Chronic Spontaneous Urticaria in Hong Kong: Clinical Characteristics, Real-World Practice and Implications for COVID-19 Vaccination

Kan Andy Ka Chun,Wong Thomas Tsz Hang,Chiang Valerie,Lau Chak Sing,Li Philip Hei 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.1

Purpose: The real-world management and clinical characteristics of chronic spontaneous urticaria (CSU) in Hong Kong and its implications for coronavirus disease 2019 (COVID-19) vaccination are unknown. We investigated the clinical characteristics of patients with CSU and the role of an immunologist-led Urticaria Clinic as well as the impact of CSU on COVID-19 vaccine uptake in Hong Kong. Methods: Longitudinal clinical data of 257 CSU patients were collected and analyzed. Association analyses were performed to identify the relationships between variables and factors associated with COVID-19 vaccine uptake. Results: After the immunologist review, the Weekly Urticaria Activity Score (UAS7) was significantly lower than baseline (median: 0.00 vs. 12.0, P < 0.001). Changes in UAS7 were significantly greater among patients with baseline UAS7 ≥ 16 compared to those with UAS7 < 16 (median: −24.0 vs. −2.00, P < 0.001). CSU patients had lower COVID-19 vaccination rates than the general population with only 176 (68.5%) and 165 (65.0%) receiving at least one dose and 2 doses of vaccination, respectively. The presence of concomitant suspected drug allergy was associated with lower COVID-19 vaccine uptake (odds ratio [OR], 0.47; P = 0.010), while regular pharmacological treatment was associated with higher COVID-19 vaccine uptake among CSU patients (OR, 3.79; P = 0.010). Conclusions: A dedicated immunologist-led Urticaria Clinic may effectively improve CSU management and outcomes in Hong Kong.

Child maltreatment hospitalisations in Hong Kong: incidence rate and seasonal pattern

Ip, Patrick,Ho, Frederick Ka-wing,Chan, Ko Ling,Yip, Paul Siu-fai,Lau, Joseph Tak-fai,Wong, Wilfred Hing-sang,Chow, Chun-bong,Jiang, Fan BMJ Publishing Group Ltd 2016 Archives of disease in childhood Vol.101 No.12

<P><B>Objective</B></P><P>We investigated the incidence and seasonal patterns of child maltreatment hospitalisations in Hong Kong.</P><P><B>Design</B></P><P>A retrospective study of subjects aged under 19 years with a primary diagnosis of child maltreatment admitted to hospitals in Hong Kong from 2001 to 2010. Data were retrieved from the centralised database of all 42 public hospitals in the Hospital Authority.</P><P><B>Main outcome measures</B></P><P>Child maltreatment incidence rate.</P><P><B>Results</B></P><P>A consistent seasonal pattern was found for non-sexual maltreatment in children aged 6–18 years (p<0.001). Hospitalisations peaked in May and October but dipped in August and January. No significant seasonal patterns were found for sexual maltreatment or among children under 6 years. The seasonal pattern of child maltreatment coincided with the two school examination periods. The annual child maltreatment hospitalisation rate in Hong Kong in 2010 was 73.4 per 100 000 children under 19 years, more than double that in 2001.</P><P><B>Conclusions</B></P><P>A peculiar seasonal pattern and an alarming increasing trend in child maltreatment hospitalisation were observed in Hong Kong, which we speculated to be related to school examination stress and increasing socioeconomic disparity. Our findings highlighted differences in the trends of child maltreatment between Hong Kong and the West. Professionals and policymakers should be made aware of these trends and develop effective strategies to tackle child maltreatment.</P>

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

Wen-jie Yang,Ka Sing Wong,Xiang-yan Chen 대한뇌졸중학회 2017 Journal of stroke Vol.19 No.3

Intracranial atherosclerosis is one of the leading causes of ischemic stroke and occurs more commonly in patients of Asian, African or Hispanic origin than in Caucasians. Although the histopathology of intracranial atherosclerotic disease resembles extracranial atherosclerosis, there are some notable differences in the onset and severity of atherosclerosis. Current understanding of intracranial atherosclerotic disease has been advanced by the high-resolution magnetic resonance imaging (HRMRI), a novel emerging imaging technique that can directly visualize the vessel wall pathology. However, the pathological validation of HRMRI signal characteristics remains a key step to depict the plaque components and vulnerability in intracranial atherosclerotic lesions. The purpose of this review is to describe the histological features of intracranial atherosclerosis and to state current evidences regarding the validation of MR vessel wall imaging with histopathology.

Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier.

Gorelick, Philip B,Wong, Ka Sing,Bae, Hee-Joon,Pandey, Dilip K American Heart Association] 2008 Stroke Vol.39 No.8

<P>BACKGROUND AND PURPOSE: Large artery intracranial occlusive disease (LAICOD) is a common and important stroke subtype. In this commentary, we review key epidemiological aspects of LAICOD. SUMMARY OF REVIEW: LAICOD has emerged as the most common stroke subtype worldwide and is associated with a high risk of recurrent stroke. Hypotheses have been proposed to explain causation, which include such factors as traditional cardiovascular risk factors, high blood volume states, and genetic abnormalities. Approaches to treatment such as antithrombotic therapies, revascularization procedures, and counterpulsation devices hold promise. CONCLUSIONS: LAICOD poses a major stroke problem worldwide and is likely the most common stroke subtype. The etiology and treatment of this disorder remain poorly defined. International collaborations are needed to pool collective knowledge and develop definitive studies to better understand causation and treatment of LAICOD.</P>

The Chemistry of Colors : Synthesis and Spectroscopic Studies of Conjugated Organic Molecules

Kwan Wang Yan,Cho Ka On,Hui Tok Chung Calvin,Ngai Vivian Cheuk Yan,Sung Hoi,Wong Ching Yan,Wong Yuk Hei,Yu Hiu Pang 국제과학영재학회 2008 APEC Youth Scientist Journal Vol.1 No.-

Correlation of Adventitial Vasa Vasorum with Intracranial Atherosclerosis: A Postmortem Study

Lu Zheng,Wen Jie Yang,Chun Bo Niu,Hai Lu Zhao,Ka Sing Wong,Thomas Wai Hong Leung,Xiang Yan Chen 대한뇌졸중학회 2018 Journal of stroke Vol.20 No.3

Background and Purpose Vasa vasorum (VV) have been believed to be rare or non-existent in small-caliber intracranial arteries. In a series of human cerebral artery specimens, we identified and examined the distribution of VV in association with co-existing intracranial atherosclerosis. Methods We obtained cerebral artery specimens from 32 consecutive autopsies of subjects aged 45 years or above. We scrutinized middle cerebral artery (MCA), vertebral artery (VA), and basilar artery (BA) for the presence of adventitial VV. We described the distribution of VV, and the characteristics of co-existing atherosclerotic lesions. Results Among 157 intracranial arteries, adventitial VV were present in 74 of the 157 specimens (47%), involving MCA (n=13, 18%), BA (n=14, 19%), and VA (n=47, 64%). Although qualitatively these 74 adventitial VV distributed similarly in arteries with or without atherosclerotic lesions (disease-free arteries n=4/8; arteries of pre-atherosclerosis n=17/42; and arteries of progressive atherosclerosis n=53/107), the presence of adventitial VV in intracranial VA was associated with a heavier plaque load (1.72±1.66 mm2 vs. 0.40±0.32 mm2, P<0.001), severer luminal stenosis (25%±21% vs. 12%±9%, P=0.002), higher rate of concentric lesions (79% vs. 36%, P=0.002), and denser intraplaque calcification (44% vs. 0%, P=0.003). Histologically, intracranial VA with VV had a larger diameter (3.40±0.79 mm vs. 2.34±0.58 mm, P<0.001), thicker arterial wall (0.31±0.13 mm vs. 0.23±0.06 mm, P=0.002), and a larger intima-media (0.19±0.09 mm vs. 0.13± 0.04 mm, P=0.003) than VA without VV. Conclusions Our study demonstrated the distribution of adventitial VV within brain vasculature and association between vertebral VV and progressive atherosclerotic lesions with a heavier plaque load and denser intraplaque calcification.

Intracranial Artery Calcifcation and Its Clinical Signifcance

Xiaohong Wu,Xiang-Yan Chen,Li Juan Wang,Ka Sing Wong 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.3

Intracranial arterial calcifcation (IAC) is an easily identifable entity on plain head computed tomography scans. Recent studies have found high prevalence rates for IAC worldwide, and this may be associated with ischemic stroke and cognitive decline. Aging, traditional cardiovascular risk factors, and chronic kidney disease have been found to be associated with IAC. Te severity of IAC can be assessed using diferent visual grading scales or various quantitative methods (by measuring volume or intensity). An objective method for assessing IAC using consistent criteria is urgently required to facilitate comparisons between multiple studies involving diverse populations. Tere is accumulating evidence from clinical studies that IAC could be utilized as an indicator of intracranial atherosclerosis. However, the pathophysiology underlying the potential correlation between IAC and ischemic stroke—through direct arterial stenosis or plaque stability—remains to be determined. More well-designed clinical studies are needed to explore the predictive values of IAC in vascular events and the underlying pathophysiological mechanisms.

External Counterpulsation Reduces Beat-to-Beat Blood Pressure Variability When Augmenting Blood Pressure and Cerebral Blood Flow in Ischemic Stroke

Ge Tian,Li Xiong,Wenhua Lin,Jinghao Han,Xiang-Yan Chen,Thomas Wai Hong Leung,Yannie Oi Yan Soo,Lawrence Ka Sing Wong 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.3

Background and PurposezzExternal counterpulsation (ECP) is a noninvasive method used to enhance cerebral perfusion by elevating the blood pressure in ischemic stroke. However, the response of the beat-to-beat blood pressure variability (BPV) in ischemic stroke patients during ECP remains unknown. MethodszzWe enrolled recent ischemic stroke patients and healthy controls. Changes in the blood fow velocities in bilateral middle cerebral arteries and the continuous beat-to-beat blood pressure before, during, and afer ECP were monitored. Power spectral analysis revealed that the BPV included oscillations at very low frequency (VLF; <0.04 Hz), low frequency (LF; 0.04– 0.15 Hz), and high frequency (HF; 0.15–0.40 Hz), and the total power spectral density (TP; <0.40 Hz) and LF/HF ratio were calculated. ResultszzWe found that ECP signifcantly increased the systolic and diastolic blood pressures in both stroke patients and controls. ECP decreased markedly the systolic and diastolic BPVs at VLF and LF and the TP, and the diastolic BPV at HF when compared with baseline. Te decreases in diastolic and systolic BPV reached 37.56% and 23.20%, respectively, at VLF, 21.15% and 12.19% at LF, 8.76% and 16.59% at HF, and 31.92% and 23.62% for the total TP in stroke patients, which did not difer from those in healthy controls. Te change in fow velocity on the contralateral side was positively correlated with the total TP systolic BPV change induced by ECP (r=0.312, p=0.035). ConclusionszzECP reduces the beat-to-beat BPV when increasing the blood pressure and cerebral blood fow velocity in ischemic stroke patients. ECP might be able to improve the clinical outcome by decreasing the beat-to-beat BPV in stroke patients, and this should be explored further in future studies.