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Sheung-Fat Ko

Publications and source records attributed to Sheung-Fat Ko.

At least 19 recordsLinked to original sources
PubMed2007

Intensity-modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma: comparisons of four radiotherapy techniques.

BACKGROUND: It was reported previously that the dosimetric superiority of conformal radiotherapy (RT), either 3-dimensional conformal RT (3D-CRT) or intensity-modulated RT (IMRT), over conventional 2D-RT translated into clinical benefits for patients with nasopharyngeal carcinoma (NPC). In this study, the authors compared quality-of-life (QOL) outcomes of NPC survivors who received treatment with 1 of 4 different RT techniques at a single institute during different periods. METHODS: The authors analyzed QOL data of from 237 patients with NPC who were cancer free for 2 or 3 years when their QOL was assessed. The study population included 152 patients who received conventional RT (2D-RT, 61 patients; 2D-RT plus 3D-CRT boost, 91 patients) and 85 patients who received conformal RT (3D-CRT, 33 patients; IMRT, 52 patients). The European Organization for the Research and Treatment of Cancer (EORTC) Core QOL questionnaire and the EORTC Head and Neck QOL questionnaire were completed. RESULTS: Compared with patients who received with conventional RT, patients who received conformal RT had both statistically (P < .05) and clinically (a difference in mean scores >or=10 points) significant improvements in the scales of global QOL, pain, appetite loss, senses, speech, social eating, teeth, opening mouth, xerostomia, sticky saliva, and feeling ill. No significant difference was observed in any of the scales that compared 2D-RT with 2D-RT plus 3D-CRT boost or that compared 3D-CRT with IMRT. Survivors who received conformal RT had a 2.01-fold higher probability (odds ratio [OR], 2.01; 95% confidence interval [95% CI], 1.19-3.68) of reporting good global QOL and a 2.70-fold lower probability (OR, 0.37; 95% CI, 0.20-0.66) of reporting a high level of xerostomia than survivors who received conventional RT. CONCLUSIONS: Conformal RT substantially improved head and neck-related symptoms and broad aspects of QOL for survivors of NPC.

Adult↗
PubMed2006

Prospective study of [18F]fluorodeoxyglucose positron emission tomography and computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with palpably negative neck.

PURPOSE: To assess the clinical usefulness of [(18)F]fluorodeoxyglucose positron emission tomography ([18F]FDG PET) as well as computed tomography (CT) or magnetic resonance imaging (MRI) in oral squamous cell carcinoma (SCC) patients with palpably negative neck. PATIENTS AND METHODS: In total, 134 oral SCC patients with palpably negative neck were prospectively evaluated with [18F]FDG PET, CT/MRI, and their visual correlation. Histopathologic analysis was used as the gold standard for assessment of these imaging techniques. RESULTS: Thirty-five (26.1%) of our 134 patients were found to have neck metastases. On a level-by-level basis, the sensitivity of [18F]FDG PET for nodal metastases was two-fold higher than that of CT/MRI (41.2% v 21.6%, respectively; P = .021). Visual correlation of [(18)F]FDG PET and CT/MRI yielded slightly higher sensitivity and specificity than [18F]FDG PET alone (47.1% v 41.2%, P = .25; 98.0% v 96.8%, P = .125, respectively). On a patient-by-patient basis, the sensitivity of [18F]FDG PET for neck metastases was 51.4% and increased to 57.1% after visual correlation with CT/MRI. The probabilities of occult neck metastasis after using [(18)F]FDG PET were 6.7% in T1 tumors, 10.8% in T2 tumors, 13.3% in T3 tumors, and 25% in T4 tumors and decreased to 3.3% in T1 tumors and to 9.2% in T2 tumors after visual correlation with CT/MRI. CONCLUSION: [(18)F]FDG PET was superior to CT/MRI for detecting palpably occult neck metastasis of oral SCC. Because [(18)F]FDG PET could reduce the probability of occult neck metastasis to less than 15% in T1 to T3 tumors, it should be indicated for evaluation of these subpopulations.

Adult↗
PubMed2006

Clinical feasibility of free-breathing, gadolinium-enhanced magnetic resonance angiography for assessing extracardiac thoracic vascular abnormalities in young children with congenital heart diseases.

OBJECTIVE: Congenital heart diseases in pediatric patients are associated with a wide variety of extracardiac thoracic vascular abnormalities. This study analyzed the value of gadolinium-enhanced magnetic resonance angiography during quiet free breathing for assessing extracardiac thoracic vascular abnormalities in young children with congenital heart diseases. METHODS: Fifty-three children with congenital heart diseases (age range, 1 day-40 months; mean, 10.9 months) associated with extracardiac thoracic vascular abnormalities who had undergone both free-breathing, gadolinium-enhanced magnetic resonance angiography and cardiac catheterization, surgical intervention, or both within 2 weeks were reviewed. Diagnostic findings on gadolinium-enhanced magnetic resonance angiography among patients grouped according to 3 major conditions of conotruncal abnormalities (n = 33), aortic or venous abnormalities (n = 11), and pulmonary vascular abnormalities (n = 9), as well as associated extracardiac thoracic vascular abnormality findings, were compared with findings made by using cardiac catheterization, surgical intervention, or both. RESULTS: Extracardiac thoracic vascular abnormality findings on gadolinium-enhanced magnetic resonance angiography were similar to those on catheterization, surgical intervention, or both in patients with conotruncal abnormalities (124 vs 127, P = .083), aortic or venous abnormalities (36 vs 33, P = .083), and pulmonary vascular abnormalities (24 vs 25, P = .317). The overall sensitivity of gadolinium-enhanced magnetic resonance angiography for detection of these lesions identified by means of catheterization, surgical intervention, or both was 97.9%. However, gadolinium-enhanced magnetic resonance angiography revealed 11 additional extracardiac thoracic vascular abnormalities that were not found on cardiac catheterization. The kappa coefficient for the correlation of image quality and diagnostic value of gadolinium-enhanced magnetic resonance angiography by using a 4-point-scale (1 = nondiagnostic to 4 = excellent) assessed by 2 independent reviewers was excellent (mean score = 3.66), with superb interobserver agreement (kappa = 0.727-0.874). CONCLUSIONS: Free-breathing, gadolinium-enhanced magnetic resonance angiography is clinically feasible for detailed anatomic delineation and treatment planning of various extracardiac thoracic vascular abnormalities in young children with congenital heart diseases.

Cardiovascular Abnormalities↗
PubMed2006

Spontaneous isolated mesenteric fibromatosis: sonographic and computed tomographic findings with pathologic correlation.

Eight cases of spontaneous isolated mesenteric fibromatosis (SIMF) were retrospectively reviewed. Clinical presentations included palpable abdominal mass (n = 6), abdominal pain (n = 4), gastrointestinal bleeding (n = 2) and acute abdomen (n = 1). On sonography and computed tomography (CT), eight SIMFs (size range 3 to 24 cm, mean 14.8 cm) were categorized into four morphologic patterns: well-defined inhomogeneous, well-defined homogeneous, well-defined cystic or infiltrative mesenteric mass patterns. Well-defined inhomogeneous SIMF (n = 3) was correlated with the histopathologic finding of bundles of fibroblasts with unevenly intermingled hyaline and/or myxoid degeneration areas, whereas well-defined homogeneous SIMF (n = 2) showed scarce degenerative changes. Well-defined cystic SIMF (n = 2) were ascribed to the presence of large areas of myxoid and cystic degenerations. One SIMF presented as an infiltrative mesenteric mass and the patient died 10 months after diagnosis. Both cases of cystic SIMFs showed tumor recurrences and one patient died after 84 months. The other five patients were cured by radical tumor resection. In summary, sonography, similar to CT, is also useful for evaluating SIMF with protean morphologic features, ascribing to the underlying histopathologic changes with varied degrees of hyaline, myxoid or cystic degenerations.

Adult↗
PubMed2006

Atypical Kawasaki disease presenting as intestinal pseudo-obstruction.

Intestinal pseudo-obstruction in atypical Kawasaki disease (KD) is rare. A boy aged 2 years and 6 months presented with a 7-day history of fever, coffee-ground vomit, and abdominal pain. Abdominal radiography and ultrasound showed a dilated duodenum. Peeling of the skin on his fingers and toes developed on hospitalization day 9. Echocardiogram revealed right and left coronary artery dilatation compatible with KD. He was treated with 2 g/kg intravenous immunoglobulin (IVIG), with rapid resolution of fever and relief of abdominal pain. Follow-up abdominal radiography and ultrasound showed improvement of bowel dilatation. This case illustrates that atypical KD can present with intestinal pseudo-obstruction. A high index of suspicion is required for early diagnosis, and prompt treatment with IVIG is recommended.

Child, Preschool↗
PubMed2006

Imaging factors related to rotator cuff tear in patients with deltoid contracture.

BACKGROUND: Bony deformity and muscular malfunction around the shoulder induced by deltoid contracture may influence rotator cuff function and lead to subsequent tearing. The purpose of this study was to investigate the imaging and clinical factors related to rotator cuff tear in patients with deltoid contracture. METHODS: We retrospectively reviewed 48 shoulders in 44 patients with magnetic resonance imaging diagnosis of deltoid contracture and surgically-proven rotator cuff tear. These shoulders were subdivided into partial-thickness and full-thickness tear groups. Another 17 shoulders in 17 patients with deltoid contracture but no evident rotator cuff tear were included as the control group. The characteristics, including age, gender and imaging features, of these three groups were compared. RESULTS: Two patients who underwent initial operations for cuff tears required secondary operations for distal release of deltoid contracture. The age of patients with full-thickness tear was significantly greater than that of patients with partial-thickness tear or without tear. The winging angle of the glenoid (WAG) in the full-thickness tear group was significantly greater than that in the partial-thickness tear group. Patients with partial-thickness tear also had greater WAG than those without tear. However, WAG was not significantly correlated with the fibrotic size or age of the patient. CONCLUSION: In patients with deltoid contracture, age and WAG are associated with the development of rotator cuff tear. To prevent the occurrence of rotator cuff tear, early surgical release of deltoid contracture is highly recommended, especially in patients with greater WAG.

Adult↗
PubMed2006

T-fastener gastropexy and percutaneous gastrostomy under CT-fluoroscopic guidance in a patient with partial gastrectomy.

The real-time images of computed tomography (CT)-fluoroscopy provide an excellent means of guidance for percutaneous interventions. We describe the performance of T-fastener gastropexy and percutaneous gastrostomy under CT-fluoroscopic guidance in a 59-year-old woman who had received total pharyngolaryngectomy for hypopharyngeal cancer and partial gastrectomy with Billroth II anastomosis for bleeding gastric ulcer 10 years before this operation. The previous gastric operation altered the gastrointestinal anatomy and made conventional fluoroscopic-guided percutaneous gastrostomy extremely difficult and risky. The T-fastener gastropexy and percutaneous gastrostomy were accomplished smoothly in a single session using CT-fluoroscopic guidance. This modified method of percutaneous gastrostomy may be useful in patients with anatomic distortion due to previous gastric surgery.

Female↗
PubMed2006

Postpartum hemoperitoneum due to avulsion of pelvic uterine adhesion band.

A 31-year-old nulliparous woman presented in labor with preterm rupture of membranes at 35 weeks of gestation. The ensuing intrapartum course was uneventful, and she delivered a healthy infant (birth weight, 2,850 g) vaginally. Four hours after delivery, the patient had a syncopal episode due to hypovolemic shock. At laparotomy, a fibrous band between the right fallopian tube and uterus was found to be avulsed and actively bleeding, confirming preoperative findings obtained with multidetector row computed tomographic angiography.

Adult↗
PubMed2006

Metastatic malignant pleural mesothelioma to the breast.

A 51-year-old woman suffered from dyspnea for several days before she came to an outside clinic for help. Pleura biopsy was performed and the histologic diagnosis was malignant mesothelioma. Sixteen months later, a palpable left breast lump was noted. Physical examination revealed a firm mass in the breast, measuring about 4 x 3.5 cm in size. Breast sonography showed a hypoechoic mass about 3 x 2 x 1.5 cm in size with irregular border in the middle part of the left breast. A mammogram revealed a speculated mass. Chest computed tomography was also performed, which revealed a large pleural mesothelioma and an irregular breast lesion. Incisional biopsy of the left breast lump was performed and histologic examination revealed an infiltrative growth of neoplastic polygonal cells bearing hyperchromatic and pleomorphic nuclei and a small amount of pale, pinkish cytoplasm. Further immunohistochemical study was performed and the tumor cells were positive for low and high molecular weight cytokeratin, thrombomodulin and focally positive for CEA. The final histologic diagnosis was metastatic malignant mesothelioma.

Breast Neoplasms↗
PubMed2006

Primary myxoid solitary fibrous tumor involving the seminal vesicle.

Although focal myxoid change is a well-recognized feature of solitary fibrous tumor (SFT), predominantly myxoid SFT are exceedingly rare. Reported herein is the case of a 65-year-old man with SFT containing abundant myxoid matrix, arising from the capsule of the right seminal vesicle. To the authors' knowledge this is the first myxoid SFT involving the male genito-urinary system. Recognition of the myxoid variant of SFT is crucial, given possible confusion with a variety of myxoid spindle cell neoplasms with different biological potential in the pelvic cavity.

12E7 Antigen↗
PubMed2005

Calcified reticulate rind sign: a characteristic feature of gossypiboma on computed tomography.

We herein report a gossypiboma resulting from a retained surgical swab, which had been left in peritoneum for 20 years after appendectomy. CT revealed a cystic mass with a calcified reticulate rind. Subsequent surgery and pathological examination showed a gossypiboma. A simple experiment, using a barium-soaked surgical swab demonstrating similar CT appearance, supported our postulation that calcium deposition on the reticulated fibers of a surgical swab could generate such a characteristic "calcified reticulate rind" sign. We believe that identification of this CT sign facilitates the diagnosis of gossypibomas.

Adult↗
PubMed2005

Retrotracheal thymoma masquerading as esophageal submucosal tumor.

A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.

Adult↗
PubMed2005

Survival outcome of lobar or segmental transcatheter arterial embolization with ethanol-lipiodol mixture in treating hepatocellular carcinoma.

AIM: To evaluate the clinical outcome and cost-effectiveness of transcatheter arterial ethanol-lipiodol embolotherapy on hepatocellular carcinoma (HCC). METHODS: One hundred patients with HCC who were treated only by lobar or segmental transarterial embolization (TAE) with ethanol-lipiodol mixture were enrolled in this study. The 1st- and 2nd-year survival rates were analyzed to evaluate the feasibility of its method. These outcomes of our patients were individually correlated to the Child-Pugh classification and the computed tomographic features of HCC. RESULTS: The overall 1st- and 2nd-year survival rates were 72% and 46%, respectively. The patients were classified into three groups according to their liver function status: 68 patients as Child-Pugh class A, 26 as Child B, and 6 as Child C. Child A had better survival rate than the Child B and/or C. The 1st-year survival rates of patients with Child A-C were 84%, 50%, and 33.3% respectively and the 2nd-year survival rates were 55.5%, 28.5%, and 33.3%, respectively. According to the computed tomographic features, solitary HCC with maximum diameter less than 5 cm had the best outcome with the 1st-year survival rate of 100% and the 2nd-year survival rate of 71.4%, while solitary HCC with maximum diameter over 5 cm and multiple HCC had the 1st-year survival rates of 75% and 63.7%, respectively, and the 2nd-year survival rates of 33.3% and 44.4%, respectively. Only one patient was complicated with abscess formation and was cured with antibiotic therapy. No mortality resulted from the procedures performed. CONCLUSION: TAE with ethanol-lipiodol mixture is an economic, safe and feasible method for treating HCC, especially for the patients with smaller solitary HCC or with liver function status of Child-Pugh class A.

Adult↗
PubMed2005

Extended survival in a patient with recurrent and metastatic adrenal cortical carcinoma by aggressive transarterial embolization--a case report.

The prognosis of inoperable recurrent or metastatic adrenal cortical carcinoma is poor due to lack of effective treatment modalities. We report a case of recurrent and metastatic adrenal cortical carcinoma in which prolonged survival of 58 months was achieved with aggressive three sequential transarterial embolization. It is probably the first reported case with the longest survival by transarterial embolization in the literature to date. A 60-year-old man received operation for left adrenal cortical carcinoma. Liver metastases, tumor bed recurrence, and spleen metastasis were noted during follow-up. Three sequential transarterial embolization for metastatic liver tumors, tumor bed recurrence, and metastatic spleen tumor were performed and resulted in relief of symptoms and prolonged survival of 58 months after recurrence verified. Aggressive transarterial embolization seems to be a safe and effective procedure for symptoms relief, and may prolong survival in the management of inoperable adrenal cortical carcinoma. It can be considered in any patient with inoperable adrenal cortical carcinoma if not contraindicated.

Adrenal Cortex Neoplasms↗
PubMed2005

Antral web associated with distal antral hypertrophy and prepyloric stenosis mimicking hypertrophic pyloric stenosis.

A 3-year-old boy presented with postprandial vomiting and epigastric pain for 3 wk. Barium meal study suggested hypertrophic pyloric stenosis. Ultrasound of the stomach after water loading revealed an echogenic antral web with an eccentric aperture and distal antral hypertrophy. Subsequent endoscopy confirmed the ultrasound findings. Web resection and antropyloroplasty resulted in excellent recovery. To our knowledge, the barium meal and ultrasound findings of an antral web-associated distal antral hypertrophy and prepyloric stenosis has not previously been described.

Barium↗