Biomedical subjects

Sheung Fat Ko

Publications and source records attributed to Sheung Fat Ko.

6 recordsLinked to original sources

PubMed2005

Use of a refined operative strategy in combination with the multidisciplinary approach to manage blunt juxtahepatic venous injuries.

BACKGROUND: Despite continuous advances in traumatology, juxtahepatic venous injuries are still the most difficult and deadly form of liver trauma. Most deaths result from exsanguination, and reported mortality ranges from 50% to 80%. This is an evaluation on our experience with the management of this high mortality injury following a refined operative strategy. METHODS: This is a retrospective study of consecutive patients sustaining blunt juxtahepatic venous injuries. The management for these patients was mainly a refined operative strategy combined with a multidisciplinary approach. Preoperative conditions and the patient demographics were gathered. In addition, the number and type of interventional procedures, overall complications, and operative procedures were collected and analyzed. RESULTS: From January, 1996 to March, 2004, 19 patients (M:F = 13:6) with juxtahepatic venous injuries were included and all were managed operatively. The operative procedures included hepatectomy by finger fracture technique for direct repair (8), perihepatic packing (1), packing and hepatic artery embolization (1), packing and hepatic artery ligation (1), hepatorrhaphy and packing (5), packing followed by hepatectomy (2) and atriocaval shunt for direct repair (1). The survival rate for the packing group was higher than that of the direct repair group (75% versus 45%), but was not statistically significant (p = 0.352). Injury to the retrohepatic vena cava influenced the patient's survival significantly (p = 0.041). The overall survival was 58% (11/19). CONCLUSION: A well-defined operative strategy helps surgeons deal with the problem of blunt juxtahepatic venous injury, and its combination with multidisciplinary management will improve patient outcomes.

Adult↗

PubMed2003

Vocal cord paralysis after transcatheter coil embolization of patent ductus arteriosus.

BACKGROUND: In patients with patent ductus arteriosus (PDA) after Gianturco coil embolization, vocal cord paralysis (VCP) had not been previously described. This study investigates the risk factors of coil embolization associated with VCP. METHODS: We reviewed the medical records of all patients who had undergone transcatheter closure of PDA with a Gianturco coil between March 1998 and May 2001, and 75 patients (age range, 6 months to 55 years; mean age, 5.5 years) were identified. The procedure was performed with local anesthesia and with sedation in some young children. No patient required general anesthesia or endotracheal intubation. RESULTS: Three of the 75 patients had hoarseness caused by VCP after coil embolization. Patients with VCP had a longer ductus length (P <.01) and a smaller ductus diameter (P <.01) than patients without VCP. The pathogenesis of VCP may be caused by tense stretching and angulation of the ductus arteriosus induced by the implanted coil, which leads to compression injury of the adjacent left recurrent laryngeal nerve. CONCLUSIONS: A long ductus length (> or =12 mm) and a small ductus diameter (<1 mm) are significant risk factors of VCP after coil embolization in children <1 year of age. We recommend that coil embolization be performed very carefully in patients with PDA.

Adolescent↗

PubMed2003

Thymoliposarcoma.

Thymoliposarcoma is an exceedingly rare thymic neoplasm with only five reports in English literature to date. We report another patient, a 36-year-old male, who developed local recurrences 4-years after initial resection. The clinicopathologic features of the present and previously reports were compared with particular emphasis on their morphologic spectrum and differential diagnosis.

Adult↗

PubMed2002

Posttreatment imaging of the nasopharynx.

Nasopharyngeal carcinoma (NPC) is the most common epithelial tumor of the nasopharynx. Radiation therapy is the mainstay of treatment while surgery or chemotherapy is used in selected patients. NPC usually regresses after 3 months of radiation therapy. Nonetheless, a residual mass may be present following treatment and this does not necessarily indicate viable tumor. Imaging studies are often used in conjunction with clinical examination following treatment. While computed tomography (CT) is widely used due to its greater availability, less expensive, and less time consuming, MR imaging is now becoming the preferred modality. MR imaging is more capable than CT for identifying mature scarring, tumor recurrence and postradiation complications. However, MR imaging cannot reliably demonstrate mucosal recurrence or differentiate tumor recurrence from postradiation tissue changes. Familiarity with the imaging findings of various posttreatment changes, tumor recurrence and postradiation complications is essential for management of NPC. Comparison with previous images or imaging-guided biopsy facilitates definitive diagnosis.

Biopsy↗

PubMed2002

Endovascular stent placement for management of total renal artery occlusion in a child.

Total renal artery occlusion is a rare complication of percutaneous transluminal angioplasty. An 8-year-old boy was referred due to left renal artery stenosis after unsuccessful balloon angioplasty. Total left renal artery occlusion was diagnosed by angiography. The combination of balloon angioplasty and stent placement allowed reestablishment of perfusion and salvage of a severely threatened kidney. His blood pressure improved after the procedure and returned to normal 3 months later. The patient has remained free of symptoms for 12 months without medication.

Angioplasty, Balloon↗

PubMedDate not supplied

Recurrent congenital diaphragmatic hernia in Ehlers-Danlos syndrome.

Ehlers-Danlos syndrome (EDS) includes a group of connective tissue disorders with abnormal collagen metabolism and a diverse clinical spectrum. We report two siblings with EDS who both presented with congenital diaphragmatic hernia (CDH). The elder sister suffered from recurrent diaphragmatic hernia twice and EDS was overlooked initially. Echocardiography as well as contrast-enhanced magnetic resonance angiography (MRA) showed dilatation of the pulmonary artery, and marked elongation and tortuosity of the aorta and its branches. A diagnosis of EDS was eventually established when these findings were coupled with the clinical features of hyperelastic skin. Her younger brother also had similar features. This report emphasizes that EDS may present as CDH in a small child which could easily be overlooked. Without appropriate surgery, diaphragmatic hernia might occur. Echocardiographic screening is recommended in patients with CDH. Contrast-enhanced MRA can be helpful in delineation of abnormally tortuous aortic great vessels that are an important clue to the early diagnosis of EDS.

Child, Preschool↗