OBJECTIVE. To evaluate the relationship between age and peripapillary retinal nerve fibre layer thickness in healthy Chinese subjects.

DESIGN. Cross-sectional study.

SETTING. Regional hospital, Hong Kong.

PARTICIPANTS. Healthy volunteers (n=218) of Chinese ethnicity with spherical equivalent of -6 to +4 dioptres were recruited for study from October 2001 to March 2003. Ocular examination was carried out and measurements of peripapillary retinal nerve fibre layer thickness were performed using optical coherence tomography (Carl Zeiss Humphrey OCT 2 machine), in a circular pattern of 3.4 mm diameter, centred on the optic disc.

MAIN OUTCOME MEASURES. Mean retinal nerve fibre layer thickness and age.

RESULTS. The mean age was 40 (standard deviation, 17; range, 11-69) years. The mean peripapillary retinal nerve fibre layer thickness was 111.6 (standard deviation, 18.5; range, 52.0-155.0) micrometres. Age correlated significantly with peripapillary retinal nerve fibre layer thickness (r= -0.28, P<0.0001).

CONCLUSION. Mean peripapillary retinal nerve fibre layer thickness (based on optical coherence tomography) correlates negatively with age, which can interfere with the assessment and monitoring of glaucoma patients. An age-adjusted normogram may be necessary to interpret results.

Key words: Image processing, computer-assisted; Nerve fibers; Optic nerve; Retina; Tomography

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OBJECTIVE. To review the clinical manifestations of phaeochromocytoma in a Hong Kong Chinese population.

DESIGN. Retrospective review.

SETTING. Five public hospitals in Hong Kong.

PATIENTS. Seventeen patients with operated phaeochromocytoma between 1994 and 2003 were reviewed retrospectively.

RESULTS. Six patients (35%) were men, 11 (65%) were women. The mean age at presentation was 47 (range, 17-72) years. The diagnosis post-presentation was delayed by 1 to 132 months. Over 70% of the patients had hypertension. The most frequent symptoms were headache (53%), palpitations (53%), and sweating (41%); all these symptoms were present in 24% of the patients. Four (24%) had hereditary phaeochromocytoma/paraganglioma syndrome. The sensitivity of 24-hour urinary catecholamine measurements was 82%. Mean urinary adrenaline and noradrenaline concentrations were respectively 7- and 8-fold greater than the upper reference limits. Computed tomography and metaiodobenzylguanidine scintigraphy were the most widely used means for tumour localisation (sensitivity, 100% and 87% respectively). Approximately 65% of the patients had intra-adrenal tumours; 53% were on right side, 18% were bilateral. All the patients were prescribed phenoxybenzamine (dosage range, 20-120 mg/day) preoperatively. Two thirds of the patients had improved blood pressure 1 year after the operation. No malignancy was reported after a mean follow-up period of 7 years.

CONCLUSION. Our series of patients with phaeochromocytomas commonly had a high frequency of normotension and extra-adrenal tumours. A high index of clinical suspicion and appropriate biochemical investigations are necessary to make the diagnosis, especially for patients manifesting adrenal incidentaloma and extra-adrenal lesion.

Key words: Adrenal gland neoplasms; adrenal medulla; Catecholamines; Paraganglioma; Pheochromocytoma

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OBJECTIVE. To identify clinical markers to predict which patients with advanced colorectal cancers are likely to benefit from cetuximab-chemotherapy.

DESIGN. Retrospective review.

SETTING. Oncology unit in a university teaching hospital in Hong Kong.

PATIENTS. A total of 102 patients with metastatic colorectal cancer treated with cetuximab-chemotherapy.

MAIN OUTCOME MEASURES. Correlation of multiple potential clinical predictive factors with tumour response to cetuximab-chemotherapy.

RESULTS. The objective response rates to cetuximab plus chemotherapy were 53% in patients receiving first-line treatment and 17% in previously treated patients. The univariate analysis indicated that fewer prior lines of chemotherapy (odds ratio=0.36; 95% confidence interval, 0.21-0.63; P<0.01) and development of cetuximab-related grade 3 rash (5.52; 1.62-18.76; P<0.01) were associated with significantly higher response rates. Multivariate analysis confirmed the independent predictive value of the number of prior chemotherapy regimens (odds ratio=0.37; 95% confidence interval, 0.20-0.69; P<0.01) and grade 3 rash (4.65; 1.21-19.29; P=0.03).

CONCLUSIONS. In this cohort of Chinese patients with advanced colorectal cancer, the presence of grade 3 rash and the number of prior chemotherapy regimens were independent predictors of response to cetuximab-chemotherapy. The utility of these clinical markers in clinical practice should be further evaluated together with established biomarkers.

Key words: Antibodies, monoclonal; Colorectal neoplasms; Exanthema; Neoplasm metastasis; Receptor, epidermal growth factor

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OBJECTIVE. To evaluate the epidemiology and clinical manifestations of human immunodeficiency virus-associated tuberculosis in Hong Kong.

DESIGN. Retrospective study.

SETTING. Tuberculosis and Chest Service and Special Preventive Programme, Public Health Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region.

PATIENTS. Cases reported to the TB/HIV Registry jointly kept by the Tuberculosis and Chest Service and Special Preventive Programme from 1996 to 2006 were reviewed. The Registry includes cases of human immunodeficiency virus-associated tuberculosis diagnosed in the two services, and cases referred from regional hospitals under the Hong Kong Hospital Authority and the private sector.

RESULTS. Tuberculosis has become an increasingly important acquired immunodeficiency syndrome-defining illness in Hong Kong, and overtook Pneumocystis jiroveci pneumonia for the first time as the most common primary acquired immunodeficiency syndrome-defining illness in 2005 (accounting for 39% and 31% of all such illnesses, respectively in that year). The presentation of human immunodeficiency virus-associated tuberculosis is often atypical. In these patients moreover, there was a slightly higher rate of multidrug-resistant tuberculosis (2%) than in the general population (range, 0.7-1.5%).

CONCLUSIONS. Programmes for the provider-initiated human immunodeficiency virus testing policy to reduce diagnostic delays should continue and be enhanced. Continual surveillance of both conditions is imperative, especially in view of a possible link between human immunodeficiency virus and multidrug-resistant tuberculosis.

Key words: AIDS-related opportunistic infections; Anti-HIV agents; HIV infections; Tuberculosis, multidrug-resistant

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OBJECTIVE. To examine whether sleep hygiene-related factors are associated with sleep quality among university students.

DESIGN. Cross-sectional survey.

SETTING. A university in Hong Kong.

PARTICIPANTS. Full-time university students recruited by convenience sampling.

MAIN OUTCOME MEASURES. Responses to a sleep questionnaire containing the Pittsburgh Sleep Quality Index and obtaining sleep hygiene knowledge and practice, as well as knowledge on caffeine were used for data collection.

RESULTS. Regression analysis with stepwise selection procedure revealed that sleep hygiene practice was significantly associated with the Pittsburgh Sleep Quality Index score after adjusting for age, gender, year of study, and type of residence (b= -0.08, P<0.001).

CONCLUSIONS. Our study's results indicated that sleep hygiene practice was significantly associated with sleep quality. Appropriate measures and sleep hygiene education need to be emphasised among university students in order to increase their awareness on the importance of adopting healthy sleep hygiene practices.

Key words: Questionnaires; Sleep; Sleep deprivation; Sleep disorders; Students

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