Safety and efficacy of the DragonFly system for transcatheter valve repair of degenerative mitral regurgitation: one-year results of the DRAGONFLY-DMR trial.

Background: Severe degenerative mitral regurgitation (DMR) can cause a poor prognosis if left untreated. For patients considered at prohibitive surgical risk, transcatheter edge-to-edge repair (TEER) has become an accepted alternative therapy. The DragonFly transcatheter valve repair system is an innovative evolution of the mitral TEER device family to treat DMR.

Intracardiac echocardiographic imaging with a cartosound module for guidance of left atrial appendage closure: a comparative study with transesophageal echocardiographic imaging.

Purpose: In most clinical trials, intracardiac echocardiography (ICE) has provided fewer views than the four standard views provided by transesophageal echocardiography (TEE) when assessing left atrial appendage closure (LAAC) devices. This study aimed to determine if ICE guided by the CartoSound system achieve adequate high-quality views and similar clinical outcomes as TEE during LAAC.

Methods: This study prospectively enrolled 202 patients who underwent LAAC using either ICE (n = 69), TEE (n = 121), or a combination of ICE and TEE (n = 12) as the procedural imaging under local anesthesia.

Gamma knife radiosurgery versus deep brain stimulation for treatment-refractory depression and obsessive-compulsive disorder: A brief comparative summary.

Both gamma knife surgery (GKS) and deep brain stimulation (DBS) have documented success in management of treatment-refractory major depressive disorder (MDD) and obsessive-compulsive disorder (OCD), but there are no formal randomized controlled trials to compare these treatment modalities in cases of psychiatric illnesses. In this brief review, comparison of GKS and DBS for management of MDD and OCD was done with regard to their efficacy, accompanying risks, reversibility of therapeutic effects, costs, availability, and daily life issues. Currently available evidence does not support the superiority of either evaluated treatment modality over each other in terms of clinical efficacy in cases of MDD and OCD.

The feasibility and safety of "one-stop" left atrial appendage closure and percutaneous coronary intervention in atrial fibrillation patients with significant coronary artery disease (PCI-LAAC study).

Background: The anti-thrombotic strategy for patients with atrial fibrillation (AF) who have undergone percutaneous coronary intervention (PCI) for coronary artery disease (CAD) is a common and difficult challenge. This pilot study aimed to assess the feasibility and safety of "one-stop" left atrial appendage closure (LAAC) combined with PCI as an alternative stroke prophylaxis strategy.

Methods: From March 2017 to October 2019, AF patients with elevated bleeding risk and significant stable CAD requiring PCI were recruited to undergo LAAC as alternative stroke prophylaxis in Fuwai Hospital, Beijing, China.

Sex differences in patients undergoing transcatheter aortic valve replacement in Asia.

Objectives: Transcatheter aortic valve replacement (TAVR) is increasingly performed. Physically small Asians have smaller aortic root and peripheral vessel anatomy. The influence of gender of Asian patients undergoing TAVR is unknown and may affect outcomes.

Apalutamide and Overall Survival in Prostate Cancer.

Background: The phase 3 SPARTAN study evaluated apalutamide versus placebo in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) and prostate-specific antigen doubling time of ≤10 mo. At primary analysis, apalutamide improved median metastasis-free survival (MFS) by 2 yr and overall survival (OS) data were immature.

Objective: We report the prespecified event-driven final analysis for OS.

Near-complete regression 19 years after Gamma Knife radiosurgery of vestibular schwannoma with massive pseudoprogression: case report.

Gamma Knife radiosurgery (GKRS) is a frequent treatment choice for patients with small- to moderate-sized vestibular schwannoma (VS). However, pseudoprogression after GKRS is commonly observed, with a reported incidence ranging from 7% to 77%. The wide range of the reported incidence of pseudoprogression reflects the fact that there is no consensus on how it should be diagnosed.

Small bowel obstruction from barbed suture following laparoscopic myomectomy-A case report.

Myomectomy is commonly performed for symptomatic fibroids in women who wish to conserve fertility. Laparoscopic myomectomy provides advantages as a minimally invasive procedure. To facilitate the closure of the uterine wound after enucleation of the fibroid, barbed sutures have been introduced as they can shorten the operative time and reduce the amount of bleeding.

Prevalence of abnormal Papanicolaou smears in female sex workers in Hong Kong.

OBJECTIVE. To investigate the prevalence of pre-cancerous uterine cervix lesions as detected in Papanicolaou (Pap) smears from female sex workers in Hong Kong. DESIGN.

A modified technique of LAVH with the Biswas uterovaginal elevator.

This was a review of 512 consecutive cases of laparoscopic-assisted vaginal hysterectomy (LAVH) for benign gynecologic conditions with the Biswas uterovaginal elevator (BUVE) from February 2003 through June 2008. A single operator, using the BUVE and a standard surgical protocol, performed all hysterectomies. Variables analysis included patient demographics, operative times, uterine weight, hospital stay, intraoperative blood loss, and intraoperative and postoperative complications.

The significance of endocervical cells and metaplastic squamous cells in liquid-based cervical cytology.

We conducted a retrospective study to investigate whether the presence or absence of endocervical cells (EC) and metaplastic squamous cells (MSC) was associated with the detection of squamous intraepithelial lesions in liquid-based cervical cytology. 90,376 cases of liquid-based cervical cytology smears received in 2006 were included in the study. Low-grade (LSIL) and high-grade squamous intraepithelial lesions (HSIL) were classified according to the Bethesda system (2001).

Characteristics of false-negative ThinPrep cervical smears in women with high-grade squamous intraepithelial lesions.

Objective: To examine the cellular characteristics and other possible factors affecting the correct prediction of ThinPrep cervical smears from patients with high-grade squamous intraepithelial lesions.

Design: Retrospective study.

Setting: Private anatomical pathology service, Hong Kong.

Breast pathology in complications associated with polyacrylamide hydrogel (PAAG) mammoplasty.

Objective: To study the tissue pathology of breast lesions associated with hydrophilic polyacrylamide gel injection augmentation mammoplasty.

Design: Retrospective study.

Setting: Private anatomical pathology practice, Hong Kong.

Clinical relevance of intra-operative sentinel lymph node examination in breast cancer management.

Objectives: To determine the sensitivity, accuracy, and clinical relevance of intra-operative examination of sentinel lymph nodes in breast cancer management.

Design: Retrospective study.

Setting: Private anatomical pathology practice.

Study of scattered photons from the collimator system of Leksell Gamma Knife using the EGS4 Monte Carlo code.

In the algorithm of Leksell GAMMAPLAN (the treatment planning software of Leksell Gamma Knife), scattered photons from the collimator system are presumed to have negligible effects on the Gamma Knife dosimetry. In this study, we used the EGS4 Monte Carlo (MC) technique to study the scattered photons coming out of the single beam channel of Leksell Gamma Knife. The PRESTA (Parameter Reduced Electron-Step Transport Algorithm) version of the EGS4 (Electron Gamma Shower version 4) MC computer code was employed.

Prolonged survival in a subgroup of patients with brain metastases treated by gamma knife surgery.

Object: The authors analyzed the factors involved in determining prolonged survival (> or = 24 months) in patients with brain metastases treated by gamma knife surgery (GKS).

Methods: Between 1995 and 2003, a total of 116 patients underwent 167 GKS procedures for brain metastases. There was no special case selection.

Dose enhancement close to platinum implants for the 4, 6, and 10 MV stereotactic radiosurgery.

Three photon interaction processes, namely, the photoelectric effect, Compton effect, and pair production, can occur when materials with high atomic numbers are irradiated by the high- and low-energy bremsstrahlung photons from a linear accelerator. A dose enhancement, due to the photoelectric effect and pair production, near targets with platinum implants (with a high atomic number) in radiosurgery cannot be predicted by the XKnife radiosurgery treatment planning system. In the present work, Monte Carlo simulations using PRESTA EGS4 were employed to investigate the resulting dose enhancements from 4, 6, and 10 MV energies commonly used in the stereotactic radiosurgery system.

Dose distribution close to metal implants in Gamma Knife Radiosurgery: a Monte Carlo study.

Materials with high atomic numbers favor the occurrence of the photoelectric effect when they are irradiated with gamma rays. Therefore, the photoelectric effects of metal implants within the target regions in Gamma Knife Radiosurgery are worth studying. In the present work, Monte Carlo simulations using EGS4 were employed to investigate the resulting dose enhancements.

Identification of treated target points for parkinsonism on gamma knife follow-up MR images.

Object: Identification of treated target points for Parkinsonism on follow-up MR images is difficult because of different orientations employed between the treatment and the follow-up MR scan. In the present work, the treated target points for Parkinsonism can be easily found, once the anterior-commissure (AC) and posterior-commissure (PC) have been defined in Leksell GammaPlan.

Methods: The follow-up MR images must first be defined with the Cartesian co-ordinate system using a non-fiducial based technique.

The accuracy of Papanicolaou smear predictions: cytohistological correlation of 283 cases.

The Papanicolaou smear is a highly effective screening test for the detection of cervical neoplastic changes. The success of the test has resulted in unrealistic expectations of the accuracy of the test by both referring medical practitioners and the public. However, as with any pathological test, it has irreducible false negative and positive rates.

Improved Papanicolaou smear reporting through the use of automated data entry.

The implementation of an automated data entry and report generation system using an optical scanner and commercially available image processing program is described. This method could be easily adapted for use in other fields of medical research where the compilation of a large amount of repetitive data is involved, such as the filling in of questionnaires. Using an optical scanner for data entry improves the efficiency of report generation, thereby improving the turnaround time of reports.