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Steroid for chronic subdural hematoma? A prospective phase IIB pilot randomized controlled trial on the use of dexamethasone with surgical drainage for the reduction of recurrence with reoperation

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Chinese Neurosurgical Journal 2015年第1期1卷 -页

作者： david yuen chung chan Tin Fung david Sun Wai Sang Poon Division of Neurosurgery Department of Surgery Prince of Wales HospitalThe Chinese University of Hong Kong 30-32 Ngan Shing Street Shatin NTHong Kong

Background: Chronic subdural hematoma is a common neurosurgical condition especially in the aging *** hole for drainage is an effective treatment, yet recurrence is reported at 8 to 22 ％ worldwide, and 1-year mortality rates could be as high as 32 ％.Our previous study on the use of dexamethasone as a primary nonsurgical treatment showed good response in selected group of *** study aims to assess the efficacy of dexamethasone with surgical drainage in the reduction of recurrence requiring ***: From October 2000 to September 2006, patients with chronic subdural hematoma admitted to the Prince of Wales Hospital, The Chinese University of Hong Kong, were randomized to surgical drainage with steroid versus surgical drainage *** primary endpoint was symptomatic recurrence requiring ***: Two hundred forty-eight patients were recruited and consented for the randomization during the study *** hundred twenty-two received both surgery and steroid (the intervention arm) while 126 received surgery only (the control arm).The recurrence rate requiring reoperation was 6.6 ％ (8/122) and 13.5 ％ (17/126),respectively (p =0.109).There was no significant difference in complications such as chest infection (p =0.201) or wound infection (p =0.987).Favorable outcome (Glasgow Outcome Score 4-5) was 104/122 (85.2 ％) in the intervention group versus 105/126 (83.3 ％) in the control group, respectively (p =0.811).Based on the recurrence rate in our study, we generate a potential sample size of at least 594 patients (type Ⅰ error =5 ％, power =80 ％,two-sided test) to detect a significant ***, brief summary, and potential implications: In this prospective pilot phase IIB randomized controlled study, steroid with surgical drainage had a lower recurrence with reoperation though statistically *** was safe with no significant difference in complication *** pilot study generates a potential sample s

关键词： Chronic subdural hematoma Steroid Burr hole for drainage

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Chronic subdural haematoma during the COVID-19 lockdown period:late presentation with a longer interval from the initial head injury to the final presentation and diagnosis

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Chinese Neurosurgical Journal 2022年第1期8卷 31-35页

作者： david yuen chung chan Wai Sang Poon Danny Tat Ming chan Wai Kit Mak George Kwok Chu Wong Division of Neurosurgery Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongPrince of Wales HospitalHong Kong SARChina

Background:The COVID-19 novel coronavirus is contagious,and the mortality is higher in the elderly *** in different parts of the world has been imposed since January *** subdural haematoma (cSDH) has a unique natural history in which symptoms can be non-specific,and the onset is *** study aims to evaluate the impact of the COVID-19 pandemic on the presentation of ***:Consecutive adult cSDH patients admitted from 1 March 2020 to 30 April 2020 were *** criteria including those who had no definite history of head injury or the diagnosis of cSDH were made from a scheduled follow-up *** data during the same period in 2019 were reviewed for *** primary outcome was the interval between the initial head injury and the final radiological diagnosis of *** outcomes include Markwalder chronic subdural haematoma grade upon admission,length of stay in the acute hospital,and the modified Rankin scale (mRS) upon ***:For the primary outcome,the average interval between head injury and the diagnosis of cSDH was significantly longer at 56.6 days (49 to 74 days,SD 9.83 days) during the period from March to April 2020,versus 29.4 days (17 to 42 days,SD 8.59 days) in 2019 for the corresponding period (p = 0.00703).There was no significant difference in the functional outcome upon ***:cSDH patients can present late during the COVID-19 lockdown *** functional outcome was comparable when operations for drainage were timely performed.

关键词： Chronic subdural haematoma Novel coronavirus COVID-19 Head injury

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ABC/2 formula for"bedside"postoperative pneumocephalus volume measurement

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Chinese Neurosurgical Journal 2022年第4期8卷 284-291页

作者： david yuen chung chan Eric Yuk Hong Cheung Ka Ho Hui Cecelia Mei Sze Leung Stephanie Chi Ping Ng Wai Kit Mak George Kwok Chu Wong Tat Ming Danny chan Wai Sang Poon Division of Neurosurgery Department of SurgeryFaculty of MedicinePrince of Wales HospitalThe Chinese University of Hong KongHong KongSARChina

Background:Postoperative pneumocephalus is associated with a higher risk of recurrence of chronic subdural hematoma(cSDH).However,there is no verified simple way to measure the pneumocephalus volume at the bedside for daily clinical *** ABC/2 method was shown to be a simple and reliable technique to estimate volumes of intracranial lesions,such as intracranial *** study aims to evaluate the accuracy of the ABC/2 formula in estimating volumes of pneumocephalus,as compared to the gold standard with computer-assisted volumetric ***:A total of 141 postoperative computed tomographic(CT)brain scans of cSDH patients with burr-hole drainage were *** volume was measured independently by both the ABC/2 formula and the computer-assisted volumetric *** the computer-assisted measurement,the volume of the air was semiautomatically segmented and calculated by computer *** regression was used to determine the correlation between the ABC/2 method and computer-assisted ***:The postoperative pneumocephalus volume after bilateral burr-hole drainage was significantly larger than that of unilateral burr-hole drainage(29.34 ml versus 12.21 ml,p<0.001).The estimated volumes by the formula ABC/2 significantly correlated to the volumes as measured by the computer-assisted volumetric technique,with r=0.992(p<0.001).The Pearson correlation coefficient is very close to 1,which signifies a very strong positive correlation,and it is statistically ***:An excellent correlation is observed between the ABC/2 method and the computer-assisted *** study verified that the ABC/2 method is an accurate and simple"bedside"technique to estimate pneumocephalus volume.

关键词： ABC/2 Chronic subdural haematoma Burr-hole Pneumocephalus

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Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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Asian Journal of Andrology 2024年第1期26卷 20-24页

作者： John Shung-Lai Leung Wai-Kit Ma Brian Sze-Ho Ho Stacia Tsun-Tsun Chun Rong Na Yongle Zhan Chi-yuen Ng Chi-Ho Ip Ada Tsui-Lin Ng Yiu-chung Lam Division of Urology Department of SurgeryQueen Mary HospitalUniversity of Hong KongHong KongChina Division of Urology Department of SurgeryPrincess Margaret HospitalHongKongChina

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance *** with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(Queen Mary Hospital and Princess Margaret Hospital,Hong Kong,China)between January 2017 and June 2022 were ***-magnetic resonance imaging fusion biopsies were performed after prostate health index *** who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were *** of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions *** detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index<25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P<0.01).Among the patients,26.9%could have avoided a biopsy with a prostate health index<25.0,at the expense of a 5.3%risk of missing clinically significant prostate *** health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 *** could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

关键词： biopsy fusion biopsy magnetic resonance imaging prostate cancer prostate health index

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Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

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Asian Journal of Urology 2024年第1期11卷 55-64页

作者： Bryan Kwun-chung Cheng Steffi Kar-Kei yuen Daniele Castellani Marcelo Langer Wroclawski Hongda Zhao Mallikarjuna Chiruvella Wei-Jin Chua Ho-Yee Tiong Yiloren Tanidir Jean de la Rosette Enrique Rijo Vincent Misrai Amy Krambeck Dean S.Elterman Bhaskar K.Somani Jeremy yuen-Chun Teoh Vineet Gauhar Department of Surgery United Christian HospitalHong KongChina S.H.Ho Urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Urology University Hospital“Ospedali Riuniti”and Polytechnic University of Marche RegionAnconaItaly Hospital Israelita Albert Einstein Sao PauloSPBrazil BP—A Beneficencia Portuguesa de Sao Paulo Sao PauloSPBrazil Faculdade de Medicina do ABC Santo AndreSPBrazil Department of Urology Asian Institute of Nephrology and UrologyHyderabadTGIndia Department of Urology National University HospitalSingapore Department of Urology Marmara University School of MedicineIstanbulTurkey Department of Urology Medipol Mega University HospitalIstanbul Medipol UniversityIstanbulTurkey Department of Urology Hospital Quiron BarcelonaBarcelonaSpain Department of Urology Clinique PasteurToulouseFrance Department of Urology Indiana University School of MedicineIndianapolisINUSA Division of Urology Department of SurgeryUniversity Health NetworkUniversity of TorontoTorontoCanada Department of Urology University Hospital Southampton NHS TrustSouthamptonUK Department of Urology Ng Teng Fong General HospitalNUHSSingapore

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction ***:A 36-item survey was developed with a Delphi *** on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were *** were invited globally to complete the online *** was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative *** in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery *** on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 ***:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining ***®,Rezum®,and EEP were regarded as MIST by most urologists.

关键词： Benignprostate hyperplasia Minimalinvasive surgical therapy Surgery Bladderoutlet obstruction

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Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease

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World Journal of Hepatology 2024年第2期16卷 211-228页

作者： Lung-Yi Mak Matthew Shing Hin chung Xue Li Francisco Tsz Tsun Lai Eric Yuk Fai Wan Celine Sze Ling Chui Franco Wing Tak Cheng Esther Wai Yin chan Ching Lung Cheung Ivan Chi Ho Au Xi Xiong Wai-Kay Seto Man-Fung yuen Carlos King Ho Wong Ian Chi Kei Wong Department of Medicine The University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina Department of Pharmacology and Pharmacy The University of Hong KongHong KongChina Laboratory of Data Discovery for Health(D24H) Hong Kong Science and Technology ParkHong KongChina Department of Family Medicine and Primary Care The University of Hong KongHong KongChina School of Nursing The University of Hong KongHong KongChina School of Public Health The University of Hong KongHong KongChina Research Department of Practice and Policy University College LondonLondon WC1E 6BTUnited Kingdom Aston School of Pharmacy Aston UniversityBirmingham B47ETUnited Kingdom

BACKGROUND Chronic liver disease(CLD)was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)*** To determine the effects of SARS-CoV-2 infection on the incidence and treatment strategy of hepatocellular carcinoma(HCC)among patients with *** A retrospective,territory-wide cohort of CLD patients was identified from an electronic health database in Hong *** with confirmed SARS-CoV-2 infection[coronavirus disease 2019(COVID-19)+CLD]between January 1,2020 and October 25,2022 were identified and matched 1:1 by propensity-score with those without(COVID-19-CLD).Each patient was followed up until death,outcome event,or November 15,*** outcome was incidence of *** outcomes included all-cause mortality,adverse hepatic outcomes,and different treatment strategies to HCC(curative,non-curative treatment,and palliative care).Analyses were further stratified by acute(within 20 d)and post-acute(21 d or beyond)phases of SARS-CoV-2 *** rate ratios(IRRs)were estimated by Poisson regression *** Of 193589 CLD patients(>95%non-cirrhotic)in the cohort,55163 patients with COVID-19+CLD and 55163 patients with COVID-19-CLD were included after 1:1 propensity-score *** 249-d median follow-up,COVID-19+CLD was not associated with increased risk of incident HCC(IRR:1.19,95%CI:0.99-1.42,P=0.06),but higher risks of receiving palliative care for HCC(IRR:1.60,95%CI:1.46-1.75,P<0.001),compared to *** both acute and post-acute phases of infection,COVID-19+CLD were associated with increased risks of allcause mortality(acute:IRR:7.06,95%CI:5.78-8.63,P<0.001;post-acute:IRR:1.24,95%CI:1.14-1.36,P<0.001)and adverse hepatic outcomes(acute:IRR:1.98,95%CI:1.79-2.18,P<0.001;post-acute:IRR:1.24,95%CI:1.13-1.35,P<0.001),compared to *** Although CLD patients with SARS-CoV-2 infection were not associated with increased risk of HCC,they

关键词： SARS-CoV-2 infection Chronic liver disease Long COVID Post-COVID-19 syndrome Cirrhosis Hepatocellular carcinoma

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Ocular image-based deep learning for predicting refractive error:A systematic review

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Advances in Ophthalmology Practice and Research 2024年第3期4卷 164-172页

作者： Samantha Min Er Yew Yibing Chen Jocelyn Hui Lin Goh david Ziyou Chen Marcus Chun Jin Tan Ching-Yu Cheng Victor Teck chang Koh Yih chung Tham Department of Ophthalmology Yong Loo Lin School of MedicineNational University of SingaporeSingapore Centre for Innovation and Precision Eye Health Yong Loo Lin School of MedicineNational University of SingaporeSingapore School of Chemistry Chemical Engineeringand BiotechnologyNanyang Technological UniversitySingapore Singapore Eye Research Institute Singapore National Eye CentreSingapore Department of Ophthalmology National University HospitalSingapore Ophthalmology and Visual Sciences(Eye ACP) Duke-NUS Medical SchoolSingapore

ackground:Uncorrected refractive error is a major cause of vision impairment worldwide and its increasing prevalent necessitates effective screening and management ***,deep learning,a subset of Artificial Intelligence,has significantly advanced ophthalmological diagnostics by automating tasks that required extensive clinical *** recent studies have investigated the use of deep learning models for refractive power detection through various imaging techniques,a comprehensive systematic review on this topic is has yet be *** review aims to summarise and evaluate the performance of ocular image-based deep learning models in predicting refractive *** text:We search on three databases(PubMed,Scopus,Web of Science)up till June 2023,focusing on deep learning applications in detecting refractive error from ocular *** included studies that had reported refractive error outcomes,regardless of publication *** systematically extracted and evaluated the continuous outcomes(sphere,SE,cylinder)and categorical outcomes(myopia),ground truth measurements,ocular imaging modalities,deep learning models,and performance metrics,adhering to PRISMA *** studies were identified and categorised into three groups:retinal photo-based(n=5),OCT-based(n=1),and external ocular photo-based(n=3).For high myopia prediction,retinal photo-based models achieved AUC between 0.91 and 0.98,sensitivity levels between 85.10%and 97.80%,and specificity levels between 76.40%and 94.50%.For continuous prediction,retinal photo-based models reported MAE ranging from 0.31D to 2.19D,and R^(2) between 0.05 and *** OCT-based model achieved an AUC of 0.79–0.81,sensitivity of 82.30%and 87.20%and specificity of 61.70%–68.90%.For external ocular photo-based models,the AUC ranged from 0.91 to 0.99,sensitivity of 81.13%–84.00%and specificity of 74.00%–86.42%,MAE ranges from 0.07D to 0.18D and accuracy ranges from 81.60%to 96.70%.The reported papers colle

关键词： Deep Learning Artificial Intelligence Refractive Error Retinal images Optical Coherence Tomography Photorefraction Ocular images Prediction

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Crack buckling in soft gels under compression

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Acta Mechanica Sinica 2012年第4期28卷 1098-1105页

作者： Rong Long chung-yuen Hui Department of Biological and Environmental Engineering Cornell University Ithaca 14853 New York USA Field of Theoretical and Applied Mechanics Cornell University Ithaca 14850 New York USA

Recent interest in designing soft gels with high fracture toughness has called for simple and robust methods to test fracture behavior. The conventional method of applying tension to a gel sample suffers from a difficulty of sample gripping. In this paper, we study a possible fracture mechanism of soft gels under uni-axial compression. We show that the surfaces of a pre-existing crack, oriented parallel to the loading axis, can buckle at a critical compressive stress. This buckling instability can open the crack surfaces and cre- ate highly concentrated stress fields near the crack tip, which can lead to crack growth. We show that the onset of crack buckling can be deduced by a dimensional argument com- bined with an analysis to determine the critical compression needed to induce surface instabilities of an elastic half space. The critical compression for buckling was verified for a neo- Hookean material model using finite element simulations.

关键词： Fracture mechanics. Soft gels. Buckling. Crack Compression

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Melt Evolution above a Spontaneously Retreating Subducting Slab in a Three-Dimensional Model

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Journal of Earth Science 2011年第2期22卷 137-142页

作者： Taras Gerya david A yuen Department of Earth Sciences Swiss Federal Institute of Technology(ETH Zurich)CH-8092 ZurichSwitzerland Adjunct Professor of Geology Department Moscow State University Department of Geology and Geophysics and Minnesota Supercomputing Institute University of MinnesotaMinneapolisMN 55415USA

Dehydration of the subducting slab favors the melting of the surrounding mantle. Water content and melt evolution atop a spontaneously retreating subducting slab are reported in a three- dimensional （3-D） model. We find that fluids, including water and melts in the rocks, vary substantially along the trench, which cannot be found in two-dimensional （2-D） models. Their maxima along the subducting slab are mainly located at about 50 to 70 and 120 to 140 kin. Volumetric melt production rate changes spatially and episodically atop the slab, which may reflect the intensity and variations of volcanoes.

关键词： subduction water and melt three-dimensional model.

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Improved anterior hepatic transection for isolated hepatocellular carcinoma in the caudate

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 219-222页

作者： TanTo Cheung WaiKey yuen Ronnie TP Poon SeeChing chan Sheung Tat Fan chung Mau Lo Department of Surgery The University of Hong Kong Department of Surgery State Key Laboratory for Liver Research The University of Hong Kong

BACKGROUND: One of the best treatments for isolated hepatocellular carcinoma in the caudate lobe is major hepatectomy with caudate lobectomy, but it is not suitable for patients with poor liver function reserve. Isolated caudate lobectomy, which is a very difficult operation, is thus an alternative ***: Here we report an isolated caudate lobectomy with an anterior approach in the treatment of a large hepatocellular carcinoma with underlying cirrhosis, with focus on the technical ***: In the operation, both the left and right lobes of the liver were mobilized. Hepatotomy was done along the round ligament where parenchymal transection was minimal. After exposure of the left and middle hepatic veins and the hilar plate the caudate lobe and the tumor were resected en bloc with a5-mm ***: Isolated caudate lobectomy can be performed safely with this anterior approach on patients with poor liver function reserve.

关键词： hepatocellular carcinoma hepatectomy liver cirrhosis

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