Loh Shwu Chun. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves [109]-120). / Abstracts in English and Chinese; appendix also in Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract (in Chinese) --- p.iv / List of Abbreviations --- p.v / List of Tables --- p.vii / List of Figures --- p.ix / Table of Contents / Chapter Chapter One: --- Introduction and Study Objectives / Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- Definition and diagnostic criteria of the metabolic syndrome --- p.2 / Chapter 1.2 --- Clinical states of the metabolic syndrome --- p.5 / Chapter 1.2.1 --- Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG) --- p.6 / Chapter 1.2.2 --- The metabolic syndrome and type 2 diabetes mellitus --- p.7 / Chapter 1.2.3 --- Dyslipidaemia --- p.8 / Chapter 1.2.4 --- Hypertension --- p.10 / Chapter 1.2.5 --- Obesity --- p.11 / Chapter 1.3 --- Effects of weight loss on the metabolic syndrome --- p.13 / Chapter 1.4 --- Ethnic differences in the prevalence of the metabolic syndrome --- p.15 / Chapter 1.5 --- Treatment of the metabolic syndrome --- p.16 / Chapter 1.6 --- Oral Hypoglycaemic agents and their failure in the metabolic syndrome --- p.17 / Chapter 1.6.1 --- Sulphonylureas --- p.17 / Chapter 1.6.2 --- Biguanides --- p.18 / Chapter 1.6.3 --- Alpha-glucosidase Inhibitors --- p.20 / Chapter 1.6.4 --- Peroxisome Proliferator-Activated Receptors (PPARs) --- p.21 / Chapter 1.6.4.1 --- Thiazolinedinediones --- p.22 / Chapter 1.6.4.1.1 --- Rosiglitazone --- p.24 / Chapter 1.6.4.1.1.1 --- Mode of Action --- p.24 / Chapter 1.6.4.1.1.2 --- Adverse events and current status --- p.26 / Chapter 1.7 --- Orlistat --- p.27 / Chapter 1.7.1 --- Mode of Action --- p.28 / Chapter 1.7.2 --- Adverse events and current status --- p.28 / Chapter 1.7.3 --- Therapeutic Potential in the Metabolic Syndrome --- p.29 / Chapter 1.8 --- Study Hypothesis --- p.30 / Chapter 1.9 --- Study Objectives --- p.30 / Chapter Chapter Two: --- Research Design and Methods / Chapter 2 --- Study Protocol --- p.31 / Chapter 2.1 --- Overall Design --- p.31 / Chapter 2.1.1 --- Patients Selection Criteria --- p.31 / Chapter 2.1.1.1 --- Inclusion Criteria --- p.31 / Chapter 2.1.1.2 --- Exclusion Criteria --- p.33 / Chapter 2.1.2 --- Recruitment Period --- p.34 / Chapter 2.1.2.1 --- Screening Period --- p.34 / Chapter 2.1.2.2 --- Run- In Period (Visit 0) --- p.35 / Chapter 2.1.2.3 --- Randomisation --- p.35 / Chapter 2.1.2.4 --- Evaluation Periods (Visit 2 to 4) --- p.37 / Chapter 2.2 --- Investigations --- p.37 / Chapter 2.2.1 --- Oral Glucose Tolerance Test (OGTT) --- p.38 / Chapter 2.2.2 --- Anthropometric measurements --- p.38 / Chapter 2.3 --- Analytical Methods --- p.39 / Chapter 2.3.1 --- Determinations of insulin levels in plasma samples --- p.39 / Chapter 2.3.1.1 --- Principle of the Insulin assay --- p.40 / Chapter 2.3.2 --- Determinations of glucose concentrations in samples --- p.42 / Chapter 2.3.2.1. --- Principle of the glucose assay --- p.42 / Chapter 2.4 --- Calculations --- p.43 / Chapter 2.4.1 --- Insulin (hepatic) sensitivity (HOMA) --- p.43 / Chapter 2.4.2 --- Area Under the Curves --- p.44 / Chapter 2.4.3 --- Sample Size Calculations --- p.45 / Chapter 2.5 --- Statistical Analysis --- p.46 / Chapter Chapter Three: --- Results / Chapter 3.1 --- Study Population --- p.48 / Chapter 3.2 --- Randomisation --- p.49 / Chapter 3.3 --- Study Results --- p.50 / Chapter 3.3.1 --- Indices of Glycaemic Control --- p.54 / Chapter 3.3.1.1 --- HbAlc --- p.54 / Chapter 3.3.1.2 --- Fasting Plasma Glucose --- p.58 / Chapter 3.3.1.3 --- Fasting Insulin --- p.58 / Chapter 3.3.1.4 --- 75g Oral Glucose Tolerance Test --- p.59 / Chapter 3.3.1.4.1 --- Glucose --- p.59 / Chapter 3.3.1.4.1.1 --- 2hr-Glucose --- p.61 / Chapter 3.3.1.4.1.2 --- GlucoseAuc --- p.62 / Chapter 3.3.1.4.2 --- Insulin --- p.63 / Chapter 3.3.1.4.2.1 --- 2-hr insulin --- p.63 / Chapter 3.3.1.4.2.2 --- InsulinAuc --- p.65 / Chapter 3.3.1.5 --- HOMA score --- p.67 / Chapter 3.3.2 --- Clinical Determinants --- p.69 / Chapter 3.3.2.1 --- Lipid Profiles --- p.69 / Chapter 3.3.2.1.1. --- Total Cholesterol --- p.69 / Chapter 3.3.2.1.2 --- HDL-Cholesterol --- p.70 / Chapter 3.3.2.1.3 --- LDL-Cholesterol --- p.71 / Chapter 3.3.2.1.4 --- Triglycerides --- p.72 / Chapter 3.3.2.2 --- Anthropometric Evaluations --- p.74 / Chapter 3.3.2.2.1 --- Body Weight --- p.74 / Chapter 3.3.2.2.2 --- Waist Circumference Difference --- p.75 / Chapter 3.3.2.2.3 --- Hip --- p.76 / Chapter 3.3.2.2.4 --- Body Fat --- p.78 / Chapter 3.3.2.2.5 --- BMI --- p.78 / Chapter 3.3.2.3 --- Blood Pressure --- p.79 / Chapter 3.3.2.4 --- RCCA and LCCA --- p.79 / Chapter 3.3.2.5 --- Other outstanding measurements --- p.82 / Chapter 3.4 --- Side Effects experienced --- p.82 / Chapter Chapter Four: --- Discussion and Conclusion / Chapter 4.1 --- Summary of the results --- p.83 / Chapter 4.1.1 --- Effects of Diet and Lifestyle Changes --- p.83 / Chapter 4.1.2 --- Effects of Orlistat --- p.84 / Chapter 4.1.3 --- Effects of Rosiglitazone --- p.35 / Chapter 4.2 --- Implications for therapy --- p.86 / Chapter 4.2.1 --- Management of metabolic syndrome --- p.87 / Chapter 4.2.2 --- Early Diagnosis --- p.88 / Chapter 4.2.3 --- Lifestyle Modification --- p.89 / Chapter 4.2.4 --- Pharmacological Targets --- p.92 / Chapter 4.2.4.1 --- Statins --- p.92 / Chapter 4.2.4.2 --- Fibrates --- p.93 / Chapter 4.2.4.3 --- ACE Inhibitors --- p.93 / Chapter 4.2.4.4 --- Thiazolidinediones --- p.94 / Chapter 4.2.4.4.1 --- Economic Evaluations of Thiazolidinediones --- p.97 / Chapter 4.2.4.5 --- Orlistat --- p.98 / Chapter 4.2.4.5.1 --- Economic Evaluations of Orlistat --- p.102 / Chapter 4.3 --- Limitations of the study --- p.104 / Chapter 4.3.1 --- Small sample size --- p.104 / Chapter 4.3.2 --- Short period of study --- p.105 / Chapter 4.3.3 --- Adherence to lifestyle modifications --- p.105 / Chapter 4.3.4 --- Analytical assays --- p.106 / Chapter 4.3.5 --- Follow up end of study --- p.106 / Chapter 4.3.6 --- Ultrasound measurement of the common carotid arteries --- p.106 / Chapter 4.3.7 --- Availability of thiazolinediones --- p.107 / Chapter 4.4 --- Conclusion and Implications for future studies --- p.107 / References --- p.110 / Appendix I --- p.121 / Appendix II --- p.122 / Appendix III --- p.125

Aim: Cisplatin is the first platinum drug that shows promising anti-tumor effect clinically. Oxaliplatin, a third-generation platinum drug that incorporates a diaminocyclohexane (DACH) structural entity, can overcome cisplatin resistance. R,R-5, a novel platinum compound that integrates the DACH entity with a demethylcantharidin (DMC) component that is derived from a traditional Chinese medicine (TCM) , can also overcome cisplatin resistance. The principal objectives of this study was to investigate in detail, the effect of these compounds at the antephase and G2 checkpoints of the cell cycle, and to establish the relationship (if any) between different structural entities with checkpoint activation. The ultimate aim of the study was to ascertain the potential for the development of novel checkpoint abrogators as anti-tumor agents. / Background: A common procedure in current cancer chemotherapy is to induce genomic stress in cancer cells, leading to irreparable DNA damage and eventually cell death. However, there are several DNA repair mechanisms in cancer cells to maintain genomic stability, which require cell cycle checkpoints to stop cell proliferation for DNA damage repair, thereby avoiding errors in cellular events like DNA replication, transcription and mitosis. Among these cell cycle checkpoints, antephase and G2 checkpoints are two gate checkpoints for mitosis. Abrogation of G2 checkpoint has been reported to give rise to synergistic cytotoxic effect with DNA damaging agents, representing a means of circumventing drug resistance in chemotherapy. / Conclusions: Acute stress to cisplatin can activate the MMR/c-Abl/MEKK1/p38MAPK pathway, leading to the activation of antephase checkpoint, and stop cells from entering mitosis immediately. DACH-containing platinum compound oxaliplatin fails to activate this antephase checkpoint. However, both cisplatin and oxaliplatin can activate the G2 checkpoint, which can be abrogated by DMC. In contrast, RR-5 can bypass both the antephase and G2 checkpoints. In summary, novel TCM-platinum compound R,R-5 can bypass mitotic DNA damage checkpoints in cancer cells and thus has the potential for further development as an anti-cancer drug. / Methods: Microarray analysis was used to detect gene transcription profiles after drug treatments. The activation of mitotic checkpoints was inspected by counting mitotic cells and utilizing flow cytometry. Using Western blotting, the activation of certain key players in the antephase and G2 checkpoint was revealed. MTT assays were performed to show the outcome of checkpoint activation. / Results: In HCT116 cells, 35 genes that facilitate G2/M transition were found to be up-regulated after R,R-5 treatment compared with oxaliplatin in the microarray analysis, implying the bypass of mitotic checkpoints by R,R-5 rather than oxaliplatin. Acute stress (2 hour) of cisplatin activated the antephase checkpoint, resulting in a rapid decrease in mitotic index and phosphorylation of histone H1, which avoided mitotic catastrophe and promoted cell survival in HeLa cells. Further experiments demonstrated that this antephase checkpoint could be abrogated by c-Abl and p38MAPK inhibitors, or siRNAs against c-Abl or MEKK1, suggesting that this checkpoint may be controlled by an MMR/c-Abl/MEKK1/p38MAPK pathway. In contrast, oxaliplatin and R,R-5 did not activate this antephase checkpoint. Moreover, after 24 hour oxaliplatin treatment in HeLa cells, the mitotic index and CDK1 activity were decreased, which could be restored by concomitant treatment with ATM/ATR inhibitor and DMC. This indicated the activation of G2 checkpoint by oxaliplatin and implied that DMC can abrogate oxaliplatin-activated G2 checkpoint by restoring CDK1 activity. Cisplatin could also activate G2 checkpoint, whereas R,R-5 apparently bypassed this G2 checkpoint. / Guan, Huaji. / Adviser: Vincent Hon Leung Lee. / Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 212-249). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Both mRNA and protein expression levels of P-glycoprotein, one of the major factors involved in drug resistance, was decreased in Pa-treated R-HepG2 cells. The chemo-sensitivity of these MDR cells towards doxorubicin would be enhanced by pretreatment of Pa. / In the study, 35 TCMs with historical background in treating liver diseases were screened. S. barbata was chosen for intensive studies based on its significant anti-hepatoma activity. Using bioassay-guided purification approach, an active component, pheophorbide a (Pa) - a chlorophyll derivative, was isolated from Scutellaria barbata. / Motivated by the severe health hazards worldwide caused by liver cancer, and the pronounced side effects of some recent anti-hepatoma agents in clinical treatment, we have initiated a research project in screening safe and effective agents from Traditional Chinese Medicine (TCM) for the treatment of hepatoma. The main objective of this research is to define the in vitro and in vivo anti-proliferative activities and to identify the action mechanisms of a TCM, the aerial part of Scutellaria barbata , in human hepatoma cells (HepG2 and Hep3B cells). / Pa exhibited anti-proliferative effects on HepG2 and Hep3B cells, through cell-cycle arrest and apoptosis, with IC50 values being 12.5 and 25.7 muM respectively. However, Pa produced insignificant cytotoxic effect on WRL-68 cells, a normal hepatic cell line. Pa also caused cell death in R-HepG2 cells, a multi-drug resistant (MDR) cell line developed from HepG2 cells. Microarray analysis indicated that a hypothetical protein FLJ10803 was found to be down-regulated upon the treatment of Pa on HepG2 cells. The sub-cellular localization of FLJ10803 was demonstrated by over-expression of the GFP fusion protein in HepG2 cells. / The anti-tumor effects of Pa could be enhanced by photodynamic therapy (PDT) approach, presumably due to the rapid generation of reactive oxygen species in the drug-binding site. Pa-PDT showed potent cytotoxicity on hepatoma cell lines, HepG2 and Hep3B, with IC50 values being 0.4 and 1.5 muM, respectively. The antitumor effects were confirmed by studies using animal model, where Pa treatment (300mug/kg/day, s.c.) could significantly inhibit the growth of Hep3B cells in nude mice after PDT treatment in vivo. Fluorescent imaging showed that Pa was located at the mitochondria, and the induction of cell death was found to be initiated by the mitochondrial dependent apoptotic pathway. Results of 2D-gel analysis suggested that Pa-PDT activated an immune-marker expression pathway that results in an over expression of HLA class I proteinsin Pa-PDT treated HepG2 cells. / To conclude, Pa may be a candidate for further development into an anti-hepatomic agent for clinical application. / Tang, Ming Kuen. / "September 2007." / Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4742. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 227-243). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Wu Xiujuan. / "May 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 294-314). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Pang Siu Kwong. / "August 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 181-191) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Chung Hoi Sing. / "August 2001." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (p. 186-204) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

by Zhao Xin. / "October 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 235-260) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Zhao Zheng. / "December 2000." / On t.p. "2" is subscript. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 187-241). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Fung Yin Lee, Annie. / "January 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 132-146). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Ma Shuang-Cheng. / "March 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 289-324). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.