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Chan JCX, Chi MS, Yeung TW, Chan ELY, Ng SH, Wong YC. Acute Tumefactive Demyelinating Lesion Confined to Spinal Cord and Brainstem Mimicking Abscess: A Case Report. Hong Kong Journal of Radiology 2019. [DOI: 10.12809/hkjr1917014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- JCX Chan
- Department of Radiology, Tuen Mun Hospital, Hong Kong
| | - MS Chi
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong
| | - TW Yeung
- Department of Radiology, Tuen Mun Hospital, Hong Kong
| | - ELY Chan
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong
| | - SH Ng
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong
| | - YC Wong
- Department of Radiology, Tuen Mun Hospital, Hong Kong
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2
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Ng SH, Roshan S. A case report of refractory kawasaki disease. Med J Malaysia 2018; 73:410-412. [PMID: 30647216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Kawasaki disease is an autoimmune disease that commonly affects children below the age of 5 years. It is a vasculitic disease of unknown aetiology effecting the skin, eyes, lymph nodes and mucosal layer. Intravenous Immunoglobulin (IVIG) and aspirin therapy are the mainstay treatment however a number of cases have been shown to be refractory to this treatment. Evidence regarding approach and treatment for such cases is limited. This case report is to share our experience in the management of Refractive Kawasaki disease at a district level.
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Affiliation(s)
- S H Ng
- Hospital Seri Manjung, Department of Paediatrics, Perak, Malaysia.
| | - S Roshan
- Hospital Sultanah Bahiyah, Department of Paediatrics, Kedah, Malaysia
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3
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Chan ELY, Lee WC, Koo CK, King HST, Woo CT, Ng SH. Electroconvulsive therapy for new-onset super-refractory status epilepticus. Hong Kong Med J 2018; 24:307-310. [DOI: 10.12809/hkmj154501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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4
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Wong AM, Wa YL, Cheung YC, Ng SH, Lee KF. CT features of mediastinal lymphangiohemangioma associated with superior vena cava ectasia: A case report. Acta Radiol 2016; 41:429-31. [PMID: 11016760 DOI: 10.1080/028418500127345866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We present a case of mediastinal mesenchymal tumor in a 53-year-old woman with a 1-month history of chest tightness. A histological diagnosis of lymphangiohemangioma was obtained by excisional biopsy. CT findings are reported with emphasis on its association with intratumoral superior vena cava ectasia.
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Affiliation(s)
- A M Wong
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Tao Yuan Hsien, Taiwan, Republic of China
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5
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Abstract
This report illustrates an adult patient presenting with tumefactive acute disseminated encephalomyelitis complicating human swine influenza. Its presentation, diagnosis, investigation findings, course, and response to treatment are discussed herein.
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Affiliation(s)
- Amanda C Y Chan
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - S H Ng
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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6
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Thai T, Zheng Y, Ng SH, Ohshima H, Altissimo M, Bach U. Facile gold nanorod purification by fractionated precipitation. Nanoscale 2014; 6:6515-6520. [PMID: 24838055 DOI: 10.1039/c4nr01592d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
An efficient and facile size- and shape-selective separation of gold nanorod (GNR) solutions is developed using a fractionated precipitation strategy. This convenient method has the benefit of eliminating nanoparticulate side products that can substantially deteriorate the quality of self-assembled nanostructures. The fabrication of advanced plasmonic metamaterials crucially depends on the capacity to supply feedstocks of high-purity building blocks.
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Affiliation(s)
- T Thai
- Department of Materials Engineering, Monash University, Wellington Road, Clayton, Victoria 3800, Australia.
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7
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Yokokawa F, Wang G, Chan WL, Ang SH, Wong J, Ma I, Rao SPS, Manjunatha U, Lakshminarayana SB, Herve M, Kounde C, Tan BH, Thayalan P, Dick T, Ng SH, Nanjundappa M, Ravindran S, Gee P, Tan M, Wei L, Goh A, Chen PY, Lee KS, Zhang C, Wagner T, Dix I, Chatterjee A, Pethe K, Kuhen K, Glynne R, Smith P, Bifani P, Jiricek J. Corrrection to Discovery of Tetrahydropyrazolopyrimidine Carboxamide Derivatives As Potent and Orally Active Novel Antitubercular Agents. ACS Med Chem Lett 2014. [DOI: 10.1021/ml500020r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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8
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Abstract
We report the first case of McLeod syndrome (MLS) in a 47-year-old Chinese man who presented with progressive limb weakness, chorea of feet, red blood cell acanthocytosis, absence of Kx red blood cell antigen and weak expression of Kell antigens. The diagnosis of MLS was confirmed by genetic testing showing a hemizygous mutation of XK gene. We review literature on neuroacanthocytosis in the Chinese population.
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Affiliation(s)
- B L Man
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, Hong Kong.
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9
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Yokokawa F, Wang G, Chan WL, Ang SH, Wong J, Ma I, Rao SPS, Manjunatha U, Lakshminarayana SB, Herve M, Kounde C, Tan BH, Thayalan P, Ng SH, Nanjundappa M, Ravindran S, Gee P, Tan M, Wei L, Goh A, Chen PY, Lee KS, Zhong C, Wagner T, Dix I, Chatterjee AK, Pethe K, Kuhen K, Glynne R, Smith P, Bifani P, Jiricek J. Discovery of tetrahydropyrazolopyrimidine carboxamide derivatives as potent and orally active antitubercular agents. ACS Med Chem Lett 2013; 4:451-5. [PMID: 24900693 DOI: 10.1021/ml400071a] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/01/2013] [Indexed: 11/29/2022] Open
Abstract
Tetrahydropyrazolo[1,5-a]pyrimidine scaffold was identified as a hit series from a Mycobacterium tuberculosis (Mtb) whole cell high through-put screening (HTS) campaign. A series of derivatives of this class were synthesized to evaluate their structure-activity relationship (SAR) and structure-property relationship (SPR). Compound 9 had a promising in vivo DMPK profile in mouse and exhibited potent in vivo activity in a mouse efficacy model, achieving a reduction of 3.5 log CFU of Mtb after oral administration to infected mice once a day at 100 mg/kg for 28 days. Thus, compound 9 is a potential candidate for inclusion in combination therapies for both drug-sensitive and drug-resistant TB.
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Affiliation(s)
- Fumiaki Yokokawa
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Gang Wang
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Wai Ling Chan
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Shi Hua Ang
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Josephine Wong
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Ida Ma
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Srinivasa P S Rao
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Ujjini Manjunatha
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | | | - Maxime Herve
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Cyrille Kounde
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Bee Huat Tan
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Pamela Thayalan
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Seow Hwee Ng
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Mahesh Nanjundappa
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Sindhu Ravindran
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Peck Gee
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Maria Tan
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Liu Wei
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Anne Goh
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Pei-Yu Chen
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Kok Sin Lee
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Chen Zhong
- Genomics Institute of the Novartis Research Foundation, 10675 John J. Hopkins
Drive, San Diego, California 92121, United States
| | - Trixie Wagner
- Novartis Institute for Biomedical Research, Basel CH-4056, Switzerland
| | - Ina Dix
- Novartis Institute for Biomedical Research, Basel CH-4056, Switzerland
| | - Arnab K. Chatterjee
- Genomics Institute of the Novartis Research Foundation, 10675 John J. Hopkins
Drive, San Diego, California 92121, United States
| | - Kevin Pethe
- Genomics Institute of the Novartis Research Foundation, 10675 John J. Hopkins
Drive, San Diego, California 92121, United States
| | - Kelli Kuhen
- Genomics Institute of the Novartis Research Foundation, 10675 John J. Hopkins
Drive, San Diego, California 92121, United States
| | - Richard Glynne
- Genomics Institute of the Novartis Research Foundation, 10675 John J. Hopkins
Drive, San Diego, California 92121, United States
| | - Paul Smith
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Pablo Bifani
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
| | - Jan Jiricek
- Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos,
138670 Singapore
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10
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Mak PA, Rao SPS, Ping Tan M, Lin X, Chyba J, Tay J, Ng SH, Tan BH, Cherian J, Duraiswamy J, Bifani P, Lim V, Lee BH, Ling Ma N, Beer D, Thayalan P, Kuhen K, Chatterjee A, Supek F, Glynne R, Zheng J, Boshoff HI, Barry CE, Dick T, Pethe K, Camacho LR. A high-throughput screen to identify inhibitors of ATP homeostasis in non-replicating Mycobacterium tuberculosis. ACS Chem Biol 2012; 7:1190-7. [PMID: 22500615 PMCID: PMC3401038 DOI: 10.1021/cb2004884] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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Growing evidence suggests that the presence of a subpopulation
of hypoxic non-replicating, phenotypically drug-tolerant mycobacteria
is responsible for the prolonged duration of tuberculosis treatment.
The discovery of new antitubercular agents active against this subpopulation
may help in developing new strategies to shorten the time of tuberculosis
therapy. Recently, the maintenance of a low level of bacterial respiration
was shown to be a point of metabolic vulnerability in Mycobacterium
tuberculosis. Here, we describe the development of a hypoxic
model to identify compounds targeting mycobacterial respiratory functions
and ATP homeostasis in whole mycobacteria. The model was adapted to
1,536-well plate format and successfully used to screen over 600,000
compounds. Approximately 800 compounds were confirmed to reduce intracellular
ATP levels in a dose-dependent manner in Mycobacterium bovis BCG. One hundred and forty non-cytotoxic compounds with activity
against hypoxic non-replicating M. tuberculosis were
further validated. The resulting collection of compounds that disrupt
ATP homeostasis in M. tuberculosis represents a valuable
resource to decipher the biology of persistent mycobacteria.
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Affiliation(s)
- Puiying A. Mak
- Genomics Institute of the Novartis Research Foundation, San Diego, California 92121, United States
| | | | - Mai Ping Tan
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Xiuhua Lin
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Jason Chyba
- Genomics Institute of the Novartis Research Foundation, San Diego, California 92121, United States
| | - Joann Tay
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Seow Hwee Ng
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Bee Huat Tan
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Joseph Cherian
- Novartis Institute for Tropical Diseases, Singapore 138670
| | | | - Pablo Bifani
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Vivian Lim
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Boon Heng Lee
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Ngai Ling Ma
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - David Beer
- Novartis Institute for Tropical Diseases, Singapore 138670
| | | | - Kelli Kuhen
- Genomics Institute of the Novartis Research Foundation, San Diego, California 92121, United States
| | - Arnab Chatterjee
- Genomics Institute of the Novartis Research Foundation, San Diego, California 92121, United States
| | - Frantisek Supek
- Genomics Institute of the Novartis Research Foundation, San Diego, California 92121, United States
| | - Richard Glynne
- Genomics Institute of the Novartis Research Foundation, San Diego, California 92121, United States
| | - Jun Zheng
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Helena I. Boshoff
- Tuberculosis Research Section, Laboratory of Clinical
Infectious Diseases, National Institute of Allergy and Infectious
Diseases, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Clifton E. Barry
- Tuberculosis Research Section, Laboratory of Clinical
Infectious Diseases, National Institute of Allergy and Infectious
Diseases, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Thomas Dick
- Novartis Institute for Tropical Diseases, Singapore 138670
| | - Kevin Pethe
- Novartis Institute for Tropical Diseases, Singapore 138670
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11
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Lam TC, Wong FCS, Leung TW, Ng SH, Tung SY. Clinical outcomes of 174 nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis. Int J Radiat Oncol Biol Phys 2011; 82:e57-65. [PMID: 21300460 DOI: 10.1016/j.ijrobp.2010.11.070] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 11/07/2010] [Accepted: 11/22/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE To retrospectively study the clinical outcomes of nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis (TLN) treated with steroids, surgery, or observation only. METHODS AND PATIENTS We performed a retrospective analysis of 174 consecutive patients diagnosed with TLN between 1990 and 2008. Before 1998, symptomatic patients were treated with oral steroids, while asymptomatic patients were treated conservatively. After 1998, most symptomatic and asymptomatic patients with a large volume of necrosis were treated by intravenously pulsed-steroid therapy with a standardized protocol. We examined factors affecting grade 4 complication-free survival and overall survival. Outcomes of the three treatment groups, those receiving conservative treatment, those receiving oral steroid, and those receiving intravenous pulse steroid, were compared. RESULTS The mean follow-up time was 115 months. Rates of grade 4 complication-free survival at 2 years and at 5 years after diagnosis of TLN were 72.2% and 54.1%, respectively. The 2-year and 5-year overall survival rates were 57.5% and 35.4%, respectively. Multivariate analysis revealed that being symptomatic at diagnosis (relative risk [RR], 4.5; p = 0.0001), re-irradiation of the nasopharynx (NP) (RR, 1.56; p = 0.008), salvage brachytherapy to the NP (RR, 1.75; p = 0.012), and a short latency period before the diagnosis of TLN (RR, 0.96, p < 0.0001) were independent prognosticators of poor grade 4 complication-free survival. Patients with all four factors had a 100% risk of developing grade 4 complications within 5 years; whereas if no factor was present, the risk was 12.5%. Intravenous pulse steroid therapy was associated with a higher clinical response rate compared with conventional steroid therapy (p < 0.0001); however, it did not affect complication-free survival in multivariate analysis. CONCLUSIONS TLN patients with good prognosticators could be observed without active treatment. Although treatment with intravenously pulsed steroid was associated with better clinical response than conventional steroid delivery, it did not affect the complication-free survival rate of TLN patients.
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Affiliation(s)
- Tai-Chung Lam
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, People's Republic of China.
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12
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Pethe K, Sequeira PC, Agarwalla S, Rhee K, Kuhen K, Phong WY, Patel V, Beer D, Walker JR, Duraiswamy J, Jiricek J, Keller TH, Chatterjee A, Tan MP, Ujjini M, Rao SPS, Camacho L, Bifani P, Mak PA, Ma I, Barnes SW, Chen Z, Plouffe D, Thayalan P, Ng SH, Au M, Lee BH, Tan BH, Ravindran S, Nanjundappa M, Lin X, Goh A, Lakshminarayana SB, Shoen C, Cynamon M, Kreiswirth B, Dartois V, Peters EC, Glynne R, Brenner S, Dick T. A chemical genetic screen in Mycobacterium tuberculosis identifies carbon-source-dependent growth inhibitors devoid of in vivo efficacy. Nat Commun 2010; 1:57. [PMID: 20975714 PMCID: PMC3220188 DOI: 10.1038/ncomms1060] [Citation(s) in RCA: 211] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 07/29/2010] [Indexed: 11/29/2022] Open
Abstract
Candidate antibacterials are usually identified on the basis of their in vitro activity. However, the apparent inhibitory activity of new leads can be misleading because most culture media do not reproduce an environment relevant to infection in vivo. In this study, while screening for novel anti-tuberculars, we uncovered how carbon metabolism can affect antimicrobial activity. Novel pyrimidine–imidazoles (PIs) were identified in a whole-cell screen against Mycobacterium tuberculosis. Lead optimization generated in vitro potent derivatives with desirable pharmacokinetic properties, yet without in vivo efficacy. Mechanism of action studies linked the PI activity to glycerol metabolism, which is not relevant for M. tuberculosis during infection. PIs induced self-poisoning of M. tuberculosis by promoting the accumulation of glycerol phosphate and rapid ATP depletion. This study underlines the importance of understanding central bacterial metabolism in vivo and of developing predictive in vitro culture conditions as a prerequisite for the rational discovery of new antibiotics. Candidate anti-tuberculosis drugs are often identified in whole-cell screens. Here, Pethe et al. show that inappropriate carbon-source selection can lead to the identification of compounds devoid of efficacy in vivo, underlining the importance of developing predictive in vitro screens.
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Affiliation(s)
- Kevin Pethe
- Novartis Institute for Tropical Diseases, #05-01 Chromos, Singapore 138670, Singapore.
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Ng SH, Tse ML, Ng HW, Lau FL. Emergency department presentation of ketamine abusers in Hong Kong: a review of 233 cases. Hong Kong Med J 2010; 16:6-11. [PMID: 20124567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES To study the acute clinical presentations of ketamine abusers in Hong Kong. DESIGN Retrospective chart review. SETTING Fifteen accident and emergency departments in Hong Kong. PATIENTS Consultations associated with recent ketamine use either confirmed by history or urine test were searched for from the database of the Hospital Authority Hong Kong Poison Information Centre from 1 July 2005 to 30 June 2008. Their medical records and investigation results were analysed. RESULTS A total of 233 records of ketamine use were included for review. Patient ages ranged from 13 to 60, with a median of 22 years, and the male-to-female ratio being 2.1:1. The most common symptoms of ketamine misuse were impaired consciousness (45%), abdominal pain (21%), lower urinary tract symptoms (12%), and dizziness (12%). The most common abnormal physical findings were high blood pressure (40%), followed by tachycardia (39%), abdominal tenderness (18%), and white powder in the nostrils (17%). CONCLUSION Most ketamine abusers presented acutely with transient central nervous system depression, abdominal pain, or lower urinary tract symptoms. Clinicians should be alert to the typical age-group, signs and symptoms of such abusers presenting in an acute medical setting.
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Affiliation(s)
- S H Ng
- Hong Kong Poison Information Centre, United Christian Hospital, Kwun Tong, Hong Kong.
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Ng SH, Lee HKH, Chan YC, Lau FL. Dilated common bile ducts in ketamine abusers. Hong Kong Med J 2009; 15:157; author reply 157. [PMID: 19342747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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15
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Wu YM, Wong HF, Ng SH. Direct Intratumoral Pre-surgical Embolization of Orbital Hemangioblastoma. A Case Report. Neuroradiol J 2008; 21:693-7. [PMID: 24257013 DOI: 10.1177/197140090802100514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 08/13/2008] [Indexed: 11/16/2022] Open
Abstract
Orbital hemangioblastomas of extraretinal origin are extremely rare and few cases have been reported. We describe a 48-year-old woman with progressive right visual loss and proptosis. Computed tomography showed an avidly enhanced transpatial solid mass in the right orbit with outward protrusion. The mass was presumed to be of extraretinal origin because of its unusually large size, but there was only mild involvement of the eyeball. The histopathologic characteristics of this tumor were identical to those seen in central nervous system hemangioblastomas. The hypervascularity of the lesion would have made surgical intervention difficult. Preoperative embolization was indicated and was performed by direct tumor puncture and injection of N-butyl cyanoacrylate with a satisfactory result.
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Affiliation(s)
- Y-M Wu
- Neuroradiology Department, Chang Gung Memorial Hospital; Taoyuan, Taiwan -
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16
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Choy YC, Lim WL, Ng SH. Audit of perioperative blood transfusion. Med J Malaysia 2007; 62:299-302. [PMID: 18551933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The main goal of perioperative transfusion is to reduce the morbidity and mortality associated with inadequate delivery of oxygen to the tissues during surgery. In this audit, the primary trigger for transfusion was clinical anaemia assessed by examination of a patient's conjunctiva [40.7%] followed by estimation of blood loss of greater 20% of total blood volume [29.3%]. Haemoglobin estimation in the operation theater was not done in 45.9% of studied patients and only 7.8% patients had transfusion based on this criteria. A common practice is to transfuse blood for hypovolaemia. This was the indication for blood transfusion in 96 patients (7.8%). Inappropriate use of blood in this way has led to wastage of a valuable resource and exposed patients to potential risks of unwanted side effects. Analysis of haemoglobin estimation at recovery room showed 32% of patient with co-morbidities had Hb > 10 gm% while 65% and 29.5% of patients without co-morbidities had Hb > 8 gm% and 10 gm% respectively. This reflects the practice of anaesthetists in maintaining a target of Hb of 10 gm% for both groups of patients while a target of 8 gm% is still relatively safe for patients with good cardiovascular reserves. This has resulted in signifant use of homologous blood which will certainly burden the blood bank and increase the cost of healthcare.
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Affiliation(s)
- Y C Choy
- Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
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Tok AIY, Su LT, Boey FYC, Ng SH. Homogeneous precipitation of Dy2O3 nanoparticles-effects of synthesis parameters. J Nanosci Nanotechnol 2007; 7:907-15. [PMID: 17450853 DOI: 10.1166/jnn.2007.203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The experimental parameters that control the size and size distribution of dysprosium oxide nanoparticles synthesized by homogeneous precipitation technique have been systematically investigated. The particles were characterized with respect to their size, shape, and thermal decomposition behavior. It was found that the precipitated particles were spherical, uniform in size, and amorphous, which upon heating in air, decomposed into the oxide form with no change in morphology. The size and size distribution of the particles showed strong dependence on the metal cation concentration ([Dy3+]) and weak dependence on urea concentration and aging time. In addition, the presence of chlorine ions (Cl-) was found to have significant effect on the growth and agglomeration of the particles. Aggregation mechanism as the growth mechanism is offered to explain the effects of these synthesis parameters on the morphology, size, and size distribution of dysprosium oxide particles.
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Guo ZP, Ng SH, Wang JZ, Huang ZG, Liu HK, Too CO, Wallace GG. Electrochemical hydrogen storage in single-walled carbon nanotube paper. J Nanosci Nanotechnol 2006; 6:713-8. [PMID: 16573126 DOI: 10.1166/jnn.2006.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Single-walled carbon nanotube (SWNT) papers were successfully prepared by dispersing SWNTs in Triton X-100 solution, then filtered by PVDF membrane (0.22 microm pore size). The electrochemical behavior and the reversible hydrogen storage capacity of single-walled carbon nanotube (SWNT) papers have been investigated in alkaline electrolytic solutions (6 N KOH) by cyclic voltammetry, linear micropolarization, and constant current charge/discharge measurements. The effect of thickness and the addition of carbon black on hydrogen adsorption/desorption were also investigated. It was found that the electrochemical charge-discharge mechanism occurring in SWNT paper electrodes is somewhere between that of carbon nanotubes (physical process) and that of metal hydride electrodes (chemical process), and consists of a charge-transfer reaction (Reduction/Oxidation) and a diffusion step (Diffusion).
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Affiliation(s)
- Z P Guo
- Institute for Superconducting and Electronic Materials, University of Wollongong, NSW 2522, Australia
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21
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Abstract
Cortical dysplasia is a neuronal migration disorder occasionally associated with anomalous draining veins. However, to our knowledge, no intracranial haemorrhage in conjunction with this association has been reported in the literature. We herein report a 7-month-old baby girl with cortical dysplasia associated with an ipsilateral cortical draining vein and complicated with subdural haemorrhage, with the diagnosis made by computed tomography and magnetic resonance imaging. This case demonstrated that patients with this condition could have an excellent prognosis even when the anomalous veins coexist with intracranial haemorrhage. We postulate that venous rupture may be the cause of this condition and further discuss the possible pathophysiology.
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Affiliation(s)
- A M C Wong
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou Medical Center, Tao Yuan, Taiwan, ROC
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22
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Dogan A, Ngu LSP, Ng SH, Cervi PL. Pathology and clinical features of angioimmunoblastic T-cell lymphoma after successful treatment with thalidomide. Leukemia 2005; 19:873-5. [PMID: 15744336 DOI: 10.1038/sj.leu.2403710] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Abstract
Combined hepatocellular-cholangiocarcinoma (HCC-CC) is a rare primary liver tumour. We report a carrier of both HBV and HCV presenting with intermittent abdominal pain, fever, chillness and elevated á-fetoprotein (AFP) of 1197 ng/ml. Computed tomography showed an irregular hypodense mass in the left lateral segment of the liver with vague contrast enhancement and multiple regional lymphadenopathy. Hepatic angiogram showed that the mass was hypovascular and the left portal vein was occluded with a tapered end. Percutaneous ultrasound-guided core needle biopsy of the liver yielded HCC-CC. We suggest that HCC-CC should be considered in hypovascular liver tumours with striking elevation of serum AFP and multiple regional lymphadenopathy.
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Affiliation(s)
- C H Toh
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
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24
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Abstract
We report an unusual case of Müllerian duct cyst in an 8-month-old infant who presented with frequent vomiting and recurrent urinary tract infections. Computed tomography showed a midline giant cyst in the pelvic floor. Delayed enhanced computed tomography demonstrated contrast filling of the cyst, indicating a communication with the urotract. Subsequent cystourethrogram and surgery confirmed a giant Müllerian duct cyst.
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Affiliation(s)
- C C Li
- Department of Radiology, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan
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25
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Chan SC, Ko SF, Ng SH, Cheung YC, Chang JTC, Liao CT, Wang HM, Lui KW. Fluoroscopically guided percutaneous gastrostomy with modified gastropexy and a large-bore balloon-retained catheter in patients with head and neck tumors. Acta Radiol 2004; 45:130-5. [PMID: 15191094 DOI: 10.1080/02841850410003707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To report on fluoroscopically guided percutaneous gastrostomy (FPG) using a modified gastropexy technique with the insertion of a large-bore balloon-retained gastrostomy catheter in patients with head and neck tumors. MATERIAL AND METHODS Thirty-four patients with head and neck tumors underwent a modified gastropexy with two T-fasteners followed by the insertion of a 14-F ballooon-retained catheter through a peel-away introducer. The success rate and the complications of the procedures were evaluated at 14 days, 30 days, and 60 days. The complications were classified as: major complications that necessitated intensive and/or surgical treatment; minor complications that could be treated conservatively; and tube-related complications manageable by tube exchange. RESULTS FPG was technically successful in all cases. There were no major complications, two minor complications where superficial stoma infection was controlled by antibiotics, three minor tube-related complications, all three easily managed by catheter replacement via the original tract. CONCLUSION FPG with insertion of a large-bore balloon-retained catheter using a modified gastropexy technique is a safe and effective method that creates a feeding access for patients with head and neck tumors and esophageal obstruction. Minor complications can be managed conservatively. FPG may be a good alternative to surgical or percutaneous endoscopic gastrostomy.
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Affiliation(s)
- S C Chan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Lin-Kou Medical Center and Keelung Hospital, Taiwan.
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26
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Huang CC, Ko SF, Chung MY, Shieh CS, Tiao MM, Lui CC, Ng SH. Infradiaphragmatic pulmonary sequestration combined with cystic adenomatoid malformation: unusual postnatal computed tomographic features. ACTA ACUST UNITED AC 2004; 29:439-42. [PMID: 15024518 DOI: 10.1007/s00261-003-0141-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We present a surgically proven case of infradiaphragmatic pulmonary sequestration combined with cystic adenomatoid malformation. Prenatal magnetic resonance imaging revealed a well-defined hyperintense mass with a hypointense septum in the left infradiaphragmatic region. Postdelivery computed tomography (CT) and 3-month follow-up CT showed replacement of intralesional cystic areas by solid content. Such unusual postnatal CT changes, to our knowledge, have not been previously documented.
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Affiliation(s)
- C C Huang
- Department of Radiology, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan
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27
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Harwood J, Giles H, McCann RM, Cai D, Somera LP, Ng SH, Gallois C, Noels K. Older adults' trait ratings of three age-groups around the Pacific rim. J Cross Cult Gerontol 2004; 16:157-71. [PMID: 14617987 DOI: 10.1023/a:1010616316082] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this paper, we assess the traits that older adults associate with younger, middle-aged, and older adults in five Pacific Rim nations from Western and Eastern cultural traditions (Australia, People's Republic of China (PRC), Hong Kong, Philippines, Thailand). We find cross-cultural trends which replicate patterns found in the US context. In most cultures, attractiveness, strength, activity, liberalism, health, and flexibility are seen to decline with increasing age. Kindness assessments are positively associated with age across cultures. Mixed patterns are found with assessments of wisdom and generosity, with respondents from the PRC and Hong Kong being notably more negative about increasing age than other respondents. Implications for the aging process across cultures are discussed, and suggestions made for future research.
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Affiliation(s)
- J Harwood
- Department of Communication Studies, University of Kansas, Lawrence, KS 66045-7574, USA.
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28
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Abstract
BACKGROUND The purpose of this study was to investigate the regenerative potential of hyaline cartilage in a neocartilage graft implant with the aid of MR cartilage imaging using a rabbit model. METHODS Surgical osteochondral defects were created in the femoral condyles of 30 mature New Zealand rabbits. The findings of neocartilage in autologous cartilage grafts packed into osteochondral defects were compared with control group of no implant to the osteochondral defect. The outcome of the implantations was correlated with histologic and MR cartilage imaging findings over a 3-month interval. RESULTS Neocartilage grafts packed into osteochondral defects showed regeneration of hyaline cartilage at the outer layer of the implant using MR cartilage imaging. Fibrosis of fibrocartilage developed at the outer layer of the autologous cartilage graft together with an inflammatory reaction within the osteochondral defect. CONCLUSION This animal study provides evidence of the regenerative ability of hyaline cartilage in neocartilage transplants to repair articular cartilage.
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Affiliation(s)
- C F Tan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu Hsing Street, Kwei Shen, Tauyuan, Taiwan ROC.
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29
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Tsui EYK, Yip SF, Ng SH, Cheung YK. Reversible MRI changes of hypothalamus in a multiple sclerosis patient with homeostatic disturbances. Eur Radiol 2002; 12 Suppl 3:S28-31. [PMID: 12522597 DOI: 10.1007/s00330-002-1468-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2001] [Revised: 03/15/2002] [Accepted: 03/20/2002] [Indexed: 10/25/2022]
Abstract
Multiple sclerosis (MS) patients occasionally present with homeostatic disturbances suggestive of hypothalamic dysfunction; however, the hypothalamus often appears normal on imaging, apart from confirmation in a few necropsy studies. In this article we describe a Chinese woman with atypical clinical presentation. She presented with relapsing symptoms and signs consistent with hypothalamic dysfunction including hyperprolactinema, syndrome of inappropriate secretion of anti-diuretic hormone (SIADH), hypersomnolence and temperature dysregulation. Serial MRI depicted the atypical reversible changes in the hypothalamus, correlating with the observed homeostatic abnormalities.
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Affiliation(s)
- E Y K Tsui
- Department of Radiology, Tuen Mun Hospital, Tuen Mun. NT, Hong Kong Special Administrative Region, The People's Republic of China.
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30
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Tsui EYK, Ng SH, Chow L, Lai KF, Fong D, Chan JHM. Syphilitic myelitis with diffuse spinal cord abnormality on MR imaging. Eur Radiol 2002; 12:2973-6. [PMID: 12439578 DOI: 10.1007/s00330-001-1244-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2001] [Accepted: 10/25/2001] [Indexed: 12/21/2022]
Abstract
Syphilitic myelitis is a very rare manifestation of neurosyphilis. The MRI appearance of syphilitic myelitis is not well documented and only a few cases have been reported. We present a 52-year-old woman with acute onset of paraplegia. Magnetic resonance imaging of the spine showed diffuse high signal intensity in the whole spinal cord on T2-weighted images. Focal enhancement was observed in the dorsal aspect of the thoracic cord on T1-weighted gadolinium-enhanced images. To our knowledge, diffuse spinal cord abnormality in syphilitic myelitis has not been reported in the international literature. Disappearance of the diffuse high-signal lesions with residual focal enhancement was noted after antibiotic therapy. The patient suffered significant neurological deficit despite improvement in the MR images. In this article we present the imaging findings and review the literature of this rare condition.
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Affiliation(s)
- E Y K Tsui
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, Hong Kong.
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31
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Tsui EYK, Leung WH, Chan JH, Cheung YK, Ng SH. Tumefactive demyelinating lesions by combined perfusion-weighted and diffusion weighted imaging. Comput Med Imaging Graph 2002; 26:343-6. [PMID: 12204240 DOI: 10.1016/s0895-6111(02)00017-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Tumefactive demyelinating lesion may sometimes mimic intracranial neoplasm or abscess and pose a diagnostic problem both clinically and radiologically. The diagnosis is even more complicated since multiple sclerosis is relatively uncommon among Chinese and due to low incidence of oligoclonal protein in the cerebrospinal fluid. We present a Chinese lady with tumefactive demyelinating lesion, which mimic cystic neoplasm and cerebral abscess. The use of perfusion and diffusion weighted imaging obviated unnecessary surgical biopsy.
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Affiliation(s)
- E Y K Tsui
- Department of Radiology, Tuen Mun Hospital, Tuen Mun NT, Hong Kong, People's Republic of China.
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32
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Abstract
Cerebral abscess may sometimes mimic necrotic tumor and cystic metastases both clinically and radiologically. The imaging findings may be indistinguishable on conventional magnetic resonance imaging. Although recent studies have shown that cerebral abscess displays restricted diffusion on diffusion-weighted imaging (DWI), it is not pathognomic. Necrotic tumor and cystic metastases may occasionally have restricted diffusion on DWI. Since the urgency of surgical intervention and approach of surgery is different, MR Spectroscopy may be used in conjunction with DWI in establishing the correct diagnosis.
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Affiliation(s)
- E Y K Tsui
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, NT, Hong Kong, People's Republic of China.
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33
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Chan SC, Ng SH, Lee KF, Hao SP, Cheung YC, Wan YL. Submandibular Castleman's disease. Int J Clin Pract 2002; 56:314-5. [PMID: 12074219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Castleman's disease is a rare benign lymphoid tumour of unknown aetiology, which usually appears as a solitary mediastinal mass. We report an unusual case of Castleman's disease, an asymptomatic submandibular mass in the lower jaw, and we discuss the computed tomography appearance.
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Affiliation(s)
- S C Chan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan
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34
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Abstract
Ruptured cystic mediastinal teratoma is rare. The diagnosis of this condition and a clear demonstration of its associated complications are important for defining the surgical approach. We report the CT findings of a case of mediastinal cystic teratoma before and after rupture. CT features of bursting of the spherical fatty compound and intrapulmonary bronchial invasion have not been previously described.
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Affiliation(s)
- Y C Cheung
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Linkuo and Keelung, 5 Fu-Hsing Road, Tao Yuan Hsien, Taiwan
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35
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Ng SH, Ko SF, Chen WC, Tang LM, Chang CN, Wai YY, Wan YL. Proton magnetic resonance spectroscopy of cerebral glioma after irradiation. Chang Gung Med J 2001; 24:708-16. [PMID: 11820651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Conventional magnetic resonance imaging (MRI) is commonly employed to assess cerebral gliomas after radiotherapy, but it cannot always differentiate tumor regrowth from post-irradiation changes. In this study, we utilized magnetic resonance spectroscopy (MRS) to evaluate changes in cerebral metabolites in patients with a cerebral glioma after irradiation. METHODS Over a period of 3 years, we performed MRS after MRI whenever soft tissue masses were found on magnetic resonance (MR) images. A total of 122 MR spectra of 58 patients was used for analysis. Spectral interpretations were based on integral values of the N-acetylaspartate (NAA) and choline (Cho) compounds relative to phosphocreatine/creatine (Cr). RESULTS Our MRS study showed that higher Cho/Cr ratios occurred in regrowing gliomas than for stable diseases (range, 0.9 to 9.5 vs. 0.4 to 2.1; mean, 3.0 vs. 1.2). A greater increment in the Cho/Cr ratio between successive studies was also noted in regrowing gliomas than for stable disease (range, 41% to 87% vs. < 32%). No significant differences in NAA/Cr ratios or lactate were found between these 2 groups. None of our patients exhibited abnormal MR spectra in the mirror area of the contralateral brain. CONCLUSION MRS provides valuable information about the metabolism of irradiated gliomas and can be used to exclude radiation encephalopathy of the contralateral brain. Cho is the most reliable indicator of a regrowing glioma. A high Cho/Cr ratio or substantial elevation in the Cho/Cr ratio between serial studies increases the likelihood of tumor regrowth. However, lower Cho/Cr ratios were inconclusive for determining if tumor regrowth or a stable process was occurring.
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Affiliation(s)
- S H Ng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Taipei, ROC.
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36
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Lee CT, Ng SH, Ko SF, Wan YL, Liu JW, Chen JB. Culture-negative tuberculous enterovesical fistula mimicking late urological complications after radiotherapy. Int J Tuberc Lung Dis 2001; 5:687. [PMID: 11467376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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37
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Abstract
A case of malignant fibrous histiocytoma (MFH) of the gastrocolic ligament is presented. It appeared as a huge, thin walled cystic tumour in the upper abdominal cavity on CT. Barium studies showed splaying of the stomach and transverse colon by the mass. 1 year after resection of the cystic tumour, recurrence occurred at the greater curvature of the stomach and in the liver, with a cystic appearance similar to the primary tumour. To our knowledge, the CT appearance of primary cystic MFH of the gastrocolic ligament has not been previously documented.
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Affiliation(s)
- C C Huang
- Department of Radiology, Chang Gung University, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan
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Abstract
OBJECTIVE Small-bowel intussusception (SBI) for pediatric patients is unusual and difficult to diagnose preoperatively. This study sought to determine the sonographic findings of pediatric SBI. METHODS The sonographic features and surgical findings of 13 pediatric patients (7 boys, 6 girls; age range 4 months-15 years; average age 4 years and 2 months) with SBI encountered in the authors' hospital over a 12-year period were retrospectively reviewed. RESULTS Most of the patients presented with nonspecific symptoms, including vomiting, abdominal pain, and/or irritable crying. Sonographic screening in the emergency department revealed a doughnut or crescent-in-doughnut sign, or a multiple-concentric-rings sign for 11 of the 13 patients, and the lesions appeared short. Eight lesions were found in the paraumbilical or left abdominal regions. Sonographic measurement of the size of the lesions from these 11 patients ranged from 2 cm to 3.7 cm (average 2.77 cm). Subsequent barium enemas were performed for these 11 patients, none of which revealed colon lesions. Surgery revealed ileoileal intussusceptions for eight cases, jejunoileal for three, and jejunojejunal for the remaining two. Bowel ischemia or necrosis and pathologic lead points were demonstrated for seven and six patients, respectively, although none were recognized preoperatively. CONCLUSIONS Small-bowel intussusception is often over-looked due to nonspecific clinical presentations. Sonographic demonstration of a 2-3-cm sized, short, doughnut-like lesion, especially in the left abdomen or paraumbilical regions, should lead to strong suspicion of SBI.
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Affiliation(s)
- M M Tiao
- Department of Pediatrics, Chang Gung University, Chang Gung Memorial Hospitals at Kaohsiung and Linkou, Kaohsiung, Taiwan
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Tsui EY, Ng SH, Cheung YK, Fong D, Yuen MK. Spontaneous intracranial hypotension with diffuse dural enhancement of the spinal canal and transient enlargement of the pituitary gland. Eur J Radiol 2001; 38:59-63. [PMID: 11287167 DOI: 10.1016/s0720-048x(01)00288-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Spontaneous intracranial hypotension is a rare phenomenon characterized by postural headache, neck rigidity, nausea and vomiting. Imaging findings on magnetic resonance imaging (MRI) is characteristic with diffuse intracranial pachymeningeal thickening and enhancement following intravenous gadolinium. We present a case of spontaneous intracranial hypotension with two unusual imaging findings; pachymeningeal enhancement of the spinal canal and enlargement of the pituitary gland in addition to the diffuse intracranial pachymeningeal enhancement. In this case report, we will discuss the clinical features, MRI findings and underlying pathophysiology of this rare condition.
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Affiliation(s)
- E Y Tsui
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, NT, Hong Kong.
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Wang HM, Ng SH, Wang CH, Liaw CT, Chen JS, Yang TS, Chen IH. Intra-arterial plus i.v. chemotherapy for advanced bulky squamous cell carcinoma of the buccal mucosa. Anticancer Drugs 2001; 12:331-7. [PMID: 11335789 DOI: 10.1097/00001813-200104000-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
From July 1994 to December 1996, 41 patients with previously untreated, advanced bulky squamous cell carcinoma arising from the buccal mucosa (BSCC) were enrolled. All patients were males with a median age of 47 years (range 29-72). The tumor extent was stage III/IV: three of 38, T4: 85%, N2-3: 20%. Patients were initially scheduled to receive intra-arterial (i.a.) chemotherapy, followed by i.v. chemotherapy and regional therapy. The i.a. chemotherapy catheter was properly placed by external carotid artery angiography via the femoral artery. The i.a. chemotherapy consisted of cisplatin (P) 100 mg/m(2) day 1 plus 5-fluorouracil (F) 1000 mg/m(2) day 1-4, and the i.v. chemotherapy consisted of PF (10 patients) or PF plus methotrexate 200 mg/m(2) day 15 and 22 (31 patients). All chemotherapy regimens were administered at 4-week intervals. The response rate of i.a. plus i.v. chemotherapy for the primary site was 85% (35 of 41) with 29% complete remission (CR) (12 of 41). The response and CR rates of neck nodes were 82% (14 of 17) and 41% (seven of 17), respectively. The combined overall response rate was 80% (33 of 41) with a 29% CR (12 of 41). Major toxicity from i.a. chemotherapy of WHO grade > or = 3 included: mucositis of infusion area (76%), hemialopecia (56%) and leukopenia (5%). Three neurologic complications of i.a. chemotherapy including one hemiparesis occurred. The median follow-up time was 47 months (range 36-66 months), and the overall survival and disease-free survival were both 34% (14 of 41). Four patients were cured with chemotherapy alone and eight patients (19.5%) were cured without surgical intervention. Using i.a. chemotherapy as a cytoreductive therapy followed by subsequent i.v. chemotherapy produces a high response rate and an encouraging degree of complete response rate in advanced bulky BSCC. However, toxicity management and catheter placement will need to be improved in order to better define the role of this therapy in advanced BSCC.
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Affiliation(s)
- H M Wang
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC
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41
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Affiliation(s)
- S F Ko
- Chang Gung University Chang Gung Memorial Hospital Kaohsiung Hsien 833, Taiwan
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42
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Affiliation(s)
- C F Tan
- Department of Diagnostic Radiology, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan
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43
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Ko SF, Ng SH, Lee TY, Wan YL, Lee CM, Hsieh MJ, Chen MC. Anomalous systemic arterialization to normal basal segments of the left lower lobe: helical CT and CTA findings. J Comput Assist Tomogr 2000; 24:971-6. [PMID: 11105720 DOI: 10.1097/00004728-200011000-00026] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this work was to evaluate the helical CT and CT angiography (CTA) findings of anomalous systemic artery (ASA) to the basal segments of the left lower lobe (LLL). METHOD Three patients (two had hemoptysis, one was asymptomatic) with blotchy nodular density in the LLL revealed on chest radiographs underwent helical CT and CTA. Bronchoscopy was performed in two of these patients. Angiography and surgery were performed in one patient. RESULTS All three patients demonstrated characteristic helical CT and CTA findings including 1) a sigmoid-shaped ASA originating from the lower descending thoracic aorta, with a distal bulbous configuration and four arterial branches supplying the basal segments of the LLL; 2) absence of an interlobar pulmonary artery or presence of a small artery lateral to the truncus basalis; 3) engorged vascular markings in the basal segments of the LLL; and 4) normal tracheobronchial tree and lung parenchyma. CONCLUSION The findings in the present three cases suggest that the use of invasive studies such as angiography or bronchoscopy may be obviated in the diagnosis of ASA to the LLL because diagnosis can be provided through a clear set of criteria on helical CT and CTA.
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Affiliation(s)
- S F Ko
- Department of Radiology, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan.
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Wu JC, Lu CS, Ng SH. Limb myorhythmia in association with hypertrophy of the inferior olive: report of two cases. Chang Gung Med J 2000; 23:630-5. [PMID: 11126156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We report on 2 patients who uncommonly developed isolated limb myorhythmia in association with inferior olive hypertrophy (IOH) after an acute stroke in the brain stem. A slow tremor presented in the proximal upper limbs predominantly when at rest. It was aggravated by outstretched arms and by active hand movements. The surface electromyogram (EMG) recorded simultaneous activities over the agonist and antagonist muscles with a rate of 3.5 Hz and 2.5 Hz in 2 patients respectively. In the first patient, bilateral limb myorhythmia presented 12 months after the brain stem stroke, and both inferior olives were hypertrophic. In the second patient, unilateral limb myorhythmia developed in the left hand 7 months after right pontine hemorrhage, and only the right inferior olive was hypertrophic. These findings indicate that limb myorhythmia commencing after brain stem insult is anatomically and temporally related to hypertrophy of the contralateral inferior olive. Based on our 2 patients and previously reported cases, we propose that a possible causal relationship exists between limb myorhythmia and contralateral IOH, although its pathophysiological mechanisms remain to be established. We suggest that, similar to palatal myoclonus, isolated limb myorhythmia is within the clinical spectrum of IOH.
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Affiliation(s)
- J C Wu
- Movement Disorders Unit, Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
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45
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Affiliation(s)
- S F Ko
- Department Radiology, Chang Gung Memorial Hospitals at Kaohsiung and Linkou, Chang Gung University, 123 Ta-Pei Rd., Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan
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46
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Abstract
We present a case of mediastinal mesenchymal tumor in a 53-year-old woman with a 1-month history of chest tightness. A histological diagnosis of lymphangiohemangioma was obtained by excisional biopsy. CT findings are reported with emphasis on its association with intratumoral superior vena cava ectasia.
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Affiliation(s)
- A M Wong
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Tao Yuan Hsien, Taiwan, Republic of China
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47
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Abstract
A 7-year-old girl underwent laparotomy for suspected acute appendicitis. Instead, bile peritonitis with hydrops of gallbladder and normal appendix were noted. Dilatation of the CBD was observed, and choledochal cyst was documented by intraoperative cholangiography. Cholecystectomy and T-tube placement were performed. Postoperative follow-up by ultrasound lasted for 9 months. The CBD remained the same size without clinical manifestation.
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Affiliation(s)
- S L Lin
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China
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48
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Abstract
PURPOSE We investigated whether there was a relationship between the sonographic and histologic appearances of medullary carcinomas of the breast to determine whether sonography is helpful in the differentiation of typical and atypical medullary carcinomas. METHODS We retrospectively reviewed the histologic slides and sonograms of 20 patients who had been diagnosed with medullary carcinoma of the breast. We then classified the carcinomas as typical or atypical based on strict histologic criteria. We also evaluated the relationship between sonographic findings and the histologic reclassification. RESULTS Eight (40%) of the 20 medullary carcinomas were classified as typical, and 12 (60%) were classified as atypical. On sonography, a smooth outline was visualized in 6 (75%) of the 8 typical medullary carcinomas but in none of the 12 atypical carcinomas. A jagged margin was sonographically visualized in 10 (83%) of the 12 atypical carcinomas, and a focal irregularity in the margin was visualized in 2 (17%) of the 12 atypical carcinomas. Four of the typical medullary carcinomas had posterior enhancement, and 9 of the atypical medullary carcinomas showed retrotumoral shadowing. The difference in tumor-margin regularity between typical and atypical medullary carcinomas was found to be statistically significant (p < 0.001) using the 2-tailed Fisher's exact test. CONCLUSIONS To prevent overdiagnosis of medullary carcinoma, a thorough pathologic review of the entire tumor is recommended if sonography shows a jagged margin or a margin with focal irregularity.
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Affiliation(s)
- Y C Cheung
- Department of Diagnostic Radiology, Chang Gung Medical Center at LinKou, 5 Fu-Hsing Street, Tao Yuan Hsien, Taiwan
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49
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Abstract
We prospectively compared the value of MRI and clinical palpation for detecting cervical metastases in patients with primary cancer of the head and neck. Sixty patients with squamous cell carcinoma of the upper aerodigestive tract were evaluated with MRI and clinical palpation before undergoing a total of 81 neck dissections. The results of preoperative clinical palpation and MRI were compared with the histopathologic outcome. The sensitivity and specificity were 75.6% and 97.5%, respectively, for clinical palpation and 73.2% and 95%, respectively, for MRI. The rate of occult cervical metastasis was 24% with clinical palpation and 26.8% with MRI. The use of MRI did not improve the rate of early detection of occult metastasis, nor did it improve the detection of extracapsular spread. Our findings show that we could not depend on palpation or MRI alone to determine the need for elective neck dissection. However, MRI can be used to improve the preoperative grading of cervical lymph nodes. In selected cases, this may direct surgeons to convert the treatment plan to choose a more conservative neck dissection or, after sentinel node sampling and frozen-section control, to convert the treatment to a more radical dissection.
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Affiliation(s)
- S P Hao
- Departments of Otolaryngology and Radiology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan
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50
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Abstract
Dynamic enhancing feature in mediastinal hemangioma was rarely reported. Slow, gradually increasing and prolonged contrast stains are the diagnostic hints in our case that avoid the hemorrhagic catastrophe from transthoracic core needle biopsy. A rare finding of an aberrant vessel entering into the tumor was valuable for operative planning. Dynamic computed tomography (CT) can provide more information for evaluation in such cases.
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Affiliation(s)
- Y C Cheung
- First Department of Diagnostic Radiology, Chang Gung Medical Center at Linkou and Keelung, Chang Gung Medical College, Chang Gung University, 5 Fu-Hsing Street, Kwei Shan Hsiang, Tao Yuan Hsien, Taiwan.
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