23 results on '"Wilson Kwan"'
Search Results
2. Recurrent Multivalvular Staphylococcus Lugdunensis Endocarditis Causing Complete Heart Block after TAVR
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Preeti Singhal, Somsupha Kanjanauthai, and Wilson Kwan
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Prosthetic valve endocarditis after transcatheter aortic valve replacement (PVE after TAVR) is a feared complication most often observed during the early postprocedural period. We report a case of severe, multivalvular PVE after TAVR with complete heart block caused by an uncommon organism. A 78-year-old female with prior Streptococcus agalactiae mitral valve endocarditis treated with antibiotics presented one year later with severe, symptomatic aortic insufficiency. She subsequently underwent TAVR given high surgical risk. Six weeks post-TAVR, she presented with syncope, fever, and complete heart block. Transthoracic echocardiogram was not demonstrative of vegetation. Blood cultures were positive for Staphylococcus lugdunensis. Transesophageal echocardiogram (TEE) demonstrated vegetations of the aortic, mitral, and tricuspid valves and aorto-mitral continuity. While awaiting surgery, the patient developed cardiac arrest; she was resuscitated and taken to surgery emergently. The patient underwent TAVR explantation, bovine pericardial tissue aortic and porcine bioprosthetic mitral valve replacements, and tricuspid valve repair. Additionally, left main coronary artery endarterectomy was performed due to presence of infectious vegetative material. Staphylococcus lugdunensis is an unusual but virulent organism that may damage both native and prosthetic valves. Early surgery is recommended for PVE after TAVR, especially in cases with perivalvular disease causing conduction abnormalities. Learning Objectives. TAVR has revolutionized the management of severe aortic stenosis and has even been successfully utilized in select cases of aortic regurgitation. Unfortunately, there are a number of associated complications that can be difficult to diagnose, such as prosthetic valve endocarditis (PVE). We emphasize maintaining a high clinical suspicion for PVE after TAVR in patients presenting with conduction abnormalities and highlight the importance of early surgical management in cases complicated by heart block, abscesses, or destructive penetrating lesions.
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- 2021
- Full Text
- View/download PDF
3. Recurrent Multivalvular Staphylococcus Lugdunensis Endocarditis Causing Complete Heart Block after TAVR
- Author
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Wilson Kwan, Preeti Singhal, and Somsupha Kanjanauthai
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medicine.medical_specialty ,medicine.diagnostic_test ,biology ,business.industry ,Heart block ,medicine.medical_treatment ,Case Report ,Transesophageal echocardiogram ,Staphylococcus lugdunensis ,medicine.disease ,biology.organism_classification ,Stenosis ,medicine.anatomical_structure ,Valve replacement ,RC666-701 ,Mitral valve ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,Diseases of the circulatory (Cardiovascular) system ,Endocarditis ,Transthoracic echocardiogram ,Cardiology and Cardiovascular Medicine ,business - Abstract
Prosthetic valve endocarditis after transcatheter aortic valve replacement (PVE after TAVR) is a feared complication most often observed during the early postprocedural period. We report a case of severe, multivalvular PVE after TAVR with complete heart block caused by an uncommon organism. A 78-year-old female with prior Streptococcus agalactiae mitral valve endocarditis treated with antibiotics presented one year later with severe, symptomatic aortic insufficiency. She subsequently underwent TAVR given high surgical risk. Six weeks post-TAVR, she presented with syncope, fever, and complete heart block. Transthoracic echocardiogram was not demonstrative of vegetation. Blood cultures were positive for Staphylococcus lugdunensis. Transesophageal echocardiogram (TEE) demonstrated vegetations of the aortic, mitral, and tricuspid valves and aorto-mitral continuity. While awaiting surgery, the patient developed cardiac arrest; she was resuscitated and taken to surgery emergently. The patient underwent TAVR explantation, bovine pericardial tissue aortic and porcine bioprosthetic mitral valve replacements, and tricuspid valve repair. Additionally, left main coronary artery endarterectomy was performed due to presence of infectious vegetative material. Staphylococcus lugdunensis is an unusual but virulent organism that may damage both native and prosthetic valves. Early surgery is recommended for PVE after TAVR, especially in cases with perivalvular disease causing conduction abnormalities. Learning Objectives. TAVR has revolutionized the management of severe aortic stenosis and has even been successfully utilized in select cases of aortic regurgitation. Unfortunately, there are a number of associated complications that can be difficult to diagnose, such as prosthetic valve endocarditis (PVE). We emphasize maintaining a high clinical suspicion for PVE after TAVR in patients presenting with conduction abnormalities and highlight the importance of early surgical management in cases complicated by heart block, abscesses, or destructive penetrating lesions.
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- 2021
4. On the estimation and diagnostic checking of the ARFIMA-HYGARCH model.
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Wilson Kwan, Wai Keung Li, and Guodong Li
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- 2012
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5. Cardiac Tamponade Secondary to IVC Filter Retrieval
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Somsupha Kanjanauthai, Jina Sohn, Wilson Kwan, and Emily Margolin
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0301 basic medicine ,medicine.medical_specialty ,Ivc filter ,Inferior vena cava filter ,complication ,030105 genetics & heredity ,Pericardial effusion ,inferior vena cava filter ,03 medical and health sciences ,0302 clinical medicine ,IVC, inferior vena cava ,Cardiac tamponade ,medicine ,Diseases of the circulatory (Cardiovascular) system ,cardiovascular diseases ,retrieval ,Mini-Focus Issue: Complications ,business.industry ,medicine.disease ,pericardial effusion ,RC666-701 ,cardiac tamponade ,cardiovascular system ,PE, pulmonary embolus ,Case Report: Clinical Case ,Radiology ,Cardiology and Cardiovascular Medicine ,Complication ,business ,030217 neurology & neurosurgery - Abstract
Cardiac tamponade is a rare but potentially fatal complication of inferior vena cava filter retrieval. We discuss such a case to facilitate prompt recognition and prevention of this complication by medical providers. (Level of Difficulty: Beginner.), Graphical abstract, Cardiac tamponade is a rare but potentially fatal complication of inferior vena cava filter retrieval. We discuss such a case to facilitate prompt…
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- 2020
6. Increasing incidence of type 1 diabetes among Hong Kong children and adolescents: The Hong Kong Childhood Diabetes Registry 2008 to 2017
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Ching‐yin Lee, Shirley Man‐yee Wong, Kwong‐tat Chan, Yuen‐yu Lam, Pik-To Cheung, Antony Chun‐cheung Fu, Kwok‐leung Ng, Jacky Chung, Elaine Yin-wai Kwan, Gloria Pang, Wilfred Hing Sang Wong, Ming‐kut Tay, Lap‐ming Wong, Ho-chung Yau, Joanna Yuet-ling Tung, Sammy Wai‐chun Wong, Priscilla Pik-fung Lo, Wilson Kwan‐yee Yeung, Betty Wai Man But, Jennifer Wing‐yan Tsang, Angela Mo‐kit Chan, and Kiran Belaramani
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Male ,medicine.medical_specialty ,Adolescent ,Annual increment ,Endocrinology, Diabetes and Metabolism ,Childhood diabetes ,Crude incidence ,030209 endocrinology & metabolism ,History, 21st Century ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,Internal Medicine ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Child ,Retrospective Studies ,Type 1 diabetes ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Infant ,medicine.disease ,Confidence interval ,Rate of increase ,Diabetes Mellitus, Type 1 ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Hong Kong ,Female ,business ,Demography - Abstract
OBJECTIVE The incidence of childhood-onset type 1 diabetes (T1D) has been reported to be rising but there is also evidence that it has been attenuated in recent years. We described the time trends and the incidence of T1D in children in Hong Kong from 2008 to 2017 and compared with the previous local registry in 1997 to 2007. METHODS Data were extracted from the Hong Kong Childhood Diabetes Registry, which was established in 2016. It consists of a retrospective registry (including all childhood diabetes diagnosed in 2008 to 2015) and a prospective registry (including all T1D children diagnosed from 2016 onwards). All T1D children diagnosed at the age of less than 18 years from 1 January 2008 to 31 December 2017 and managed in the public system were included in this study. RESULTS For the incident years in the 2008 to 2017 period, a total of 498 children with T1D was identified. The crude incidence rate was 4.3 per 100 000 person/year (95% confidence interval 3.96-4.72), which was much higher than the last registry of 2.2 per 100 000 persons/year. Using general linear model, the increment is statistically significant (P = .02). When compared to the last registry, the rate of increment had attenuated, with annual increment in crude incidence in the two periods for T1D
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- 2020
7. Pulmonary vascular resistance index: Getting the units right and why it matters
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Wilson Kwan, David M. Shavelle, and David Laughrun
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medicine.medical_specialty ,Hypertension, Pulmonary ,Pulmonary Artery ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Pulmonary Wedge Pressure ,030212 general & internal medicine ,Confusion ,Pulmonary vascular resistance index ,business.industry ,General Medicine ,medicine.disease ,Pulmonary hypertension ,Clinical Practice ,Editorial ,medicine.anatomical_structure ,Vascular resistance ,Cardiology ,Vascular Resistance ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Pulmonary vascular resistance (PVR) and PVR index (PVRI) are key variables in a broad range of contexts, including prediction of outcomes in heart and liver transplantation, determining candidacy for closure of atrial or ventricular septal defects, and guiding treatment of pulmonary hypertension. Significant variability exists among the units used to report PVRI in current literature, making the interpretation of data and translation into clinical practice difficult. Here, we will review the measurement and derivation of PVR and PVRI and demonstrate the extent of confusion in the literature. We conducted a literature search of all published articles in PubMed using the term "PVRI." This yielded 218 sources with defined units for PVRI, including 33 unique variants. Among all reviewed literature, 45.4% of sources reported PVRI with units ending in m2 (meters squared), which we defined as correct, whereas 54.6% reported PVRI with units not ending in m2 , which we defined as incorrect. This lack of uniformity has led to considerable confusion among researchers and clinicians, with potentially life-altering consequences.
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- 2019
8. Incidence and clinical characteristics of pediatric-onset type 2 diabetes in Hong Kong: The Hong Kong childhood diabetes registry 2008 to 2017
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Kiran Belaramani, Betty Wai-man But, Joanna Yuet-ling Tung, Ching‐yin Lee, Lap‐ming Wong, Kwok‐leung Ng, Kwong‐tat Chan, Priscilla Pik-fung Lo, Jacky Chung, Angela Mo‐kit Chan, Yuen‐yu Lam, Shirley Man‐yee Wong, Elaine Yin‐wah Kwan, Ming‐kut Tay, Pik-To Cheung, Antony Chun‐cheung Fu, Gloria Pang, Wilfred Hing Sang Wong, Ho-chung Yau, Sammy Wai‐chun Wong, Jennifer Wing‐yan Tsang, and Wilson Kwan‐yee Yeung
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Pediatrics ,medicine.medical_specialty ,Pediatric Obesity ,Adolescent ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,Asymptomatic ,Childhood obesity ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Registries ,Child ,business.industry ,Incidence (epidemiology) ,Incidence ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,medicine.disease ,Confidence interval ,Diabetes Mellitus, Type 2 ,Pediatrics, Perinatology and Child Health ,Hong Kong ,Microalbuminuria ,medicine.symptom ,business - Abstract
OBJECTIVE With increasing prevalence of childhood obesity worldwide, the incidence of pediatric-onset type 2 diabetes (T2D) is also increasing in many countries. We aim to analyze the time trend and incidence of T2D in children in Hong Kong from 2008 to 2017, and to characterize clinical characteristics at diagnosis. METHODS Data were retrieved from the Hong Kong Childhood Diabetes Registry. All children with T2D diagnosed at the age of less than 18 years from January 1, 2008 to December 31, 2017 and managed in the public health care system were included in this study. RESULTS In the incident years of 2008-2017 period, 391 children were diagnosed with T2D. The crude incidence rate was 3.42 per 100,000 persons/year [95% confidence interval (CI) 3.08-3.76], which was much higher than that in last registry of 1.27 per 100,000 persons/year in 1997-2007 (P
- Published
- 2021
9. Author response for 'Incidence and Clinical Characteristics of Paediatric‐onset Type 2 Diabetes in Hong Kong: The Hong Kong Childhood Diabetes Registry 2008 to 2017'
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Ching‐yin Lee, Gloria Pang, Wilfred Hing Sang Wong, Betty Wai-man But, Kwong‐tat Chan, Yuen‐yu Lam, Joanna Yuet-ling Tung, Pik-To Cheung, Jennifer Wing‐yan Tsang, Antony Chun‐cheung Fu, Wilson Kwan‐yee Yeung, Kwok‐leung Ng, Angela Mo‐kit Chan, Kiran Belaramani, Ming‐kut Tay, Ho-chung Yau, Sammy Wai‐chun Wong, Shirley Man‐yee Wong, Lap‐ming Wong, Jacky Chung, Elaine Yin‐wah Kwan, and Priscilla Pik-fung Lo
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Pediatrics ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,medicine ,Childhood diabetes ,Type 2 diabetes ,medicine.disease ,business - Published
- 2021
10. Fulminant myocarditis secondary to murine typhus mimicking acute coronary syndrome
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David M. Shavelle, Christopher Vo, Wilson Kwan, and Dana Toy
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medicine.medical_specialty ,Acute coronary syndrome ,Ejection fraction ,Myocarditis ,business.industry ,Fulminant ,Cardiogenic shock ,Case Report ,Disease ,030204 cardiovascular system & hematology ,Murine typhus ,medicine.disease ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Cardiology ,030212 general & internal medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Myocarditis is a disease with variable clinical presentation, ranging from an uncomplicated febrile illness to cardiogenic shock. Herein, we report a case of fulminant myocarditis secondary to murine typhus in a 52-year-old male that initially mimicked an acute coronary syndrome. Emergent coronary angiography showed angiographically normal coronary arteries. Left ventriculography showed global hypokinesis with an ejection fraction of 10%. The patient required mechanical support with an intra-aortic balloon pump and fully recovered.
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- 2021
11. Incidence and clinical characteristics of pediatric‐onset type 2 diabetes in Hong Kong: The Hong Kong childhood diabetes registry 2008 to 2017.
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Tung, Joanna Yuet‐ling, Kwan, Elaine Yin‐wah, But, Betty Wai‐man, Wong, Wilfred Hing‐sang, Fu, Antony Chun‐cheung, Pang, Gloria, Tsang, Jennifer Wing‐yan, Yau, Ho‐chung, Belaramani, Kiran, Wong, Lap‐ming, Wong, Shirley Man‐yee, Lo, Priscilla, Ng, Kwok‐leung, Yeung, Wilson Kwan‐yee, Chan, Kwong‐tat, Chan, Angela Mo‐kit, Wong, Sammy Wai‐chun, Tay, Ming‐kut, Chung, Jacky, and Lee, Ching‐yin
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REPORTING of diseases ,CONFIDENCE intervals ,CHILDHOOD obesity ,PUBLIC health ,TYPE 2 diabetes ,SYMPTOMS ,DESCRIPTIVE statistics ,DATA analytics ,ODDS ratio ,COMORBIDITY ,DISEASE complications ,CHILDREN - Abstract
Objective: With increasing prevalence of childhood obesity worldwide, the incidence of pediatric‐onset type 2 diabetes (T2D) is also increasing in many countries. We aim to analyze the time trend and incidence of T2D in children in Hong Kong from 2008 to 2017, and to characterize clinical characteristics at diagnosis. Methods: Data were retrieved from the Hong Kong Childhood Diabetes Registry. All children with T2D diagnosed at the age of less than 18 years from January 1, 2008 to December 31, 2017 and managed in the public health care system were included in this study. Results: In the incident years of 2008–2017 period, 391 children were diagnosed with T2D. The crude incidence rate was 3.42 per 100,000 persons/year [95% confidence interval (CI) 3.08–3.76], which was much higher than that in last registry of 1.27 per 100,000 persons/year in 1997–2007 (P < 0.001).Most children (76%) were asymptomatic and were diagnosed by routine screening. At presentation, a significant proportion presented with co‐morbidities including fatty liver (37.9%), dyslipidaemia (35.3%), hypertension (22.5%), and microalbuminuria (12.8%). Conclusions: The incidence of T2D in children has increased significantly in Hong Kong. Most of them were asymptomatic and picked up on routine health screening. Yet, comorbidities were commonly identified at diagnosis. [ABSTRACT FROM AUTHOR]
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- 2022
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12. Incidence and clinical characteristics of pediatric‐onset type 2 diabetes in Hong Kong : The Hong Kong childhood diabetes registry 2008 to 2017
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Tung, Joanna Yuet‐ling, primary, Kwan, Elaine Yin‐wah, additional, But, Betty Wai‐man, additional, Wong, Wilfred Hing‐sang, additional, Fu, Antony Chun‐cheung, additional, Pang, Gloria, additional, Tsang, Jennifer Wing‐yan, additional, Yau, Ho‐chung, additional, Belaramani, Kiran, additional, Wong, Lap‐ming, additional, Wong, Shirley Man‐yee, additional, Lo, Priscilla, additional, Ng, Kwok‐leung, additional, Yeung, Wilson Kwan‐yee, additional, Chan, Kwong‐tat, additional, Chan, Angela Mo‐kit, additional, Wong, Sammy Wai‐chun, additional, Tay, Ming‐kut, additional, Chung, Jacky, additional, Lee, Ching‐yin, additional, Lam, Yuen‐yu, additional, and Cheung, Pik‐to, additional
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- 2021
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13. Author response for 'Increasing incidence of type 1 diabetes among Hong Kong Children and Adolescents: The Hong Kong Childhood Diabetes Registry 2008 to 2017'
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Ming‐kut Tay, Kwong‐tat Chan, Joanna Yuet-ling Tung, Ching‐yin Lee, Pik-To Cheung, Sammy Wai‐chun Wong, Shirley Man‐yee Wong, Betty Wai-man But, Antony Chun‐cheung Fu, Jacky Chung, Jennifer Wing‐yan Tsang, Elaine Yin-wai Kwan, Ho-chung Yau, Kiran Belaramani, Priscilla Pik-fung Lo, Wilson Kwan‐yee Yeung, Kwok‐leung Ng, Lap‐ming Wong, Yuen‐yu Lam, Angela Mo‐kit Chan, Gloria Pang, and Wilfred Hing Sang Wong
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Type 1 diabetes ,Pediatrics ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,medicine ,Childhood diabetes ,medicine.disease ,business - Published
- 2020
14. Partial parotidectomy under local anesthesia for benign parotid tumors - An experience of 50 cases
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Siu Hong Cheung, Kwan Pok Tsui, Tam Lin Chow, and Wai Yin Wilson Kwan
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Adult ,Male ,medicine.medical_specialty ,Biopsy, Fine-Needle ,Sialocele ,Cohort Studies ,Pleomorphic adenoma ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Parotid Gland ,Medicine ,Local anesthesia ,030223 otorhinolaryngology ,Aged ,Retrospective Studies ,Palsy ,business.industry ,Parotidectomy ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Parotid Neoplasms ,Parotid gland ,Surgery ,Dissection ,Treatment Outcome ,medicine.anatomical_structure ,Otorhinolaryngology ,Superficial Parotidectomy ,030220 oncology & carcinogenesis ,Feasibility Studies ,Hong Kong ,Female ,business ,Anesthesia, Local ,Follow-Up Studies - Abstract
Purpose Benign parotid tumors are adequately treated with partial parotidectomy, which is often performed under general anesthesia (GA). We have reported our preliminary results on the feasibility to perform parotidectomy under local anesthesia (LA). We hereby present our accumulated experience of partial parotidectomy under LA to further consolidate its feasibility, efficacy and safety in a larger series. Materials and methods Case series review was carried out using our own center patients' database. 50 patients with parotid tumors were treated with partial parotidectomy under LA, using a retrograde nerve dissection approach from January 2006 to October 2016. The inclusion criteria encompassed mobile parotid nodules primarily operated after non-suspicious fine-needle aspiration cytology. Their demographics, complications and outcomes were evaluated. Results No procedure required conversion to GA. There were 48 benign tumors and 2 lymphomas based on the histopathologic examination. The commonest pathologies were pleomorphic adenoma (40%), Warthin's tumor (38%) and cyst (8%). The mean tumor size was 2.68 ± 1.5 cm and the mean operative time was 91.5 ± 34.7 min. Forty-two operations were done as day cases. Ten (20%) patients suffered from transient ear lobe numbness and two (4%) patients had sialocele. Transient facial palsy occurred in 2(4%) patients while another patient (2%) had persistent House-Brackmann grade II facial palsy. No tumor recurrence was noted during follow-up period. Conclusions Partial parotidectomy adopting a retrograde nerve dissection under LA is feasible and minimally invasive in treating benign parotid tumors. It can avoid the adverse effects of general anesthesia and promote day surgery or minimize hospital stay.
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- 2018
15. Increasing incidence of type 1 diabetes among Hong Kong children and adolescents: The Hong Kong Childhood Diabetes Registry 2008 to 2017
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Tung, Joanna Yuet‐ling, primary, Kwan, Elaine Yin‐wai, additional, But, Betty Wai‐man, additional, Wong, Wilfred Hing‐sang, additional, Fu, Antony Chun‐cheung, additional, Pang, Gloria, additional, Tsang, Jennifer Wing‐yan, additional, Yau, Ho‐chung, additional, Belaramani, Kiran, additional, Wong, Lap‐ming, additional, Wong, Shirley Man‐yee, additional, Lo, Priscilla, additional, Ng, Kwok‐leung, additional, Yeung, Wilson Kwan‐yee, additional, Chan, Kwong‐tat, additional, Chan, Angela Mo‐kit, additional, Wong, Sammy Wai‐chun, additional, Tay, Ming‐kut, additional, Chung, Jacky, additional, Lee, Ching‐yin, additional, Lam, Yuen‐yu, additional, and Cheung, Pik‐to, additional
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- 2020
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16. RECURRENT MULTIVALVULAR ENDOCARDITIS IN A POST-TAVR PATIENT
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Saul Barajas, Fady Gabra, W. Dean Wallace, Wilson Kwan, Somsupha Kanjanauthai, and Preeti Singhal
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medicine.medical_specialty ,business.industry ,Medicine ,Endocarditis ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Surgery - Published
- 2021
17. Discharging coronavirus disease 2019 (COVID-19) patients with faecal viral shedding and prolonged hospitalisation
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Ivan C. S. Lam, Kelvin K. W. To, Chit Kwong Chow, Wilson Kwan‐yee Yeung, Mike Y. W. Kwan, Joshua S.C. Wong, Patrick Ip, Wa Keung Chiu, Chi-man Victor Chan, Marco Ho, Phoebe Q. Mak, Gilbert T. Chua, and Jaime S. Rosa Duque
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medicine.medical_specialty ,Isolation (health care) ,Coronavirus disease 2019 (COVID-19) ,Transmission (medicine) ,business.industry ,viruses ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,virus diseases ,Mild symptoms ,Internal medicine ,medicine ,Faecal excretion ,Viral shedding ,business ,Paediatric patients - Abstract
The implication of gastrointestinal infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its transmission remains to be fully understood. We studied 4 paediatric patients with several weeks of faecal excretion of SARS-CoV-2 RNA who had only mild symptoms. International consensus on isolation practices is urgently needed.
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- 2020
18. Complication rates of central compartment dissection in papillary thyroid cancer
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Wai-Yin Wilson Kwan, Siu-Ho Lam, Chi-Yee Choi, and Tam-Lin Chow
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medicine.medical_specialty ,urogenital system ,business.industry ,Retrospective cohort study ,General Medicine ,equipment and supplies ,medicine.disease ,Cancer registry ,Surgery ,Papillary thyroid cancer ,Dissection ,Hypoparathyroidism ,medicine ,Carcinoma ,Recurrent laryngeal nerve ,Complication ,business - Abstract
Background The benefits of central compartment dissection (CCD) in papillary thyroid carcinoma (PTC) are still debatable and should be weighed against its potential risks. We aim to compare the complication rates in total thyroidectomy with and without CCD for patients with PTC. Methods This is a retrospective study on prospectively collected data from our cancer registry over a 15-year period. Patients with pathologically proven PTC treated with total thyroidectomy alone or with CCD were included. CCD was performed at the operating surgeon's discretion. A total of 105 patients were included and divided into two groups for analysis: group A – total thyroidectomy alone (51 patients, 49%) and group B – total thyroidectomy with CCD (54 patients, 51%). The operative complications between the two groups were then evaluated. Results Overall, 6.9% and 0.98% patients had transient and permanent recurrent laryngeal nerve palsies, respectively. About 19.0% and 2.9% patients had transient and permanent hypoparathyroidism, respectively and 27.6% patients had parathyroid glands found to be included in the resected specimen. Complication rates in terms of transient or permanent recurrent laryngeal nerve palsy or hypoparathyroidism did not differ significantly between groups A and B. Within group B, 41 patients had unilateral CCD and 12 had bilateral CCD. Transient hypoparathyroidism was more frequent in bilateral CCD (50% versus 12.2%, P = 0.01). Conclusions Total thyroidectomy with prophylactic unilateral CCD is a safe procedure for PTC without added complication rates compared with total thyroidectomy alone. It is recommended for patients with PTC and clinically negative neck lymph nodes.
- Published
- 2013
19. Modelling the Term Structure of Hong Kong Inter-Bank Offered Rates (HIBOR)
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null Sandy Chau, null Andy Tai, and null Wilson Kwan
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- 2016
20. Stimulation of NF-κB activity by the HIV restriction factor BST2
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John C. Guatelli, Wilson Kwan, Kathleen Fitzpatrick, Andrey Tokarev, Marissa Suarez, and Rajendra Singh
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Immunology ,Human Immunodeficiency Virus Proteins ,Biology ,GPI-Linked Proteins ,Microbiology ,Cell Line ,Antigens, CD ,Virology ,Humans ,Immunoprecipitation ,Viral Regulatory and Accessory Proteins ,Protein kinase A ,Adaptor Proteins, Signal Transducing ,MAP kinase kinase kinase ,Kinase ,Endoplasmic reticulum ,NF-kappa B ,NFKB1 ,MAP Kinase Kinase Kinases ,Molecular biology ,Virus Release ,Virus-Cell Interactions ,Ectodomain ,Insect Science ,Tetherin ,HIV-1 - Abstract
BST2 (HM1.24; CD317; tetherin) is an interferon-inducible transmembrane protein that restricts the release of several enveloped viruses, including HIV, from infected cells. Before its activity as an antiviral factor was described, BST2 was identified as an inducer of NF-κB activity. Here we show that human BST2 induces NF-κB in a dose-dependent manner. This activity is separable from the restriction of virus release: a YxY sequence in the cytoplasmic domain of BST2 is required for the induction of NF-κB but is dispensable for restriction, whereas the glycosylphosphatidylinositol (GPI) addition site in the protein's ectodomain is required for restriction but is largely dispensable for the induction of NF-κB. Mutations predicted to disrupt the coiled-coil structure of the BST2 ectodomain impaired both signaling and restriction, but disruption of the tetramerization interface differentially affected signaling. The induction of NF-κB by BST2 was impaired by inhibition of transforming growth factor β (TGF-β)-activated kinase 1 (TAK1) or by calcium chelation, suggesting potential linkage to the mitogen-activated protein kinase and endoplasmic reticulum (ER) stress response pathways. Consistent with a role for TAK1, BST2 coimmunoprecipitated with TAK1 and the TAK1-associated pseudophosphatase TAB1; these interactions required the YxY sequence in BST2. Moreover, signaling by BST2 was blocked by expression of an IκB-mutant that inhibits the canonical pathway of NF-κB activation. The expression of HIV-1 Vpu inhibited the induction of NF-κB by BST2; this inhibition required Vpu's ability to bind the cellular β-TrCP-E3-ubiquitin ligase complex. The expression of HIV-1 lacking vpu augmented the induction of NF-κB activity by BST2, suggesting that BST2 can act as a virus sensor. This augmentation was also inhibited by Vpu in a β-TrCP-dependent manner. The role of BST2 in the host-pathogen relationship is apparently multifaceted: signaling during the innate immune response, sensing of viral gene expression, and direct restriction of virus release. HIV-1 Vpu counteracts each of these functions.
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- 2012
21. Role of the Endocytic Pathway in the Counteraction of BST-2 by Human Lentiviral Pathogens ▿
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John C. Guatelli, Wilson Kwan, and David Lau
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Endosome ,viruses ,Immunology ,Endocytic cycle ,Human Immunodeficiency Virus Proteins ,Endocytosis ,GPI-Linked Proteins ,Microbiology ,Clathrin ,HIV Envelope Protein gp160 ,Viral envelope ,Antigens, CD ,Virology ,Humans ,Viral Regulatory and Accessory Proteins ,Dynamin ,biology ,virus diseases ,biochemical phenomena, metabolism, and nutrition ,Cell biology ,Virus-Cell Interactions ,Insect Science ,HIV-2 ,biology.protein ,Tetherin ,HIV-1 ,Ap180 ,HeLa Cells - Abstract
The interferon-inducible transmembrane protein BST-2 (CD317, tetherin) restricts the release of several enveloped viruses from infected cells. BST-2 is broadly active against retroviruses, including HIV-1 and HIV-2. To counteract this host defense, HIV-1 uses the accessory protein Vpu, whereas HIV-2 uses its envelope glycoprotein (Env). In both cases, viral antagonism is associated with decreased expression of BST-2 at the cell surface. Here, we provide evidence supporting a role for the clathrin-mediated endocytic pathway in the downregulation of BST-2 from the cell surface and the counteraction of restricted virion release. A catalytically inactive, dominant negative version of the vesicle “pinch-ase” dynamin 2 (dyn2K44A) inhibited the downregulation of BST-2 by Vpu, and it inhibited the release of wild-type (Vpu-expressing) HIV-1 virions. Similarly, dyn2K44A inhibited the downregulation of BST-2 by HIV-2 Env, and it inhibited the release of vpu -negative HIV-1 virions when HIV-2 Env was provided in trans . dyn2K44A inhibited Env more robustly than Vpu, suggesting that dynamin 2, while a cofactor for both Env and Vpu, might support just one of several pathways though which Vpu counteracts BST-2. In support of a role for clathrin in these effects, the C-terminal domain of the clathrin assembly protein AP180 also inhibited the downregulation of BST-2 by either Vpu or HIV-2 Env. Consistent with modulation of the postendocytic itinerary of BST-2, Vpu enhanced the accumulation of cell surface-derived BST-2 in transferrin-containing endosomes. Vpu also inhibited the transport of BST-2 from a brefeldin A-insensitive compartment to the cell surface, consistent with a block to endosomal recycling. We propose that HIV-1 Vpu, and probably HIV-2 Env, traps BST-2 in an endosomal compartment following endocytosis, reducing its level at the cell surface to counteract restricted viral release.
- Published
- 2011
22. Pathways from emotional adjustment to glycemic control in youths with diabetes in Hong Kong
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David O'Donnell, Wilson Kwan‐yee Yeung, Anna Cheng, Peter W. H. Lee, Kwai Fun Huen, Louis C K Low, and Sunita M. Stewart
- Subjects
Cross-Cultural Comparison ,Male ,Adolescent ,media_common.quotation_subject ,Psychological intervention ,Developmental psychology ,Diabetes mellitus ,Adaptation, Psychological ,Developmental and Educational Psychology ,medicine ,Ethnicity ,Personality ,Humans ,Glycemic ,media_common ,Self-efficacy ,Glycated Hemoglobin ,Sick role ,Sick Role ,Social environment ,medicine.disease ,Social relation ,Self Efficacy ,Diabetes Mellitus, Type 1 ,Pediatrics, Perinatology and Child Health ,Hong Kong ,Patient Compliance ,Female ,Psychology ,Clinical psychology - Abstract
Objective: To examine factors that influence emotional adjustment, adherence to diabetic care, and glycemic control in Hong Kong youths with insulin-dependent diabetes mellitus (IDDM). Methods: Seventy youths, their mothers, and matched controls provided information on health beliefs, authoritarian parenting style, parent-child conflict, emotional adjustment, and adherence to medical regimen. Glycosylated hemoglobin levels were obtained to measure glycemic control. Results: Predictors explained 34% of the variance in emotional adjustment and 39% of the variance in glycemic control. The data supported a pathway from emotional adjustment to self-efficacy to adherence behaviors to glycemic control. In contrast to Western culture and consistent with prediction, parenting style did not associate with negative outcomes, and even relatively low levels of parent-child conflict correlated negatively with emotional adjustment in this culture. Conclusions: Management of conflict and self-efficacy enhancing interactions are suggested interventions to enhance adherence to diabetic care in Hong Kong youths with IDDM.
- Published
- 2000
23. On the surface electric field of junction diodes with a tapered window
- Author
-
Yearn-Ik Choi and Wilson Kwan
- Subjects
Surface (mathematics) ,Optics ,Materials science ,business.industry ,Junction diodes ,Electric field ,Materials Chemistry ,Window (computing) ,Optoelectronics ,Electrical and Electronic Engineering ,Condensed Matter Physics ,business ,Electronic, Optical and Magnetic Materials - Published
- 1987
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