Hong Kong, China
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Lam Y.,United Christian Hospital | Yuen K.K.Y.,Tseung Kwan O Hospital | Chong L.C.,Tseung Kwan O Hospital
Hong Kong Medical Journal | Year: 2012

The 'wandering spleen' is a rare condition due to extreme laxity or absence of ligaments that fix the organ in its normal anatomical position within the left upper quadrant. Without early surgical intervention, wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important, so as to salvage the spleen and prevent complications. We present a case of torsion of a wandering spleen in a 21-year-old young woman, who presented with a painful pelvic mass. We also reviewed the literature on this entity.


Fu S.-N.,Hong Kong Polytechnic University | Chan Y.-H.,Tseung Kwan O Hospital
Disability and Rehabilitation | Year: 2011

Purpose: To translate, cross-culturally adapt and validate the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF-C) to Chinese. Method. Forward and backward translations were conducted by two bilingual professional translators. Content validity was verified by a panel of a senior orthopaedic surgeon and six physiotherapists. The IKDC-SKF-C was tested on 84 patients. Psychometric testing included internal consistency (Cronbach's α) and test-retest reliability. Convergent validity used Spearman's correlation coefficient (rho) tests by comparing its score with the Chinese version of SF-36. Results. The Internal consistency was excellent with Cronbach's α=0.97. Test-retest reliability was supported with an ICC=0.87. The IKDC-SKF-C was moderately related to concurrent measures of physical function and bodily pain (r=0.64, p<0.05). Conclusion. The translated Chinese IKDC-SKF is a reliable and valid tool with equal measurement properties and conceptual equivalent to the original version. © 2011 Informa UK, Ltd.


Ho E.T.L.,Westmead Hospital | Ho E.T.L.,Tseung Kwan O Hospital | Wong G.,Westmead Hospital | Wong G.,University of Sydney | And 4 more authors.
Transplantation | Year: 2013

BACKGROUND: A simplified dosing regimen may improve drug compliance in kidney transplant recipients and long-term graft outcomes. We aimed to identify, appraise, and synthesize the current evidence comparing the relative safety and efficacy of the recently introduced daily versus standard twice-daily tacrolimus administration. METHODS: We systematically reviewed all randomized controlled trials and observational studies that compared the outcomes of daily versus twice-daily tacrolimus formulation in kidney transplant recipients. Medline (from 1948 to July week 4 2011), Embase (1980 to 2011 week 31), the Cochrane Library (1991 to June 2011), and conference proceedings were searched without language restriction. RESULTS: Six randomized controlled trials (n=2499) and 15 observational studies (n=2886) were included in the review. There were no significant differences in biopsy-proven acute rejection (two trials, n=1093; risk ratio [RR; confidence interval (CI)], 1.24 [0.93-1.65]; P=0.15; I=0%), patient survival (three trials, n=1156; RR [CI], 0.99 [0.97-1.02]; P=0.55; I=32%), and graft survival (three trials, n=1156; RR [CI], 0.99 [0.97-1.02]; P=0.67; I=0%) between the two formulations at 12 months. Similar results for acute rejection (five studies, n=391; RR [CI], 0.99 [0.93-1.06]; P=0.84; I=0%) and overall patient survival (two studies, n=218; RR [CI], 1.02 [0.94-1.10]; P=0.62; I=0%) were observed in observational studies. CONCLUSIONS: Once-daily tacrolimus appears to be as effective as twice-daily tacrolimus up to 12 months after kidney transplantation. Copyright © 2013 Lippincott Williams & Wilkins.


Tong S.H.Y.,Tseung Kwan O Hospital
Hong Kong Journal of Emergency Medicine | Year: 2011

We report a case of silver nitrate stain on the finger that masqueraded as an avulsion fracture on radiograph. Radiopacity in the proximal phalanx was demonstrated on radiograph after topical silver nitrate was applied to achieve haemostasis to a bleeding laceration on that area. The radiopacity was initially diagnosed as an avulsion fracture. The correct diagnosis of radiopacity corresponding to silver nitrate application was confirmed by correlation of physical examination with radiographic finding. The lesion spontaneously resolved with conservative management. The importance of correlating the clinical site of silver nitrate application with radiographic finding for accurate diagnosis and avoidance of unnecessary surgical intervention is emphasized.


Hung J.L.P.,Tseung Kwan O Hospital | Chan S.C.F.,Tseung Kwan O Hospital
Journal of Foot and Ankle Surgery | Year: 2016

Cuneiform dislocation associated with Lisfranc injury is a very rare injury. Dislocation over the midfoot due to a seizure has not been previously reported in published studies. A 35-year-old female presented with an intercuneiform dislocation and Lisfranc fracture-dislocation after a generalized seizure. Immediate close reduction of the dorsally dislocated cuneiforms was performed, followed by definitive treatment to restore the foot arches. A proposed underlying pathophysiology of dislocation due to seizure in terms of the biomechanics is discussed. The purpose of our report was to present the unusual etiology of this form of cuneiform dislocation and Lisfranc joint complex injury. © 2016 American College of Foot and Ankle Surgeons.


Chu W.P.,Princess Margaret Hospital | Chu W.P.,Tseung Kwan O Hospital
Hong Kong Medical Journal | Year: 2013

Rhabdomyosarcoma is a common paediatric soft tissue tumour. However, the anterior mediastinum is an extremely rare site for its occurrence. This report describes the imaging and histological findings of such a tumour in a 4-month-old boy.


Wong V.W.-S.,Chinese University of Hong Kong | Wong G.L.-H.,Chinese University of Hong Kong | Tsang S.W.-C.,Tseung Kwan O Hospital | Fan T.,Tseung Kwan O Hospital | And 9 more authors.
Gut | Year: 2011

Objective: Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology. Design: Cross-sectional study. Setting: University hospital with case recruitment from the community and clinics. Patients: Subjects aged 40-70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy. Main outcome measures: Prevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia. Results: NAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects. Conclusions: Non-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group.


Hung J.L.P.,Tseung Kwan O Hospital
Hong Kong Journal of Emergency Medicine | Year: 2015

We report an extremely rare case of isolated fracture of the volar rim of lunate fossa which extends into the sigmoid notch, resulting in distal radioulnar joint (DRUJ) and radiocarpal joint instability. This fracture is easily missed with radiography alone in emergency setting, and should not be treated with casting due to DRUJ instability. © 2015, Medcom Limited. All rights reserved.


Kwan P.,Chinese University of Hong Kong | Wong V.,University of Hong Kong | Ng P.W.,United Christian Hospital | Lui C.H.T.,Tseung Kwan O Hospital | And 3 more authors.
Pharmacogenomics | Year: 2011

Aim: To determine the association between polymorphisms of the multidrug transporter genes ABCC2, ABCC5 and ABCG2, and drug resistance in epilepsy by genotyping comprehensive sets of tagging SNPs. Materials & methods: A total of 25 tagging SNPs from ABCC2, ABCC5 and ABCG2 genes were genotyped in a total of 590 Han Chinese epilepsy patients (262 drug resistant and 328 drug responsive). Genotype and allele distributions in drug-responsive and drug-resistant patients were compared. Results: Genotype distributions of all the selected SNPs were consistent with Hardy-â€"Weinberg equilibrium. None of the polymorphisms, either genotype or allele distributions, were significantly associated with drug resistance. For each gene, no haplotypes of over 1% frequency, and that included all SNPs of the gene, were associated with drug resistance. Conclusion: This gene-wide tagging study revealed no association between ABCC2, ABCC5 and ABCG2 genetic polymorphisms and multidrug resistance in epilepsy. © 2011 Future Medicine Ltd.


Ngai W.Y.H.,Tseung Kwan O Hospital | Chan S.C.F.,Tseung Kwan O Hospital
Journal of Foot and Ankle Surgery | Year: 2010

The Achilles tendon is the largest palpable tendon in the human body, and rupture of this tendon is not an uncommon injury encountered by foot and ankle surgeons. A number of different minimally invasive methods have been described for repair of the ruptured Achilles tendon. In this article, we describe a relatively simple, minimally invasive technique of Achilles tendon repair that does not require special instrumentation, the key requirement being that of a sponge forceps. © 2010 American College of Foot and Ankle Surgeons.

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