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Since the early 1990s, the laparoscopic technique has been increasingly used for the treatment of perforated peptic ulcer. It is important to validate a risk scoring system that can stratify patients into various risk groups before comparing the treatment outcome of laparoscopic repair against that of conventional open surgery. The scoring system should be able to predict the likelihood of mortality and morbidity. Boey score and APACHE II (Acute Physiology and Chronic Health Evaluation II) score may be of use in patient stratification.Design: Retrospective review of relevant case notes by one reviewer.Setting: A teaching hospital treating 0.5 million to 1 million patients during the study period.

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Purpose: Colorectal cancer is an important cause of cancer deaths. Here, we focused our investigation on the ␤-catenin gene which is implicated in colorectal carcinogenesis and tested whether ␤-catenin mRNA is detectable in the plasma of colorectal carcinoma and adenoma patients using quantitative reverse transcriptase-PCR.Experimental Design: Plasma ␤-catenin mRNA was measured from 58 colorectal carcinoma patients, 49 colorectal adenoma patients, and 43 apparently normal subjects using intron-spanning primers and Taqman probes. Five clinicopathological parameters were studied and correlated with plasma ␤-catenin mRNA concentration. Additionally, 19 colorectal carcinoma patients after tumor removal were also recruited for plasma ␤-catenin mRNA measurement to further demonstrate the clinical usefulness of this test.Results: ␤-catenin mRNA was detected with median concentrations of 8737 (range: 1480 -933,100), 1218 (range: 541-2,254) and 291 (range: 0 -1,366) copies/ml plasma in colorectal carcinoma, colorectal adenoma, and apparently normal subjects, respectively. Statistical analysis demonstrated that plasma ␤-catenin mRNA concentration was correlated to tumor stage but not sex, age, lymph node status, and degree in differentiation. Moreover, plasma ␤-catenin mRNA concentration decreased significantly after tumor removal in 16 of 19 (84%) colorectal carcinoma patients. Conclusions:We conclude that plasma ␤-catenin mRNA may potentially serve as a marker for colorectal cancer.

The relations among maternal concern and restrictiveness, self-evaluated academic competence, and life satisfaction were explored in a short-term longitudinal study of 346 7th-grade students (126 males and 220 females) in Hong Kong. The authors found that perceived maternal concern, academic competence, and life satisfaction significantly declined from the beginning to the end of the 7th grade. Mothers viewed themselves as higher in parental concern than adolescents viewed them. Structural equation modeling found that adolescents’ perceived maternal concerns and academic competences significantly predicted life satisfaction over time, whereas perceived maternal restrictiveness did not. The data support the importance of perceived maternal concern and academic competence in predicting early adolescent life satisfaction.

Findings suggested that the transition to motherhood is a period of stress that may either precipitate or exacerbate disordered eating.

Objective To explore men's psychological reaction and its evolutionary course over 1 year after miscarriage, to compare this reaction with that of their female partners and to investigate the possible correlation of psychological states between partners.Design Prospective 1-year longitudinal observational study.Setting A university-affiliated tertiary referral hospital in Hong Kong.Sample Eighty-three miscarrying couples.Methods The psychological reactions of miscarrying women and their male partners were assessed immediately and at 3, 6 and 12 months after miscarriage.Main outcome measures Psychological outcomes were assessed using the 12-item General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI).Results A substantial proportion of men (43.4%) scored high in GHQ-12 and 16.9% scored high in BDI immediately after miscarriage. In men, both psychometric scores decreased sharply within the first 3 months and reached a plateau. When compared with women, men scored significantly lower in GHQ-12 and BDI during the 1-year course after miscarriage. A planned pregnancy was a significant risk factor (P = 0.008) associated with an initial high BDI score in men. There was a significant positive correlation between couples in both GHQ-12 and BDI scores throughout the longitudinal course.Conclusions Although the psychological impact of miscarriage on men was less enduring when compared with that on women, a significant proportion of men demonstrated psychological distress after miscarriage. The significant positive correlation in a couple's psychological reaction indicated that psychological morbidity was not confined only to a woman's own experience, but also affected her relationship with her male partner.

Without substantial differences in the clinical and psychological impact between different treatment modalities, a more conservative approach with expectant management for miscarriage may be an option for women.