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Epac2-deficiency leads to more severe retinal swelling, glial reactivity and oxidative stress in transient middle cerebral artery occlusion induced ischemic retinopathy

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Science China(Life Sciences) 2015年第6期58卷 521-530页

作者： LIU Jin YEUNG patrick Ka Kit CHENG Lu LO Amy Cheuk Yin chung Stephen Sum Man chung Sookja Kim Department of Anatomy Li Ka Shing Faculty of Medicine The University of Hong Kong Department of Ophthalmology Li Ka Shing Faculty of Medicine The University of Hong Kong Research Centre of Heart Brain Hormone and Healthy Aging Li Ka Shing Faculty of Medicine The University of Hong Kong Division of Science and Technology United International College Zhuhai 519085 China State Key Laboratory of Pharmaceutical Biotechnology The University of Hong Kong

Ischemia occurs in diabetic retinopathy with neuronal loss, edema, glial cell reactivity and oxidative stress. Epacs, consisting of Epac 1 and Epac2, are cAMP mediators playing important roles in maintenance of endothelial barrier and neuronal functions To investigate the roles of Epacs in the pathogenesis of ischemic retinopathy, transient middle cerebral artery occlusion （tMCAO） was performed on Epacl-deficient （Epacl-/- ） mice, Epac2-deficient （Epac2-/-） mice, and their wild type counter-parts （Epacl＋/＋ and Epac2＋/＋）. Two-hour occlusion and 22-hour reperfusion were conducted to induce ischemia/reperfusion injury to the retina. After tMCAO, the contralateral retinae displayed similar morphology between different genotypes. Neu-ronal loss, retinal edema and increase in immunoreactivity for aquaporin 4 （AQP4）, glial fibrillary acidic protein （GFAP）, peroxiredoxin 6 （Prx6） were observed in ipsilateral retinae. Epac2 / ipsilateral retinae showed more neuronal loss in retinal ganglion cell layer, increased retinal thickness and stronger immunostaining of AQP4, GFAP, and Prx6 than those of Epac2＋/＋. However, Epacl-/- ipsilateral retinae displayed similar pathology as those in Epacl＋/＋ mice. Our observations suggest that Epac2-deficiency led to more severe ischemic retinopathy after retinal ischemia/reperfusion injury.

关键词： Epac retina ischemia retinopathy

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

Survival analysis of breast cancer liver metastasis treated by hepatectomy: A propensity score analysis for Chinese women in Hong Kong

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Hepatobiliary & Pancreatic Diseases International 2019年第5期18卷 452-457页

作者： Tan To Cheung Kenneth SH Chok Albert CY Chan Simon hy Tsang Wing Chiu Dai Thomas CC Yau Ava Kwong chung Mau Lo Department of Surgery Queen Mary HospitalThe University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Medicine Queen Mary HospitalThe University of Hong Kong102 Pok Fu Lam RoadHong KongChina

Background: Survival of patients with breast cancer liver metastasis is very poor. This study aimed to analyze the survival outcome of hepatectomy for this patient population. Methods: From January 1995 to December 2014, 2522 patients with liver cancer received hepatectomy at our hospital. Twenty-one of them, all female, received the operation for breast cancer liver metastasis. Performance was compared with patients with colorectal liver metastasis treated with hepatectomy after propensity score analysis in a ratio of 1:3. Results: Twenty-one patients received hepatectomy for breast cancer. After propensity score matching, 63 patients who had hepatectomy for colorectal cancer were selected for comparison. There was no significant difference in immediate or short-term outcomes between the two groups of patients in terms of operative time, blood loss and surgical morbidities. All patients with breast cancer had R0 resection. No hospital death occurred. After hepatectomy, the 1-, 3- and 5-year overall survival rates were 100.0%, 58.9% and 58.9% respectively in patients with breast cancer. The 1-, 3- and 5-year overall survival rates were 95.0%, 57.2% and 39.7% respectively in patients with colorectal cancer (P = 0.572). On multivariate analysis, triple negative status was the only independent poor prognostic factor in breast cancer liver metastasis (OR = 6.411;95% CI: 1.351–30.435;P = 0.019). Conclusions: Hepatectomy is a safe and effective way of treating breast cancer liver metastasis at experienced centers where multidisciplinary adjuvant treatments are available. It can be considered more frequently as part of the multidisciplinary care for this patient population.

关键词： Liver cancer Breast cancer Hepatectomy Metastases

Samaritan donor interchange in living donor liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2014年第1期13卷 105-109页

作者： See Ching Chan Kenneth SH Chok William W Sharr Albert CY Chan Simon hy Tsang Wing Chiu Dai chung Mau Lo State Key Laboratory for Liver Research The University of Hong Kong Department of Surgery The University of Hong Kong

BACKGROUND: In order to overcome ABO blood group incompatibility, paired donor interchange has been practised in living donor liver transplantation. Liver transplantations using grafts donated by Samaritan living donors have been performed in Europe, North America, South Korea, and Hong Kong. Such practice is clearly on strong biological grounds although social and psychological implications could be far-reaching. Local experience has been satisfactory but is still limited. As few centers have this arrangement, its safety and viability are still being assessed under a clinical trial setting. METHODS: Here we report a donor interchange involving an ABO-compatible pair with a universal donor and an ABOincompatible pair with a universal recipient. This matching was not only a variation but also an extension of the donor interchange scheme. RESULTS: The four operations(two donor hepatectomies and two recipient operations) were successful. All the two donors and the two recipients recovered well. Such donor interchange further supports the altruistic principle of organ donation in contrast to exchange for a gain. CONCLUSIONS: Samaritan donor interchange certainly taxes further the ethical challenge of donor interchange. Although this practice has obvious biological advantages, such advantages have to be weighed against the potential increase in potential psychological risks to the subjects in the interchange. Further ethical and clinical evaluations of local and overseas experiences of donor interchange should guide future clinical practice in utilizing this potential organ source for transplantation.

关键词： orthotopic liver transplantation living donor liver transplantation right lobe

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

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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

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,P<0.0001) and at an earlier stage(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%,P<0.0001).They also had significantly 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

The ‘Unsigned highway’:An alternative route for portal vein anastomosis for non-malignant portal vein thrombosis during pediatric re-transplantation

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Hepatobiliary & Pancreatic Diseases International 2021年第2期20卷 193-195页

作者： Albert Chi Yan Chan Wing Chiu Dai patrick Ho Yu chung Wong Hoi She Sui Ling Sin Division of Liver Transplantation Department of SurgeryThe University of Hong KongHong KongChina Division of Paediatric Surgery Department of SurgeryThe University of Hong KongHong KongChina

To the Editor:Non-malignant portal vein thrombosis(PVT)remains an important issue in liver transplantation due to the technical challenges in re-establishing the portal flow to the liver *** prevalence of complex PVT(*** grade 4)was reported to be around 2.0%[1].In the early history of liver transplantation,PVT was regarded as a contraindication.

关键词： malignant thrombosis anastomosis

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

Validity of Alvarado Score in predicting disease severity and postoperative complication in pediatric acute appendicitis

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World Journal of Pediatric Surgery 2019年第1期2卷 1-5页

作者： patrick H Y chung Kanglin Dai Zhen Yang Kenneth K Y Wong Department of Surgery The University of Hong KongQueen Mary HospitalHong KongChina Department of Surgery The University of Hong Kong-Shenzhen HospitalShenzhenChina

background This study evaluates the validity of Alvarado Score in predicting disease severity and the development of postoperative complications in pediatric *** This is a retrospective,bicentered study on pediatric patients with emergency appendicectomy performed from 2006 to *** relationship of Alvarado Score(low:1-4,medium:5-6,high:7-10)and operative findings/complications was *** A total of 316 patients were included and the median age on admission was 10.8 *** overall median score was 8.***.13.3%,20.2%,and 66.5%of patients had low,medium,and high risk scores,respectively.36.1%of patients had complicated appendicitis and the median score was comparable with that of the uncomplicated cases(7.0 vs 7.4,p=0.21).More complicated cases were found in the medium-risk group(high vs medium vs low=29.7%vs 61.4%vs 31.0%,p=0.01).Rebound tenderness had the highest positive predictive value(65%)for complicated *** complications were found in 16.5%of patients with a higher median score(7.87 vs 5.8,p=0.01).Conclusion Alvarado Score does not predict disease severity but postoperative *** with medium risk score should also be treated promptly for the risk of having complicated *** tenderness may be a signal for complicated appendicitis and should be properly examined.

关键词： severity pediatric postoperative