EUS could detect ascites missed by CT scan [4]

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Phenotype and management of patients with familial adenomatous polyposis in Hong Kong: perspective of the Hereditary Gastrointestinal Cancer Registry.

OBJECTIVES: To report on the phenotypic spectrum and clinical management of Chinese patients suffering from the rare autosomal dominant colorectal cancer syndrome of familial adenomatous polyposis. DESIGN: Analysis of prospectively collected data from the database of a regional registry. SETTING: The Hereditary Gastrointestinal Cancer Registry, Hong Kong. PARTICIPANTS: One hundred and eight patients with proven familial adenomatous polyposis from 36 local Chinese families with the condition recruited to the Registry from 1995 to 2001. INTERVENTIONS: Screening programme for at-risk family members, prophylactic surgery at presymptomatic diagnosis, and surveillance programme for extracolonic lesions in affected individuals. MAIN OUTCOME MEASURES: Rate of colorectal cancer, type of surgical treatment, spectrum of extracolonic lesions, and management of the syndrome. RESULTS: Fifty patients suffered from colorectal cancer with a mortality rate of 78.0%. The strategy of presymptomatic diagnosis by screening and appropriate prophylactic surgery reduced the incidence of colorectal cancer. Affected individuals were prone to develop potentially serious extracolonic lesions including thyroid cancer (5.7%), desmoid tumour (15.7%), gastroduodenal adenomas (7.1%), duodenal microadenoma (17.1%), and pouch polyposis (17.4%). CONCLUSIONS: Screening and prophylactic surgery are effective ways to prevent colorectal cancer for patients with familial adenomatous polyposis. Lifelong regular surveillance is necessary to detect and manage extracolonic lesions. A dedicated registry is essential to coordinate clinical management and to compile data for furthering knowledge of this rare but complex syndrome.published_or_final_versio

Patients with Helicobacter pylori positive and negative duodenal ulcers have distinct clinical characteristics

Aim: To assess the clinical characteristics of Helicobacter pylori (H pylori) negative duodenal ulcer. Methods: Patients with an endoscopic diagnosis of duodenal ulcer between 1996 and 2002 were included in the present study. Patients were considered to be negative for H pylori, if both histological examination and rapid urease test of biopsy specimens were negative. A comparison was made between patients with H pylori positive and negative duodenal ulcers. Results: A total of 1 343 patients were studied. Their mean age was 54.7±0.5 years. There was a male preponderance (M:F = 2.5:1). Three hundred and ninety-eight patients (29.6%) did not have H pylori infection. The annual proportion of patients with H pylori negative duodenal ulcers increased progressively from 1996 to 2002. On multivariate analysis, patients with H pylori negative duodenal ulcer were more likely to be older, have concomitant medical problem, pre-existing malignancy, recent surgery, underlying sepsis, or taken non-steroidal anti-inflammatory drugs. In terms of clinical presentations, patients with H pylori negative duodenal ulcer were more likely to present with bleeding, multiple ulcers and larger ulcers. Conclusion: The proportion of patients with H pylori negative duodenal ulcers is on the rise because of a continued drop in incidence of H pylori positive duodenal ulcers in recent years. Such patients have distinct clinical characteristics and it is important to ascertain the H pylori status before starting eradication therapy. © 2005 The WJG Press and Elsevier Inc. All rights reserved.published_or_final_versio

A new recursive algorithm for time-varying autoregressive (TVAR) model estimation and its application to speech analysis

This paper proposes a new state-regularized (SR) and QR decomposition based recursive least squares (QRRLS) algorithm with variable forgetting factor (VFF) for recursive coefficient estimation of time-varying autoregressive (AR) models. It employs the estimated coefficients as prior information to minimize the exponentially weighted observation error, which leads to reduced variance and bias over traditional regularized RLS algorithm. It also increases the tracking speed by introducing a new measure of convergence status to control the FF. Simulations using synthetic and real speech signals show that the proposed method has improved tracking performance and reduced estimation error variance than conventional TVAR modeling methods during rapid changing of AR coefficients. © 2012 IEEE.published_or_final_versionThe 2012 IEEE International Symposium on Circuits and Systems (ISCAS), Seoul, Korea, 20-23 May 2012. In IEEE International Symposium on Circuits and Systems Proceedings, 2012, p. 1026-102

A New Variable Regularized QR Decomposition-Based Recursive Least M-Estimate Algorithm-Performance Analysis and Acoustic Applications

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Steering vector estimation and beamforming under uncertainties

In this paper, we propose a new method for estimating the steering vector under uncertainties, which is utilized for improving the robustness of beamforming. We show that the desired steering vector can be estimated in closed form from a convex optimization problem by making use of the subspace principle. As this method is developed based on an extended version of the orthonormal PAST (OPAST), the steering vector can be recursively estimated with very low complexity and moving sources can be handled. To further improve the performance of beamforming, the uncertainty of the array covariance matrix is taken into account. Numerical results demonstrate that the proposed method performs well in the presence of uncertainties. © 2012 IEEE.published_or_final_versio

Strongyloidiasis in a nonagenarian who previously worked in conservancy services

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A three-miRNA signature as promising non-invasive diagnostic marker for gastric cancer

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Standards of pancreaticoduodenectomy in a tertiary referral centre in Hong Kong: retrospective case series.

OBJECTIVE: To evaluate the perioperative outcomes of pancreaticoduodenectomy in a tertiary referral centre in Hong Kong. DESIGN: Retrospective case series. SETTING: University teaching hospital, Hong Kong. PATIENTS: One hundred and forty patients who underwent pancreaticoduodenectomy from July 1989 through June 2001. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULTS: Overall hospital mortality among 140 patients was 2.9% (n=4), and 30-day operative mortality was 2.1% (n=3). There was no significant difference in the hospital mortality rate between 43 elderly patients aged 70 years or older and 97 younger patients (2.3% versus 3.1%). The overall morbidity rate was 38.6% (n=54). Intra-abdominal abscess (13.6%) and pancreaticojejunal anastomotic leakage (12.9%) were the two most common complications. Presence of co-morbid illness (risk ratio, 2.823; 95% confidence interval, 1.541-4.385; P=0.01), preoperative cholangitis (risk ratio, 2.565; 95% confidence interval, 1.166-5.643; P=0.02), and intra-operative blood loss >/=1.5 L (risk ratio, 2.236; 95% confidence interval, 1.132-6.213; P=0.03) were independent risk factors for postoperative morbidity. CONCLUSIONS: Pancreaticoduodenectomy is associated with a low risk of operative death when performed in a tertiary referral setting in Hong Kong. The postoperative morbidity rate remains high, however. Further improvement by reducing intra-operative blood loss may help curtail the high postoperative morbidity.published_or_final_versio