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Pediatric Application of Dynamic Contrast-Enhanced MR Imaging (DCE-MR) in the Management of Extra-Cranial Tumor: Experience in Routine Clinical Practice

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Open Journal of Radiology 2020年第2期10卷 57-68页

作者： Wendy Wai-Man lam Daniel Cheuk Godfrey Chi-Fung chan Department of Radiology Queen Mary Hospital Hong Kong SAR China Department of Paediatrics & Adolescent Medicine The University of Hong Kong Hong Kong SAR China

Background: Dynamic contrast-enhanced MR imaging (DCE-MR) is becoming a widely accepted complementary method for diagnosing breast cancer and other cancers in adults. It is useful to predict tumor response to anticancer therapy and monitor the tumor response to the therapy. This form of imaging techniques has not been adequately explored in pediatric oncology patients. Objective: To determine the potential role of dynamic contrast-enhanced MR imaging (DCE-MR) in the diagnosis and treatment response monitoring of childhood and young adult extra-cranial tumors in routine clinical setting. Methods: Children with suspected extra-cranial solid tumors, including newly diagnosed or follow-up cases of confirmed tumors, were recruited. DCE-MR was performed with intravenous injection of 0.1 mmol/kg contrast. The enhancement time curves were plotted and the enhancement patterns were categorized into type 1, 2 and 3 curves. Enhancement curve patterns and maximal enhancement intensity were compared with types of tumor in newly diagnosed cases. The preoperative percentiles of inactive area on the colour map were compared with the necrotic areas on histologic sections of the resected specimens in follow-up cases. Pearson Chi-square test and Unpaired two-sample t-test were used for statistical analysis. Results: There were 36 patients, involving 28 malignant and 8 benign cases. There were 14 type 3 curves, (all of them were malignant tumors), 6 type 2 curves and 16 type 1 curves. All the benign cases (n = 8) demonstrated type 1 curve (accuracy & negative predictive value = 100%). All the malignant cases after treatment showed type 2 or 1 curve. For those cases with operation done afterwards, the extent of tumor necrosis was correlated closely with pathology findings (accuracy = 93.3%). Conclusion: Type 1 curve was a good predictor of benign lesion. DEC-MR may have a role to play in the monitoring o

关键词： MR DCE-MR Dynamic Contrast MR Tumor Children Pediatric

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Outcome analysis of management of liver trauma: A 10-year experience at a trauma center

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World Journal of Hepatology 2016年第15期8卷 644-648页

作者： Wong hoi She Tan To Cheung Wing Chiu Dai Simon HY Tsang Albert CY chan Daniel KH Tong Gilberto KK Leung Chung Mau Lo Department of Surgery Queen Mary Hospital the University of Hong Kong

AIM: To review the outcomes of liver trauma in patients with hepatic injuries only and in patients with associated injuries outside the ***: Data of liver trauma patients presented to our center from January 2003 to October 2013 were reviewed. The patients were divided into two groups. Group 1 consisted of patients who had hepatic injuries only. Group 2 consisted of patients who also had associated injuries outside the ***: Seven(30.4%) patients in group 1 and 10(28.6%) patients in group 2 received non-operative management; the rest underwent operation. Blunt trauma occurred in 82.8%(48/58) of the patients and penetrative trauma in 17.2%(10/58). A higher injury severity score(ISS) was observed in group 2(median 45 vs 25, P < 0.0001). More patients in group 1 were hemodynamically stable(65.2% vs 37.1%, P = 0.036). Other parameters were comparable between groups. Group 1 had better 30-d survival(91.3% vs 71.4%, P = 0.045). On multivariate analysis using the logistic regression model, ISS was found to be associated with mortality(P = 0.004, hazard ratio = 1.035, 95%CI:CONCLUSION: Liver trauma patients with multiple injuries are relatively unstable on presentation. Despite a higher ISS in group 2, non-operative management was possible for selected patients. Associated injuries outside the liver usually account for morbidity and mortality.

关键词： Non-operative management Liver trauma Multiple injuries Penetrative trauma Liver laceration Blunt trauma

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Role of C11-FDG dual-tracer PET-CT scan in metastatic screening of hepatocellular carcinoma-a cost-effectiveness analysis

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 301-307页

作者： Kevin K.W.Chu Albert C.Y.chan Ka Wing Ma Wong hoi She Wing Chiu Dai Kenneth S.H.Chok Tan To Cheung Chung Mau Lo Department of Surgery The University of Hong KongHong KongChina

Background:We aimed to identify predictive factors for positron emission tomography(PET)-detected hepatocellular carcinoma(HCC)metastasis and a cost-effective approach to preoperative PET-computed tomography(CT)for detecting ***:Clinicopathological and survival data of HCC patients having PET-CT with 18F-fludeoxyglucose(FDG)and 11C-acetate(ACT)following contrast-enhanced CT/magnetic resonance imaging(MRI)for preoperative tumor staging were *** logistic regression was performed to identify predictive factors for PET-detected metastasis.A cost-benefit analysis model was built for the incurred costs and the impact of PET-CT findings on treatment strategy was ***:Totally 152 patients were ***-tracer PET-CT detected metastasis in 17 patients(11%).By multivariate analysis,alpha-fetoprotein(AFP)≥400 ng/mL[relative risk(RR):4.30,95%confidence interval(CI):1.41-13.15,P=0.011]and bilobar disease(RR:3.94,95%CI:1.24-12.52,P=0.014)were independent predictive factors for PET-detected ***-CT findings altered the treatment strategy for 12 patients(7.9%);three partial hepatectomies,eight episodes of transarterial chemoembolization(TACE)and one episode of ablation were avoided,with an estimated cost-saving of US$91,000,$150,000 and$10,600 *** the PET-CT been performed only for patients with AFP≥400 ng/mL or bilobar disease(n=74),metastasis would have been confirmed in 14 patients(18.9%),and the cost-saving per patient was estimated at US$1,***:Dual-tracer PET-CT is cost-effective and useful for preoperative HCC staging in patients with AFP≥400 ng/mL or bilobar *** routine use in preoperative workup for all HCC patients is not *** disease with AFP<400 ng/mL can achieve good negative predictive value for PET-detected *** patients with either factor can avoid unnecessary procedures and is thus cost-effective for preoperative HCC workup.

关键词： Cost-effectiveness study dual-tracer positron emission tomography-computed tomography(dual-tracer PET-CT) hepatocellular carcinoma(HCC) metastatic screening preoperative investigation

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Macrophage migration inhibitory factor stimulated by He/icobacter py/oriincreases proliferation of gastric epithelial cells

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World Journal of Gastroenterology 2005年第13期11卷 1946-1950页

作者： Harry Hua-Xiang Xia Shiu Kum lam Annie O.O.chan Marie Chia Mi Lin Hsiang Fu Kung Keiji Ogura Douglas E.Berg Benjamin Chun-Yu Wong Department of Medicine Institute of Molecular Biology Department of Molecular Microbiology

AIM: Helicobacter pylori (H pylori) is associated with increased gastric inflammatory and epithelial expression of macrophage migration inhibitory factor (MIF) and gastric epithelial cell proliferation. This study aimed at determining whether H pylori directly stimulates release of MIF in monocytes, whether the cag pathogenicity island (PAI) is involved for this function, and whether MIF stimulated by H pylori increases gastric epithelial cell proliferation in vitro. METHODS: A cytotoxic wild-type H pylori strain (TN2), its three isogenic mutants (TN2Δcag,TN2ΔcagA and TN2ΔcagE) were co-cultured with cells of a human monocyte cell line, THP-1, for 24 h at different organism/ cell ratios. MIF in the supernatants was measured by an ELISA. Cells of a human gastric cancer cell line, MKN45, were then co-cultured with the supernatants, with and without monoclonal anti-MIF antibody for 24 h. The cells were further incubated for 12 h after addition of 3H-thymidine, and the levels of incorporation of 3H-thymidine were measured with a liquid scintillation counter. RESULTS: The wild-type strain and the isogenic mutants, TN2ΔcagA and TN2ΔcagE, increased MIF release at organism/cell ratios of 200/1 and 400/1, but not at the ratios of 50/1 and 100/1. However, the mutant TN2Δcag did not increase the release of MIF at any of the four ratios. 3H-thymidine readings for MKN-45 cells were significantly increased with supernatants derived from the wild-type strain and the mutants TN2ΔcagA and TN2ΔcagE, but not from the mutant TN2Δcag. Moreover, in the presence of monoclonal anti-MIF antibody, the stimulatory effects of the wild-type strain on cell proliferation disappeared. CONCLUSION: H pylori stimulates MIF release in monocytes, likely through its cag PAI, but not related to cagA or cagE. H pylori-stimulated monocyte culture supernatant increases gastric cell proliferation, which is blocked by anti-MIF antibody, suggesting that MIF plays an important role in H pylori-induced gastric ep

关键词： H pylori MIF PAI

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Hallux rigidus: How do I approach it?

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World Journal of Orthopedics 2017年第5期8卷 364-371页

作者： Aaron lam Jimmy J chan Michele F Surace Ettore Vulcano Albert Einstein College of Medicine Leni and Peter W. May De-partment of Orthopaedic Surgery Icahn School of Medicine at Mount Sinai Department of Orthopedics University of Insubria

Hallux rigidus is a degenerative disease of the first metatarsalphalangeal(MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1^(st) MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intraarticular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient's goal and expectations, and surgeon's experience with the technique.

关键词： Hallux rigidus Cheilectomy Arthrodiastasis Moberg osteotomy Arthodesis Interpositional arthroplasty Arthroplasty

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LINEAR AND HYPERBRANCHED POLYMERS WITH HIGH THERMAL STABILITY AND LUMINESCENCE EFFICIENCY

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Chinese Journal of Polymer Science 2001年第6期19卷 585-590页

作者： Jacky Wing Yip lam Jing-dong Luo Han Peng Zhi-liang Xie Kai-tian Xue Yu-ping Dong Lin Cheng Cheng-feng Qiu hoi Sing Kwok Ben-zhong Tang Departments of Chemistry and Electrical & Electronic Engineering Hong Kong University of Science & Technology Clear Water Bay, Kowloon, Hong Kong China 香港科技大学香港

New acetylene monomers, 6-{[(1-naphthylethynyl-4-phenyl)carbonyl]oxy}-1-phenyl-1-hexyne (1), 2,5-diethynyl-thiophene (3), and 4,4'-diethynylbiphenyl (6) were synthesized. Homopolymerization of 1 and copolycyclotrimerizations of 3 and 6 with 1-heptyne and 1-octyne have been achieved with WCl6- and TaCl5-Ph4Sn catalysts, respectively, giving soluble linear disubstituted polyacetylene (2) and hyperbranched polyarylenes (5 and 8) with high molecular weights (up to 1.2 x 10(5)) in high yields (up to 98%). The structures and properties of the polymers are characterized and evaluated by R NMR, TGA, UV, photoluminescence (PL), and electroluminescence (EL) analyses. All the polymers possess high thermal stability and emit strong blue light upon photoexcitation. The intensity of the emitted light is greater than that of poly(1-phenyl-1-octyne), a well-known highly luminescent disubstituted polyacetylene. Little aggregation-induced red shift in the PL was observed in the thin films of the polymers. By constructing a multi-layer EL device, high EL quantum yield (0.18%) has been achieved in 2, which are the best results for substituted polyacetylenes attainable so far.

关键词： disubstituted polyacetylene hyperbranched polyarylene light emission

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Fracture of Extensively Porous-Coated Cylindrical Femoral Stem Following Revision Total Hip Arthroplasty

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Chinese Medical Journal 2016年第11期129卷 1374-1376页

作者： Chao-Fan Zhang Chun hoi Yan Fu Yuen Ng Ping Keung chan Kwong Yuen Chiu Department of Orthopaedics and Traumatelogy The University of Hong Kong Queen Mary Hospital Hong Kong SAR China Department of Orthopaedics The First Affiliated Hospital of Fujian Medical University Fuzhou Fujian 350004 China Department of Orthopaedics and Traumatology The University of Hong Kong Shenzhen Hospital Shenzhen Guangdong 518053 China

Total hip arthroplasty （THA） is one of the most clinically successful surgeries. Despite the prevalence of THA, the number of revisions for septic or aseptic reasons continues to increase.

关键词： Extensively Porous-coated Stem Femoral Stem Fracture Revision Total Hip Arthroplasty

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Anesthetic Management of Pheochromocytoma in Pediatric Patient—Case Report

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Open Journal of Anesthesiology 2021年第6期11卷 175-183页

作者： lam Wai Teng Siu Man Kit chan Si Wai Leong Fai Department of Anesthesiology Centro Hospitalar Conde de S?o Januário Macao Special Administrative Region China

Background: Pediatric pheochromocytoma is very rare, accounting for only about 1% of pediatric hypertension. Case Presentation: We presented a case of pediatric pheochromocytoma in a 12-year-old girl undergoing laparoscopic adrenalectomy, with the aim of highlighting an anesthetic challenge. Conclusion: Preoperative screening of hereditary conditions, investigations for end-organ dysfunction, preoperative blood pressure optimization, intensive intraoperative hemodynamic management and good communication with surgeons were the cornerstones for this successful surgery.

关键词： Anesthesia Hemodynamic Pediatrics Pheochromocytoma

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Evaluation of the Psychological Impact of COVID-19 Pandemic on Chinese Patients with Common Mental Disorders in Primary Care: A Cross-Sectional Study

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Open Journal of Psychiatry 2022年第2期12卷 157-173页

作者： hoi Tik Fung Kit Ping Loretta Lai Man Hei Matthew Luk Pang Fai chan Department of Family Medicine and Primary Health Care United Christian Hospital and Tseung Kwan O Hospital Kowloon East Cluster Hospital Authority Hong Kong China

Purpose: Our study aimed to evaluate the psychological impact of COVID-19 pandemic on Chinese patients with common mental disorders in primary care in Hong Kong. Method: A cross-sectional study was conducted on 102 Chinese patients with common mental disorders and being followed up in two public integrated mental health clinics in Hong Kong from 1st November 2020 to 31st January 2021. Patients would be evaluated about the impact of COVID-19 pandemic on their mood and daily life by using a questionnaire which assessed social distancing effects, financial impact, relationship with family, anxiety and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 Questionnaire (GAD-7) would also be used to assess patients’ mood symptoms. Factors which were related to COVID-19 pandemic and associated with anxiety or depressive symptoms would be analysed. Results: The mean age of the subjects was 58.0 years and more patients were female (77.5%). There were 84.3% and 72.5% of patients reported their anxiety and depressive symptoms being affected by COVID-19 pandemic respectively. It was found that 17.6% of patients had their income decreased or were unemployed. About one-third (30.4%) of patients indicated that their relationship with their family was worsened while 8.8% was improved. Social distancing was significantly associated with anxiety (p = 0.006) and depressive symptoms (p 0.001) in patients with common mental disorders. Conclusion: There was considerably more psychological impact including an increase in anxiety and depressive symptoms due to COVID-19 pandemic in Chinese patients with existing common mental disorders in primary care. Primary care physicians should raise their awareness of the psychological impact of COVID-19 pandemic on their patients. Our findings shed light on mental health care planning and preventive measures during the COVID-19 pandemic and potential subsequent pandemics.

关键词： Psychological COVID-19 Common Mental Disorders Primary Care

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Spray freeze drying of small nucleic acids as inhaled powder for pulmonary delivery

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Asian Journal of Pharmaceutical Sciences 2018年第2期13卷 163-172页

作者： Wanling Liang Alan Y.L.chan Michael Y.T.Chow Fiona F.K.Lo Yingshan Qiu Philip C.L.Kwok Jenny K.W.lam Department of Pharmacology and Pharmacy Li Ka Shing Faculty of Medicine The University of Hong Kong Advanced Drug Delivery Group Faculty of Pharmacy The University of Sydney

The therapeutic potential of small nucleic acids such as small interfering RNA(siRNA) to treat lung diseases has been successfully demonstrated in many in vivo studies. A major barrier to their clinical application is the lack of a safe and efficient inhaled *** this study, spray freeze drying was employed to prepare dry powder of small nucleic *** and herring sperm DNA were used as bulking agent and model of small nucleic acid therapeutics, respectively. Formulations containing different solute concentration and DNA concentration were produced. The scanning electron microscope(SEM) images showed that the porosity of the particles increased as the solute concentration decreased. Powders prepared with solute concentration of 5% w/v were found to maintain a balance between porosity and robustness. Increasing concentration of DNA improved the aerosol performance of the formulation. The dry powder formulation containing 2% w/w DNA had a median diameter of 12.5 μm, and the aerosol performance study using next generation impactor(NGI) showed an emitted fraction(EF) and fine particle fraction(FPF) of 91% and 28% respectively. This formulation(5% w/v solute concentration and 2% w/w nucleic acid) was adopted subsequently to produce siRNA powder. The gel retardation and liquid chromatography assays showed that the siRNA remained intact after spray freeze drying even in the absence of delivery vector. The siRNA powder formulation exhibited a high EF of 92.4%and a modest FPF of around 20%. Further exploration of this technology to optimise inhaled siRNA powder formulation is warranted.

关键词： Inhalation Pulmonary delivery Small interfering RNA Spray freeze drying

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