinical features, polysomnographic findings and treatment were reviewed.

RESULTSOne hundred and twenty-two patients were diagnosed to have OSA. Demographic and clinical features were similar to Caucasian data with a male predominance of 84%, a mean age of about 50 years, and obesity as a risk factor at a mean body mass index of 30.4, which was higher than that of the average local population, although lower than that of OSA patients in Caucasian series. About 27% of the patients have a body mass index (BMI) similar to or below the population average. Nearly all were habitual snorers, and the majority had excessive daytime sleepiness. On polysomnography, the mean apnea-hypopnea index was 38. Common associated medical conditions were hypertension (34%), diabetes mellitus (10%), ischemic heart disease (9%), hyperlipidemia (6%). Most patients were managed successfully with nasal continuous positive airway pressure. Treatment with oral appliances for milder cases is being explored.

CONCLUSIONSOSA has been increasingly recognised among Chinese adults in Hong Kong in the past decade. Demographic features were similar to Caucasian data. The majority of patients were overweight, although 27% were not, and further investigation on the contribution of faciomaxillary morphology to OSA in this group is warranted.

Aged ; Asian Continental Ancestry Group ; Diabetes Complications ; Female ; Hong Kong ; epidemiology ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Prevalence ; Sleep Apnea Syndromes ; complications ; epidemiology ; therapy

Asia-Pacific is one of the most densely populated regions of the world and is experiencing rapid economic changes and urbanization. Environmental pollution is a significant problem associated with the rapid modernization of many cities in South Asia. It is not surprising that the prevalences of asthma and allergies are increasing rapidly, although the underlying reasons remain largely unknown. Many studies from this region have documented the changing prevalence of allergic diseases in various parts of the world. However, the methodologies used were neither standardized nor validated, making the results difficult to evaluate. The International Study of Asthma and Allergies in Childhood (ISAAC) has provided a global epidemiology map of asthma and allergic diseases, as well as the trend of changes in the prevalence of these diseases. Allergic sensitization is extremely common in many Asian communities. However, the prevalence of allergic diseases remains relatively rare. The rapid urbanization in the region, which increases environmental pollution and can affect the rural environment, will likely increase the prevalence of asthma and allergies in Asia.
Asia ; Asian Continental Ancestry Group ; Asthma ; Environmental Pollution ; Humans ; Hypersensitivity ; Prevalence ; Social Change ; Urbanization

INTRODUCTIONThe objective of this case report was to illustrate the diagnostic and intervention approach of anomalous right coronary artery (RCA).

CLINICAL PICTUREA 60-year-old man presented with acute inferior myocardial infarction. Cardiac catheterisation revealed an anomalous RCA arising from the posterior coronary sinus as the infarct-related artery.

TREATMENTAd hoc percutaneous coronary intervention with stent implantation was performed using a few technical modifications.

OUTCOMEGood angiographic result was achieved within 90 minutes, with 260 mL of contrast used.

CONCLUSIONA high index of suspicion and logical diagnostic and intervention approach are required for the proper management of anomalous RCA.

Angioplasty, Balloon, Coronary ; Cardiac Catheterization ; methods ; Coronary Angiography ; Coronary Vessel Anomalies ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; surgery

PURPOSE: A cell-cell interaction in which in vivo inoculation of androgen-dependent, non-tumorigenic LNCaP and human bone fibroblast resulted in derivation of androgen-independent and metastatic LNCaP subline(C4-2) in castrated hosts. The purpose of this study is to evaluate if human prostate fibroblasts when grown together with LNCaP may promote androgen-independent growth and enhance metastatic potential. MATERIALS AND METHODS: LNCaP cells and human prostate fibroblasts derived either from peripheral or transition zone co-inoculated in athymic mice for 8 weeks, and then mice were castrated. The chimeric tumors were maintained for additional 4 weeks. The LNCaP sublines, designated P4 and T4, were established and characterized. These sublines were co-inoculated again in castrated mice with human prostate fibroblasts for 8-12 weeks. And then second generation LNCaP sublines, P4-2 and T4-2, were established and also characterized. RESULTS: Marked cytogenetic alterations were observed in P4-2, P4, T4-2 and T4 LNCaP sublines in comparison to parental LNCaP. Although LNCaP cells injected orthotopically did not form tumors in castrated hosts, LNCaP sublines formed PSA-producing tumors and had metastatic potentials to lymph node, lung, liver and bone. These P and T sublines had androgen-independent growth characteristics and metastatic potential. CONCLUSIONS: Cell-cell interactions between prostatic epithelium and their surrounding fibroblasts could contribute to androgen-independent characteristics and enhanced metastatic potential of localized prostate cancer in vivo.
Animals ; Cytogenetics ; Epithelium ; Fibroblasts* ; Humans* ; Liver ; Lung ; Lymph Nodes ; Mice ; Mice, Nude ; Parents ; Prostate* ; Prostatic Neoplasms

Rhabdomyosarcoma is a very rare case in urological field. We have experienced a case of rbabdomyosarcoma originating from the prostate. So we present this case report with the article review.
Prostate* ; Rhabdomyosarcoma*

The p53 tumor suppressor gene is one of the genes with greatest therapeutic potential for cancer treatment and its growth inhibitory mechanism is thought to be mediated through the activation of its downstream mediator, WAF1/Clip1. In this study, we evaluated the effect of the replication-defective recombinant adenovirus expressing wild-type p53 gene(Ad5CMV-p53) in human glioma cell lines(U-251, LG) harboring mutant-type p53. beta-galactosidase histochemistry revealed that 90% of the U-251 and 42% the of LG cells are infected with the adenovirus at a multiplicity of infection(MOI) of 25 plaque-forming units(PFU)/cell. Immunoblot analyses showed that endogenous p53 protein is expressed at a high level, and significant exogenous p53 protein expression and WAF1/Clip 1 induction peaked on day 1 and day 3 after Ad5CMV-p53 treatment. Introduction of Ad5CMV-p53 inhibited the cell rowth of U-251(85% inhibition) and LG cells(36% inhibition), and influenced cell morphology. The optimal dose of Ad5CMV-p53 for the tumor cel ls growth inhibition was MOI of 10-40 PFU/cell. These results suggest that Ad5CMV-p53 infects human glioma cells and transduces the p53 gene with high efficiency, and could be further developed for the gene therapy of human gliomas.
Adenoviridae ; beta-Galactosidase ; Brain* ; Genes, p53* ; Genes, Tumor Suppressor ; Genetic Therapy* ; Glioma* ; Humans*

PURPOSE: Three-dimensional(3-D) organization is critical for both the normal development and, tumor growth and progression. Cell-cell and cell-matrix interactions determine normal prostate development and its subsequent neoplastic transformation. To understand the epigenetic factors that lead to cell transformation, a 3-D human prostate cell culture was established with prostate epithelial cells grown in a rotating-wall vessel(RWV) under microgravity-simulated conditions with either alone or with prostate or bone stromal cells. We tested the hypothesis of whether phenotypic and genotypic alterations of LNCaP cells may be achived when grown as 3-D organoids. MATERIALS AND METHODS: LNCaP cells were seeded in RWV alone and with either human prostate or bone fibroblasts. After period of 2 months, RWV1, 2, and 3 cell lines were established from the prostate organoids and were characterized. RESULTS: While LNCaP cells injected orthotopically failed to form tumors in castrated mouse, RWV-derived cell lines formed PSA-producing tumors and metastasized to lymph node, bone, lung and liver, which stained positively by PSA antibody. RWV cells grew faster than parental LNCaP, especially in sex hormone-free conditions. Unlike parental LNCaP cells which respond positively to androgen and estrogen-induced growth and PSA expression, RWV cells are insensitive to sex steroid-induced growth, but remain sensitive to androgen for induction of PSA expression. Comparative genomic hybridization(CGH) results demonstrated that RWV cell lines have different chromosomal gain and loss each other as compared to those of LNCaP. CONCLUSIONS: Cell-cell and cell-matrix interactions of androgen-dependent and non-metastatic LNCaP cultured alone or with either prostate or bone fibroblasts in 3-D culture under microgravity-simulated conditions resulted in induction of androgen- independent and metastatic LNCaP sublines, RWV cell lines, meaning androgen- independent progression. Phenotype and genotype of RWV cell lines are definitely dissimilar to those of parental LNCaP. 3-D culture of prostatic epithelial cells under microgravity-simulated conditions could be novel approach to the study of normal development and cancer of prostate as an ideal in vitro model and, will be further exploited.
Animals ; Cell Culture Techniques ; Cell Line ; Epigenomics ; Epithelial Cells ; Fibroblasts ; Genotype ; Humans ; Liver ; Lung ; Lymph Nodes ; Mice ; Organoids* ; Parents ; Phenotype ; Prostate* ; Prostatic Neoplasms ; Stromal Cells

Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either thermo-coagulation or hemo-clipping compares favorably with dual therapies. The use of adsorptive powder (Hemo-spray) is a promising treatment although it needs comparative studies between hemospray and other modalities. Stronger hemo-clips with better torque control and wider span are now available. Over-the-scope clips capture a large amount of tissue and may prove useful in refractory bleeding. Experimental treatments include an endoscopic stitch device to over-sew the bleeding lesion and targeted therapy to the sub-serosal bleeding artery as guided by echo-endoscopy. Angiographic embolization of bleeding artery should be considered in chronic ulcers that fail endoscopic treatment especially in elderly patients with a major bleed manifested in hypotension.
Aged ; Arteries ; Endosonography ; Epinephrine ; Hemorrhage ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Hypotension ; Minerals ; Torque ; Ulcer

OBJECTIVETo determine the benefit of carotid endarterectomy (CEA) for stroke prevention by reviewing the early and late outcomes of Hong Kong Chinese patients undergoing CEA who have a high reported incidence of intracranial atherosclerotic disease (IAD).

METHODSFifty-nine Chinese patients underwent 62 CEA. There were 48 males and 11 females, with a mean age of 70 +/- 7 years (range: 52 - 86 years). Twenty-one CEA (34%) were performed for asymptomatic disease. Duplex scan was the primary tool of evaluation prior to surgery. Preoperative angiography was done in 36 instances (58%). All CEA were performed under general anaesthesia with routine intraoperative shunting. The arteriotomy was closed primarily in all patients except three. Patients were followed up regularly with six-monthly Duplex scan surveillance.

RESULTSThere were 2 perioperative neurological events consisting of one transient ischemic attack and one minor stroke. There was no operative mortality or major morbidity such as bleeding or cranial nerve injury. Mean hospital stay was 6.5 +/- 4 days (range: 3 - 26 days). The patients were followed up for a mean interval of 24 +/- 17 months (range: 1 - 57 months). Seven patients died during follow-up and subsequent neurological events occurred in 5 patients, including 2 fatal strokes. The 3-year survival, freedom from stroke and stroke free survival were 86%, 87% and 83%, respectively. One recurrent stenosis of 80% was detected on follow-up Duplex scan.

CONCLUSIONSDespite a high incidence of IAD, CEA in Hong Kong Chinese patients is associated with acceptable perioperative morbidity and mortality with satisfactory long-term efficacy in stroke prevention.

Aged ; Aged, 80 and over ; Carotid Stenosis ; surgery ; Endarterectomy, Carotid ; adverse effects ; Female ; Follow-Up Studies ; Hong Kong ; Humans ; Ischemic Attack, Transient ; etiology ; Male ; Middle Aged ; Stroke ; etiology ; Survival Analysis ; Time Factors ; Treatment Outcome