No description available.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Objective The goal of this study is to report on the linguistic validation and reliability of the Hong Kong Chinese version of the Pediatric Quality of Life Inventory™ (PedsQL™) End-stage Renal Disease Module for Children with end-stage renal disease (ESRD) in Hong Kong, and its use to assess health-related quality of life (HRQOL) in end-stage renal disease children receiving different treatment modalities: peritoneal dialysis, haemodialysis and renal transplantation. Methods In part 1, forward and backward translations following a stringent validation protocol produced the Chinese translation version. Content validity of the translated instrument was assessed. In part 2, internal consistency and reliability of the questionnaire was evaluated by 38 pairs of parents and children with end-stage renal disease aged 5 to 18. The data was further analysed according to different treatment modalities. Results The translated Hong Kong Chinese version of the Pediatric Quality of Life Inventory ™ (PedsQL™) End-stage Renal Disease Module (PedsQL™ 3.0 ESRD Module-HKC) was found to have good content validity and was acceptable to most patients and parents. Internal consistency was excellent (Cronbach’s α = 0.91 in Patient version and = 0.94 in Parent version). Test-retest reliability, determined with the intraclass correlation coefficients, was excellent (0.89 in Patient version and 0.93 in Parent version). It was found that there was significant better HRQOL in patient received renal transplantation compared with Dialysis (peritoneal dialysis or haemodialysis, p=0.006.) Conclusions This study suggested good content validity, internal consistency, and reliability of the Chinese version of the Pediatric Quality of Life Inventory ™ (PedsQL™) End-stage Renal Disease Module (PedsQL™ 3.0 ESRD Module-HKC). It opened a new dimension of health care assessment for end-stage renal disease children in Hong Kong. Transplantation was reported to have a significant better quality of life score. Further studies with larger samples should be performed to confirm the psychometric properties of this translated instrument. / published_or_final_version / Public Health / Master / Master of Public Health

No description available.

published_or_final_version / Medicine / Master / Doctor of Medicine

Cimetidine is a histamine H2-receptor antagonist that is among the most widely prescribed drugs in the world. In addition to its inhibitory action on gastric acid secretion, a possible role in kidney tubulointerstitial disease has been suggested. Isolated reports have also suggested an association between cimetidine administration and acute interstitial nephritis. The present study examined the effect of cimetidine on renal function in the rat. The nine rats used in this study had normal renal function and urinalyses before treatment with cimetidine. The cimetidine treated rats then developed a clinical picture of weakness, hematuria, proteinuria, casturia, oliguria, and increases in serum blood urea nitrogen and creatinine.Following the 6 weeks treatment period, all rats were sacrificed and their kidneys prepared for microscopic study. Histologically, the patchy, intense tubulointerstitial infiltration of lymphocytes, plasma cells, and other cells observed in the cortex of the rat kidneys is quite similar to findings described in human cases of drug-induce hypersensitivity tubulointerstitial disease. In addition, other pathologic conditions which can cause tubulointerstitial disease were adequately ruled out. Specifically, bacterial pyelonephritis was excluded as a result of the consistently sterile urine test. In conclusion, the author feels that the clinical, aboratory, and histologic findings in this study strongly suggests an association between of tubulointerstitial disease and the use of cimetidine. / Department of Physiology and Health Science

No description available.

No description available.

Precision medicine involves a personalized approach to healthcare acknowledging an individual-to-individual variability in genetics, environment, and lifestyle. Research in precision medicine can be pulled from basic, clinical or epidemiological sciences from which imaging, omics, or other types of data can be mined to contribute to the ‘information commons’ from which patient-specific patterns are drawn. Advancement in basic sciences that focus on imaging and other high content information processing for precision medicine is of particular importance in fields like oncology and nephrology where, diseases like focal segmented glomerular sclerosis have neither seen drug development in the past two decades, nor have an affirmative treatment plan. One reason is the lack of high-content high-throughput platforms for drug testing with a physiologically appropriate microenvironment. This work aims to build a high-content platform for podocyte-based drug discovery. Having demonstrated that cells in patterns demonstrate a phenotypic change representative of the in vivo condition, we first start by building a robust 96-well plate with our microfabricated platform as its base. We demonstrate a relevant increase in expression of podocyte specific proteins like synaptopodin in our patterned podocytes along with a decrease in cell-to-cell variability when compared with their unpatterned counterparts. Next, we demonstrate the use of our platform as a tool for drug discovery by showing that we achieve a reproducible actin-based dose response curve using human podocyte cell lines, something that has never been done to our knowledge. We see that our platform pushes immortalized podocytes towards cell cycle arrest at a much earlier timepoint during differentiation with improved functional performance metrics, such as lower motility and increased cytoskeletal segregation. We show that our platform may be able to extend its versatility by synergizing the effects of substrate shape and stiffness, and we show a potential application in studying the effect of this platform on the expression of Yes associated protein (YAP). We demonstrate the flexibility of this platform using another case study, this time with cancer cells. It is well known that the progression of neoplastic cells to metastasis is a major contributing factor to poor prognosis. The metastatic cascade involves invasion and migration coupled by angiogenesis and intravasation. The subsequent cells that survive circulation and attach to the endothelium extravasate and colonize in a distal location. Current techniques, such as Transwell and scratch assays that attempt to quantify metastatic potential are difficult to scale and consequently may be challenging to use in large-scale drug testing. We show that using our platform, we are able to rapidly quantify the metastatic potential of cancer cells in situ with high sensitivity, independent of cell seeding density. By changing the dimensions of our microfabricated patterns, we are able to vary the mechanical resistance that the cell experiences traversing and use this to mimic cell invasion across different microenvironments. Importantly, we show that we can quantify the effect of the metastatic potential in response to a pharmacological intervention and thus demonstrate that we can use this platform for drug testing. In conclusion, we present a novel multifaceted platform and demonstrate its versatility with two different applications. In the context of drug discovery, we show that the platform serves as a superior model for podocyte injury. The reproducible Puromycin aminonucleocide (PAN) actin-based dose response curves obtained using this platform, opens avenues to investigate the effect of various targeted therapies for podocyte-based kidney diseases. In the context of screening for metastatic potential of cancer cells, we show that our platform exhibits a superior sensitivity to existing screening techniques. Additionally, the potential of using a patient’s own cells in the future for either application presents exciting avenues for precision medicine.

published_or_final_version / Medicine / Master / Doctor of Medicine