Ming-Leung Szeto

Epidemiology and clinical characteristics of ulcerative colitis in Chinese population: Experience from a single center in Hong Kong

Background and Aim:  Rising incidence and prevalence of ulcerative colitis (UC) had been observed in Asian countries. We conducted a study in an Asian center, aiming to describe the epidemiology and clinical characteristics of UC in local Chinese population.

Chinese tea consumption and lower risk of Helicobacter infection

Abstract Background: Our first study had shown that Chinese tea has anti‐Helicobacter activity. The present study investigated the relationship between patients’Helicobacter status and the history of Chinese tea consumption.

Efficacy of enzyme immunoassay for the detection of Helicobacter pylori antigens in frozen stool specimens: local validation

Aim : To investigate the efficacy of measurement of Helicobacter pylori stool antigen (HpSA) using stored frozen stool specimens, and to assess whether there were factors affecting efficacy in Hong Kong.

Congenital Chloride Diarrhea: A Missed Diagnosis in an Adult Patient

TO THE EDITOR: We have read the article by Su et al. with great interest (1). In our opinion, there is room for argument in the method and result of their study to reach their conclusion. First, they have used a nonmagnifying colonoscope to identify the pit pattern of each polyp for histology prediction. Using a magnifying colonoscope for screening colonoscopy, lesions are often initially diagnosed on conventional view, and then are evaluated by chromoendoscopy with magnification followed by chromoendoscopy. Thus, we have conducted a prospective study to clarify if dye spraying and magnification used in each step contribute to further endoscopic distinction in comparison to conventional endoscopic view (2). The overall diagnostic accuracy of chromoendoscopy with magnification was 95.6%, which was 10% and 5% significantly better than those of conventional view and chromoendoscopy without magnification, respectively. Su et al. also have previously reported the feasibility of chromoendoscopy with magnification for distinction of colonic polyps (3). In the present study, they provided a similar result of interpreting the pit patterns with a nonmagnifying colonoscope. However, we can hardly identify the pit patterns presented in figures 5 and 8, which are obviously different from those presented in figures 1 and 2. We believed that the pictures of pit patterns shown in figures 1 and 2 were taken by a magnifying colonoscope but not a nonmagnifying one. Moreover, they also provided an extremely high interobserver agreement for interpreting pit patterns, which demonstrated that the kappa value was 0.960 for chromoendoscopy without magnification. Although, interobserver and intraobserver consistency in the endoscopic assessment of colonic pit patterns have been reported to be good for experienced endoscopists, the mean kappa for interobserver agreement was 0.776 (range 0.729–0.836), which was not as high as they described (4). Additionally, despite the fact that the narrow band imaging (NBI) system is newly developed equipment that was not yet worldwide commercially available at the time of their study, even without magnification they also presented an excellent kappa value of NBI of 1.0. To the best of our knowledge, there are no such excellent data concerning pit pattern analysis with a nonmagnifying colonoscope as they have described in the present study. Actually, if nonmagnification could provide the same result as magnification, it would be much more convenient. However, in our opinion, they should provide clear images to show the reliability and reproducibility of their study. In 1999, we developed a prototype NBI system with the assistance of Olympus Optical Co., Ltd., and we have reported that the observation of surface structure (pit pattern) using the NBI with magnification is useful for differentiating neoplasia from nonneoplasia (5). Furthermore, we recently described that the presence of “meshed brown capillary vessels” on magnifying endoscopy with NBI is also useful for differential diagnosis without dye solution (6, 7). Histologically, we also have evaluated microvascular proliferation with CD-31 immunohistochemical staining, and as a result, the diameter of meshed capillary (MC) vessels in normal colonic mucosa and hyperplastic polyps are reported to range from 8 to 12 μm, and are invisible or faintly visible under NBI with magnification. On the other hand, MC vessels in adenomatous or cancerous lesions range from 13 to 20 μm in diameter, and can be clearly visible under NBI with magnification.

One‐week ranitidine bismuth citrate, amoxicillin and metronidazole triple therapy for the treatment of Helicobacter pylori infection in Chinese

Background : We have previously shown that ranitidine bismuth citrate‐based, clarithromycin‐containing triple therapy achieves a higher eradication rate than proton pump inhibitor‐based regimens in areas with a high prevalence of metronidazole resistance.

Evaluation of five commercial serological tests for the detection of Helicobacter pylori infection in Chinese.

Commercial serological tests for the detection of Helicobacter pylori infection must be locally validated. We evaluated the accuracy of five commercial tests in the Chinese population.

Strongyloidiasis as a possible cause of nephrotic syndrome

Chronic strongyloidiasis is a mild disease and has never been reported to be associated with nephrotic syndrome. Disseminated strongyloidiasis is known to have high mortality, but it frequently is not diagnosed until autopsy. We report a patient with nephrotic syndrome developing disseminated strongyloidiasis after steroid therapy. The findings in renal biopsy, the time course of the development, and resolution of nephrotic syndrome after thiabendazole treatment suggested a possible causal relationship between chronic strongyloidiasis and nephrotic syndrome. The case also demonstrated the importance of early diagnosis in disseminated strongyloidiasis and the good clinical outcome of early treatment before the development of organ failure.