1.Radiological study of the Asian coracoid process and clavicle: Implications for coracoclavicular ligament reconstruction
Loong Chi JEN ; Hao Dong TOON ; Hui Chung TAN
Chinese Journal of Traumatology 2020;23(1):56-59
Purpose::Iatrogenic coracoid and clavicle fracture is a known complication of drilling bone tunnels during anatomic coracoclavicular ligament reconstruction (ACCR). This study aims to measure the dimensions of coracoid process and clavicle in an Asian population to evaluate the suitability of drilling coracoid and clavicle tunnels for ACCR in Asians.Methods::Width measurements of 196 coracoids and 189 clavicles were obtained after reviewing all computed tomography (CT) scans of the shoulder performed over a 6 years period. Coracoid measurements were made on the CT slice which showed the maximum cross sectional width of the coracoid base. Medial to lateral measurements of the coracoid width were taken on an axial view, 4 mm above the identified junction of the coracoid base and glenoid base. Antero-posterior clavicle width was measured through a point directly above the midpoint of the coracoid and perpendicular to the long axis of the clavicle.Results::The overall mean coracoid width was 14.8 mm ± 2.54 mm (range 9.2-23.3 mm) and clavicle width was 17.1 mm ± 2.72 mm (range 11.1-25.3 mm).Conclusion::The Asian coracoid process is smaller than its Western equivalent. More research is required to validate this conclusion as no cadaveric studies with equivalent measurement techniques have been performed on Asians. Given the potentially narrower dimensions of the Asian coracoid process, extra precautions are required to minimize the risk of iatrogenic coracoid and clavicle fractures.
2.Computer Navigation-aided Resection of Sacral Chordomas.
Yong-Kun YANG ; Chung-Ming CHAN ; Qing ZHANG ; Hai-Rong XU ; Xiao-Hui NIU
Chinese Medical Journal 2016;129(2):162-168
BACKGROUNDResection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the recurrence rate is high. Use of computer navigation may allow optimal preoperative planning and improve precision in tumor resection. The purpose of this study was to evaluate the safety and feasibility of computer navigation-aided resection of sacral chordomas.
METHODSBetween 2007 and 2013, a total of 26 patients with sacral chordoma underwent computer navigation-aided surgery were included and followed for a minimum of 18 months. There were 21 primary cases and 5 recurrent cases, with a mean age of 55.8 years old (range: 35-84 years old). Tumors were located above the level of the S3 neural foramen in 23 patients and below the level of the S3 neural foramen in 3 patients. Three-dimensional images were reconstructed with a computed tomography-based navigation system combined with the magnetic resonance images using the navigation software. Tumors were resected via a posterior approach assisted by the computer navigation. Mean follow-up was 38.6 months (range: 18-84 months).
RESULTSMean operative time was 307 min. Mean intraoperative blood loss was 3065 ml. For computer navigation, the mean registration deviation during surgery was 1.7 mm. There were 18 wide resections, 4 marginal resections, and 4 intralesional resections. All patients were alive at the final follow-up, with 2 (7.7%) exhibiting tumor recurrence. The other 24 patients were tumor-free. The mean Musculoskeletal Tumor Society Score was 27.3 (range: 19-30).
CONCLUSIONSComputer-assisted navigation can be safely applied to the resection of the sacral chordomas, allowing execution of preoperative plans, and achieving good oncological outcomes. Nevertheless, this needs to be accomplished by surgeons with adequate experience and skill.
Adult ; Aged ; Aged, 80 and over ; Chordoma ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Sacrum ; surgery ; Spinal Neoplasms ; surgery ; Surgery, Computer-Assisted ; methods ; Treatment Outcome
3.AN EVALUATION OF A STUDENT-LED FACULTY-SUPPORTED INTER-PROFESSIONAL STUDENT MEDICAL-NURSING EDUCATION CONFERENCE (SMEC)
Gerald Choon-Huat Koh ; Ae Ra Kee ; Jared Ryan Durnford ; Fang yi Lim ; Edwin Wei Xiang Chow ; Kimberly Hui Oen Qian ; Yew Seng Tan ; Prakash S Prajwala ; John Kit Chung Tam
The Singapore Family Physician 2016;42(3):70-74
Purpose: There are relatively few student-led medical
conferences worldwide. A group of medical and nursing
students from Yong Loo Lin School of Medicine,
National University of Singapore, organized an annual
student-led faculty-supported inter-professional
Student Medical-Nursing Education Conference
(SMEC), which consisted of plenary talks, lectures and
workshops, and a scientific competition. This research
focused on the evaluation of workshops conducted
during the 8th SMEC 2012.
Method: The authors used various process variables to
survey the conference participants on the educational
value of the 4 plenary lectures and 20 workshops, half of
which were run by experienced healthcare professionals
and the other half by current seniors or recent
graduates.
Results: A total of 270 medical and nursing students
completed the survey. Good to excellent educational
value was reported for most of the workshops. Higher
educational value was associated with use of props
(correlation coefficient, r=0.733 and 0.568), adherence
to workshop topic/focus (r=0.608 and 0.815) and
openness of presenter to questions (r=0.555 and 0.453).
Conclusion: A student-led, faculty-supported interprofessional
conference organized by medical and
nursing students had good to excellent self-reported
education value in helping their fellow medical and
nursing students learn about various healthcare
disciplines and prepare for medical and nursing school.
4.Short-term comparative outcomes between reverse shoulder arthroplasty for shoulder trauma and shoulder arthritis: a Southeast Asian experience
Julia Poh Hwee NG ; Sherlyn Yen Yu THAM ; Saketh KOLLA ; Yiu Hin KWAN ; James Chung Hui TAN ; Timothy Wei Wen TEO ; Andy Teck Huat WEE ; Dong Hao TOON
Clinics in Shoulder and Elbow 2022;25(3):210-216
Background:
Reverse shoulder arthroplasty (RSA), first introduced as a management option for cuff tear arthropathy, is now an accepted treatment for complex proximal humeral fractures. Few studies have identified whether the outcomes of RSA for shoulder trauma are comparable to those of RSA for shoulder arthritis.
Methods:
This is a retrospective, single-institution cohort study of all patients who underwent RSA at our institution between January 2013 and December 2019. In total, 49 patients met the inclusion criteria. As outcomes, we evaluated the 1-year American Shoulder and Elbow Surgeons (ASES) and Constant shoulder scores, postoperative shoulder range of motion, intra- and postoperative complications, and cumulative revision rate. The patients were grouped based on preoperative diagnosis to compare postoperative outcomes across two broad groups.
Results:
The median follow-up period was 32.8 months (interquartile range, 12.6–66.6 months). The 1-year visual analog scale, range of motion, and Constant and ASES functional scores were comparable between RSAs performed to treat shoulder trauma and that performed for arthritis. The overall complication rate was 20.4%, with patients with a preoperative diagnosis of arthritis having significantly more complications than those with a preoperative diagnosis of trauma (34.8% vs. 7.7%).
Conclusions
Patients who underwent RSA due to a proximal humeral fracture or dislocation did not fare worse than those who underwent RSA for arthritis at 1 year, in terms of both functional and radiological outcomes.
5.Novel method of intraoperative liver tumour localisation with indocyanine green and near-infrared imaging.
Hui Jun LIM ; Adrian Kah Heng CHIOW ; Lip Seng LEE ; Siong San TAN ; Brian Kp GOH ; Ye Xin KOH ; Chung Yip CHAN ; Ser Yee LEE
Singapore medical journal 2021;62(4):182-189
INTRODUCTION:
Fluorescence imaging (FI) with indocyanine green (ICG) is increasingly implemented as an intraoperative navigation tool in hepatobiliary surgery to identify hepatic tumours. This is useful in minimally invasive hepatectomy, where gross inspection and palpation are limited. This study aimed to evaluate the feasibility, safety and optimal timing of using ICG for tumour localisation in patients undergoing hepatic resection.
METHODS:
From 2015 to 2018, a prospective multicentre study was conducted to evaluate feasibility and safety of ICG in tumour localisation following preoperative administration of ICG either on Day 0-3 or Day 4-7.
RESULTS:
Among 32 patients, a total of 46 lesions were resected: 23 were hepatocellular carcinomas (HCCs), 12 were colorectal liver metastases (CRLM) and 11 were benign lesions. ICG FI identified 38 (82.6%) lesions prior to resection. The majority of HCCs were homogeneous fluorescing lesions (56.6%), while CLRM were homogeneous (41.7%) or rim-enhancing (33.3%). The majority (75.0%) of the lesions not detected by ICG FI were in cirrhotic livers. Most (84.1%) of ICG-positive lesions detected were < 1 cm deep, and half of the lesions ≥ 1 cm in depth were not detected. In cirrhotic patients with malignant lesions, those given ICG on preoperative Day 0-3 and Day 4-7 had detection rates of 66.7% and 91.7%, respectively. There were no adverse events.
CONCLUSION
ICG FI is a safe and feasible method to assist tumour localisation in liver surgery. Different tumours appear to display characteristic fluorescent patterns. There may be no disadvantage of administering ICG closer to the operative date if it is more convenient, except in patients with liver cirrhosis.
6.Asian Society of Gynecologic Oncology International Workshop 2018
Tae Wook KONG ; Hee Sug RYU ; Seung Cheol KIM ; Takayuki ENOMOTO ; Jin LI ; Kenneth H KIM ; Seung Hyuk SHIM ; Peng Hui WANG ; Suwanit THERASAKVICHYA ; Yusuke KOBAYASHI ; Maria LEE ; Tingyan SHI ; Shin Wha LEE ; Mikio MIKAMI ; Satoru NAGASE ; Myong Cheol LIM ; Jianliu WANG ; Sarikapan WILAILAK ; Sang Wun KIM ; Sook Hee HONG ; David SP TAN ; Masaki MANDAI ; Suk Joon CHANG ; Ruby Yun Ju HUANG ; Kimio USHIJIMA ; Jung Yun LEE ; Xiaojun CHEN ; Kazunori OCHIAI ; Taek Sang LEE ; Bingyi YANG ; Farhana KALAM ; Qiaoying LV ; Mohd Faizal AHMAD ; Muhammad Rizki YAZNIL ; Kanika Batra MODI ; Manatsawee MANOPUNYA ; Dae Hoon JEONG ; Arb aroon LERTKHACHONSUK ; Hyun Hoon CHUNG ; Hidemichi WATARI ; Seob JEON
Journal of Gynecologic Oncology 2019;30(2):e39-
The Asian Society of Gynecologic Oncology International Workshop 2018 on gynecologic oncology was held in the Ajou University Hospital, Suwon, Korea on the 24th to 25th August 2018. The workshop was an opportunity for Asian doctors to discuss the latest findings of gynecologic cancer, including cervical, ovarian, and endometrial cancers, as well as the future of fertility-sparing treatments, minimally invasive/radical/debulking surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Clinical guidelines and position statement of Asian countries were presented by experts. Asian clinical trials for gynecologic cancers were reviewed and experts emphasized the point that original Asian study is beneficial for Asian patients. In Junior session, young gynecologic oncologists presented their latest research on gynecologic cancers.
Antineoplastic Agents
;
Asian Continental Ancestry Group
;
Drug Therapy
;
Education
;
Endometrial Neoplasms
;
Female
;
Gyeonggi-do
;
Humans
;
Immunotherapy
;
Korea
;
Ovarian Neoplasms
;
Radiotherapy
;
Uterine Cervical Neoplasms
7.Hydroxychloroquine for COVID-19: A Single Center, Retrospective Cohort Study
Wen Chung Ho ; Wei Xin Yong ; Khai Shin Tan ; Woh Yon Mak ; Mandeep Kaur Gill ; Agnes Hui Ching Lok ; Shazwani Zulkifli ; Salmah Idris ; Khairil Erwan Khalid ; Chee Loon Leong ; Kang Nien How
Malaysian Journal of Medicine and Health Sciences 2023;19(No.2):8-13
Introduction: The outbreak of coronavirus disease (COVID-19) in December 2019 called for a rapid solution, leading to repurposing of existing drugs. Due to its immunomodulatory effect and antiviral properties, hydroxychloroquine (HCQ) has been used in early 2020 for treatment of COVID-19 patients. This study was conducted to evaluate
the treatment outcome of HCQ monotherapy in Malaysia. Methods: A retrospective cohort study was conducted in
COVID-19 ward in Hospital Kuala Lumpur (HKL), from March to April 2020. A total of 446 COVID-19 patients were
recruited, only 325 patients were finally included for analysis. Statistical analysis was done using SPSS, with a significant value set at p<0.05. Results: The mean age of the patients were 38.5 ±15.5. They were majority male, (n=210,
64.6%) Malaysian (n=239, 73.5%) and Malay ethnicity (n=204, 62.8%). Ninety-one (28%) patients received HCQ
monotherapy. HCQ monotherapy was associated with worse outcome (OR: 10.29, 95% CI 1.17-90.80). There was a
significant difference in mean length of stay between those with and without HCQ treatment (t323=5.868, p<0.001,
95% CI, 2.56-5.31). The average length of stay for HCQ treated group was 3.84 days longer than those without
treatment. 6.6% of the patient receiving HCQ monotherapy encountered adverse drug effects. Conclusion: Similar
to study reported worldwide, our study demonstrated that HCQ did not improve length of stay and the outcome of
COVID-19 patients.
8.Shanghai Autism Early Development: An Integrative Chinese ASD Cohort.
Yuan DAI ; Yuqi LIU ; Lingli ZHANG ; Tai REN ; Hui WANG ; Juehua YU ; Xin LIU ; Zilin CHEN ; Lin DENG ; Minyi TAO ; Hangyu TAN ; Chu-Chung HUANG ; Jiaying ZHANG ; Qiang LUO ; Jianfeng FENG ; Miao CAO ; Fei LI
Neuroscience Bulletin 2022;38(12):1603-1607