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

Fast detection of venous air embolism in Doppler heart sound using the wavelet transform

The introduction of air bubbles into the systemic circulation can result in significant morbidity. Real-time monitoring of continuous heart sound in patients detected by precordial Doppler ultrasound is, thus, vital for early detection of venous air embolism (VAE) during surgery. In this study, the multiscale feature of wavelet transforms (WT's) is exploited to examine the embolic Doppler heart sound (DHS) during intravenous air injections in dogs. As both humans and dogs share similar physiological conditions, the authors' methods and results for dogs are expected to be applicable to humans. The WT of DHS at scale 2 j(j=1,2) selectively magnified the power of embolic, but not the normal, heart sound. Statistically, the enhanced embolic power was found to be sensitive (P<0.01 at 0.01 ml of injected air) and correlated significantly (P<0.0005, τ=0.83) with the volume of injected air from 0.01 to 0.10 ml. A fast detection algorithm of O(N) complexity with unit complexity constant for VAE was developed (processing speed=8 ms per heartbeat), which confirmed the feasibility of real-time processing for both humans and dogs.published_or_final_versio

The efficacy of surgery for recurrent nasopharyngeal carcinoma

Conference Theme: Challenges to specialists in the 21st centurypublished_or_final_versio

Volume Estimation by Wavelet Transform of Doppler Heart Sound During Venous Air-Embolism in Dogs

The Doppler heart sound signals detected by the precordial Doppler ultrasound method under simulated sub clinical and clinically significant venous air embolism were studied in anesthetized dogs. Signal processing using wavelet transform enhanced the contrast of embolic to normal signal, facilitating automatic detection and extraction of embolic signal simply by thresholding. Linear relationship of good correlation coefficient was obtained in log-log scale between the subclinical volume of injected air and the corresponding embolic signal power in all dogs. The calibration curve was found to be good estimate of the volume of embolic air during simulated clinically significant venous air embolism. Hence, we overcame the need of constant human attention for detecting venous air embolism and the lack of quantitative information on the volume of embolic air in the traditional precordial Doppler ultrasound method by the present approach.published_or_final_versio

Detection and quantification of venous air embolism by wavelet analysis of Doppler heart sound

The wavelet analysis of the Doppler heart sound detected under controlled venous air embolism at sub-clinically and clinically significant volumes was studied in anaesthetized dogs. Signal processing with wavelet enhances the Dower of embolic signal and facilitates the simple detection and extraction of embolic heart beats by thresholding. The cumulative power of the extracted embolic heart beats is found to be linearly related to the volume of embolic air on the log-log scale, suggesting that it is feasible to estimate clinically significant volume of embolic air in human subjects by linearly extrapolating from sub-clinical embolic volumes.published_or_final_versio

Consensus statement on ischaemic stroke care in Hong Kong

Objective. To issue guidelines for the care of acute stroke in Hong Kong, with the target audience of all health care professionals who are involved in acute stroke care. Participants. The Hong Kong Neurological Society and the Hong Kong Stroke Society. Evidence. The panel applied the 'rule of evidence' used by the United States Agency for Health Care Policy and Research. When there is insufficient evidence, the recommendation was based on customary practice and was circulated among the members and fellows of the two societies before coming to a consensus. Consensus process. Group meetings were held in 2002 to review the literature about acute care for patients with ischaemic stroke and to issue a consensus statement with reference to the local health care system. Participants of the meetings were appointed by the councils of The Hong Kong Neurological Society and the Hong Kong Stroke Society. The draft statement was circulated among the members and fellows of the two societies for comments before it was finalised. Conclusions. Ischaemic stroke is a heavy health care burden to Hong Kong. The current consensus statement provides a framework to establish a multidisciplinary approach towards its acute management.published_or_final_versio

Transient ischaemic attack patients are often underevaluated: Authors' reply

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A real-time monitor using wavelet analysis of the Doppler heart sound for the detection of venous air embolism

A fast detection algorithm for venous air embolism (VAE) was developed and implemented as a real-time monitor for detecting embolic heart sound and estimating embolic air volume. Its performance was evaluated under bolus injection of sub-clinical (0.0l to 0.80 ml) and continuous infusion of clinically significant (0.80 to 9.60 ml) air volumes in anaesthetized dogs. The clinically significant air emboli could be estimated based on the calibration curve obtained during sub-clinical VAE for a subject. The monitor also kept track of the cumulative embolic air volumes and alerted the anaesthetists once a predefined clinically significant embolic air volume was reached. As both humans and dogs share similar physiological conditions, our monitor for dogs are expected to be applicable to humans.published_or_final_versio