James Kong - Academia.edu (original) (raw)

Papers by James Kong

Research paper thumbnail of Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

The Lancet, 2003

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Research paper thumbnail of The Hong Kong Hospital Authority's Information Architecture

Medinfo 2004: Proceedings Of THe 11th …, 2004

Since 1994, the Hospital Authority has been developing and deploying clinical applications at its... more Since 1994, the Hospital Authority has been developing and deploying clinical applications at its constituent 39 hospitals and clinics. The Clinical Management System (CMS) is now used by over 4000 doctors and 20000 other clinicians to document and review care. Since 1999, the territory-wide integrated Electronic Patient Record (ePR) has given clinicians a longitudinal view of the data collected through the CMS and its adjunct systems. The ePR currently has nearly 3TB of data covering 44 million episodes for 6.4 million patients. This paper describes the Hospital Authority's Information Architecture, which allows the ePR to accept and integrate any clinical information from any internal or external system. The ePR operates in a high volume and high performance environment, yet only requires low maintenance, while still retaining the information structure and semantics required for advanced applications.

Research paper thumbnail of Fine Needle Aspiration Cytology of Ductal Breast Carcinoma with Neuroendocrine Differentiation

Acta Cytologica, 2002

To describe the fine needle aspiration cytology findings of ductal breast carcinoma with neuroend... more To describe the fine needle aspiration cytology findings of ductal breast carcinoma with neuroendocrine differentiation and correlate them with the histologic appearance. We reviewed the cytologic features of eight cases of ductal carcinoma with neuroendocrine differentiation in the files of Pamela Youde Nethersole Eastern Hospital during the three-year period 1998-2000. Immunohistochemical study for neuroendocrine markers was performed, with ultrastructural correlation. All cases showed similar cytologic features. The smears were of moderate to high cellularity with predominantly dispersed or loosely cohesive tumor cells. The carcinoma cells were mostly of low cytologic grade. They possessed round and relatively uniform, eccentric nuclei; finely stippled chromatin; sometimes small, distinct nucleoli; and discrete cell borders. Abundant eosinophilic and focally granular cytoplasm was a common finding. In some of the cases there was accentuation of staining in the paranuclear region; it correlated with aggregates of dense core neurosecretory granules seen ultrastructurally. Mucoid substance was seen in the background in some of the aspirates. Histologic examination of the tumors showed invasive ductal carcinoma with an organoid growth pattern and sometimes mucinous component. The neuroendocrine differentiation was confirmed immunohistochemically. Although this subtype of ductal carcinoma probably carries no significant prognostic value per se, it has distinct cytologic features, rendering preoperative diagnosis possible. Recognition of this entity is important in order to avoid the misdiagnosis of neuroendocrine tumor metastatic to the breast.

Research paper thumbnail of Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

BMJ global health, 2017

In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enab... more In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enable countries to measure their surgical and anaesthesia care delivery. These indicators have subsequently been accepted by the World Bank for inclusion in the World Development Indicators. With support from the Royal Australasian College of Surgeons and the Pacific Islands Surgical Association, 14 South Pacific countries collaborated to collect the first four of six LCoGS indicators. Thirteen countries collected all four indicators over a 6-month period from October 2015 to April 2016. Australia and New Zealand exceeded the recommended LCoGS target for all four indicators. Only 5 of 13 countries (38%) achieved 2-hour access for at least 80% of their population, with a range of 20% (Papua New Guinea and Solomon Islands) to over 65% (Fiji and Samoa). Five of 13 (38%) countries met the target surgical volume of 5000 procedures per 100 000 population, with six performing less than 1600. Four ...

Research paper thumbnail of Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

Lancet, 2003

We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epid... more We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epidemic in Hong Kong. The epidemic to date has been characterized by two large clusters, initiated by two separate "super-spread" events (SSEs), and ongoing community transmission. By fitting a stochastic model to data on 1512 cases, including these clusters, we show that the etiological agent of SARS is moderately transmissible. Excluding SSEs, we estimate 2.7 secondary infections were generated per case on average at the start of the epidemic, with a substantial contribution from hospital transmission. Transmission rates fell during the epidemic, primarily due to reductions in population contact rates and improved hospital infection control, but also as a result of more rapid hospital attendance by symptomatic individuals. As a result, the epidemic is now in decline, though continued vigilance is necessary for this to be maintained. Restrictions on longer-range population movement are shown to be a potentially useful additional control measure in some contexts. We estimate that most currently infected persons are now hospitalized, emphasizing the importance of control of nosocomial transmission.

Research paper thumbnail of Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

The Lancet, 2003

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Research paper thumbnail of The Hong Kong Hospital Authority's Information Architecture

Medinfo 2004: Proceedings Of THe 11th …, 2004

Since 1994, the Hospital Authority has been developing and deploying clinical applications at its... more Since 1994, the Hospital Authority has been developing and deploying clinical applications at its constituent 39 hospitals and clinics. The Clinical Management System (CMS) is now used by over 4000 doctors and 20000 other clinicians to document and review care. Since 1999, the territory-wide integrated Electronic Patient Record (ePR) has given clinicians a longitudinal view of the data collected through the CMS and its adjunct systems. The ePR currently has nearly 3TB of data covering 44 million episodes for 6.4 million patients. This paper describes the Hospital Authority's Information Architecture, which allows the ePR to accept and integrate any clinical information from any internal or external system. The ePR operates in a high volume and high performance environment, yet only requires low maintenance, while still retaining the information structure and semantics required for advanced applications.

Research paper thumbnail of Fine Needle Aspiration Cytology of Ductal Breast Carcinoma with Neuroendocrine Differentiation

Acta Cytologica, 2002

To describe the fine needle aspiration cytology findings of ductal breast carcinoma with neuroend... more To describe the fine needle aspiration cytology findings of ductal breast carcinoma with neuroendocrine differentiation and correlate them with the histologic appearance. We reviewed the cytologic features of eight cases of ductal carcinoma with neuroendocrine differentiation in the files of Pamela Youde Nethersole Eastern Hospital during the three-year period 1998-2000. Immunohistochemical study for neuroendocrine markers was performed, with ultrastructural correlation. All cases showed similar cytologic features. The smears were of moderate to high cellularity with predominantly dispersed or loosely cohesive tumor cells. The carcinoma cells were mostly of low cytologic grade. They possessed round and relatively uniform, eccentric nuclei; finely stippled chromatin; sometimes small, distinct nucleoli; and discrete cell borders. Abundant eosinophilic and focally granular cytoplasm was a common finding. In some of the cases there was accentuation of staining in the paranuclear region; it correlated with aggregates of dense core neurosecretory granules seen ultrastructurally. Mucoid substance was seen in the background in some of the aspirates. Histologic examination of the tumors showed invasive ductal carcinoma with an organoid growth pattern and sometimes mucinous component. The neuroendocrine differentiation was confirmed immunohistochemically. Although this subtype of ductal carcinoma probably carries no significant prognostic value per se, it has distinct cytologic features, rendering preoperative diagnosis possible. Recognition of this entity is important in order to avoid the misdiagnosis of neuroendocrine tumor metastatic to the breast.

Research paper thumbnail of Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

BMJ global health, 2017

In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enab... more In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enable countries to measure their surgical and anaesthesia care delivery. These indicators have subsequently been accepted by the World Bank for inclusion in the World Development Indicators. With support from the Royal Australasian College of Surgeons and the Pacific Islands Surgical Association, 14 South Pacific countries collaborated to collect the first four of six LCoGS indicators. Thirteen countries collected all four indicators over a 6-month period from October 2015 to April 2016. Australia and New Zealand exceeded the recommended LCoGS target for all four indicators. Only 5 of 13 countries (38%) achieved 2-hour access for at least 80% of their population, with a range of 20% (Papua New Guinea and Solomon Islands) to over 65% (Fiji and Samoa). Five of 13 (38%) countries met the target surgical volume of 5000 procedures per 100 000 population, with six performing less than 1600. Four ...

Research paper thumbnail of Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

Lancet, 2003

We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epid... more We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epidemic in Hong Kong. The epidemic to date has been characterized by two large clusters, initiated by two separate "super-spread" events (SSEs), and ongoing community transmission. By fitting a stochastic model to data on 1512 cases, including these clusters, we show that the etiological agent of SARS is moderately transmissible. Excluding SSEs, we estimate 2.7 secondary infections were generated per case on average at the start of the epidemic, with a substantial contribution from hospital transmission. Transmission rates fell during the epidemic, primarily due to reductions in population contact rates and improved hospital infection control, but also as a result of more rapid hospital attendance by symptomatic individuals. As a result, the epidemic is now in decline, though continued vigilance is necessary for this to be maintained. Restrictions on longer-range population movement are shown to be a potentially useful additional control measure in some contexts. We estimate that most currently infected persons are now hospitalized, emphasizing the importance of control of nosocomial transmission.