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Aggarwal C.,University of Pennsylvania | Meropol N.J.,Case Western Reserve University | Punt C.J.,University of Amsterdam | Iannotti N.,Hematology Oncology Associates | And 8 more authors.
Annals of Oncology | Year: 2013

Background: We previously reported results of a prospective trial evaluating the significance of circulating tumor cells (CTCs) in patients with metastatic colorectal cancer (mCRC). This secondary analysis assessed the relationship of the CTC number with carcinoembryonic antigen (CEA) and overall survival. Patients and methods: Patients with mCRC had CTCs measured at baseline and specific time points after the initiation of new therapy. Patients with a baseline CEA value ≥10 ng/ml and CEA measurements within ±30 days of the CTC collection were included. Results: We included 217 patients with mCRC who had a CEA value of ≥10 ng/ml. Increased baseline CEA was associated with shorter survival (15.8 versus 20.7 months, P = 0.012). Among all patients with a baseline CEA value of ≥25 ng/ml, patients with low baseline CTCs (<3, n = 99) had longer survival than those with high CTCs (≥3, n = 58; 20.8 versus 11.7 months, P = 0.001). CTCs added prognostic information at the 3-5- and 6-12-week time points regardless of CEA. In a multivariate analysis, CTCs at baseline but not CEA independently predicted survival and both CTCs and CEA independently predicted survival at 6-12 weeks. Conclusions: This study demonstrates that both CEA and CTCs contribute prognostic information for patients with mCRC. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


Chan Y.,Tuen Mun Hospital | Mok C.C.,Tuen Mun Hospital | Tang W.Y.M.,Union Hospital
Rheumatology International | Year: 2011

Erythema elevatum diutinum (EED) is a rare chronic form of leukocytoclastic vasculitis with unknown etiology. EED has been described in association with hematological malignancies, infections and a number of rheumatological diseases. We report a patient with systemic lupus erythematosus (SLE) who presented with intermittent attacks of tender nodules and plaques on the shins and ankles for 6 months. Skin biopsy confirmed the diagnosis of EED. Treatment with dapsone resulted in complete resolution of the skin lesions. EED is rarely reported in SLE, and its presentation and treatment is reviewed. © Springer-Verlag 2010.


Wong A.C.M.,Union Hospital | Mak S.T.,Tuen Mun Hospital
Journal of AAPOS | Year: 2012

Preseptal cellulitis in children can be caused by a reaction to embedded insects, their body parts, or secretions. We report the case of a 2-year-old girl who presented with preseptal cellulitis caused by an insect identified as Megacopta centrosignatum in her superior fornix. Copyright © 2012 by the American Association for Pediatric Ophthalmology and Strabismus.


Mak S.T.,United Christian Hospital | Io I.Y.-F.,Caritas Medical Center | Wong A.C.-M.,Union Hospital
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2013

Purpose To evaluate the prognostic factors for outcome of endoscopic dacryocystorhinostomy (DCR) in patients with primary acquired nasolacrimal duct obstruction. Materials and Methods Eighty-three consecutive cases of endoscopic DCR performed for primary acquired nasolacrimalduct obstruction by a single surgeon were included in a retrospective, noncomparative case series. The outcome was assessed at aminimumof 5months after surgery, being at least 3 months after removal of stents. Surgical success was defined both subjectively and objectively. Subjective success was defined as absence of epiphora. Objective anatomical success was defined as patency on syringing, and presence of a functioning rhinostomy evaluated using the functional endoscopic dye test. Variables assessed included age at surgery, gender,side, duration of intraoperative mitomycin C application, and duration of stent left in-situ. The prognostic factors for outcome were analyzed by the logistic regression test. Results Of the 79 analyzed cases, 74 (93.7 %) had successful surgical outcomes. The mean age at time of surgery was 55.5±13.3 years, and the majority of patients were female (85 %). The mean follow-up period was 23.3±16.8 months. Age at surgery is a significant factor influencing the surgical outcome (P<0.05). Gender, side, duration of intraoperativemitomycin C application, and duration of stent left in-situ had no significant association with the outcome (P>0.05). Conclusion In endoscopic DCR for primary acquired nasolacrimal duct obstruction, younger patient age at time of surgerywas associated with a higher rate of failure. © Springer-Verlag Berlin Heidelberg 2012.


Wong A.C.-M.,Union Hospital | Mak S.T.,Caritas Medical Center
Journal of Cataract and Refractive Surgery | Year: 2011

A 47-year-old man who had been using finasteride for male pattern alopecia for 4 years complained of progressive bilateral blurring of vision. His general health had been good, and he was not on any other long-term medication. Examination showed bilateral anterior subcapsular cataracts. Phacoemulsification and insertion of intraocular lenses were performed, and both eyes showed features of intraoperative floppy-iris syndrome (IFIS), including undulation and billowing of the iris, iris prolapse, and pupil constriction. We believe the use of finasteride can be associated with cataract formation and IFIS. Ophthalmologists and physicians prescribing finasteride should be aware of this possible association. © 2011 ASCRS and ESCRS.

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