Louis Yik-Si Chan

SARS Transmission among Hospital Workers in Hong Kong

Despite infection control measures, breakthrough transmission of severe acute respiratory syndrome (SARS) occurred for many hospital workers in Hong Kong. We conducted a case-control study of 72 hospital workers with SARS and 144 matched controls. Inconsistent use of goggles, gowns, gloves, and caps was associated with a higher risk for SARS infection (unadjusted odds ratio 2.42 to 20.54, p < 0.05). The likelihood of SARS infection was strongly associated with the amount of personal protection equipment perceived to be inadequate, having <2 hours of infection control training, and not understanding infection control procedures. No significant differences existed between the case and control groups in the proportion of workers who performed high-risk procedures, reported minor protection equipment problems, or had social contact with SARS-infected persons. Perceived inadequacy of personal protection equipment supply, infection control training <2 hours, and inconsistent use of personal protection equipment when in contact with SARS patients were significant independent risk factors for SARS infection.

Sexual behavior and activity in Chinese pregnant women

Objective.  To evaluate sexual activities, attitudes, and complications related to intercourse among Chinese pregnant women and to study their source of the information.

Guillain-Barré syndrome in pregnancy.

Guillain–Barré syndrome (GBS) complicating pregnancy is a rare event. Reports before the mid‐1980s suggested that GBS in pregnancy carries a high maternal morbidity and mortality. However, it is uncertain whether availability of active treatment such as plasmapheresis and intravenous immunoglobulin together with advancement in intensive care has improved maternal outcome. This review examines the maternal and fetal outcomes of GBS complicating pregnancy reported in the recent English literature.

Left ventricular diastolic function during normal pregnancy: assessment by spectral tissue Doppler imaging

Tissue Doppler imaging (TDI) is an echocardiographic technique for assessing the diastolic function that is relatively independent of preload. Since loading conditions change significantly during pregnancy, a load‐independent technique will give a more accurate assessment of diastolic function in pregnant women. The aim of this study was to evaluate maternal diastolic function using tissue Doppler imaging.

High incidence of obstetric interventions after successful external cephalic version

Objective To investigate the delivery outcome after successful external cephalic version (ECV).

SARS in Three Categories of Hospital Workers, Hong Kong

The SARS attack rate for hospital workers in Hong Kong was 1.20% and was significantly higher in nonmedical support staff.

Rapid recurrence of endometrioma after transvaginal ultrasound-guided aspiration

OBJECTIVE Ultrasound-guided aspiration is a less invasive management option for recurrent endometrioma. We postulated that the endometriotic tissue in the epithelial lining of endometrioma had undergone pressure atrophy after a period of observation, and resolution of the endometrioma can be achieved by aspiration of its content. STUDY DESIGN A prospective study was carried out in which patients with recurrent endometrioma that remain stationary in size for a period of at least 6 months were included. Ultrasound-guided aspiration of endometrioma was performed transvaginally under conscious sedation. Ultrasound scan examination was performed at 1, 3, 6, and 12 months after aspiration to detect recurrence. RESULTS Eight endometriomas were aspirated in six patients. The mean diameter and volume of endometrioma at aspiration were 31.0 mm (range, 18.0-46.3 mm) and 21.9 ml (range, 3.16-52.0 ml), respectively. There were no major complications. Cytological examination revealed hemosiderin-laden macrophages; neither malignant cells nor endometrial cells were detected in all cases. Six ovarian cysts recurred in five women (83.3%), all recurrence were detected within 3 months after aspiration. CONCLUSION We concluded that although transvaginal ultrasound-guided aspiration is a safe procedure, but the recurrence rate after aspiration is unacceptably high, and hence cannot be recommended as a treatment option for recurrent endometrioma.

Influences of perinatal factors on cord blood thyroid‐stimulating hormone level

Background. Cord blood thyroid‐stimulating hormone level is affected by various perinatal factors. The aim of this study is to investigate the relative impact of these factors on the cord blood thyroid‐stimulating hormone results in singleton pregnancies.

Use of traditional Chinese herbal medicine during pregnancy: a prospective survey

(2005). Use of traditional Chinese herbal medicine during pregnancy: a prospective survey. Acta Obstetricia et Gynecologica Scandinavica: Vol. 84, No. 7, pp. 699-700.

ACE2 Gene Polymorphisms Do Not Affect Outcome of Severe Acute Respiratory Syndrome

Severe acute respiratory syndrome (SARS) is the first pandemic of the 21st century (1). Since its recognition, 8437 individuals have been affected and 813 have died (2). Approximately 20–30% of patients required intensive care admission (1). Although there was a slight predominance of female SARS patients, possibly because of the overrepresentation of female healthcare workers (1), male SARS patients were more likely to suffer poor outcomes (3). In a major hospital outbreak in Hong Kong (4), 32% of male and 15% of female SARS patients required intensive care or died. Remarkably, similar demographic data were seen among SARS patients in the greater Toronto area, Canada, where 32% of males and 14% of females with SARS required intensive care or died (5). Karlberg et al. (3) studied the case fatality rates among all confirmed SARS patients documented in the Hong Kong SARS epidemic in 2003. The authors concluded that the mortality rates differed significantly between males and females, being 21.9% and 13.2%, respectively. The relative risk for death in males was 1.62 after adjustment for age. It is thus an intriguing coincidence that ACE2 , the gene for the newly identified functional receptor for the SARS coronavirus, angiotensin-converting enzyme 2, maps to the X-chromosome (Xp22) (6). ACE2 was first identified as a homolog of angiotensin-converting enzyme with zinc metalloproteinase activity (7). Many of its activities differ from those of angiotensin-converting enzyme (8). ACE2 has been found …