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Indications of pro-inflammatory cytokines in laparoscopic and open liver resection for early-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 257-264页

作者： Kevin Tak-Pan Ng Li Pang Jia-Qi Wang Wong Hoi She simon hing-yin tsang Chung Mau Lo Kwan Man Tan To Cheung Department of Surgery HKU-SZH&School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:Our clinical practice of laparoscopic liver resection(LLR)had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma(HCC)over open liver resection(OLR),but the underlying mechanisms are not *** study was to find out whether systemic inflammation plays an important ***:A total of 103 patients with early-stage HCC under liver resection were enrolled(LLR group,n=53;OLR group,n=50).The expression of 9 inflammatory cytokines in patients at preoperation,postoperative day 1(POD1)and POD7 was quantified by Luminex Multiplex *** relationships of the cytokines and the postoperative outcomes were compared between LLR and ***:Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative *** to OLR,the POD1 levels of granulocytemacrophage colony-stimulating factor(GM-CSF),interleukin-6(IL-6),IL-8,and monocyte chemoattractant protein-1(MCP-1)in the LLR group were significantly *** POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during *** levels of these cytokines were positively associated with postoperative liver injury,and the length of hospital ***,a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver ***:Significantly lower level of GM-CSF,IL-6,IL-8,and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

关键词： Laparoscopic liver resection Open liver resection Hepatocellular carcinoma Postoperative cytokines Inflammatory responses

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Post-fontan circulation hepatocellular carcinoma:Open and laparoscopic hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 90-93页

作者： Karin KY Ho Wong Hoi She simon HY tsang Kevin S Lo Tan To Cheung Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Anaesthesiology Queen Mary Hospital102 Pok Fu Lam RoadHong KongChina

To the Editor:Fontan-associated liver disease shows increasing incidence as advances in pediatric cardiology have prolonged life expectancy in patients with single ventricle congenital heart defects[1].Their unique physiology and procedure-related sequelae present an increasingly relevant challenge in hepatic *** hereby reported a series of patients suffering from hepatocellular carcinoma(HCC)who successfully underwent open and laparoscopic hepatectomy.

关键词： hepatocellular hepatectomy surgery

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Integration of Chinese Medicine and Western Medicine in Clinical Practice(Patient Care):Past,Present,and A Proposed Model for the Future

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Chinese Journal of Integrative Medicine 2013年第2期19卷 83-85页

作者： Ian tsang simon Huang Barry Koehler Division of Rheumatology Department of MedicineUniversity of British ColumbiaVancouverBCCanada

Historic Background Chinese medicine （CM） has over 2,000 years of history in China and was the only health care system providing care for Chinese prior to the introduction of Western medicine （WM） into China. WM was slowly introduced into China by missionaries from the middle 17th century to the beginning of the 19th century. By 1840, WM began to take root in China. Western hospitals, clinics, medical schools and nursing schools spread rapidly throughout the country. At that time, with the might and power portrayed by Western countries,

关键词： Patient Care Past,Present,and A Proposed Model for the Future WM

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A joint computational-experimental study of intracranial aneurysms:Importance of the aspect ratio

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Journal of Hydrodynamics 2016年第3期28卷 462-472页

作者： simon Sui-Man LAI Abraham Yik-Sau TANG Anderson Chun-On tsang Gilberto Ka-Kit LEUNG Alfred Cheuk-Hang YU Kwok Wing CHOW Department of Electrical and Electronic Engineering University of Hong Kong Hong Kong China Department of Mechanical Engineering University of Hong Kong Hong Kong China Department of Surgery Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong China Department of Electrical and Computer Engineering University of Waterloo Ontario Canada

Rupture of a cerebral aneurysm （abnormal swelling of blood vessel in the brain） will cause subarachnoid hemorrhage, and will result in an alarming rate of mortality and morbidity. A joint computational-experimental study is conducted to assess the importance of the aspect ratio in the dynamics of blood flow. The aspect ratio is defined here to be the ratio of the height of the aneurysm to the linear dimension of the neck. Idealized models of such aneurysms located near a bifurcation point were investigated. Numerical simulations for hemodynamic properties like shear stress and flow rate were performed. The computational results were verified experimentally with specially fabricated phantoms, blood mimicking fluid and Doppler ultrasound imaging. Excellent agreements were obtained. Two features are highlighted, providing information in the intensely debated link between rupture risk and geometric factors. On increasing the aspect ratios, firstly, a jet impinging on the distal part of the neck can be observed, and secondly, a region of positive shear stress gradient can be found there. Furthermore, computational analyses for four patient-specific models were conducted to correlate with the results of idealized models and to provide further clinical insight.

关键词： intracranial aneurysms aspect ratio Doppler ultrasound

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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

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Current and future molecular diagnostics in colorectal cancer and colorectal adenoma

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World Journal of Gastroenterology 2014年第14期20卷 3847-3857页

作者： Andy Hin-Fung tsang Ka-Ho Cheng Apple Siu-Ping Wong simon Siu-Man Ng Brigette Buig-Yue Ma Charles Ming-Lok Chan Nancy Bo-yin Tsui Lawrence Wing-Chi Chan Benjamin Yat-Ming Yung Sze-Chuen Cesar Wong Department of Health Technology and Informatics Faculty of Health and Social SciencesHong Kong Polytechnic University Department of Surgery Prince of Wales Hospital State Key Laboratory in Oncology in South China Sir Y K Pao Centre for CancerDepartment of Clinical OncologyHong Kong Cancer Institute and Prince of Wales HospitalThe Chinese University of Hong Kong

Colorectal cancer(CRC)is one of the most prevalent cancers in developed *** the other hand,CRC is also one of the most curable cancers if it is detected in early stages through regular colonoscopy or *** CRC develops slowly from precancerous lesions,early detection can reduce both the incidence and mortality of the *** occult blood test is a widely used non-invasive screening tool for *** fecal occult blood test is simple and cost-effective in screening CRC,there is room for improvement in terms of the accuracy of the *** dysregulations have been found to play an important role in CRC *** better understanding of the molecular basis of CRC,there is a growing expectation on the development of diagnostic tests based on more sensitive and specific molecular markers and those tests may provide a breakthrough to the limitations of current screening tests for *** this review,the molecular basis of CRC development,the characteristics and applications of different non-invasive molecular biomarkers,as well as the technologies available for the detection were *** review intended to provide a summary on the current and future molecular diagnostics in CRC and its pre-malignant state,colorectal adenoma.

关键词： Colorectal cancer Colorectal adenoma Molecular diagnostics Fecal occult blood test Non-invasive

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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

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Computational Intelligence Determines Effective Rationality

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International Journal of Automation and computing 2008年第1期5卷 63-66页

作者： Edward P.K.tsang Centre for Computational Finance and Economic Agents University of EssexColchester CO4 3SQUK

Rationality is a fundamental concept in economics. Most researchers will accept that human beings are not fully rational. Herbert simon suggested that we are ＂bounded rational＂. However, it is very difficult to quantify ＂bounded rationality＂, and therefore it is difficult to pinpoint its impact to all those economic theories that depend on the assumption of full rationality. Ariel Rubinstein proposed to model bounded rationality by explicitly specifying the decision makers＇ decision-making procedures. This paper takes a computational point of view to Rubinstein＇s approach. From a computational point of view, decision procedures can be encoded in algorithms and heuristics. We argue that, everything else being equal, the effective rationality of an agent is determined by its computational power - we refer to this as the computational intelligence determines effective rationality （CIDER） theory. This is not an attempt to propose a unifying definition of bounded rationality. It is merely a proposal of a computational point of view of bounded rationality. This way of interpreting bounded rationality enables us to （computationally） reason about economic systems when the full rationality assumption is relaxed.

关键词： Rationality bounded rationality computational intelligence economics computational intelligence determines effective rationality (CIDER) theory.

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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

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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,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

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