Burden of ketamine cystitis in Chinese society

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Peritoneal implantation of ureter in cadaveric renal transplant

Case reportWe report here a case of complication of peritoneal implantation of ureter in cadaveric renal transplant. The patient presented with anuria and delayed graft function. The diagnosis was suspected upon physical examination and radiological investigation. The complication was managed with reimplantation of the ureter into the bladder and the patient recovered with good graft function. We discuss this case, review the literature on this rare complication, and share our suggestions on how it can be prevented.published_or_final_versio

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

Effects of practice schedules on speech motor learning

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Effects of errorless learning on the acquisition of velopharyngeal movement control

Session 1pSC - Speech Communication: Cross-Linguistic Studies of Speech Sound Learning of the Languages of Hong Kong (Poster Session)The implicit motor learning literature suggests a benefit for learning if errors are minimized during practice. This study investigated whether the same principle holds for learning velopharyngeal movement control. Normal speaking participants learned to produce hypernasal speech in either an errorless learning condition (in which the possibility for errors was limited) or an errorful learning condition (in which the possibility for errors was not limited). Nasality level of the participants’ speech was measured by nasometer and reflected by nasalance scores (in %). Errorless learners practiced producing hypernasal speech with a threshold nasalance score of 10% at the beginning, which gradually increased to a threshold of 50% at the end. The same set of threshold targets were presented to errorful learners but in a reversed order. Errors were defined by the proportion of speech with a nasalance score below the threshold. The results showed that, relative to errorful learners, errorless learners displayed fewer errors (50.7% vs. 17.7%) and a higher mean nasalance score (31.3% vs. 46.7%) during the acquisition phase. Furthermore, errorless learners outperformed errorful learners in both retention and novel transfer tests. Acknowledgment: Supported by The University of Hong Kong Strategic Research Theme for Sciences of Learning © 2012 Acoustical Society of Americapublished_or_final_versio

Mammography machine compression paddle movement andobserver performance analysis

Full field digital mammography (FFDM) was introduced into the United Kingdom (UK) as a replacement for screen-film mammography (SFM) in 2005. Since then, individual breast screening centres have begun to report blurred images through local audits. Blurring was probably present in SFM as well, however the improvement in contrast resolution in FFDM may have made it more apparent. The sources of blurring include improper imaging techniques, patient movement caused by breathing and heart motion,the viscoelastic motion of the breast, and paddle motion. This thesis aims to test the hypothesis that paddle motion might cause image blur. It investigates whether blurring can be detected visually on technical review monitors and reporting grade monitors.The thesis presents a method to minimise paddle motion during X-ray exposure. Six papers have been published. Two of these (papers 1 and 2) investigated paddle displacement using linear potentiometers. Three investigated the influence of paddle motion on image quality. Paper 3 investigated whether paddle motion can cause image blur; paper 4 determined the minimum amount of simulated motion required for the visual detection of blurring; and paper 5 evaluated the practitioner’s ability to identify blurring on monitors with different resolutions (2.3 MP and 5 MP). The final research paper (paper 6) investigated a way to reduce paddle displacement settling time; this involved the use of a closed-loop control system.Results: In papers 1 and 2 paddle displacement followed a bi-exponential function with a settling time of approximately 40 s. The use of average paddle displacement to estimate the amount of paddle motion would underestimate the worst case of the threedifferent runs of the experiment. The estimated paddle motion would be greatly reduced if the time of exposure is delayed from 5 to 10 s. In paper 3 all metal ball bearings shown increased in diameters and the range of magnification varied from 1.04 to 1.21. T-test results shown that there was a significant difference (p < 0.05) in the ball bearing diameters between the intensity thresholding and the edge detection methods for all paddle/ compression force combinations. The ball bearing diameters calculated by the intensity thresholding method had higher variability than the edge detection method.In paper 4 the soft-edged mask method best represented the physical process that caused the blurring effect and was chosen as the standard simulation approach for motion blurring. The ratio between the vertical paddle motion and the horizontal breast motion estimated by the mathematical model is approximately 1:0.3.In paper 5 the angular size calculation shown that for a viewing distance of 75 cm the screen resolution for 5 MP and 12 MP monitors was better than the observer eyes' resolution. For a viewing distance of 30 cm the observer eyes' resolution was betterthan the screen resolution for 2.3 MP, 5 MP and 12 MP monitors. Among all three monitors, image displayed on the 12 MP monitor has the lowest loss in image quality after interpolation. In paper 6 the simulation results shown that force overshoot is possible for position control system. Force overshoot occurred almost instantaneously for step input and its magnitude is about 10 times larger than the ramp input. Force overshoot and steadystateerror can be eliminated by the use of force control system.Conclusion: The magnitude of calculated paddle motion is much lower than the minimum amount of simulated motion required for the visual detection of blurring. Mathematical models have shown that vertical paddle motion caused a smaller horizontal breast displacement when compressed. Therefore, there is no sufficientevidence to support the hypothesis that paddle motion is a cause of image blurring in FFDM

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

Impact analysis of crossovers in a multi-objective evolutionary algorithm

Multi-objective optimization has become mainstream because several real-world problems are naturally posed as a Multi-objective optimization problems (MOPs) in all fields of engineering and science. Usually MOPs consist of more than two conflicting objective functions and that demand trade-off solutions. Multi-objective evolutionary algorithms (MOEAs) are extremely useful and well-suited for solving MOPs due to population based nature. MOEAs evolve its population of solutions in a natural way and searched for compromise solutions in single simulation run unlike traditional methods. These algorithms make use of various intrinsic search operators in efficient manners. In this paper, we experimentally study the impact of different multiple crossovers in multi-objective evolutionary algorithm based on decomposition (MOEA/D) framework and evaluate its performance over test instances of 2009 IEEE congress on evolutionary computation (CEC?09) developed for MOEAs competition. Based on our carried out experiment, we observe that used variation operators are considered to main source to improve the algorithmic performance of MOEA/D for dealing with CEC?09 complicated test problems