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Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer

World Journal of Gastrointestinal Surgery 2020年第4期12卷 178-189页

作者： kar yong wong Aloysius MN Tan Colorectal Surgery Service Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Pelvic recurrence after rectal cancer surgery is still a significant problem despite the introduction of total mesorectal excision and chemoradiation treatment(CRT),and one of the most common areas of recurrence is in the lateral pelvic lymph ***,there is a possible role for lateral pelvic lymph node dissection(LPND)in rectal *** To evaluate the short-term outcomes of patients who underwent minimally invasive LPND during rectal cancer *** outcomes were to evaluate for any predictive factors to determine lymph node metastases based on pre-operative *** From October 2016 to November 2019,22 patients with stage II or III rectal cancer underwent minimally invasive rectal cancer surgery and *** patients were all discussed at a multidisciplinary tumor board meeting and most of them received neoadjuvant chemoradiation prior to *** patients had radiologically positive lateral pelvic lymph nodes on the initial staging scans,defined as lymph nodes larger than 7 mm in long axis measurement,or abnormal radiological *** was only performed on the involved *** Majority of the patients were male(18/22,81.8%),with a median age of 65 years(44-81).Eighteen patients completed neoadjuvant CRT pre-operatively.18 patients(81.8%)had unilateral LPND,with the others receiving bilateral *** median number of lateral pelvic lymph nodes harvested was 10(3-22)per pelvic side wall.8 patients(36.4%)had positive metastases identified in the lymph nodes *** median pre-CRT size of these positive lymph nodes was 10 *** length of stay was 7.5 d(3-76),and only 2 patients failed initial removal of their urinary *** rates were low,with only 1 lymphocele and 1 anastomotic *** was only 1 mortality(4.5%).There have been no recurrences so *** Chemoradiation is inadequate in completely eradicating lateral wall metastasis and there are still technical limitations in ac

关键词： Lateral pelvic lymph node dissection Robotic rectal surgery Locally advanced rectal cancer Local recurrence Pelvic side wall recurrence

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Feasibility of robotic assisted bladder sparing pelvic exenteration for locally advanced rectal cancer:A single institution case series

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World Journal of Gastrointestinal Surgery 2020年第4期12卷 190-196页

作者： Nathaniel H Heah kar yong wong Department of Urology Tan Tock Seng HospitalSingapore 308433Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Pelvic exenteration for locally advanced rectal cancer involving prostate has been performed via open *** pelvic exenteration offers benefits of better pelvic visualisation and dissection for bladder preserving prostatectomy with vesicourethral anastomosis,while achieving clear *** To determine the feasibility of robotic assisted bladder sparing pelvic *** We describe robotic assisted pelvic exenteration in three cases of locally advanced rectal cancer involving prostate and seminal vesicles(SV).The da Vinci S robotic system was *** console was docked at left oblique position for abdominal phase and redocked to between the patient’s legs for pelvic *** three cases were performed fully robotically at Tan Tock Seng Hospital by colorectal and urological *** Case 1:67-year-old with low rectal tumour 3 cm from anal verge involving the *** underwent neo-adjuvant chemoradiotherapy and robotic abdominoperineal resection with en-bloc *** 2:66-year-old with low rectal tumour 3 cm from anal verge involving prostate and bilateral *** underwent neo-adjuvant chemoradiotherapy and robot assisted ultra-low anterior resection with coloanal anastomosis and en-bloc *** 3:57-year-old with metachronous rectal tumour in the rectovesical pouch inseparable from the anterior mid rectum,prostate and bilateral *** underwent robot assisted ultra-low anterior resection with en-bloc *** neck margin revealed cauterized tumour cells,and he underwent total cystectomy and ileal conduit *** revealed no residual *** patients are currently disease free CONCLUSION Robot assisted bladder sparing pelvic exenteration can be safely performed in locally advanced rectal cancer with acceptable surgical outcome while preserving benefits of minimally invasive surgery.

关键词： Rectal cancer Robot surgery Pelvic exenteration Anterior resection Prostatectomy Minimal invasive surgery

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Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 777-789页

作者： Kai Siang Chan Biquan Liu Ming Ngan Aloysius Tan Kwang Yeong How kar yong wong Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality *** 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on *** LARC invading into other structures(i.e.T4b),multivisceral resection(MVR)and/or pelvic ex-enteration(PE)remains the only potential curative surgical *** and/or PE is a major and complex surgery with high post-operative *** invasive surgery(MIS)has been shown to improve short-term post-operative outcomes in other gastrointestinal malignancies,but there is little evi-dence on its use in MVR,especially so for robotic *** is a single-center retrospective cohort study from 1st January 2015 to 31st March *** criteria were patients diagnosed with cT4b rectal cancer and underwent MVR,or stage 4 disease with resectable systemic ***-tients who underwent curative MVR for locally recurrent rectal cancer,or me-tachronous rectal cancer were also *** criteria were patients with systemic metastases with non-resectable *** patients planned for elective surgery were enrolled into the standard enhanced recovery after surgery pathway with standard peri-operative management for colorectal *** sur-gery was defined based on technical difficulty of surgery(*** PE,bladder-sparing prostatectomy,pelvic lymph node dissection or need for flap creation).Our primary outcomes were the margin status,and complication ***-gorical values were described as percentages and analysed by the chi-square *** variables were expressed as median(range)and analysed by Mann-Whitney U *** overall survival(OS)and recurrence-free survival(RFS)were analysed using Kaplan-Meier estimates with life table ***-rank test was performed to determine statistical significance between cumulative *** significance was defined as P<*** estimates with li

关键词： Laparoscopy Minimally invasive surgical procedures Multivisceral resection Pelvic Exenteration Rectal neoplasms Robotic surgical procedures

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Is colonic lavage a suitable alternative for left-sided colonic emergencies?

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 379-391页

作者： Hui Yu Tham Wen Hui Lim Sneha Rajiv Jain Cheng Han Mg Snow Yunni Lin Jie Ling Xiao Fung Joon Foo kar yong wong Choon Seng Chong Department of Surgery University Surgical ClusterNational University HospitalSingapore 11759Singapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingapore 11759Singapore Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang HealthSingapore 544886Singapore Colorectal Surgery Service Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Division of Colorectal Surgery University Surgical ClusterNational University Health SystemSingapore 119228Singapore Department of General Surgery Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119228Singapore

BACKGROUND The use of intra-operative colonic lavage(IOCL)with primary anastomosis remains controversial in the emergency left-sided large bowel pathologies,with alternatives including Hartmann’s procedure,manual decompression and subtotal *** To compare the peri-operative outcomes of IOCL to other *** Electronic databases were searched for articles employing IOCL from inception till July 13,*** ratio and weighted mean differences(WMD)were estimated for dichotomous and continuous outcomes ***-arm meta-analysis was conducted using DerSimonian and Laird random *** Of 28 studies were included in this meta-analysis,involving 1142 undergoing IOCL,and 634 other *** leads to comparable rates of wound infection when compared to Hartmann’s procedure,and anastomotic leak and wound infection when compared to manual *** was a decreased length of hospital stay(WMD=-7.750;95%CI:-13.504 to-1.996;P=0.008)compared to manual decompression and an increased operating ***-arm meta-analysis found that overall mortality rates with IOCL was 4%(CI:0.03-0.05).Rates of anastomotic leak and wound infection were 3%(CI:0.02-0.04)and 12%(CI:0.09-0.16)*** IOCL leads to similar rates of post-operative complications compared to other *** extensive studies are needed to assess the outcomes of IOCL for emergency left-sided colonic surgeries.

关键词： Colon Colonic irrigation Intra-operative colonic lavage Anastomosis Emergency surgery Colonic neoplasm

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Surface-tailoring chlorine resistant materials and strategies for polyamide thin film composite reverse osmosis membranes

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Frontiers of Chemical Science and Engineering 2022年第5期16卷 564-591页

作者： Pei Sean Goh kar Chun wong Tuck Whye wong Ahmad Fauzi Ismail Advanced Membrane Technology Research Centre(AMTEC) School of Chemical and Energy EngineeringFaculty of EngineeringUniversiti Teknologi Malaysia81310 Johor BahruMalaysia

Polyamide thin film composite membranes have dominated current reverse osmosis market on account of their excellent separation performances compared to the integrally skinned *** their very promising separation performance,chlorine-induced degradation resulted from the susceptibility of polyamide toward chlorine attack has been regarded as the Achilles’s heel of polyamide thin film *** free chlorine species present during chlorine treatment can impair membrane performance through chlorination and depolymerization of the polyamide selective *** material point of view,a chemically stable membrane is crucial for the sustainable application of membrane separation process as it warrants a longer membrane lifespan and reduces the cost involved in membrane *** strategies,particularly those involved membrane material optimization and surface modifications,have been established to address this *** review discusses membrane degradation by free chlorine attack and its correlation with the surface chemistry of *** advancement in the development of chlorine resistant polyamide thin film composite membranes is reviewed based on the state-of-the-art surface modifications and tailoring approaches which include the in situ and postfabrication membrane modifications using a broad range of functional *** challenges and future directions in this field are also highlighted.

关键词： reverse osmosis polyamide thin film composite membranes chlorine resistance surface modification

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The construction of orthodox super rpp semigroups

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Science China Mathematics 2004年第4期47卷 552-565页

作者： He yong Guo Yuqi kar Ping Shum School of Computer Science Hunan University of Science&TechnologyXiangtan 411201China Department of Mathematics Southwest Normal UniversityChongqing 400715China Department of Mathematics Soochow UniversitySuzhou 215000China Faculty of Science The Chinese University of Hong KongShatinN.T.Hong KongChina

We define orthodox super rpp semigroups and study their semilattice decompositions. Standard representation theorem of orthodox super rpp semigroups whose subband of idempotents is in the varieties of bands described ... 详细信息

关键词： orthodox super rpp semigroup, band-like extension, left cancellative plank, semilattice decomposition, standard representation.

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Cryptococcal meningitis with pulmonary cryptococcoma in an immunocompetent patient: A case report

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Asian Pacific Journal of Tropical Medicine 2020年第1期13卷 46-48页

作者： Kee Tat Lee kar Ying yong Hock Hin Chua Department of Medicine Miri General HospitalSarawakMalaysia Infectious Disease Unit Department of MedicineSarawak General HospitalSarawakMalaysia

Rationale:Cryptococcal infections commonly occur in immunosuppressed patients and are uncommon in immunocompetent *** concerns:A 32 year old lady,active smoker presented with right chest pain,dry cough and loss of *** chest radiograph showed a lobulated lung mass in the right lower *** developed headache and right cranial nerve palsy during *** investigations were done including lumbar puncture,brain and chest ***:Cryptococcal meningitis with pulmonary ***:She received five months of effective antifungal treatment;however,the patient did not respond ***,removal of pulmonary cryptococcoma was ***:Her condition improved and she no longer had any ***:Disseminated cryptococcosis is rare in immunocompetent *** case highlights the importance of high index of suspicion and we postulate that lobectomy helped in reducing the cryptococcal burden in her body,thus facilitating better response to antifungal therapy.

关键词： Cryptococcoma Meningitis Immunocompetent Antifungal Lobectomy

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Modeling the causal regulatory network by integrating chromatin accessibility and transcriptome data

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National Science Review 2016年第2期3卷 240-251页

作者： yong Wang Rui Jiang Wing Hung wong Department of Statistics Department of Biomedical Data ScienceBio-X ProgramStanford University Academy of Mathematics and Systems Science National Center for Mathematics and Interdisciplinary SciencesChinese Academy of Sciences MOE Key Laboratory of Bioinformatics Bioinformatics Division and Center for Synthetic and Systems BiologyTNLISTDepartment of AutomationTsinghua University

Cell packs a lot of genetic and regulatory information through a structure known as chromatin,*** is wrapped around histone proteins and is tightly packed in a remarkable *** express a gene in a specific coding region,the chromatin would open up and DNA loop may be formed by interacting enhancers and ***,the mediator and cohesion complexes,sequence-specific transcription factors,and RNA polymerase Ⅱ are recruited and work together to elaborately regulate the expression *** is in pressing need to understand how the information,about when,where,and to what degree genes should be expressed,is embedded into chromatin structure and gene regulatory *** to large consortia such as Encyclopedia of DNA Elements(ENCODE) and Roadmap Epigenomic projects,extensive data on chromatin accessibility and transcript abundance are available across many tissues and cell *** rich data offer an exciting opportunity to model the causal regulatory ***,we will review the current experimental approaches,foundational data,computational problems,interpretive frameworks,and integrative models that will enable the accurate interpretation of regulatory ***,we will discuss the efforts to organize,analyze,model,and integrate the DNA accessibility data,transcriptional data,and functional genomic regions *** believe that these efforts will eventually help us understand the information flow within the cell and will influence research directions across many fields.

关键词： gene regulatory network open chromatin DNA accessibility transcription factor colocalization statistical model data integration

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Voltage-gated K^+channels promote BT-474 breast cancer cell migration

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Chinese Journal of Cancer Research 2018年第6期30卷 613-622页

作者： Louis WC Chow Ka-Shun Cheng kar-Lok wong Yuk-Man Leung State Key Laboratory of Quality Research in Chinese Medicines Macao University of Science and TechnologyTaipaMacao 999078China UNIMED Medical Institute Hong Kong 999077China Organisation for Oncology and Translational Research Hong Kong 999077China Department of Anesthesiology China Medical University HospitalTaiehung 40447TaiwanChina Department of Anesthesiology the Qingdao University Yuhuangding HospitalYantai 264000China Department of Physiology China Medical UniversityTaichung 40402TaiwanChina

Objective: A variety of ion channels have been implicated in breast cancer proliferation and *** K+(Kv) channels not only cause repolarization in excitable cells,but are also involved in multiple cellular functions in non-excitable *** this study we investigated the role of Kv channels in migration of BT474 breast cancer ***: Transwell technique was used to separate migratory cells from non-migratory ones and these two groups of cells were subject to electrophysiological examinations and microfluorimetric measurements for cytosolic *** migration was examined in the absence or presence of Kv channel ***: When compared with non-migratory cells,migratory cells had much higher Kv current densities,but rather unexpectedly,more depolarized membrane potential and reduced *** transcriptasepolymerase chain reaction(RT-PCR) analysis revealed the presence of Kv1.1,Kv1.3,Kv1.5,Kv2.1,Kv3.3,Kv3.4 and Kv4.3 *** migration was markedly inhibited by tetraethylammonium(TEA),a delayed rectifier Kv channel blocker,but not by 4-aminopyridine,an A-type Kv channel ***: Taken together,our results show that increased Kv channel expression played a role in BT474 cell migration,and Kv channels could be considered as biomarkers or potential therapeutic targets for breast cancer *** mechanism(s) by which Kv channels enhanced migration appeared unrelated to membrane hyperpolarization and Cainflux.

关键词： Breast cancer Kv channels migration biomarkers

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Investigation of Taylor-Gortler-like Vortices Using the Parallel Consistent Splitting Scheme

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Advances in Applied Mathematics and Mechanics 2009年第6期1卷 799-815页

作者： yong Hong Kuo Kawi-Lam wong Jeff Chak-Fu wong The Joint Institute for Computational Sciences University of Tennessee/Oak Ridge National LaboratoryBuilding 5100RM 209Mail Stop 6013Bethel Valley RoadP.O.Box 2008 Oak RidgeTN 37831-6013 Department of Mathematics Room 220Lady Shaw BuildingThe Chinese University of Hong KongShatinHong KongChina

Symmetric Taylor-Gortler-like vortices at Re=3200 and 5000 in 3D rectangular cavities with a moving top lid are studied numerically and tested with a spanwise aspect ratio of 1:1:L,where L=1,2,*** are obtained by solving the momentum equations and the continuity equations using the consistent splitting *** code presented here was ported to the Parallel Interoperable Computational Mechanics System Simulator(PICMSS).Stable solutions are obtained as limit cases of the transients.

关键词： Mixed finite element consistent splitting scheme PICMSS

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