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K F Leung

Publications and source records attributed to K F Leung.

11 recordsLinked to original sources
PubMed2005

An instrument to assess mental patients' capacity to appraise and report subjective quality of life.

Quality of life (QOL) is increasingly recognized as an important outcome measure in treatment studies and service evaluation. However, patients or service users may sometimes lack the capacity to either evaluate or express their subjective QOL, for example due to cognitive impairment, communication disorders, symptom distress or burden of completing the assessment itself. This paper describes the development of an instrument, the capacity to report subjective quality of life inventory (CapQOL), which evaluates the ability of patients to appraise their subjective QOL and to complete related measures. The CapQOL is a simple and brief screening tool, designed for use in people with a wide range of mental disabilities. It helps researchers to identify individuals who are unable to appraise or report their subjective quality of life. We administered the CapQOL to 442 patients with early psychosis. About 89% of the participants were assessed to be able to complete a subjective QOL measure. The CapQOL demonstrated satisfactory psychometric properties. Further validation studies in people with psychosis as well as other mental disabilities are indicated.

Adult↗
PubMed2005

Development and validation of the interview version of the Hong Kong Chinese WHOQOL-BREF.

INTRODUCTION: The Hong Kong Chinese version of the WHOQOL-BREF was designed as a self-administered questionnaire and has limitations in clinical application on subjects who have limitations in reading or writing. An interview version is therefore needed to avoid sampling biases in clinical studies. Since there are significant differences in the written Chinese and spoken Cantonese, which is a dialect commonly spoken among people in Hong Kong, and adaptation process for converting the written Chinese into spoken Cantonese was necessary. The interview version was designed to allow administration in both face-to-face interview and telephone interview mode. METHODS: Three members of the research team translated the formal written Chinese in the self-administered version of the WHOQOL-BREF(HK) into colloquial Cantonese separately. Brief notes extracted from the facet definitions of the WHOQOL-100 were added in brackets after some questions to further explain the intention of the questions. Two series of focus groups were conducted and subsequently the field test version was produced. 329 subjects were recruited by convenient sampling method for the field test. RESULTS: The interview version and the self-administered version was found equivalent. The ICC values of the domain scores ranged from 0.73 in the environment domain to 0.83 in the psychological domain. The face-to-face interview and telephone interview mode of administration were also found equivalent. The ICC for the domain scores ranged from 0.76 in the social interaction domain to 0.84 in the psychological domain. The other psychometric properties of the interview version were found comparable to the self-administered version. CONCLUSION: The self-administered and the interview version of the WHOQOL-BREF are regarded as identical in group comparison. The authors advise that it is acceptable to use different versions on different subjects in the same study, provided that the same version is applied on the same subject throughout the study.

Adult↗
PubMed2005

Impact of untreated psychosis on quality of life in patients with first-episode schizophrenia.

Despite increasing interest in the quality of life (QOL) of psychiatric patients in recent years, few studies have focused on the potential adverse effects of the illness on QOL during the period of untreated psychosis. Our study compares the QOL of patients with first-episode schizophrenia when they first presented to the psychiatric service with that of the normal population, and identifies possible relationships with various clinical parameters. One hundred and seventeen patients with schizophrenia (aged 14-28 years) who entered the Early Assessment Services for Young People with Psychosis (EASY) programme in Hong Kong from June 2001 to January 2004 were assessed with the MOS 36 item Short Form Health Survey (SF-36) and the World Health Organization Quality of Life Measure, abbreviated Hong Kong version (WHOQOL-BREF(HK)). We compared their SF-36 scores with controls from the normal population matched by age, sex, marital status and educational level. We assessed clinical parameters including positive, negative and depressive symptoms by the Positive and Negative Syndrome Scale (PANSS), the Scale for Assessment of Negative Symptoms (SANS), and the Montgomery and Asberg Depression Rating Scale (MADRS). When compared with matched controls from the normal population, significantly lower scores in all of the eight scales of the SF-36 were found in our patient group (p < 0.005). Various QOL domain scores had significant inverse correlations with the total MADRS score. However, there was no significant correlation with other clinical parameters. Young patients with first-episode schizophrenia have poorer QOL in the period of untreated psychosis than their counterparts in the community. Amongst various clinical parameters, the severity of depressive symptoms correlates most with QOL.

Adolescent↗
PubMed2005

Two-port needlescopic cholecystectomy: prospective study of 100 cases.

OBJECTIVE: To test the feasibility of needlescopic cholecystectomy using a two-port technique with 3-mm miniaturised instruments. DESIGN: Prospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: One hundred consecutive patients undergoing elective cholecystectomy from September 2001 to August 2002. INTERVENTION: Two-port needlescopic cholecystectomy all performed or supervised by a single laparoscopic surgeon. MAIN OUTCOME MEASURES: Conversion of the procedure, the operating time, postoperative analgesic requirement, pain score using the 10-cm visual analog scale, complications, and the postoperative stay. To determine the technical difficulty of this new technique, the data from the first 50 patients were compared with those of the latter 50. Outcome variables were also compared with a group of 58 patients operated on with the standard two-port laparoscopic cholecystectomy in a previous randomised trial. RESULTS: One conversion to open cholecystectomy was reported. Three patients required the enlargement of epigastric port to a size of 5 mm and six patients required an additional port to complete the operation. The median operating time was 62 minutes (range, 33-168 minutes). The median pain score was 3.5 (range, 0-9) and the median postoperative stay was 2 days (range, 1-14 days). Six patients had postoperative complications. When the first 50 patients were compared with the latter 50, there were no differences in the conversion rate, operating time, complication rate, and duration of hospital stay. However, the latter 50 patients had significantly lower pain scores (median, 3.5 vs 4.9; P=0.007) and faster resumption of diet (median, 5 vs 9 hours; P<0.001). The median operating time of needlescopic cholecystectomy was notably longer (62 vs 46 minutes; P<0.001) compared with that of the two-port laparoscopic cholecystectomy. Patients undergoing needlescopic cholecystectomy had a better resumption of diet (median, 5 vs 7 hours; P<0.001) and less postoperative pain (overall pain score, median, 3.5 vs 4.8; P=0.052) than the two-port laparoscopic cholecystectomy group. Pain scores at individual port sites were also lower in needlescopic cholecystectomy group (umbilical port: median, 3 vs 4.4, P=0.015; epigastric port: median, 2.0 vs 3.6, P=0.036). CONCLUSION: Two-port needlescopic cholecystectomy is technically feasible and may further improve the surgical outcomes in terms of postoperative pain and cosmesis. It can be considered for routine practice by surgeons who are familiar with the two-port laparoscopic cholecystectomy technique.

Aged↗
PubMed2001

Haemoglobin Q-Thailand and hereditary spherocytosis in a Chinese family.

A Chinese family with concurrent hereditary spherocytosis (HS) and haemoglobin (Hb) Q-Thailand is described. The Hb Q-Thailand mutation was found on the remaining alpha1 globin gene on a chromosome 16 containing the (-alpha 4.2) deletion. Active haemolysis in members of this family is segregated with the HS phenotype, and the Hb Q-Thailand in the heterozygous state does not seem to show any modulating effect on HS.

Adult↗
PubMed1999

Important role of cardiac spect imaging in patients undergoing percutaneous transluminal coronary angioplasty.

OBJECTIVE: To examine the utilization and contribution of cardiac perfusion scans to patients undergoing percutaneous transluminal coronary angioplasty. METHODS: From July 1996 to January 1998, 34 patients underwent percutaneous transluminal coronary angioplasty and cardiac SPECT imaging was studied. Twenty-five patients had pre-procedure SPECT scans. The agreement between angioplasty strategies and SPECT findings of ischemia and hypokinesia was examined. RESULTS: When radionuclide imaging was performed before revascularization procedures, 84% of the patients had intervention strategies guided by scan findings. Perfusion scan findings including extent and severity of ischemia, degree of hypokinesia directed the selection of target vessel for angioplasty in the patient subgroup with multi-vessel disease. Post-angioplasty radionuclide cardiac scans were performed only on symptomatic patients, demonstrating ischemia and hypokinesia in most of them, conceivably reflected the selection bias. CONCLUSION: We recommend routine pre- and post-angioplasty radionuclide imaging with multigated scans for wall motion assessment for all patients receiving coronary intervention.

Aged↗
PubMed1998

Undiagnosed acute myocardial infarction in the accident and emergency department: reasons and implications.

Because acute myocardial infarction causes significant morbidity and mortality, a correct diagnosis in the accident and emergency department is important so that early treatment including thrombolytic therapy can be given. The aim of this study was to evaluate the reasons for missed diagnosis of acute myocardial infarction in the accident and emergency department, and the implications. All patients admitted to our coronary care unit in 1995 with the confirmed diagnosis of acute myocardial infarction were analysed retrospectively. The demographic data, clinical profiles, diagnosis made at the accident and emergency department and feasibility of thrombolytic therapy were assessed. Analysis of the electrocardiography by the accident and emergency department doctor and the coronary care unit doctor were also compared. Forty-three out of 159 patients (27.0%) with acute myocardial infarction were missed in the accident and emergency department. The diagnoses made were mostly angina or chest pain. Absence of chest pain (25.6%) [vs. 10.2% in correct diagnosis group, p < 0.05] and lack of ST elevation in electrocardiograph (62.8%) [vs. 18.1% in correct diagnosis group, p < 0.0001] were the main predisposing factors for missed diagnosis. Because of missed diagnosis, only 25.6% (vs. 67.2% in correct diagnosis group, p < 0.01) of patients were admitted to the coronary care unit. About one-third (34.9%) of missed diagnosis patients (vs. 6.0% in correct diagnosis, p < 0.01) did not receive thrombolytic therapy because of delayed diagnosis. In the missed diagnosis group, 34.8% of them might be avoidable, if electrocardiogram interpretation was more accurate. More education and training of the involved medical personnel might improve the overall situation.

Adult↗
PubMed1996

Laparoscopic cholecystectomy: two-port technique.

BACKGROUND AND STUDY AIMS: Conventional laparoscopic cholecystectomy requires four ports. The present study describes a new laparoscopic cholecystectomy technique using two ports only. PATIENTS AND METHODS: Sixty-two consecutive patients with symptomatic gallstones underwent laparoscopic cholecystectomy using this two-port technique. The operation requires a straightforward laparoscope and a percutaneous sling to retract the gallbladder laterally and cephalad. RESULTS: The two-port method was successful in 52 patients; eight required an additional port, and two required conversion to open surgery. Our results showed that the operating time and complication rate were comparable to those in other series using the conventional laparoscopic method. CONCLUSION: The two-port method is technically more demanding, and should only be used to remove simple, uncomplicated gallbladders. The surgeon should always be prepared to insert more trocars or convert to open procedures when necessary.

Cholecystectomy, Laparoscopic↗
PubMedDate not supplied

One-stage thoracoscopic oesophagectomy: ligature intrathoracic stapled anastomosis.

Thoracoscopic oesophagectomy is usually performed in stages and intrathoracic oesophagogastric anastomosis often requires mini-thoracotomy or extension of the thoracoscopic incisions. This paper describes a new technique whereby such an operation could be completed in one stage and the need to extend the thoracoscopic incisions is obviated.

Adenocarcinoma↗