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Outcomes and satisfaction of patients with orthopaedic implants left in-situ for more than three years： a retrospective study

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Chinese Medical Journal 2011年第15期124卷 2297-2300页

作者： Aaran Heng-Chi leung Jeffrey Shen Andraay Hon-Chi leung Yuk-Wah Hung Anna HW Mok Wing-Hoi Cheung kwok-sui leung Department of Orthopaedics and Traumatology The Chinese University of Hong Kong Shatin New Territories Hong Kong China Specialty Registrar Trauma and Orthopaedics West of Scotland Region NHS Scotland United Kingdom

Background There are no clear guidelines on implant removal. Few have assessed the long-term outcomes of patients with implants left in-situ, or removed. Therefore, removal of implants after fracture fixation remains controversial. Methods In this retrospective study, we reviewed 53 patients with implant for fracture fixation in-situ for more than 3 years. All patients were younger than 60 years. Quality of life of each patient was assessed with the Chinese （Hong Kong） validated Short Form-36 and the pain was assessed with visual analogue scale （VAS）. All patients were clinically examined and plain radiographs were taken. Results The total SF-36 score of the patients was not statistically different from the Hong Kong norm （P 〉0.05）. Mean score of VAS was 2.08. Thirty-three patients （62.3%） reported limited range of movement, 9 patients （17%） complained of cosmetic problems, and 10 patients （18.9%） complained of weakness. Clinically, 82.6% of patients had no scarring, 84.7% of patients had full range of movement and all had no tenderness on assessment. Radiologically, no abnormality was detected except for one patient with known avascular necrosis of the femoral head after screw fixation. Conclusion As most patients were clinically and radiologically normal with quality of life scores comparable to the norm, removal of implants is not advisable as a routine practice.

关键词： fracture fixation implant removal quality of life visual analogue scale refracture

Type ⅡB human skeletal muscle fibers positively correlate with bone mineral density irrespective to age

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Chinese Medical Journal 2010年第21期123卷 3009-3014页

作者： Wing-Hoi Cheung Wing-Sze Lee Ling Qin Ning Tang Vivian Wing-Yin Hung kwok-sui leung Department of Orthopaedics and Traumatology The Chinese University of Hong Kong Shatin Hong Kong China

Background Age-associated decrease in type ⅡA/B human skeletal muscle fibers was detected in human biopsies in our previous study. The relationship between change in muscle fiber typing and bone mineral density （BMD） is, however,unknown either cross-sectionally or longitudinally. We therefore conducted a cross-sectional study to investigate their correlation using human muscle *** Forty human subjects aged （53.4±20.2） years were recruited. Histomorphometric parameters of their muscle biopsies were measured by ATPase staining and image analysis, including average area percentage, fiber number percentage, mean fiber area, and area percentage of connective tissues. Hip and spine BMD was measured by dual-energy X-ray absorptiometry. Partial correlation with adjusting age was *** Type ⅡB muscle fiber was found positively correlated with hip BMD irrespective to age and demonstrated significantly stronger relationship with BMD among all fiber types, in terms of its cross-sectional area （r=0.380, P=0.029）and size （r=0.389, P=0.025）. Type ⅡA muscle fibers associated with hip BMD in mean fiber area only （r=0.420, P=0.015）.Conclusions Type ⅡB muscle fiber may play an important role in maintaining bone quality. This may also be a relatively more sensitive fiber type of sarcopenia and osteoporosis. These findings further consolidate the muscle-bone relationship.

关键词： type ⅡB muscle fiber bone mineral density muscle biopsy sarcopenia osteoporosis

Osteogenic enhancement of low intensity pulsed ultrasound on bone marrow mesenchymal stem cell

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Osteogenic enhancement of low intensity pulsed ultrasound on...

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

International Conference on Osteoporosis and Bone Research 2008

作者： Fan Fong Celine Hui Kwong Man Lee kwok sui leung Chun Yiu Jack Cheng Department of Orthopaedics and Traumatology The Chinese University of Hong KongHong KongChina Lee Hysan Clinical Research Laboratories The Chinese University of Hong KongHong KongChina

＜正＞Objective:Low intensity pulsed ultrasound （LIPUS） is known to accelerate mineralization and bone regeneration,but the osteogenic effect on mesenchymal stem cells （MSCs） is still *** study investigated the ef...

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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

Structural, densitometric and biomechanical evaluations of Chinese patients with long-term bisphosphonate treatment

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Chinese Medical Journal 2013年第1期126卷 27-33页

作者： leung kwok-sui TANG Ning James Griffith CHOY Tak-Kee HUNG Vivian Wing-Yin MOK Hoi-Wa SHI Lin leung Ping-Chung CHEUNG Wing-Hoi Department of Orthopaedics and Traumatology and Bone Quality and Health Center The Chinese University of Hong Kong Shatin Hong Kong SAR China Department of Imaging and Interventional Radiology The Chinese University of Hong Kong Shatin Hong Kong SAR China The Jockey Club Center for Osteoporosis Care and Control The Chinese University of Hong Kong Shatin Hong Kong SAR China Orthopaedic Research Laboratory of Translational MedicineResearch and Development Center Institute of Biomedical andHealth Engineering Shenzhen Institutes of Advanced TechnologyChinese Academy of Sciences China

Background The association of long-term bisphosphonate treatment for osteoporosis and related safety problems such as atypical fractures were not clearly defined. This study was to evaluate the structural, densitometric and biomechanical properties of the prolonged bisphosphonate-loaded bones. Methods Bone mineral density （BMD） at hip and femoral midshaft, bone cross-sectional area, moment of inertia of both femurs, bone formation and resorption biochemical markers were compared between 28 elderly with at least 4 years of bisphosphonate treatment from 2002 through 2006 and age-matched group of 37 elderly. Results The total hip BMD and t-score were found not different between two groups. However, bisphosphonate treated patients were found to have significantly lower bone mineral content in the femoral shaft （P 〈0.05）; morphological study showed lower cross-sectional area in subtrochanteric and mid-diaphyseal region and thus significantly lower moment of inertia （P 〈0.01）. High resolution-peripheral quantitative computed tomography showed significantly decreased trabeculardensity, bone volume ratio, trabecular number but increased trabecular spacing in tibia and distal radius. Finite element analysis further confirmed significantly lower stiffness and failure load in tibia. Biochemical studies also showed lower bone resorption and severely suppressed bone formation activity （P 〈0.001）. Conclusions The unchanged total hip BMD between two groups confirmed the beneficial effects of bisphosphonate on trabecular bone, thus preventing osteoporotic fractures at large in previous studies. However, the inferior structural, densitometric and biomechanical properties at cortical bones, especially femur midshaft, need a special attention to look into the association between long-term bisphosphonate intake and the occurrence of stress fractures. When patients taking bisphosphonate complain of proximal thigh pain or discomfort, plain X-ray film can be the first line screening. All

关键词： bisphosphonate bone mineral density moment of inertia HR-pQCT cortical bone

Revealing the residual stress distribution in laser welded Eurofer97 steel by neutron diffraction and Bragg edge imaging

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Journal of Materials Science & Technology 2022年第19期114卷 249-260页

作者： Bin Zhu Nathanael leung Winfried Kockelmann Saurabh Kabra Andrew JLondon Michael Gorley Mark JWhiting Yiqiang Wang Tan sui School of Mechanical Engineering Sciences University of SurreyGuildfordSurrey GU27XHUnited Kingdom Science and Technology Facilities Council(STFC)Rutherford Appleton Laboratory ISIS FacilityHarwell OX110QXUnited Kingdom United Kingdom Atomic Energy Authority Culham Centre for Fusion EnergyCulham Science CentreAbingdonOxon OX143DBUnited Kingdom

Eurofer97 steel is a primary structural material for applications in fusion reactors. Laser welding is a promising technique to join Eurofer97 plasma-facing components and overcome remote handling and maintenance challenges. The interaction of the induced residual stress and the heterogeneous microstructure degrades the mechanical performance of such fusion components. The present study investigates the distribution of residual stress in as-welded and post-heat treated Eurofer97 joints. The mechanistic connections between microstructure, material properties, and residual stress are also studied. Neutron diffraction is used to study the through-thickness residual stress distribution in three directions,and neutron Bragg edge imaging(NBEI) is applied to study the residual strain in high spatial *** microstructures and micro-hardness are characterised by electron backscatter diffraction and nanoindentation, respectively. The M-shaped residual stress distribution through the thickness of the as-welded weldment is observed by neutron diffraction line scans over a region of 1.41 × 10 mm^(2). These profiles are cross-validated over a larger area(∼56 × 40 mm^(2)) with the higher spatial resolution by NBEI. The micro-hardness value in the fusion zone of the as-welded sample almost doubles from 2.75 ± 0.09 GPa to 5.06 ± 0.29 GPa due to a combination of residual stress and cooling-induced martensite. Conventional post weld heat treatment(PWHT) is shown to release ∼90% of the residual stress but not fully restore the microstructure. By comparing its hardness with that of stress-free samples, it is found that the microstructure is the primary contribution to the hardening. This study provides insight into the prediction of structural integrity for critical structural components of fusion reactors.

关键词： Laser-welded Eurofer97 steel Residual stress Neutron diffraction Neutron Bragg edge imaging Nanoindentation EBSD

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X线透视导航技术在创伤骨科的应用

中华创伤骨科杂志 2005年第7期7卷 604-609页

作者：梁国穗香港特别行政区香港中文大学矫形外科及创伤学系

X线透视导航技术对创伤骨科尤为重要。因为术前骨折块及骨折移位的方向可发生改变,所以需在术中将骨折块整复对位后,才能进行透视图像的获取和导航手术操作。X线透视导航技术的优点包括减少X线暴露的时间、准确放置植入物、术中适时测... 详细信息

X线透视导航技术对创伤骨科尤为重要。因为术前骨折块及骨折移位的方向可发生改变,所以需在术中将骨折块整复对位后,才能进行透视图像的获取和导航手术操作。X线透视导航技术的优点包括减少X线暴露的时间、准确放置植入物、术中适时测量评估及改善创伤骨科的微创操作。随着软件和硬件的不断改进及发展,许多需要术中X线透视监控的手术操作现在都可以借助X线透视导航技术完成。我们过去四年的临床经验已证实X线透视导航技术的优点及不断扩大的应用领域。X线透视导航技术在不断进展,因此需要更多的临床实践来评价此技术的使用价值。另外,X线透视导航系统在虚拟外科环境的外科培训和评价中发挥重要作用。这一技术将不仅为年轻外科医生提供实践机会,而且也将产生设计外科技术资格客观评价系统的新领域。

关键词： X线透视导航技术创伤骨科微创

Attitudes of visitors at adult intensive care unit toward organ donation and organ support

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Chinese Medical Journal 2019年第3期132卷 373-376页

作者： Nga-Wing Tsai Yee-Man leung Pauline Yeung Ng Ting Liong sui-Fong Lee Chun-Wai Ngai Wai-Ching Sin Jenny Koo Wai-Ming Chan Adult Intensive Care Unit Queen Mary HospitalHong Kong 999077China Intensive Care Unit United Christian HospitalHong Kong 999077China Intensive Care Unit Kwong Wah HospitalHong Kong 999077China Central Nursing Department Queen Mary HospitalHong Kong 999077China

The concept of brain death was 1st introduced in the 1960s, providing an essential conceptual change to medical practice,[1] and its diagnosis is based on demonstrating the complete, irreversible cessation of brainste... 详细信息

关键词： brain death toward organ donation organ support

计算机辅助骨科手术常用器具和医学词汇英中文对照表

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中华创伤骨科杂志 2005年第7期7卷 620-624页

作者：梁国穗秦岭邓宁张戈香港特别行政区香港中文大学矫形外科及创伤学系

本文旨在介绍计算机辅助外科手术在术前计划、手术模拟和术中导航的应用,以及医用自动化机械臂的引入和手术导航系统的基本原理等.手术导航要求很高的精确度,因此引入和发展医用自动化机械臂十分必要.我们简要地回顾了目前的医用机器... 详细信息

本文旨在介绍计算机辅助外科手术在术前计划、手术模拟和术中导航的应用,以及医用自动化机械臂的引入和手术导航系统的基本原理等.手术导航要求很高的精确度,因此引入和发展医用自动化机械臂十分必要.我们简要地回顾了目前的医用机器人系统,同时也介绍了在香港中文大学所发展的机械臂系统以及在手术中的应用.导航指引下远端置入髓内钉的实验室测定显示机械臂的使用可以获得更好地可重复性和准确性.手术导航机械臂已经广泛应用于远端髓内钉的置入,经皮置入骶髂关节螺钉、髂骨螺钉、髋螺钉等骨科治疗中 .医用机械臂无疑将是计算机辅助手术未来发展的主要技术之一.

关键词：计算机辅助骨科手术 X线透视导航机械臂螺钉