Marcus Ying

RANDOMIZED TRIAL COMPARING PANTOPRAZOLE INFUSION, BOLUS AND NO TREATMENT ON GASTRIC pH AND RECURRENT BLEEDING IN PEPTIC ULCERS

Background:  To study the effects of pantoprazole on gastric pH and recurrent bleeding after endoscopic treatment for bleeding peptic ulcers.

Laparoscopic Intragastric Approach for Stromal Tumours Located at the Posterior Gastric Wall

Surgical resection is indicated for gastrointestinal stromal tumour (GIST). Laparoscopic resection with clear margins is effective in gastric GIST. However, GIST located in the posterior gastric wall with close proximity to the oesophagogastric junction poses special challenges. Laparoscopic intragastric resection offers a new approach to the management of these tumours. The surgical technique, our experience and a summary of the literature are presented.

A BRCA2 founder mutation and seven novel deleterious BRCA mutations in southern Chinese women with breast and ovarian cancer

Breast cancer incidence in Asia has doubled over the past 10 years and is one of the highest in Hong Kong [1]. Studies in western populations have found differences in breast cancer epidemiology between Asian and Caucasian populations, potentially due to interactions between different lifestyle and genetic characteristics [2–4]. As the genetic predisposition to breast cancer is increasingly understood, it has been suggested that there are differences in different ethnic populations. To date, only a few investigations on the spectrum of BRCA [5, 6] mutations in Chinese populations have been performed, most of which were performed in single institutions or a small number of medical centers [7–9]. Some studied only the BRCA1 gene [10, 11] and most did not perform mutational screening using conventional full gene sequencing [12, 13]. Between March 2007 and February 2008, patients with breast and/or ovarian cancer were recruited from the Hong Kong Hereditary Breast Cancer Family Registry, which was formed in March 2007. In this Registry, all patients were recruited from 11 government-based hospitals, private hospitals, and clinics that cover all three areas of Hong Kong. Sequence analysis of all exons in BRCA1 and BRCA2 of a total of 119 high-risk female probands were

Minimally invasive technology in the management of breast disease

Minimally invasive surgery is gaining popularity around the world because it achieves the same or even superior results when compared to standard surgery but with less morbidity. Minimally invasive breast surgery is a broad concept encompassing new developments in the field of breast surgery that work on this minimally invasive principle. In this regard, breast-conserving surgery and sentinel lymph node biopsy are good illustrations of this concept. There are three major areas of progress in the minimally invasive management of breast disease. First, percutaneous excisional devices are now available that can replace the surgical excision of breast mass lesions. Second, various ablative treatments are capable of destroying breast cancers in situ instead of surgical excision. Third, mammary ductoscopy provides a new approach to the investigation of mammary duct pathology. Clinical experience and potential applications of these new technologies are reviewed.

Intra-operative Assessment of Axillary Sentinel Lymph Nodes by Frozen Section—An Observational Study of 260 Procedures

BACKGROUND Sentinel lymph node biopsy (SLNB) has become the standard treatment for patients with invasive breast cancer. Intra-operative frozen section allows for the detection of nodal metastases, thereby allowing a simultaneous axillary lymph node dissection (ALND) for those patients with nodal metastases. We herein report the accuracy of frozen section in the detection of SLN metastases. METHODS Patients with operable breast cancer and clinically negative axillae were recruited for SLNB. The SLNs were identified by blue dye, an isotope, or a combination. Enlarged lymph nodes that were not SLNs were also excised. All nodes were examined by intra-operative frozen section. ALND was performed if frozen section was positive. For those without metastases on frozen section, ALND was not performed. All lymph nodes underwent further paraffin sectioning with immuno-histochemical staining. RESULTS A total of 260 SLNB procedures were performed for invasive carcinoma over a 3-year period. The SLN was identified in 93.5% of patients. Of the 243 successful procedures, 53 had nodal metastases on frozen section. A total of 33 patients had false-negative frozen sections (false-negative rate, 38.4%), and 97% of them were less than 2 mm in size. The false-negative rate for macro-metastases, micro-metastases, and isolated tumour cells_were 2.4%, 57.7%, and 94.4%, respectively (p < 0.0001). A total of 22 patients had delayed ALND, and the re-operation rate was 8.5%. CONCLUSION Frozen section was useful for the detection of nodal metastases in the SLNs and allowed for ALND to be performed in the same operation. The main failure of frozen sections was in the detection of micro-metastases.

Communicative characteristics of interactions between surgeons and Chinese women with breast cancer in oncology consultation: a conversation analysis

While previous studies have analysed features of interaction in cancer consultations using observational coding frames, relatively little attention is being given to how actual interactions are sequentially organized and achieved by participants in the course of talk‐in‐interaction. Research into the interactional practices in consultations, which involves Chinese patients, is largely absent.