Retrograde thoracic duct embolization in an idiopathic case of chylopericardium.

This is a novel case of idiopathic chylopericardium and chylothorax in a young male who had no significant medical history. He first presented with dyspnea due to idiopathic chylopericardium, which was refractory to medical and surgical treatments, including a medium-chain triglyceride diet, octreotide, and video-assisted pericardial window. The chylopericardium persisted and progressed to concomitant left-sided chylothorax.

A case series of FDG PET scan: hypometabolic lesions that matter in oncology.

Interpretation of FDG PET images in oncology patients is in general a visual exercise of search for focal increased uptake (hypermetabolism). However, in some cases, hypometabolism (focal decreased uptake) can matter as much as hypermetabolism. We report three cases of FDG PET studies for oncological indications.

The diagnostic value of hepatobiliary scintigraphy for choledochal cysts in the era of magnetic resonance imaging with cholangiopancreatography and contrast-enhanced hepatobiliary phase: a case report and review.

Objective: Choledochal cysts (CCs) represent cystic dilatations of the intra- or extrahepatic biliary tract. The diagnosis of CCs may not always be straightforward particularly for the intrahepatic subtype. Whereas the gold standard for diagnosing CCs is endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP) is commonly used as primary diagnostic tool for delineation of biliary pathologies including CCs.

HIV status: the prima facie right not to know the result.

When a patient regains consciousness from Cryptococcus meningitis, the clinician may offer an HIV test (in case it has not already been done) (scenario 1) or offer to tell the patient his HIV status (in case the test has already been performed with a positive result while the patient was unconscious) (scenario 2). Youngs and Simmonds proposed that the patient has the prima facie right to refuse an HIV test in scenario 1 but not the prima facie right not to be told the HIV status in scenario 2. I submit that the claims to the right of refusal in both scenarios are similarly strong as they should both be grounded in privacy, self determination or dignity.

The policy statement of the American Academy of Pediatrics -- children as hematopoietic stem cell donors -- a proposal of modifications for application in the UK.

Background: With a view to addressing the moral concerns about the use of donor siblings, the Policy Statement of the American Academy of Pediatrics - Children as Hematopoietic Stem Cell Donors (the Policy) has laid out the criteria upon which tissue harvest from a minor would be permissible.

Discussion: Although tissue harvest serves the best interests of recipient siblings, parents are also obliged to act in the best interests of the donor sibling in the UK. Tissue harvest should proceed if and only if it serves the best interests of both the donor and recipient.

A child born with Edward's syndrome: the legal and moral duty to accede to the request for parentage determination.

Advances in medical technology inevitably bring about different kinds of ethical challenges for practising doctors. The following hypothetical case of assisted reproduction is presented as an example. A boy is born with Edward's syndrome following assisted reproduction.

Should we continue treatment for M? The benefits of living.

Wilkinson and Savulescu did not agree with the court's decision to continue M's treatment and suggested in their recent commentary that the magnitude of benefits of being alive for M is small compared with the potential use of health resources for other patients. We argue that the benefits of being sensate to the surroundings for an otherwise unconscious person are not necessarily small. One cannot assess on behalf of another person the magnitude of benefits of being alive according to the intensity or the duration of negative experiences.

The best interests of persistently vegetative patients: to die rather that to live?

Adults without the capacity to make their own medical decisions have their rights protected under the Mental Capacity Act (2005) in the UK. The underlying principle of the court's decisions is the best interests test, and the evaluation of best interests is a welfare appraisal. Although the House of Lords in the well-known case of Bland held that the decision to withhold treatment for patients in a persistent vegetative state should not be based on their best interests, judges in recent cases have still held that the best interests of persistently vegetative patients demand that the right to die with dignity prevails over society's interest to preserve life.

A public opinion survey: is presumed consent the answer to kidney shortage in Hong Kong?

Objective: To project the impact of an opt-out system (presuming consent) in Hong Kong on the likelihood that a potential donor donates his or her kidneys after death and the likelihood of violating a potential donor's autonomy.

Setting: Cross-sectional population-based anonymous telephone survey.

Participants: Random sample of 802 adults aged between 18 and 64.