Hospital Authority audit of the outcome of endoscopic resection of superficial upper gastro-intestinal lesions in Hong Kong

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MSH2 c.1452-1455delAATG Is a Founder Mutation and an Important Cause of Hereditary Nonpolyposis Colorectal Cancer in the Southern Chinese Population

Hereditary nonpolyposis colorectal cancer (HNPCC) accounts for ∼2% of all colorectal cancer (CRC) cases and is the most common hereditary CRC syndrome. We have previously reported a high incidence of microsatellite instability (MSI) and germline mismatch repair (MMR) gene mutations in young Hong Kong Chinese with CRC. Ongoing studies at the Hereditary Gastrointestinal Cancer Registry in Hong Kong have revealed a unique germline MSH2 c.1452-1455delAATG mutation that has not been reported in other ethnic groups. Detailed analysis showed that this specific MSH2 mutation constituted 21% of all germline MMR gene mutations and 36% of all MSH2 germline mutations identified. We designed a specific PCR-based diagnostic test on paraffin-embedded tissues and identified this germline mutation in 2 1.5%) of 138 consecutive patients with early-onset CRC (93 million. Further analysis suggested that this founder mutation may date back to between 22 and 103 generations ago. The identification of this MSH2 founder mutation has important implications for the design of mutation-detection strategies for the southern Chinese population. Since there were major emigrations from Hong Kong and Guangdong province during the 19th and 20th centuries, this finding is also significant for Chinese communities worldwide.published_or_final_versio

A comparison of angiographic embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers

Background: In patients with bleeding peptic ulcers in whom endoscopic hemostasis fails, surgery usually follows. Transarterial embolization (TAE) has been proposed as an alternative. Objective: To compare the outcomes of TAE and salvage surgery for patients with peptic ulcers in whom endoscopic hemostasis failed. Design: Retrospective study. Setting: A university hospital. Patients: Patients with peptic ulcer bleeding in whom endoscopic hemostasis failed. Interventions: TAE and surgery as salvage of peptic ulcer bleeding. Main Outcomes Measurements: All-cause mortality, rebleeding, reintervention, and complication rate. Results: Thirty-two patients underwent TAE and 56 underwent surgery. In those who underwent TAE, the bleeding vessels were gastroduodenal artery (25 patients), left gastric artery (4 patients), right gastric artery (2 patients), and splenic artery (1 patient). Active extravasation was seen in 15 patients (46.9%). Embolization was attempted in 26 patients, and angiographic coiling was successful in 23 patients (88.5%). Bleeding recurred in 11 patients (34.4%) in the TAE group and in 7 patients (12.5%) in the surgery group (P = .01). More complications were observed in patients who underwent surgery (40.6% vs 67.9%, P = .01). There was no difference in 30-day mortality (25% vs 30.4%, P = .77), mean length of hospital stay (17.3 vs 21.6 days, P = .09), and need for transfusion (15.6 vs 14.2 units, P = .60) between the TAE and surgery groups. Limitations: Retrospective study. Conclusions: In patients with ulcer bleeding after failed endoscopic hemostasis, TAE reduces the need for surgery without increasing the overall mortality and is associated with fewer complications. © 2011 American Society for Gastrointestinal Endoscopy.link_to_subscribed_fulltex

A comparison of angiographic embolization with surgery after failed endoscopic hemostasis to bleeding peptic ulcers

Background: In patients with bleeding peptic ulcers in whom endoscopic hemostasis fails, surgery usually follows. Transarterial embolization (TAE) has been proposed as an alternative. Objective: To compare the outcomes of TAE and salvage surgery for patients with peptic ulcers in whom endoscopic hemostasis failed. Design: Retrospective study. Setting: A university hospital. Patients: Patients with peptic ulcer bleeding in whom endoscopic hemostasis failed. Interventions: TAE and surgery as salvage of peptic ulcer bleeding. Main Outcomes Measurements: All-cause mortality, rebleeding, reintervention, and complication rate. Results: Thirty-two patients underwent TAE and 56 underwent surgery. In those who underwent TAE, the bleeding vessels were gastroduodenal artery (25 patients), left gastric artery (4 patients), right gastric artery (2 patients), and splenic artery (1 patient). Active extravasation was seen in 15 patients (46.9%). Embolization was attempted in 26 patients, and angiographic coiling was successful in 23 patients (88.5%). Bleeding recurred in 11 patients (34.4%) in the TAE group and in 7 patients (12.5%) in the surgery group (P = .01). More complications were observed in patients who underwent surgery (40.6% vs 67.9%, P = .01). There was no difference in 30-day mortality (25% vs 30.4%, P = .77), mean length of hospital stay (17.3 vs 21.6 days, P = .09), and need for transfusion (15.6 vs 14.2 units, P = .60) between the TAE and surgery groups. Limitations: Retrospective study. Conclusions: In patients with ulcer bleeding after failed endoscopic hemostasis, TAE reduces the need for surgery without increasing the overall mortality and is associated with fewer complications. © 2011 American Society for Gastrointestinal Endoscopy.link_to_subscribed_fulltex

Lower limb muscles’ activation during ascending and descending a single step-up movement : comparison between in water and on land exercise at different step cadences in young injury-free adults

202403 bcvcVersion of Recordself-fundedPublishedC

Designing learning objects that afford learners the experience of important variations in Chinese characters

Effective teaching should focus the attention of learners to its essential aspects. It follows that instructional software can be designed in such a way that allows learners to experience the important variations in the critical aspects of the content to be learned. This paper reports on the experience of designing such special kinds of instructional learning objects for the learning of Chinese characters. The design of these learning objects takes into consideration not only what Chinese characters are all about but also how learners commonly make errors while they learn to write the characters. Out of the analysis of these learners' errors, variations in the structural features of Chinese characters were pulled out and embodied in the design of the learning objects. Learners tinkering with the learning objects can thus implicitly develop a sense of the structural features or regularity of Chinese characters, which most importantly should prepare the learners to learn more new characters in the future. The main proposal of this paper is the notion of this variation-affording instructional software that allows learners to attend to the essential aspects of what is to be learned. Furthermore, the idea of the learning object also differs from other instructional software in its small, self-contained and reusable nature, such that teachers can flexibly embed the learning objects into their own teaching materials.link_to_subscribed_fulltex