A Lethal Sequelae of Spinal Infection Complicating Surgery and Radiotherapy for Head and Neck Cancer

Jason Pui Yin Cheung,Kin Cheung Mak,Helen Hoi Lun Tsang,Keith Dip-Kei Luk 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.4

Patients who have undergone neck dissection and radiotherapy are at risk of cervical spine infections. Furthermore, previous radiotherapy and cervical spine infections can lead to fistula formation to the subarachnoid space and intracranial infection. This report discusses the serious consequences of a missed cervical spine infection including cerebrospinal fluid fistula formation and persistent central nervous system infection, and serves as a reminder to clinicians of the possible association between cervical spine infections and prior head and neck surgery and radiotherapy. In all such cases, the posterior pharyngeal wall should be inspected during followup. Despite the appearance of an intracranial infection, the cervical spine should be investigated, especially if the response to appropriate antibiotics is suboptimal.

Integration of Adults with Mental Handicaps into the Community of Hong Kong

David Ping-Pui,Tak-wah yeung,Man-hung Ngan,Chau-Kiu Cheung,Kin-yin Li BK21 Project Force of Special Education Deagu Univ 2001 Journal of Asia-Pacific Special Education Vol.1 No.3

The exten and factors of the integration of adults with mental handicaps into the community of Hong Kong is an uncharted area for rigorous investigation. To conduct the investigation, this study surveyed a representative sample of 692 adults, aged 15 or above, from the end of 1998 through early 1999. The survey sapmle sufficient numbers of adults of the three levels of handicaps, mild(n=234), moderate(n=337), and severe grades(n=121). To measure community intergration, the study employed a comprehensive set of scales, which demonstrated satisfactory reliability. With data weighted to best represent the population adults with mental handicaps in Hong Kong, the study found that being accepred was the highest.

Illicit drug use is associated with lower bone mineral density and bone strength

Suhas Krishnamoorthy,Gloria Hoi-Yee Li,Kelvin Shun-Cheong Ho,Yin-Pan Chau,Constance Mak,Donna Ng,Albert Kar-Kin Chung,Jody Kwok-Pui Chu,Kathryn Choon-Beng Tan,Ruby Lai-Chong Hoo,Ching-Lung Cheung 대한골다공증학회 2023 Osteoporosis and Sarcopenia Vol.9 No.3

Objectives: To evaluate the association of illicit drug use with bone mineral density (BMD) and hip geometric parameters at the narrow neck. Methods: This is a cross-sectional matched cohort study conducted in the Hong Kong Chinese population. Associations with illicit drug use were estimated using linear regression for BMD (lumbar spine and femoral neck) and hip geometrical parameters (cross-sectional area [CSA], cross-sectional moment of inertia [CSMI], section modulus [SM], average cortical thickness [ACT] and BMD at the narrow neck) after adjusting for age, body mass index (BMI), smoking status, drinking status, physical activity, and history of antipsychotic and antidepressant use. Mean difference and 95% confidence intervals (95% CI) were calculated between 108 illicit drug users and 108 controls using an adjusted linear model and cluster-robust standard errors after matching by age and sex. The false discovery rate was used to correct for multiple testing. Results: Illicit drug users had a significantly lower BMD (g/cm2 ) at the lumbar spine (mean difference: -0.062; 95% CI: -0.108 to − 0.015), and femoral neck (mean difference: -0.058; 95% CI: -0.106 to − 0.010) in the fully adjusted model. Illicit drug users also had a significantly lower CSA (mean difference: -0.238 cm2 ; 95% CI: -0.462 to − 0.013), ACT (mean difference: -0.018 cm; 95% CI: -0.030 to − 0.006) and BMD (mean difference: -0.070 g/ cm2 ; 95% CI: -0.128 to − 0.012) at the narrow neck. Conclusions: Illicit drug use is associated with lower BMD and bone strength. Future studies evaluating the risk of illicit drug use with fragility fracture are warranted.

Prospective randomized trial comparing efficacy and safety of intravenous and intra-articular tranexamic acid in total knee arthroplasty

Li Moses Man-Lung,Kwok Jojo Yan-Yan,Chung Kwong-Yin,Cheung Kin-Wing,Chiu Kwok-Hing,Chau Wai-Wang,Ho Kevin Ki Wai 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-

Total knee arthroplasty (TKA) is associated with significant perioperative blood loss and postoperative allogenic blood transfusion. Tranexamic acid (TXA) reversibly blocks lysine binding sites on plasminogen molecules and inhibits plasmin formation. Comparisons of the efficacy and safety of intra-articular and intravenous TXA in primary TKA have not previously been reported.A prospective randomized trial was conducted in 150 patients who underwent TKA, and these patients were randomized into three groups. Patients in Group A were injected by intra-articular TXA according to body weight (20 mg/kg). Patients in Group B received a standard dose of intra-articular TXA (2000 mg), and those in Group C were infused with TXA according to body weight (20 mg/kg) before tourniquet deflation and again 3 h later. Baseline characteristics and data collected at blood transfusion were compared. Differences among four time points (baseline, day 0, day 2, and day 5) were carried out using ANOVA. The hemoglobin levels at postoperative day 5 were 10.6 g/dL for Group A, 10.6 g/dL for Group B, and 10.7 g/dL for Group C. The drain output was 399 ml for Group A, 314 ml for Group B, and 305 ml for Group C ( p = 0.03). Group C had significantly less drain output than Group A after post hoc comparisons ( p = 0.05), whereas no significant difference was observed between Group A and B ( p = 0.09) or between Group B and C. The weight-adjusted dose of TXA administered intravenously significantly reduced the drain output but not the total blood loss when compared with the weight-adjusted dose of TXA administered intra-articularly. No significant difference was observed in the other parameters among the three groups. The Joint CUHK-NTEC CREC, CRE-2013.644-T . Registered 1 March 2014.

Study on Treatment Planning for the Prostate in Proton Therapy with Oxygen Enhancement Ratio Effect

Yoo Seung Hoon,Geng Hui,Lam Wai Wang,Kong Chi Wah,Yang Bin,Chiu Tin Lok,Wu Po Man,Cheung Kin Yin,Yu Siu Ki,Shin Dongho,Min Byung Jun 한국물리학회 2020 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.77 No.7

The purpose of this study was to investigate the oxygen enhancement ratio (OER) effects on treatment planning for a hypoxic prostate tumor with proton scanning beams. Two different OER-based dose calculation models (the average model and the voxel model) were investigated by using hypoxic tumor models in this simulation study. For the hypoxic tumor model, an oxygen distribution with a range of 2.4-9.4 mmHg was used according to the clinical data. The results given by the average model and the voxel model were compared for 50% and 90% tumor control probabilities with variations in the hypoxic tumor volume and fractionation. Comparison between the treatment plans with OER-based higher predicted dose and with the conventional prescription dose was conducted to investigate the organ-at-risk (OAR) doses for the prostate case. The average model showed a higher calculated dose than the voxel model. The voxel model with a 50% control probability showed good agreement with the current prescription dose. The OER values of the average model ranged from 1.05 to 1.25, which were applied to the whole tumor volume in treatment planning. The voxel-model-based OERs were higher (1.50-1.75) than those of average model, and these OERs should be applied only for the hypoxic boost region. Regarding treatment plans, the doses of the rectum and the bladder were reduced to the tolerable range V80Gy (volume receiving equal to or greater than 80Gy) < 15% and V75Gy (volume receiving equal to or greater than 75Gy) < 15% respectively after an optimization, but the maximum dose to femoral heads was higher than 50 Gy. In conclusion, we investigated the possible ranges of the OER (1.3-1.8) for proton-beam treatment of prostate cases. A dose escalation of up to about 1.8 times can be applied for the small hypoxic region. This result, which was obtained using a model study, should be verified through clinical experiment.

No difference in long-term functional outcomes or survivorship after total knee arthroplasty with or without computer navigation: a 17-year survivorship analysis

( Ng Jonathan Patrick ),( Lau Lawrence Chun Man ),( Chau Wai-wang ),( Ong Michael Tim-yun ),( Cheung Kin Wing ),( Chiu Kwok Hing ),( Chung Kwong Yin ),( Ho Kevin Ki-wai ) 대한슬관절학회 2021 대한슬관절학회지 Vol.33 No.-

Background: The literature comparing the long-term outcomes and survivorship of computer navigation-assisted and conventional total knee replacement (TKR) is sparse. Moreover, of the available comparative studies with followup duration of more than 10 years, the results seem to be conflicting. The purpose of this long-term study was to compare the clinical and radiological outcomes, and implant survivorship, of TKR performed with and without computer navigation. Methods: We retrospectively compared the results of 49 computer-navigated TKRs and 139 conventional TKRs. The mean age of the patients was 67.9 (range 52-81) years for the navigation group and 67.1 (range 50-80) years for the conventional TKR group. The mean duration of follow-up for the conventional and navigation TKR groups was 12.9 and 13.2 years, respectively. Clinical and radiographic follow-up examinations of the patients were performed at 2 weeks, 1 month, 3 months and 6 months post-operatively, and at 1-year intervals thereafter. Results: There were no significant differences in the post-operative Knee Society knee and function score between the two groups. The mean overall deviation from neutral alignment and the radiological outliers were significantly higher in the conventional TKR group. The overall survival rates at 17 years were 92.9% for the navigation group and 95.6% for the conventional TKR group (p = 0.62). Conclusions: Navigated TKR resulted in fewer radiological outliers; however, this did not translate to better long-term functional outcomes or implant survival.