Publications by authors named "Paul Choi"

Introduction: The accuracy of fenestrations in stent grafts for complex aortic aneurysms and dissections can be significantly improved using three-dimensional (3D)-printed phantoms. Standardization is enhanced by using artificial intelligence (AI) for image pre-processing before 3D printing. These methods address fallacies in centerline image analysis and manual image pre-processing.

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Resting heart rate variability (HRV) is typically higher in those with better emotional well-being. In the current study, we examined whether changes in resting HRV mediated changes in negative emotions during a 7-week clinical trial of HRV biofeedback. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5 weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); or (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-).

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Introduction: Extramammary Paget disease (EMPD) is an uncommon malignant cutaneous neoplasm that are divided into primary and secondary forms. In this multicenter study, histologically proven cases of primary and secondary EMPD were reviewed for clinical outcomes with subgroup analysis for secondary EMPD.

Methodology: Cases of EMPD were identified from pathology report of the involved institutions over a period of over 2 decades.

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A 74-year-old Chinese man underwent extracapsular cataract extraction in his right eye and developed a translucent iris membrane 4 months later. He was treated with two intracameral 5-FU injections and membranectomy at 2 weeks apart. At one year following the second membranectomy, the patient maintained a clear cornea without residual or recurrent membrane, an endothelial cell density of 1072 cell/mm, a visual acuity of 20/50 and a normal intraocular pressure.

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Immune thrombocytopenic purpura (ITP) is a challenging condition to manage especially when conventional treatment methods, including splenectomy, fail. This report evaluates the effectiveness of laparoscopic removal of accessory spleen for chronic refractory ITP after an initial splenectomy. A 73-year-old African American male with a history of ITP, previously treated with laparoscopic splenectomy nine years ago, presented with severe thrombocytopenia that was found to be refractory to medical therapies.

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Fabry disease (FD) is a rare X-linked lysosomal storage disorder that commonly manifests cardiovascular complications. We aimed to assess the prevalence of FD in a Chinese population with left ventricular hypertrophy (LVH) whilst implementing a gender-specific screening approach. Patients with LVH, defined as a maximum thickness of the left ventricular septal/posterior wall ≥ 13 mm, were considered eligible.

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Article Synopsis
  • The study investigates the use of PRAME immunostaining to diagnose genital melanocytic lesions, including invasive melanoma and atypical genital nevi, reporting that PRAME has shown significant promise in confirming malignancy.
  • After analyzing 66 cases, results indicated that invasive melanoma and melanoma-in-situ had much higher PRAME expression compared to atypical genital nevi and other benign lesions, suggesting that PRAME can help differentiate between these conditions.
  • However, the findings also caution that low levels of PRAME expression, particularly in atypical genital nevi, should not be seen as conclusive evidence of malignancy, highlighting the need for thorough histological examination.
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Percutaneous central venous catheterization, despite ultrasound guidance, is known to carry significant risks. While central venous catheters are widely used in clinical practice, they are also associated with various complications, including incorrect positioning during insertion. Arterial puncture is a well-recognized complication, and although unintended subclavian or carotid artery cannulation is rare, it can lead to serious consequences.

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Introduction: Inferior vena cava (IVC) filters act in preventing pulmonary embolisms (PE). Various complications have been reported with their use. However, a credible urological complication rate, filter characteristics, and clinical presentation has yet to be summarized.

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Article Synopsis
  • The celiacomesenteric trunk (CMT) is a rare anatomical variation that connects the celiac artery and superior mesenteric artery (SMA), having important clinical implications for surgeries and patient management.
  • A case study of a 99-year-old woman with septic shock uncovered an incidental CMT, along with significant lab findings indicating severe illness, requiring immediate medical intervention.
  • Complications related to CMT, such as stenosis or thrombosis, could lead to complex surgical procedures, highlighting the necessity for healthcare professionals to thoroughly understand these risks to prevent complications in critically ill patients.
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Background: In healthy people, the "fight-or-flight" sympathetic system is counterbalanced by the "rest-and-digest" parasympathetic system. As we grow older, the parasympathetic system declines as the sympathetic system becomes hyperactive. In our prior heart rate variability biofeedback and emotion regulation (HRV-ER) clinical trial, we found that increasing parasympathetic activity through daily practice of slow-paced breathing significantly decreased plasma amyloid-β (Aβ) in healthy younger and older adults.

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Anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis is characterized by serological detection of anti-MDA5 antibody and rapidly progressive interstitial lung disease. In this study, the largest cohort of skin biopsies to date of anti-MDA5 dermatomyositis was reviewed and compared with cases of dermatomyositis with negative serology. Findings contribute to the histological diagnosis and evaluation of the severity of cutaneous inflammation in anti-MDA5 dermatomyositis.

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We present data from the Heart Rate Variability and Emotion Regulation (HRV-ER) randomized clinical trial testing effects of HRV biofeedback. Younger (N = 121) and older (N = 72) participants completed baseline magnetic resonance imaging (MRI) including T-weighted, resting and emotion regulation task functional MRI (fMRI), pulsed continuous arterial spin labeling (PCASL), and proton magnetic resonance spectroscopy (H MRS). During fMRI scans, physiological measures (blood pressure, pulse, respiration, and end-tidal CO) were continuously acquired.

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Background: Poorly controlled post-operative pain following Posterior Spinal Instrumented Fusion (PSIF) for scoliosis may be associated with delayed ambulation and longer hospital stays. Multimodal analgesia use has been shown to provide superior analgesia with improved recovery and reduction of post-operative morbidity in other orthopedic subspecialties, but has not been described with pediatric patients undergoing spinal surgery.

Objective: We describe a novel, pre-emptive, opioid-sparing pediatric pain medication protocol that is started two days prior to surgery, in accordance with first-order pharmacokinetics, and continued post-operatively until discharge with the goal of decreasing post-operative pain, improving early mobilization, and ultimately decreasing the patient's length of hospital stay.

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Unlabelled: Purpose To report the first series of Mohs micrographic surgery (MMS) in Hong Kong, where the roles of a Mohs surgeon were shared and coordinated by a "mobile" surgeon.

Methods Design: Prospective non-comparative interventional case series.

Subjects: 20 consecutive Chinese patients (10 male, age 78.

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The purpose of this study was to assess if behavior and emotional function, as measured by the Pearson Behavioral Assessment Survey for Children, Second Edition (BASC-2) in patients and parents, changes with differing treatment protocols in patients with adolescent idiopathic scoliosis (AIS). One previous study showed abnormal BASC-2 scores in a substantial number of patients diagnosed with AIS; however, no study has assessed how these scores change over the course of treatment. AIS patients aged 12 to 21 years completed the BASC-2.

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Background: Pemphigus is a group of immunobullous dermatoses characterized by the presence of autoantibodies directed against adhesion molecules of keratinocytes, with pemphigus vegetans being the rarest form, accounting for 1%-2% of all cases of pemphigus. Pemphigus vegetans is characterized by verrucous vegetative lesions in addition to vesiculobullous lesions.

Methods: We report a rare case of pemphigus vegetans presenting as an isolated vegetative lesion in the groin 3 months prior to the development of blisters.

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Previous studies indicate that the structure and function of medial prefrontal cortex (PFC) and lateral orbitofrontal cortex (OFC) are associated with heart rate variability (HRV). Typically, this association is assumed to reflect the PFC's role in controlling HRV and emotion regulation, with better prefrontal structural integrity supporting greater HRV and better emotion regulation. However, as a control system, the PFC must monitor and respond to heart rate oscillatory activity.

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The use of immunostain for PRAME antigen is well established for cutaneous melanolocytic lesions. However, its staining in other cutaneous structures and lesions is under reported. This study assessed PRAME staining in a large cohort of normal skin tissue, sebaceous lesions, and cutaneous carcinomas to better delineate patterns of PRAME immunoreactivity.

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Electrocorticography (ECoG) is a conventional, invasive technique for recording brain signals from the cortical surface using an array of electrodes. In this study, we developed a highly flexible 22-channel ECoG microelectrode array on a thin Parylene film using novel fabrication techniques. Narrow (<40 µm) and thin (<500 nm) microelectrode patterns were first printed on PDMS, then the patterns were transferred onto Parylene films via vapor deposition and peeling.

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Purpose: To evaluate the readability, understandability, and actionability of online patient education materials (OPEM) related to breast cancer risk assessment.

Material And Methods: We queried seven English-language search terms related to breast cancer risk assessment: breast cancer high-risk, breast cancer risk factors, breast cancer family history, BRCA, breast cancer risk assessment, Tyrer-Cuzick, and Gail model. Websites were categorized as: academic/hospital-based, commercial, government, non-profit or academic based on the organization hosting the site.

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Operando experiments attract increasing attention in lithium-ion batteries (LIBs) studies for their ability to capture non-equilibrium and fast-transient processes during electrochemical reactions. They provide valuable information and mechanisms that cannot be obtained from ex-situ methods. Designing a suitable and reliable electrochemical cell is the first crucial step for most operando studies.

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We present a self-therapeutic nanoparticle for topical delivery to epidermal keratinocytes to prevent and treat psoriasis. Devoid of known chemical or biological antipsoriatic drugs, this sub-15 nm nanoparticle contains a 3 nm gold core and a shell of 1000 Da polyethylene glycol strands modified with 30% octadecyl chains. When it is applied to imiquimod-induced psoriasis mice without an excipient, the nanoparticle can cross the stratum corneum and preferentially enter keratinocytes.

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Objective: To assess understandability, actionability, and readability of online patient educational materials (OPEM) related to breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Methods: Search volumes for query terms related to BIA-ALCL including "breast implant associated lymphoma," "breast implant associated anaplastic large cell lymphoma," and "BIA-ALCL" were analyzed in one-week increments and normalized to total Google search volume. The same terms were then queried using an online search engine to identify commonly accessed OPEM on this topic.

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