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Chen AH, Rosli SA, Ahmad A, Moore BD. Preliminary study of a new online and equipment-free vision screening alternative for remote and isolated community. Med J Malaysia 2024; 79:140-147. [PMID: 38555899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Vision screening has been initiated to detect potential vision problems, paving referral pathways towards a full eye examination. Time-cost-labour practicality challenges of equipment-based vision screening have lingered for decades. Going for the highest sensitivity and specificity or opting for a pragmatic and affordable vision screening program remains a dilemma in public eye health. We aimed to report the development of a new online and equipment-free vision screening called Eye: Questionnairebased Vision Screening (EyeQVS). We also analysed the visual profile of Orang Bateq resided in a remote locality, using findings from EyeQVS, single test vision screening and full eye examination. MATERIALS AND METHODS Multi-perspective development strategies were employed in designing EyeQVS. The questionnaire items were constructed using the working backward technique, compiling common vision disorders from the literature and face validation using expert panels. Face validation and usability assessment were performed on EyeQVS. The vision screening was carried out using EyeQVS and single test visual acuity screening method. The full eye examination included visual acuity, refraction, binocular vision and ocular health assessment. The visual profile of indigenous people (Orang Bateq) at Kampung Bengoi and Kampung Atok, Jerantut, Pahang was analysed using EyeQVS, single test visual acuity screening method and full eye examination. RESULTS The performance of EyeQVS was affirmative in both face validation and usability. About 95% of Orang Bateq failed full eye examination, while 55% failed EyeQVS screening. None of them failed single test vision screening. Binocular disorders and dry eye problems were commonly found in Orang Bateq. EyeQVS unearthed more various vision problems compared to the single test vision screening (visual acuity alone) as a screening tool in a remote location. CONCLUSION EyeQVS can screen for binocular disorders and dry eyes problem commonly found among indigenous people, which might be missed using a single-test visual acuity screening approach. EyeQVS is a practical alternative for vision screening in places where financial or location hinders eye healthcare access.
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Affiliation(s)
- A H Chen
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Optometry Studies, Puncak Alam Campus, Selangor, Malaysia.
| | - S A Rosli
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Optometry Studies, Puncak Alam Campus, Selangor, Malaysia
| | - A Ahmad
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Optometry Studies, Puncak Alam Campus, Selangor, Malaysia
| | - B D Moore
- New England College of Optometry, Boston, United States of America
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Zhang H, Dickson PI, Stiles AR, Chen AH, Le SQ, McCaw P, Beasley J, Millington DS, Young SP. Comparison of dermatan sulfate and heparan sulfate concentrations in serum, cerebrospinal fluid and urine in patients with mucopolysaccharidosis type I receiving intravenous and intrathecal enzyme replacement therapy. Clin Chim Acta 2020; 508:179-184. [PMID: 32442432 DOI: 10.1016/j.cca.2020.05.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 04/26/2020] [Accepted: 05/18/2020] [Indexed: 01/04/2023]
Abstract
AIMS To validate a liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the measurement of glycosaminoglycans (GAGs) in plasma and serum. To establish plasma, cerebrospinal fluid (CSF) and urine reference intervals. To compare GAGs in serum with that in urine and CSF from patients with MPS I. METHODS Dermatan sulfate (DS), heparan sulfate (HS), and chondroitin sulfate (CS) in serum/plasma, urine and CSF were methanolysed into dimers and analyzed using pseudo isotope dilution UPLC-MS/MS assay. Serum, CSF and urine DS and HS were quantified for 11 patients with mucopolysaccharidosis (MPS) type I before and after treatment with Aldurazyme® (laronidase) enzyme replacement therapy (ERT). RESULTS The method showed acceptable imprecision and recovery for the quantification of serum/plasma CS, DS, and HS. The serum, urine, and CSF DS and HS concentrations were reduced after 26 weeks of ERT in 4 previously untreated patients. Serum DS and HS concentrations normalized in some patients, and were mildly elevated in others after ERT. In contrast, urine and CSF DS and HS values remained elevated above the reference ranges. Compared with serum GAGs, urine and CSF DS and HS were more sensitive biomarkers for monitoring the ERT treatment of patients with MPS I.
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Affiliation(s)
- Haoyue Zhang
- Biochemical Genetics Laboratory, Duke University Health System, Durham, NC, USA.
| | - Patricia I Dickson
- Division of Medical Genetics and Genomics, Washington University School of Medicine in St. Louis, MO, USA
| | - Ashlee R Stiles
- Biochemical Genetics Laboratory, Duke University Health System, Durham, NC, USA; Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
| | - Agnes H Chen
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Steven Q Le
- Division of Medical Genetics and Genomics, Washington University School of Medicine in St. Louis, MO, USA
| | - Patricia McCaw
- Biochemical Genetics Laboratory, Duke University Health System, Durham, NC, USA
| | - James Beasley
- Biochemical Genetics Laboratory, Duke University Health System, Durham, NC, USA
| | - David S Millington
- Biochemical Genetics Laboratory, Duke University Health System, Durham, NC, USA; Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
| | - Sarah P Young
- Biochemical Genetics Laboratory, Duke University Health System, Durham, NC, USA; Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
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Vera MU, Le SQ, Victoroff A, Passage MB, Brown JR, Crawford BE, Polgreen LE, Chen AH, Dickson PI. Evaluation of non-reducing end pathologic glycosaminoglycan detection method for monitoring therapeutic response to enzyme replacement therapy in human mucopolysaccharidosis I. Mol Genet Metab 2020; 129:91-97. [PMID: 31630958 PMCID: PMC7219480 DOI: 10.1016/j.ymgme.2019.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
Therapeutic development and monitoring require demonstration of effects on disease phenotype. However, due to the complexity of measuring clinically-relevant effects in rare multisystem diseases, robust biomarkers are essential. For the mucopolysaccharidoses (MPS), the measurement of glycosaminoglycan levels is relevant as glycosaminoglycan accumulation is the primary event that occurs due to reduced lysosomal enzyme activity. Traditional dye-based assays that measure total glycosaminoglycan levels have a high background, due to a normal, baseline glycosaminoglycan content in unaffected individuals. An assay that selectively detects the disease-specific non-reducing ends of heparan sulfate glycosaminoglycans that remain undegraded due to deficiency of a specific enzyme in the catabolic pathway avoids the normal background, increasing sensitivity and specificity. We evaluated glycosaminoglycan content by dye-based and non-reducing end methods using urine, serum, and cerebrospinal fluid from MPS I human samples before and after treatment with intravenous recombinant human alpha-l-iduronidase. We found that both urine total glycosaminoglycans and serum heparan sulfate derived non-reducing end levels were markedly decreased compared to baseline after 26 weeks and 52 weeks of therapy, with a significantly greater percentage reduction in serum non-reducing end (89.8% at 26 weeks and 81.3% at 52 weeks) compared to urine total glycosaminoglycans (68.3% at 26 weeks and 62.4% at 52 weeks, p < 0.001). Unexpectedly, we also observed a decrease in non-reducing end levels in cerebrospinal fluid in all five subjects for whom samples were collected (mean 41.8% reduction, p = 0.01). The non-reducing ends in cerebrospinal fluid showed a positive correlation with serum non-reducing end levels in the subjects (r2 = 0.65, p = 0.005). Results suggest utility of the non-reducing end assay in evaluating a therapeutic response in MPS I.
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Affiliation(s)
- Moin U Vera
- Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Steven Q Le
- Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Merry B Passage
- Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | - Lynda E Polgreen
- Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Agnes H Chen
- Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Patricia I Dickson
- Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.
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Chen AH, Harmatz P, Nestrasil I, Eisengart JB, King KE, Rudser K, Kaizer AM, Svatkova A, Wakumoto A, Le SQ, Madden J, Young S, Zhang H, Polgreen LE, Dickson PI. Intrathecal enzyme replacement for cognitive decline in mucopolysaccharidosis type I, a randomized, open-label, controlled pilot study. Mol Genet Metab 2020; 129:80-90. [PMID: 31839529 PMCID: PMC7813548 DOI: 10.1016/j.ymgme.2019.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 11/28/2022]
Abstract
Central nervous system manifestations of mucopolysaccharidosis type I (MPS I) such as cognitive impairment, hydrocephalus, and spinal cord compression are inadequately treated by intravenously-administered enzyme replacement therapy with laronidase (recombinant human alpha-L-iduronidase). While hematopoietic stem cell transplantation treats neurological symptoms, this therapy is not generally offered to attenuated MPS I patients. This study is a randomized, open-label, controlled pilot study of intrathecal laronidase in eight attenuated MPS I patients with cognitive impairment. Subjects ranged between 12 years and 50 years old with a median age of 18 years. All subjects had received intravenous laronidase prior to the study over a range of 4 to 10 years, with a mean of 7.75 years. Weekly intravenous laronidase was continued throughout the duration of the study. The randomization period was one year, during which control subjects attended all study visits and assessments, but did not receive any intrathecal laronidase. After the first year, all eight subjects received treatment for one additional year. There was no significant difference in neuropsychological assessment scores between control or treatment groups, either over the one-year randomized period or at 18 or 24 months. However, there was no significant decline in scores in the control group either. Adverse events included pain (injection site, back, groin), headache, neck spasm, and transient blurry vision. There were seven serious adverse events, one judged as possibly related (headache requiring hospitalization). There was no significant effect of intrathecal laronidase on cognitive impairment in older, attenuated MPS I patients over a two-year treatment period. A five-year open-label extension study is underway.
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Affiliation(s)
- Agnes H Chen
- Department of Pediatrics, Los Angeles Biomedical Institute at Harbor-UCLA, Torrance, CA, United States of America.
| | - Paul Harmatz
- Children's Hospital Oakland Research Institute, Oakland, CA, United States of America
| | - Igor Nestrasil
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Julie B Eisengart
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Kelly E King
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Kyle Rudser
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Alexander M Kaizer
- Department of Biostatistics and Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States of America
| | - Alena Svatkova
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Amy Wakumoto
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Steven Q Le
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States of America
| | - Jacqueline Madden
- Children's Hospital Oakland Research Institute, Oakland, CA, United States of America
| | - Sarah Young
- Duke University, Durham, NC, United States of America
| | - Haoyue Zhang
- Duke University, Durham, NC, United States of America
| | - Lynda E Polgreen
- Department of Pediatrics, Los Angeles Biomedical Institute at Harbor-UCLA, Torrance, CA, United States of America
| | - Patricia I Dickson
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States of America
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Carrubba AR, Jijon AJ, Chen AH. X Marks the Knot: Simplified Laparoscopic Intra-Corporeal Knot Tying. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Acosta DA, Carrubba AR, Pettit PD, Chen AH. Urethral Diverticulum Excision and Placement of Autologous Fascia Lata Sling. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Duan YL, Zhu Y, Xu BP, Li CC, Chen AH, Deng L, Bao YX, Cao L, Sun Y, Ning LM, Fu Z, Liu CY, Yin J, Shen KL, Zhou YL, Xie ZD. [Multicenter study of human adenovirus infection in pediatric community-acquired pneumonia in China]. Zhonghua Er Ke Za Zhi 2019; 57:27-32. [PMID: 30630228 DOI: 10.3760/cma.j.issn.0578-1310.2019.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To investigate the predominant genotypes and epidemiological characteristics of human adenovirus (HAdV) in pediatric community-acquired pneumonia (CAP) in China. Methods: This was a repeated cross sectional study. Between November 2014 and November 2016, nasopharyngeal aspirates (NPAs) or throat swabs from each hospitalized pediatric patients diagnosed as CAP in 12 hospitals in Northern and Southern China were collected. Respiratory specimens were screened for 18 respiratory viruses including HAdV by using Luminex xTAG RVP Fast V2 multiplex Assay. Typing of HAdV and analysis for the epidemiological characteristic of HAdV were performed. Results: (1) A total of 2 723 hospitalized pediatric patients with CAP were enrolled in this study and 156 (5.7%, 156/2 723) respiratory specimens were positive for HAdV, and 74 (6.6%, 74/1 128) and 82 (5.1%, 82/1 595) were in Northern and Southern China, respectively. There was no significant difference in the positive detection rate between the Northern and Southern China. (2) In Northern China, the HAdV positive rate of children at the age of <6 months, 6 months-<1 years, 1-<3 years, 3-<5 years and ≥5 years was 5.9%(6/101), 6.7%(7/104), 10.3%(34/331), 4.1%(11/266) and 4.9%(16/326), respectively, and the incidence of HAdV infection peaked in children aged 1-3 years (χ(2)=11.511, P=0.021). While in Southern China the HAdV positive rate of children at the age of <6 months, 6 months-<1 years, 1-<3 years, 3-<5 years and ≥5 years was 2.2% (7/312), 4.6% (12/259), 6.3% (31/494), 7.3% (18/245) and 4.9%(14/285), respectively. There was no significant difference in the positive detection rate among age groups. (3) In 2015, the highest detection rate of HAdV in northern China was 12.5% (25/200) in winter, and in Southern China was 6.7% (35/525) in spring and 5.3% (19/357) in summer. (4) In 108 cases of HAdV positive specimens typing was done and 80 in cases classification was successfully performed.Totally 7 genotypes of HAdV, including HAdV-3 (n=32), HAdV-7 (n=9), HAdV-1 (n=12), HAdV-2 (n=15), HAdV-5 (n=10), HAdV-6 (n=1) and HAdV-4 (n=1), were detected. The predominant HAdV genotypes were HAdV-3 (30.8%, 8/26) and HAdV-7 (26.9%, 7/26) in Northern China, while HAdV-3 (44.4%, 24/54) and HAdV-2 (22.2%, 12/54) were the most prevalent genotypes in Southern China. Conclusions: HAdV is an important viral pathogen in pediatric CAP. The predominant HAdV genotypes and peak seasons of HAdV infections were different between Northern and Southern China. The predominant HAdV genotypes were HAdV-3 and HAdV-7 in Northern China, while HAdV-3 and HAdV-2 in Southern China. The peak season of HAdV infections was winter in Northern China. However, HAdV infections are more common in spring and summer in Southern China.
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Affiliation(s)
- Y L Duan
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y Zhu
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - B P Xu
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - C C Li
- the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - A H Chen
- the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - L Deng
- Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
| | - Y X Bao
- Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - L Cao
- Children's Hospital Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Sun
- Yinchuan Women and Children Healthcare Hospital, Yinchuan 750001, China
| | - L M Ning
- Children's Hospital of Changchun, Changchun 130000, China
| | - Z Fu
- Children's Hospital of Chongqing Medical University, Chongqing 150001, China
| | - C Y Liu
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - J Yin
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - K L Shen
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y L Zhou
- the Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China
| | - Z D Xie
- Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Marcogliese PC, Shashi V, Spillmann RC, Stong N, Rosenfeld JA, Koenig MK, Martínez-Agosto JA, Herzog M, Chen AH, Dickson PI, Lin HJ, Vera MU, Salamon N, Graham JM, Ortiz D, Infante E, Steyaert W, Dermaut B, Poppe B, Chung HL, Zuo Z, Lee PT, Kanca O, Xia F, Yang Y, Smith EC, Jasien J, Kansagra S, Spiridigliozzi G, El-Dairi M, Lark R, Riley K, Koeberl DD, Golden-Grant K, Yamamoto S, Wangler MF, Mirzaa G, Hemelsoet D, Lee B, Nelson SF, Goldstein DB, Bellen HJ, Pena LD, Callens S, Coucke P, Dermaut B, Hemelsoet D, Poppe B, Steyaert W, Terryn W, Van Coster R, Adams DR, Alejandro ME, Allard P, Azamian MS, Bacino CA, Balasubramanyam A, Barseghyan H, Batzli GF, Beggs AH, Behnam B, Bican A, Bick DP, Birch CL, Bonner D, Boone BE, Bostwick BL, Briere LC, Brown DM, Brush M, Burke EA, Burrage LC, Chen S, Clark GD, Coakley TR, Cogan JD, Cooper CM, Cope H, Craigen WJ, D’Souza P, Davids M, Dayal JG, Dell’Angelica EC, Dhar SU, Dillon A, Dipple KM, Donnell-Fink LA, Dorrani N, Dorset DC, Douine ED, Draper DD, Eckstein DJ, Emrick LT, Eng CM, Eskin A, Esteves C, Estwick T, Ferreira C, Fogel BL, Friedman ND, Gahl WA, Glanton E, Godfrey RA, Goldstein DB, Gould SE, Gourdine JPF, Groden CA, Gropman AL, Haendel M, Hamid R, Hanchard NA, Handley LH, Herzog MR, Holm IA, Hom J, Howerton EM, Huang Y, Jacob HJ, Jain M, Jiang YH, Johnston JM, Jones AL, Kohane IS, Krasnewich DM, Krieg EL, Krier JB, Lalani SR, Lau CC, Lazar J, Lee BH, Lee H, Levy SE, Lewis RA, Lincoln SA, Lipson A, Loo SK, Loscalzo J, Maas RL, Macnamara EF, MacRae CA, Maduro VV, Majcherska MM, Malicdan MCV, Mamounas LA, Manolio TA, Markello TC, Marom R, Martínez-Agosto JA, Marwaha S, May T, McConkie-Rosell A, McCormack CE, McCray AT, Might M, Moretti PM, Morimoto M, Mulvihill JJ, Murphy JL, Muzny DM, Nehrebecky ME, Nelson SF, Newberry JS, Newman JH, Nicholas SK, Novacic D, Orange JS, Pallais JC, Palmer CG, Papp JC, Parker NH, Pena LD, Phillips JA, Posey JE, Postlethwait JH, Potocki L, Pusey BN, Reuter CM, Robertson AK, Rodan LH, Rosenfeld JA, Sampson JB, Samson SL, Schoch K, Schroeder MC, Scott DA, Sharma P, Shashi V, Signer R, Silverman EK, Sinsheimer JS, Smith KS, Spillmann RC, Splinter K, Stoler JM, Stong N, Sullivan JA, Sweetser DA, Tifft CJ, Toro C, Tran AA, Urv TK, Valivullah ZM, Vilain E, Vogel TP, Wahl CE, Walley NM, Walsh CA, Ward PA, Waters KM, Westerfield M, Wise AL, Wolfe LA, Worthey EA, Yamamoto S, Yang Y, Yu G, Zastrow DB, Zheng A. IRF2BPL Is Associated with Neurological Phenotypes. Am J Hum Genet 2018; 103:456. [PMID: 30193138 PMCID: PMC6128320 DOI: 10.1016/j.ajhg.2018.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Tran Mau-Them F, Guibaud L, Duplomb L, Keren B, Lindstrom K, Marey I, Mochel F, van den Boogaard MJ, Oegema R, Nava C, Masurel A, Jouan T, Jansen FE, Au M, Chen AH, Cho M, Duffourd Y, Lozier E, Konovalov F, Sharkov A, Korostelev S, Urteaga B, Dickson P, Vera M, Martínez-Agosto JA, Begemann A, Zweier M, Schmitt-Mechelke T, Rauch A, Philippe C, van Gassen K, Nelson S, Graham JM, Friedman J, Faivre L, Lin HJ, Thauvin-Robinet C, Vitobello A. De novo truncating variants in the intronless IRF2BPL are responsible for developmental epileptic encephalopathy. Genet Med 2018; 21:1008-1014. [DOI: 10.1038/s41436-018-0143-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/13/2018] [Indexed: 02/06/2023] Open
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Marcogliese PC, Shashi V, Spillmann RC, Stong N, Rosenfeld JA, Koenig MK, Martínez-Agosto JA, Herzog M, Chen AH, Dickson PI, Lin HJ, Vera MU, Salamon N, Graham JM, Ortiz D, Infante E, Steyaert W, Dermaut B, Poppe B, Chung HL, Zuo Z, Lee PT, Kanca O, Xia F, Yang Y, Smith EC, Jasien J, Kansagra S, Spiridigliozzi G, El-Dairi M, Lark R, Riley K, Koeberl DD, Golden-Grant K, Yamamoto S, Wangler MF, Mirzaa G, Hemelsoet D, Lee B, Nelson SF, Goldstein DB, Bellen HJ, Pena LDM. IRF2BPL Is Associated with Neurological Phenotypes. Am J Hum Genet 2018; 103:245-260. [PMID: 30057031 PMCID: PMC6081494 DOI: 10.1016/j.ajhg.2018.07.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/02/2018] [Indexed: 12/23/2022] Open
Abstract
Interferon regulatory factor 2 binding protein-like (IRF2BPL) encodes a member of the IRF2BP family of transcriptional regulators. Currently the biological function of this gene is obscure, and the gene has not been associated with a Mendelian disease. Here we describe seven individuals who carry damaging heterozygous variants in IRF2BPL and are affected with neurological symptoms. Five individuals who carry IRF2BPL nonsense variants resulting in a premature stop codon display severe neurodevelopmental regression, hypotonia, progressive ataxia, seizures, and a lack of coordination. Two additional individuals, both with missense variants, display global developmental delay and seizures and a relatively milder phenotype than those with nonsense alleles. The IRF2BPL bioinformatics signature based on population genomics is consistent with a gene that is intolerant to variation. We show that the fruit-fly IRF2BPL ortholog, called pits (protein interacting with Ttk69 and Sin3A), is broadly detected, including in the nervous system. Complete loss of pits is lethal early in development, whereas partial knockdown with RNA interference in neurons leads to neurodegeneration, revealing a requirement for this gene in proper neuronal function and maintenance. The identified IRF2BPL nonsense variants behave as severe loss-of-function alleles in this model organism, and ectopic expression of the missense variants leads to a range of phenotypes. Taken together, our results show that IRF2BPL and pits are required in the nervous system in humans and flies, and their loss leads to a range of neurological phenotypes in both species.
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Affiliation(s)
- Paul C Marcogliese
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Vandana Shashi
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Rebecca C Spillmann
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Nicholas Stong
- Institute for Genomic Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Jill A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mary Kay Koenig
- Division of Child & Adolescent Neurology, Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Julián A Martínez-Agosto
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Child and Adolescent Psychiatry, Resnick Neuropsychiatric Hospital, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Matthew Herzog
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Agnes H Chen
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Patricia I Dickson
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Henry J Lin
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Moin U Vera
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Noriko Salamon
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - John M Graham
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Damara Ortiz
- Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Elena Infante
- Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Wouter Steyaert
- Department of Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium
| | - Bart Dermaut
- Department of Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium
| | - Bruce Poppe
- Department of Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hyung-Lok Chung
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zhongyuan Zuo
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Pei-Tseng Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Oguz Kanca
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Fan Xia
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Yaping Yang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Edward C Smith
- Division of Neurology, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Joan Jasien
- Division of Neurology, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Sujay Kansagra
- Division of Neurology, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Gail Spiridigliozzi
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Mays El-Dairi
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Robert Lark
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Kacie Riley
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Dwight D Koeberl
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Katie Golden-Grant
- Division of Genetic Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Shinya Yamamoto
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Program in Developmental Biology, Baylor College of Medicine, Houston, TX 77030, USA; Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michael F Wangler
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Program in Developmental Biology, Baylor College of Medicine, Houston, TX 77030, USA; Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA
| | - Ghayda Mirzaa
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, Seattle, WA 98105, USA
| | - Dimitri Hemelsoet
- Department of Neurology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stanley F Nelson
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - David B Goldstein
- Institute for Genomic Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Hugo J Bellen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Program in Developmental Biology, Baylor College of Medicine, Houston, TX 77030, USA; Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA; Howard Hughes Medical Institute, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Loren D M Pena
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA.
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Fouad LS, Chen AH, Pettit PD, Micallef A. Transvaginal Trigger Point Injections for Pelvic Floor Myofascial Spasm: A Retrospective Review of Pain Assessment and Development of a Treatment Algorithm. J Minim Invasive Gynecol 2015; 22:S247-S248. [DOI: 10.1016/j.jmig.2015.08.864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Maarup TJ, Chen AH, Porter FD, Farhat NY, Ory DS, Sidhu R, Jiang X, Dickson PI. Intrathecal 2-hydroxypropyl-beta-cyclodextrin in a single patient with Niemann-Pick C1. Mol Genet Metab 2015; 116:75-9. [PMID: 26189084 PMCID: PMC4633280 DOI: 10.1016/j.ymgme.2015.07.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/06/2015] [Accepted: 07/06/2015] [Indexed: 11/28/2022]
Abstract
Niemann-Pick C, type 1 (NPC1) is a progressive autosomal recessive neurologic disease caused by defective intracellular cholesterol and lipid trafficking. There are currently no United States Food and Drug Administration approved treatments for NPC1. We undertook a study evaluating the safety, efficacy, and biomarker response of intrathecal 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) in a 12-year old subject with mildly symptomatic NPC. The subject received 200mg intrathecal HP-β-CD administered biweekly via lumbar puncture. To date the subject has received 27 intrathecal HP-β-CD injections. Intrathecal HP-β-CD has been generally safe and well tolerated in this subject. There has been an improvement in vertical gaze. The subject has developed subclinical hearing loss at high frequency that is likely HP-β-CD related. Plasma 24-(S)-hydroxycholesterol, a pharmacodynamic biomarker for cholesterol redistribution in the central nervous system, was significantly increased in response to each of the first 5 drug administrations. Further dosing as well as dose escalations are needed to more completely ascertain the safety and efficacy of intrathecal HP-β-CD.
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Affiliation(s)
- Timothy J Maarup
- Department of Pediatrics, Division of Medical Genetics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
| | - Agnes H Chen
- Department of Pediatrics, Division of Neurology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Forbes D Porter
- Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - Nicole Y Farhat
- Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - Daniel S Ory
- Diabetic Cardiovascular Disease Center, Washington University School of Medicine, St Louis, MO, USA
| | - Rohini Sidhu
- Diabetic Cardiovascular Disease Center, Washington University School of Medicine, St Louis, MO, USA
| | - Xuntian Jiang
- Diabetic Cardiovascular Disease Center, Washington University School of Medicine, St Louis, MO, USA
| | - Patricia I Dickson
- Department of Pediatrics, Division of Medical Genetics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
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Dickson PI, Kaitila I, Harmatz P, Mlikotic A, Chen AH, Victoroff A, Passage MB, Madden J, Le SQ, Naylor DE. Safety of laronidase delivered into the spinal canal for treatment of cervical stenosis in mucopolysaccharidosis I. Mol Genet Metab 2015; 116:69-74. [PMID: 26260077 PMCID: PMC4572891 DOI: 10.1016/j.ymgme.2015.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/13/2015] [Accepted: 07/14/2015] [Indexed: 02/08/2023]
Abstract
Enzyme replacement therapy with laronidase (recombinant human alpha-l-iduronidase) is successfully used to treat patients with mucopolysaccharidosis type I (MPS I). However, the intravenously-administered enzyme is not expected to treat or prevent neurological deterioration. As MPS I patients suffer from spinal cord compression due in part to thickened spinal meninges, we undertook a phase I clinical trial of lumbar intrathecal laronidase in MPS I subjects age 8 years and older with symptomatic (primarily cervical) spinal cord compression. The study faced significant challenges, including a heterogeneous patient population, difficulty recruiting subjects despite an international collaborative effort, and an inability to include a placebo-controlled design due to ethical concerns. Nine serious adverse events occurred in the subjects. All subjects reported improvement in symptomatology and showed improved neurological examinations, but objective outcome measures did not demonstrate change. Despite limitations, we demonstrated the safety of this approach to treating neurological disease due to MPS I.
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Affiliation(s)
- Patricia I Dickson
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States.
| | - Ilkka Kaitila
- Medical Genetics, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Paul Harmatz
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States
| | - Anton Mlikotic
- Department of Radiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Agnes H Chen
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States; Department of Neurology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Alla Victoroff
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Merry B Passage
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Jacqueline Madden
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States
| | - Steven Q Le
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| | - David E Naylor
- Department of Neurology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
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Hu DC, Zhao XL, Shao JC, Wang W, Qian J, Chen AH, Zhang HQ, Guo H, Jiang J, Li HY. Interaction of six candidate genes in essential hypertension. Genet Mol Res 2014; 13:8385-95. [PMID: 25366732 DOI: 10.4238/2014.october.20.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We explored the interaction of 6 candidate genetic mutations in essential hypertension (EH). The mutations AGT M235T, ACE I/D, eNOS Glu298Asp, ET-2 A985G, ANP T2238C, and NPRC A-55C were detected using a genechip microarray in 100 patients with EH and 97 controls from the Han population living in the Yunnan Province of China. Risks of EH were evaluated with respect to a combination of these genotypes. Interactions were analyzed using multifactor dimensionality reduction (MDR). P values were corrected using Bonferroni's adjustment. Results showed that CC genotype frequencies for NPRC A-55C (0.540) in EH were significantly higher than those in controls (0.237, Pc < 0.01; odds ratio (OR) = 3.777; 95% confidence interval (CI) = 2.050-6.960). The OR for NPRC A-55C CC combined with ET-2 A985G GG increased to 4.673 and to 5.529 when the MT genotype of AGT M235T, the EE genotype of eNOS Glu298Asp, the GG genotype of ET-2 A985G, and the CC genotype of NPRC A-55C were combined. MDR showed that ET-2/NPRC is the best model (OR = 4.002; 95%CI = 2.1597-7.4159). The CC genotype for NPRC A-55C and the G allele for ET-2 A985G were associated with susceptibility to EH. Although the contributions of the candidate genes differ, they may have cooperative effects on conferring risk for EH. Moreover, potential gene-gene interactions were found between ET-2 A985G and NPRC A-55C in EH.
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Affiliation(s)
- D C Hu
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - X L Zhao
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - J C Shao
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - W Wang
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - J Qian
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - A H Chen
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - H Q Zhang
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - H Guo
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - J Jiang
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
| | - H Y Li
- Department of Clinical Laboratory, The First People's Hospital of Kunming, The Key Clinical Molecular Biology Laboratory of Kunming, Kunming, China
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Dickson PI, Chen AH. Intrathecal enzyme replacement therapy for mucopolysaccharidosis I: translating success in animal models to patients. Curr Pharm Biotechnol 2011; 12:946-55. [PMID: 21506913 DOI: 10.2174/138920111795542642] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 06/17/2010] [Indexed: 11/22/2022]
Abstract
Intrathecal enzyme replacement therapy has been proposed to treat central nervous system (CNS) disease due to mucopolysaccharidosis type I. Our research has shown that repeated injections of recombinant enzyme into the spinal fluid corrects enzyme deficiency and normalizes lysosomal storage in the canine model. The challenge is to translate the success in the animal where there are fewer study limitations to human patients where studies are more restricted. This review will explore what is known about the measurement of clinically-relevant outcomes of intrathecal enzyme replacement therapy for MPS I (including ongoing clinical trials), the challenges in translating therapies for the CNS in rare diseases, and new outcome measures that could aid translation of CNS therapies for MPS disorders.
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Affiliation(s)
- Patricia I Dickson
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
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Dierenfeld AD, McEntee MF, Vogler CA, Vite CH, Chen AH, Passage M, Le S, Shah S, Jens JK, Snella EM, Kline KL, Parkes JD, Ware WA, Moran LE, Fales-Williams AJ, Wengert JA, Whitley RD, Betts DM, Boal AM, Riedesel EA, Gross W, Ellinwood NM, Dickson PI. Replacing the enzyme alpha-L-iduronidase at birth ameliorates symptoms in the brain and periphery of dogs with mucopolysaccharidosis type I. Sci Transl Med 2011; 2:60ra89. [PMID: 21123810 DOI: 10.1126/scitranslmed.3001380] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disease caused by loss of activity of α-l-iduronidase and attendant accumulation of the glycosaminoglycans dermatan sulfate and heparan sulfate. Current treatments are suboptimal and do not address residual disease including corneal clouding, skeletal deformities, valvular heart disease, and cognitive impairment. We treated neonatal dogs with MPS I with intravenous recombinant α-l-iduronidase replacement therapy at the conventional 0.58 mg/kg or a higher 1.57 mg/kg weekly dose for 56 to 81 weeks. In contrast to previous results in animals and patients treated at a later age, the dogs failed to mount an antibody response to enzyme therapy, consistent with the induction of immune tolerance in neonates. The higher dose of enzyme led to complete normalization of lysosomal storage in the liver, spleen, lung, kidney, synovium, and myocardium, as well as in the hard-to-treat mitral valve. Cardiac biochemistry and function were restored, and there were improvements in skeletal disease as shown by clinical and radiographic assessments. Glycosaminoglycan levels in the brain were normalized after intravenous enzyme therapy, in the presence or absence of intrathecal administration of recombinant α-l-iduronidase. Histopathological evidence of glycosaminoglycan storage in the brain was ameliorated with the higher-dose intravenous therapy and was further improved by combining intravenous and intrathecal therapy. These findings argue that neonatal testing and early treatment of patients with MPS I may more effectively treat this disease.
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Affiliation(s)
- Ashley D Dierenfeld
- Department of Animal Science and Center for Integrated Animal Genomics, Iowa State University, Ames, IA 50011-3150, USA
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Affiliation(s)
- Agnes H Chen
- Division of Pediatric Neurology, Los Angeles County-Harbor-UCLA Medical Center, David Geffen School of Medicine at University of California Los Angeles, Box 468, 1000 West Carson Street, Torrance, CA 90502-2004, USA.
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Dickson PI, Hanson S, McEntee MF, Vite CH, Vogler CA, Mlikotic A, Chen AH, Ponder KP, Haskins ME, Tippin BL, Le SQ, Passage MB, Guerra C, Dierenfeld A, Jens J, Snella E, Kan SH, Ellinwood NM. Early versus late treatment of spinal cord compression with long-term intrathecal enzyme replacement therapy in canine mucopolysaccharidosis type I. Mol Genet Metab 2010; 101:115-22. [PMID: 20655780 PMCID: PMC2950221 DOI: 10.1016/j.ymgme.2010.06.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 06/26/2010] [Accepted: 06/26/2010] [Indexed: 11/29/2022]
Abstract
Enzyme replacement therapy (ERT) with intravenous recombinant human alpha-l-iduronidase (IV rhIDU) is a treatment for patients with mucopolysaccharidosis I (MPS I). Spinal cord compression develops in MPS I patients due in part to dural and leptomeningeal thickening from accumulated glycosaminoglycans (GAG). We tested long-term and every 3-month intrathecal (IT) and weekly IV rhIDU in MPS I dogs age 12-15months (Adult) and MPS I pups age 2-23days (Early) to determine whether spinal cord compression could be reversed, stabilized, or prevented. Five treatment groups of MPS I dogs were evaluated (n=4 per group): IT+IV Adult, IV Adult, IT + IV Early, 0.58mg/kg IV Early and 1.57mg/kg IV Early. IT + IV rhIDU (Adult and Early) led to very high iduronidase levels in cervical, thoracic, and lumber spinal meninges (3600-29,000% of normal), while IV rhIDU alone (Adult and Early) led to levels that were 8.2-176% of normal. GAG storage was significantly reduced from untreated levels in spinal meninges of IT + IV Early (p<.001), IT+IV Adult (p=.001), 0.58mg/kg IV Early (p=.002) and 1.57mg/kg IV Early (p<.001) treatment groups. Treatment of dogs shortly after birth with IT+IV rhIDU (IT + IV Early) led to normal to near-normal GAG levels in the meninges and histologic absence of storage vacuoles. Lysosomal storage was reduced in spinal anterior horn cells in 1.57mg/kg IV Early and IT + IV Early animals. All dogs in IT + IV Adult and IV Adult groups had compression of their spinal cord at 12-15months of age determined by magnetic resonance imaging and was due to protrusion of spinal disks into the canal. Cord compression developed in 3 of 4 dogs in the 0.58mg/kg IV Early group; 2 of 3 dogs in the IT + IV Early group; and 0 of 4 dogs in the 1.57mg/kg IV Early group by 12-18months of age. IT + IV rhIDU was more effective than IV rhIDU alone for treatment of meningeal storage, and it prevented meningeal GAG accumulation when begun early. High-dose IV rhIDU from birth (1.57mg/kg weekly) appeared to prevent cord compression due to protrusion of spinal disks.
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Affiliation(s)
- Patricia I. Dickson
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA: , , , , ,
- Corresp: Patricia I. Dickson, M.D. 1124 W. Carson Street, HH1 Torrance, CA 90502 Tel. 310-781-1399 Fax. 310-782-2999
| | - Stephen Hanson
- Veterinary Neurology Center, 3051 Edinger Ave, Tustin, CA 92780, USA:
| | - Michael F. McEntee
- Department of Pathobiology, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA:
| | - Charles H. Vite
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, PA 19104, USA:
| | - Carole A. Vogler
- Department of Pathology, St. Louis University School of Medicine, 1402 South Grand Blvd., St. Louis, MO 63104, USA:
| | - Anton Mlikotic
- Department of Radiology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA, 90509, USA:
| | - Agnes H. Chen
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA: , , , , ,
- Department of Neurology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA:
| | - Katherine P. Ponder
- Department of Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8125, St. Louis, MO 63110, USA:
| | - Mark E. Haskins
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, 3800 Spruce Street, Philadelphia, PA 19104, USA:
| | - Brigette L. Tippin
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA: , , , , ,
| | - Steven Q. Le
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA: , , , , ,
| | - Merry B. Passage
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA: , , , , ,
| | - Catalina Guerra
- Biological Resource Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA:
| | - Ashley Dierenfeld
- Department of Animal Science and the Center for Integrated Animal Genomics, Iowa State University, Ames, IA, 50011, USA: , , ,
| | - Jackie Jens
- Department of Animal Science and the Center for Integrated Animal Genomics, Iowa State University, Ames, IA, 50011, USA: , , ,
| | - Elizabeth Snella
- Department of Animal Science and the Center for Integrated Animal Genomics, Iowa State University, Ames, IA, 50011, USA: , , ,
| | - Shih-hsin Kan
- Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA: , , , , ,
| | - N. Matthew Ellinwood
- Department of Animal Science and the Center for Integrated Animal Genomics, Iowa State University, Ames, IA, 50011, USA: , , ,
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Ong LC, Chandran V, Lim YY, Chen AH, Poh BK. Factors associated with poor academic achievement among urban primary school children in Malaysia. Singapore Med J 2010; 51:247-252. [PMID: 20428748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The aim of this study was to identify factors associated with poor academic achievement during the early school years. METHODS This was a cross-sectional study of urban Primary Two children. Sociodemographic and medical data were obtained from questionnaires and interviews. Achievement was based on marks obtained in the core subjects of the Primary One examination. All students underwent the Raven's Standard Progressive Matrices test as a general measure of cognitive ability, audiometry and visual tests, and standardised measurements of weight and height. RESULTS Out of 1,470 eligible children, 206 (14 percent) had poor academic achievement. Of the 919 children who participated in the study, 111 (12.1 percent) had poor achievement compared with 95 (17.2 percent) of the 551 non-participants. Using logistic regression analysis, the factors that were found to be independently associated with poor academic achievement were lower mean Raven scores (p-value is less than 0.001), lower mean socioeconomic status scores (p-value is less than 0.001), larger sibship size (p-value is 0.031), male gender (odds ratio [OR] 1.7; 95 percent confidence interval [CI] 1.1-2.65) and a history of prematurity (OR 14; 95 percent CI 2-97.8). CONCLUSION Cognitive ability, gender, prematurity and social factors contribute to poor academic achievement during the early school years. The higher proportion of poor achievers among non-participants warrants further attention.
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Affiliation(s)
- L C Ong
- Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia.
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Wang CR, Chen J, Zhao JP, Chen AH, Zhai YQ, Li L, Zhu XQ. Orientobilharzia species: neglected parasitic zoonotic agents. Acta Trop 2009; 109:171-5. [PMID: 19081387 DOI: 10.1016/j.actatropica.2008.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 11/09/2008] [Accepted: 11/14/2008] [Indexed: 12/01/2022]
Abstract
Parasites of the genus Orientobilharzia belong to Platyhelminthes, Trematoda, Digenea, Schistosomatidae, and the type species is Orientobilharzia turkestanicum. O. turkestanicum was first described by Skrjabin from cattle in Russian Turkestan in 1913. Adult worms of Orientobilharzia species live in the portal veins or intestinal veins of cattle, sheep and other mammals, and often cause orientobilharziasis in China, India, Mongolia, Pakistan, Iraq, Iran in Asia, and Russia and Turkey in Europe. More importantly, the cercariae of Orientobilharzia species can infect humans and often cause cercarial dermatitis. Though Orientobilharzia species have been confirmed as zoonotic agents, they have been largely neglected, compared with other pathogens causing cercarial dermatitis, such as Trichobilharzia spp., Schistosoma spindale and Bilharziella sp., which have attracted considerable attention. Here we review the current status of knowledge on the taxonomy of Orientobilharzia spp., human and animal infections with Orientobilharzia spp., and address some considerations for further work on the systematics and pathogenesis of these organisms.
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Affiliation(s)
- C R Wang
- College of Animal Science and Technology, Heilongjiang August-First Land Reclamation University, Daqing, Heilongjiang Province, People's Republic of China.
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Tan KY, Liu CB, Chen AH, Ding YJ, Jin HY, Seow-Choen F. The role of traditional Chinese medicine in colorectal cancer treatment. Tech Coloproctol 2008; 12:1-6; discussion 6. [PMID: 18512006 DOI: 10.1007/s10151-008-0392-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Accepted: 12/28/2007] [Indexed: 02/07/2023]
Abstract
Surgery, chemotherapy and radiotherapy have been the mainstay of colorectal cancer treatment. There is however current intense research on traditional Chinese medicine (TCM) as novel or additional treatment methods for colorectal cancer. This article reviews the current use of TCM in colorectal cancer so as to increase the awareness of colorectal surgeons. The pathogenesis of colorectal cancer according to TCM is discussed. TCM has been used successfully during the perioperative period to relieve intestinal obstruction, reduce postoperative ileus and reduce urinary retention after rectal surgery. Good results have been reported in the treatment of the complications of chemotherapy and radiation enterocolitis. Favourable results have also been shown in the use of TCM either alone or in combination with chemotherapy to treat advanced colorectal cancer. Molecular studies have shown some TCM compounds to reduce tumour cell proliferation and induce apoptosis. Although the reported results of TCM have been exciting thus far, problems of lack of consensus on treatment regimes and questions on the reliability, validity and applicability of published studies prevent its widespread use. There is now an urgent need for colorectal surgeons to work with TCM physicians in the continuing research on this 6,000-year-old art so as to realize its full potential for our patients.
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Affiliation(s)
- K Y Tan
- Department of Surgery Colorectal Service, Alexandra Hospital, Singapore
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Frangos SG, Knox R, Yano Y, Chen E, Di Luozzo G, Chen AH, Sumpio BE. The integrin-mediated cyclic strain-induced signaling pathway in vascular endothelial cells. Endothelium 2002; 8:1-10. [PMID: 11409847 DOI: 10.3109/10623320109063153] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The irregular distribution of plaque in the vasculature results from the interaction of local hemodynamic forces with the vessel wall. One well-characterized force is cyclic circumferential strain, the repetitive pulsatile pressure distention on the arterial wall. This review summarizes current research, which has aimed to elicit the signal transduction pathway by which cyclic strain elicits functional and structural responses in endothelial cells; specifically, it summarizes the signaling pathway that begins with the reorganization of integrins. One method by which these extracellular matrix receptors affect signal transduction is through their ability to initiate the process of phosphorylation on tyrosine residues of cytoplasmic protein kinases, including focal adhesion kinase. The strain-induced pathway appears to also involve ras and the mitogen-activated protein kinase family of enzymes, and preliminary data suggests a role for src as well. Ultimately, it is the regulation of gene expression through the modulation of transcription factors that allows endothelial cells to respond to changes in local hemodynamics.
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Affiliation(s)
- S G Frangos
- Section of Vascular Surgery, Yale University School of Medicine, New Haven, CT 06510, USA
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Affiliation(s)
- S Kilaru
- Department of Surgery, Yale University School of Medicine, New Haven, CT 06520, USA
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Lee RE, Goldberg JH, Sallis JF, Hickmann SA, Castro CM, Chen AH. A prospective analysis of the relationship between walking and mood in sedentary ethnic minority women. Women Health 2001; 32:1-15. [PMID: 11548133 DOI: 10.1300/j013v32n04_01] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Walking for exercise is becoming widely recognized for bestowing health benefits. This study examined the association of walking for exercise and mood in sedentary, ethnic minority women over a five-month period. Ethnic minority women (N = 102) participated in a randomized, controlled trial of a 7-week behaviorally based telephone and mail intervention that promoted the adoption of walking for exercise compared to a non-behavioral minimal intervention. At 2-month post-test and 5-month follow-up, participants reported significant decreases in depressive mood and increases in vigor. Increase in walking over the course of the study was associated with change in vigor. Limited evidence was found to support a relationship between walking for exercise and mood improvement in ethnic-minority women.
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Affiliation(s)
- R E Lee
- Department of Psychology, San Diego University, California, USA.
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Chen AH, Gortler DS, Kilaru S, Araim O, Frangos SG, Sumpio BE. Cyclic strain activates the pro-survival Akt protein kinase in bovine aortic smooth muscle cells. Surgery 2001; 130:378-81. [PMID: 11490374 DOI: 10.1067/msy.2001.116668] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pulsatile pressure induced by the beating heart causes cyclic strain on arterial endothelial cells and smooth muscle cells (SMCs). This study examined whether Akt, a serine/threonine protein kinase known to promote cell survival by inhibiting apoptosis, is activated by cyclic strain in bovine aortic SMCs. METHODS Bovine aortic SMCs were cultured on flexible-bottomed membranes and then serum-starved for 24 to 36 hours. The cells were then exposed to 150-mm Hg repetitive deformations, which created an average of 10% strain on the monolayer SMCs at a frequency of 60 cycles/minute for 0 (negative control) and 30 minutes. Platelet-derived growth factor (PDGF)--stimulated SMCs were used as positive controls. Phosphorylation of Akt was determined by means of Western blot analysis. An apoptosis assay (TUNEL) was also performed on SMCs exposed to cyclic strain. RESULTS Akt phosphorylation was significantly increased over that of the negative control after 30 minutes of cyclic strain and in the PDGF group. Cyclic strain did not increase the prevalence of apoptosis in SMCs over the control. CONCLUSIONS Cyclic strain activated the pro-survival Akt kinase. The pro-survival function was supported by the fact that cyclic strain did not increase apoptosis in bovine aortic SMCs. This experiment suggests that cyclic strain may induce arterial wall thickening by tipping the balance toward arterial SMC proliferation through the inhibition of apoptosis.
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Affiliation(s)
- A H Chen
- Section of Vascular Surgery, Yale University School of Medicine, New Haven, CT 06520, USA
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Chen AH, Stephan DA, Hasson T, Fukushima K, Nelissen CM, Chen AF, Jun AI, Ramesh A, Van Camp G, Smith RJ. MYO1F as a candidate gene for nonsyndromic deafness, DFNB15. Arch Otolaryngol Head Neck Surg 2001; 127:921-5. [PMID: 11493199 DOI: 10.1001/archotol.127.8.921] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Earlier studies have mapped the autosomal recessive nonsyndromic deafness locus, DFNB15, to chromosomes 3q21.3-q25.2 and 19p13.3-13.1, identifying one of these chromosomal regions (or possibly both) as the site of a deafness-causing gene. Mutations in unconventional myosins cause deafness in mice and humans. One unconventional myosin, myosin 1F (MYO1F), is expressed in the cochlea and maps to chromosome 19p13.3-13.2. OBJECTIVE To evaluate MYO1F as a candidate gene for deafness at the DFNB15 locus by determining its genomic structure and screening each exon for deafness-causing mutations to identify possible allele variants of MYO1F segregating in the DFNB15 family. METHODS We used radiation hybrid mapping to localize MYO1F on chromosome arm 19p. We next determined its genomic structure using multiple long-range polymerase chain reaction experiments. Using these data, we completed mutation screening using single-stranded conformational polymorphism analysis and direct sequencing of affected and nonaffected persons in the original DFNB15 family. RESULTS Radiation hybrid mapping placed MYO1F in the DFNB15 interval, establishing it as a positional candidate gene. Its genomic structure consists of 24 coding exons. No mutations or genomic rearrangements were found in the original DFNB15 family, making it unlikely that MYO1F is the disease-causing gene in this kindred. CONCLUSIONS Although we did not find MYO1F allele variants in one family with autosomal recessive nonsyndromic hearing loss, the gene remains an excellent candidate for hereditary hearing impairment. Given its wide tissue expression, MYO1F might cause syndromic deafness.
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Affiliation(s)
- A H Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospital and Clinics, Iowa City, IA 52242, USA
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Abstract
There are many reports of how IPC is used effectively in the clinical setting; including the prevention of deep venous thrombosis, improvement of circulation in patients with lower extremity arterial diseases, reduction of lymphoedema, and the healing of venous ulcers. However, despite the widely accepted use of IPC, it is still unclear how IPC actually exerts its beneficial effects. The exact physiological mechanisms of action are unknown. The clinical utility of IPC and the putative mechanisms by which IPC could exert its therapeutic effect will be reviewed. The paper will examine the mechanical effects of IPC exerted on the lower extremity, and the subsequent biochemical changes in the circulation. In vitro studies of the effects of mechanical stress such as compressive strain and shear on cultured endothelial cells, and their clinical relevance to IPC will also be reviewed.
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Affiliation(s)
- A H Chen
- Yale University School of Medicine, Section of Vascular Surgery, 333 Cedar Street, New Haven, FMB 137, CT 06520, USA
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McGuirt WT, Lesperance MM, Wilcox ER, Chen AH, Van Camp G, Smith RJ. Characterization of autosomal dominant non-syndromic hearing loss loci: DFNA 4, 6, 10 and 13. Adv Otorhinolaryngol 2000; 56:84-96. [PMID: 10868218 DOI: 10.1159/000059085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- W T McGuirt
- Molecular Otolaryngology Research Laboratories, Department of Otolaryngology, Head and Neck Surgery, Iowa City, Iowa, USA
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29
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Chen AH, Fukushima K, McGuirt WT, Smith RJ. DFNB15: autosomal recessive non-syndromic hearing loss gene-chromosome 3q, 19p or digenic recessive inheritance? Adv Otorhinolaryngol 2000; 56:171-5. [PMID: 10868231 DOI: 10.1159/000059089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- A H Chen
- Department of Otolaryngology, Head and Neck Surgery, University of Iowa, Iowa City, USA
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Chen AH, O'Leary DJ. Free-space accommodative response and minus lens-induced accommodative response in pre-school children. Optometry 2000; 71:454-8. [PMID: 15326899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
PURPOSE The purpose of this study was to investigate and compare the accommodative accuracy of pre-school children between free-space accommodative stimulus and minus lens-induced accommodative stimulus. METHODS The accommodative responses of 59 pre-school children, ages 2 to 5 years, were measured objectively with a Canon Autoref R-1 under two different conditions, giving an optical accommodative stimulus of 1 D; first, viewing a target placed 100 cm away (free-space stimulus), and second, viewing a distant target through a -1.00 D lens. RESULTS The mean lag of the accommodative response for the free-space accommodative stimulus is 0.24 D, while the mean lag of the accommodative response with the minus lens-induced accommodative stimulus is 0.69 D. The lag of accommodative response for free-space accommodative stimulus is significantly lower than the lag of accommodative response for minus lenses. CONCLUSIONS Pre-school children can accommodate more accurately toward a free-space accommodative stimulus, as compared with minus lens-induced accommodative stimulus.
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Affiliation(s)
- A H Chen
- Department of Optometry, Faculty of Allied Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
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Affiliation(s)
- S G Frangos
- Section of Vascular Surgery, Yale University School of Medicine, New Haven, CT 06510, USA
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32
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Chen AH, O'Leary DJ, Howell ER. Near visual function in young children. Part I: Near point of convergence. Part II: Amplitude of accommodation. Part III: Near heterophoria. Ophthalmic Physiol Opt 2000; 20:185-98. [PMID: 10897340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- A H Chen
- School of Optometry, University of New South Wales, Sydney, Australia
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Abstract
Stereocilia of the inner ear play an integral role in the mechanotransduction of sound. Their structural support is derived from actin filaments and actin-binding proteins. We have identified a novel actin-binding protein, 2E4-kaptin (KPTN), which appears to be involved in this structural network. Using double label immunofluorescence, we now show that KPTN extends beyond the barbed ends of actin filaments at the tips of stereocilia, and using cloned human cDNA, we mapped KPTN to chromosome 19q13.4. A combination of FISH, radiation hybrid mapping and YAC screening localized KPTN between markers D19S412 and NIB1805, making this gene an excellent functional and positional candidate for DFNA4, a form of autosomal dominant non-syndromic hearing loss. We identified a second family with inherited deafness that also maps to the DFNA4 region. To screen KPTN for deafness-causing mutations, we first determined its genomic structure and then completed a mutational analysis by direct sequencing and SSCP in affected family members. Although no deafness-causing mutations were identified in the coding region, KPTN remains an excellent candidate gene for hearing loss; by synteny, its murine orthologue also remains a candidate gene for the Nijmegan waltzer (nv) mouse mutant, which has vestibular defects and a variable sensorineural hearing loss.
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Affiliation(s)
- E L Bearer
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI 02912, USA.
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Arnold DJ, Funk GF, Karnell LH, Chen AH, Hoffman HT, Ricks JM, Zimmerman MB, Corbae DP, Zhen W, McCulloch TM, Graham SM. Laryngeal cancer cost analysis: association of case-mix and treatment characteristics with medical charges. Laryngoscope 2000; 110:1-7. [PMID: 10646706 DOI: 10.1097/00005537-200001000-00001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the relationship of various pretreatment case-mix characteristics and treatment modalities with medical charges incurred during diagnosis, treatment, and 2-year follow-up for patients with laryngeal cancer. DESIGN Retrospective chart review and billing record analysis. METHODS The charts and billing records of patients diagnosed with laryngeal cancer at the University of Iowa Hospitals and Clinics (UIHC) between January 1, 1991 and December 31, 1994 were reviewed. The independent variables included various pretreatment patient-mix and tumor characteristics (age, AJCC TNM clinical stage, smoking history, ASA class, and comorbidity as defined by Kaplan-Feinstein grade) as well as type of treatment. The dependent variables included total physician, office, and university hospital-based charges incurred during the pretreatment evaluation and 0- to 3-, 3- to 12, and 12- to 24-month billing periods after the initiation of cancer-directed therapy. Total 1-year and 2-year charges were also evaluated. Univariate and multivariate analyses were used to investigate the relationships between dependent and independent variables and to develop models predictive of management charges during the individual and total billing periods. RESULTS Pretreatment charges showed no significant associations (P < .05) with any of the independent variables. Multiple regression analyses indicated that comorbidity, stage, and initial treatment modality were significant variables in one or more of the models predicting charges incurred during the 0- to 3-month, 3- to 12-month, total 1-year, and total 2-year billing periods. The models yielded R2 values for the total 1- and 2-year billing periods of 0.5246 and 0.5055, respectively. CONCLUSIONS This work supports continued study of measures that may result in earlier detection of laryngeal cancer as a potential means of reducing management charges. These results also indicate that a more accurate method of stratifying the disease severity of laryngeal cancer patients for reimbursement purposes would include measurements of the severity of the index disease as well as comorbid diseases.
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Affiliation(s)
- D J Arnold
- Department of Otolaryngology--Head and Neck Surgery, University of Miami, Florida, USA
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Moore PA, Cuddy MA, Magera JA, Caputo AC, Chen AH, Wilkinson LA. Oral transmucosal fentanyl pretreatment for outpatient general anesthesia. Anesth Prog 2000; 47:29-34. [PMID: 11881693 PMCID: PMC2149014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The oral transmucosal formulation of fentanyl citrate (OTFC) has been reported to be an effective sedative, providing convenient and atraumatic sedation for children prior to general anesthesia or painful diagnostic procedures. Thirty-three young children (24-60 months of age) scheduled for outpatient general anesthesia for treatment of dental caries were enrolled in this randomized placebo-controlled clinical trial. To determine the effectiveness of the OTFC premedication, patient behavior was evaluated using three distinct outcome ratings. A sedation score rated behavior in the waiting room prior to OTFC as well as 10 minutes and 20 minutes after OTFC. A separation score rated the child's response to being separated from his/her parent or guardian for transport to the dental operatory. Finally, a cooperation score rated the child's acceptance of the mask induction. The OTFC formulation was well tolerated by most of the children in this study. Compared with the placebo oralet, the active OTFC improved behavior for separation from the parent (P < .05) and cooperation with the mask induction (P < .05). The duration of surgery and the time of recovery did not differ between placebo and active premedication. Side effects including respiratory and cardiovascular complications were reported more frequently in the active fentanyl group. Continuous monitoring of respiratory function is essential when using this unique and effective formulation of fentanyl for pediatric preanesthetic sedation.
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Affiliation(s)
- P A Moore
- Department of Dental Public Health, University of Pittsburgh, School of Dental Medicine, Pennsylvania, USA
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Abstract
BACKGROUND A retrospective review of women age < or = 40 years with epithelial ovarian carcinoma was undertaken to determine whether patient age and tumor grade are independent prognostic factors for survival, to investigate the survival rate for young women with ovarian carcinoma, and to characterize these young women in terms of reproductive capability. METHODS The tumor registry of the Massachusetts General Hospital was used to identify cases of ovarian carcinoma diagnosed between January 1980 and July 1996. Patient records and pathology were reviewed. Survival rates were calculated by the Kaplan-Meier method and Cox proportional hazards models were used to determine the independent effect of each variable on survival. RESULTS Ninety-two tumors epithelial tumors were identified with 46 (50%) classified as borderline. In the univariate analysis, stage (P < 0.001), grade (P < 0.001), residual disease (< or = 2 cm vs. > 2 cm, P < 0.001), and age (< 30 years vs. 31-40 years; P = 0.019) were found to be significant prognostic factors for survival. However, in the multivariate analysis only tumor grade (with borderline tumors assigned a grade of 0) and stage were significant predictors of survival (P < 0.01 for both). The 5-year survival rate for carcinoma patients with advanced disease was 22.9%. Patients with borderline tumors were more likely be diagnosed during an evaluation for infertility and were more likely to have successful live births after carcinoma treatment. CONCLUSIONS Young women with advanced epithelial carcinoma have a 5-year survival rate similar to that quoted in the literature, despite the use of more aggressive chemotherapeutic regimens. Patients with borderline tumors of any stage have an excellent prognosis for preserving fertility options.
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Affiliation(s)
- L R Duska
- Vincent Gynecology, Division of Gynecologic Oncology, Massachusetts General Hospital, Boston 02114-2617, USA
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Chen CH, Rama P, Chen AH, Franch A, Sulewski M, Orlin S, Chen EH, Tseng SH, Lee H, Wang CC, Hung GY, Chan MY, Huang MS, Chen SC. Efficacy of media enriched with nonlactate-generating substrate for organ preservation: in vitro and clinical studies using the cornea model. Transplantation 1999; 67:800-8. [PMID: 10199726 DOI: 10.1097/00007890-199903270-00004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Using a rabbit cornea model, our recent study demonstrated that Chen Medium (CM), an isotonic media enriched with nonlactate-generating high-energy substrates, is very effective for organ preservation. In the present study, the efficacy of CM is further evaluated with human corneas METHODS The effectiveness of CM and Optisol for preserving the endothelial integrity of human corneas in vitro was evaluated by scanning electron microscopy. Clinical efficacy was evaluated in a total of 83 patients: 10 patients with keratoconus grafted randomly with either CM- or Optisol-stored cornea of the same donor, and 73 patients with various conditions grafted with CM-stored corneas. After surgery, visual acuity and quality of the graft were monitored for up to 4.6 years. RESULTS The scanning electron microscopic study revealed that after 11-day storage at 4 degrees C, the CM-stored cornea had only marginal disruptive changes, 9.4+/-1.1%, in endothelial cells, as opposed to 42.4+/-4.6% of the Optisol-stored cornea. All 78 CM-stored corneas, including 67 with 12.2- to 17.7-hr death-to-storage time, 3-7.6 days of storage time, and initial marginal quality before storage, were successfully transplanted. These grafts were thin and clear, with an excellent epithelial integrity and without significant changes in endothelial cell density. Five Optisol-stored corneas were also successfully grafted; one of them, however, was edematous for about 4 weeks, and all the grafts were slightly thicker with substantial endothelial cell loss. CONCLUSION Using a cornea model, present and recent studies show that CM is very effective for preserving tissue viability and endothelial integrity. Previous study revealed that CM-stored tissues maintained high levels of ATP and metabolic function, with suppression of lactate formation and accumulation. Thus, these findings support the concept that preservation of tissue viability is closely associated with the ability of the tissues to retain metabolic activity, to generate ATP efficiently, and to prevent acidosis effectively during storage.
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Affiliation(s)
- C H Chen
- Chen Laboratories, Baltimore, Maryland, USA
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Chen AH. Toxicity and allergy to local anesthesia. J Calif Dent Assoc 1998; 26:683-92. [PMID: 9879238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Considering the amount of local anesthetic administered on a daily basis, dental professionals must be familiar with the factors that influence the dose and type of local anesthetic that induces a toxic or allergic reaction. In addition to the route and rate of administration, the patient's physical condition and health may also influence the dose of local anesthetic that could be safely administered. This article reviews the different causes of local anesthesia toxicity and allergy. With prevention and early recognition of the warning signs, poor prognosis can be avoided.
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Affiliation(s)
- A H Chen
- University of Southern California School of Dentistry, Department of Anesthesiology and Medicine, USA
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Lee RE, McGinnis KA, Sallis JF, Castro CM, Chen AH, Hickmann SA. Active vs. passive methods of recruiting ethnic minority women to a health promotion program. Ann Behav Med 1998; 19:378-84. [PMID: 9706365 DOI: 10.1007/bf02895157] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Ethnic minority women have been underrepresented in health promotion research. There is a need to develop effective methods of recruiting ethnic minority women to health promotion programs and research studies. This article evaluates several methods for recruiting ethnic minority women to a study of a telephone and mail intervention encouraging participation in a home-based walking program. One hundred twenty-six sedentary ethnic minority women between the ages of 25 and 55 were recruited using two types of approaches. Number of participants screened, number enrolled, and recruitment efficiency (ratio of number recruited/number screened) were assessed. "Active" recruitment, contacting targeted individuals in person, by phone, or by mail, yielded 236 screened and 29 recruited with a recruitment efficiency of 11%. "Passive" recruitment, informing the community through public notices and waiting for volunteers to call, yielded 151 screened and 97 recruited with a recruitment efficiency of 64%. Those recruited by active or passive methods did not differ by demographic characteristics, baseline psychosocial variables, or dropout rates. Passive recruits walked significantly more at five-month follow-up than active recruits. Passive recruitment may be more economical at the cost of potentially biased samples.
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Affiliation(s)
- R E Lee
- San Diego State University/University of California 92120, USA
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40
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Greinwald JH, Wayne S, Chen AH, Scott DA, Zbar RI, Kraft ML, Prasad S, Ramesh A, Coucke P, Srisailapathy CR, Lovett M, Van Camp G, Smith RJ. Localization of a novel gene for nonsyndromic hearing loss (DFNB17) to chromosome region 7q31. Am J Med Genet 1998; 78:107-13. [PMID: 9674898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Autosomal recessive nonsyndromic hearing loss (ARNSHL) is the most common form of hereditary hearing impairment (HHI). To date, 16 different loci have been reported, making ARNSHL an extremely heterogeneous disorder. One of these loci, DFNB4, was mapped to a 5-cM interval of 7q31 in a large Middle-Eastern Druze family. This interval also includes the gene for Pendred syndrome. We report on three new families with HHI from the Madras region of southern India that demonstrate linkage to 7q. Their pedigrees are compatible with autosomal recessive inheritance. Furthermore, the largest family identifies a novel locus (DFNB17) telomeric to the DFNB4 and Pendred intervals. A 3-cM region of homozygosity by descent between markers D7S486 and D7S2529 is present in all affected individuals in this family and generates a multipoint LOD score of 4.24. The two other families map to the previously reported DFNB4 region but have insufficient power to attain significant LOD scores. However, mutations in the Pendred syndrome gene are present in one of these families.
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Affiliation(s)
- J H Greinwald
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA
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Chen AH, Sallis JF, Castro CM, Lee RE, Hickmann SA, William C, Martin JE. A home-based behavioral intervention to promote walking in sedentary ethnic minority women: project WALK. Womens Health 1998; 4:19-39. [PMID: 9520605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A home-based telephone and mail intervention was evaluated for its effectiveness in promoting walking in a sample of sedentary, ethnic minority women. One hundred twenty-five women (ages 23-54) were randomly assigned to behavioral or brief educational interventions. Women in the 8-week behavioral condition received behavior change materials through the mail and 6 structured telephone counseling sessions. Educational condition participants received a single 5-min telephone call and educational information. Both groups reported significantly increased walking at a 2-month posttest (M change = 86 and 81 min per week for behavioral and educational groups, respectively) and 5-month follow-up (M change = 40 and 52 min per week). A 30-month follow-up of 50 participants indicated both groups continued to report more walking than at baseline. The behavioral intervention was not superior to the educational condition at any assessment point. The findings may be explained as (a) both interventions were equally effective, so extensive telephone counseling is unnecessary; (b) changes over time reflected secular trends; or (c) increases in self-reported walking may be due to socially desirable reporting. Other strategies need to be evaluated for promoting walking that are tailored to the needs of ethnic minority women.
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Chen AH, Mueller RF, Prasad SD, Greinwald JH, Manaligod J, Muilenburg AC, Verhoeven K, Van Camp G, Smith RJ. Presymptomatic diagnosis of nonsyndromic hearing loss by genotyping. Arch Otolaryngol Head Neck Surg 1998; 124:20-4. [PMID: 9440775 DOI: 10.1001/archotol.124.1.20] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Nonsyndromic hearing loss (NSHL) is the most common type of hereditary hearing impairment (HHI). It is genetically heterogeneous, and although the exact number of genes is not known, 38 loci have been identified. By cloning the relevant genes and studying the function of the encoded proteins at the molecular level, it may be possible to impact the habitation of persons at risk for HHI. Currently, for select families, presymptomatic diagnosis of NSHL by genotyping is possible. OBJECTIVE To provide presymptomatic diagnosis of HHI to individuals in select families who have participated in linkage studies. DESIGN In 2 large families with autosomal dominant HHI, genes for NSHL were mapped to chromosomes 6 (DFNA10) and 19 (DFNA4). In each family, the phenotype is one of progressive sensorineural hearing loss that begins in the individual's mid-30s and progresses to a severe-to-profound loss requiring amplification. Presymptomatic diagnosis was requested by, and provided to, 19 at-risk persons in these kindreds. RESULTS By reconstructing haplotypes through the use of short tandem repeat polymorphisms tightly linked to the disease gene, risk calculations and genetic counseling were provided to these persons. CONCLUSIONS By simple Mendelian genetics, the risk of inheriting a fully penetrant autosomal dominant NSHL gene from a single affected parent is 50% for each offspring. However, by reconstructing haplotypes in families in which an HHI gene has been localized, this risk can be changed substantially.
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Affiliation(s)
- A H Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City 52242, USA
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Sanchez-Ramos L, Chen AH, Kaunitz AM, Gaudier FL, Delke I. Labor induction with intravaginal misoprostol in term premature rupture of membranes: a randomized study. Obstet Gynecol 1997; 89:909-12. [PMID: 9170463 DOI: 10.1016/s0029-7844(97)00113-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate the safety and clinical effectiveness of intravaginal misoprostol, a synthetic prostaglandin E1 analogue, for labor induction in gravidas with premature rupture of membranes (PROM) at term. METHODS One hundred forty-one pregnant women with term PROM were assigned randomly to one of two induction groups: 1) intravaginal misoprostol or 2) intravenous oxytocin by continuous infusion. RESULTS Seventy subjects were allocated to the misoprostol group and 71 to the oxytocin group. The mean (+/- standard deviation) interval from induction to delivery was significantly shorter in the misoprostol group (416 +/- 276 compared with 539 +/- 372 minutes; P = .04). In 85.7% of patients in the misoprostol group, only one dose was required. Intrapartum complication rates, mode of delivery, and neonatal or maternal adverse event rates were similar in the two treatment groups. Uterine tachysystole occurred more frequently with misoprostol than with oxytocin (28.6% compared with 14.0%; P < .04). CONCLUSION Intravaginal administration of misoprostol induces labor safely and effectively in patients with PROM at term.
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Affiliation(s)
- L Sanchez-Ramos
- Department of Obstetrics and Gynecology, University of Florida Health Science Center, Jacksonville, USA
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Abstract
PURPOSE The effect of the rate of the interpupillary distance (IPD) change with age on the near fusion free position was investigated in the present study. METHODS Three hundred and fifty-two children aged from 2 to 16 years of age were tested. Interpupillary distance was estimated with a modified Viktorin's method and the near fusion free position was measured with a modified Maddox Wing. RESULTS The results reveal a significant difference in IPD growth rate between females and males and between children aged below and above 5 years. Most children below 5 years of age were orthophoric, but heterophoria became more common above 5 years of age. CONCLUSION The present study suggests that the oculomotor control system for convergence can compensate for age changes in IPD.
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Affiliation(s)
- A H Chen
- School of Optometry, University of New South Wales, Sydney, Australia
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Abstract
In a 3-year survey, respiratory symptoms, spirometry, and methacholine reactivity were measured annually in welders (n = 51) and non-welder controls subjects (n = 54) to determine whether welding-related symptoms are associated with accelerated decline in lung function or changes in airway reactivity. In the cross-workshift study, maximal midexpiratory flow rate declined reversibly during a welding day, whereas 1-second forced expiratory volume and forced-vital capacity were unchanged. In the longitudinal study, the welders had significantly more reversible work-related symptoms of cough, phlegm, wheeze, and chest tightness than the non-welder shipyard control subjects. In this group of actively working welders, across-workshift changes in midflow and reversible symptoms were related to the welding occupation, but evidence for chronic irreversible effects on spirometry or airway reactivity was not seen over the 3 years of observation. The short period of observation was not optimal for detecting a chronic effect on lung function. Work practices and engineering controls may be successfully preventing irreversible respiratory effects, but not mild reversible effects, in this group of welders.
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Affiliation(s)
- W S Beckett
- Occupational Medicine Program, Yale University School of Medicine, New Haven, Conn., USA
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Chen AH, Nakao T, Brodman RF, Greenberg M, Charney R, Menegus M, Johnson M, Grose R, Frame R, Hu EC, Choi HK, Safyer S. Early postoperative angiographic assessment of radial grafts used for coronary artery bypass grafting. J Thorac Cardiovasc Surg 1996; 111:1208-12. [PMID: 8642822 DOI: 10.1016/s0022-5223(96)70223-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
UNLABELLED Despite a revival of interest in using the radial artery as an alternative conduit for myocardial revascularization, little angiographic documentation of early postoperative results has been presented, particularly in North America. Accordingly, 60 of 150 patients who underwent coronary artery bypass with radial arteries from November 1993 to July 1995 have had postoperative cardiac catheterization at our institution. The patency rate of the radial artery grafts was 95.7% (90 of 94 grafts patent) with an average internal diameter of 2.51 mm. Four radial artery grafts showed diffuse narrowing. The patency rate of the internal thoracic artery grafts was 100% with an average internal diameter of 2.25 mm. Three of 62 grafts demonstrated diffuse narrowing. Two of 24 (7.7%) saphenous vein grafts were occluded; the average internal diameter was 3.23 mm. The internal thoracic artery, the radial artery, and saphenous vein grafts were, respectively, 7.5%, 19.5%, and 53.3% larger than the anastomosed native coronary arteries. Graft-dependent flow was found in 81.1% of the radial artery grafts. CONCLUSION The results of this study demonstrate that the short-term patency rate of radial artery grafts is excellent.
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Affiliation(s)
- A H Chen
- Department of Cardiothoracic Surgery, Albert Einstein College of Medicine, Bronx N.Y., USA
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Abstract
BACKGROUND Left-sided, iatrogenic vocal fold paralysis (IVFP) secondary to recurrent laryngeal nerve injury is a potential complication of ligation of patent ductus arteriosus (PDA). This study investigates specific risk factors associated with IVFP. METHODS A retrospective chart review was performed for all infants 12 months of age or younger who underwent operative PDA closure at the University of Iowa from January 1, 1991, to January 1, 1994. RESULTS Six cases of IVFP were diagnosed in 68 infants who underwent PDA ligation using clips (52.9%), suture ligatures (41.2%) or both (5.9%). Compared with infants without postoperative IVFP, infants with IVFP were smaller at birth (0.9 versus 2.3 kg; p < 0.001) and more premature (gestational age, 26.3 versus 33.8 weeks; p < 0.001), and were smaller (1.1 versus 3.4 kg; p < 0.001) and younger (31.9 versus 88.4 days; p < 0.001) at operation. Weight gain from birth to operation was significant only in infants without postoperative IVFP (p < 0.05). Although the overall incidence of IVFP in all infants undergoing PDA closure was 8.8%, five of the six cases (83.3%) of IVFP occurred in extremely low birth weight infants, ie, those weighing 1 kg or less at birth. Among the cohort of extremely low birth weight babies undergoing operation, the incidence of IVFP was 22.7%. Iatrogenic vocal fold paralysis was associated only with the use of surgical clips; however, because clips were used in 90.9% of the premature infants requiring PDA ligation, it was not possible to establish whether suture ligature is a safer technique. CONCLUSIONS This study demonstrates that the single major risk factor for IVFP after ligation of PDA is birth weight less than 1 kg.
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Affiliation(s)
- R I Zbar
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA
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Chen AH, Moreano EH, Houston B, Funk GF. Chondroid syringoma of the head and neck: clinical management and literature review. Ear Nose Throat J 1996; 75:104-8. [PMID: 8714424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
This report describes the case of a chondroid syringoma occurring in the nasofacial groove of a 60-year-old woman. This benign, mixed epithelial tumor is infrequently seen by the otolaryngologist-head and neck surgeon, and therefore may not be included in the differential diagnosis of a nodular lesion on the skin of the head and neck. However, the most frequent site of occurrence for these relatively rare cutaneous lesions is the head and neck region. Histologically, these tumors are quite similar to pleomorphic adenomas of salivary gland origin, and optimal surgical management similarly requires removal of a cuff of normal tissue, rather than a simple shelling out of the lesion. The clinical presentation, pathology and recommended management of this rare tumor are discussed.
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Affiliation(s)
- A H Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa College of Medicine, Iowa City 52242-1078, USA
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Gurling H, Kalsi G, Chen AC, Green M, Butler R, Read T, Murphy P, Curtis D, Sharma T, Chen AH, Petursson H, Brynjolfsson J. Schizophrenia susceptibility and chromosome 6p24-22. Nat Genet 1995; 11:234-5. [PMID: 7581442 DOI: 10.1038/ng1195-234] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Chen AH. [Recent advances in studies of IL-12]. Sheng Li Ke Xue Jin Zhan 1995; 26:355-8. [PMID: 8745568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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