16 results on '"CHUI, KM"'
Search Results
2. Publisher Correction: A multi-year campus-level smart meter database.
- Author
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Li M, Wang Z, Qu Y, Chui KM, and Leung-Shea M
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- 2025
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3. A multi-year campus-level smart meter database.
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Li M, Wang Z, Qu Y, Chui KM, and Leung-Shea M
- Abstract
With the growing need for precise campus electricity management, understanding load patterns is crucial for improving energy efficiency and optimizing energy use. However, detailed electricity load data for campus buildings and their internal equipment is often lacking, hindering research. This paper introduces an energy consumption monitoring dataset from The Hong Kong University of Science and Technology (HKUST) campus in Hong Kong, comprising data from over 1400 meters across more than 20 buildings and collected over two and a half years. Using the Brick Schema curation strategy, raw data was curated into a research-ready format. This dataset supports various research tasks, including load pattern recognition, fault detection, demand response strategies, and load forecasting., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)
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- 2024
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4. Early diagnosis of intra-abdominal inflammation and sepsis by neutrophil CD64 expression in newborns.
- Author
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Lam HS, Wong SP, Cheung HM, Chu WC, Wong RP, Chui KM, Liu FY, Li K, Fok TF, and Ng PC
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- Biomarkers blood, Early Diagnosis, Female, Humans, Infant, Newborn, Inflammation blood, Inflammation immunology, Male, Predictive Value of Tests, Prospective Studies, ROC Curve, Receptors, IgG blood, Sensitivity and Specificity, Sepsis blood, Sepsis immunology, Inflammation diagnosis, Neutrophils immunology, Receptors, IgG biosynthesis, Sepsis diagnosis
- Abstract
Background: Newborn infants with intra-abdominal inflammation/sepsis often present with nonspecific signs in the early stages of the disease, but can rapidly develop life-threatening complications. A reliable 'early' biomarker would be invaluable., Objective: To evaluate the effectiveness of neutrophil CD64 as an 'early' biomarker of intra-abdominal inflammation/sepsis., Methods: Blood was collected from newborns with suspected intra-abdominal pathology for neutrophil CD64 and C-reactive protein (CRP) determination at the onset of clinical presentation and 24 h later. They were classified into three groups: intra-abdominal inflammation/sepsis (group 1), extra-abdominal sepsis (group 2) and nonsepsis (group 3). Between-group comparisons were made by Kruskal-Wallis and χ(2) tests. Receiver-operating characteristic curves and diagnostic utilities for single and combination of tests were determined., Results: 310 infants were recruited (102, 34 and 174 in groups 1, 2 and 3, respectively). CD64 (conventional cutoff = 6,010 antibody-PE molecules bound/cell) had substantially better sensitivity (0.81 vs. 0.56) and negative predictive value (0.90 vs. 0.79) for diagnosing intra-abdominal sepsis than CRP, at presentation. Pairing CD64 with routine abdominal radiograph (AXR) substantially increased the sensitivity and negative predictive value for group 1 to 0.99 and 0.99, respectively. By adjusting the CD64 cutoff to 12,500 units, a substantial improvement in specificity could be achieved (0.62 to 0.80) without significantly compromising sensitivity (0.99 to 0.97)., Conclusions: CD64 is a sensitive and 'early' biomarker for diagnosing intra-abdominal inflammation/sepsis. Intra-abdominal catastrophes, including necrotizing enterocolitis, intestinal necrosis, perforation and peritonitis can confidently be excluded using CD64 and AXR early in the course of the disease., (Copyright © 2010 S. Karger AG, Basel.)
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- 2011
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5. Host-response biomarkers for diagnosis of late-onset septicemia and necrotizing enterocolitis in preterm infants.
- Author
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Ng PC, Ang IL, Chiu RW, Li K, Lam HS, Wong RP, Chui KM, Cheung HM, Ng EW, Fok TF, Sung JJ, Lo YM, and Poon TC
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- Apolipoproteins blood, Apolipoproteins metabolism, Biomarkers blood, Enterocolitis, Necrotizing blood, Female, Humans, Infant, Newborn, Infant, Premature, Diseases blood, Male, Proteomics, Blood Proteins analysis, Enterocolitis, Necrotizing diagnosis, Infant, Premature, Diseases diagnosis, Sepsis diagnosis
- Abstract
Preterm infants are highly susceptible to life-threatening infections that are clinically difficult to detect, such as late-onset septicemia and necrotizing enterocolitis (NEC). Here, we used a proteomic approach to identify biomarkers for diagnosis of these devastating conditions. In a case-control study comprising 77 sepsis/NEC and 77 nonsepsis cases (10 in each group being monitored longitudinally), plasma samples collected at clinical presentation were assessed in the biomarker discovery and independent validation phases. We validated the discovered biomarkers in a prospective cohort study with 104 consecutively suspected sepsis/NEC episodes. Proapolipoprotein CII (Pro-apoC2) and a des-arginine variant of serum amyloid A (SAA) were identified as the most promising biomarkers. The ApoSAA score computed from plasma apoC2 and SAA concentrations was effective in identifying sepsis/NEC cases in the case-control and cohort studies. Stratification of infants into different risk categories by the ApoSAA score enabled neonatologists to withhold treatment in 45% and enact early stoppage of antibiotics in 16% of nonsepsis infants. The negative predictive value of this antibiotic policy was 100%. The ApoSAA score could potentially allow early and accurate diagnosis of sepsis/NEC. Upon confirmation by further multicenter trials, the score would facilitate rational prescription of antibiotics and target infants who require urgent treatment.
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- 2010
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6. Oxidative challenge and glucose-6-phosphate dehydrogenase activity of preterm and term neonatal red blood cells.
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Ko CH, Wong RP, Ng PC, Li K, Chui KM, Yuen PM, and Fok TF
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- Erythrocytes drug effects, Female, Gestational Age, Glutathione metabolism, Humans, Infant, Newborn, Male, Naphthols pharmacology, Parenteral Nutrition, Total, Erythrocytes enzymology, Glucosephosphate Dehydrogenase metabolism, Infant, Premature blood, Oxidative Stress, Term Birth blood
- Abstract
Background: Recent studies suggest that a low antioxidant level in preterm infants may predispose them to increased oxidative stress and results in hyperbilirubinemia, whereas glucose-6-phosphate dehydrogenase (G6PD) activity was found to be higher in preterm infants than in term infants., Objectives: To evaluate (1) the oxidative effect of alpha-naphthol on preterm and term red blood cells, and (2) the relationship between G6PD activity and the gestational age of these infants., Methods: G6PD activities were determined in preterm and term infants by a standard diagnostic method. Whole blood samples were incubated with alpha-naphthol for 2 h and their pre- and post-challenged reduced glutathione (GSH) levels were quantified., Results: The mean G6PD activity in preterm infants (n = 113; 13.52 +/- 0.19 U/g Hb; gestational age 30.67 +/- 0.28 weeks) was significantly higher than that in term infants (n = 100; 12.36 +/- 0.16 U/g Hb; gestational age 39.82 +/- 0.14 weeks; p < 0.001). A significantly negative correlation was demonstrated between gestational age and G6PD activity (r = -0.34, p < 0.001). GSH levels of preterm and term subjects were similar at baseline, but were significantly decreased upon challenge with alpha-naphthol (p < 0.001). The percentage reduction in GSH levels was similar in the various gestational age groups., Conclusions: Our data show that G6PD activities had a negative correlation with gestational age of G6PD-normal infants. The similar response of preterm and term erythrocytes to an alpha-naphthol challenge indicates the manifestation of an active anti-oxidative pathway mediated by cellular GSH., (Copyright 2009 S. Karger AG, Basel.)
- Published
- 2009
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7. Pro-oxidative effects of Chinese herbal medicine on G6PD-deficient erythrocytes in vitro.
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Ko CH, Li K, Ng PC, Fung KP, Wong RP, Chui KM, Gu GJ, Yung E, and Fok TF
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- Adult, Dose-Response Relationship, Drug, Erythrocytes chemistry, Erythrocytes enzymology, Glucosephosphate Dehydrogenase genetics, Glucosephosphate Dehydrogenase Deficiency blood, Glucosephosphate Dehydrogenase Deficiency genetics, Glutathione analysis, Humans, Male, Methemoglobin analysis, Drugs, Chinese Herbal toxicity, Erythrocytes drug effects, Glucosephosphate Dehydrogenase blood, Medicine, Chinese Traditional, Oxidants toxicity
- Abstract
Glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects are susceptible to chemical-induced oxidative haemolysis. Little is known concerning the haemolytic properties of Chinese herbal medicine on G6PD-deficient subjects. Our objective was to investigate the pro-oxidative effect of 18 commonly used Chinese herbal medicine (CHM) on human G6PD-deficient red blood cells. G6PD-deficient (n=10) and normal (n=10) whole blood samples were incubated with water extracts of CHM. The resulting levels of reduced glutathione (GSH) and methaemoglobin (MetHb) were determined by biochemical assays. Rhizoma Coptidis significantly reduced GSH level by 48.9+/-5.4% (at 1 mg/mL) in the G6PD-deficient erythrocytes (P<0.001) compared with the respective control group without challenge. Similar dose-dependent responses were observed at higher concentrations of Cortex Moutan, Radix Rehmanniae, Radix Bupleuri, Rhizoma Polygoni Cuspidati and Flos Chimonanthi (P<0.01, 5-10 mg/mL). In addition, the levels of MetHb were elevated significantly when challenged with Rhizoma Coptidis (2.8 fold at 5 mg/mL) and Cortex Moutan (3.4 fold at 10 mg/mL). This is the first report on the pro-oxidative action of CHM on G6PD-deficient blood samples in vitro as demonstrated by the decrease of GSH and increase of MetHb. G6PD-deficient subjects should restrain from excessive consumption of these pro-oxidative herbs.
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- 2008
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8. IP-10 is an early diagnostic marker for identification of late-onset bacterial infection in preterm infants.
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Ng PC, Li K, Chui KM, Leung TF, Wong RP, Chu WC, Wong E, and Fok TF
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- Age of Onset, Biomarkers, Chemokine CXCL10, Female, Humans, Infant, Newborn, Male, Sepsis diagnosis, Sepsis metabolism, Bacterial Infections diagnosis, Bacterial Infections metabolism, Chemokines, CXC metabolism, Infant, Premature
- Abstract
Very low birth weight (VLBW) infants with suspected late-onset infection requiring sepsis screening were enrolled in a prospective study to evaluate the diagnostic utilities of a comprehensive panel of key chemokines and cytokines, both individually and in combination, to identify diagnostic markers for early recognition of bacterial sepsis and necrotizing enterocolitis (NEC). Plasma chemokines interleukin (IL)-8, interferon-gamma-inducible protein 10 (IP-10), monokine induced by interferon-gamma (MIG), monocyte chemoattractant protein 1 (MCP-1), growth-related oncogene-alpha (GRO-alpha), and regulated upon activation of normal T cell expressed and secreted (RANTES) and cytokines IL-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor alpha (TNF-alpha) were measured at the onset of sepsis (0 h) and 24 h later. Of 155 suspected infection episodes, 44 were classified as infected. Concentrations of all studied inflammatory mediators (except IL-1beta and RANTES) were significantly higher in the infected than in the noninfected group at 0 h, but the levels decreased precipitously by 24 h. IP-10 with a plasma cutoff concentration > or = 1250 pg/mL could identify all septicemic and NEC cases and had the highest overall sensitivity (93%) and specificity (89%) at 0 h. We conclude that preterm infants have the ability to induce a robust chemokine and cytokine response during sepsis, and IP-10 is a sensitive early marker of infection.
- Published
- 2007
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9. Pro-oxidative effects of tea and polyphenols, epigallocatechin-3-gallate and epigallocatechin, on G6PD-deficient erythrocytes in vitro.
- Author
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Ko CH, Li K, Ng PC, Fung KP, Li CL, Wong RP, Chui KM, Gu GJ, Yung E, Wang CC, and Fok TF
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- Adult, Camellia sinensis chemistry, Catechin analysis, Catechin pharmacology, Erythrocytes enzymology, Flavonoids analysis, Flavonoids pharmacology, Glucosephosphate Dehydrogenase genetics, Glucosephosphate Dehydrogenase Deficiency genetics, Glutathione analysis, Glutathione Disulfide analysis, Humans, Male, Mutation, Oxidants analysis, Phenols analysis, Phenols pharmacology, Polyphenols, Catechin analogs & derivatives, Erythrocytes drug effects, Glucosephosphate Dehydrogenase metabolism, Oxidants pharmacology, Tea chemistry
- Abstract
Glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects are vulnerable to chemical-induced hemolysis if exposed to oxidative agents. Recent studies reported that green tea and its constituents might act as pro-oxidants. Our objective was to investigate effects of tea and its polyphenolic components on the oxidative status of human G6PD-deficient erythrocytes. Erythrocytes of G6PD-deficient (n = 8) and normal (n = 8) subjects were incubated with water extracts of 3 types of tea samples (black tea, green tea and decaffeinated green tea extract) and 6 polyphenols. The resulting levels of reduced glutathione (GSH) and glutathione disulphide (GSSG), methemoglobin and plasma hemoglobin were quantified by HPLC and biochemical assays. The tea extracts significantly reduced GSH and increased GSSG levels in G6PD-deficient erythrocytes in a dose-dependent manner (0.5-10 mg/ml), but not in normal erythrocytes. Similar dose-dependent responses to (-)-epigallocatechin (EGC) and (-)-epigallocatechin-3-gallate (EGCG), but not to the other polyphenols, were observed. In G6PD-deficient cells, GSH was reduced by 43.3% (EGC at 0.05 mg/ml) and 33.3% (EGCG at 0.5 mg/ml), compared with pre-challenged levels. The concentration of methemoglobin was increased significantly when challenged with tea extracts, and EGC. Plasma hemoglobin levels were higher in G6PD-deficient samples after exposure to tea extracts, EGCG, EGC and gallic acid, compared with those in normal blood. Tea extracts and polyphenols significantly altered the oxidative status of G6PD-deficient erythrocytes in vitro as demonstrated by the decrease of GSH, and increased GSSG, methemoglobin and plasma hemoglobin. Our data caution against the excessive consumption of concentrated tea polyphenolic products by G6PD-deficient subjects.
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- 2006
10. Multiplex primer extension reaction screening and oxidative challenge of glucose-6-phosphate dehydrogenase mutants in hemizygous and heterozygous subjects.
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Ko CH, Yung E, Li K, Li CL, Ng PC, Fung KP, Wong RP, Chui KM, Gu GJ, and Fok TF
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- China epidemiology, Genetic Testing economics, Genotype, Glucosephosphate Dehydrogenase analysis, Glucosephosphate Dehydrogenase Deficiency diagnosis, Glucosephosphate Dehydrogenase Deficiency genetics, Glutathione analysis, Humans, Incidence, Molecular Epidemiology, Naphthols pharmacology, Oxidation-Reduction, Genetic Testing methods, Glucosephosphate Dehydrogenase genetics, Mutation, Nucleic Acid Amplification Techniques
- Abstract
The primary objective of our study was to provide a simple and reliable assay for identifying the majority of G6PD genetic variants in the Chinese population. We optimized the multiplex primer extension reaction (MPER) assay for simultaneous screening of 14-point mutations in 98 G6PD-deficient subjects. Our data demonstrated that this method is precise, cost-effective and has successfully identified mutations in 97 out of 98 subjects, including all heterozygous mutants. We also detected a relatively high incidence (12.3%) of c.871G > A, and all of them harbored the silent mutation c.1311C > T. Apart from the screening program, the pharmacogenetic relationship between G6PD level and residual reduced glutathione (GSH) level was studied upon oxidative challenge by alpha-naphthol. The GSH levels were correlated with their status of G6PD deficiency, but no significant difference was observed between individual G6PD-deficient groups. Our data demonstrated the potentials of the MPER assay for characterization of G6PD deficiency and other genetic diseases.
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- 2006
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11. Early prediction of sepsis-induced disseminated intravascular coagulation with interleukin-10, interleukin-6, and RANTES in preterm infants.
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Ng PC, Li K, Leung TF, Wong RP, Li G, Chui KM, Wong E, Cheng FW, and Fok TF
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- Disseminated Intravascular Coagulation etiology, Disseminated Intravascular Coagulation immunology, Down-Regulation, Enterocolitis, Necrotizing blood, Enterocolitis, Necrotizing complications, Humans, Infant, Low Birth Weight, Infant, Newborn, Predictive Value of Tests, Prospective Studies, Sepsis blood, Up-Regulation, Chemokine CCL5 blood, Disseminated Intravascular Coagulation diagnosis, Infant, Premature, Interleukin-10 blood, Interleukin-6 blood, Sepsis complications
- Abstract
Background: The progression to disseminated intravascular coagulation (DIC) in infected very low birth weight (VLBW; <1500 g) infants is difficult to predict with precision at the onset of sepsis. We investigated the immunologic profiles of preterm infants with sepsis, using chemokine and cytokine measurements to predict the development of sepsis-induced DIC at the onset of infection., Methods: We measured a panel of chemokines and cytokines at 0 and 24 h after clinical presentation in VLBW infants with suspected infection requiring full sepsis screening. The chemokines measured were interleukin (IL)-8, interferon-gamma-inducible protein-10 (IP-10), monokine induced by interferon-gamma, monocyte chemoattractant protein-1, and regulated upon activation normal T-cell expressed and secreted (RANTES), and the cytokines were IL-6, IL-10, and tumor necrosis factor-alpha., Results: Of 195 episodes of suspected clinical sepsis investigated, 62 were culture-confirmed septicemia or necrotizing enterocolitis (28 of these infants developed DIC), 22 were culture-negative clinical infections, and 111 involved noninfected episodes. All studied inflammatory mediators except RANTES showed significantly greater up-regulation in culture-positive infected infants than in noninfected infants at 0 and 24 h, whereas RANTES showed significant down-regulation. The model that used plasma IL-10 (>208 ng/L), IL-6 (>168 ng/L), and RANTES (<3110 ng/L) at 0 h had sensitivity, specificity, and positive and negative predictive values of 100%, 97%, 85%, and 100%, respectively, for identifying infected patients who subsequently developed DIC., Conclusions: IL-10, IL-6, and RANTES measured at clinical presentation sensitively and accurately predicted the development of DIC in severely infected infants. This information could be vital for early and effective treatment of neonatal sepsis.
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- 2006
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12. Quantitative measurement of monocyte HLA-DR expression in the identification of early-onset neonatal infection.
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Ng PC, Li G, Chui KM, Chu WC, Li K, Wong RP, and Fok TF
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- Biomarkers analysis, C-Reactive Protein analysis, Escherichia coli Infections diagnosis, Humans, Infant, Newborn, Infections immunology, Neutrophils immunology, Phycoerythrin immunology, Pneumonia, Bacterial microbiology, ROC Curve, Receptors, IgG analysis, Sensitivity and Specificity, Sepsis microbiology, Streptococcal Infections diagnosis, HLA-DR Antigens analysis, Infections diagnosis, Monocytes immunology
- Abstract
Background: This study aimed to evaluate the diagnostic utilities of monocyte HLA-DR as an infection marker in the identification of early-onset clinical infection and pneumonia in newborn infants., Methods: Term newborns in whom infection was suspected when they were <72 h of age were eligible for enrollment in the study. C-reactive protein (CRP), monocyte HLA-DR and neutrophil CD64 expressions were quantitatively measured at the time of sepsis evaluation (0 h) and 24 h afterwards by flow cytometry and standard laboratory method., Results: A total of 288 infants with suspected sepsis were investigated, and 93 were found to be clinically infected. There were no significant differences in monocyte HLA-DR expression between the infected, non-infected and control groups at 0 h (median (interquartile range): 13,986 (10,994-18,544), 14,234 (12,045-17,474) and 18,441 (14,250-21,537) antibody phycoerythrin (PE) molecules bound/cell), and between infected and non-infected infants at 24 h (median (interquartile range): 17,772 (12,933-25,167) and 19,406 (14,885-24,225) antibody PE molecules bound/cell). The areas under the receiver operating characteristics (ROC) curves for HLA-DR, CD64 and CRP were 0.52-0.54, 0.88-0.94 and 0.75-0.77, respectively. We were unable to determine an optimal cutoff value for HLA-DR, as the diagnostic utilities of any cutoff point on the ROC curves were unable to satisfy the criteria (i.e. sensitivity and specificity >or=80%) for consideration as an useful diagnostic marker of infection., Conclusions: Our findings did not support the use of monocyte HLA-DR alone or in combination with other infection markers in the diagnosis of early-onset clinical infection and pneumonia in term newborns.
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- 2006
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13. Neutrophil CD64 is a sensitive diagnostic marker for early-onset neonatal infection.
- Author
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Ng PC, Li G, Chui KM, Chu WC, Li K, Wong RP, Chik KW, Wong E, and Fok TF
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- Age of Onset, C-Reactive Protein metabolism, Flow Cytometry, Humans, Infant, Newborn, Pneumonia immunology, Predictive Value of Tests, Sensitivity and Specificity, Sepsis immunology, Biomarkers, Neutrophils metabolism, Pneumonia diagnosis, Receptors, IgG metabolism, Sepsis diagnosis
- Abstract
This prospective study aimed to evaluate the diagnostic utilities of neutrophil CD64 expression for the identification of early-onset clinical infection and pneumonia in term infants and to define the optimal cutoff value so that it may act as a reference with which future studies can be compared. Term newborns in whom infection was suspected when they were <72 h of age were recruited into the study. C-reactive protein (CRP) and expression of CD64 on neutrophils were measured at 0 h (at the time of sepsis evaluation) and 24 h. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of CRP, CD64, and the combination of these two markers for predicting neonatal sepsis were determined. A total of 338 infants with suspected clinical sepsis were investigated, 115 of whom were found to be clinically infected. CRP and CD64 in infected infants were both significantly elevated at 0 and 24 h compared with noninfected infants (p < 0.001). The calculated optimal cutoff value for CD64 was 6136 antibody-phycoerythrin molecules bound/cell. CD64 has a very high sensitivity (96%) and NPV (97%) at 24 h. The addition of CRP only marginally enhanced the sensitivity and NPV (97 and 98%, respectively). In conclusion, neutrophil CD64 is a very sensitive diagnostic marker for the identification of early-onset clinical infection and pneumonia in term newborns. The results strongly suggest that measurement of neutrophil CD64 may allow neonatal clinicians to discontinue antibiotic treatment at 24 h in infants who are clinically stable and whose CD64 expressions are below the optimal cutoff level.
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- 2004
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14. Neutrophil CD64 expression: a sensitive diagnostic marker for late-onset nosocomial infection in very low birthweight infants.
- Author
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Ng PC, Li K, Wong RP, Chui KM, Wong E, and Fok TF
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- Biomarkers, Cross Infection immunology, Humans, Infant, Newborn, Leukocyte Common Antigens analysis, Macrophage-1 Antigen analysis, Predictive Value of Tests, Receptors, Interleukin-2 analysis, Sensitivity and Specificity, Sepsis diagnosis, Sepsis immunology, Cross Infection diagnosis, Infant, Very Low Birth Weight immunology, Neutrophils chemistry, Receptors, IgG analysis
- Abstract
This study aims to evaluate the diagnostic utilities of four leukocyte surface antigens-two lymphocyte antigens (CD25 and CD45RO) and two neutrophil antigens (CD11b and CD64)-for identification of late-onset nosocomial bacterial infection in preterm, very low birthweight infants, and to define the optimal cutoff value for each marker so that it may act as a reference with which future studies can be compared. Very low birthweight infants in whom infection was suspected when they were >72 h of age were eligible for the study. A full sepsis screen was performed in each episode. IL-6, C-reactive protein, and leukocyte surface antigens (CD25, CD45RO, CD11b, and CD64) were measured at 0 (at the time of sepsis evaluation), 24, and 48 h by standard biochemical methods and quantitative flow cytometric analysis. The diagnostic utilities including sensitivity, specificity, and positive and negative predictive values of each marker and combination of markers for predicting late-onset neonatal infection were determined. One hundred twenty-seven episodes of suspected clinical sepsis were investigated in 80 infants. Thirty-seven episodes were proven infection. The calculated optimal cutoff values for CD25, CD45RO, CD11b, and CD64 were 3,100, 2,900, 10,450, and 4,000 phycoerythrin-molecules bound per cell, respectively. An interim analysis of data after 68 episodes suggested that CD25 and CD45RO were poor predictors of neonatal infection with sensitivity or specificity <75% during a single measurement. Thus, these two markers were excluded from further investigation. In the final analysis, CD64 has the highest sensitivity (95-97%) and negative predictive value (97-99%) at 0 and 24 h after the onset. The addition of IL-6 or C-reactive protein (0 h) to CD64 (24 h) further enhanced the sensitivity and negative predictive value to 100%, and has the specificity and positive predictive value exceeding 88% and 80%, respectively. Neutrophil CD64 expression is a very sensitive marker for diagnosing late-onset nosocomial infection in very low birthweight infants. If further validated, the use of CD64 as an infection marker should allow early discontinuation of antibiotic treatment at 24 h without waiting for the definitive microbiologic culture results. The quantitative flow cytometric analysis applied in this study could be developed into a routine clinical test with high comparability and reproducibility across different laboratories.
- Published
- 2002
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15. Value of magnetic resonance imaging with an endovaginal receiver coil in the pre-operative assessment of Stage I and IIa cervical neoplasia.
- Author
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deSouza NM, McIndoe GA, Soutter WP, Krausz T, Chui KM, Hughes C, and Mason WP
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- Adult, Aged, Cross-Sectional Studies, False Negative Reactions, False Positive Reactions, Female, Humans, Hysterectomy methods, Magnetic Resonance Imaging instrumentation, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging methods, Prognosis, Prospective Studies, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms surgery, Uterine Cervical Neoplasms diagnosis
- Abstract
Objective: To assess the value of high resolution endovaginal magnetic resonance images (MRI) of the uterine cervix in planning management of early cervical cancer., Design: Prospective cross-sectional study., Setting: Specialist gynaecological oncology unit of a postgraduate teaching hospital., Participants: Thirty nine women aged 25-76 years old (mean 42.5 years) with invasive carcinoma Stage I or IIa of the cervix., Methods: A ring coil was positioned endovaginally around the cervix. Imaging was performed on a 1.0 T HPQ Vista or 0.5 T Asset (Picker, Highland Heights, Ohio, USA) using T1 weighted and T2 weighted sequences in transverse and sagittal planes with thin slices (2.5 mm) and small fields of view (12 cm). Tumour volumes were measured and any extension into adjacent organs and parametrium was noted. The patients were followed up after treatment and the outcome related to the MRI findings., Results: There was one false positive and one false negative result among five Stage Ia patients being assessed for residual disease after cone biopsy or LLETZ. The MRI assessment of the size and distribution of the tumour was confirmed histologically in all 31 patients with Stage Ib or IIa disease who were treated surgically. One of these patients in whom no endocervical tumour was visible on MRI underwent radical trachelectomy. Three patients had radiotherapy as primary treatment. Patients with Stage Ib or IIa disease who had tumour volumes > 10 cm3 with early parametrial extension on MRI had a substantially worse prognosis at 24 months (disease-free survival 58.3% vs 95.5%, P = 0.003)., Conclusion: High resolution MRI with an endovaginal coil allows precise measurement of tumour volume and identifies patients with small volume disease who might be considered for more conservative therapy. This technique also reveals early parametrial invasion that cannot be identified reliably by any other method. Early parametrial invasion in women with large tumours appears to have a very much worse prognosis.
- Published
- 1998
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16. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birthweight infants.
- Author
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Ng PC, Cheng SH, Chui KM, Fok TF, Wong MY, Wong W, Wong RP, and Cheung KL
- Subjects
- C-Reactive Protein metabolism, Cytokines blood, E-Selectin blood, Female, Humans, Infant, Newborn, Infant, Premature blood, Infant, Premature, Diseases blood, Male, Predictive Value of Tests, Reference Values, Sensitivity and Specificity, Sepsis blood, Biomarkers blood, Infant, Premature, Diseases diagnosis, Infant, Very Low Birth Weight blood, Sepsis diagnosis
- Abstract
Aims: To evaluate the commonly used markers--namely IL-6, TNF alpha, IL-1 beta, C-reactive protein and E-selection for identification of late onset neonatal sepsis; to define the optimal cutoff value for each marker in preterm neonates; to assess whether these markers could assist in early discontinuation of antibiotics in non-infected cases; and to delineate the profile of these markers during systemic infection and in relation to successful treatment., Methods: Very low birthweight infants in whom clinical sepsis was suspected when they were > 72 hours of age were eligible for study. A full sepsis screen was performed in each episode. Cytokines, C-reactive protein, and E-selectin were serially measured on days 0 (at the time of sepsis evaluation), 1, 2, 4 and 7. The optimal cutoff value for each marker was calculated after minimising the number of misclassified episodes over all possible cutoff values for days 0 and 1. The sensitivity, specificity, positive and negative predictive values for each test and combination of tests for predicting systemic infection were also determined., Results: One hundred and one episodes of suspected clinical sepsis were investigated in 68 infants. Forty five episodes were proved to be infections. The optimal cutoff values were IL-6 31 pg/ml, TNF alpha 17 pg/ml, IL-1 beta 1 pg/ml, C reactive protein 12 mg/l and E-selectin 174 ng/ml. IL-6 had the highest sensitivity (89%) and negative predictive value (91%) for detecting late onset infection on day 0. However, between 24 and 48 hours of onset, C-reactive protein was the best single marker, with an overall sensitivity and specificity of 84% and 96%, respectively. The use of serial and multiple markers in the first 48 hours further enhanced the sensitivity and specificity of these tests. Performing IL-6 and C-reactive protein on day 0, together with either TNF alpha on day 1 or C-reactive protein on day 2, showed the best overall sensitivity (98%) and specificity (91%) for the diagnosis of late onset infection., Conclusions: Optimal cutoff values for these markers in detecting late onset systemic infection in very low birthweight infants have been defined. Withholding antibiotic treatment at the onset of infection could be fatal and is not recommended, but the concomitant use of IL-6 and C-reactive protein or TNF alpha should allow antimicrobial treatment to be discontinued at 48 hours without waiting for microbiological results, provided that the infants are in good clinical condition.
- Published
- 1997
- Full Text
- View/download PDF
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