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Chow BCK, Lo SSM, Lee JCY, Chiang JB, Chan HF, Ho CB, Szeto LT, Tang KW. Familial Amyloidotic Polyneuropathy with Leptomeningeal and Cardiac Involvement in a Patient with Gly73Glu Transthyretin Gene Mutation — Non-invasive Diagnostic Approach with Multimodality Imaging Findings: a Case Report. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2217296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- BCK Chow
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - SSM Lo
- Scanning Department, St. Teresa’s Hospital, Hong Kong
| | - JCY Lee
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - JB Chiang
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - HF Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - CB Ho
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - LT Szeto
- Department of Nuclear Medicine, Queen Elizabeth Hospital, Hong Kong
| | - KW Tang
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
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Johnson JN, Loriaux DB, Jenista E, Kim HW, Baritussio A, De Garate Iparraguirre E, Bucciarelli-Ducci C, Denny V, O'Connor B, Siddiqui S, Fujikura K, Benton CW, Weinsaft JW, Kochav J, Kim J, Madamanchi C, Steigner M, Kwong R, Chango-Azanza D, Chapa M, Rosales-Uvera S, Sitwala P, Filev P, Sahu A, Craft J, Punnakudiyil GJ, Jayam V, Shams F, Hughes SG, Lee JCY, Hulten EA, Steel KE, Chen SSM. Society for Cardiovascular Magnetic Resonance 2021 cases of SCMR and COVID-19 case collection series. J Cardiovasc Magn Reson 2022; 24:42. [PMID: 35787291 PMCID: PMC9251594 DOI: 10.1186/s12968-022-00872-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
The Society for Cardiovascular Magnetic Resonance (SCMR) is an international society focused on the research, education, and clinical application of cardiovascular magnetic resonance (CMR). "Cases of SCMR" is a case series hosted on the SCMR website ( https://www.scmr.org ) that demonstrates the utility and importance of CMR in the clinical diagnosis and management of cardiovascular disease. The COVID-19 Case Collection highlights the impact of coronavirus disease 2019 (COVID-19) on the heart as demonstrated on CMR. Each case in series consists of the clinical presentation and the role of CMR in diagnosis and guiding clinical management. The cases are all instructive and helpful in the approach to patient management. We present a digital archive of the 2021 Cases of SCMR and the 2020 and 2021 COVID-19 Case Collection series of nine cases as a means of further enhancing the education of those interested in CMR and as a means of more readily identifying these cases using a PubMed or similar literature search engine.
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Affiliation(s)
- Jason N Johnson
- Division of Pediatric Cardiology and Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Daniel B Loriaux
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Elizabeth Jenista
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Han W Kim
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Anna Baritussio
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, Padua, Italy
- Bristol Heart Institute, NIHR Bristol Biomedical Research Centre University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Estefania De Garate Iparraguirre
- Bristol Heart Institute, NIHR Bristol Biomedical Research Centre University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, NIHR Bristol Biomedical Research Centre University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Vanessa Denny
- Goryeb Children's Hospital, Atlantic Health System, Morristown, NJ, USA
| | - Brian O'Connor
- Robert Wood Johnson University Hospital, New Brunswick, NJ, USA
| | - Saira Siddiqui
- Goryeb Children's Hospital, Atlantic Health System, Morristown, NJ, USA
| | - Kana Fujikura
- Department of Health and Human Services, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles W Benton
- Department of Health and Human Services, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Jiwon Kim
- Weill Cornell Medicine, New York, NY, USA
| | | | | | | | - Diego Chango-Azanza
- National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Mónica Chapa
- National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Sandra Rosales-Uvera
- National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | | | | | | | - Jason Craft
- Dematteis Research Center, Greenvale, NY, USA
| | | | - Viraj Jayam
- Dematteis Research Center, Greenvale, NY, USA
| | - Farah Shams
- Infectious Diseases, St Francis Hospital, Roslyn, NY, USA
| | - Sean G Hughes
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonan C Y Lee
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong, China
| | | | | | - Sylvia S M Chen
- Department of Adult Congenital Heart Disease and Cardiology, The Prince Charles Hospital, Brisbane, Australia.
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Lui JCF, Tang AM, Law CC, Lee JCY, Lee FKH, Chiu J, Wong KH. A practical methodology to improve the dosimetric accuracy of MR-based radiotherapy simulation for brain tumors. Phys Med 2021; 91:1-12. [PMID: 34678686 DOI: 10.1016/j.ejmp.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the dosimetric accuracy of synthetic computed tomography (sCT) images generated by a clinically-ready voxel-based MRI simulation package, and to develop a simple and feasible method to improve the accuracy. METHODS 20 patients with brain tumor were selected to undergo CT and MRI simulation. sCT images were generated by a clinical MRI simulation package. The discrepancy between planning CT and sCT in CT number and body contour were evaluated. To resolve the discrepancies, an sCT specific CT-relative electron density (RED) calibration curve was used, and a layer of pseudo-skin was created on the sCT. The dosimetric impact of these discrepancies, and the improvement brought about by the modifications, were evaluated by a planning study. Volumetric modulated arc therapy (VMAT) treatment plans for each patient were created and optimized on the planning CT, which were then transferred to the original sCT and the modified-sCT for dose re-calculation. Dosimetric comparisons and gamma analysis between the calculated doses in different images were performed. RESULTS The average gamma passing rate with 1%/1 mm criteria was only 70.8% for the comparison of dose distribution between planning CT and original sCT. The mean dose difference between the planning CT and the original sCT were -1.2% for PTV D95 and -1.7% for PTV Dmax, while the mean dose difference was within 0.7 Gy for all relevant OARs. After applying the modifications on the sCT, the average gamma passing rate was increased to 92.2%. Mean dose difference in PTV D95 and Dmax were reduced to -0.1% and -0.3% respectively. The mean dose difference was within 0.2 Gy for all OAR structures and no statistically significant difference were found. CONCLUSIONS The modified-sCT demonstrated improved dosimetric agreement with the planning CT. These results indicated the overall dosimetric accuracy and practicality of this improved MR-based treatment planning method.
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Affiliation(s)
- Jeffrey C F Lui
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong.
| | - Annie M Tang
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
| | - C C Law
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
| | - Jonan C Y Lee
- Department of Radiology, Queen Elizabeth Hospital, Hong Kong
| | - Francis K H Lee
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
| | - Jeffrey Chiu
- Department of Radiology, Queen Elizabeth Hospital, Hong Kong
| | - Kam-Hung Wong
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
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Johnson JN, Mandell JG, Christopher A, Olivieri LJ, Loke YH, Campbell MJ, Darty S, Kim HW, Clark DE, Frischhertz BP, Fish FA, Bailey AL, Mikolaj MB, Hughes SG, Oneugbu A, Chung J, Burdowski J, Marfatia R, Bi X, Craft J, Umairi RA, Kindi FA, Williams JL, Campbell MJ, Kharabish A, Gutierrez M, Arzanauskaite M, Ntouskou M, Ashwath ML, Robinson T, Chiang JB, Lee JCY, Lee MSH, Chen SSM. Society for Cardiovascular Magnetic Resonance 2020 Case of the Week series. J Cardiovasc Magn Reson 2021; 23:108. [PMID: 34629101 PMCID: PMC8504030 DOI: 10.1186/s12968-021-00799-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 12/26/2022] Open
Abstract
The Society for Cardiovascular Magnetic Resonance (SCMR) is an international society focused on the research, education, and clinical application of cardiovascular magnetic resonance (CMR). Case of the week is a case series hosted on the SCMR website ( https://www.scmr.org ) that demonstrates the utility and importance of CMR in the clinical diagnosis and management of cardiovascular disease. Each case consists of the clinical presentation and a discussion of the condition and the role of CMR in diagnosis and guiding clinical management. The cases are all instructive and helpful in the approach to patient management. We present a digital archive of the 2020 Case of the Week series of 11 cases as a means of further enhancing the education of those interested in CMR and as a means of more readily identifying these cases using a PubMed or similar search engine.
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Affiliation(s)
- Jason N Johnson
- Division of Pediatric Cardiology and Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jason G Mandell
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - Adam Christopher
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - Laura J Olivieri
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - Yue-Hin Loke
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - Michael J Campbell
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Steve Darty
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Han W Kim
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Daniel E Clark
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Benjamin P Frischhertz
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frank A Fish
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alison L Bailey
- Division of Cardiovascular Medicine, University of Tennessee College of Medicine Chattanooga/Erlanger Health System, Chattanooga, TN, USA
| | - Michael B Mikolaj
- Division of Cardiovascular Medicine, University of Tennessee College of Medicine Chattanooga/Erlanger Health System, Chattanooga, TN, USA
| | - Sean G Hughes
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Jina Chung
- Division of Cardiology, Harbor UCLA Medical Center, Torrance, CA, USA
| | | | - Ravi Marfatia
- Division of Cardiology, St. Francis Hospital, Roslyn, NY, USA
| | - Xiaoming Bi
- Siemens Medical Solutions, Los Angeles, CA, USA
| | - Jason Craft
- Division of Cardiology, St. Francis Hospital, Roslyn, NY, USA
| | | | - Faiza A Kindi
- Department of Radiology, The Royal Hospital, Muscat, Oman
| | - Jason L Williams
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Michael J Campbell
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Ahmed Kharabish
- Radiology Department, Cairo University Hospitals, Cairo, Egypt
- Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Manuel Gutierrez
- Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Monika Arzanauskaite
- Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
- Cardiovascular Research Center-ICCC, Hospital de La Santa Creu I Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Marousa Ntouskou
- Radiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Mahi L Ashwath
- Division of Cardiology, University of Iowa Hospitals and Clinic, Iowa City, Iowa, USA
| | - Tommy Robinson
- Division of Cardiology, University of Iowa Hospitals and Clinic, Iowa City, Iowa, USA
| | - Jeanie B Chiang
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong, People's Republic of China
| | - Jonan C Y Lee
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong, People's Republic of China
| | - M S H Lee
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, People's Republic of China
| | - Sylvia S M Chen
- Department of Cardiology and Adult Congenital Heart Disease, The Prince Charles Hospital, Brisbane, Australia.
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Lee JCY, Chiang JB, Ng PP, Chow BCK, Cheng YW, Wong CY. Utility of cardiac magnetic resonance imaging in troponin-positive chest pain with non-obstructive coronary arteries: literature review. Hong Kong Med J 2021; 27:266-275. [PMID: 34413254 DOI: 10.12809/hkmj208690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- J C Y Lee
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - J B Chiang
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - P P Ng
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - B C K Chow
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - Y W Cheng
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - C Y Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
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Tsang KH, Chan WSW, Shiu CK, Lee JCY, Chan MK. Magnetic Resonance Imaging of Hypertrophic Cardiomyopathy. Hong Kong J Radiol 2018. [DOI: 10.12809/hkjr1815336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lee JCY, Tse KS, Lau HY, Fok WS, Chan KK, Chat WH, Yung WK, Mui TM. High-pitch Dual-source Computed Tomography Coupled with Sinogram-affirmed Iterative Reconstruction: Image Quality and Radiation Dose in Children. Hong Kong J Radiol 2018. [DOI: 10.12809/hkjr1616427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lee JCY, Tsang KH, Cheuk W, Chan MK. Positron-emission Tomography–Computed Tomography for Detection of Primary Pericardial Lymphoma. Hong Kong J Radiol 2018. [DOI: 10.12809/hkjr1616405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lee JCY, Shiu CK, Lai KC, Chan MK. Metal Artefact Reduction for Orthopaedic Devices Using Monoenergetic Extrapolation from Dual-energy Computed Tomography. Hong Kong J Radiol 2017. [DOI: 10.12809/hkjr1716423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Chan KH, Lee R, Lee JCY, Tse ACT, Pang SYY, Lau GKK, Teo KC, Ho PWL. Central nervous system inflammatory demyelinating disorders among Hong Kong Chinese. J Neuroimmunol 2013; 262:100-5. [PMID: 23838529 DOI: 10.1016/j.jneuroim.2013.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/24/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
Classical multiple sclerosis (CMS) and neuromyelitis optica spectrum disorders (NMOSD) are distinct central nervous system inflammatory demyelinating disorders (CNS IDD). Early diagnosis of CNS IDD is important as appropriate immunotherapies to optimize prognosis. We studied the diagnoses of CNS IDD among Hong Kong Chinese in a hospital-based setting. Consecutive Chinese patients who presented to our hospital with clinically isolated syndrome and subsequently diagnosed to have CNS IDD from 1980 to 2010 were reviewed. Patients with known diagnosis of CNS IDD referred for further care were excluded. Serial sera were assayed for aquaporin-4 autoantibodies (AQP4 Ab), at least 3 assays within 2-5years. A total of 210 patients diagnosed to have CNS IDD with disease duration of at least 2years were studied. Among 198 patients with serial sera available, 40 (20.2%, 20 had NMO and 20 other NMOSD) were AQP4 Ab-positive. Four patients who were AQP4 Ab-negative on the initial assay converted to AQP4 Ab-positive on repeated assays. The diagnoses of 210 patients were CMS in 88 (41.9%), NMOSD 47 (22.4%, 27 NMO, 20 other NMOSD), single attack of myelitis 23 (11.0%), single attack of optic neuritis 21 (10.0%), relapsing myelitis 10 (4.8%), acute disseminated encephalomyelitis (ADEM) 9 (4.3%), relapsing optic neuritis in 6 (2.9%), opticospinal multiple sclerosis 3 (1.4%) and single attack of brainstem encephalitis 3 (1.4%). Compared to CMS, NMOSD patients had older onset age, lower frequencies of brain MRI abnormalities and CSF OCB, higher frequency of LETM, higher CNS inflammation attack frequency in the first 2years, worse clinical outcome with higher EDSS score and mortality rate. This hospital-based study suggests that CMS (41.9%) and NMOSD (22.4%) are the most common CNS IDD among Hong Kong Chinese. NMOSD has worse clinical outcome than CMS. Detection of AQP4 Ab facilitates early diagnosis and prompts immunotherapies of NMOSD.
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Affiliation(s)
- K H Chan
- University Department of Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; Neuroimmunology and Neuroinflammation Research Laboratory, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; Research Center of Heart, Brain, Hormone and Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
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Leong KP, Yeak SCL, Saurajen ASM, Mok PKH, Earnest A, Siow JK, Chee NWC, Yeo SB, Khoo ML, Lee JCY, Seshadri R, Chan SP, Tang CY, Chng HH. Why generic and disease-specific quality-of-life instruments should be used together for the evaluation of patients with persistent allergic rhinitis. Clin Exp Allergy 2005; 35:288-98. [PMID: 15784105 DOI: 10.1111/j.1365-2222.2005.02201.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The importance of assessing health-related quality of life (HRQL) of patients with allergic rhinitis (AR) has been well established, but the specific roles of rhinitis-specific or general health instruments have not been delineated. OBJECTIVE We analysed the psychometric properties of a disease-specific instrument, the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ) and the general health instrument, the Medical Outcome Short-Form 36 (SF-36) as they are employed in combination in patients with persistent AR in clinical practice. METHOD We analysed the data collected from a prospective study of 43 newly diagnosed patients with persistent AR and 44 controls. We interviewed the patients four times, at baseline, weeks 4, 8 and 10. RESULTS The RQLQ and SF-36 have good discriminative property, internal consistency, and test-retest reliability. The RQLQ is superior to the SF-36 as an evaluative instrument because more of its domains respond to change, the magnitude of change was greater, and the response was faster. The SF-36 is more susceptible to floor and ceiling effects. Both instruments are unsuitable for mildly symptomatic patients based on Rasch model analysis. Each questionnaire assesses a distinct and significant portion of the total HRQL of persistent AR. CONCLUSION The SF-36 and RQLQ are good for discriminating rhinitis patients from controls, but the former is poor for detecting changes in QOL. Both are inappropriate for mildly symptomatic patients. Each instrument measures non-overlapping halves of the measurable HRQL. For an assessment of the HRQL in persistent AR that is complete and responsive both instruments should be employed together.
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Affiliation(s)
- K P Leong
- Department of Rheumatology, Tan Tock Seng Hospital, Singapore 308433.
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Lee JCY, Chen PP, Yeo JKS, So HY. Hong Kong Chinese teachers' attitudes towards life-sustaining treatment in the dying patients. Hong Kong Med J 2003; 9:186-91. [PMID: 12777654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVE To evaluate the attitudes of Hong Kong Chinese teachers towards life-sustaining treatment in the dying patients. DESIGN Prospective structured questionnaire survey. SETTING Hong Kong Institute of Education. SUBJECTS AND METHODS All teaching staff at the Hong Kong Institute of Education were sent the survey questionnaire. The questionnaire gathered demographic data, information on experience of 'life and death' decision-making, and views on life-sustaining treatment decisions. Respondents were also requested to respond to statements on life-sustaining treatment using a 5-point Likert Scale (1 representing strong disagreement and 5 representing strong agreement). RESULTS A total of 436 questionnaires were sent to teaching staff at the Hong Kong Institute of Education. The response rate was 27.8%. More than half (65.8%) of the respondents were aged between 30 and 49 years. There was an equal proportion of men and women among respondents. The respondents agreed with statements supporting end-of-life decisions (mean aggregate score, 3.13; standard deviation, 1.24; P<0.0001), and disagreed with statements against such decisions (mean aggregate score, 2.81; standard deviation, 1.22; P<0.0001). If the patient is competent, half of the respondents agreed that the patient alone should make the decision, while 27.2% believed that it should be a joint decision made by the patient, the family, and the doctor. Conversely, if the patient is incompetent, 52.6% agreed that it should be a joint decision made by the family and the doctor. There was strong support for advanced directives, whereby decisions in relation to life-sustaining treatment were legally recorded in advance (mean score, 3.62; P=0.0001). CONCLUSION The teachers in this survey appear to support the practice of withdrawing and withholding life-sustaining treatment in the dying patients when medical treatment is considered futile. Although patient autonomy in decision-making was supported by the greatest number of respondents, joint decision-making by the patient, family members, and doctors was also favoured by a substantial group. There was strong support for the use of advanced directives with respect to life-sustaining treatment.
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Affiliation(s)
- J C Y Lee
- Department of Anaesthesiology, Intensive Care and Operating Services, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, Hong Kong
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Lee JCY, Siow JK. Thyroid surgery--the Tan Tock Seng Hospital otolaryngology experience. Ann Acad Med Singap 2002; 31:158-64. [PMID: 11957551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Central to the management of a patient with a thyroid nodule is the evaluation of the risk of malignancy. Postoperative morbidity, though rare, remains a concern because of its impact on the quality of the life of the patient. MATERIALS AND METHODS A retrospective audit of 91 consecutive patients who underwent thyroid surgery for thyroid nodules, at the Department of Otolaryngology, Tan Tock Seng Hospital, between January 1995 and December 2000. RESULTS The sensitivity and specificity of fine-needle aspiration cytology (FNAC) were 60% and 100%, respectively. The sensitivity and specificity of intraoperative frozen section examination was 82% and 100%, respectively. Sixty-four patients experienced no postoperative morbidity. Of the 27 patients with postoperative morbidity, only 1 was permanent. The incidence of transient and permanent biochemical hypocalcaemia was 44% and 0%, respectively. Nodal dissection performed together with total thyroidectomy increased the incidence of postoperative hypocalcaemia (P < 0.05). The number of parathyroid glands preserved in situ did not predict for postoperative hypocalcaemia. The incidence of transient and permanent recurrent laryngeal nerve (RLN) palsy was 10.3% and 1.1% (8.2% and 0.9% of nerves at risk), respectively. Tracheo-oesophageal groove clearance performed together with thyroid lobectomy did not increase the incidence of postoperative RLN palsy (P > 0.05). The median hospital stay was 3 days for benign thyroid disease, 4.5 and 16 days for malignant disease with tracheo-oesophageal groove clearance only and with neck dissection, respectively. CONCLUSION The combination of clinical examination and FNAC remains the mainstay in selecting patients for surgery. Frozen section examination is an important intraoperative diagnostic adjunct to decide the extent of surgery. With proper surgical training and experience, thyroid surgery for malignancy can be undertaken with minimum postoperative morbidity and a short hospital stay.
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Affiliation(s)
- J C Y Lee
- Department of Otolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
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