Kim Au - Academia.edu (original) (raw)
Papers by Kim Au
Gastroenterology, 2009
No abstract is available. To read the body of this article, please view the PDF online. ... © 200... more No abstract is available. To read the body of this article, please view the PDF online. ... © 2009 AGA Institute. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site do not constitute ...
Gut, 2018
ObjectivesIn the management of patients with bleeding peptic ulcers, recurrent bleeding is associ... more ObjectivesIn the management of patients with bleeding peptic ulcers, recurrent bleeding is associated with high mortality. We investigated if added angiographic embolisation after endoscopic haemostasis to high-risk ulcers could reduce recurrent bleeding.DesignAfter endoscopic haemostasis to their bleeding gastroduodenal ulcers, we randomised patients with at least one of these criteria (ulcers≥20 mm in size, spurting bleeding, hypotensive shock or haemoglobin<9 g/dL) to receive added angiographic embolisation or standard treatment. Our primary endpoint was recurrent bleeding within 30 days.ResultsBetween January 2010 and July 2014, 241 patients were randomised (added angiographic embolisation n=118, standard treatment n=123); 22 of 118 patients (18.6%) randomised to angiography did not receive embolisation. In an intention-to-treat analysis, 12 (10.2%) in the embolisation and 14 (11.4%) in the standard treatment group reached the primary endpoint (HR 1.14, 95% CI 0.53 to 2.46; p...
Lancet (London, England), Jan 11, 2017
Present guidelines are conflicting for patients at high risk of both cardiovascular and gastroint... more Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin. After ulcer healing, an independent staff member randomly assigned (1:1) patients who were negative for Helicobacter pylori with a computer-generated list of random numbers to receive oral administrations of either celecoxib 100 mg twice per day plus esomeprazole 20 m...
Gastroenterology, 2012
of 889,057 NSAID users, 729,000 were identified as short-term and 49,553 as long-term users. Long... more of 889,057 NSAID users, 729,000 were identified as short-term and 49,553 as long-term users. Long term users were significantly older (61 years vs. 48 years), were more often women (63% vs. 54%) and had significantly more comorbidities than short term users. The incidence rate for short term users was 6 UGIBs per 1,000 follow-up years and for long term users this was 3 per 1,000 follow-up years. Independent risk factors for UGIB in short term NSAID users were age above 60 years (Hazard Ratio [HR] 2.4, confidence interval 95% [CI] 1.9-3.0), anemia (HR 1.6, CI 1.0-2.3), chronic blood loss (HR 9.7, CI 3.9-24.0), concomitant use of anticoagulants (HR 2.4, CI 1.0-5.3) and H2 receptor antagonists (HR 2.9, CI 1.2-7.0), and a history of proton pump inhibitor (PPI) use (HR 1.3, CI 1.0-1.6). Independent risk factors in long term users were age above 60 years (HR 2.8, CI 2.2-3.5), gastroesophageal reflux disease (HR 3.8, CI 1.7-8.4), cirrhosis (HR 7.4, CI 1.8-30.2) and having one or more comorbid diseases (HR 1.8, CI 1.2-2.6). Concomitant use of PPIs and prior episodes of NSAID use were associated with a lower UGIB risk (HR 0.69, CI 0.5-0.8 and HR 0.8, CI 0.6-0.9 respectively). Conclusions: The overall incidence of UGIB in short and long term NSAID users was low, but twofold higher in short-term users. We found age above 60 years as the only risk factor associated with increased risk in both short and long-term NSAID users. All other risk factors were different, with a more prominent role of comorbidities in long term users. Use of PPIs in long term NSAID users was associated with a lower risk of UGIB. Our results emphasize that stratification into different risk levels in short-and long-term NSAID users is required.
Gastroenterology, 2014
Relationship of Blood Transfusion, SOFA Score, and Mortality. The numbers of patients with each S... more Relationship of Blood Transfusion, SOFA Score, and Mortality. The numbers of patients with each SOFA score are shown in the corresponding columns under SOFA scores.
Gastroenterology, Aug 26, 2016
It is not clear whether use of low-dose aspirin should be resumed after an episode of lower gastr... more It is not clear whether use of low-dose aspirin should be resumed after an episode of lower gastrointestinal (GI) bleeding. We assessed the long-term risks of recurrent lower GI bleeding and serious cardiovascular outcomes after aspirin-associated lower GI bleeding. We performed a retrospective study of patients diagnosed with lower GI bleeding (documented melena or hematochezia, and absence of upper GI bleeding) from January 1, 2000 through December 31, 2007 at the Prince of Wales Hospital in Hong Kong. Using the hospital registry, we analyzed data from 295 patients on aspirin and determined their outcomes over a 5-year period. Outcomes included recurrent lower GI bleeding, serious cardiovascular events, and death from other causes, as determined by an independent, blinded adjudication committee. Outcomes were compared between patients assigned to the following groups, based on cumulative duration of aspirin use: less than 20% of the follow-up period (121 non-users) versus 50% or m...
Gastrointestinal Endoscopy, 2015
There is as yet no ideal design of a plastic biliary stent with the longest patency period. To st... more There is as yet no ideal design of a plastic biliary stent with the longest patency period. To study the safety and effective patency period of a new plastic antireflux biliary stent in the clinical setting. We conducted a prospective, randomized trial to compare the patency of 2 similar plastic biliary stents, one of which has an antiduodenobiliary reflux property. The study was conducted at 2 separate tertiary centers in 2 countries. Patients with inoperable distal malignant biliary obstruction were recruited. One of the 2 types of plastic stents under study was randomly chosen and inserted in the common bile duct of the study subjects. The subjects were followed until the end of study or occlusion occurrence. Our primary endpoint was the time to stent occlusion in days, with stent-related adverse events and all-cause mortality the secondary endpoints. A total of 16 subjects were recruited for the study; 7 were allocated to group A (ordinary Tannenbaum stent) and 9 to group B (antireflux biliary stent). Five of 7 subjects (71%) in group B had stent occlusion within 8 days, and the primary end point was reached in all 7 subjects within 30 days, whereas the primary endpoint was not reached within 30 days in any of the subjects in group A. Our data showed a significantly shorter stent patency period in group B compared with group A (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .003). Small sample size. Routine use of antireflux plastic biliary stents in the palliative management of malignant biliary obstructions cannot be recommended at present. (Clinical trial registration number: NCT01142921.).
Vascular Medicine, 2011
The Walking Impairment Questionnaire (WIQ) is a frequently used questionnaire to evaluate patient... more The Walking Impairment Questionnaire (WIQ) is a frequently used questionnaire to evaluate patients with intermittent claudication on four subscales: pain severity, walking distance, walking speed and the ability to climb stairs. The aim of this study is to translate and validate the WIQ in Chinese. After translation and cultural adaptation of the WIQ, 134 patients with intermittent claudication completed the Chinese WIQ and European Quality of Life 5 Dimension (EQ-5D). Walking distances were determined by the 6-minute walk test (6MWT). Correlations between the WIQ, quality of life questionnaire and walking distances were calculated to determine validity. Reliability and internal consistency were determined using the intra-class correlation coefficient (ICC) and Cronbach's alpha (α), respectively. Significant correlations were found between the WIQ score, initial claudication distance (ICD), absolute claudication distance (ACD) and all domains of the EQ-5D (all p ≤ 0.01). Test-retest reliability (ICC = 0.74) and the overall internal consistency determined (α = 0.90) showed good agreement. A lower WIQ score corresponded to shorter walking distances. In conclusion, this study showed that the Chinese version of the WIQ is a valid, reliable and clinically relevant instrument for assessing walking impairment in patients with intermittent claudication.
International Journal of Cardiology, 2011
Objective: High density lipoprotein cholesterol (HDL-C) level is an independent inverse predictor... more Objective: High density lipoprotein cholesterol (HDL-C) level is an independent inverse predictor of coronary heart disease (CHD). It lowers the risk for atherosclerotic cardiovascular disease. To test the hypothesis that the HDL carries proteins that might have cardioprotective activities, we used two-dimensional difference gel electrophoresis (2D-DIGE) to investigate the composition of HDL isolated from healthy subjects and subjects with coronary heart disease (CHD). Methods: Two-dimensional difference gel electrophoresis (2D-DIGE) technique, in combination with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), was used to determine the differentially expressed protein in HDL isolated from 15 CHD and 15 healthy control subjects. To confirm the 2D-DIGE protein expression data, validation of the results was carried out using Western blotting and ELISA in another independent serum series (30 control subjects and 30 subjects with CHD). Results: Image analysis showed 5 spots were significantly upregulated whereas 28 spots were down-regulated in the CHD group. MALDI-TOF MS results showed 2 identified proteins were increased: A-SAA and apoL1, 2 proteins were decreased: apoA-I and apoA-IV. ApoA-I, apoA-IV and A-SAA have undergone extensive validation in original cohort and also from a larger independent cohort of patients.
Gastrointestinal Endoscopy, 2011
In patients with bleeding peptic ulcers in whom endoscopic hemostasis fails, surgery usually foll... more In patients with bleeding peptic ulcers in whom endoscopic hemostasis fails, surgery usually follows. Transarterial embolization (TAE) has been proposed as an alternative.
Gastroenterology, 2009
The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonstero... more The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown. This 7-year prospective cohort study recruited patients with bleeding ulcers from January to December 2000. H pylori-negative idiopathic bleeding ulcers were defined as having tested negative for H pylori, having no exposure to aspirin or analgesics within 4 weeks before endoscopy, and having no other identifiable causative factors. After ulcers healed, patients were divided into 2 groups: patients with prior H pylori-negative idiopathic bleeding ulcers (H pylori-negative idiopathic ulcer cohort; n = 120) and those with H pylori-positive, NSAID-negative bleeding ulcers who received eradication therapy (H pylori ulcer cohort; n = 213). Both groups were followed for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;or=7 years without gastroprotective therapy. The primary endpoints were recurrent ulcer bleeding and mortality. The 7-year cumulative incidence of recurrent ulcer bleeding was 42.3% (95% CI, 36.5%-48.1%) in the H pylori-negative idiopathic ulcer cohort and 11.2% (95% CI, 8.8%-13.6%) in the H pylori ulcer cohort (a difference of 31.1%; 95% CI, 27.7%-34.5%; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). Significantly more patients died in the H pylori-negative idiopathic ulcer cohort (87.6%; 95% CI, 83.0%-92.2%) than in the H pylori ulcer cohort (37.3%; 95% CI, 34.0%-40.6%) with a difference of 50.3% (95% CI, 49.0%-51.6%; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). Patients with history of H pylori-negative idiopathic bleeding ulcers have a high risk of recurrent ulcer bleeding and mortality.
Gastroenterology, 2009
No abstract is available. To read the body of this article, please view the PDF online. ... © 200... more No abstract is available. To read the body of this article, please view the PDF online. ... © 2009 AGA Institute. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site do not constitute ...
Gastroenterology, 2009
No abstract is available. To read the body of this article, please view the PDF online. ... © 200... more No abstract is available. To read the body of this article, please view the PDF online. ... © 2009 AGA Institute. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site do not constitute ...
Gut, 2018
ObjectivesIn the management of patients with bleeding peptic ulcers, recurrent bleeding is associ... more ObjectivesIn the management of patients with bleeding peptic ulcers, recurrent bleeding is associated with high mortality. We investigated if added angiographic embolisation after endoscopic haemostasis to high-risk ulcers could reduce recurrent bleeding.DesignAfter endoscopic haemostasis to their bleeding gastroduodenal ulcers, we randomised patients with at least one of these criteria (ulcers≥20 mm in size, spurting bleeding, hypotensive shock or haemoglobin<9 g/dL) to receive added angiographic embolisation or standard treatment. Our primary endpoint was recurrent bleeding within 30 days.ResultsBetween January 2010 and July 2014, 241 patients were randomised (added angiographic embolisation n=118, standard treatment n=123); 22 of 118 patients (18.6%) randomised to angiography did not receive embolisation. In an intention-to-treat analysis, 12 (10.2%) in the embolisation and 14 (11.4%) in the standard treatment group reached the primary endpoint (HR 1.14, 95% CI 0.53 to 2.46; p...
Lancet (London, England), Jan 11, 2017
Present guidelines are conflicting for patients at high risk of both cardiovascular and gastroint... more Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin. After ulcer healing, an independent staff member randomly assigned (1:1) patients who were negative for Helicobacter pylori with a computer-generated list of random numbers to receive oral administrations of either celecoxib 100 mg twice per day plus esomeprazole 20 m...
Gastroenterology, 2012
of 889,057 NSAID users, 729,000 were identified as short-term and 49,553 as long-term users. Long... more of 889,057 NSAID users, 729,000 were identified as short-term and 49,553 as long-term users. Long term users were significantly older (61 years vs. 48 years), were more often women (63% vs. 54%) and had significantly more comorbidities than short term users. The incidence rate for short term users was 6 UGIBs per 1,000 follow-up years and for long term users this was 3 per 1,000 follow-up years. Independent risk factors for UGIB in short term NSAID users were age above 60 years (Hazard Ratio [HR] 2.4, confidence interval 95% [CI] 1.9-3.0), anemia (HR 1.6, CI 1.0-2.3), chronic blood loss (HR 9.7, CI 3.9-24.0), concomitant use of anticoagulants (HR 2.4, CI 1.0-5.3) and H2 receptor antagonists (HR 2.9, CI 1.2-7.0), and a history of proton pump inhibitor (PPI) use (HR 1.3, CI 1.0-1.6). Independent risk factors in long term users were age above 60 years (HR 2.8, CI 2.2-3.5), gastroesophageal reflux disease (HR 3.8, CI 1.7-8.4), cirrhosis (HR 7.4, CI 1.8-30.2) and having one or more comorbid diseases (HR 1.8, CI 1.2-2.6). Concomitant use of PPIs and prior episodes of NSAID use were associated with a lower UGIB risk (HR 0.69, CI 0.5-0.8 and HR 0.8, CI 0.6-0.9 respectively). Conclusions: The overall incidence of UGIB in short and long term NSAID users was low, but twofold higher in short-term users. We found age above 60 years as the only risk factor associated with increased risk in both short and long-term NSAID users. All other risk factors were different, with a more prominent role of comorbidities in long term users. Use of PPIs in long term NSAID users was associated with a lower risk of UGIB. Our results emphasize that stratification into different risk levels in short-and long-term NSAID users is required.
Gastroenterology, 2014
Relationship of Blood Transfusion, SOFA Score, and Mortality. The numbers of patients with each S... more Relationship of Blood Transfusion, SOFA Score, and Mortality. The numbers of patients with each SOFA score are shown in the corresponding columns under SOFA scores.
Gastroenterology, Aug 26, 2016
It is not clear whether use of low-dose aspirin should be resumed after an episode of lower gastr... more It is not clear whether use of low-dose aspirin should be resumed after an episode of lower gastrointestinal (GI) bleeding. We assessed the long-term risks of recurrent lower GI bleeding and serious cardiovascular outcomes after aspirin-associated lower GI bleeding. We performed a retrospective study of patients diagnosed with lower GI bleeding (documented melena or hematochezia, and absence of upper GI bleeding) from January 1, 2000 through December 31, 2007 at the Prince of Wales Hospital in Hong Kong. Using the hospital registry, we analyzed data from 295 patients on aspirin and determined their outcomes over a 5-year period. Outcomes included recurrent lower GI bleeding, serious cardiovascular events, and death from other causes, as determined by an independent, blinded adjudication committee. Outcomes were compared between patients assigned to the following groups, based on cumulative duration of aspirin use: less than 20% of the follow-up period (121 non-users) versus 50% or m...
Gastrointestinal Endoscopy, 2015
There is as yet no ideal design of a plastic biliary stent with the longest patency period. To st... more There is as yet no ideal design of a plastic biliary stent with the longest patency period. To study the safety and effective patency period of a new plastic antireflux biliary stent in the clinical setting. We conducted a prospective, randomized trial to compare the patency of 2 similar plastic biliary stents, one of which has an antiduodenobiliary reflux property. The study was conducted at 2 separate tertiary centers in 2 countries. Patients with inoperable distal malignant biliary obstruction were recruited. One of the 2 types of plastic stents under study was randomly chosen and inserted in the common bile duct of the study subjects. The subjects were followed until the end of study or occlusion occurrence. Our primary endpoint was the time to stent occlusion in days, with stent-related adverse events and all-cause mortality the secondary endpoints. A total of 16 subjects were recruited for the study; 7 were allocated to group A (ordinary Tannenbaum stent) and 9 to group B (antireflux biliary stent). Five of 7 subjects (71%) in group B had stent occlusion within 8 days, and the primary end point was reached in all 7 subjects within 30 days, whereas the primary endpoint was not reached within 30 days in any of the subjects in group A. Our data showed a significantly shorter stent patency period in group B compared with group A (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .003). Small sample size. Routine use of antireflux plastic biliary stents in the palliative management of malignant biliary obstructions cannot be recommended at present. (Clinical trial registration number: NCT01142921.).
Vascular Medicine, 2011
The Walking Impairment Questionnaire (WIQ) is a frequently used questionnaire to evaluate patient... more The Walking Impairment Questionnaire (WIQ) is a frequently used questionnaire to evaluate patients with intermittent claudication on four subscales: pain severity, walking distance, walking speed and the ability to climb stairs. The aim of this study is to translate and validate the WIQ in Chinese. After translation and cultural adaptation of the WIQ, 134 patients with intermittent claudication completed the Chinese WIQ and European Quality of Life 5 Dimension (EQ-5D). Walking distances were determined by the 6-minute walk test (6MWT). Correlations between the WIQ, quality of life questionnaire and walking distances were calculated to determine validity. Reliability and internal consistency were determined using the intra-class correlation coefficient (ICC) and Cronbach's alpha (α), respectively. Significant correlations were found between the WIQ score, initial claudication distance (ICD), absolute claudication distance (ACD) and all domains of the EQ-5D (all p ≤ 0.01). Test-retest reliability (ICC = 0.74) and the overall internal consistency determined (α = 0.90) showed good agreement. A lower WIQ score corresponded to shorter walking distances. In conclusion, this study showed that the Chinese version of the WIQ is a valid, reliable and clinically relevant instrument for assessing walking impairment in patients with intermittent claudication.
International Journal of Cardiology, 2011
Objective: High density lipoprotein cholesterol (HDL-C) level is an independent inverse predictor... more Objective: High density lipoprotein cholesterol (HDL-C) level is an independent inverse predictor of coronary heart disease (CHD). It lowers the risk for atherosclerotic cardiovascular disease. To test the hypothesis that the HDL carries proteins that might have cardioprotective activities, we used two-dimensional difference gel electrophoresis (2D-DIGE) to investigate the composition of HDL isolated from healthy subjects and subjects with coronary heart disease (CHD). Methods: Two-dimensional difference gel electrophoresis (2D-DIGE) technique, in combination with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), was used to determine the differentially expressed protein in HDL isolated from 15 CHD and 15 healthy control subjects. To confirm the 2D-DIGE protein expression data, validation of the results was carried out using Western blotting and ELISA in another independent serum series (30 control subjects and 30 subjects with CHD). Results: Image analysis showed 5 spots were significantly upregulated whereas 28 spots were down-regulated in the CHD group. MALDI-TOF MS results showed 2 identified proteins were increased: A-SAA and apoL1, 2 proteins were decreased: apoA-I and apoA-IV. ApoA-I, apoA-IV and A-SAA have undergone extensive validation in original cohort and also from a larger independent cohort of patients.
Gastrointestinal Endoscopy, 2011
In patients with bleeding peptic ulcers in whom endoscopic hemostasis fails, surgery usually foll... more In patients with bleeding peptic ulcers in whom endoscopic hemostasis fails, surgery usually follows. Transarterial embolization (TAE) has been proposed as an alternative.
Gastroenterology, 2009
The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonstero... more The long-term prognosis of peptic ulcers associated with neither Helicobacter pylori nor nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown. This 7-year prospective cohort study recruited patients with bleeding ulcers from January to December 2000. H pylori-negative idiopathic bleeding ulcers were defined as having tested negative for H pylori, having no exposure to aspirin or analgesics within 4 weeks before endoscopy, and having no other identifiable causative factors. After ulcers healed, patients were divided into 2 groups: patients with prior H pylori-negative idiopathic bleeding ulcers (H pylori-negative idiopathic ulcer cohort; n = 120) and those with H pylori-positive, NSAID-negative bleeding ulcers who received eradication therapy (H pylori ulcer cohort; n = 213). Both groups were followed for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;or=7 years without gastroprotective therapy. The primary endpoints were recurrent ulcer bleeding and mortality. The 7-year cumulative incidence of recurrent ulcer bleeding was 42.3% (95% CI, 36.5%-48.1%) in the H pylori-negative idiopathic ulcer cohort and 11.2% (95% CI, 8.8%-13.6%) in the H pylori ulcer cohort (a difference of 31.1%; 95% CI, 27.7%-34.5%; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). Significantly more patients died in the H pylori-negative idiopathic ulcer cohort (87.6%; 95% CI, 83.0%-92.2%) than in the H pylori ulcer cohort (37.3%; 95% CI, 34.0%-40.6%) with a difference of 50.3% (95% CI, 49.0%-51.6%; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). Patients with history of H pylori-negative idiopathic bleeding ulcers have a high risk of recurrent ulcer bleeding and mortality.
Gastroenterology, 2009
No abstract is available. To read the body of this article, please view the PDF online. ... © 200... more No abstract is available. To read the body of this article, please view the PDF online. ... © 2009 AGA Institute. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site do not constitute ...