Partial nephrectomy for T1 renal cancer can achieve an equivalent oncological outcome to radical nephrectomy with better renal preservation: the way to go

INTRODUCTION: Patients who undergo partial nephrectomy have been shown to be at decreased risk of renal impairment compared with radical nephrectomy. We examined the oncological outcome of patients in our centre who underwent partial or radical nephrectomy for T1 renal cancer (7 cm or smaller), and compared the likelihood of developing chronic kidney disease. METHODS: This historical cohort study with internal comparison was conducted in a tertiary hospital in Hong Kong. A cohort of 86 patients with solitary T1 renal cancer and a normal contralateral kidney who underwent radical (38 patients) or partial (48 patients) nephrectomy between January 2005 and December 2010 was included. The overall and cancer-free survival, change in glomerular filtration rate, and new onset of chronic kidney disease were compared between the radical and partial nephrectomy groups. RESULTS: A total of 32 (84%) radical nephrectomy patients and 43 (90%) partial nephrectomy patients were alive by 31 December 2012. The mean follow-up was 43.5 (standard deviation, 22.4) months. There was no significant difference in overall survival (P=0.29) or cancer-free survival (P=0.29) between the two groups. Both groups enjoyed good oncological outcome with no recurrence in the partial nephrectomy group. Overall, 18 (21%) patients had pre-existing chronic kidney disease. The partial nephrectomy group had a significantly smaller median reduction in glomerular filtration rate (12.6% vs 35.4%; P<0.001), and radical nephrectomy carried a significantly higher risk of developing chronic kidney disease (hazard ratio=5.44; 95% confidence interval, 1.26-23.55; P=0.02). CONCLUSIONS: Compared with radical nephrectomy, partial nephrectomy can prevent chronic kidney disease and still achieve an excellent oncological outcome for T1 renal tumours, in particular T1a tumours and tumours with a low R.E.N.A.L. score.published_or_final_versio

The Chinese version of the pelvic pain and urgency / frequency symptom scale: a useful assessment tool for street-ketamine abusers with lower urinary tract symptoms

OBJECTIVE: To investigate the use of a translated Chinese version of the pelvic pain and urgency/frequency symptom scale as an assessment and prognostic tool to evaluate the severity of street-ketamine-associated lower urinary tract symptoms and their reversibility after abstinence. DESIGN: Cross-sectional study. SETTING: A special designated out-patient clinic in a regional hospital in Hong Kong. PARTICIPANTS: There were 50 patients with street-ketamine-associated lower urinary tract symptoms and 20 healthy individuals. MAIN OUTCOME MEASURES: Reliability and validity of the questionnaire; frequency of individual lower urinary tract symptoms, cystoscopic, urodynamic and radiological abnormalities, and their correlation with pelvic pain and the urgency/frequency score. RESULTS: The test-retest reliability coefficient was 0.755 (P<0.001). Cronbach's alpha was 0.974. Mann-Whitney U test proved the discriminatory ability of the questionnaire (P<0.001). Patients with specific lower urinary tract symptoms had a higher mean pelvic pain and urgency/frequency total score compared to those without them: frequency (23.8 vs 17.3), nocturia (22.4 vs 14.0), urgency (22.5 vs 15.1), dysuria (22.7 vs 13.3), and haematuria (24.8 vs 16.2). The number of daytime voids and nocturia episodes correlated well with pelvic pain and urgency/frequency scores. With an increasing score, the likelihood of having cystitis changes, urodynamic abnormalities and hydronephrosis increased, while the cystometrically determined bladder capacity decreased. None of the patients with a score of 16 or below had urodynamic abnormality or hydronephrosis. The mean score change in the abstinence group was -4.33, versus +3.33 in their counterparts. CONCLUSIONS: The Chinese version of the pelvic pain and urgency/frequency questionnaire is reliable and valid for assessment in patients with street-ketamine-associated lower urinary tract symptoms. The pelvic pain and urgency/frequency score correlates well with symptom severity as well as endoscopic, urodynamic and radiological abnormalities in patients with street-ketamine-associated lower urinary tract symptoms. A cut-off total pelvic pain and urgency/frequency score of 17 may suggest more serious urological sequelae from ketamine abuse. Abstinence from ketamine reduced lower urinary tract symptoms, but the extent of reversibility of urinary tract damage is yet to be evaluated.published_or_final_versio

Optimal submission problem in a limit order book with VaR constraints

We consider an optimal selection problem for bid and ask quotes subject to a value-at-Risk (VaR) constraint when arrivals of the buy and sell orders are governed by a Poisson process. The problem is formulated as a constrained utility maximization problem over a finite time horizon. Using a diffusion approximation to Poisson arrivals of market orders, the dynamic programming principle can be applied here. We propose an efficient procedure to solve this constrained utility maximization problem based on a successive approximation algorithm. Numerical examples with and without the VaR constraint are used to illustrate the effect of the risk constraint on the dealer's choices. We also conduct numerical experiments to analyze the impacts of the risk constraint on dealer's terminal profit. © 2012 IEEE.published_or_final_versionThe 5th International Joint Conference on Computational Sciences and Optimization (CSO 2012), Harbin, Heilongjiang Province, China, 23-26 June 2012. In Proceedings of the 5th CSO, 2012, p. 266-27

Successful emergency endovascular treatment of juxtarenal and infrarental mycotic aortic aneurysms in patients with small diameter aortae using Cook® Zenith ESLE stentgrafts

BACKGROUND: Endovascular repair of mycotic aneurysm is an alternative to open repair if the patho-anatomy is suitable. The aortic size above and below the mycotic aneurysm may be small. METHODS: A retrospective review was made of prospectively collected departmental computerised database. RESULTS: Three oriental patients with juxta- and infra-renal mycotic aortic aneurysms with a small aortic diameter of 17 mm to 18 mm underwent successful emergency endovascular treatment using Cook® Zenith ESLE stentgrafts. These are ancillary devices aimed at iliac extensions usually. CONCLUSION: This is to our knowledge the fi rst case series of Cook® Zenith ESLE iliac component endografts for the treatment of aortic mycotic aneurysms with small aortae, and short- and mid-term results are encouraging.published_or_final_versio

Image registration in intra-oral radiography

Image registration is one of the image processing methods which is widely used in computer vision, pattern recognition, and medical imaging. In digital subtraction radiography, image registration is one of the important prerequisites to match the reference and subsequent images. In this paper, we propose an automatic non-rigid registration method namely curvature-based registration that relies on a curvature based penalizing term and its application on dental radiography. The regularizing term of this intensity-based registration approach provides affine linear transformation so that pre-registration step is no longer necessary. This leads to faster and more reliable solutions. The implementation of this approach is based on the numerical solution of the underlying Euler-Lagrange equations. In addition, a comparison between this algorithm and Linear Alignment Method (LAM) with 20 image pairs is presented. © 2005 IEEE.published_or_final_versio

Exploring the influence of contract governance on construction dispute negotiation

This is an Accepted Manuscript of an article published by the American Society of Civil Engineers in the Journal of Professional Issues in Engineering Education and Practice. October 2008. This material may be downloaded for personal use only. Any other use requires prior permission of the American Society of Civil Engineers. This material may be found at https://doi.org/10.1061/(ASCE)1052-3928(2008)134:4(391)Publishe

Prevalence of antibiotic-resistant intestinal flora in patients undergoing transrectal ultrasonography-guided prostate biopsy (TRUS-Bx) and its implication for clinical practice: preliminary results

Oral (Free Paper) Session I - Prostate Cancer: Diagnosis to Treatment: OP.1-2香港泌尿外科學會OBJECTIVE: An important factor determining the choice of antibiotic for TRUS-Bx prophylaxis and treatment of post-biopsy infection is the prevalence of quinolone-resistant and ESBL-producing organisms in the rectum of patients undergoing this procedure. We aim to determine these prevalence values in patients undergoing TRUS-Bx and to study their correlation with the microbiological data of patients ...published_or_final_versionThe 17th Annual Scientific Meeting of the Hong Kong Urological Association, Hong Kong, 6 November 2011. In Program Book, 2011, p. 3

Initial results of selective renal parenchymal clamping with an adjustable kidney clamp in nephron-sparing surgery: an easy way to minimise renal ischaemia

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Subcapsular hematoma after ureteroscopy and laser lithotripsy

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Construction of online catalog topologies using decision trees

Organization of a Web site is important to help users get the most out of the site. A good Web site should help visitors find the information they want easily. Visitors typically find information by searching for selected terms of interest or by following links from one Web page to another. The first approach is more useful if the visitor knows exactly what he is seeking, while the second approach is useful when the visitor has less of a preconceived notion about what he wants. The organization of a Web site is especially important in the latter case. Traditionally, Web site organization is done by hand. In this paper, we introduce the problem of automatic Web site construction and propose a solution for solving a major step of the problem based on decision tree algorithms. The solution is found to be useful in automatic construction of product catalogs.published_or_final_versio