Developments in early intervention for psychosis in Hong Kong.

The year 2011 marked the 10-year milestone of early intervention for psychosis in Hong Kong. Since 2001, the landscape of early psychosis services has changed markedly in Hong Kong. Substantial progress has been made in the areas of early intervention service implementation, knowledge generation, and public awareness promotion. Favourable outcomes attributable to the early intervention service are supported by solid evidence from local clinical research studies; early intervention service users showed improved functioning, ameliorated symptoms, and decreased hospitalisation and suicide rates. Continued development of early intervention in Hong Kong over the decade includes the introduction and maturation of several key platforms, such as the Hospital Authority Early Assessment Service for Young People with Psychosis programme, the Psychosis Studies and Intervention Unit by the University of Hong Kong, the Hong Kong Early Psychosis Intervention Society, the Jockey Club Early Psychosis Project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. In this paper, we reviewed some of the major milestones in local service development with reference to features of the Hong Kong mental health system. We describe chronologically the implementation and consolidation of public early intervention services as well as recent progresses in public awareness work that are tied in with knowledge generation and transfer, and outline the prospects for early intervention in the next decade and those that follow.

Gene expression profiling of human synovial sarcoma cell line (Hs701.T) in response to IL-1beta stimulation.

OBJECTIVE: Synovial sarcoma (SS) is a malignant mesenchymal tumor that accounts for 5-10% of all soft tissue sarcoma. IL-1beta, a pleiotrophic cytokine, has been found in the tumor microenvironment which plays crucial roles in the pathogenesis of tumors. METHODS: In this study, we used Hs701.T as a cellular model to study the short-term (4-h) and long-term (48-h) stimulatory effect of IL-1beta on cell proliferation and differential gene expression. RESULTS: The results showed that IL-1beta can stimulate cell proliferation through activation of NF-kappaB and AP-1 transcription factors; sequentially triggers the expression of genes related to tumor progression. The microarray data indicated that most of the up-regulated genes were related to tumor progression. Five candidate genes which are involved in the mediation of proliferation (IL-6), apoptosis (Hsp27 and Daxx), and angiogenesis (PlGF and SPARC) were further validated by RT-PCR. CONCLUSION: These findings may be useful for understanding the pathogenesis of synovial sarcoma.

Protective effects of Danshensu from the aqueous extract of Salvia miltiorrhiza (Danshen) against homocysteine-induced endothelial dysfunction.

Homocysteine (Hcy) is a by-product of methionine metabolism. An imbalance of Hcy in the body may lead to hyperhomocysteinemia, a condition with elevated Hcy concentration in blood that may be one of the risk factors responsible for the development of several vascular diseases (thromboembolism, atherosclerosis, stroke, vascular diseases and dementia). Radix Salvia miltiorrhiza (Danshen), a well-known Chinese medicinal herb that can activate and improve blood microcirculation, is noticeable for its beneficial effect in treating cardiovascular diseases. The present study is to demonstrate the protective effect of Danshen extract against the homocysteine-induced adverse effect on human umbilical vein endothelial cell (HUVEC). Homocysteine (5 mM) not only decreased the cell viability but also caused the disruption of capillary-like structure formation in vitro. The protective effect of Danshen aqueous extract and its active compounds on endothelial cell function were demonstrated through an in vitro tube formation assay, which mimics the new blood vessel formation. To identify the active components in the aqueous extract of Danshen, the content was characterized by instrumental analysis using high performance liquid chromatography with diode array detector (DAD) and electrospray tandem mass spectrometry (ESI-MS/MS). Interestingly, Danshen extract and its pure compounds showed different effectiveness in protecting HUVEC against Hcy-induced injury according to the following descending order: Danshen aqueous extract, 3-(3,4-dihydroxy-phenyl)-2-hydroxy-propionic acid (Danshensu), protocatechuic acid, catechin and protocatechualdehyde. We believed that such findings might provide evidence in understanding the beneficial effects of Danshen on the cardiovascular system.

Modeling transport kinetics with StarLogo.

StarLogo, an agent-based modeling and simulation platform, was used to simulate adsorption-mediated transcytosis of a molecule from the lumen side of a cell membrane to the abluminal extra-cellular fluid (ECF). The model contains small nondiffusible substrate molecules, transporters, and substrate-transporter agents. The "reaction" is a transporter combining with the substrate which then crosses the cell cytoplasm. The substrate that is deposited on the ECF side becomes the "product". Results showed characteristics consistent with Michaelis-Menten enzyme kinetics. The model can serve as an example of agent-based modeling and simulation.

Bronchopulmonary segmental lavage with Surfaxin (KL(4)-surfactant) for acute respiratory distress syndrome.

We performed a trial to assess the safety and tolerability of sequential bronchopulmonary segmental lavage with a dilute synthetic surfactant (Surfaxin) in 12 adults with ARDS. Patients received one of three dosing regimens in which aliquots of Surfaxin were administered via a wedged bronchoscope to each of the 19 bronchopulmonary segments. Suctioning was performed 10-30 s after instillation of individual aliquots. Group 1 patients (n = 3) received one 30-ml aliquot of a 2.5-mg/ml concentration of Surfaxin in each segment, followed by a second 30-ml aliquot with a 10-mg/ml concentration. Group 2 patients (n = 4) received two 30-ml aliquots of the 2.5-mg/ml concentration followed by a third lavage with the 10-mg/ml concentration. Group 3 patients (n = 5) received therapy identical to that received by patients in Group 2 and were eligible for repeat dosing 6 to 24 h later. All patients tolerated the procedure. There were no serious adverse experiences ascribed to either the procedure or the surfactant. In the 96 h after treatment initiation, FI(O(2)) decreased from 0.80 to 0.52 and PEEP decreased from 10.3 to 7.6 cm H(2)O. Bronchoscopic "cleansing" of the lungs with dilute Surfaxin may offer a safe and feasible approach to improving outcomes in patients with ARDS. Wiswell TE, Smith RM, Katz LB, Mastroianni L, Wong DY, Willms D, Heard S, Wilson M, Hite RD, Anzueto A, Revak SD, Cochrane CG. Bronchopulmonary segmental lavage with Surfaxin (KL(4)-surfactant) for acute respiratory distress syndrome.

High rate of clinical complete response to weekly outpatient neoadjuvant chemotherapy in oral carcinoma patients using a new regimen of cisplatin, 5-fluorouracil, and bleomycin alternating with methotrexate and epirubicin.

BACKGROUND: A Phase II trial was initiated to evaluate the response to and toxicity of a new regimen of weekly outpatient neoadjuvant chemotherapy in patients with oral carcinoma. METHODS: Patients with previously untreated squamous cell carcinoma of the oral cavity were eligible for this trial. The neoadjuvant chemotherapy was comprised of cisplatin, 25 mg/m2, 5-fluorouracil, 1000 mg/m2, and bleomycin, 10 mg/m2, mixed in normal saline as a 24-hour intravenous (i.v.) infusion, alternating with methotrexate, 30 mg/m2, and epirubicin, 30 mg/m2, as an i.v. bolus (PFB/ME) on a weekly schedule for 8-12 weeks. In patients with American Joint Committee on Cancer Stage IV disease who completed neoadjuvant chemotherapy, surgery was preferred to radiotherapy, unless patients refused surgery. RESULTS: A total of 40 patients (82.5% with Stage IV disease) with previously untreated oral carcinoma were enrolled. The median size of the primary tumor was 7 cm (range, 3-13 cm). Fifty percent of patients had tumor penetrating through the oral mucosa to the cheek skin and 62.5% had bony destruction. Detectable cervical lymph nodes were noted in 77.5% of patients. After neoadjuvant weekly chemotherapy, 22 patients (55%) showed complete response (CR) and 15 patients (37.5%) showed partial response, for an overall response rate of 92.5%. World Health Organization Grade 3/4 toxicity included mucositis (7.5%), leukopenia (25%), anemia (10%), and thrombocytopenia (2.5%). Eleven of 33 patients with Stage IV disease underwent surgery, and pathologic CR (2 patients) or microscopic residual tumor (4 patients) was noted (54.5%). CONCLUSIONS: The results of the current study indicate that a weekly PFB/ME neoadjuvant chemotherapy regimen is highly effective for the treatment of patients with oral carcinoma. In addition, this regimen has low toxicity. The authors believe that implementation of this regimen into a multimodality therapy protocol deserves further study.

Measurement of the radiation doses absorbed by jaw bones during irradiation of nasopharyngeal cancers.

BACKGROUND: Nasopharyngeal carcinoma (NPC) occurs more frequently for Chinese than for other ethnic groups. The most common treatment for NPC is radiotherapy, but there is no report of the doses of radiation absorbed by the mandibular and maxillary bones, although exposure to radiation is one of the most important references for those patients who need to have oral surgical treatments. METHODS: Thermoluminescent dosimeter (TLD) was used to measure radiation absorbed by a rando phantom and cancer patients. RESULTS: The results showed that the doses absorbed by the mandible and maxilla depend on the dose applied, field size, and field shape. In the rando phantom, the range of absorption in the mandible was, for the central incisor 1.89-3.36 Gy, canine 1.96-3.78 Gy, bicuspid 2.24-14.14 Gy, second molar 4.34-31.92 Gy, internal pterygoid muscle region 70 Gy. In the maxilla the range was, for the central incisor 2.17-2.94 Gy, canine 2.24-3.36 Gy, bicuspid 3.15-4.41 Gy, second molar 7.00-7.42 Gy. In nasopharyngeal carcinoma patients, the mean radiation absorbed by the bicuspid vestibular region of the mandible was 3.09 Gy, by the bicuspid vestibule of the maxilla 3.35 Gy and by the midline vestibule 2.31 Gy. The radiation doses absorbed by maxilla and mandible from the incisor to the second premolars were less than 20% of the dose to the primary tumor. CONCLUSIONS: The doses absorbed by the mandible and maxilla are relatively low in NPC patients receiving radiation therapy.

Ovarian vein thrombosis during cesarean section. A report of two cases.

BACKGROUND: Puerperal ovarian vein thrombosis occurs in 0.2-0.5% of deliveries. It is usually thought to result from infection, but it has been hypothesized that thrombosis may occur as a primary event, and radiologic studies raise the possibility that ovarian vein thrombosis may occur quite frequently. CASES: Case 1 had right ovarian vein thrombosis diagnosed at the time of nonemergency cesarean section for placenta previa. This was treated with ligation of the infundibulopelvic ligament above the level of the clot. Subsequent magnetic resonance imaging showed contralateral ovarian vein thrombosis, and therefore anticoagulant therapy was begun. The patient was asymptomatic. Case 2 had right ovarian vein thrombosis extending to the inferior vena cava diagnosed at elective repeat cesarean section. She was heparinized in the recovery room; subsequent ventilation/perfusion scan showed a probable pulmonary embolism. Both patients recovered uneventfully. CONCLUSION: These two cases demonstrate that ovarian vein thrombosis may occur as a primary event, in the absence of infection, and result in pulmonary embolism. Individualized management based on operative findings is recommended.

Glutathione concentration in oral cancer tissues.

Glutathione (GSH) concentrations in human epidermoid carcinoma tissues were measured by high performance liquid chromatography. The mean glutathione content of 26 epidermoid carcinoma intratumor tissue specimens was 24.36 nmol/mg protein, which was significantly higher than that in adjacent non-tumor tissue parts (3.04 nmol/mg protein). The mean concentration found in normal oral mucosa was 4.80 nmol/mg protein. Tissue GSH levels were not correlated with the age of the patients or tumor size. Additionally, cellular GSH levels in nine different cell lines were found to spread over a wide range from 0.97 to 50.97 nmol/mg protein. Elevated GSH levels in cancer tissues were probably due to their abnormal proliferative activities. These results indicate that the glutathione level of oral tissues may be a useful marker for oral cancer, which is in agreement with findings from lung squamous cell carcinoma, cervical squamous cell carcinoma and other squamous cell carcinomas.

Acoustic emission during the deformation of alpha-lactose monohydrate and anhydrous alpha-lactose monocrystals.

During the deformation of single crystals of alpha-lactose monohydrate and anhydrous alpha-lactose in a crushing strength rig, their acoustic activity was monitored using a portable activity meter. The acoustic parameters measured were the average signal level (ASL), count rates and total acoustic counts. Both types of lactose, even though deformed by fragmentation, differed fundamentally in the degree and nature of this fragmentation. Close correlation was observed between the ASL, count rate profiles and the force-displacement profiles. The monohydrate form is acoustically more active than the anhydrous form during deformation. Small internal fractures which were neither visually observed nor detected in the force-displacement profiles (in particular the anhydrous alpha-lactose) were detected by monitoring the acoustic signals during the deformation of these crystals. This work illustrates the potential of using the acoustic emission technique as an aid in the assessment of the deformation characteristics of pharmaceutical materials during single crystal compression studies.

Oral leiomyoma: case report.

Leiomyoma of the oral cavity is infrequently found because of the scarcity of smooth muscle in the mouth. A review of the literature yielded only 124 cases reported from 1884 to 1987. A new case of primary leiomyoma of the lower buccal sulcus is presented. Although the recurrence rate has been very low, wide surgical excision is recommended because of the high incidence of malignancy of this tumor in the oral cavity contrasted with other parts of the body.

Characterization of two new cell lines derived from oral cavity human squamous cell carcinomas--OC1 and OC2.

Two continuous cell lines, OC1 and OC2, have been established. Each one was derived from a surgical specimen of buccal mucosa squamous carcinoma from a Chinese man. Both cell lines grew as adherent monolayers and had an epithelioid morphology. The cell lines have now been grown in vitro for more than 200 passages over a 2-year period. Both cell lines were tumorigenic in nude mice. Histologic examination of the mice tumors showed a positive identification with those from the original human squamous cell carcinoma. Electron microscopic examination convincingly demonstrated their epithelial origin. Chromosomal numbers of the OC1 cell ranged from 58 to 78 and of the OC2 cells ranged from 62 to 82. Analysis of cytokeratin showed that all cell lines were positive. The carcinoembryonic antigen (CEA) tested negative in these two cell lines. The OC2 cell line showed the presence of HPV16, but the OC1 cell line did not. These cell lines should be useful for investigation of anticancer treatment and for their possible relationship to human papilloma virus (HPV).

Incidence of growth of syngeneic oral squamous cell carcinoma in C57B1 bg/bg beige mice.

The incidence of tumor growth in C57B1 beige mice and the cytotoxic response generated toward a syngeneic oral squamous cell carcinoma cell line (A5) were investigated. Viable A5 tumor cells were inoculated into the left hind limb of the mice and the tumor volume was determined weekly. Cytotoxicity in mice was generated in vivo immunization with viable A5 tumor cells. Splenic lymphocytes were restimulated in a mixed lymphocyte-tumor cell culture to enhance their cytotoxicity, which was determined via a 51Chromium release microcytotoxicity assay. The result shows a higher incidence of tumor growth in beige mice as well as less cytotoxicity than in their littermate control. These studies suggest that higher incidence of tumor growth in beige mice may be due to the impairment in cytotoxic T cell activity rather than a pure NK cell deficit.

The long-term stability of recombinant (serine-17) human interferon-beta.

Escherichia coli-derived (Serine 17) human interferon-beta (HuIFN-beta SER) was formulated with SDS and placed at multiple isothermal temperatures (-70 degrees C to 37 degrees C). Three stability-indicating test methods (bioassay, SDS-PAGE, RP-HPLC) were used to evaluate the long-term stability of this preparation. No change was observed when stored for nearly a year at either -70 degrees C or 4 degrees C. At the elevated temperatures, proteolytic cleavage, noncovalent oligomer formation, and loss of antiviral activity were observed. The absence of a carrier protein makes this stable IFN-beta frozen reference preparation useful as a standard in both biological assays and protein chemical methods of analysis.

Parameters for the evaluation of long-term stability of tumour necrosis factor preparations.

Escherichia coli-derived Tumour Necrosis Factor (TNF) was formulated in the absence of a protein-carrier, both as a solution and as a lyophilized preparation. By means of three stability-indicating test methods (bioassay, SDS-PAGE, IEF), the long-term stability of these TNF preparations was evaluated. Both preparations showed no change upon storage for 9 months at -70 degrees C and -20 degrees C. Depending upon the test method, different rates of change were detected at elevated temperature. The analysis presented will assist in the design of future TNF reference standards.

Cations and calmodulin in normal and neoplastic cell growth regulation.

The purpose of this presentation is to review pertinent literature pertaining to the role of divalent cations and calmodulin in regulating growth of nonneoplastic and neoplastic cells and to examine the anticancer efficacy of some calmodulin inhibitors. Although normal eukaryotic cell replication and proliferation is closely controlled by a complex system of endogenous substances, it is likely that the coordination of purposeful interactions between these substances is the ultimate responsibility of two groups of cellular components, namely the divalent cations Ca2+ and Mg2+ and the versatile intracellular Ca2+-binding protein calmodulin (CaM). When free Ca2+ enters normal cells, it acts as a positive signal for proliferation; this action appears to be specifically associated with the late G1 phase, just prior to DNA synthesis. This period is designated G1/S and is considered to contain Pardee's "restriction point." Reduction of extracellular Ca2+ concentrations between physiological levels (1-0.1 mM) results in gradually reduced rates of cell proliferation; at Ca2+ concentrations of 0.1 mM or less, normal cell proliferation is reversibly inhibited. Since an extracellular concentration of about 0.7 mM Mg2+ is required for Ca2+ to initiate cell replication, it has been proposed that Ca2+ and Mg2+ act in concert via a common mechanism, however, in contrast to Ca2+, Mg2+ appears to be required throughout the entire cell cycle. Intracellular Ca2+ can activate CaM which, in turn, can modulate various cellular processes that affect cell proliferation, including cyclic nucleotide metabolism, protein phosphorylation, polyamine metabolism, prostaglandin metabolism, Ca2+ transport, DNA synthesis, and microtubular function including mitosis.(ABSTRACT TRUNCATED AT 250 WORDS)