Gastroscopy (1)

1. What is Gastroscopy?

Gastroscopy is the use of endoscope, going into upper digestive system through the patient's mouth, esophagus, into the stomach, duodenum and jejunum. The doctor can observe the internal status in order to carry out the examination, diagnosis and appropriate treatment.

2. What is the function of Gastroscopy?

By the use of endoscope, doctor can check the internal conditions of the upper digestive system (esophagus, stomach, duodenum and jejunum). If necessary, the doctor can perform some treatments as follow:

    Biopsy collection for lab test
    Removal of foreign body
    Varicose veins treatment
    Laser treatment
    Pyloroplasty for Pyloric Stenosis
    Polypectomy
    Inner lining hemostasis


3. Before Gastroscopy, what do I need to prepare and pay attention?

Points to note for patients before gastroscopy:

Sign the consent form for receiving gastroscopy examination or treatment after well understanding with doctor’s explanation.
   
Do not eat within 6 hours before the examination in order to avoid aspiration when inducing vomiting, and provide a clear vision view for gastroscopy.
   
Follow doctor’s instruction for arrangement of taking the chronic illness medication (diabetes, hypertension, or drug allergy).
   
Follow the date, time and place for meeting the appointment of the gastroscopy.

.......cont'l











Reference information:  http://esteemmedical.com.hk/gastroscopy.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your physicians for diagnosis and treatment. 

香港是醫療品牌

經常有香港境外的病人,特地來香港求醫做手術,有的是在國內工作的外籍人士、有的是國內居民、澳門居民、也有些是已經移民外地的香港人,即使山長水遠、長途跋涉,費用也不特別便宜,他們也要選擇香港作為他們動手術治病的地方,把健康與生命交托,原因為何?

香港的手術醫療水平,是否世界頂尖、傲視同儕、我不敢說,但可以肯定的是沒有「落後大市」。香港作為國際城市,外科醫生要接觸世界先進的醫療技術及知識,可說是易如反掌,在香港舉行的國際醫學會議,多不勝數;差不多每位外科醫生都曾到其他國家觀摩學習,眼光及思想都是國際化的。而香港的醫療語言,仍是以英語這國際語言為主,故醫療水平要與國際接軌,絕不困難。這些我們行內習以為常,看似芝麻綠豆的東西,看在病人眼中,就是信心的來源。

即使醫生信得過,那醫院呢?打針的護士呢?化驗室的技術員呢?注射的抗生素呢?手術室的儀器呢?醫療系統環環相扣,莫說是行外人,即使是醫生也沒可能事事過問,親力親為。這些事情,病人信任的就是「香港」這個品牌,他們印象中這品牌下的各行各業,無論是法官丶警察、醫生、護士或記者都是專業、廉潔及可信的。這品牌的正面形象,並非一朝一夕而成,是源自長久以來香港健全的社會體制,一點一滴地建立的。希望日後的社會改革,不會影響這品牌的形象。

外科專科醫生
謝卓華

新聞來源: AM730
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向醫生查詢，而不應單倚賴以上提供的資料。

慢性疾病-周邊血管疾病

周邊血管疾病(peripheral vascular disease, PVD)是由下肢血管收窄、硬化或被脂肪阻塞所致，減少血流到小腿及足部。足部血液循環會最受影響，因為血液循環欠佳，沒有血液把養份(包括氧氣)帶到傷口，妨礙傷口修復。一旦有任何潰瘍、傷口、感染等在足上形成後，若傷口缺乏專業的護理，會需要更長的痊癒時間。徵狀嚴重情度需視乎動脈的大小及血流受阻的程度。

部份徵狀包括:

間歇性跛行(Claudication): 步行一段距離後，小腿會出現輕微抽筋的現像，休息一回便會復原。

•     腳/腳趾麻痺或刺痛
•     皮膚變色(變白/藍/紅)
•     足部皮膚溫度較低
•     皮膚破損，傷口或感染需要更長時間才痊癒

資料來源:   http://podi.com.hk/peripheral-vascular-disease.html
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向醫生查詢，而不應單倚賴以上提供的資料。

「糖尿足」引發的傷口

在之前的文章指出過，足部的傷口大多跟下肢血管疾病有關。而糖尿病患者，就特別容易出現下肢動脈血管阻塞，故引發潰瘍並發症的機會也特別高，亦即「糖尿足」。

糖 尿足的成因，跟血糖控制不理想有關，患者的足部末梢神經會受影響，令足部感覺遲緩、麻木，即使於日常生活當中如鞋子太窄、走路過多、或剪甲而出現傷口，亦 未必及時察覺。糖尿病人的動脈血管，亦容易出現末端微絲血管閉塞及中小型血管硬化及收窄的情況，導致足部供血變差，令傷口較難愈合。另外，糖尿病人的傷口 是特別容易受感染的，細菌也可很快地蔓延至腿部其他位置，令情況惡化得很快，甚至因此需要截肢保命。

故糖尿病患者若出現足部傷口時，實不 應掉以輕心。現時醫學上傾向使用較進取的方法治療，第一時間會檢查足部傷口有否受感染並處方抗生素治療、透過量度足部血壓並與手部血壓作對比，評估足部動 脈有否阻塞，有需要時，可進一步進行電腦掃描，檢視動脈血管的閉塞情況及受影響位置。

確認問題後，血管外科醫生可透過微創手術，將有問題的血管位置擴張打通，從而恢復血流暢通，避免糖尿足情況惡化而引起的截肢，甚至有生命危險的風險。

外科專科醫生謝卓華

新聞來源: www.am730.com.hk/column-289612
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向醫生查詢，而不應單倚賴以上提供的資料。

Causes of Goiter

Goiters are not equivalent to hyperthyroidism. Goiter describes hyperplasia of the thyroid gland which most commonly due to problems with the immune system. However, the increase in size of the thyroid gland does not have any relationship with the amount of hormone to be secreted.

In the more underdeveloped countries, goiters could be caused by iodine deficiency, as patients may not be able to intake enough iodine from seafood to fulfill their body needs. This causes the thyroid hormones T3 and T4 in the blood to be lower than normal, prompting the pituitary glands to continuously secrete TSH (Thyroid Stimulating Hormones), stimulating growth of the thyroid glands.

Amazing Seaweed – Nutritious, Low in Calorie and Prevent Goiter

 

Seaweed, which grows in the ocean, has excellent source of minerals especially iodine that can possess powers to prevent goiter. Goiter refers to over-production of thyroid hormones, leading to enlargement of the thyroid glands. Iodine is essential to maintain proper functioning of thyroid glands, which helps to regulate body’s metabolism, growth, temperature, heart rates etc., and deficiency in iodine can lead to a disease called goiter. Large and thick neck resulted from goiter that affects nearby organs such as esophagus and trachea may lead to dysphagia and breathing difficulty, while stunted growth and mental retardation can be seen in children with goiter due to hypothyroidism.

Seaweed is categorized into three main groups, and they are red, green, and brown seaweeds. Brown seaweed has the highest iodine content, with dry kelp contains 1500-8000 ppm (parts per million), while red and green seaweeds have lower contents, about 100-300 ppm in dried seaweed, but still considered as high when compared to other land plants. Adults and children who are actively growing are recommended to have a daily intake of 150 µg and 90-120 µg iodine respectively, which is actually covered by very little amount of seaweed, as only one gram of dried brown seaweed can already provide 500-8,000 µg of iodine. Thus, just a tablespoon of seaweed is already enough for recommended daily intake.

In addition to iodine, seaweed is also an excellent source of calcium and iron, which is especially suitable for vegetarians who avoid dairy and meat products. Therefore, seaweed is highly recommended to be included in our diet. This can be done by sprinkling kelp flakes onto a salad or soup, wrapping rice or vegetables using nori sheets or having seaweeds snacks during tea time. Although iodine intake may be related to the situation of Goiter, other factors can also lead to Goiter. Thus, it is recommended to seek a doctor immediately for medical check when the problem of thyroid enlargement arises.




Reference information: http://www.thyro.com.hk/goiter-thyroid.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your doctor for diagnosis and treatment.

手術是科學嗎?

醫學的知識,博大精深,每天都有推陳出新,日新月異的資訊.在醫學院五年的訓練,只是學習基本的理論,實戰經驗要待畢業後,正式接觸病人,在前輩醫生的指導下,才能慢慢地累積.這情況在外科手術的範疇,就特別明顯.

訓練出一位有獨立能力的外科醫生,畢業後動輾需要十年八年,或更長的時間.什麼時候動什麼手術,一般來說,可根據前人的經驗總結,及記載在於文獻上的數據作為參考,形成一套套路.而這些文獻上的醫學資訊,在香港這國際城市,基本上與世界的先進國家,是差不多同步接軌的.因此醫生選擇哪一種治療方案時,必須有理有據,並有文獻上的證據支持,這便是醫學上的「實證醫療」.

一間公司的老闆,可以根據自己的喜好,指示員工按他的主意辦事,反正賺蝕都是老闆的.但在醫學上,無論是老闆、上司或特首,也不能要醫生作出一些不合情理的醫治方案.這便是「專業」,而專業的決定是建基於科學的研究及分析之上的.因此專業自主,是一個健全社會必須要全力維護的.

話雖如此,醫學上也總有一些灰色地帶,未有實證作指引.況且科技日新月異,手術的方法跟昔日也大有不同,總不能一本通書讀到老.這些情況,很多時是進退兩難、模棱兩可的. 那便要靠醫生的判斷、風險的管理、及對自己手術的信心,當然亦要考慮病人及家屬的意願.在這艱難情況下的醫治,已不單是科學,更是藝術!



外科專科醫生謝卓華

新聞來源: AM730
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向醫生查詢，而不應單倚賴以上提供的資料。

What is Peripheral Arterial Disease?

What is Peripheral Arterial Disease?

Peripheral arterial disease (PAD) is a chronic disease usually due to atherosclerosis, when the atheromatous plaque cause thickening of the arterial wall, resulting in narrowing or occlusion of the arteries. This problem can occur in all arteries from the body, but one of the commonest site is the arteries of the legs.

What are the risk factors of PAD?

The following are the risk factors of atherosclerosis and its associated diseases which could increase the risk of developing cardiovascular and cerebrovascular diseases.
 
These include:

• Aging (over 50 years old);
• Smoking;
• High cholesterol;
• Diabetes;
• High blood pressure;
• Chronic kidney disease;

High plasma levels of homocysteine elevated fibrinogen concentration;
Personal history of vascular disease, heart attack or stroke, and
Family history of premature atherosclerosis.

Patients with PAD are suggested to have evaluation and control of underlying cardio and cerebrovascular diseases, and atherosclerosis risk factors.

 
Clinical Classification of PAD

The varieties of signs and symptoms present help doctor to stage the severity of PAD for patients. The most commonly used methods are the Fontaine and Rutherford classification which classify the disease based on the following 4 categories of symptoms:

Asymptomatic: Most of the patients are asymptomatic, but with clinical examination such as palpation and checking the Ankle-Brachial Index (ABI) may reveal cold extremities, and other signs of incomplete blood vessels obstruction.



Intermittent Claudication (IC): Fatigue; heaviness; tiredness or cramping in the lower extremity precipitated by walking or exercise and relieved with rest. The location of the pain depends on the site of occlusion of the artery, but the commonest site is at the calf.

 

Critical Limb Ischaemia (CLI): Leg pain persist even at rest; decrease temperature of leg; toe or leg sores, wounds that do not heal, or heal very slowly; loss of hair on the skin; brittle nail, with absent or diminished pulse in the legs. Patients in this condition must be referred to a vascular surgeon ASAP to prevent limb loss.

 

Ulceration or gangrene: Minor to major tissue loss due to severe arterial occlusion, with non-healing wound in foot & ankle, or the toes turn black in color. Patients with this condition must be urgently referred to a vascular surgeon for revascularization in order to salvage the limb.

Reference information: http://esteemmedical.com.hk/peripheral-arterial-disease-cause.html 
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your doctor for diagnosis and treatment.