Adolescent ; Adult ; Female ; Fenestration, Labyrinth ; methods ; Humans ; Male ; Middle Aged ; Neuroma, Acoustic ; surgery ; Young Adult

Humans ; Rectal Neoplasms/surgery* ; Anastomosis, Surgical ; Anal Canal/surgery* ; Treatment Outcome

AIM: To study the effects of Sodium Hyaluronate (HA) and Bion Tears on corneal thickness in adult myopic patients.METHODS: A total of 38 cases (76 eyes) were involved in this study. Three consecutive corneal measurements (the thinnest point of the cornea,THN) were evaluated before and half an hour after the instillation of one drop of HA in one eye and Bion Tears in the other at random with the Orbscan Corneal Topography System II (Orbscan,Inc,Salt Lake City,UT,USA,Version 3.00E).RESULTS: There were no significant between-group differences in baseline variable (t=0.264). Thirty minutes after the instillation of HA and Bion tears,THN were significantly increased by 5.57±7.00μm (t=4.906,P<0.01) and 7.89±7.64μm (t=6.369,P<0.01) respectively. However,there were no between-group differences in THN changes(t=1.381,P>0.05).Increase in the corneal thickness were found in 32 eyes (84%) and 33 eyes (87%) for the HA and Bion tears group,respectively.CONCLUSION: Artificial tears including HA and Bion Tears can significantly increase the corneal thickness in a short period of time. Corneal thickness can be used as one of the objective indices for evaluating the quality and therapeutic role of artificial tears.

INTRODUCTIONWe evaluated the accuracy of endorectal magnetic resonance imaging (MRI) in the staging of prostate cancer.

MATERIALS AND METHODSWe retrospectively reviewed 32 patients who underwent endorectal MR prostate prior to radical prostatectomy. The tumour stage based on MR imaging was compared with the pathologic stage. The sensitivity and specificity of endorectal MR prostate in the evaluation of extracapsular extension (ECE) of the tumour were then determined.

RESULTSMR correctly diagnosed 17 cases of organ-confined prostate carcinoma and 2 cases of locally advanced disease. In the evaluation of ECE, endorectal MR achieved a high specificity of 94.4%, low sensitivity of 14.3% and moderate accuracy of 59.4%.

CONCLUSIONEndorectal MR prostate has high specificity for the detection of ECE. It is useful in the local staging of prostate cancer in patients with intermediate risk as this helps to ensure that few patients will be deprived of potentially curative surgery.

Adult ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Medical Audit ; Middle Aged ; Neoplasm Staging ; methods ; Prostatectomy ; Prostatic Neoplasms ; pathology ; surgery ; Rectum ; Retrospective Studies ; Sensitivity and Specificity

Objectives: To determine the knowledge, attitude, and practices (KAP) on rabies prevention and control among primary care providers of children 0-18 years old. Methodology: This is an analytical cross-sectional study conducted among primary care providers of children 0- 18-years old in Barangay Sambag I, Cebu City, Philippines. A questionnaire to determine the KAP on rabies prevention and control, originally developed by Lañada et al., was modified and contextualized to the local setting. Respondents with at least 75% correct answers per domain were considered to have good overall knowledge, attitude, and practices. Furthermore, each question under the above domains was analyzed separately to determine any gaps in KAP. Results were recorded as frequencies and percentages. The association of KAP to one another and the respondents’ profiles were analyzed using Chi-square test with a level of significance of 0.05. Results: Among 285 respondents, 59.3% had poor knowledge, 35.8% had wrong practices, and 21.8% had negative attitude on rabies prevention and control. We found that 92.6% did not know that rabies is incurable. As to practices, performing “tandok” (42.5%), or the act of removal of rabies from a wound by using an animal horn, and applying herbal medicines (34%) were still done. Use of dog restraint (44.6%) and euthanasia (40%) weren’t favorable to study participants. Surprisingly, non-dog owners had good knowledge and positive attitude than dog owners. Conclusion Our study showed that majority of the study population had poor knowledge on rabies prevention and control, on disease transmission, and on the incurability of rabies. While majority had a positive attitude and correct practices, the unacceptability on the use of a dog restraint and euthanasia, especially among dog owners, were still evident.
Rabies ; Knowledge

INTRODUCTIONThis study aims to determine if the quantitative method of region-of-interest (ROI) analysis of lesion attenuation on CT may be a useful adjunct to the conventional approach of diagnosis by visual assessment in assessing tracer wash-out in hepatocellular carcinomas.

MATERIALS AND METHODSFrom a surgical database of 289 patients from 2 institutions, all patients with complete surgical, pathological and preoperative multiphasic CT scans available for review were selected. For each phase of scanning, HU readings of lesion obtained (Lesion(arterial), Lesion(PV) and Lesion(equilibrium)) were analysed using receiver operating curves (ROC) to determine the optimal method and cut-off value for quantitative assessment of tumour wash-out (Lesion(arterial - equilibrium), Lesion(PV - equilibrium) or Lesion(peak - equilibrium)).

RESULTSNinety-four patients with one lesion each met the inclusion criteria. The area under the curve (AUC) values for Lesion(arterial - equilibrium) (0.941) was higher than the AUC for Lesion(pv - equilibrium) (0.484) and for Lesion(peak - equilibrium) (0.667). Based on ROC analysis, a cut-off of 10HU value for Lesion(arterial - equilibrium) would yield sensitivity and specificity of 91.5% and 80.9%, respectively. ROI analysis detected 9/21 (42.9%) of lesions missed by visual analysis. Combined ROI and visual analysis yields a sensitivity of 82/94 (87.2%) compared to 73/94 (77.7%) for visual analysis alone.

CONCLUSIONUsing a cut-off of 10 HU attenuation difference between the arterial and equilibrium phases is a simple and objective method that can be included as an adjunct to visual assessment to improve sensitivity for determining lesion wash-out on CT.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; surgery ; Confidence Intervals ; Databases, Factual ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Preoperative Period ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; instrumentation ; Young Adult

OBJECTIVETo evaluate whether deletion of chromosome 14q is involved in the carcinogenesis of primary glioblastoma multiforme and to identify possibly common deletion regions. METHJODS: Fourteen fluorescent dye-labeled polymorphic markers were used and polymerase chain reaction-based microsatellite analysis was employed to investigate loss of heterozygosity (LOH) on chromosome 14q in 20 primary glioblastoma multiforme (GBM).

RESULTSTen of twenty (50%) GBM displayed LOH at one or more of the markers on chromosome 14q. Five tumors showed either LOH or non-informative on all markers tested. The most frequent LOH was observed at locus D14S65 (57.1%) on 14q32.1, and in the chromosomal region spanning from D14S63 (47.1%) to D14S74 (46.7%) on 14q23-31. None of the informative loci exhibited microsatellite instability.

CONCLUSIONSAllelic deletion on chromosome 14q plays an important role in the pathogenesis of GBM. Chromosomal regions at locus D14S65 on 14q32.1 and spanning from D14S63 to D14S74 on 14q23-31 may harbor multiple tumor suppressor genes associated with GBM.

Adult ; Aged ; Chromosomes, Human, Pair 14 ; Female ; Genes, Tumor Suppressor ; Glioblastoma ; genetics ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged

To study the effects of sodium valproate (VPA) on human myelodysplastic syndrome cell line MUTZ-1. The cell proliferation was determined by MTT assay, apoptotic morphological features were observed by light microscopy and transmission electronmicroscopy, cell apoptosis and cell cycle shift were analyzed by flow cytometry (FCM). The results showed that VPA could inhibit the growth of MUTZ-1 cells in dose-and time-dependent manners. The typical apoptotic morphological features appeared in MUTZ-1 cells treated with 4 mmol/L VPA for 72 hours. Pyknosis of cells and nuclei, disintegration of nuclear chromatin and apoptotic body could be observed by light microscopy. Aggregation and margination of nuclear chromatin, concentration of plasm, increment of density and chromatin mass of irregular size could be observed by transmission electronmicroscope. The flow cytometric analysis indicated that the VPA could induce cell apoptosis, apoptosis rate increased in dose-dependent manner, ratio of cells at G(0)/G(1) phase increased and ratio of cells at S phase decreased in dose-dependent manner, the cells were arrested at G(0)/G(1) phase. It is concluded that the VPA can induce apotosis and inhibite proliferation of MUTZ-1 cells via arresting cells at G(0)/G(1) phase.
Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line ; Dose-Response Relationship, Drug ; Humans ; Myelodysplastic Syndromes ; pathology ; Valproic Acid ; pharmacology

Background/Aims: Data on treatment efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) for chronic hepatitis C virus (HCV) infection in Asian patients with severe renal impairment are limited. This study aimed to study the treatment and side effects of GLE/PIB in these patients infected with non-1 genotype (GT) HCV. Methods: We prospectively recruited patients with Child’s A cirrhosis and eGFR <30 mL/min/1.73 m2 in Hong Kong and Taiwan during 2017–2018 to receive GLE/PIB treatment. Results: Twenty-one patients (GT2, n=7; GT3, n=6; and GT6, n=8) received GLE/PIB for 11.2±1.8 weeks. All except one were treatment-naïve. GLE/PIB was initiated in 16 patients while on dialysis (seven on peritoneal dialysis [PD] and nine on hemodialysis) and in five patients before dialysis. One patient died of PD-related peritonitis during treatment and two were lost to follow up. The SVR12 rate in the remaining 18 patients was 100%. All patients achieved undetectable levels at 4-, 12-, 24- and 48-week after treatment. Patients with deranged alanine aminotransferase showed normalization after 4 weeks and the response was sustained for 48 weeks. No significant adverse event was observed. Conclusions GLE/PIB treatment was associated with high efficacy and tolerability in HCV-infected patients with severe renal impairment.

INTRODUCTIONAcute pancreatitis appears to be less prevalent in multi-ethnic Southeast Asia, where the aetiology also appears to be influenced by ethnicity. As with acute pancreatitis elsewhere, however, pancreatic necrosis is a cause of significant mortality and the aim of this study was to review our institutional experience with pancreatic necrosectomy.

MATERIALS AND METHODSThe records of all patients who underwent pancreatic necrosectomy from January 2000 to December 2004 were analysed. Indications for surgery were the presence of infected necrosis, unresolving sepsis attributable to ongoing pancreatitis or the presence of gas in the pancreatic bed on imaging. Surgical debridement was achieved by debridement with closure over drains or by debridement with open packing.

RESULTSThe cohort comprised 14 of 373 patients admitted for acute pancreatitis (3.8%), with an overall mortality rate of 29%. All patients had infected necrosis with positive bacteriological cultures. Eight patients (57%) underwent debridement with closure over drains and 6 patients (43%) underwent debridement with open packing. All mortalities occurred in patients who underwent open packing, who were also associated with a higher mean Acute Physiology and Chronic Health Evaluation (APACHE) II score. The mortality rate in patients who underwent debridement less than 4 weeks after admission was 33% (2 of 6), compared with 25% (2 of 8) in patients who underwent debridement after 4 weeks. There were no mortalities in patients operated on after 6 weeks.

CONCLUSIONSurgical debridement with closure of drains and a policy of performing delayed necrosectomy are viable in our population.

APACHE ; Adult ; Aged ; Asia, Southeastern ; epidemiology ; Cohort Studies ; Debridement ; methods ; Drainage ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy ; methods ; Pancreatitis, Acute Necrotizing ; diagnosis ; mortality ; surgery ; Time Factors ; Tomography, X-Ray Computed