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      • KCI등재

        Forecasted 2040 global prevalence of nonalcoholic fatty liver disease using hierarchical bayesian approach

        Michael H. Le,Yee Hui Yeo,Biyao Zou,Scott Barnet,Linda Henry,Ramsey Cheung,Mindie H. Nguyen 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.4

        Background/Aims: Due to increases in obesity and type 2 diabetes, the prevalence of nonalcoholic fatty liver disease (NAFLD) has also been increasing. Current forecast models may not include non-obese NAFLD. Here, we used the Bayesian approach to forecast the prevalence of NAFLD through the year 2040. Methods: Prevalence data from 245 articles involving 2,699,627 persons were used with a hierarchical Bayesian approach to forecast the prevalence of NAFLD through 2040. Subgroup analyses were performed for age, gender, presence of metabolic syndrome, region, and smoking status. Sensitivity analysis was conducted for clinical setting and study quality. Results: The forecasted 2040 prevalence was 55.7%, a three-fold increase since 1990 and a 43.2% increase from the 2020 prevalence of 38.9%. The estimated average yearly increase since 2020 was 2.16%. For those aged <50 years and ≥50 years, the 2040 prevalence were not significantly different (56.7% vs. 61.5%, P=0.52). There was a significant difference in 2040 prevalence by sex (males: 60% vs. 50%) but the trend was steeper for females (annual percentage change: 2.5% vs. 1.5%, P=0.025). There was no difference in trends overtime by region (P=0.48). The increase rate was significantly higher in those without metabolic syndrome (3.8% vs. 0.84%, P=0.003) and smokers (1.4% vs. 1.1%, P=0.011). There was no difference by clinical/community setting (P=0.491) or study quality (P=0.85). Conclusions: By 2040, over half the adult population is forecasted to have NAFLD. The largest increases are expected to occur in women, smokers, and those without metabolic syndrome. Intensified efforts are needed to raise awareness of NAFLD and to determine long-term solutions addressing the driving factors of the disease.

      • KCI등재

        Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws

        Michael Siu Hei Tse,Chi Hin Chan,Kam Kwong Wong,Wing Cheung Wong 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.4

        Study Design: Retrospective study. Purpose: To analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients. Overview of Literature: C7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width. Methods: We have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl’s technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images. Results: CT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm. Conclusions: The mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan.

      • KCI등재

        Global incidence of adverse clinical events in nonalcoholic fatty liver disease: A systematic review and meta-analysis

        Michael H. Le,David M. Le,Thomas C. Baez,Hansen Dang,Vy H. Nguyen,KeeSeok Lee,Christopher D. Stave,Takanori Ito,Yuankai Wu,Yee Hui Yeo,Fanpu Ji,Ramsey Cheung,Mindie H. Nguyen 대한간학회 2024 Clinical and Molecular Hepatology(대한간학회지) Vol.30 No.2

        Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is associated with a multitude of adverse outcomes. We aimed to estimate the pooled incidence of NAFLD-related adverse events. Methods: We performed a systematic review and meta-analysis of cohort studies of adults with NAFLD to evaluate the pooled incidence of adverse events. Results: 19,406 articles were screened, 409 full-text articles reviewed, and 79 eligible studies (1,377,466 persons) were included. Mean age was 51.47 years and body mass index 28.90 kg/m2. Baseline comorbidities included metabolic syndrome (41.73%), cardiovascular disease (CVD) (16.83%), cirrhosis (21.97%), and nonalcoholic steatohepatitis (NASH) (58.85%). Incidence rate per 1,000 person-years for mortality included: all-cause (14.6), CVD-related (4.53), non-liver cancer-related (4.53), and liver-related (3.10). Incidence for liver-related events included overall (24.3), fibrosis progression (49.0), cirrhosis (10.9), liver transplant (12.0), and hepatocellular carcinoma (HCC) (3.39). Incidence for non-liver events included metabolic syndrome (25.4), hypertension (25.8), dyslipidemia (26.4), diabetes (19.0), CVD (24.77), renal impairment (30.3), depression/anxiety (29.1), and non-liver cancer (10.5). Biopsy-proven NASH had higher incidence of HCC (P=0.043) compared to non-NASH. Higher rates of CVD and mortality were observed in North America and Europe, hypertension and non-liver cancer in North America, and HCC in Western Pacific/Southeast Asia (P<0.05). No significant differences were observed by sex. Time-period analyses showed decreasing rates of cardiovascular and non-liver cancer mortality and increasing rates of decompensated cirrhosis (P<0.05). Conclusions: People with NAFLD have high incidence of liver and non-liver adverse clinical events, varying by NASH, geographic region, and time-period, but not sex.

      • β-Secretase Protein and Activity Are Increased in the Neocortex in Alzheimer Disease

        Fukumoto, Hiroaki,Cheung, Bonnie S.,Hyman, Bradley T.,Irizarry, Michael C. 한림대학교 환경·생명과학연구소 2003 [일송 국제심포지엄] 노화와 만성퇴행성 신경질환 Vol.- No.5

        Context : Amyloid plaques, a major pathological feature of Alzheimer disease(AD), are composed of an internal fragment of amyloid precursor protein (APP): the 4-kd amyloid-β protein(Aβ). The metabolic processing of APP that results in Aβ formation requires 2 enzymatic cleavage events, а γ-secretase cleavage dependent on presenilin, and a β-secretase cleavage by the aspartyl protease β-site APP-cleaving enzyme(BACE). Objective : To test the hypothesis that BACE protein and activity are increased in regions of the brain that develop amyloid plaques in AD. Methods : We developed an antibody capture system to measure BACE protein level and BACE-specific β-secretase activity in frontal, temporal, and cerebellar brain homogenates from 61 brains with AD and 33 control branis. Results : In the brains with AD, BACE activity and protein were significantly increased (p<.001). Enzymatic activity increased by 63% in the temporal neocortex (P=.007) and 13% in the frontal neocortex (P=.003) in brains with AD, but not in the cerebellar cortex. Activity in the temporal neocortex increased with the duration of AD(P=.008) but did not correlate with enzyme-linked immunosorbent assay measures of insoluble Aβ in brains with AD. Protein level was increased by 14% in the frontal cortex of brains with AD (P=.004), with a trend toward a 15% increase in BACE protein in the temporal cortex (P=.07) and no difference in the cerebellar cortex. Immunohistochemical analysis demonstrated that BACE immunoreactivity in the brain was predominantly neuronal and was found in tangle-bearing neurons in AD. Conclusions : The BACE protein and activity levels are increased in brain regions affected by amyloid deposition and remain increased despite significant neuronal and synaptic loss in AD.

      • KCI등재

        Electromyographic Discrepancy in Paravertebral Muscle Activity Predicts Early Curve Progression of Untreated Adolescent Idiopathic Scoliosis

        Fan Yunli,To Michael Kai-Tsun,Yeung Eric Hiu Kwong,Kuang Guan-Ming,Liang Ruixin,Cheung Jason Pui Yin 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5

        Study Design: This study adopted a prospective cohort study design.Purpose: This study aimed to examine electromyogram (EMG) discrepancy in paravertebral muscle activity and scoliosis progression, determine how vertebral morphology and EMG discrepancy evolve during scoliosis progression, and identify differences in EMG activity between individuals with and without adolescent idiopathic scoliosis (AIS).Overview of Literature: Higher EMG activity is observed in the convex side of scoliotic curves, but not in populations without scoliosis, suggesting that higher EMG activity is a causative factor for curve progression.Methods: In this study, 267 matched pairs of AIS and controls were recruited. The participants underwent EMG measurements at their first presentation and did not receive any treatment for 6 months at which point they underwent EMG and radiographs. Early curve progression was defined as >5° in Cobb angle at 6 months. The root mean square of the EMG (rms-EMG) signal was recorded with the participants in sitting and back extension. The rms-EMG ratio at the upper end vertebrae, apical vertebrae (AV), and lower end vertebrae (LEV) of the major curve was calculated.Results: The rms-EMG ratio in the scoliosis cohort was high compared with that in the controls (sitting: 1.2±0.3 vs. 1.0±0.1, <i>p</i><0.01; back extension: 1.1±0.2 vs. 1.0±0.1, <i>p</i><0.01). An AV rms-EMG ratio in back extension, with a cutoff threshold of ≥1.5 in the major thoracic curve and ≥1.3 in the major lumbar curve, was a risk factor for early curve progression after 6 months without treatment (odds ratio, 4.1; 95% confidence interval, 2.8–5.9; <i>p</i><0.01). Increases in side deviation (SD) (distance between the AV and the central sacral line) were related to a higher rms-EMG ratio in LEV of the major thoracic curve (baseline: <i>r<sub>s</sub></i>=0.2, <i>p</i>=0.03; 6 months: <i>r<sub>s</sub></i>=0.3, <i>p</i><0.01).Conclusions: An EMG discrepancy was detected in the scoliosis cohort, which was related to increases in SD in the major thoracic curve. The AV rms-EMG ratio in back extension was correlated with curve progression after 6 months of no treatment.

      • KCI등재

        A Survey of Osteoporosis and Breast Cancer Risk Perception among Menopausal and Postmenopausal Women in Hong Kong

        ( Louis Wc Chow ),( Michael Mc Cheung ),( Jennifer Wj Chu ),( Ivy Cf Li ) 대한폐경학회 2017 대한폐경학회지 Vol.23 No.2

        Objectives: A lack of understanding in menopausal and postmenopausal women`s (PMW) risk perception towards osteoporosis and breast cancer still exists, which is explored in this study. This information might allow health professionals to conduct interventions to improve health behaviors before menopause-related diseases are imminent. Methods: Between 10 December 2015 and 31 January 2016, 573 menopausal or PMW were successfully interviewed on 17 questions, comprising separate sections for osteoporosis and breast cancer. The target respondents were menopausal or PMW aged 45 to 60 years, with no previous diagnosis of osteoporosis or breast cancer, who attended private clinics across Hong Kong for annual physical examination. Results: Regarding menopausal issues, the top three concerns were osteoporosis and fracture (72%), breast cancer (44%), and sleep disorder/insomnia/headache (40%). Among 314 respondents (55%) who tried to prevent osteoporosis, 74% of them began to do it after they were 40 years old. On the other hand, 65% of respondents never had a bone density test. For respondents who said “I`m too young, so I don`t need to check”, their mean age was 52 years old. Ninety percent of respondents mistakenly believed that regular breast examination, regular breast massage, drink soy milk, or vaccine can prevent breast cancer. Conclusions: This survey revealed osteoporosis and breast cancer as the top concerns among menopausal and PMW in Hong Kong. Inadequate health behaviors and misconceptions still exist despite widespread health education in the recent years. (J Menopausal Med 2017;23:102-107)

      • KCI등재

        The Inaccuracy of Surface Landmarks for the Anterior Approach to the Cervical Spine in Southern Chinese Patients

        Tin Sui Ko,Michael Siu Hei Tse,Kam Kwong Wong,Wing Cheung Wong 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6

        Study Design: Observational study. Purpose: To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. Overview of Literature: Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. Methods: The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. Results: In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. Conclusions: The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels.

      • KCI등재

        Clinical effectiveness of mindfulness-based music therapy on improving emotional regulation in blind older women: A randomized controlled trial

        Sunny H.W. Chan,Meryl Y.C. Cheung,Armstrong T.S. Chiu,Mimi H.T. Leung,Michael C.C. Kuo,Donald Y.C. Yip,Carole C.Y. Hui,Sally W.I. Kam,King Yeung,Doreen S.P. Mui,Shu-Mei Wang,Calvin C.K. Yip 한국한의학연구원 2023 Integrative Medicine Research Vol.12 No.4

        Background: This study aimed to investigate clinical effectiveness of a structured eight-week mindfulness-based music therapy (MBMT) program on improving mood regulation in older women with blindness. This investigation compared a MBMT group with a mindfulness intervention (MI) group and a control group. Methods: Ninety-two older females with blindness from a residential setting in Hong Kong were recruited and randomly allocated to a MBMT (n = 31), MI (n = 30), or control (n = 31) group. Psychological measurements regarding mood regulation and general mood states (namely, Difficulties in Emotion Regulation Scale [DERS], Geriatric Depression Scale [GDS], and Depression Anxiety Stress Scales-21), were taken at pretest and posttest. Outcome assessors were blinded to group assignment. Results: Data was analyzed based on intention-to-treat basis. At posttest, DERS scores in the MBMT group (mean differences and 95% confidence interval: 12.1, 5.5 to 18.8) and the MI group (7.2, 0.5 to 13.8) were lower than that in the control group. GDS scores in the MBMT group (2.9, 1.7 to 4.0) and the MI group (1.7, 0.6 to 2.9) were lower than those in the control group. Compared with the MI group, the MBMT group improved emotional awareness sub-scores in DERS (2.1, 0.2 to 4.1) and appeared to lower depression in GDS scores (1.1, -0.0 to 2.3; p = 0.053). Conclusion: MBMT seems more beneficial than MI alone for improving emotional regulation in older women with blindness. The combination of mindfulness and music can generate a synergetic effect by enhancing both attention and appraisal components within the emotional-regulation process. Trial registration: ClinicalTrials.gov, NCT05583695.

      • KCI등재

        Formation and Functionality of Canola Protein Isolate with Both High- and Low-methoxyl Pectin under Associative Conditions

        Andrea K. Stone,Anzhelika Teymurova,Chang Chang,Lamlam Cheung,Michael T. Nickerson 한국식품과학회 2015 Food Science and Biotechnology Vol.24 No.4

        Electrostatic interactions within mixtures of a canola protein isolate (CPI) and both low (LMP) and highmethoxyl (HMP) pectin were investigated as a function of mixing ratio (1:1 to 30:1; CPI-pectin) and pH (8.0-1.5) using turbidity and electrophoretic mobility measurements during an acid titration. The rheological (flow behavior) and functional (solubility, foaming, and emulsifying properties) attributes of CPI-pectin complexes were also studied. Increasing biopolymer mixing ratios shifted critical pH values associated with formation of soluble and insoluble complexes to higher values until plateauing at approximately 10:1. Maximum coacervation of CPI-HMP and CPI-LMP mixtures occurred at pH values of 5.3 and 4.8, respectively, and at a 10:1 mixing ratio. The functionality of formed complexes was similar to CPI alone, except for a slight increase in solubility for the CPI-HMP system and a reduction in foaming capacity for CPI-LMP mixtures. For both mixed systems, viscosity was enhanced relative to CPI alone, showing greater pseudoplastic behavior.

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