Cardiac ion channelopathies encompass a set of inherited or acquired conditions that are due to dysfunction in ion channels or their associated proteins, typically in the presence of structurally normal hearts. They are associated with the development of ventricular arrhythmias and sudden cardiac death. The aim of this review is to provide a historical perspective and recent advances in the research of the cardiac ion channelopathies, Brugada syndrome, long QT syn‑ drome and catecholaminergic polymorphic ventricular tachycardia, in Hong Kong, China. In particular, recent works on the development of novel predictive models incorporating machine learning techniques to improve risk strati‑ fication are outlined. The availability of linked records of affected patients with good longitudinal data in the public sector, together with multidisciplinary collaborations, implies that ion channelopathy research efforts have advanced significantly.

Pregnancy ; Female ; Humans ; COVID-19/epidemiology* ; Singapore ; Telemedicine ; SARS-CoV-2 ; Parturition

Background: In non-alcoholic fatty liver disease (NAFLD), transient elastography (TE) is an accurate non-invasive method to identify patients at risk of advanced fibrosis (AF). We developed a diabetes-specific, non-invasive liver fibrosis score based on TE to facilitate AF risk stratification, especially for use in diabetes clinics where TE is not readily available. Methods: Seven hundred sixty-six adults with type 2 diabetes and NAFLD were recruited and randomly divided into a training set (n=534) for the development of diabetes fibrosis score (DFS), and a testing set (n=232) for internal validation. DFS identified patients with AF on TE, defined as liver stiffness (LS) ≥9.6 kPa, based on a clinical model comprising significant determinants of LS with the lowest Akaike information criteria. The performance of DFS was compared with conventional liver fibrosis scores (NFS, FIB-4, and APRI), using area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive and negative predictive values (NPV). Results: DFS comprised body mass index, platelet, aspartate aminotransferase, high-density lipoprotein cholesterol, and albuminuria, five routine measurements in standard diabetes care. Derived low and high DFS cut-offs were 0.1 and 0.3, with 90% sensitivity and 90% specificity, respectively. Both cut-offs provided better NPVs of >90% than conventional fibrosis scores. The AUROC of DFS for AF on TE was also higher (P<0.01) than the conventional fibrosis scores, being 0.85 and 0.81 in the training and testing sets, respectively. Conclusion Compared to conventional fibrosis scores, DFS, with a high NPV, more accurately identified diabetes patients at-risk of AF, who need further evaluation by hepatologists.

PURPOSE: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. METHODS: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009–2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. RESULTS: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. CONCLUSIONS: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.
Calculi ; Dental Caries ; Dental Clinics ; Diagnosis ; Diagnosis, Oral ; Humans ; Inflammation ; Mass Screening ; National Health Programs ; Radiography, Dental ; Radiography, Panoramic ; Root Caries ; Sensitivity and Specificity ; Survival Rate ; Tooth ; Tooth Loss

PURPOSE: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. METHODS: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. RESULTS: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. CONCLUSIONS: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.
Bicuspid* ; Dental Implants* ; Dental Implants, Single-Tooth ; Follow-Up Studies* ; Humans ; Incidence ; Molar ; Periodontal Ligament ; Retrospective Studies ; Splints ; Tooth ; Tooth Mobility

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 follow-up. Despite the appearance of an intracranial infection, the cervical spine should be investigated, especially if the response to appropriate antibiotics is suboptimal.
Anti-Bacterial Agents ; Central Nervous System Infections ; Cerebrospinal Fluid ; Discitis ; Fistula ; Follow-Up Studies ; Head ; Head and Neck Neoplasms* ; Humans ; Neck ; Neck Dissection ; Radiotherapy* ; Spine ; Subarachnoid Space

OBJECTIVE: To evaluate the technical feasibility, performance, and interobserver agreement of a computer-aided classification (CAC) system for regional ventilation at two-phase xenon-enhanced CT in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Thirty-eight patients with COPD underwent two-phase xenon ventilation CT with resulting wash-in (WI) and wash-out (WO) xenon images. The regional ventilation in structural abnormalities was visually categorized into four patterns by consensus of two experienced radiologists who compared the xenon attenuation of structural abnormalities with that of adjacent normal parenchyma in the WI and WO images, and it served as the reference. Two series of image datasets of structural abnormalities were randomly extracted for optimization and validation. The proportion of agreement on a per-lesion basis and receiver operating characteristics on a per-pixel basis between CAC and reference were analyzed for optimization. Thereafter, six readers independently categorized the regional ventilation in structural abnormalities in the validation set without and with a CAC map. Interobserver agreement was also compared between assessments without and with CAC maps using multirater kappa statistics. RESULTS: Computer-aided classification maps were successfully generated in 31 patients (81.5%). The proportion of agreement and the average area under the curve of optimized CAC maps were 94% (75/80) and 0.994, respectively. Multirater kappa value was improved from moderate (kappa = 0.59; 95% confidence interval [CI], 0.56-0.62) at the initial assessment to excellent (kappa = 0.82; 95% CI, 0.79-0.85) with the CAC map. CONCLUSION: Our proposed CAC system demonstrated the potential for regional ventilation pattern analysis and enhanced interobserver agreement on visual classification of regional ventilation.
Aged ; Area Under Curve ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Pulmonary Disease, Chronic Obstructive/physiopathology/*radiography ; Pulmonary Emphysema/physiopathology/radiography ; *Respiration ; Retrospective Studies ; Tomography, X-Ray Computed/*methods ; Xenon/*diagnostic use

Female ; Humans ; Middle Aged ; Radiography ; Subarachnoid Hemorrhage ; cerebrospinal fluid ; diagnosis ; diagnostic imaging

PURPOSE: The frequency of thoracic endovascular aortic repair (TEVAR) is increasing due to lower morbidity and mortality than that of open repair. The aim is to evaluate the results of TEVAR in patients with thoracic aortic disease. METHODS: Twenty seven patients have undergone TEVAR from October, 2003 to November, 2012. Aortic diagnoses were 7 descending thoracic aortic aneurysms, 6 acute descending aortic dissections, 6 traumatic aortic transactions, 4 aortic arch aneurysms, 2 chronic descending aortic dissections, and 2 penetrating aortic ulcers (PAU). Multi detector computerized tomography (MDCT) aortography was done at one week, one month, six months, and one year interval. RESULTS: Indications for TEVAR were aortic diameter of more than 5.5 cm in 9 patients, traumatic aortic transaction in 6, persistent chest pain in 4, increasing aortic diameter during follow-up period in 3, aneurysm rupture in 3, and PAU more than 2 cm in 2. Hybrid TEVAR was done in 7 patients. Primary technical success, showing complete aneurysmal exclusion, was done except in one patient (96%). There was one operation death (4%). Two patients developed perioperative stroke, but recovered without sequelae. MDCT was done during the mean of 18 months (range, 1 to 98 months) follow-up period. Small type I endoleak was found in two patients (7%), and type III endoleak was found in a patient (4%). Stent graft migration was in one patient. There was no aorta related deaths during the follow-up period. CONCLUSION: Intermediate term result of TEVAR in patients with thoracic aortic aneurysmal disease was encouraging. It may be used as a treatment option for thoracic aortic disease.
Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Aortic Diseases ; Aortography ; Chest Pain ; Chimera ; Endoleak ; Follow-Up Studies ; Humans ; Rupture ; Stents ; Stroke ; Transplants ; Ulcer

PURPOSE: The aim of this study was to provide sex-matched three-dimensional (3D) statistical shape models of the mandible, which would provide cephalometric parameters for 3D treatment planning and cephalometric measurements in orthognathic surgery. MATERIALS AND METHODS: The subjects used to create the 3D shape models of the mandible included 23 males and 23 females. The mandibles were segmented semi-automatically from 3D facial CT images. Each individual mandible shape was reconstructed as a 3D surface model, which was parameterized to establish correspondence between different individual surfaces. The principal component analysis (PCA) applied to all mandible shapes produced a mean model and characteristic models of variation. The cephalometric parameters were measured directly from the mean models to evaluate the 3D shape models. The means of the measured parameters were compared with those from other conventional studies. The male and female 3D statistical mean models were developed from 23 individual mandibles, respectively. RESULTS: The male and female characteristic shapes of variation produced by PCA showed a large variability included in the individual mandibles. The cephalometric measurements from the developed models were very close to those from some conventional studies. CONCLUSION: We described the construction of 3D mandibular shape models and presented the application of the 3D mandibular template in cephalometric measurements. Optimal reference models determined from variations produced by PCA could be used for craniofacial patients with various types of skeletal shape.
Cephalometry ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mandible ; Passive Cutaneous Anaphylaxis ; Principal Component Analysis