Densities and abundances of hot cometary ions in the coma of P/Halley

On its flight by P/Halley, the Giotto spacecraft carried a High Energy Range Spectrometer (HERS) for measuring the properties of cometary ions picked up by the solar wind in the nearly collisionless regions of the coma. Preliminary estimates of the ion densities observed by HERS were reevaluated and extended; density profiles along the Giotto trajectory are presented for 13 values of ion mass/charge. Comparison with the physical-chemical model of the interaction of sunlight and the solar wind with the comet by other researchers reveals that, with the exception of protons and H2(+), all ion densities were at least an order of magnitude higher than predicted. The high ion densities cannot be explained on the basis of compression of the plasma, but require additional or stronger ionization mechanisms. Ratios of the densities of different ion species reveal an overabundance of carbonaceous material and an underabundance of H2(+) compared to the predictions of the Schmidt. While the densities of solar wind ions (H(+) and He(++)) changed sharply across a magnetic discontinuity located 1.35(10)(exp 5) km from the comet, this feature, which has been called both the 'cometopause' and the 'magnetic pileup boundary' was barely distinguishable in the density profiles of hot cometary ions. This result is consistent with the interpretation that the magnetic pileup boundary detected by Giotto was caused by a discontinuity in the solar wind and is not an intrinsic feature of the interaction of the solar wind with an active comet

Mallampati score is a good and independent predictive factor for obstructive sleep apnoea (OSA)

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Review article: Mycobacterium marinum infection of the hand and wrist.

Misdiagnosis and delayed treatment of Mycobacterium marinum infection is common because of its diverse manifestations. This leads to inappropriate use of antimicrobials, extension of the infection from the skin to the tenosynovium, and a poor prognosis (loss of tendons and prolonged immobilisation, secondary to multiple debridements and joint contractures). Clinicians should be aware of this type of infection, especially in subjects at risk (fishermen and aquarium enthusiasts), and those with a history of trauma coupled with exposure to water or marine life. A proactive approach to obtain a biopsy for histopathological and microbiological diagnosis is advised. Anti-mycobacterial treatment should be started promptly. The combined use of rifampicin, ethambutol, and clarithromycin appears to be effective, and debridement is indicated in patients with deep-seated infections.published_or_final_versio

Efficacy and side effects of an oral appliance in the treatment of mild and moderate obstructive sleep apnoea in Chinese subjects

Conference Theme: Challenges to specialists in the 21st centurypublished_or_final_versio

Lymphangioleimyomatosis: the Hong Kong experience

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Mycobacterium marinum infection of the hand and wrist

PURPOSE: To review records of 166 patients who underwent treatment for Mycobacterium marinum tenosynovitis of the hand and wrist to identify factors associated with functional outcome. METHODS: Records of 97 men and 69 women aged 13 to 85 (mean, 50) years who underwent treatment for suspected M marinum tenosynovitis of the hand and wrist were retrospectively reviewed. All underwent open biopsy; synovectomy was performed when florid synovitis was present. Rifampicin and ethambutol were usually prescribed. Clarithromycin, minocycline and/or levofloxacin were used as adjuvants if there was drug intolerance, allergy, or relapse. The duration of antibiotic treatment depended on the clinical recovery. Patients were followed up for one year after completion of drug treatment. Functional outcome was considered excellent for those with >195 masculine total active motion (TAM) and >75% return of motion, good for those with 130 masculine to 195 masculine TAM and 50 to 75% return of motion, fair for those with 65 masculine to 129 masculine TAM and 25 to 49% return of motion, and poor for those with2 months after injury (27% [21/79] vs. 9% [7/77], p=0.004, Pearson Chi squared test), and have undergone synovectomy (23% [28/124]) vs. 0% [0/32], p=0.001, Fisher's exact test). Worse functional outcome correlated with late presentation (r=0.218) and the greater number of debridement procedures (r=0.453). CONCLUSION: Delayed antibiotic treatment of M marinum infections and steroid injections were associated with unsatisfactory outcome. Clinicians must have a high index of suspicion for this condition and avoid inappropriate management such as intralesional steroid injections. Public awareness to this condition should be raised.published_or_final_versio

Occupational repetitive strain injuries in Hong Kong

OBJECTIVE: To review currently available evidence on the epidemiology and management of occupational repetitive strain injuries with particular reference to Hong Kong. DATA SOURCES AND STUDY SELECTION: Medline, PubMed and Cochrane Library searches of local and internationally published English journals from 1990 to 2007 regarding repetitive strain injuries. DATA EXTRACTION: All articles involving occupational repetitive strain injuries in Hong Kong were included in this review. DATA SYNTHESIS: There were 16 articles contributing data on the impact of repetitive strain injuries both in Hong Kong and around the world. There were seven articles dealing with the problem of computer station set-ups and methods for improving the workstation environments. CONCLUSION: Currently there were significant data on the impact of repetitive strain injuries in Hong Kong. The data took the form of compensation claims, days away from work, and cost of medical consultations. Other articles described proper workplace adjustments to help prevent repetitive strain injuries. However, there were no figures in the current literature showing the impact of these adjustments in reducing the incidence of repetitive strain injuries. More research could help to delineate the relationship between different types of interventions and occupational repetitive strain injuries.published_or_final_versio

The combined use of gemcitabine and ifosfamide in patients with Stage III or IV non-small cell lung cancer (NSCLC)

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一個患有重度地中海型貧血病人因克雷白氏肺炎菌引發壞死性筋膜炎

We present a case of Klebsiella pneumoniae necrotizing fasciitis in a patient with thalassaemia major. Klebsiella sp. is known to cause severe infections in patients with thalassaemia, with high mortality rates. © 2011. 我們敍述一個患有重度地中海型貧血病人因克雷白氏肺炎菌引發壞死性筋膜炎的病例。克雷白氏菌屬已知會對地中海型貧血的病人造成嚴重的感染並有很高的死亡率。published_or_final_versio