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Successful reduction of sharp injuries in the Operating Room using a quality improvement process

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Successful reduction of sharp injuries in the Operating Room...

Malignant triton tumor in the abdominal wall:A case report

首届国际手术室护理学术交流暨专题讲座会议

作者： Chan HC Cheng KP ho ct Lui SM Poon SK Operating Room Department United Christian HospitalHong Kong SAR Operating Room Department United Christian HospitalHong Kong SAR Operating Room Department United Christian HospitalHong Kong SAR Operating Room Department United Christian HospitalHong Kong SAR Operating Room Department United Christian HospitalHong Kong SAR

＜正＞Introduction: Sharp injuries constitute the leading cause of job-related injuries because OR staffs have more chances in handling of surgical blades, suturing needles, injection needles, wires and etc. From the Incident on duty （IOD）’s report, thirty-one cases induced by sharp injuries （n=31） were reported during the 3-year period （2001- 2003）, for an average rate of 0.85 injury per month. Its mean value was 48% (95% CI 35.3% -

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World Journal of Clinical Cases 2024年第8期12卷 1467-1473页

作者： ho Jik Yang Donghyun Kim Won Suk Lee Sang-Ha Oh Department of Plastic and Reconstructive Surgery Chungnam National University Sejong HospitalSejong 30099South Korea Department of Plastic and Reconstructive Surgery Chungnam National University HospitalDaejeon 35015South Korea Department of Emergency Eulji University HospitalDaejeon 35233South Korea Department of Plastic and Reconstructive Surgery Chungnam National University College of MedicineDaejeon 35015South Korea

BACKGROUND Malignant triton tumors(MTTs)comprise a subgroup of malignant peripheral nerve sheath tumors(MPNSTs)that exhibits rhabdomyosarcomatous differen-tiation and follow an aggressive *** are primarily located along peripheral *** of MTTs in the abdominal wall have not been *** has a poorer prognosis than classic MPNSTs,and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis *** for MTTs mirrors that for MPNSTs and is predominantly *** SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdo-minal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the *** had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the *** computed tomography(ct)showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis *** was no sign of metastasis(T1N0M0).An incisional biopsy identified sporadic MTT of the lower abdomen.A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was ***-quently,the general surgeon utilized an approach akin to the open peritoneal onlay mesh *** patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin *** complications arose,and annual follow-up cts did not show signs of recurrence or *** An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction,eliminating the need for postoperative radiotherapy.

关键词： Malignant triton tumor Abdominal wall Surgical excision Reconstruction Case report

Value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer

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World Journal of Clinical Cases 2024年第5期12卷 931-941页

作者： hongsik Kim Song-Yi Choi Tae-Young Heo Kyeong-Rok Kim Jisun Lee Min Young Yoo Taek-Gu Lee Joung-ho Han Department of Internal Medicine Chungbuk National University HospitalCheongju 28644South Korea Department of Pathology Chungnam National University College of MedicineDaejeon 35015South Korea Information and Statistics Chungbuk National UniversityCheongju 28644South Korea Department of Radiology College of MedicineChungbuk National UniversityChungbuk National University HospitalCheongju-si 28644South Korea Department of Nuclear Medicine School of MedicineInha UniversityIncheon 22332South Korea Department of Surgery Chungbuk National UniversityCollege of MedicineCheongju-si 28644South Korea Department of Internal Medicen Chungbuk National UniversityCollege of medicineCheongju-si 28644South Korea

BACKGROUND There are limited data on the use of glucose transport protein 1(GLUT-1)expre-ssion as a biomarker for predicting lymph node metastasis in patients with colorectal ***-1 and GLUT-3,hexokinase(HK)-II,and hypoxia-induced factor(HIF)-1 expressions may be useful biomarkers for detecting primary tumors and lymph node metastasis when combined with fluorodeoxyglucose(FDG)uptake on positron emission tomography/computed tomography(PET/ct).AIM To evaluate GLUT-1,GLUT-3,HK-II,and HIF-1 expressions as biomarkers for detecting primary tumors and lymph node metastasis with 18F-FDG-PET/*** This retrospective study included 169 patients with colorectal cancer who underwent colectomy and preoperative 18F-FDG-PET/ct at Chungbuk National University hospital between January 2009 and May *** tissue cores from the central and peripheral areas of the tumors were obtained and were examined by a dedicated pathologist,and the expressions of GLUT-1,GLUT-3,HK-II,and HIF-1 were determined using immunohisto-chemical *** analyzed the correlations among their expressions,various clinicopathological factors,and the maximum standardized uptake value(SUVmax)of PET/*** GLUT-1 was found at the center or periphery of the tumors in 109(64.5%)of the 169 ***-1 positivity was significantly correlated with the SUVmax of the primary tumor and lymph nodes,regardless of the biopsy site(tumor center,Pctively).GLUT-1 positivity and negativity were associated with higher and lower sensitivities of PET/ct,respectively,for the detection of lymph node metastasis,regardless of the biopsy ***3,HK-II,and HIF-1 expressions were not significantly correlated with the SUVmax of the primary tumor and lymph *** GLUT-1 expression was significantly correlated with the SUVmax of 18F-FDG-PET/ct for primary tumors and lymph *** should consider GLUT-1 expression in preoperative endoscop

关键词： 18F-FDG-PET-ct Biomarker Colorectal neoplasms Glucose transporter type 1 Lymph node

ct colonography in the diagnosis and management of colorectal cancer:Emphasis on pre-and post-surgical evaluation

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World Journal of Gastroenterology 2014年第8期20卷 2014-2022页

作者： Nurhee hong Seong ho Park Department of Radiology and Research Institute of Radiology University of Ulsan College of MedicineAsan Medical CenterSeoul 138-736South Korea

This article addresses the use of computed tomographic colonography (ctC) for the diagnosis and management of colorectal cancer, focusing on presurgical evaluation of the colon proximal to an occlusive cancer and surveillance after cancer resection surgery. The key evidences accumulated in the literature and future work needed are summarized. ctC is a technically robust and the most practical method to evaluate the colon proximal to an occlusive cancer, which prevents colonoscopic examination past the occlusion, either before or after metallic stent placement. The high sensitivity of ctC for detecting cancers and advanced adenomas in the proximal colon can help prevent additional surgical procedures in patients showing negative results. however, the accuracy of ctC for distinguishing intramural cancers from adenomas is low, and the technique is limited in guiding management when a medium-sized lesion that do not show invasive features such as pericolic extension or nodal metastasis is found in the proximal colon. A maximal diameter ≥ 15 mm has been proposed as a criterion for surgical removal of proximal lesions. however, this needs to be verified in a larger cohort. In addition, the influence of presurgical ctC results on the current post-cancer resection colonic surveillance timeline remains to be determined. ctC can be readily added to the routine abdominopelvic ct in the form of contrast-enhanced ctC, which can serve as an effective stand-alone tool for post-cancer resection surveillance of both the colorectum and extracolonic organs. Although the accuracy of ctC has been demonstrated, its role in the current colonoscopy-based postoperative colonic surveillance protocols remains to be determined. Readers of ctC also need to be knowledgeable on the colonic lesions that are unique to the postoperative colon.

关键词： Computed tomographic colonography Colonic cancer Rectal cancer Surgery Colonoscopy

Is endoscopic ultrasonography still the modality of choice in preoperative staging of gastric cancer?

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World Journal of Gastroenterology 2014年第38期20卷 13775-13782页

作者： Sung Wook Hwang Dong ho Lee Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Department of Internal Medicine Seoul National University Bundang HospitalSeongnam

The treatment option for gastric cancer is usually based on preoperative staging by imaging modalities. Endoscopic ultrasonography (EUS) and computed tomography (ct) have been used as the diagnostic modality of choice in preoperative staging of gastric cancer. Magnetic resonance imaging (MRI) has been employed in several studies, and (18F) 2-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has emerged as a new promising imaging modality. The purpose of this article is to provide summarized information on preoperative staging using EUS, multi-detector row ct (MDct), MRI and PET for gastric cancer. In T staging, both EUS and MDct show high accuracy. MRI seemed to have better performance, but the number of MRI studies is limited. FDG-PET is not able to properly evaluate the depth of invasion. In N staging, the diagnostic accuracy of EUS, MDct and MRI is not sufficient. In preoperative M staging, MDct and FDG-PET showed similar diagnostic accuracies. FDG-PET/ct fusion could be expected to show better performance in the future. Physicians should keep in mind that each diagnostic modality has advantages and limitations and choose an appropriate diagnostic strategy tailored for each patient.

关键词： Gastric cancer Endoscopic ultrasonography Computed tomography Magnetic resonance imaging Positron emission tomography

Appendicitis-mimicking presentation in fishbone induced microperforation of the distal duodenum:A case report

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World Journal of Gastrointestinal Surgery 2020年第2期12卷 77-84页

作者： Daniel Lim Cheng-Maw ho Department of Surgery National Taiwan University HospitalTaipei 100Taiwan College of Medicine and Veterinary Medicine University of EdinburghEdinburgh EH164TJUnited Kingdom Victoria hospital Kirkcaldy NHS LothianSouth-East Scotland Deanery KY25AHUnited Kingdom

BACKGROUND Upper gastrointestinal fishbone microperforations are rare and not commonly reported in medical *** the increasing use of computer tomography(ct)imaging and the employment of the Alvardo criteria,misdiagnosis of acute appendicitis can still *** report the rare case of an elderly Chinese gentleman who had a fish-bone induced microperforation of the duodenum that closely mimicked the symptoms of acute *** SUMMARY This 79-year-old man presented with migratory lower abdominal pain that localized at his periumbilical region and right lower *** had associated pyrexia,general malaise and was noted to have an elevated white cell *** investigations initially revealed a distended appendix which was resected laparoscopically but showed no obvious signs of gross *** patient then deteriorated clinically and had increased oxygen requirements immediately after the *** prompted further investigations.A further review of his ct scan revealed a fine fishbone microperforation in the distal duodenum associated with retroperitoneal abscess formation and seepage extending into the right lower *** was then started on broad spectrum intravenous antibiotics and subsequently underwent a laparotomy 12 h later to manage the obscure aetiology and to drain the *** post-operative course was uneventful and he was discharged 11 d later including a 2-d stay in the intensive care *** This case offers an insight into a potential mimic of acute appendicitis and the diagnostic difficulties experienced in such presentations.

关键词： Fish bone Duodenal microperforation Acute appendicitis mimic Case report Observer error

Primary thymic mucosa-associated lymphoid tissue lymphoma with multiple thin walled lung cysts: case report and literature review

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Chinese Journal of Cancer Research 2013年第3期25卷 354-357页

作者： Lung-Yun Kang Szu-Pei ho Yi-Pin Chou Department of Emergency Medicine Kaohsiung Veterans General Hospital Department of Pathology Kaohsiung Veterans General Hospital

Mucosa-associated lymphoid tissue （MALT） lymphoma of the thymus is rare. We reported a case of a 37-year-old Chinese female with Sjtgren＇s syndrome and hyperglobulinemia. She suffered from chronic cough for 3 weeks. Chest computed tomography （ct） demonstrated a multiloculated cystic mass in mediastinum prevascular space and multiple lung cysts. Laboratory exam of autoimmune markers showed positive of antinuclear antibody （ANA）, Sjtgren＇s syndrome A （SSA）, Sjtgren＇s syndrome B （SSB）, and rheumatoid factors （RF）. Thymectomy with lymph node dissection was performed. The pathology report revealed thymic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Under immunohistochemical stains, CD20 and Bcl-2 were positive. No evidence of recurrence of disease was found.

关键词： Mucosa-associated lymphoid tissue (MALT) lymphoma thymus Sj6gren's syndrome hyperglobulinemia

Genome sequencing reveals the role of rare genomic variants in Chinese patients with symptomatic intracranial atherosclerotic disease

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Stroke & Vascular Neurology 2022年第3期7卷 182-189页

作者： Mengmeng Shi Xinyi Leng Ying Li Zihan Chen Ye Cao Tiffany Chung Bonaventure YM Ip Vincent HL Ip Yannie OY Soo Florence SY Fan Sze ho Ma Karen Ma Anne Y Y Chan Lisa WC Au howan Leung Alexander Y Lau Vincent ct Mok Kwong Wai Choy Zirui Dong Thomas W Leung Department of Obstetrics and Gynaecology The Chinese University of Hong KongHong KongChina Key Laboratory for Regenerative Medicine Ministry of Education(Shenzhen Base)Shenzhen Research InstituteThe Chinese University of Hong KongShenzhenChina hong Kong Hub of Paediatric Excellence The Chinese University of Hong KongHong KongChina Department of Medicine and Therapeutics The Chinese University of Hong KongPrince of Wales HospitalHong KongChina Department of Paediatrics The Chinese University of Hong KongHong KongChina The Chinese University of hong Kong-Baylor College of Medicine Joint Center For Medical Genetics The Chinese University of Hong KongHong KongChina

Objectives The predisposition of intracranial atherosclerotic disease(ICAD)to East Asians over Caucasians infers a genetic basis which,however,remains largely *** prevalence of vascular risk factors(VRFs)in Chinese over Caucasian patients who had a stroke,and shared risk factors of ICAD with other stroke subtypes indicate genes related to VRFs and/or other stroke subtypes may also contribute to *** Unrelated symptomatic patients with ICAD were recruited for genome sequencing(GS,60-fold).Rare and potentially deleterious single-nucleotide variants(SNVs)and small insertions/deletions(InDels)were detected in genome-wide and correlated to genes related to VRFs and/or other stroke *** aneuploidies,copy number variants(CNVs)and chromosomal structural rearrangements were also ***,candidate genes were used for pathway and gene ontology enrichment *** Among 92 patients(mean age at stroke onset 61.0±9.3 years),GS identified likely ICAD-associated rare genomic variants in 54.3%(50/92)of ***-eight patients(52.2%,48/92)had 59 rare SNVs/InDels reported or predicted to be deleterious in genes related to VRFs and/or other stroke *** of the 59 rare variants were identified in local subjects without ICAD(n=126).31 SNVs/InDels were related to conventional VRFs,and 28 were discovered in genes related to other stroke *** study also showed that rare CNVs(n=7)and structural rearrangement(a balanced translocation)were potentially related to ICAD in 8.7%(8/92)of ***,candidate genes were significantly enriched in pathways related to lipoprotein metabolism and cellular lipid catabolic *** Our GS study suggests a role of rare genomic variants with various variant types contributing to the development of ICAD in Chinese patients.

关键词： patients metabolism intracranial

Systematic review of diagnostic tools for peritoneal metastasis in gastric cancer-staging laparoscopy and its alternatives

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World Journal of Gastrointestinal Surgery 2023年第10期15卷 2280-2293页

作者： Si Ying Adelina ho Kon Voi Tay Lee Kong Chian School of Medicine Singapore 308232Singapore Upper GI and Bariatric Division General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Upper GI and Bariatric Division General SurgeryWoodlands HealthSingapore 768024Singapore

BACKGROUND Gastric cancer is one of the leading causes of cancer burden and mortality,often resulting in peritoneal metastasis in advanced stages with negative survival *** laparoscopy has become standard practice for suspected cases before a definitive gastrectomy or *** systematic review aims to compare the efficacy of other diagnostic modalities instead of staging laparoscopy as the alternatives are able to reduce cost and invasive staging ***,a radiomic model based on computed tomography and positron emission tomography(PET)has also emerged as another method to predict peritoneal *** To determine if the efficacy of computed tomography,magnetic resonance imaging and PET is comparable with staging *** Articles comparing computed tomography,PET,magnetic resonance imaging,and radiomic models based on computed tomography and PET to staging laparoscopies were filtered out from the Cochrane Library,EMBASE,PubMed,Web of Science,and Reference Citations Analysis(https://***/).In the search for studies comparing computed tomography(ct)to staging laparoscopy,five retrospective studies and three prospective studies were ***,five retrospective studies and two prospective studies were also included for papers comparing ct to PET *** one retrospective study and one prospective study were found to be suitable for papers comparing ct to magnetic resonance imaging *** Staging laparoscopy outperformed computed tomography in all measured aspects,namely sensitivity,specificity,positive predictive value and negative predictive *** resonance imaging and PET produced mixed results,with the former shown to be only marginally better than computed *** performed slightly better than PET in most measured domains,except in specificity and true negative *** speculate that this may be due to the limited F-fluorodeoxyglucose uptake in small peri

关键词： Gastric cancer Peritoneal metastases Computed tomography Positron emission tomography Magnetic resonance imaging Staging laparoscopy