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Modulation of graft vascular inflow guided by flowmetry and manometry in liver transplantation

Hepatobiliary & Pancreatic Diseases International 2011年第6期10卷 649-656页

作者： See Ching Chan Chung.mau Lo Kenneth SH Chok William W Sharr Tan To Cheung Simon HY Tsang Albert CY Chan Sheung Tat Fan Department of Surgery The University of Hong Kong 102 Pokfulam RoadHong KongChina State Key Laboratory for Liver Research The University of Hong Kong 102 Pokfulam RoadHong KongChina

BACKgROUND:Survival of the partial graft after living donor liver transplantation owes much to its tremendous regenerative *** excellent venous outflow capacity,a graft within a wide range of graft-to-standard-liver-volume ratios can cope with portal hypertension that is common in liver transplant ***,when the ratio range is exceeded,modulation of graft vascular inflow becomes necessary for graft *** interplay between graft-to-standard-liver-volume ratio and portal pressure,in the presence of portosystemic shunt or otherwise,requires individualized modulation of graft portal and arterial *** of portal inflow by shunt ligation can be guided by transonic flowmetry,whereas muting of portal inflow by splenic artery ligation can be monitored by portal electronic ***:We describe four cases to illustrate the ***:One patient had hepatic artery thrombosis resulting from splenic artery steal syndrome which was the sequela of small-for-size *** splenic artery ligation and re-anastomosis of the hepatic artery successfully muted the portal inflow and boosted the hepatic arterial *** patient with portal vein thrombosis underwent *** inflow was boosted with ligation of portosystemic shunt,which is often present in these patients with portal *** coexistence of splenic aneurysm and splenorenal shunt required ligation of both in the third *** fourth patient,with portal pressure and flow monitoring,avoided ligation of a coronary vein which became a main portal inflow after portal ***:Management of graft inflow modulation guided selectively by transonic flowmetry or portal manometry was described.

关键词： graft inflow liver transplantation modulation

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Asia's first combined liver transplant and aortic valve replacement

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 86-87页

作者： chung yeung cheung kenneth s.h.chok oswald j.lee kevin s.lo see ching chan chung.mau lo department of surgery queen mary hospitalhong kongChina department of surgery the university of hong konghong kongChina state key laboratory for liver research the university of hong konghong kongChina department of cardiothoracic surgery queen mary hospitalhong kongChina department of anesthesiology queen mary hospitalhong kongChina

To the editor:Liver transplantation is the only cure for patients with endstage liver *** is however an ultra-major surgery which is physiologically challenging to the cardiopulmonary function of the ***,in patients w... 详细信息

关键词： Asia’s first combined liver transplant and aortic valve replacement

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Rapid measurement of indocyanine green retention by pulse spectrophotometry: a validation study in 70 patients with Child-Pugh A cirrhosis before hepatectomy for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第3期11卷 267-271页

作者： Tan To Cheung See Ching Chan Kenneth SH Chok Albert CY Chan Wan Ching Yu Ronnie TP Poon Chung.mau Lo Sheung Tat Fan Department of Surgery the University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong

BACKgROUND: The indocyanine green (ICg) retention test is the most popular liver function test for selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly- developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON , one of the pulse spectrophotometry systems, in measuring preoperative ICg retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICg retention was measured by the traditional method. METHODS: We measured the liver function of 70 Child-Pugh A cirrhotic patients before hepatectomy for hepatocellular carcinoma from September 2008 to January 2009. ICg retention at 15 minutes measured by traditional spectrophotometry (ICgR15) was compared with ICg retention at 15 minutes measured by the LiMON (ICgR15(L)). RESULTS: The median ICgR15 was 14.7% (5.6%-32%) and the median ICgR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation between ICgR15 and ICgR15(L) (correlation coefficient, 0.844; 95% confidence interval, 0.762-0.899). The following formula was devised: ICgR15=1.16×ICgR15(L)+***: The LiMON provides a fast and repeatable way to measure ICg retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results obtained by traditional spectrophotometry and the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula.

关键词： Child-Pugh A liver cirrhosis hepatocellular carcinoma indocyanine green clearance LiMON pulse spectrophotometry

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Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 552-555页

作者： See Ching Chan William W Sharr Tan To Cheung Albert CY Chan Simon HY Tsang Kenneth SH Chok Kin Chung Leung Chung.mau Lo Department of Surgery The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong Department of Pathology The University of Hong Kong

The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena *** is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total *** we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular *** order to ensure clear resection margins,the anterior portion of the inferior vena cava was *** right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena *** this technique,we observed the no-touch technique in tumor removal,hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation.

关键词： hepatocellular carcinoma liver transplantation

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The impact of family history of hepatocellular carcinoma on its patients' survival

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Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 160-164页

作者： Wing Chiu Dai Sheung Tat Fan Tan To Cheung Kenneth SH Chok Albert CY Chan Simon HY Tsang Ronnie TP Poon Chung.mau Lo Department of Surgery The University of Hong Kong 102 Pokfulam Road Hong Kong China State Key Laboratory for Liver Research The University of Hong Kong 102 Pokfulam Road Hong Kong China

BACKgROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the *** aim of this study is to evaluate the impact of such a history on HCC patients’ ***:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively *** patients were quizzed on their various characteristics including family HCC ***:Totally 475(10.48%) patients had a family history of *** presented the disease at a significantly earlier age(median 53 vs 59 years,Pge(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin *** more of them presented the disease without symptoms(44.0% vs 29.4%,Pgnificantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III ***:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a *** believe this was in part due to earlier diagnosis of the disease and better liver function in this group of ***,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified.

关键词： hepatocellular carcinoma family history resection survival risk factor

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High-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients awaiting liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 542-544页

作者： Tan To Cheung Kenneth SH Chok Regina CL Lo William W Sharr See Ching Chan Ronnie TP Poon Sheung Tat Fan Chung.mau Lo Department of Surgery The University of Hong Kong Department of Pathology The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong

The scarcity of liver grafts in Asia leads to a significant dropout of patients from liver transplant waiting lists, particularly patients with hepatocellular carcinoma and a low model for end-stage liver disease score. In order to reduce dropping out, different bridging therapies are employed. We report the use of high-intensity focused ultrasound ablation as a bridging therapy for a patient with hepatocellular carcinoma of stage two and an extremely low platelet count (20×10 9 /L). The ablation was successful. Blood tests showed that his liver function was similar before and after the treatment. No adhesion was encountered in the liver transplantation performed six months later.

关键词： high-intensity focused ultrasound hepatocellular carcinoma liver cirrhosis liver transplantation bridging therapy

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Validated model for prediction of recurrent hepatocellular carcinoma after liver transplantation in Asian population

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World Journal of gastrointestinal Oncology 2019年第4期11卷 322-334页

作者： Ka Wing Ma Wong Hoi She Albert Chi Yan Chan Tan To Cheung James Yan Yue Fung Wing Chiu Dai Chung.mau Lo Kenneth Siu Ho Chok Department of Surgery the University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong Department of Medicine and State Key Laboratory for Liver Research The University of Hong Kong

BACKgROUND Liver transplantation(LT) is regarded as the best treatment for both primary and recurrent hepatocellular carcinoma(HCC). Post-transplant HCC recurrence rate is relatively low but significant, ranging from 10%-30% according to different series. When recurrence happens, it is usually extrahepatic and associated with poor prognosis. A predictive model that allows patient stratification according to recurrence risk can help to individualize post-transplant surveillance protocol and guidance of the use of anti-tumor immunosuppressive *** To develop a scoring system to predict HCC recurrence after LT in an Asian *** Consecutive patients having LT for HCC from 1995 to 2016 at our hospital were recruited. They were randomized into the training set and the validation set in a60:40 ratio. Multivariable Cox regression model was used to identity factors associated with HCC recurrence. A risk score was assigned to each factor according to the odds ratio. Accuracy of the score was assessed by the area under the receiver operating characteristic *** In total, 330 patients were eligible for analysis(183 in training and 147 invalidation). Recurrent HCC developed in 14.2% of them. The median follow-up duration was 65.6 mo. The 5-year disease-free and overall survival rates were78% and 80%, respectively. On multivariate analysis, alpha-fetoprotein > 400 ng/mL [P = 0.012, hazard ratio(HR) 2.92], sum of maximum tumor size and number(P = 0.013, HR 1.15), and salvage LT(P = 0.033, HR 2.08) were found to be independent factors for disease-free survival. A risk score was calculated for each patient with good discriminatory power(c-stat 0.748 and 0.85, respectively,in the training and validation sets). With the derived scores, patients were classified into low-(0–9), moderate-(> 9–14), and high-risk groups(> 14), and the risk of HCC recurrence in the training and validation sets was 10%, 20%, 54%(cstat 0.67) and 4%, 22%, 62%(c-stat 0.811), accordin

关键词： Hepatocellular carcinoma Liver transplantation Post-transplant recurrence Predictive model

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钢筋轴向编排距离对方形钢筋混凝土柱承载能力的影响

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工业建筑 1998年第8期28卷 25-29页

作者：周思柱 S.T.mau 江汉石油学院休斯顿大学

总结了美、欧等国有关钢筋轴向编排距离对方形钢筋混凝土柱承载能力的影响的研究现状，采用有限元方法将混凝土划分成三维砖块单元，钢筋划分成杆单元，利用单元粘贴技术形成了完整的钢筋混凝土有限元分析模型。经过有限元计算，提出了... 详细信息

总结了美、欧等国有关钢筋轴向编排距离对方形钢筋混凝土柱承载能力的影响的研究现状，采用有限元方法将混凝土划分成三维砖块单元，钢筋划分成杆单元，利用单元粘贴技术形成了完整的钢筋混凝土有限元分析模型。经过有限元计算，提出了“期望标准应力”，定义了“有效限定应力因子”、“平均有效限定应力”和“平均限定因子”的概念。分析了五种钢筋轴向编排距离对钢筋混凝土柱承载能力的影响，给出了直观图形描述和平均限定因子的回归方程。

关键词：钢筋混凝土柱承载力钢筋轴向编排距离

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Pancreaticoduodenectomy with vascular reconstruction for adenocarcinoma of the pancreas with borderline resectability

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World Journal of gastroenterology 2014年第46期20卷 17448-17455页

作者： Tan To Cheung Ronnie TP Poon Kenneth SH Chok Albert CY Chan Simon HY Tsang Wing Chiu Dai See Ching Chan Sheung Tat Fan Chung.mau Lo Department of Surgery Queen Mary HospitalUniversity of Hong Kong

AIM: To analyze whether pancreaticoduodenectomy with simultaneous resection of tumor-involved vessels is a safe approach with acceptable patient survival.

关键词： Adjuvant therapy Head of pancreas Liver transplant Morbidity Mortality Portal vein resection Survival analysis Whipple operation

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Characteristics of the gene encoding pyrroline-5-carboxylate synthase(P5CS) in Vietnamese soybean cultivars(glycine max ***)

Characteristics of the gene encoding pyrroline-5-carboxylate...

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International Conference on Biology, Environment and Chemistry（ICBEC 2010）

作者： Chu Hoang.mau Nguyen Thi Thuy Huong Chu Hoang Lan Nguyen Tuan Anh Le Van Son Chu Hoang Ha Dept.of genetics Faculty of Biology Thainguyen University Dept.of genetics Faculty of Biology Vietnam National University of Science Dept.of Environment Faculty of Agricultural Environment Thainguyen University Lab.of Plant Cell Biotechnology Institute of Biotechnology

ISBN: (纸本)9789810886424

This research evaluates the ability of six soybean local cultivars and a control cultivar(DT84) to tolerate severe *** this research,SL5 and SL6 have the most stress tolerance while DT84 and SL1 have the least stress *** have isolated P5CS gene as it relates to stress tolerance by using PCR with *** results show that the size of the P5CS gene of the studied cultivars is 2,148 bp,which encodes for 715 amino *** these proteins are compared with the P5CS proteins of the other species,the result shows that the isolated P5CS proteins have a higher identity than other bean *** are located on the same branch of the phylogenetic ***(Pro) is one of the most accumulated osmolytes in salinity and water deficit conditions in plants.P5CS is a key regulatory enzyme involved in prolin biosynthesis in plants and is subject to feedback inhibition by *** conserved aspartate residue at 126 and the phenylalanine at 129 are involved in the feedback inhibition by Pro binding.A gene encoding a feedback insensitive P5CS enzyme was obtained by mutating the P5CS *** mutation was due to a change of an aspartate at position 125 to alanine in the *** mutated gene was cloned in pBT vector and *** gene will be transfered to plants to increase the level of proline overproduction and to enhance the drought tolerance ability.

关键词： drought,glycine max,point mutation,P5CS,proline.

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