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| 1 | 香港华人妇女产后抑郁危险因素的前瞻性研究显示文摘目的:产后抑郁是一种常见的精神障碍,对产妇、新生儿和其它家庭成员导致广泛的伤害。产后抑郁的病因学研究大多是基于西方样本,对其中的社会文化原因也缺乏实证研究。本研究从人口学、心理社会及种族文化因素等方面探讨中国妇女产后抑郁症状学的决定因素。方法:在大学附属综合医院产前门诊连续收集登记的中国孕妇959例,从她们第一次产前检查开始评估(基线),以后分别在孕期的最后3个月、产后即刻和产后3个月时评估。调查涉及的危险因素分6个方面:人口学和社会经济背景,躯体疾病及精神疾病病史, 产前抑郁情绪,围生期应激源,人际关系,和种族文化环境。采用等级回归进行分析。因变量是产后3个月时的抑郁评分。结果:决定产后抑郁症状学的因素有:目前的生活事件,缺乏社会支持,婚姻不满意,既往有故意自伤史,以及产前存在抑郁情绪。婆媳关系不好和没有陪月在产后阶段也与抑郁评分高有关联。结论:西方研究所确立的产后抑郁危险因素大体适用于中国妇女。产褥期的社会文化特点同样对产妇情绪有影响。 | Dominic TS Lee Alexander SK Yip Sandra SM Chan Fiona FY Lee Tony YS Leung Tony KH Chung | 2005 | 中国心理卫生杂志2005,19,9: | 50 |
| 2 | High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients显示文摘AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 mo.Twenty-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before transplantation.Five patients received HIFU ablation as a bridging therapy.Another five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison.Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of cirrhosis.RESULTS:The HIFU group and TACE group showed no difference in terms of tumor size and tumor number.One patient in the HIFU group and no patient in the TACE group had gross ascites.The median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication occurred.In the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the treatment.In the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis.It may reduce the drop-out rate of liver transplant candidate. | Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai Ronnie TP Poon Chung Mau Lo | 2013 | World Journal of Gastroenterology2013,19,20: | 23 |
| 3 | Estimating liver weight of adults by body weight and gender显示文摘瞄准:为了为估计接枝的足够估计标准肝重量,为癌症在主要肝切除术在实时施主肝移植和残余肝缩放。方法:在这研究,体重和身高的人体测量的数据在 159 个实时的肝施主为与肝重量的关联被测试包括中间的肝的静脉经历了施主权利肝切除术。肝重量从在背表格获得的正确脑叶接枝重量被计算,在计算断层摄影术上由正确脑叶的比例划分了。结果:这些题目,所有汉语,有 35.8+/-10.5 年,和女性的吝啬的年龄到 118:41 的男比率。正确脑叶的吝啬的体积是 710.14+/-131.46 mL 并且在计算断层摄影术上占据了整个肝的 64.55%+/-4.47% 。正确脑叶称了 598.90+/-117.39 g,估计的肝重量是 927.54+/-168.78 g。当体重和身高受到多重逐步的线性回归分析时,身高被发现不足道。一样的体重的女性有稍微更低的肝重量。一个公式基于体重和性被导出:估计的标准肝重量(g)= 218 + BW (kg ) x 12.3 + 性 x 51 (R2 = 0.48 )( 女 = 0,男 = 1 ) 。基于这 159 个题目,的人体测量的数据肝重量用在白种人,日语,朝鲜语,和汉语上从研究导出的以前出版的公式被计算。所有公式与这个公式相比过高估计肝重量。日本公式为成年人过高估计估计的标准肝重量(ESLW ) 不到 60 kg。结论:对中国男性和女性适用的一个公式是可得到的。为单个赛跑的一个公式显得必要。 | See Ching Chan Chi Leung Liu Chung Mau Lo Banny K Lam Evelyn W Lee Yik Wong Sheung Tat Fan | 2006 | World Journal of Gastroenterology2006,12,14: | 22 |
| 4 | Prevalence of clonorchiasis in patients with gastrointestinal disease: A Korean nationwide multicenter survey显示文摘AIM: To investigate prevalence of Clonorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea.METHODS: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire.RESULTS: Of 3080 patients with gastrointestinal diseases, 396 (12.9%) had clonorchiasis and 1140 patients (37.2%) had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 (20.9%) patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than non-infected patients [34/396 (8.6%) vs 145/2684 (5.4%), P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation (P = 0.008). Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis.CONCLUSION: Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite. | Ho Gak Kim Jimin Han Myung-Hwan Kim Kyu Hyun Cho Im Hee Shin Gwang Ha Kim Jae Seon Kim Jin Bong Kim Tae Nyeun Kim Tae Hyeon Kim Tae Hyo Kim Jae Woo Kim Ji Kon Ryu Young-Soo Moon Jong Ho Moon Sung Jae Park Chan Guk Park Sung-Jo Bang Chang Heon Yang Kyo-Sang Yoo Byung Moo Yoo Kyu Taek Lee Dong Ki Lee Byung Seok Lee Sang Soo Lee Seung Ok Lee Woo Jin Lee Chang Min Cho Young-Eun Joo Gab Jin Cheon Young Woo Choi Jae Bok Chung Yong Bum Yoon | 2009 | World Journal of Gastroenterology2009,15,1: | 15 |
| 5 | Combined resection and radiofrequency ablation for multifocal hepatocellular carcinoma: Prognosis and outcomes显示文摘AIM: To analyze the combined treatment of resection and intraoperative radiofrequency ablation (RFA) for multifocal hepatocellular carcinoma in terms of prognosis and surgical outcomes.METHODS: This study was a retrospective case comparison study using prospectively collected data. The study covered the period from April 2001 to December 2006. The data of 200 patients with histologically confirmed hepatocellular carcinoma were reviewed. Nineteen patients (17 men and 2 women) having received resection in combination with RFA were chosen as subjects of the study (the combination group). Fiftyfour patients (43 men and 11 women) having received resection alone were selected for comparison (the resection group). The two groups matched tumor number and tumor size, and all the patients in the two groups displayed no tumor rupture, major vascular involvement and distant metastasis. Their demographics, preoperative assessment, disease recurrence patterns, overall survival and diseasefree survival were compared.RESULTS: In the combination group, the medianage was 65 years (range, 3477 years), the median tumor number was 3 (range, 29), and the median tumor size was 6 cm (range, 1.214 cm). In the resection group, the median age was 51.5 years (range, 2780 years, P = 0.003), the median tumor number was 3 (range, 29, P = 0.574), and the median tumor size was 6 cm (range, 114 cm, P = 0.782). The two groups were similar in characteristics of tumors and comorbidities, and had comparable results in preoperative liver function tests. All patients had ChildPugh class A status. Bilobar involvement occurred in 14 patients (73.6%) in the combination group and 3 patients (5.5%) in the resection group (P = 0.04). Six patients (32%) in the combination group and 35 patients (65%) in the resection group underwent major hepatectomy. Thirteen patients (68%) in the combination group and 19 patients (35%) in the resection group underwent minor hepatectomy (P = 0.012). The combination group had fewer major resections (32% vs 65%, P = 0.012), less blood loss (400 vs 657 mL, P = 0.007), shorter operation time (270 vs 400 min, P = 0.001), and shorter hospital stay (7 vs 8.5 d, P = 0.042). The two groups displayed no major differences in surgical complications (15.8% vs 31.5%, P = 0.24), disease recurrence (63.2% vs 50%, P = 0.673), hospital mortality (5.3% vs 5.6%, P = 1), and overall survival (53 vs 44.5 mo, P = 0.496).CONCLUSION: Safe and effective for selected patients with multifocal hepatocellular carcinoma, the combination of resection and intraoperative RFA widens the applicability of surgical intervention for the disease. | Tan To Cheung Kelvin K Ng Kenneth S Chok See Ching Chan Ronnie T Poon Chung Mau Lo Sheung Tat Fan | 2010 | World Journal of Gastroenterology2010,16,24: | 14 |
| 6 | Low grade gastric mucosa associated lymphoid tissue lymphoma:Treatment strategies based on 10 year follow-up显示文摘AIM:To deduce strategic guidelines of gastric mucosa associated lymphoid tissue lymphoma (MALTOMA) by evaluating the long-term outcome of patients in respect to various treatment modalities.METHODS:A total of 55 patients with MALTOMA from May 1992 to August 2002 were retrospectively reviewed.RESULTS: Complete remission was obtained in 24 (82.8%) of 29 patients treated with anti Helicobacter pylori(H pylori) regimen only. The duration to reach complete remission was 12 months (85 percentile, 2-33 months).Five patients showed complete remission with radiation therapy (26-86 months).Two of them were Hpyloritreatment failure cases.CONCLUSION: Hpylorieradication is an effective primary treatment option for low grade MALTOMA and radiation therapy could be considered in patients with no evidence of Hpyloninfection or who do not respond to Hpylorieradication therapy 12 months after successful eradication. | Sang Kil Lee Yong Chan Lee Jae Bock Chung Chae Yoon Chon Young Myoung Moon Jin Kyung Kang In-Suh Park Chang Ok Suh Woo Ik Yang | 2004 | World Journal of Gastroenterology2004,10,2: | 12 |
| 7 | 亚洲近视管理共识显示文摘指南的目标本指南是从国际近视研究所(IMI)白皮书中提取出来的有关近视管理方面的建议[1,2]。本指南所提供的内容都是根据现有最新数据(截至2022年3月)而来,其治疗可行性和执业范围因地区而异,应根据实际情况做调整。眼保健专家组通过对现有最优科学数据进行分析诠释,从而形成了本指南。在工作中,近视管理从业者应该将患者需求放在首位,全面考虑患者具体情况后再提出合适的处理意见。 | Monica Jong Serge Resnikoff Kah Ooi Tan 吕帆 Kah Meng Chung 胡楚南 Ian Morgan Oliver Kam Tong Woo 蓝卫忠 齐备 瞿佳 杨智宽 樊志诚 吴佩昌 Ian Flitcroft Murphy Hian Kee Chan Thok Chuan Tan Charlie Ho David Chai Wong Chong Liang Hwee Koh Olivia Qian Ru Cheng | 2022 | 中华眼视光学与视觉科学杂志2022,24,3: | 11 |
| 8 | Indoleamine 2,3-dioxygenase (IDO) is essential for dendritic cell activation and chemotactic responsiveness to chemokines显示文摘Indoleamine 2, 3-dioxygenase (IDO) is a rate-limiting enzyme for the tryptophan catabolism. In human and murine cells, IDO inhibits antigen-specific T cell proliferation in vitro and suppresses T cell responses to fetal alloantigens during murine pregnancy. In mice, IDO expression is an inducible feature of specific subsets of dendritic cells (DCs), and is important for T cell regulatory properties. However, the effect of IDO and tryptophan deprivation on DC func- tions remains unknown. We report here that when tryptophan utilization was prevented by a pharmacological inhibitor of IDO, 1-methyl tryptophan (1MT), DC activation induced by pathogenic stimulus lipopolysaccharide (LPS) or inflam- matory cytokine TNF-α was inhibited both phenotypically and functionally. Such an effect was less remarkable when DC was stimulated by a physiological stimulus, CD40 ligand. Tryptophan deprivation during DC activation also regu- lated the expression of CCR5 and CXCR4, as well as DC responsiveness to chemokines. These results suggest that tryptophan usage in the microenvironment is essential for DC maturation, and may also play a role in the regulation of DC migratory behaviors. | Shih Ling HWANG Nancy Pei-Yee CHUNG Jacqueline Kwai-Yi CHAN Chen-Lung Steve LIN | 2005 | Cell Research2005,15,3: | 11 |
| 9 | Impact of tumor location on clinical outcomes of gastric endoscopic submucosal dissection显示文摘AIM:To determine whether there is a correlation between the location of the lesion and endoscopic submucosal dissection(ESD)outcome.METHODS:From January 2008 to December 2010,ESD of 1443 gastric tumors was performed.En bloc resection rate,complete resection rate,procedure time and complication rate were analyzed according to the tumor location.RESULTS:The rates of en bloc resection and complete resection were 91%(1318/1443)and 89%(1287/1443),respectively.The post-ESD bleeding rate was 4.3%,and perforation rate was 2.7%.Tumors located in the upper third of the stomach were associated with a longer procedure time and significantly higher rates of incomplete resection,piecemeal resection,and perforation than tumors below the upper third of the stomach.Posterior wall lesions had significantly longer procedure times and higher rates of incomplete resection and piecemeal resection than lesions in other locations.In multivariate analysis,posterior wall lesions and upper third lesions were significantly associated with incomplete resection and perforation,respectively.In post-ESD bleeding analysis,location was not a significant related factor.CONCLUSION:More advanced endoscopic techniques are required during ESD for lesions located in the upper third or posterior wall of the stomach to decrease complications and improve therapeutic outcomes. | Ji Young Yoon Choong Nam Shim Sook Hee Chung Wan Park Hyunsoo Chung Hyuk Lee Sung Kwan Shin Sang Kil Lee Yong Chan Lee Jun Chul Park | 2014 | World Journal of Gastroenterology2014,20,26: | 10 |
| 10 | Pancreaticoduodenectomy with vascular reconstruction for adenocarcinoma of the pancreas with borderline resectability显示文摘AIM:To analyze whether pancreaticoduodenectomy with simultaneous resection of tumor-involved vessels is a safe approach with acceptable patient survival.METHODS:Between January 2001 and March 2012,136 patients received pancreaticoduodenectomy for adenocarcinoma at our hospital.Seventy-eight patients diagnosed with pancreatic head carcinoma were included in this study.Among them,46 patients received standard pancreaticoduodenectomy(group 1)and32 patients received pancreaticoduodenectomy with simultaneous resection of the portal vein or the superior mesenteric vein or artery(group 2)followed by reconstruction.The immediate surgical outcomes and survivals were compared between the groups.Fifty-five patients with unresectable adenocarcinoma of the pancreas without liver metastasis who received only bypassoperations(group 3)were selected for additional survival comparison.RESULTS:The median ages of patients were 67 years(range:37-82 years)in group 1,and 63 years(range:35-86 years)in group 2.All group 2 patients had resection of the portal vein or the superior mesenteric vein and three patients had resection of the superior mesenteric artery.The pancreatic fistula formation rate was21.7%(10/46)in group 1 and 15.6%(5/32)in group2(P=0.662).Two hospital deaths(4.3%)occurred in group 1 and one hospital death(3.1%)occurred in group 2(P=0.641).The one-year,three-year and five-year overall survival rates in group 1 were 71.1%,23.6%and 13.5%,respectively.The corresponding rates in group 2 were 70.6%,33.3%and 22.2%(P=0.815).The one-year survival rate in group 3 was13.8%.Pancreaticoduodenectomy with simultaneous vascular resection was safe for pancreatic head adenocarcinoma.CONCLUSION:The short-term and survival outcomes with simultaneous resection were not compromised when compared with that of standard pancreaticoduodenectomy. | 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 | 2014 | World Journal of Gastroenterology2014,20,46: | 8 |
| 11 | High level of preoperative carbohydrate antigen 19-9 is a poor survival predictor in gastric cancer显示文摘AIM:To assess the clinical significance and the prognostic value of preoperative serum carbohydrate antigen 19-9(CA 19-9)level in gastric cancer.METHODS:Between January 2005 and December2006,1960 patients underwent surgery for histologically confirmed gastric cancer.Of these,163 patients had elevated serum levels of CA 19-9 preoperatively,and1628 patients had normal serum levels of CA 19-9 preoperatively.For this study,325 patients were selected from the group of 1628 patients by age,sex,and cancer stage to serve as controls.Statistically significant differences in survival rates were calculated using the log-rank test.A P value less than 0.05 was considered statistically significant and was determined using SAS software.RESULTS:The baseline characteristics showed some differences between the two groups with regard to histology.Overall survival(OS)in the elevated and nonelevated group was 37.90 and 68.67 mo,respectively(P<0.001).N stage(P=0.001)was a significant predictor of disease-free survival by multivariate analysis.Also,N stage(P<0.001),and the presence of peritoneal metastasis(P<0.001)remained independent factors in predicting OS by multivariate analysis.Additionally,preoperative serum CA 19-9 levels were significantly associated with OS in univariate(P=0.009)and multivariate(P=0.021)analyses.CONCLUSION:Serum CA 19-9 can be considered an independent prognostic factor in predicting OS in patients anticipating surgery for gastric cancer. | A Ra Choi Jun Chul Park Jie-Hyun Kim Sung Kwan Shin Sang Kil Lee Yong Chan Lee Jae Bock Chung | 2013 | World Journal of Gastroenterology2013,19,32: | 8 |
| 12 | Awareness and knowledge of hepatitis B infection and prevention and the use of hepatitis B vaccination in the Hong Kong adult Chinese population显示文摘背景肝炎 B 病毒( HBV )感染仍然是一个全球公共健康问题,它是尖锐、长期、暴发性的肝炎,肝肝硬化和在在在 10 点未改变的仍然是的过去的十年的香港的 HBV 感染的 hepatocellular carcinoma.The 流行的一个重要原因,尽管有实现通用新生并且当前的局势对 HBV 传播和预防的不适当的了解和知识可归因的成年 vaccination.We | Wah, Chung Pui Hung, Suen Sik Ka, Chan Oi Hsi, Lao Tzu Yeung, Leung Tak | 2012 | Chinese Medical Journal2012,,3: | 8 |
| 13 | Little girl who conquered the 'ALPPS''显示文摘An insufficient future liver remnant(FLR)is associated with post-hepatectomy liver failure.Associating liver partition and portal vein ligation for stage hepatectomy(ALPPS)has been shown to be effective for the induction of rapid FLR hypertrophy so as to improve the resectability in patients with insufficient FLR.We hereby report our experience of this novel approach for a 6-year-old patient with hepatoblastoma.Computed tomography showed a hepatoblastoma measuring12.5 cm×9.9 cm×11.7 cm in the right liver(Couinaud segmentⅣ,ⅤandⅧ).Volumetric assessment of the FLR i.e.,left lateral section was 112.6 mL i.e.,21.2%of the estimated total liver volume.In view of the small-for-size FLR,ALPPS was contemplated.An anterior approach was adopted for the in-situ parenchymal split without mobilisation of the right liver.FLR volumetry on the seventh postoperative day was 160.7 mL,which represented a 46.1%gain in volume,and a FLR/ESLV ratio of 30.2%.A right trisectionectomy was performed on the eighth postoperative day.Postoperative recovery was uneventful.Patient was discharged on day 16 after the first operation.To our knowledge,this was the first report that showed the applicability of ALPPS to a paediatric patient. | Albert Chan Patrick HY Chung Ronnie TP Poon | 2014 | World Journal of Gastroenterology2014,20,29: | 8 |
| 14 | Rapid measurement of indocyanine green retention by pulse spectrophotometry: a validation study in 70 patients with Child-Pugh A cirrhosis before hepatectomy for hepatocellular carcinoma显示文摘BACKGROUND: The indocyanine green (ICG) retention test is the most popular liver function test for selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly- developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON , one of the pulse spectrophotometry systems, in measuring preoperative ICG retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICG retention was measured by the traditional method. METHODS: We measured the liver function of 70 Child-Pugh A cirrhotic patients before hepatectomy for hepatocellular carcinoma from September 2008 to January 2009. ICG retention at 15 minutes measured by traditional spectrophotometry (ICGR15) was compared with ICG retention at 15 minutes measured by the LiMON (ICGR15(L)). RESULTS: The median ICGR15 was 14.7% (5.6%-32%) and the median ICGR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation between ICGR15 and ICGR15(L) (correlation coefficient, 0.844; 95% confidence interval, 0.762-0.899). The following formula was devised: ICGR15=1.16×ICGR15(L)+2.73.CONCLUSIONS: The LiMON provides a fast and repeatable way to measure ICG retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results obtained by traditional spectrophotometry and the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula. | Tan To Cheung See Ching Chan Kenneth SH Chok Albert CY Chan Wan Ching Yu Ronnie TP Poon Chung Mau Lo Sheung Tat Fan | 2012 | Hepatobiliary & Pancreatic Diseases International2012,11,3: | 8 |
| 15 | Survival outcomes of liver transplantation for hepatocellular carcinoma in patients with normal, high and very high preoperative alpha-fetoprotein levels显示文摘AIM To investigate the impact of alpha-fetoprotein(AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient survival.METHODS Data of adult patients who received liver transplant(LT) for hepatocellular carcinoma(HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes. Patients were mostly listed for LT based on Milan or UCSF criteria. For the purpose of this study, normal AFP level was defined as AFP value < 10 ng/m L, high AFP level was defined as AFP value ≥ 10 to < 400 ng/m L, and very highAFP level was defined as AFP ≥ 400 ng/m L. The patients were divided into these 3 groups accordingly. Survival rates were plotted as Kaplan-Meier curves and compared by log-rank analysis. Continuous variables were expressed as median(interquartile range). Categorical variables were compared by Spearman's test. Discriminative analysis was used to define the lowest value of AFP that could affect the overall survival in study population. Statistical significance was defined by a P value of < 0.05.RESULTS Totally 250 adult patients underwent LT for HCC in the study period. Eight-four of them received deceaseddonor LT and 166 had living-donor LT. The patients were divided into 3 groups: Group A, AFP < 10 ng/m L(n = 83); Group B, AFP ≥ 10 to < 400 ng/m L(n = 131); Group C, AFP ≥ 400 ng/m L(n = 36). The commonest etiology was hepatitis-B-related cirrhosis. The Model for End-stage Liver Disease scores in these groups were similar(median, 13 vs 13 vs 12; P = 0.745). The time to operation in Group A was longer(median, 94 vs 31 vs 35 d; P = 0.001). The groups were similar in hospital mortality(P = 0.626) and postoperative complication(P = 0.702). Pathology of explants showed that the 3 groups had similar numbers of tumor nodules, but the tumors in Group C were larger(A: 2.5 cm, B: 3.0 cm, C: 4.0 cm; P = 0.003). Group C had a bigger proportion of patients who were beyond Milan criteria(P = 0.010). Poor differentiation and vascular permeation were also more common in this group(P = 0.017 and P = 0.003 respectively). It also had poorer 5-year survival(A: 85.5%, B: 82.4%, C: 66%; P = 0.029). The 5-year disease-free survival was 84.3% in Group A, 80.1% in Group B, and 61.1% in Group C. Receiver operating characteristic area under the curve for AFP in predicting tumor recurrence was 0.685. The selected cut-off value was 54 ng/m L for AFP(C-index 0.685; 95%CI: 0.592-0.779; sensitivity 0.595; specificity 0.687). On discriminative analysis, AFP value of 105 ng/m L was shown to affect the overall survival of the patients.CONCLUSION HCC patients with a high preoperative AFP level had inferior survival after LT. AFP level of 54 ng/m L was associated with disease recurrence, and AFP level of 105 ng/m L was found to be the cut-off value for overall survival difference. | Wong Hoi She Albert Chi Yan Chan Tan To Cheung Chung Mau Lo Kenneth Siu Ho Chok | 2018 | World Journal of Hepatology2018,10,2: | 7 |
| 16 | Survival outcomes of right-lobe living donor liver transplantation for patients with high Model for End-stage Liver Disease scores显示文摘BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a high MELD score would result in inferior outcomes of right-lobe LDLT. METHODS: Among 411 consecutive patients who received right-lobe LDLT at our center, 143 were included in this study. The patients were divided into two groups according to their MELD scores: a high-score group (MELD score ≥25; n=75) and a low-score group (MELD score <25; n=68). Their demographic data and perioperative conditions were compared. Univariable and multivariable analyses were performed to identify risk factors affecting patient survival. RESULTS: In the high-score group, more patients required preoperative intensive care unit admission (49.3% vs 2.9%; P<0.001), mechanical ventilation (21.3% vs 0%; P<0.001), or hemodialysis (13.3% vs 0%; P=0.005); the waiting time before LDLT was shorter (4 vs 66 days; P<0.001); more blood was transfused during operation (7 vs 2 units; P<0.001); patients stayed longer in the intensive care unit (6 vs 3 days; P<0.001) and hospital (21 vs 15 days; P=0.015) after transplantation;more patients developed early postoperative complications (69.3% vs 50.0%; P=0.018); and values of postoperative peak blood parameters were higher. However, the two groups had comparable hospital mortality. Graft survival and patient overall survival at one year (94.7% vs 95.6%; 95.9% vs 96.9%), three years (91.9% vs 92.6%; 93.2% vs 95.3%), and five years (90.2% vs 90.2%; 93.2% vs 95.3%) were also similar between the groups. CONCLUSIONS: Although the high-score group had signifi-cantly more early postoperative complications, the two groups had comparable hospital mortality and similar satisfactory rates of graft survival and patient overall survival. Therefore, a high MELD score should not be a contraindication to right-lobe LDLT if donor risk and recipient benefit are taken into full account. | Kenneth SH Chok See Ching Chan James YY Fung Tan To Cheung Albert CY Chan Sheung Tat Fan Chung Mau Lo | 2013 | Hepatobiliary & Pancreatic Diseases International2013,12,3: | 6 |
| 17 | Differential diagnosis of left-sided abdominal pain:Primary epiploic appendagitis vs colonic diverticulitis显示文摘AIM:To investigate the clinical characteristics of left primary epiploic appendagitis and to compare them with those of left colonic diverticulitis.METHODS:We retrospectively reviewed the clinical records and radiologic images of the patients who presented with left-sided acute abdominal pain and had computer tomography(CT) performed at the time of presentation showing radiological signs of left primary epiploic appendagitis(PEA) or left acute colonic diverticulitis(ACD) between January 2001 and December 2011. A total of 53 consecutive patients were enrolled and evaluated. We also compared the clinical characteristics,laboratory findings,treatments,and clinical results of left PEA with those of left ACD.RESULTS:Twenty-eight patients and twenty-five patients were diagnosed with symptomatic left PEA and ACD,respectively. The patients with left PEA had focal abdominal tenderness on the left lower quadrant(82.1%). On CT examination,most(89.3%) of the patients with left PEA were found to have an oval fatty mass with a hyperattenuated ring sign. In cases of left ACD,the patients presented with a more diffuse abdominal tenderness throughout the left side(52.0%vs 14.3%; P = 0.003). The patients with left ACD had fever and rebound tenderness more often than those with left PEA(40.0% vs 7.1%,P = 0.004; 52.0% vs14.3%,P = 0.003,respectively). Laboratory abnormalities such as leukocytosis were also more frequently observed in left ACD(52.0% vs 15.4%,P = 0.006).CONCLUSION:If patients have left-sided localized abdominal pain without associated symptoms or laboratory abnormalities,clinicians should suspect the diagnosis of PEA and consider a CT scan. | Jeong Ah Hwang Sun Moon Kim Hyun Jung Song Yu Mi Lee Kyung Min Moon Chang Gi Moon Hoon Sup Koo Kyung Ho Song Yong Seok Kim Tae Hee Lee Kyu Chan Huh Young Woo Choi Young Woo Kang Woo Suk Chung | 2013 | World Journal of Gastroenterology2013,19,40: | 6 |
| 18 | Acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases显示文摘BACKGROUND: Acute pancreatitis is a relatively rare but potentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma.METHODS: A total of 1632 patients with hepatocellular carcinoma who had undergone transarterial chemoembolization from January 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential complications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications.RESULTS: Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these patients was 61 years. Most(79.6%) of the patients suffered from HBV-related hepatocellular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin eluting bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven(0.4%) patients suffered from acute pancreatitis postchemoembolization. Six patients had chemoembolization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxorubicin eluting bead had a higher risk of acute pancreatitis [6/145(4.1%) vs 1/1487(0.1%), P<0.0001]. Two patients had anatomical arte-rial variations. Four patients developed acute pancreatitisrelated complications including necrotizing pancreatitis(n=3) and pseudocyst formation(n=1). All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication.CONCLUSIONS: Acute pancreatitis after transarterial chemoembolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of current treatment with transarterial chemoembolization after acute pancreatitis is feasible providing the initial attack is completely resolved. | Wong Hoi She Albert CY Chan Tan To Cheung Kenneth SH Chok See Ching Chan Ronnie TP Poon Chung Mau Lo | 2016 | Hepatobiliary & Pancreatic Diseases International2016,15,1: | 6 |
| 19 | Improved anterior hepatic transection for isolated hepatocellular carcinoma in the caudate显示文摘BACKGROUND: One of the best treatments for isolated hepatocellular carcinoma in the caudate lobe is major hepatectomy with caudate lobectomy, but it is not suitable for patients with poor liver function reserve. Isolated caudate lobectomy, which is a very difficult operation, is thus an alternative option.METHODS: Here we report an isolated caudate lobectomy with an anterior approach in the treatment of a large hepatocellular carcinoma with underlying cirrhosis, with focus on the technical aspects.RESULTS: In the operation, both the left and right lobes of the liver were mobilized. Hepatotomy was done along the round ligament where parenchymal transection was minimal. After exposure of the left and middle hepatic veins and the hilar plate the caudate lobe and the tumor were resected en bloc with a5-mm margin.CONCLUSION: Isolated caudate lobectomy can be performed safely with this anterior approach on patients with poor liver function reserve. | TanTo Cheung WaiKey Yuen Ronnie TP Poon SeeChing Chan Sheung Tat Fan Chung Mau Lo | 2014 | Hepatobiliary & Pancreatic Diseases International2014,13,2: | 6 |
| 20 | Modulation of graft vascular inflow guided by flowmetry and manometry in liver transplantation显示文摘BACKGROUND:Survival of the partial graft after living donor liver transplantation owes much to its tremendous regenerative ability.With 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 recipients.However,when the ratio range is exceeded,modulation of graft vascular inflow becomes necessary for graft survival.The 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 inflows.Boosting 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 manometry.METHOD:We describe four cases to illustrate the above.RESULTS:One patient had hepatic artery thrombosis resulting from splenic artery steal syndrome which was the sequela of small-for-size syndrome.Emergency splenic artery ligation and re-anastomosis of the hepatic artery successfully muted the portal inflow and boosted the hepatic arterial inflow.Another patient with portal vein thrombosis underwent thrombendvenectomy.Portal inflow was boosted with ligation of portosystemic shunt,which is often present in these patients with portal hypertension.The coexistence of splenic aneurysm and splenorenal shunt required ligation of both in the third patient.The fourth patient,with portal pressure and flow monitoring,avoided ligation of a coronary vein which became a main portal inflow after portal thrombendvenectomy.CONCLUSION:Management of graft inflow modulation guided selectively by transonic flowmetry or portal manometry was described. | See Ching Chan Chung Mau Lo Kenneth SH Chok William W Sharr Tan To Cheung Simon HY Tsang Albert CY Chan Sheung Tat Fan | 2011 | Hepatobiliary & Pancreatic Diseases International2011,10,6: | 5 |