Nasopharyngeal carcinoma research in Hong Kong in the past decade

OBJECTIVE: To review the research carried out in Hong Kong on nasopharyngeal carcinoma (NPC) over the past 10 years. METHODS: The literature published in Hong Kong over the past 10 years on nasopharyngeal carcinoma were reviewed in the light of other important international publications on the same subject. RESULTS: The research carried out in Hong Kong covers etiology, natural behavior, treatment and prognosis of NPC. These studies not only elucidated the different aspects of NPC, many of these new findings will also guide future directions of research. CONCLUSIONS: Major efforts have been made to research into the various aspects of NPC with important findings which will translate into better treatment results. As this tumor is uncommon in other parts of the world, continued efforts to improve the prevention, early diagnosis, treatment and care of this tumor are required in China.     

Tonsillar carcinoma: analysis of treatment results

A diffusion cell with an artificial membrane and the single-pass perfused rabbit ear were used to evaluate the percutaneous absorption of clonazepam from various 2-hydroxyethyl acetate (HEA) patches. The influence on drug permeation of the various type of enhancers (isopropylmyristate, lauryl alcohol, propylene glycol and water) in the patches was tested. A comparison between the two types of systems of percutaneous absorption of clonazepam has been done. The results showed that HEA patches produce controlled uniform drug release, modulated by the addition of enhancers.     

Surgical treatment of bronchogenic carcinoma. Long-term results in 496 surgical patients

BACKGROUND: The operability of lung cancer and the period of survival after resection of the lungs in our country does not yet attain the standard recorded in some advanced countries. The objective of the present work is to analyze factors which influence the survival period after resection therapy of lung cancer. METHODS AND RESULTS: In 1985-90 in our department 496 patients were operated on account of lung cancer. This number comprised 31 patients subjected to explorative thoracototomy and three patients with pulmonary resection on account of a stage IIIb (pTNM) tumour who were excluded from the statistical analysis. The retrospective study proper analyzes the results of 462 patients (403 men and 59 women) operated in stages I, II and IIIa. Their mean age was 57 years (range 30-74 years, SD 7.5 years). The most frequent histological type was epidermoid carcinoma (68.8%), adenocarcinoma 18.2%, small-cell tumours 5.4% (25 patients). In 262 patients operated on account of lung cancer in stage I (pTNM) the probability of five-year survival was 49.2%, in patients in stage II 42.1%, in 158 patients in stage IIIa 20.9% (for all histological types combined). In 437 patients after resection of the lungs on account of non-small-cellular carcinoma the probability of five-year survival was as follows: stage I 50.0%, stage II 45.0%, stage IIIa 21.2%. CONCLUSIONS: The probability of five-year survival for the whole group of 462 patients in stages I, II and IIIa was 38.8%. The most important factor which influenced the probability of five-year survival was the stage of the disease. Neither age nor sex of the patients nor the histological type of the tumour had a statistically significant effect on the probability of five-year survival.     

Indications for reduction of tongue in surgical treatment of mandibular prognathism

It is suggested that there should be available post-graduate training schemes for members of the profession who ultimately wish to work on an Intensive Therapy Unit at Consultant level. The duties of the Medical Unit administrator are described and schemes are suggested for further training of an anaesthetist or physician particularly interested in critical patient care.     

Site Safety Management in Hong Kong

The construction industry is well known for its complexities and inefficiencies in dealing with human safety and construction processes. The industry itself has been notorious for its high casualty records over many years. Especially in Hong Kong, the concept of improving safety in construction sites has only started to be developed in recent years. The government has set up new ordinances and regulations, and companies are willing to invest more on this issue before the construction commences. Nowadays in Hong Kong, from the small to the sizable, nearly all construction companies have their own site safety plans indicating safety guidelines and protective measures to achieve certain safety standards on the project sites. However, when viewing the past records published by the Labour Department, no trend in injury frequency reduction was noted. Consequently, an effort has been made in this report to compare three different site safety plans of three renowned civil and building contractors were investigated. Moreover, in order to review the effectiveness of the prevailing site safety plans and the safety performance of the contractors, a questionnaire survey targeting some site staff was conducted to solicit their opinions on the implementation of site safety plans. From the results of the questionnaire survey the authors determined that the construction companies are now regarding occupational health and safety as prerequisites of all the site operations.     

Knowledge of stroke in Hong Kong Chinese

Cervical ribs were observed in six hydropic fetuses with 45X karyotype. To test the usefulness of this observation in the macerated hydropic fetus where chromosome culture is problematic, a group of 36 hydropic fetuses was examined. Cases were chosen to include fetuses with several karyotypic and pathological abnormalities known to be associated with fetal hydrops. Whole-body anteroposterior radiographs were evaluated without knowledge of the fetal karyotype or pathological findings. Twenty-five fetuses had an abnormal karyotype, seven had a normal karyotype and in four culture failed. In the last group, the number of X, 21 and 18 chromosomes per nucleus was estimated using FISH. Radiographic analysis demonstrated that among the 16 fetuses with 45,X karyotype or a single copy of X and female phenotype, 12 had a pair of cervical ribs. Three other fetuses had a single cervical rib. Only one fetus had no cervical ribs. The last fetus had tubular hypoplasia of the aortic arch and persistent mesocolon. Twelve of the sixteen 45,X fetuses had tubular hypoplasia of the aortic arch. Seven had other cardiovascular anomalies, five had renal anomalies, and five had anomalies of intestinal rotation. Cervical rib appears to be more common than other frequently recorded associations of 45,X. It is a useful and easily demonstrated mark in the evaluation of the macerated hydropic fetus.     

Hepatocellular carcinoma: surgical treatment

Worldwide the hepatocellular carcinoma (HCC) is one of the most common malignancies. There is a coincidence with liver cirrhosis or chronic hepatitis B/C in most cases. HCC can be suspected by ultrasound and by rise of the tumor marker (AFP). Further investigations, like biopsies, are not necessary if angiography or computed tomography in combination with patient history and elevated AFP levels are positive. The prognosis of untreated HCC is extremely poor. Live expectancy of symptomatic patients is only a couple of weeks. Radical tumor removal by liver resection or transplantation is the only treatment with curative intent. However these options are only suitable for patients with limited disease. Five year survival after curative liver resection depends on the tumor stage, ranging from 25% to 67%. The results after liver transplantation are similar for small cancer. Large, symptomatic tumors are in most cases only suitable for palliative treatment (chemoembolisation, ethanol injection, chemotherapy, immunotherapy). The strong dependence of prognosis on tumor extent underlines the importance of screening patients with elevated risk of developing an HCC. The early recognition of small tumors allows curative therapy with good results.     

Hong Kong Experience in Managing BOT Projects

BOT (build-operate-transfer) project delivery systems have provided effective routes to mobilize private sector funds, innovative technologies, management skills, and operational efficiencies for public infrastructure development. However, many countries and regions lack BOT expertise and experience. Hong Kong, one of the pioneers in optimizing private sector participation in infrastructure development, has developed five large tunnels on the BOT basis since the late 1960s, the first of which recently completed its franchise period and entered into the posttransfer operation phase. Experience and lessons gained in formulating and managing BOT projects over more than 30 years have enabled the Hong Kong government to develop a well-structured BOT framework. This proven BOT model is useful for countries and regions lacking such expertise and still in need of BOT-based infrastructure. This paper discusses key development aspects of the five BOT tunnels, including feasibility study; tender selection; legal, financial, and land issues; design and construction; operation and maintenance; transfer; and posttransfer management.     

Culture and psychology in Hong Kong.

Comments on a discussion of clinical psychology in Hong Kong by D. Ho (see record 1986-15498-001). It is argued that Ho's otherwise admirable article is marred by the misidentification of Maslow and Rogers as "modern prophets of individualism," as both would have accepted Ho's synthesis of Western individualism and Chinese collectivism. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Haemophilia and HIV infection in Hong Kong

This is a retrospective study of the problems faced and support received by HIV (human immunodeficiency virus) infected haemophilia patients in Hong Kong. Between December 1984 and December 1994, 63 patients were detected to be HIV positive, out of a total of 231 haemophiliacs screened. Infection could be traced back to before August 1985, when safer heat-treated clotting factors were not yet available. Psychosocial impacts were obvious in this group of patients because of the double blow of HIV infection and haemophilia. Amongst the more evident problems were obstacles in schooling, employment difficulties, and disturbed relationships with family and friends, to mention a few. Psychosocial support services have been rendered by both the government and non-governmental organizations in Hong Kong. Financial assistance has also been given by the government since April 1993. To date, only eleven (17.5%) patients were known to have progressed to AIDS. Medical treatment, psychosocial support and financial assistance are integral components of an effective AIDS care programme for HIV-infected haemophilia patients.     

Field Studies of Well-Instrumented Barrette in Hong Kong

A large excavated rectangular pile (barrette) with lateral earth pressure and pore-water pressure cells was successfully constructed and tested in a sequence of marine, alluvial, and weathered granite soils. A “soft” base formed beneath the bottom of the barrette permitted over 100 mm of vertical settlement, completely mobilizing the shaft friction at the barrette-soil interface. During the vertical load tests, an unusual and complex response of pore-water pressures and earth pressures at the barrette-soil interface was measured. During each vertical loading cycle (except the last one) and before interface slippage of the barrette occurred, excess positive pore-water pressures were recorded in all soil layers. Upon the initiation of slip at the barrette-soil interface, a sudden drop in the measured pore pressures as well as a substantial drop in lateral earth pressures generally resulted. Subsequent loading or unloading slippage events did not show the same dramatic behavior unless a period of consolidation∕recovery was allowed first. This implies that caution must be used in design of barrettes relying heavily on skin friction when shearing induces contractive soil behavior. The current test results indicated that the empirical uncorrected SPT-N value approach and the effective stress β-method were inconsistent.     

Long-term results of surgical treatment of thumb polydactyly

One hundred thirteen hands exhibiting thumb polydactyly were treated and followed up for an average of 49 months. Of these, 109 hands were treated by resection of a supernumerary hypoplastic thumb. Radial thumbs were resected in 107 hands and ulnar thumbs in 2 hands. Four hands were treated using a modified Bilhaut procedure. According to a modified Tada's evaluation, the results were evaluated as good in 97 hands, fair in 12 hands, and poor in 4 hands. Patients and/or their parents were satisfied with the results in 100 hands and dissatisfied with the results in 13 hands. The factors that influenced the surgical results were analyzed. The incidence of unsatisfactory results was relatively high in Wassel types 3, 5, and 6 and triphalangeal-type thumb polydactyly. It was higher when the ulnar digit was removed than when the radial digit was removed. The results for those patients treated between 1983 and 1991 were better than for those treated between 1976 and 1982. The type of deformity, type of procedure, and skillfulness of the surgeon were factors in the results after surgery.