Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws

Study DesignRetrospective study.PurposeTo analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients.Overview of LiteratureC7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width.MethodsWe have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl's technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images.ResultsCT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm.ConclusionsThe mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan

The Inaccuracy of Surface Landmarks for the Anterior Approach to the Cervical Spine in Southern Chinese Patients

Study Design Observational study. Purpose To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. Overview of Literature Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. Methods The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. Results In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. Conclusions The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels

Clinical and biomechanical outcome of minimal invasive and open repair of the Achilles tendon

Introduction: With evolutions in surgical techniques, minimally invasive surgical (MIS) repair with Achillon applicator has been introduced. However, there is still a lack of literature to investigate into the clinical merits of MIS over open surgery. This study aims to investigate the correlation between clinical outcome, gait analysis and biomechanical properties comparing both surgical methods.Materials and methods: A single centre retrospective review on all the consecutive operated patients between January 2004 and December 2008 was performed. Twenty-six patients (19 male and 7 female; age 40.4 ± 9.2 years) had experienced a complete Achilles tendon rupture with operative repair. Nineteen of the patients, 10 MIS versus 9 open repairs (13 men with a mean age of 40.54 ± 10.43 (range 23-62 yrs) and 6 women with a mean age of 45.33 ± 7.71 (range 35-57 yrs) were further invited to attend a thorough clinical assessment using Holz's scale and biomechanical evaluation at a mean of 25.3 months after operation. This study utilized the Cybex II isokinetic dynamometer to assess the isokinetic peak force of plantar-flexion and dorsiflexion of both ankles. The patients were also invited to return to our Gait Laboratory for analysis. The eight-infrared camera motion capture system (VICON, UK) was utilized for the acquisition of kinematic variables. Their anthropometric data was measured according to the Davis and coworkers' standard.Results: The mean operative time and length of hospital stay were shorter in the MIS group. The operative time was 54.55 ± 15.15 minutes versus 68.80 ± 18.23 minutes of the MIS group and Open group respectively (p = 0.045), whereas length of stay was 3.36 ± 1.21 days versus 6.40 ± 3.70 days respectively (p = 0.039). There is statistically significant decrease (p = 0.005) in incision length in MIS group than the open surgery group, 3.23 ± 1.10 cm versus 9.64 ± 2.55 cm respectively. Both groups attained similar Holz's scores, 11.70 ± 0.95 versus 12.0 ± 1.50 respectively (p = 0.262). The mean percentage stance time of the injured leg for MIS patient was 58.44% while the mean percentage stance time of the injured leg for patients with open repair was 56.57%. T-test has shown there were no significance differences between the results of the two groups of patients. The loss of peak torque and total work done with respect to the injured side were similar between the MIS and open group.Discussion and conclusion: MIS using Achillon method can achieve smaller incisions, shorter operative time and hospital stay. There is no statistical significance difference in clinical outcome, the stance time to strike time ratio and biomechanical properties on the leg receiving Achilles tendon repair using MIS method and open surgery. © 2011 Chan et al; licensee BioMed Central Ltd

Clinical and biomechanical outcome of minimal invasive and open repair of the Achilles tendon

Introduction: With evolutions in surgical techniques, minimally invasive surgical (MIS) repair with Achillon applicator has been introduced. However, there is still a lack of literature to investigate into the clinical merits of MIS over open surgery. This study aims to investigate the correlation between clinical outcome, gait analysis and biomechanical properties comparing both surgical methods.Materials and methods: A single centre retrospective review on all the consecutive operated patients between January 2004 and December 2008 was performed. Twenty-six patients (19 male and 7 female; age 40.4 ± 9.2 years) had experienced a complete Achilles tendon rupture with operative repair. Nineteen of the patients, 10 MIS versus 9 open repairs (13 men with a mean age of 40.54 ± 10.43 (range 23-62 yrs) and 6 women with a mean age of 45.33 ± 7.71 (range 35-57 yrs) were further invited to attend a thorough clinical assessment using Holz's scale and biomechanical evaluation at a mean of 25.3 months after operation. This study utilized the Cybex II isokinetic dynamometer to assess the isokinetic peak force of plantar-flexion and dorsiflexion of both ankles. The patients were also invited to return to our Gait Laboratory for analysis. The eight-infrared camera motion capture system (VICON, UK) was utilized for the acquisition of kinematic variables. Their anthropometric data was measured according to the Davis and coworkers' standard.Results: The mean operative time and length of hospital stay were shorter in the MIS group. The operative time was 54.55 ± 15.15 minutes versus 68.80 ± 18.23 minutes of the MIS group and Open group respectively (p = 0.045), whereas length of stay was 3.36 ± 1.21 days versus 6.40 ± 3.70 days respectively (p = 0.039). There is statistically significant decrease (p = 0.005) in incision length in MIS group than the open surgery group, 3.23 ± 1.10 cm versus 9.64 ± 2.55 cm respectively. Both groups attained similar Holz's scores, 11.70 ± 0.95 versus 12.0 ± 1.50 respectively (p = 0.262). The mean percentage stance time of the injured leg for MIS patient was 58.44% while the mean percentage stance time of the injured leg for patients with open repair was 56.57%. T-test has shown there were no significance differences between the results of the two groups of patients. The loss of peak torque and total work done with respect to the injured side were similar between the MIS and open group.Discussion and conclusion: MIS using Achillon method can achieve smaller incisions, shorter operative time and hospital stay. There is no statistical significance difference in clinical outcome, the stance time to strike time ratio and biomechanical properties on the leg receiving Achilles tendon repair using MIS method and open surgery. © 2011 Chan et al; licensee BioMed Central Ltd

Preliminary results of trial NPC-0501 evaluating the therapeutic gain by changing from concurrent-adjuvant to induction-concurrent chemoradiotherapy, changing from fluorouracil to capecitabine, and changing from conventional to accelerated radiotherapy fractionation in patients with locoregionally advanced nasopharyngeal carcinoma

© 2014 American Cancer Society. BACKGROUND A current recommendation for locoregionally advanced nasopharyngeal carcinoma (NPC) is conventional fractionated radiotherapy with concurrent cisplatin plus adjuvant cisplatin and fluorouracil (PF). In this randomized trial, the authors evaluated the potential therapeutic benefit from changing to an induction-concurrent chemotherapy sequence, replacing fluorouracil with oral capecitabine, and/or using accelerated rather than conventional radiotherapy fractionation. METHODS Patients with stage III through IVB, nonkeratinizing NPC were randomly allocated to 1 of 6 treatment arms. The protocol was amended in 2009 to permit confining randomization to the conventional fractionation arms. The primary endpoint was progression-free survival. Secondary endpoints included overall survival and safety. RESULTS In total, 803 patients were accrued, and 706 patients were randomly allocated to all 6 treatment arms. Comparisons of induction PF versus adjuvant PF did not indicate a significant improvement. Unadjusted comparisons of induction cisplatin and capecitabine (PX) versus adjuvant PF indicated a favorable trend in progression-free survival for the conventional fractionation arm (P = .045); analyses that were adjusted for other significant factors and fractionation reflected a significant reduction in the hazards of disease progression (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.36-0.80) and death (HR, 0.42; 95% CI, 0.25-0.70). Unadjusted comparisons of induction sequences versus adjuvant sequences did not reach statistical significance, but adjusted comparisons indicated favorable improvements by induction sequence. Comparisons of induction PX versus induction PF revealed fewer toxicities (neutropenia and electrolyte disturbance), unadjusted comparisons of efficacy were statistically insignificant, but adjusted analyses indicated that induction PX had a lower hazard of death (HR, 0.57; 95% CI, 0.34-0.97). Changing the fractionation from conventional to accelerated did not achieve any benefit but incurred higher toxicities (acute mucositis and dehydration). CONCLUSIONS Preliminary results indicate that the benefit of changing to an induction-concurrent sequence remains uncertain; replacing fluorouracil with oral capecitabine warrants further validation in view of its convenience, favorable toxicity profile, and favorable trends in efficacy; and accelerated fractionation is not recommended for patients with locoregionally advanced NPC who receive chemoradiotherapy.postprin

Specific two-photon imaging of live cellular and deep-tissue lipid droplets by lipophilic AIEgens at ultra-low concentration

Lipid droplets are highly associated with obesity, diabetes, inflammatory disorders and cancer. A reliable two-photon dye for specific lipid droplets imaging in live cells and live tissues at ultra-low concentration has rarely been reported. In this work, four new aggregation-induced emission luminogens (AIEgens) based on the naphthalene core were designed and synthesized for specific two-photon lipid droplets staining. The new molecules, namely NAP AIEgens, exhibit large Stokes shift (>110 nm), high solid-state fluorescence quantum yield (up to 30%), good two-photon absorption cross section (45–100 GM at 860 nm), high biocompatibility and good photostability. They could specifically stain lipid droplets at ultra-low concentration (50 nM) in a short time of 15 min. Such ultra-low concentration is the lowest value for lipid droplets staining in live cells reported so far. In vitro and ex vivo two-photon imaging of lipid droplets in live cells and live mice liver tissues were successfully demonstrated. In addition, selective visualization of lipid droplets in live mice liver tissues could be achieved at a depth of about 70 μm. These excellent properties render them as promising candidates for investigating lipid droplets-associated physiological and pathological processes in live biological samples

「回首．動情．傳承」長者生命故事計劃

嶺南大學亞太老年學研究中心獲華人永遠墳場管理委員會（「華永會」）資助為期一年的「回首．動情．傳承」長者生命故事計劃(「計劃」)。此計劃旨在讓青年人認識長者生命經驗，學習克服困難與挫折以提升抗逆力，建立正向人生觀。 近年，主流媒體經常批評年輕人的負面人生觀，例如：「躺平主義」、「享樂主義」、「犬儒心態」等，亦不時看到青年人輕生的新聞。我們曾在大學內處理過不少受情緒困擾及企圖自殺的個案，與學生深入交流後，發現他們面對着沉重的學業壓力、財政困難或複雜的家庭關係，內心充滿掙扎不安。 此計劃讓嶺大學生與長者導師進行深度的對談，透過了解長者走過的路、他們經歷過的挫折和教訓，給予年輕人生命的啟示。如果我們以旅遊比喻人生，長者就像環遊世界的資深背包客，即使大家遊覽不同的地點、觀賞過不同的風景，他們總能夠分享一些旅遊的心得，讓新手遊客走少一點冤枉路，或領悟到旅遊的樂趣和意義。長者亦可以藉由敍述人生片段回顧他們生命中的故事，學習接納過去，增加自我認同感。青年人創作生命教育書冊，將長者積極的人生觀傳給年輕一代，並藉此鼓勵其他長者豁達地度過餘年。 我們於2022年初招募嶺南大學學生接受「生命故事敍述」培訓，內容包括：本港的人口老化現象、敍述治療理論、與長者溝通的技巧及模擬實踐練習等，以裝備同學的知識和技巧。本中心再向屯門、元朗區的長者機構發邀請信，誠邀長者擔任生命導師接受訪問。 嶺大安排同學以兩人一組的小隊形式，於2022年6至7月期間前往長者中心、日間護理中心、嶺南大學或長者家中，與十二位長者進行深入訪談。訪談結束後，同學根據訪談的內容，為長者書寫他們獨特的生命故事。例如在人離鄉賤的異國環境下，努力打拼事業的Alfred；堅持不懈持續進修的淑芹和馮春林；即使沒機會求學，仍憑一雙巧手闖出一片天的譚惠；在文化大革命的漩渦中，憑着熱忱而改變命運的蘭英；還有為家人無私奉獻的鳳群、歐婆婆、雅芳及細女；離鄉別井勇闖異地的阿美和阿水；即使被家人賣去做「妹仔」，仍能以「阿Q精神」面對的諒餘。 為保障長者的私隱權益，本書內所有刊登之故事皆經過受訪者或社工審閱，部份受訪者選擇以化名的形式來分享自己的故事，我們亦移除了部份敏感的個人資料。https://commons.ln.edu.hk/apias_guide/1008/thumbnail.jp