Recurrence of carcinoma of tongue after irradiation-result of surgical salvage

Conference Theme: Challenges to specialists in the 21st centurypublished_or_final_versio

Patients with epistaxis who need hospitalization

published_or_final_versio

A survey of chronic rhinitis in Hong Kong

published_or_final_versio

Reconstruction after craniofacial trauma

Management of craniofacial trauma has became a sophisticated branch of reconstructive surgery in the last 20 years. New operative techniques and advanced technologies have evolved to allow much better treatment results to be achieved. The general principles of diagnosis and management of craniofacial trauma are discussed. The approach to individual fractures is also highlighted.published_or_final_versio

Association of High Myopia with Crystallin Beta A4 (CRYBA4) Gene Polymorphisms in the Linkage-Identified MYP6 Locus

Background: Myopia is the most common ocular disorder worldwide and imposes tremendous burden on the society. It is a complex disease. The MYP6 locus at 22 q12 is of particular interest because many studies have detected linkage signals at this interval. The MYP6 locus is likely to contain susceptibility gene(s) for myopia, but none has yet been identified. Methodology/Principal Findings: Two independent subject groups of southern Chinese in Hong Kong participated in the study an initial study using a discovery sample set of 342 cases and 342 controls, and a follow-up study using a replication sample set of 316 cases and 313 controls. Cases with high myopia were defined by spherical equivalent ⠤ -8 dioptres and emmetropic controls by spherical equivalent within ±1.00 dioptre for both eyes. Manual candidate gene selection from the MYP6 locus was supported by objective in silico prioritization. DNA samples of discovery sample set were genotyped for 178 tagging single nucleotide polymorphisms (SNPs) from 26 genes. For replication, 25 SNPs (tagging or located at predicted transcription factor or microRNA binding sites) from 4 genes were subsequently examined using the replication sample set. Fisher P value was calculated for all SNPs and overall association results were summarized by meta-analysis. Based on initial and replication studies, rs2009066 located in the crystallin beta A4 (CRYBA4) gene was identified to be the most significantly associated with high myopia (initial study: P = 0.02; replication study: P = 1.88e-4; meta-analysis: P = 1.54e-5) among all the SNPs tested. The association result survived correction for multiple comparisons. Under the allelic genetic model for the combined sample set, the odds ratio of the minor allele G was 1.41 (95% confidence intervals, 1.21-1.64). Conclusions/Significance: A novel susceptibility gene (CRYBA4) was discovered for high myopia. Our study also signified the potential importance of appropriate gene prioritization in candidate selection. © 2012 Ho et al.published_or_final_versio

Hippocampal MR spectroscopic abnormalities in a cohort of syphilitic patients with HIV and neurosyphilis infection

published_or_final_versio

The efficacy of surgery for recurrent nasopharyngeal carcinoma

Conference Theme: Challenges to specialists in the 21st centurypublished_or_final_versio

Advances in the management of hearing problems

The recent advances in the management of hearing problems are in three areas; firstly, early detection and diagnosis of hearing loss in children so that rehabilitation can be started whenever appropriate. Secondly, prostheses can be made from better tolerated material and employed for surgical reconstruction of the ossicular chain in the middle ear. Finally, the rehabilitation of those patients who have sensorineural problems can be enhanced by the programmable hearing aids. For the unfortunate patients who suffer from profound deafness, a cochlear implantation can be carried out to enable them to regain functional hearing.published_or_final_versio

Bronchoscopy for Removal of Aspirated Tracheobronchial Foreign Bodies at Kenyatta National Hospital, in Kenya

Background: This study was aimed at defining the presentation, morbidity and mortality following inhalation and subsequent removal of  tracheobronchial foreign body using a rigid bronchoscope.Methods: This was a retrospective, cross-sectional study undertaken in the Ear Nose and Throat-Head and Neck Surgery Unit of Kenyatta National Hospital. The study population consisted of patients with brochoscopically proven tracheobronchial foreign body. Case notes of 107 consecutive admissions with brochoscopically verified tracheobronchial foreign bodieswere analyzed for age, sex, time interval between inhalation and removal, duration of stay in hospital, complications and mortality.Results: The vast majority of patients were below 3 years of age and 63% of them presented within 3 days after onset of symptoms. The right bronchus was the most frequent destination of inhaled foreign bodies (50.5%) followed by the left bronchus (17.8%) and carina (14.2%) inthat order. The turnover of patients with inhaled foreign bodies was high with 86.9% being discharged within 6 days after surgery. The bronchoscopic procedure was uneventful in 76.6% of patients. Repeat bronchoscopy was performed in three patients with one undergoing eventual thoracotomy.Intraoperative cardiac arrest occurred in 5 cases (4.6%) with successful resuscitation in 2 and mortality in three (2.7%) % cases.Conclusion: Bronchoscopic removal of inhaled foreign bodies remains one of the riskiest otolaryngologic emergencies in Kenyatta National Hospital partly because of involvement of the life sustaining airway and partly because of lack of ideal equipment and adequate expertise. The need for hands on experience and close cooperation and familiarity between theanaesthesiologist and the bonchoscopist is emphasized

The prognosis of allocentric and egocentric neglect : evidence from clinical scans

We contrasted the neuroanatomical substrates of sub-acute and chronic visuospatial deficits associated with different aspects of unilateral neglect using computed tomography scans acquired as part of routine clinical diagnosis. Voxel-wise statistical analyses were conducted on a group of 160 stroke patients scanned at a sub-acute stage. Lesion-deficit relationships were assessed across the whole brain, separately for grey and white matter. We assessed lesions that were associated with behavioural performance (i) at a sub-acute stage (within 3 months of the stroke) and (ii) at a chronic stage (after 9 months post stroke). Allocentric and egocentric neglect symptoms at the sub-acute stage were associated with lesions to dissociated regions within the frontal lobe, amongst other regions. However the frontal lesions were not associated with neglect at the chronic stage. On the other hand, lesions in the angular gyrus were associated with persistent allocentric neglect. In contrast, lesions within the superior temporal gyrus extending into the supramarginal gyrus, as well as lesions within the basal ganglia and insula, were associated with persistent egocentric neglect. Damage within the temporo-parietal junction was associated with both types of neglect at the sub-acute stage and 9 months later. Furthermore, white matter disconnections resulting from damage along the superior longitudinal fasciculus were associated with both types of neglect and critically related to both sub-acute and chronic deficits. Finally, there was a significant difference in the lesion volume between patients who recovered from neglect and patients with chronic deficits. The findings presented provide evidence that (i) the lesion location and lesion size can be used to successfully predict the outcome of neglect based on clinical CT scans, (ii) lesion location alone can serve as a critical predictor for persistent neglect symptoms, (iii) wide spread lesions are associated with neglect symptoms at the sub-acute stage but only some of these are critical for predicting whether neglect will become a chronic disorder and (iv) the severity of behavioural symptoms can be a useful predictor of recovery in the absence of neuroimaging findings on clinical scans. We discuss the implications for understanding the symptoms of the neglect syndrome, the recovery of function and the use of clinical scans to predict outcome