Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references. Available also from UMI/Dissertation Abstracts International.

Thesis (Ph. D.)--University of Texas at Austin, 2003. / Vita. Includes bibliographical references. Available also from UMI Company.

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references (leaves 229-224). Available also in a digital version from Dissertation Abstracts.

published_or_final_version / Orthopaedics and Traumatology / Master / Master of Medical Sciences

Introduction Total hip arthroplasty is one of the most effective interventions to treat patients with end-stage hip arthritis. Although the outcomes of total hip arthroplasty have already been widely studied and most of the published results are positive, the dominant outcomes measures are focused on implant survivorship, patient mortality and complication rates. Quality of life assessment is regarded as a gold standard for outcomes measurement nowadays and was more frequently adopted in researches. However, in most of the study assessing the quality of life of patients undergoing total hip arthroplasty ignored the importance of quality of sexual life. Moreover, none of them are studying the Chinese population. In order to assess the quality of life of patients holistically, a study that focused on the quality of sexual life among Chinese population undergoing total hip arthroplasty is recommended. The aim of the present study is to investigate the changes in quality of sexual life in young Chinese patients undergoing primary total hip arthroplasty. Methodology The present study is a descriptive survey adopted a retrospective design and was conducted either as a phone interview or interview in person. 118 Patients who have undergone total hip arthroplasty at the Queen Mary Hospital are recruited from March 2012 to June 2012. Questionnaires assessing the pre-operation and post-operation sexual life and quality are administered. 118 subjects participated in the study finally. Results 118 subjects participated in the present study. 35 of them reported to have no sexual life due to reasons other than the condition of their hip and were analyzed separately. 83 of the subjects were included in the analysis of changes in sexual life. Preoperatively 50.6% of subjects reported having severe to extreme sexual difficulty. 64 (78.0%) and 16 (19.5%) subjects reported the cause of sexual difficulty to be joint pain and joint stiffness respectively. 61 (73.5%) subjects believed the condition of their hip caused some degree of distress in the relationship with their partner preoperatively. 83.2% of subjects rated their level of sexual difficulty from minimal to mild after having total hip arthroplasty. 23 (28%) and 47 (57.3%) of subjects reported their post-operation sexual life experience to be better and much better respectively. It is shown that greater joint pain (p<0.001) and stiffness (p=0.003) and lower Harris hip score (p=0.001) are significantly correlate with greater pre-total hip arthroplasty sexual difficulty, while only the range of motion of hip remained to be negatively correlated with sexual difficulty post-operatively (p=0.022). Subjects with ankylosing spondylitis are having significantly greater sexual difficulty than participants with other diagnosis post-operatively (p<0.001). None of the subjects have discussed post-total hip arthroplasty sexual life issue with the health care professional. 24 (28.9%) subjects reported their need of more sexual life related information and the most wanted information is safe position for sexual intercourse (75%). Conclusion Total hip arthroplasty can significantly improve the quality of sexual life experience of Chinese patients. Further studies are necessary to be done in order to obtain more relevant information and modify the current patient routine assessment and education. / published_or_final_version / Orthopaedics and Traumatology / Master / Master of Medical Sciences

Introduction: This study aimed to assess the outcomes and implant survivorship in Chinese patients aged 55 years or younger. Methods: We reviewed our local joint replacement registry on a total of 102 knees from 68 Chinese patients aged 55 years or below at the time of surgery. All patients were operated on from January 2000 to July 2007. The mean followup was 8.3 years (range, 5 ? 12.5 years). We included patients with osteoarthritis (70 knees), rheumatoid arthritis (24 knees), hemophilia (4 knees), psoriatic arthropathy (1 knee), post?traumatic (1 knee) and tuberculosis (2 knees). All implants were cemented. 53 were posterior cruciate ligament (PCL) sacrificing, 47 were posterior stabilized implants and 1 was constrained implant. The preoperative and latest Knee Society Knee Scores, Knee Society Functional Score, knee range of motion and lower limb mechanical alignment on long film measurement were obtained. The postoperative occurrence of radiolucent lines, complications, revision operation and deaths were noted. Each knee was analyzed separately. Results: Mean Knee Society Knee Score improved from 41 (range: 13?79, SD 12.9) to 88 (range: 30?100, SD 13.3)(p <0.0001), while the mean Knee Society Functional Score improved from 41 (range: 0?80, SD 19.2) to 69 (range 0?100, SD 26.5 ) (p<0.0001). 70% achieved a postoperative coronal mechanical axis of within 3 from neutral alignment. Implant survivorship was 97% at 5 years and 85% at 10 years. 11 knees from 9 patients had complications requiring revision surgery. Aseptic loosening occurred in 10 knees of 8 patients. Among those with aseptic loosening, 3 knees from different patients had coexisting osteolysis. Heterotopic ossification occurred in 1 knee. There were no cases of infection. Rheumatoid arthritis patients when compared with osteoarthritis patients had a more valgus preoperative lower limb alignment (p<0.001), a lower mean preoperative KSFS (30 and 45 respectively, p=0.004) and a lower mean postoperative KSFS (53 and 74 respectively, p=0.006). There were no significant differences in mean improvement of KSFS, KSKS, radiological outcomes and implant survival. There were no statistically significant differences in clinical outcomes, radiological outcomes and implant survival between PCL sacrificing and PCL substituting implants. There were no statistically significant differences between the postoperatively neutrally aligned group and the outlying group in terms of clinical outcomes, radiological outcomes and implant survival. Conclusion: Total knee arthroplasty provides good clinical and functional outcomes in young Chinese comparable to those of international standards. Careful patient selection is crucial to avoid complications. / published_or_final_version / Orthopaedics and Traumatology / Master / Master of Medical Sciences

Introduction: This retrospective comparative study was to define the validity and reliability of a translated, culturally adapted Chinese version questionnaire of the New Knee Society Knee Scoring System (NKSS). This study is aim to investigate the validity and reliability of the translated Chinese version of the NKSS and assess its feasibility of measuring the scale on Chinese patients by performing its cross-cultural adaptation for patients after Total Knee Arthroplasty (TKA) in Hong Kong. Methods: A total of 104 knees from 64 Chinese patients performed TKA were included in the study using the translated, culturally adapted Chinese version of the NKSS. All Patients were operated on from October 2010 to May 2013 at Queen Mary Hospital. Patients who participated in this study have been clinically screened and established a set of including criteria. The outpatients were evaluated by completing the five questionnaires containing the NKSS, the Knee Society Clinical Rating System (KSS), Medial Outcomes Study 36+Item Short Form (SF-36), Bristol Knee Score and Oxford Knee Score. Reliability was evaluated using the Split-half reliability, Chronbach's α coefficient and inter-item correlation. To assess validity, all patients filled in the same NKSS questionnaire, and previously validated Chinese version of the SF-36, Bristol Knee Score and Oxford Knee Score. The validity was determined with Content Validity and Contract Validity. Results: The NKSS showed ideal split-half reliability as evidenced by the high correlation coefficient (R>0.7, P<0.05). Chronbach's α coefficient for five major domains demographics, objective knee score, expectations, satisfaction and function was high (α>0.7. P<0.05). Also, the inter-item correlation was also excellent for all domains. For validity, the NKSS was found to have excellent correlation with Bristol Knee Score and Oxford Knee Score, good correlation with KSS and SF 36 Discussion: The NKSS as a validated approach is adapted to the diverse health-related quality of lives and activities of contemporary patients with TKA. Orthopaedics surgeons are allowed to appreciate differences in the priorities of individual patients and the interplay among function, expectation, symptoms, and satisfaction after TKA using this assessment instrument. Conclusion: The results of this study show that the NKSS as a functional status questionnaire has been translated into Chinese without missing any psychometric properties of the original version. This culturally and linguistics adapted Chinese version of the NKSS outcome assessment has satisfactory internal consistency and good validity. It is an adequate and helpful instrument for the evaluation of Chinese speaking patients after TKA in clinical studies. / published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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This thesis describes the total synthesis of the thiopeptide antibiotic micrococcin P1. It unambiguously elucidates its structure, which has been subject to controversy for over thirty years. The centerpiece of the route to the target molecule is a facile one-pot construction of the central thiazole/pyridine cluster developed in our laboratory. This highlyconvergent route entails a delicate Michael addition to yield a Hantzsch dihydropyridine intermediate, which undergoes further oxidation to the fully aromatised heterocycle. The synthesis was completed by the coupling of this core with a highly-modified sensitive peptide chain. The modular nature of the synthesis can also accommodate modifications for SAR studies, contributing thereby to the fields of medicinal chemistry, pharmacology, and microbiology. At a purely chemical level, we remain confident that this work will serve as a valuable guide in the elaboration of other members of the thiopeptide family.

The Neogene sediment from the Pattani Basin, Gulf of Thailand, were subjected to detailed organic geochemical study. The results suggest that the Neogene source rocks have potential for hydrocarbon generation (as shown by high TOC content). Sequences 2, 3 and part of Sequence 4 are mature and capable of producing hydrocarbons, while those from Sequence 5 are immature. The top of the oil window estimated from biomarker maturity parameters (i.e. CPI and homohopane ratios) is at approximately 6000 feet. SCI data also support this proposal. The biomarker composition and distributions of the bitumen extracts reflect the abundance of higher plant contributions with varying amount of bacterial input, in oxic to sub-oxic conditions during deposition of the sediments. A strong contribution of terrestrially derived organic matter (higher plants) is indicated by the bimodal distribution of <i>n</i>-alkanes, OEP distribution of the <i>n</i>-alkanes in the range C₂₃-C₃₃, high Pr/Ph ratios, low S%, the occurrence and abundance of several biological markers, including oleanenes, oleanane, bicadinanes, tricyclic terpanes, abnormally high C₃₁ homohopane R epimer, and high C₂₉ steranes. Abundant coals in Sequences 5 and 4 contain higher plant material, interpreted as deposited in deltaic swamp environments. Kerogen typing shows that vitrinite (Type III kerogen) is the dominant organic matter in the samples from the Pattani Basin, suggesting potential to generate gas and condensate. The other organic macerals found include cutinite and spore/pollen (Type II kerogen), amorphous (Type I/II/III kerogen) and inertinite (Type IV). In general, molecular and microscopic examination of the Neogene succession of the Pattani Basin suggests a fluvio-deltaic environment, with peat swamps in Sequence 5 and the upper part of Sequence 4. This interpretation is confirmed by pollen analysis data. The age diagnostic pollen found in a few samples from Sequence 5 suggest the time of deposition as Middle Miocene to Pliocene.