Seropositive Neuromyelitis Optica imitating an Intramedullary Cervical Spinal Cord Tumor: Case Report and Brief Review of the Literature

Peter Yat-Ming Woo,Jennifer Hiu-Fung Chiu,Kar-Ming Leung,Kwong-Yau Chan 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.5

A 44-year-old woman with progressive cervical myelopathy and central cord syndrome was noted to have an extensive cervical intramedullary contrast-enhancing lesion on magnetic resonance imaging (MRI). The lesion resembled a spinal astrocytoma or ependymoma that required surgical intervention. She was subsequently diagnosed to have neuromyelitis optica (NMO), a rare idiopathic inflammatory demyelinating disorder, when the clinical examination revealed left optic atrophy. This was confirmed by a test showing seropositivity for NMO-immunoglobulin (IgG). Disease control was achieved with corticosteroids and immunosuppressive therapy. We report a rare case of a patient with NMO who had MRI features that could have easily led to the condition being misdiagnosed as a spinal cord tumor. The importance of careful history taking, awareness of typical radiological findings and the usefulness of serum NMO-IgG as a diagnostic tool are emphasized.

Splenic T1-Mapping for Predicting Adenosine Stress Adequacy in Cardiac Magnetic Resonance Myocardial Perfusion Imaging: A Validation and Reproducibility Study

Wan Fiona Fong-ying,Yeung Catherine Ming-mun,Yam Pak-ki,Ng Pan Pan,Chow Boris Chun Kei,Chiang Jeanie Betsy,Lee Jonan Chun-yin,Cheung Kenneth Kai-yat,Ng Ming-yen 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.3

Objective:Splenic switch-off (SSO) sign has been utilized as a surrogate marker of adequate stress but can only be assessed after first-pass perfusion imaging. A study previously reported that drop in T1spleen ≥30 ms during adenosine infusion predicts presence of SSO, but this finding has not been externally validated. This study aimed to prospectively validate whether drop in T1spleen ≥30 ms is a reliable marker of SSO and hence adequate stress, and to assess reproducibility of T1spleen measurements. Materials and Methods: Data of fifty consecutive patients undergoing stress cardiac magnetic resonance were prospectively collected. Native T1-maps were acquired at rest and at 2.5 min after adenosine infusion in short axis slices, followed by perfusion images at 3 min. To measure T1spleen pre- and post-adenosine infusion, regions of interest were manually placed to include most splenic tissue. Adenosine stress adequacy was evaluated by visual SSO assessment and semi-quantitative splenic perfusion analysis. Results:A significant association was found between a drop in T1spleen of ≥30 ms and SSO response (p<0.001). There was excellent correlation between SSO response and semiquantitative perfusion change in spleen (rho=0.847, p<0.001). Inter-observer and intra-observer agreement for measurement of ΔT1spleen values were excellent, with intra-class correlation coefficients of 0.987 and 0.995, respectively. By receiver-operating characteristic analysis, the optimal cut-off value of ΔT1spleen for predicting presence of SSO was -28 ms, with area under the curve=0.76 (p=0.002). Conclusion:Splenic T1-mapping is accurate and reproducible for predicting SSO, potentially allowing optimization of adenosine dosage for adequate stress.

Volume Measurement of the Intracranial Aneurysm: A Discussion and Comparison of the Alternatives to Manual Segmentation

Siang-Hua Victor Chan,Kai-Sing Alain Wong,Yat-Ming Peter Woo,Kwong-Yau Chan,Kar-Ming Leung 대한뇌혈관외과학회 2014 Journal of Cerebrovascular and Endovascular Neuros Vol.16 No.4

Objective : Several modalities are available for volumetric measurement ofthe intracranial aneurysm. We discuss the challenges involved in manualsegmentation, and analyze the application of alternative methods usingautomatic segmentation and geometric formulae in measurement of aneurysmvolumes and coil packing density. Methods : The volumes and morphology of 38 aneurysms treated withendovascular coiling at a single center were measured using three-dimensionalrotational angiography (3DRA) reconstruction software using automaticsegmentation. Aneurysm volumes were also calculated from theirheight, width, depth, size of neck, and assumed shape in 3DRA imagesusing simple geometric formulae. The aneurysm volumes were dichotomizedas "small" or "large" using the median volume of the studied population(54 mm3) measured by automatic segmentation as the cut-off valuefor further statistical analysis. Results : A greater proportion of aneurysms were categorized as being"small" when geometric formulae were applied. The median aneurysm volumesobtained were 54.5 mm3 by 3DRA software, and 30.6 mm3 usingmathematical equations. An underestimation of aneurysm volume with aresultant overestimation in the calculated coil packing density (p = 0.002)was observed. Conclusion : Caution must be exercised in the application of simple geometricformulae in the management of intracranial aneurysms as volumesmay potentially be underestimated and packing densities falsely elevated. Future research should focus on validation of automatic segmentation involumetric measurement and improving its accuracy to enhance its applicationin clinical practice.

Methodological Study on the Evaluation of Face Mask Use Scale among Public Adult: Cross-Language and Psychometric Testing

Lam, Simon Ching,Chong, Andy Chun Yin,Chung, Jessie Yuk Seng,Lam, Ming Yee,Chan, Lai Man,Shum, Cho Yee,Wong, Eliza Yi Ni,Mok, Yat Man,Lam, Ming Tat,Chan, Man Man,Tong, Ka Ying,Chu, Oi Lee,Siu, Fong Ki 한국성인간호학회 2020 성인간호학회지 Vol.32 No.1

Purpose: This study aimed to establish the translation adequacy and examine the psychometric properties of FaceMask Use Scale (FMUS). Methods: This methodological study employed a cross-sectional design with repeatedmeasures. Phase 1 examined the equivalence and relevance of English and Chinese versions of FMUS. Phase2 examined the internal consistency, stability and construct validity. Different sample batches (213 universitystudents and 971 general public) were used appropriately for psychometric testing. The 2-phase data were collectedbetween January and April 2017. Results: In Phase 1, the semantic equivalence and relevance (item- and scale-levelcontent-validity-index=100%) was satisfactory. Furthermore, from 133 paired test-retest responses, the quadraticweighted kappa (.53~.73, p<.001) and Intraclass Correlation Coefficient (ICC=.81) between the English andChinese version of FMUS were satisfactory. In Phase 2, FMUS demonstrated satisfactory internal consistency(Cronbach’s ⍺=.80~.81; corrected item-total correlation coefficients=.46~.67) and two-week test-retest stability(ICC=.84). The known-groups method (t=3.08, p<.001), exploratory (71.10% of total variance in two-factor model)and confirmatory factory analysis (x2/df=4.02, Root Mean Square Residual=.03, Root Mean Square Error ofApproximation=.06, Goodness of Fit Index=.99, Comparative Fit Index=.99) were all satisfactory for establishingthe construct validity. Conclusion: The FMUS has an equivalence Chinese and English versions, satisfactoryreliability and validity for measuring the practice of face mask use. This poses clinical and research implications forthose community health nurses who works on respiratory protection. Further research should be conducted on the‘negligent practice’ of FMU.

Minimum 2-Year Experience with Magnetically Controlled Growing Rods for the Treatment of Early-Onset Scoliosis: A Systematic Review

Ai-Min Wu,Jason Pui Yin Cheung,Kenneth Man Chee Cheung,Jia-Liang Lin,Hai-Ming Jin,Dong Chen,Xiang-Yang Wang,Jie Zhao,Kenny Yat Hong Kwan 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.4

Magnetically controlled growing rods have been used to treat early-onset scoliosis for the last 9 years; however, few studies have been published, with only short-term follow-up. The aim of the present study is to systematically review the outcomes of magnetically controlled growing rods in the treatment of early-onset scoliosis with a minimum of 2-year follow-up. Studies were included if patients with early-onset scoliosis (scoliosis diagnosed before 10 years of age) underwent implantation of magnetically controlled growing rods with a minimum of 2-year follow-up. The literature review and data extraction followed the established preferred reporting items for systematic review and meta-analysis guidelines. Data of distraction frequency, number of distractions, distracted length, Cobb angle, kyphosis, T1–T12 length, and T1–S1 length preoperatively, postoperatively, and at final follow-up were collected. Data regarding complications and unplanned reoperations were also extracted. The mean values of these parameters were calculated, or pooled meta-analysis was performed if available. Ten articles were included in this systematic review, with a total of 116 patients and a follow-up period between 23 and 61 months. The mean preoperative Cobb angle and kyphosis angle were 60.1° and 38.0°, respectively, and improved to 35.4° and 26.1° postoperatively. At final follow-up, the Cobb and kyphosis angles were maintained at 36.9° and 36.0°, respectively. The average preoperative T1–T12 and T1–S1 lengths were 180.6 mm and 293.6 mm, respectively, and increased to 198.3 mm and 320.3 mm postoperatively. T1–T12 and T1–S1 lengths were 212.3 mm and 339.3 mm at final follow-up, respectively. The overall rate of patients with complications was 48% (95% confidence interval [CI], 0.38–0.58) and unplanned reoperation 44% (95% CI, 0.33–0.55) after sensitivity analysis. The current evidence from different countries with a minimum of a 2-year follow-up suggests that magnetically controlled growing rods are an effective technique to treat pediatric scoliosis and promote spine growth. However, nearly half of patients still developed complications or required unplanned reoperations.