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Liao Q, Fielding R, Lam WWT, Yang L, Tian L, Lee TC. Climate change beliefs, perceptions of climate change-related health risk, and responses to heat-related risks among Hong Kong adults: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 4:16-17. [PMID: 37690801] [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: 09/12/2023] Open
Affiliation(s)
- Q Liao
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - R Fielding
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - W W T Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - L Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - L Tian
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - T C Lee
- Climate Information Services and Tropical Cyclone, Hong Kong Observatory, Hong Kong SAR, China
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Chong KC, Chan PKS, Lee TC, Goggins WB, Wu P, Lai CKC, Fung KSC. Meteorologically favourable zones for seasonal influenza A and B in Hong Kong: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 3:19-22. [PMID: 37357586] [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: 06/27/2023] Open
Affiliation(s)
- K C Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - T C Lee
- Hong Kong Observatory, Hong Kong SAR, China
| | - W B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P Wu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C K C Lai
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K S C Fung
- Department of Pathology, United Christian Hospital, Hong Kong SAR, China
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Chong KC, Chan PKS, Lee TC, Lau SYF, Wu P, Lai CKC, Fung KSC, Tse CWS, Leung SY, Kwok KL, Li C, Jiang X, Wei Y. Determining meteorologically-favorable zones for seasonal influenza activity in Hong Kong. Int J Biometeorol 2023; 67:609-619. [PMID: 36847884 DOI: 10.1007/s00484-023-02439-x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Investigations of simple and accurate meteorology classification systems for influenza epidemics, particularly in subtropical regions, are limited. To assist in preparing for potential upsurges in the demand on healthcare facilities during influenza seasons, our study aims to develop a set of meteorologically-favorable zones for epidemics of influenza A and B, defined as the intervals of meteorological variables with prediction performance optimized. We collected weekly detection rates of laboratory-confirmed influenza cases from four local major hospitals in Hong Kong between 2004 and 2019. Meteorological and air quality records for hospitals were collected from their closest monitoring stations. We employed classification and regression trees to identify zones that optimize the prediction performance of meteorological data in influenza epidemics, defined as a weekly rate > 50th percentile over a year. According to the results, a combination of temperature > 25.1℃ and relative humidity > 79% was favorable to epidemics in hot seasons, whereas either temperature < 16.4℃ or a combination of < 20.4℃ and relative humidity > 76% was favorable to epidemics in cold seasons. The area under the receiver operating characteristic curve (AUC) in model training achieved 0.80 (95% confidence interval [CI], 0.76-0.83) and was kept at 0.71 (95%CI, 0.65-0.77) in validation. The meteorologically-favorable zones for predicting influenza A or A and B epidemics together were similar, but the AUC for predicting influenza B epidemics was comparatively lower. In conclusion, we established meteorologically-favorable zones for influenza A and B epidemics with a satisfactory prediction performance, even though the influenza seasonality in this subtropical setting was weak and type-specific.
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Affiliation(s)
- Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Paul K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tsz Cheung Lee
- Hong Kong Observatory, Hong Kong Special Administrative Region, China
| | - Steven Y F Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Peng Wu
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Christopher K C Lai
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kitty S C Fung
- Department of Pathology, United Christian Hospital, Hong Kong Special Administrative Region, China
| | - Cindy W S Tse
- Department of Pathology, Kwong Wah Hospital, Hong Kong Special Administrative Region, China
| | - Shuk Yu Leung
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong Special Administrative Region, China
| | - Ka Li Kwok
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong Special Administrative Region, China
| | - Conglu Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiaoting Jiang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yuchen Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
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Wang P, Tong HW, Lee TC, Goggins WB. Projecting future temperature-related mortality using annual time series data: An example from Hong Kong. Environ Res 2022; 212:113351. [PMID: 35490827 DOI: 10.1016/j.envres.2022.113351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous studies projecting future temperature-related mortality under climate change have mostly used short-term temperature-mortality associations based on daily time series data. The present study aimed to project mortality under different Representative Concentration Pathways (RCPs) in 21st century in Hong Kong by using analysis of annual data during 1976-2018. METHODS We employed a degree-days approach, calculating the sum of daily degrees above or below certain temperature threshold within a relevant historical year. The yearly age-standardized mortality rates (ASMRs) were regressed on annual hot and cold degree-days in quasi-Poisson generalized additive models to assess the exposure-response function that was subsequently used to calculate future changes in ASMR. The projection was performed without and with certain human adaptation assumed. RESULTS ASMRs were projected to have net increases under RCPs 4.5, 6.0, and 8.5, with increased mortality attributable to excess hot days exceeding decreases attributable to excess cold days. The average net changes under RCP8.5 was estimated to be 0.12%, 12.44%, 38.99%, and 89.25% during 2030s, 2050s, 2070s, and 2090s, respectively. Higher projected ASMRs were estimated for those aged over 75 years and for cardiovascular deaths. When human adaptation was considered, slope reduction alone under RCP4.5 and 6.0 and all adaptation assumptions under RCP8.5 might still not offset its corresponding adverse impact. CONCLUSIONS The projected decreases in cold-related mortality do not compensate for projected increases in heat-related mortality in Hong Kong. Better public adaptations strategies are warranted for coping with the adverse health impacts of climate change on a local scale.
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Affiliation(s)
- Pin Wang
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | | | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Rodighiero J, McDonald EG, Lee TC, Piazza N, Martucci G, Langlois Y, Morin JF, Bendayan M, Piancova P, Lantagne S, Ouimet MC, Mantzanis H, Afilalo J. Polypharmacy in older adults after transcatheter or surgical aortic valve replacement. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Polypharmacy is associated with higher rates of adverse drug events and unplanned hospital visits in medical patients. Little is known about polypharmacy in frail older adults undergoing transcatheter (TAVR) or surgical (SAVR) aortic valve replacement.
Purpose
To determine the prevalence and prognostic implications of polypharmacy and potentially inappropriate medications (PIM) following TAVR or SAVR.
Methods
A post hoc analysis of the McGill Frailty Registry was conducted. Patients 70 years of age or older who were discharged alive after TAVR or SAVR at two university hospitals were included. Discharge prescriptions were codified and analyzed using the MedSafer electronic tool that has been validated to flag drug interactions and PIMs considering patient-specific comorbidities. Associations with the primary outcome of 30-day all-cause readmission were examined by logistic regression after adjusting for age, sex, Charlson Comorbidity Index, and procedure type.
Results
The cohort consisted of 495 patients (52% TAVR, 21% isolated SAVR, 27% combined SAVR). The mean age was 80.1±5.5 years with 52% females. The mean number of medications was 10.2±3.7 with 90% having 5 or more medications. A total of 55 patients were readmitted within 30 days. While the total number of medications was not predictive, three specific PIMs were found to be harmful and one PIM was found to be protective for readmission: clopidogrel with warfarin or heparin (OR 3.99; 95% CI 1.47, 10.82), diltiazem with heart failure (OR 3.16; 95% CI 1.04, 36.41), doxazosin or terazosin with hypertension (OR 6.21; 95% CI 0.99, 38.88), and any proton pump inhibitor (OR 0.47; 95% CI 0.26, 0.86). Of note, the combination of clopidogrel with direct oral anticoagulants was not found to be harmful for readmission.
Conclusion
The prevalence of polypharmacy is elevated in older patients undergoing TAVR or SAVR. Specific PIMs, but not total number of medications prescribed, were found to be associated with potentially preventable readmissions.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Rodighiero
- Lady Davis Institute for Medical Research, Centre for Clinical Epidemiology, Montreal, Canada
| | - E G McDonald
- McGill University Health Centre, Division of Internal Medicine, Montreal, Canada
| | - T C Lee
- Mcgill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Canada
| | - N Piazza
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - G Martucci
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - Y Langlois
- Jewish General Hospital, Division of Cardiac Surgery, Montreal, Canada
| | - J F Morin
- Jewish General Hospital, Division of Cardiac Surgery, Montreal, Canada
| | - M Bendayan
- Lady Davis Institute for Medical Research, Centre for Clinical Epidemiology, Montreal, Canada
| | - P Piancova
- Lady Davis Institute for Medical Research, Centre for Clinical Epidemiology, Montreal, Canada
| | - S Lantagne
- Lady Davis Institute for Medical Research, Centre for Clinical Epidemiology, Montreal, Canada
| | - M C Ouimet
- McGill University Health Centre, Research Institute, Montreal, Canada
| | - H Mantzanis
- Jewish General Hospital, Pharmacy Department, Montreal, Canada
| | - J Afilalo
- Jewish General Hospital, Division of Cardiology, Montreal, Canada
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Chong KC, Chan E, Lee TC, Kwok KL, Lau SYF, Wang P, Lam HCY, Goggins W, Mohammad K, Leung SY, Chan PKS. 91Is rainfall associated with paediatric acute gastroenteritis in an affluent setting? A 21-Year Retrospective Investigation. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Although many literatures demonstrated heavy rainfall was associated with an increased risk of acute gastroenteritis via contaminated food and water, we hypothesized there is no association between rainfall and paediatric acute gastroenteritis in a setting with high-standard food and water hygiene.
Methods
Intestinal infection-related hospital admissions data during 1998-2018 for children under 5 years of age in Hong Kong were collected. Meteorological data were collected from the Hong Kong Observatory. A distributed lag nonlinear model was employed to examine the associations between meteorological factors and the risk of hospital admissions due to acute gastroenteritis.
Results
Rainfall did not exhibit a statistically significant association with the risk of paediatric admission due to acute gastroenteritis but low temperature, low and high relative humidity did. The risk was 6.3% higher (95% confidence interval: 0.3% to 12.6%) when temperature was at 15.1oC (i.e. the 5th percentile). The adjusted relative risk was statistically significantly higher when relative humidity was ≤73.0% or ≥ 84.0%.
Conclusions
Text: We suggest rainfall playing a minor role in disease transmission via contaminated food and water in affluent societies like Hong Kong. Instead, we speculate low temperature and humidity extremes have greater impact on transmission through increased stability and infectivity of enteric viruses.
Key messages
Weather plays a minor role in food and water contamination in affluent societies.
Low temperature and humidity extremes might improve survival of enteric viruses.
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Affiliation(s)
- Ka Chun Chong
- School of Public Health and Primary Care, The Chinese University Of Hong Kong, Hong Kong
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, Shenzhen, China
| | - Emily Chan
- School of Public Health and Primary Care, The Chinese University Of Hong Kong, Hong Kong
| | - TC Lee
- Hong Kong Observatory, Hong Kong
| | - KL Kwok
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong
| | - SYF Lau
- School of Public Health and Primary Care, The Chinese University Of Hong Kong, Hong Kong
| | - P Wang
- School of Public Health and Primary Care, The Chinese University Of Hong Kong, Hong Kong
| | - HCY Lam
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - W Goggins
- School of Public Health and Primary Care, The Chinese University Of Hong Kong, Hong Kong
| | - K Mohammad
- School of Public Health and Primary Care, The Chinese University Of Hong Kong, Hong Kong
| | - SY Leung
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong
| | - PKS Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong
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7
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Chong KC, Chan EYY, Lee TC, Kwok KL, Lau SYF, Wang P, Lam HCY, Goggins WB, Mohammad KN, Leung SY, Chan PKS. A 21-year retrospective analysis of environmental impacts on paediatric acute gastroenteritis in an affluent setting. Sci Total Environ 2021; 764:142845. [PMID: 33183801 DOI: 10.1016/j.scitotenv.2020.142845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/08/2020] [Accepted: 10/03/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Extreme weather events happen more frequently along with global warming and they constitute a challenge for public health preparedness. For example, many investigations showed heavy rainfall was associated with an increased risk of acute gastroenteritis. In this study, we examined the associations between different meteorological factors and paediatric acute gastroenteritis in an affluent setting in China controlling for pollutant effects. METHODS Aggregated total weekly number of intestinal infection-related hospital admissions, and meteorological and air pollution data during 1998-2018 in Hong Kong were collected and analysed by a combination of quasi-Poisson generalized additive model and distributed lag nonlinear model. Study population was restricted to children under 5 years of age at the time of admission. RESULTS While heavy rainfall did not exhibit a statistically significant association with the risk of paediatric admission due to intestinal infections, low temperature and humidity extremes (both relative humidity and vapour pressure) did. Compared with the temperature at which the lowest risk was detected (i.e. 22.5 °C), the risk was 6.4% higher (95% confidence interval: 0.0% to 13.0% at 15.1 °C (i.e. the 5th percentile)). We also found the risk of paediatric admission was statistically significantly associated with an increase in the number of extreme cold days in a week over the study period. CONCLUSION Cold condition may have greater impact on disease transmission through increased stability and infectivity of enteric viruses in affluent settings like Hong Kong and thus resulted in an increased risk for paediatric acute gastroenteritis. On the contrary, an insignificant impact from heavy rainfall and high temperature may indicate a minor effect on disease transmission through bacterial growth in contaminated food and water. With the identified impacts of weather factors, extreme weather events are likely to distort the prevalence and seasonal pattern of diarrhoeal diseases in the future.
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Affiliation(s)
- Ka Chun Chong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China; Centre for Health System and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Ying Yang Chan
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Ka Li Kwok
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China
| | - Steven Yuk Fai Lau
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Pin Wang
- Yale School of Public Health, Yale University
| | - Holly Ching Yu Lam
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - William Bernard Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Kirran N Mohammad
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Shuk Yu Leung
- Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China
| | - Paul Kay Sheung Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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8
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Belfort MA, Whitehead WE, Shamshirsaz AA, Espinoza J, Nassr AA, Lee TC, Olutoye OO, Keswani SG, Sanz Cortes M. Comparison of two fetoscopic open neural tube defect repair techniques: single- vs three-layer closure. Ultrasound Obstet Gynecol 2020; 56:532-540. [PMID: 31709658 DOI: 10.1002/uog.21915] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/10/2019] [Accepted: 10/17/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES We reported previously on an exteriorized-uterus fetoscopic repair for open neural tube defect (ONTD) using a single-layer closure (SLC) technique. However, because SLC was associated with a high rate of cerebrospinal fluid (CSF) leakage at birth, we developed a three-layer closure (3LC) technique comprising a bovine collagen patch, a myofascial layer and a skin layer. The aims of this study were to compare SLC and 3LC in terms of intraoperative, postoperative and obstetric outcomes, as well as short-term neonatal neurologic and non-neurologic outcomes. METHODS This was a retrospective analysis of prospectively collected data, from 32 consecutive SLC controls and 18 consecutive 3LC cases, that underwent exteriorized-uterus two-port fetoscopic repair of ONTD at our center, between April 2014 and December 2018. All patients satisfied the Management of Myelomeningocele Study (MOMS) criteria. Obstetric, maternal, fetal and early neonatal outcomes were compared between the SLC and 3LC groups. RESULTS Maternal demographics and mean gestational age (GA) at fetal surgery (25.0 ± 0.7 vs 25.0 ± 0.5 weeks' gestation; P = 0.96), and at delivery (36.5 ± 3.5 vs 37.6 ± 3.0 weeks; P = 0.14), were similar between the SLC and 3LC groups, respectively. The rate of preterm prelabor rupture of membranes (PPROM) < 37 weeks (28% vs 29%; P = 0.9), mean GA at PPROM (32.3 ± 3.4 vs 32.7 ± 1.9 weeks; P = 0.83) and rate of vaginal delivery (50% vs 47%; P = 0.84) were similar for the SLC vs 3LC groups, respectively. In pregnancies that had SLC compared with those that had 3LC, there was a significantly higher incidence of CSF leakage at birth (8/32 (25%) vs 0/17 (0%); P = 0.02) and a significantly lower rate of reversal of hindbrain herniation at 6 weeks postoperatively (18/30 (60%) vs 14/15 (93%); P = 0.02). The rate of infants that met the MOMS criteria for shunt placement or died before 12 months of age (23/31 (74%) vs 7/12 (58%); P = 0.31) and those that required treatment for hydrocephalus by 12 months (15/32 (47%) vs 4/12 (33%); P = 0.42) were similar between the SLC and 3LC groups, respectively. CONCLUSIONS Compared to SLC, 3LC preserves the fetal and obstetric benefits of fetoscopic repair and shows improved rates of CSF leakage and reversal of hindbrain herniation at 6 weeks postoperatively. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M A Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
- Department of Neurosurgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
- Department of Surgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - W E Whitehead
- Department of Obstetrics and Gynecology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
- Department of Neurosurgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - A A Shamshirsaz
- Department of Obstetrics and Gynecology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
- Department of Surgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - J Espinoza
- Department of Obstetrics and Gynecology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - A A Nassr
- Department of Obstetrics and Gynecology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - T C Lee
- Department of Surgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - O O Olutoye
- Department of Surgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - S G Keswani
- Department of Surgery, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - M Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
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9
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Shamshirsaz AA, Lee TC, Hair AB, Erfani H, Espinoza J, Shamshirsaz AA, Fox KA, Gandhi M, Nassr AA, Abrams SA, Mccullough LB, Chervenak FA, Olutoye OO, Belfort MA. Elective delivery at 34 weeks vs routine obstetric care in fetal gastroschisis: randomized controlled trial. Ultrasound Obstet Gynecol 2020; 55:15-19. [PMID: 31503365 DOI: 10.1002/uog.21871] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate whether elective preterm delivery (ED) at 34 weeks is of postnatal benefit to infants with isolated gastroschisis compared with routine obstetric care (RC). METHODS Between May 2013 and September 2015, all women with a sonographic diagnosis of fetal gastroschisis referred to a single tertiary center, before 34 weeks' gestation, were invited to participate in this study. Eligible patients were randomized to ED (induction of labor at 34 weeks) or RC (spontaneous labor or delivery by 37-38 weeks, based on standard obstetric indications). The primary outcome measure was length of time on total parenteral nutrition (TPN). Secondary outcomes were time to closure of gastroschisis and length of stay in hospital. Outcome variables were compared using appropriate statistical methods. Analysis was based on intention-to-treat. RESULTS Twenty-five women were assessed for eligibility, of whom 21 (84%; 95% CI, 63.9-95.5%) agreed to participate in the study; of these, 10 were randomized to ED and 11 to RC. The trial was stopped at the first planned interim analysis due to patient safety concerns and for futility; thus, only 21 of the expected 86 patients (24.4%; 95% CI, 15.8-34.9%) were enrolled. Median gestational age at delivery was 34.3 (range, 34-36) weeks in the ED group and 36.7 (range, 27-38) weeks in the RC group. One patient in the ED group delivered at 36 weeks following unsuccessful induction at 34 weeks. Neonates of women who underwent ED, compared to those in the RC group, showed no difference in the median number of days on TPN (54 (range, 17-248) vs 21 (range, 9-465) days; P = 0.08), number of days to closure of gastroschisis (7 (range, 0-15) vs 5 (range, 0-8) days; P = 0.28) and length of stay in hospital (70.5 (range, 22-137) vs 31 (range, 19-186) days; P = 0.15). However, neonates in the ED group were significantly more likely to experience late-onset sepsis compared with those in the RC group (40% (95% CI, 12.2-73.8%) vs 0%; P = 0.03). CONCLUSION This study demonstrates no benefit of ED of fetuses with gastroschisis when postnatal gastroschisis management is similar to that used in routine care. Rather, the data suggest that ED is detrimental to infants with gastroschisis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A A Shamshirsaz
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - T C Lee
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A B Hair
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - H Erfani
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - J Espinoza
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A A Shamshirsaz
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - K A Fox
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - M Gandhi
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A A Nassr
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - S A Abrams
- University of Texas at Austin, Austin, TX, USA
| | - L B Mccullough
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University/New York Presbyterian Hospital, New York, NY, USA
| | - F A Chervenak
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University/New York Presbyterian Hospital, New York, NY, USA
| | - O O Olutoye
- Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - M A Belfort
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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Abstract
Anatomy played a significant role in the establishment of academies in art, initially in Italy and France, and then more widely in Europe and the Americas. This paper considers the role of anatomy in two such academies, the Royal Academy of Arts in London, and the Royal Hibernian Academy of Arts in Dublin. In both cases, anatomy teaching for art students was formalised by the appointment of a Professor of Anatomy, positions that continue to this day. The first Professor of Anatomy in the RA, William Hunter, set the standard by delivering lectures, carrying out dissections and producing écorchés. Some of his successors have published anatomy books specifically for artists, but their enthusiasm has varied. Unlike the continuity of the RA, the RHA has only had bespoke premises from 1826 to 1916, and from 1985 onwards, and its Schools or School have operated from 1826 to 1942, and from 2008 onwards. Anatomy teaching was a casualty of the decline of the formal art academy in the 20th century, but the fortunes of both are reviving in the early 21st century.
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Affiliation(s)
- T C Lee
- Royal Hibernian Academy of Arts, Dublin, Ireland.,Department of History of Art & Architecture, Trinity College, Dublin, Ireland.,St John's College, Oxford, UK.,Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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11
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Abstract
The structure of the human body and its parts is of obvious relevance in medicine, but it has also played a role in art. Accurate observation of surface or external anatomy is essential in both disciplines, and its understanding has been enhanced by knowledge of what is found beneath the skin, the internal anatomy, usually based on dissection. The role of anatomy in art in general, and in academies of art in particular, is the theme of this paper. The revival of dissection in 14th-century Italy was, if not causative, at least coincidental with the Renaissance. In 1563, Vasari founded the Accademia del Disegno in Florence, with una Anatomia included in its regulations. As a liberal art taught by university graduates, anatomy helped raise the status of painters and sculptors from artisans to artists and from guild to academy. Anatomy teaching was required in subsequent academies in Rome (1593) and Paris (1648), where the pattern of drawing from drawings, from casts, and from life was established and a Professor of Anatomy appointed in 1777. Anatomy was central to two of the Academy's most important genres, history painting and portraiture. The Academy system, with its emphasis on anatomy, spread to other European cities and to the Caribbean and the Americas from the 17th to the 19th centuries. This paper is concerned with the role of anatomy in the founding of art academies in general, while its companion paper, 'A Tale of Two Cities', considers the cases of the academies in London and Dublin in particular.
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Affiliation(s)
- U Sealy
- Royal Hibernian Academy of Arts, Dublin, Ireland.,Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - T C Lee
- Royal Hibernian Academy of Arts, Dublin, Ireland.,Department of History of Art & Architecture, Trinity College, Dublin, Ireland.,St John's College, Oxford, UK.,Department of Anatomy & Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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12
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Style CC, Olutoye OO, Belfort MA, Ayres NA, Cruz SM, Lau PE, Shamshirsaz AA, Lee TC, Olutoye OA, Fernandes CJ, Cortes MS, Keswani SG, Espinoza J. Fetal endoscopic tracheal occlusion reduces pulmonary hypertension in severe congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2019; 54:752-758. [PMID: 30640410 DOI: 10.1002/uog.20216] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/19/2018] [Accepted: 01/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Fetal endoscopic tracheal occlusion (FETO) is associated with increased perinatal survival and reduced need for extracorporeal membrane oxygenation (ECMO) in fetuses with severe congenital diaphragmatic hernia (CDH). This study evaluates the impact of FETO on the resolution of pulmonary hypertension (PH) in fetuses with isolated CDH. METHODS We reviewed retrospectively the medical records of all fetuses evaluated for CDH between January 2004 and July 2017 at a single institution. Fetuses with additional major structural or chromosomal abnormalities were excluded. CDH cases were classified retrospectively into mild, moderate and severe groups based on prenatal magnetic resonance imaging indices (observed-to-expected total fetal lung volume and percentage of intrathoracic liver herniation). Presence of PH was determined based on postnatal echocardiograms. Logistic regression analyses were performed to evaluate the relationship between FETO and resolution of PH by 1 year of age while controlling for side of the CDH, use of ECMO, gestational age at diagnosis, gestational age at delivery, fetal gender, sildenafil use at discharge and CDH severity. Resolution of PH by 1 year of age was compared between a cohort of fetuses with severe CDH that underwent FETO and a cohort that did not have the procedure (non-FETO). A subanalysis was performed restricting the analysis to isolated left CDH. Parametric and non-parametric tests were used for comparisons. RESULTS Of 257 CDH cases evaluated, 72% (n = 184) had no major structural or chromosomal anomalies of which 58% (n = 107) met the study inclusion criteria. The FETO cohort consisted of 19 CDH cases and the non-FETO cohort (n = 88) consisted of 31 (35%) mild, 32 (36%) moderate and 25 (28%) severe CDH cases. All infants with severe CDH, regardless of whether they underwent FETO, had evidence of neonatal PH. FETO (OR, 3.57; 95% CI, 1.05-12.10; P = 0.041) and ECMO (OR, 5.01; 95% CI, 2.10-11.96; P < 0.001) were independent predictors of resolution of PH by 1 year of age. A higher proportion of infants with severe CDH that underwent FETO had resolution of PH by 1 year after birth compared with infants with severe CDH in the non-FETO cohort (69% (11/16) vs 28% (7/25); P = 0.017). Similar results were observed when the analysis was restricted to cases with left-sided CDH (PH resolution in 69% (11/16) vs 28% (5/18); P = 0.032). CONCLUSION In infants with severe CDH, FETO and ECMO are independently associated with increased resolution of PH by 1 year of age. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C C Style
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - O O Olutoye
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - M A Belfort
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - N A Ayres
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Cardiology Section, Baylor College of Medicine, Houston, TX, USA
| | - S M Cruz
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - P E Lau
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - A A Shamshirsaz
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - T C Lee
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - O A Olutoye
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA
| | - C J Fernandes
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Newborn Section, Baylor College of Medicine, Houston, TX, USA
| | - M Sanz Cortes
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
| | - S G Keswani
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - J Espinoza
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX, USA
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
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13
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Guenette JP, Ben-Shlomo N, Jayender J, Seethamraju RT, Kimbrell V, Tran NA, Huang RY, Kim CJ, Kass JI, Corrales CE, Lee TC. MR Imaging of the Extracranial Facial Nerve with the CISS Sequence. AJNR Am J Neuroradiol 2019; 40:1954-1959. [PMID: 31624121 DOI: 10.3174/ajnr.a6261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging is not routinely used to image the extracranial facial nerve. The purpose of this study was to determine the extent to which this nerve can be visualized with a CISS sequence and to determine the feasibility of using that sequence for locating the nerve relative to tumor. MATERIALS AND METHODS Thirty-two facial nerves in 16 healthy subjects and 4 facial nerves in 4 subjects with parotid gland tumors were imaged with an axial CISS sequence protocol that included 0.8-mm isotropic voxels on a 3T MR imaging system with a 64-channel head/neck coil. Four observers independently segmented the 32 healthy subject nerves. Segmentations were compared by calculating average Hausdorff distance values and Dice similarity coefficients. RESULTS The primary bifurcation of the extracranial facial nerve into the superior temporofacial and inferior cervicofacial trunks was visible on all 128 segmentations. The mean of the average Hausdorff distances was 1.2 mm (range, 0.3-4.6 mm). Dice coefficients ranged from 0.40 to 0.82. The relative position of the facial nerve to the tumor could be inferred in all 4 tumor cases. CONCLUSIONS The facial nerve can be seen on CISS images from the stylomastoid foramen to the temporofacial and cervicofacial trunks, proximal to the parotid plexus. Use of a CISS protocol is feasible in the clinical setting to determine the location of the facial nerve relative to tumor.
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Affiliation(s)
- J P Guenette
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - N Ben-Shlomo
- Otolaryngology-Head and Neck Surgery (N.B.-S., J.I.K., C.E.C), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - J Jayender
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - R T Seethamraju
- Siemens Medical Solutions USA (R.T.S.), Boston, Massachusetts
| | - V Kimbrell
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - N-A Tran
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - R Y Huang
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - C J Kim
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - J I Kass
- Otolaryngology-Head and Neck Surgery (N.B.-S., J.I.K., C.E.C), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - C E Corrales
- Otolaryngology-Head and Neck Surgery (N.B.-S., J.I.K., C.E.C), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - T C Lee
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
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14
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Chong KC, Lee TC, Bialasiewicz S, Chen J, Smith DW, Choy WSC, Krajden M, Jalal H, Jennings L, Alexander B, Lee HK, Fraaij P, Levy A, Yeung ACM, Tozer S, Lau SYF, Jia KM, Tang JWT, Hui DSC, Chan PKS. Association between meteorological variations and activities of influenza A and B across different climate zones: a multi-region modelling analysis across the globe. J Infect 2019; 80:84-98. [PMID: 31580867 DOI: 10.1016/j.jinf.2019.09.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 01/23/2019] [Revised: 09/03/2019] [Accepted: 09/25/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To elucidate the effects of meteorological variations on the activity of influenza A and B in 11 sites across different climate regions. METHODS Daily numbers of laboratory-confirmed influenza A and B cases from 2011-2015 were collected from study sites where the corresponding daily mean temperature, relative humidity, wind speed and daily precipitation amount were used for boosted regression trees analysis on the marginal associations and the interaction effects. RESULTS Cold temperature was a major determinant that favored both influenza A and B in temperate and subtropical sites. Temperature-to-influenza A, but not influenza B, exhibited a U-shape association in subtropical and tropical sites. High relative humidity was also associated with influenza activities but was less consistent with influenza B activity. Compared with relative humidity, absolute humidity had a stronger association - it was negatively associated with influenza B activity in temperate zones, but was positively associated with both influenza A and B in subtropical and tropical zones. CONCLUSION The association between meteorological factors and with influenza activity is virus type specific and climate dependent. The heavy influence of temperature on influenza activity across climate zones implies that global warming is likely to have an impact on the influenza burden.
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Affiliation(s)
- Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tsz Cheung Lee
- Hong Kong Observatory, Government of The Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Seweryn Bialasiewicz
- Child Health Research Centre, The University of Queensland, Brisbane, Australia; Centre for Children's Health Research, Brisbane, Australia
| | - Jian Chen
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - David W Smith
- Faculty of Medicine and Health Sciences, University of Western Australia, Perth, Australia; Department of Microbiology, PathWest QEII Medical Centre, Perth, Australia
| | - Wisely S C Choy
- Hong Kong Observatory, Government of The Hong Kong Special Administrative Region, Hong Kong Special Administrative Region, China
| | - Mel Krajden
- British Columbia Centre for Disease Prevention and Control, Vancouver, BC, Canada
| | - Hamid Jalal
- Clinical Microbiology and Public Health Laboratory, Health Protection Agency, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Lance Jennings
- Pathology Department, University of Otago, Christchurch, New Zealand
| | - Burmaa Alexander
- National Influenza Center, National Center of Communicable Diseases, Ministry of Health, Mongolia
| | - Hong Kai Lee
- Department of Laboratory Medicine, National University Hospital, Singapore
| | | | - Avram Levy
- Faculty of Medicine and Health Sciences, University of Western Australia, Perth, Australia; Department of Microbiology, PathWest QEII Medical Centre, Perth, Australia
| | - Apple C M Yeung
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sarah Tozer
- Child Health Research Centre, The University of Queensland, Brisbane, Australia; Centre for Children's Health Research, Brisbane, Australia
| | - Steven Y F Lau
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Katherine M Jia
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Julian W T Tang
- University Hospitals Leicester, University of Leicester, Leicester, United Kingdom
| | - David S C Hui
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
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15
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Guenette JP, Seethamraju RT, Jayender J, Corrales CE, Lee TC. MR Imaging of the Facial Nerve through the Temporal Bone at 3T with a Noncontrast Ultrashort Echo Time Sequence. AJNR Am J Neuroradiol 2018; 39:1903-1906. [PMID: 30139756 DOI: 10.3174/ajnr.a5754] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/03/2018] [Indexed: 11/07/2022]
Abstract
The pointwise encoding time reduction with radial acquisition (PETRA) ultrashort echo time MR imaging sequence at 3T enables visualization of the facial nerve from the brain stem, through the temporal bone, to the stylomastoid foramen without intravenous contrast. Use of the PETRA sequence, or other ultrashort echo time sequences, should be considered in the MR imaging evaluation of certain skull base tumors and perhaps other facial nerve and temporal bone pathologies.
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Affiliation(s)
- J P Guenette
- From the Division of Neuroradiology (J.P.G., J.J., T.C.L.)
| | - R T Seethamraju
- Siemens Medical Solutions USA, Inc. (R.T.S.), Boston, Massachusetts
| | - J Jayender
- From the Division of Neuroradiology (J.P.G., J.J., T.C.L.)
| | - C E Corrales
- Division of Otolaryngology-Head and Neck Surgery (C.E.C.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - T C Lee
- From the Division of Neuroradiology (J.P.G., J.J., T.C.L.)
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16
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George E, Liacouras P, Lee TC, Mitsouras D. 3D-Printed Patient-Specific Models for CT- and MRI-Guided Procedure Planning. AJNR Am J Neuroradiol 2017; 38:E46-E47. [PMID: 28450440 DOI: 10.3174/ajnr.a5189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- E George
- Department of Radiology Brigham and Women's Hospital Boston, Massachusetts
| | - P Liacouras
- Walter Reed National Military Medical Center Bethesda, Maryland
| | - T C Lee
- Department of Radiology Brigham and Women's Hospital Boston, Massachusetts
| | - D Mitsouras
- Department of Radiology Brigham and Women's Hospital Boston, Massachusetts
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17
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Aparicio JG, Hopp H, Choi A, Mandayam Comar J, Liao VC, Harutyunyan N, Lee TC. Temporal expression of CD184(CXCR4) and CD171(L1CAM) identifies distinct early developmental stages of human retinal ganglion cells in embryonic stem cell derived retina. Exp Eye Res 2017; 154:177-189. [PMID: 27867005 PMCID: PMC5359064 DOI: 10.1016/j.exer.2016.11.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 08/29/2016] [Accepted: 11/14/2016] [Indexed: 12/29/2022]
Abstract
Human retinal ganglion cells (RGCs) derived from pluripotent stem cells (PSCs) have anticipated value for human disease study, drug screening, and therapeutic applications; however, their full potential remains underdeveloped. To characterize RGCs in human embryonic stem cell (hESC) derived retinal organoids we examined RGC markers and surface antigen expression and made comparisons to human fetal retina. RGCs in both tissues exhibited CD184 and CD171 expression and distinct expression patterns of the RGC markers BRN3 and RBPMS. The retinal progenitor cells (RPCs) of retinal organoids expressed CD184, consistent with its expression in the neuroblastic layer in fetal retina. In retinal organoids CD184 expression was enhanced in RGC competent RPCs and high CD184 expression was retained on post-mitotic RGC precursors; CD171 was detected on maturing RGCs. The differential expression timing of CD184 and CD171 permits identification and enrichment of RGCs from retinal organoids at differing maturation states from committed progenitors to differentiating neurons. These observations will facilitate molecular characterization of PSC-derived RGCs during differentiation, critical knowledge for establishing the veracity of these in vitro produced cells. Furthermore, observations made in the retinal organoid model closely parallel those in human fetal retina further validating use of retinal organoid to model early retinal development.
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Affiliation(s)
- J G Aparicio
- The Vision Center, Division of Ophthalmology, and Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - H Hopp
- The Vision Center, Division of Ophthalmology, and Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - A Choi
- The Vision Center, Division of Ophthalmology, and Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - V C Liao
- The Vision Center, Division of Ophthalmology, and Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - N Harutyunyan
- The Vision Center, Division of Ophthalmology, and Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - T C Lee
- The Vision Center, Division of Ophthalmology, and Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Ophthalmology and USC Eye Institute, University of Southern California, USA
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18
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Guenette JP, Tuncali K, Himes N, Tatli S, Lee TC. Spine Cryoablation: A Multimodality Image-Guided Approach for Tumors Adjacent to Major Neural Elements. AJNR Am J Neuroradiol 2016; 37:2396-2399. [PMID: 27609619 DOI: 10.3174/ajnr.a4923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/08/2016] [Indexed: 12/16/2022]
Abstract
We report percutaneous cryoablation of spine tumors in 7 consecutive patients (5 men, 2 women [mean age, 47 years; range, 17-68 years]) by using intraprocedural image monitoring of ice ball margins to protect adjacent neural elements. Complete tumor ablation was achieved in all patients without neurologic complication. Pain relief was achieved in 4 of 5 (80%) patients; the patient with persistent pain was later found to have enlarging metastases at other sites.
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Affiliation(s)
- J P Guenette
- From the Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts.
| | - K Tuncali
- From the Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts
| | - N Himes
- From the Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts
| | - S Tatli
- From the Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts
| | - T C Lee
- From the Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts
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19
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Lee KL, Chan YH, Lee TC, Goggins WB, Chan EYY. The development of the Hong Kong Heat Index for enhancing the heat stress information service of the Hong Kong Observatory. Int J Biometeorol 2016; 60:1029-39. [PMID: 26546311 DOI: 10.1007/s00484-015-1094-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 05/26/2023]
Abstract
This paper presents a study to develop a heat index, for use in hot and humid sub-tropical climate in Hong Kong. The study made use of hospitalization data and heat stress measurement data in Hong Kong from 2007 to 2011. The heat index, which is called Hong Kong Heat Index (HKHI), is calculated from the natural wet bulb temperature, the globe temperature, and the dry bulb temperature together with a set of coefficients applicable to the high humidity condition in the summer of Hong Kong. Analysis of the response of hospitalization rate to variation in HKHI and two other heat indices, namely Wet Bulb Globe Temperature (WBGT) and Net Effective Temperature (NET), revealed that HKHI performed generally better than WBGT and NET in reflecting the heat stress impact on excess hospitalization ratio in Hong Kong. Based on the study results, two reference criteria of HKHI were identified to establish a two-tier approach for the enhancement of the heat stress information service in Hong Kong.
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Affiliation(s)
- K L Lee
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China
| | - Y H Chan
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China.
| | - T C Lee
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China
| | - William B Goggins
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Emily Y Y Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
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20
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Agnelli G, Buller HR, Cohen A, Gallus AS, Lee TC, Pak R, Raskob GE, Weitz JI, Yamabe T. Oral apixaban for the treatment of venous thromboembolism in cancer patients: results from the AMPLIFY trial. J Thromb Haemost 2015; 13:2187-91. [PMID: 26407753 DOI: 10.1111/jth.13153] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 09/15/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND The AMPLIFY trial compared apixaban with enoxaparin followed by warfarin for the treatment of acute venous thromboembolism (VTE). OBJECTIVE To perform a subgroup analysis to compare the efficacy and safety of apixaban and enoxaparin followed by warfarin for the treatment of VTE in patients with cancer enrolled in AMPLIFY. PATIENTS/METHODS Patients with symptomatic VTE were randomized to a 6-month course of apixaban or enoxaparin followed by warfarin. The primary efficacy outcome and principal safety outcome were recurrent VTE or VTE-related death and major bleeding, respectively. RESULTS Of the 5395 patients randomized, 169 (3.1%) had active cancer at baseline, and 365 (6.8%) had a history of cancer without active cancer at baseline. Among patients with active cancer, recurrent VTE occurred in 3.7% and 6.4% of evaluable patients in the apixaban and enoxaparin/warfarin groups, respectively (relative risk [RR] 0.56, 95% confidence interval [CI] 0.13-2.37); major bleeding occurred in 2.3% and 5.0% of evaluable patients, respectively (RR 0.45, 95% CI 0.08-2.46). Among patients with a history of cancer, recurrent VTE occurred in 1.1% and 6.3% of evaluable patients in the apixaban and enoxaparin/warfarin groups, respectively (RR 0.17, 95% CI 0.04-0.78); major bleeding occurred in 0.5% and 2.8% of treated patients, respectively (RR 0.20, 95% CI 0.02-1.65). CONCLUSIONS The results of this subgroup analysis suggest that apixaban is a convenient option for cancer patients with VTE. However, additional studies are needed to confirm this concept and to compare apixaban with low molecular weight heparin in these patients.
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Affiliation(s)
- G Agnelli
- Internal and Cardiovascular Medicine - Stroke Unit, University of Perugia, Perugia, Italy
| | - H R Buller
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - A Cohen
- Guy's and St Thomas Hospital's, King's College, London, UK
| | - A S Gallus
- Department of Haematology, SA Pathology at Flinders Medical Centre & Flinders University, Adelaide, Australia
| | - T C Lee
- Pfizer Inc., New York, NY, USA
| | - R Pak
- Pfizer Inc., Groton, CT, USA
| | - G E Raskob
- College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - J I Weitz
- McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
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Mulcahy LE, Curtin CM, McCoy RJ, O'Brien FJ, Taylor D, Lee TC, Duffy GP. The effect of bisphosphonate treatment on the biochemical and cellular events during bone remodelling in response to microinjury stimulation. Eur Cell Mater 2015; 30:271-81. [PMID: 26614482 DOI: 10.22203/ecm.v030a19] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Osteoporosis is one of the most prevalent bone diseases worldwide and is characterised by high levels of bone turnover, a marked loss in bone mass and accumulation of microdamage, which leads to an increased fracture incidence that places a huge burden on global health care systems. Bisphosphonates have been used to treat osteoporosis and have shown great success in conserving bone mass and reducing fracture incidence. In spite of the existing knowledge of the in vivo responses of bone to bisphosphonates, the cellular responses to these drugs have yet to be fully elucidated. In vitro model systems that allow the decoupling of complex highly integrated events, such as bone remodelling, provide a tool whereby these biological processes may be studied in a more simplified context. This study firstly utilised an in vitro model system of bone remodelling and comprising all three major cell types of the bone (osteocytes, osteoclasts and osteoblasts), which was representative of the bone's capacity to sense microdamage and subsequently initiate a basic multicellular unit response. Secondly, this system was used to study the effect of two commonly utilised aminobisphosphonate treatments for osteoporosis, alendronate and zoledronate. We demonstrated that microinjury to osteocyte networks being treated with bisphosphonates modulates receptor activator of nuclear factor kappa-B ligand and osteoprotegerin activity, and subsequently osteoclastogenesis. Furthermore, bisphosphonates increased the osteogenic potential following microinjury. Thus, we have shown for the first time that bisphosphonates act at all three stages of bone remodelling, from microinjury to osteoclastogenesis and ultimately osteogenesis.
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Affiliation(s)
- L E Mulcahy
- Department of Anatomy, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2,
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Affiliation(s)
- V B Morris
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Corrigan
- Department of Electronic and Electrical Engineering, Trinity College, Dublin, Ireland
| | - U Sealy
- Royal Hibernian Academy of Arts, Dublin, Ireland
| | - A Kokaram
- Department of Electronic and Electrical Engineering, Trinity College, Dublin, Ireland
| | - M O'Dea
- Royal Hibernian Academy of Arts, Dublin, Ireland
| | - T C Lee
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland.,Royal Hibernian Academy of Arts, Dublin, Ireland
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Chan PKS, Tam WWS, Lee TC, Hon KL, Lee N, Chan MCW, Mok HY, Wong MCS, Leung TF, Lai RWM, Yeung ACM, Ho WCS, Nelson EAS, Hui DSC. Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City. Medicine (Baltimore) 2015; 94:e2024. [PMID: 26579810 PMCID: PMC4652819 DOI: 10.1097/md.0000000000002024] [Citation(s) in RCA: 29] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Information on respiratory viruses in subtropical region is limited.Incidence, mortality, and seasonality of influenza (Flu) A/B, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza viruses (PIV) 1/2/3 in hospitalized patients were assessed over a 15-year period (1998-2012) in Hong Kong.Male predominance and laterally transversed J-shaped distribution in age-specific incidence was observed. Incidence of Flu A, RSV, and PIV decreased sharply from infants to toddlers; whereas Flu B and ADV increased slowly. RSV conferred higher fatality than Flu, and was the second killer among hospitalized elderly. ADV and PIV were uncommon, but had the highest fatality. RSV, PIV 2/3 admissions increased over the 15 years, whereas ADV had decreased significantly. A "high season," mainly contributed by Flu, was observed in late-winter/early-spring (February-March). The "medium season" in spring/summer (April-August) was due to Flu and RSV. The "low season" in late autumn/winter (October-December) was due to PIV and ADV. Seasonality varied between viruses, but predictable distinctive pattern for each virus existed, and temperature was the most important associating meteorological variable.Respiratory viruses exhibit strong sex- and age-predilection, and with predictable seasonality allowing strategic preparedness planning. Hospital-based surveillance is crucial for real-time assessment on severity of new variants.
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Affiliation(s)
- Paul K S Chan
- Department of Microbiology (PKSC, MCWC, RWML, ACMY, WCSH), Stanley Ho Centre for Emerging Infectious Diseases (PKSC, NL, DSCH), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore (WWST); Jockey Club School of Public Health and Primary Care (WWST, MCSW), Department of Pediatrics (KLH, TFL, EASN) and Department of Medicine and Therapeutics (NL, DSCH), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Hong Kong Observatory, Government of the Hong Kong Special Administrative Region, China (TCL, HYM)
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Werneck Britto IS, Olutoye OO, Cass DL, Zamora IJ, Lee TC, Cassady CI, Mehollin-Ray A, Welty S, Fernandes C, Belfort MA, Lee W, Ruano R. Quantification of liver herniation in fetuses with isolated congenital diaphragmatic hernia using two-dimensional ultrasonography. Ultrasound Obstet Gynecol 2015; 46:150-154. [PMID: 25366655 DOI: 10.1002/uog.14718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/04/2014] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To describe a method of quantifying the amount of liver herniation in fetuses with isolated congenital diaphragmatic hernia (CDH) using two-dimensional ultrasonography and to correlate this finding with neonatal outcome. METHODS Ultrasound images obtained from 77 consecutive fetuses that presented with isolated CDH between January 2004 and July 2012 were reviewed. Liver herniation and thoracic area were measured in a cross-sectional plane of the fetal chest at the level of the four-chamber view of the heart (the same section as is used to measure the lung area-to-head circumference ratio) and the ultrasound-derived liver-to-thoracic area ratio (US-LiTR) was calculated by dividing the liver herniation area by the thoracic area. Receiver-operating characteristics (ROC) curve analysis was used to evaluate the performance of US-LiTR in predicting neonatal outcome (survival to 6 months after delivery and need for extracorporeal membrane oxygenation (ECMO)). In addition, the US-LiTR was compared with the magnetic resonance imaging (MRI)-derived volume ratio (MRI-LiTR) and percentage of liver herniation (MRI-%LH). RESULTS The overall neonatal mortality in the 77 cases with isolated CDH was 20.8% (16/77). ECMO was needed in 35.5% (27/76) of the newborns, with a survival rate of 52%. The US-LiTR was associated statistically with mortality (P < 0.01) and with the need for ECMO (P < 0.01). Good correlations were observed between US-LiTR and MRI-LiTR (r = 0.87; P < 0.001) and between US-LiTR and MRI-%LH (r = 0.90; P < 0.001). Based on ROC curve analysis, all three parameters had similar accuracy in predicting mortality (US-LiTR: area under the ROC curve (AUC), 0.78 (95% CI, 0.65-0.92), P < 0.01; MRI-LiTR: AUC, 0.77 (95% CI, 0.63-0.90), P < 0.01; MRI-%LH: AUC, 0.79 (95% CI, 0.65-0.92), P < 0.01, respectively) as well as the need for ECMO (US-LiTR: AUC, 0.72 (95% CI, 0.60-0.84), P < 0.01; MRI-LiTR: AUC, 0.73 (95% CI, 0.60-0.88), P < 0.01; MRI-%LH: AUC, 0.77 (95% CI, 0.64-0.89), P < 0.01, respectively). CONCLUSIONS Two-dimensional ultrasound measurement of the amount of liver herniation in fetuses with isolated CDH is feasible and demonstrates a predictive accuracy for neonatal outcome similar to that of MRI.
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MESH Headings
- Adult
- Cohort Studies
- Extracorporeal Membrane Oxygenation/methods
- Female
- Fetal Diseases/diagnostic imaging
- Fetal Diseases/pathology
- Fetal Diseases/therapy
- Hernias, Diaphragmatic, Congenital/diagnostic imaging
- Hernias, Diaphragmatic, Congenital/pathology
- Hernias, Diaphragmatic, Congenital/surgery
- Hernias, Diaphragmatic, Congenital/therapy
- Humans
- Infant, Newborn
- Liver Diseases/diagnostic imaging
- Liver Diseases/embryology
- Liver Diseases/pathology
- Liver Diseases/therapy
- Magnetic Resonance Imaging/methods
- Predictive Value of Tests
- Pregnancy
- Retrospective Studies
- Ultrasonography, Prenatal/methods
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Affiliation(s)
- I S Werneck Britto
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - O O Olutoye
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - D L Cass
- Texas Children's Fetal Center, Houston, TX, USA
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - I J Zamora
- Texas Children's Fetal Center, Houston, TX, USA
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - T C Lee
- Texas Children's Fetal Center, Houston, TX, USA
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - C I Cassady
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - A Mehollin-Ray
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - S Welty
- Texas Children's Fetal Center, Houston, TX, USA
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - C Fernandes
- Texas Children's Fetal Center, Houston, TX, USA
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - M A Belfort
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - W Lee
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - R Ruano
- Texas Children's Fetal Center, Houston, TX, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
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Ruano R, Javadian P, Kailin JA, Maskatia SA, Shamshirsaz AA, Cass DL, Zamora IJ, Sangi-Haghpeykar H, Lee TC, Ayres NA, Mehollin-Ray A, Cassady CI, Fernandes C, Welty S, Belfort MA, Olutoye OO. Congenital heart anomaly in newborns with congenital diaphragmatic hernia: a single-center experience. Ultrasound Obstet Gynecol 2015; 45:683-688. [PMID: 25158239 DOI: 10.1002/uog.14648] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 05/31/2014] [Accepted: 08/07/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the impact of the presence of a congenital heart anomaly (CHA) and its potential contribution to morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). METHODS In this retrospective cohort study, prenatal and postnatal data of all newborns diagnosed with CDH between January 2004 and December 2012 in a single center were reviewed. Cases were classified into two groups: those with 'isolated' CDH and those with both CDH and CHA. Patients with CHA were further subclassified into those with a major or minor CHA based on the Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1), and the Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery (STS-EACTS) scoring systems. Patients with associated non-cardiac anomalies, including 'syndromic cases', were excluded from the analysis. Primary and secondary outcomes were survival up to 1 year of age and a need for extracorporeal membrane oxygenation (ECMO), respectively. RESULTS Of the 180 infants with CDH, 41 were excluded because of the presence of non-cardiac associated anomalies, 118 had isolated CDH and 21 had CDH with CHA (16 with minor and five with major CHA). Receiver-operating characteristics curve analysis demonstrated that the best cut-off for survival was when the score for CHA was ≤ 2 for both RACHS-1 (area under the curve (AUC), 0.74 (P = 0.04); sensitivity, 80.0%; specificity, 87.5%) and STS-EACTS (AUC, 0.83 (P = 0.03); sensitivity, 100%; specificity, 87.5%). Survival rate at 1 year was significantly lower in those with CHD and a major CHA (40.0%; P = 0.04) than in those with isolated CDH (77.1%) and those with CDH and a minor CHA (81.3%). We found no significant differences among the groups with regard to the need for ECMO. CONCLUSIONS In general, a milder form of CHA does not appear to have a negative impact on the survival of infants with CDH. However, mortality appears to be significantly higher in infants with CDH and a major form of CHA. The scoring systems appear to be useful as predictors for classifying the effects of CHA in this population of patients.
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Affiliation(s)
- R Ruano
- Department of Obstetrics and Gynecology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - P Javadian
- Department of Obstetrics and Gynecology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - J A Kailin
- Department of Pediatrics, Division of Cardiology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - S A Maskatia
- Department of Pediatrics, Division of Cardiology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - A A Shamshirsaz
- Department of Obstetrics and Gynecology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - D L Cass
- Michael E. DeBakey Department of Surgery, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - I J Zamora
- Michael E. DeBakey Department of Surgery, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - H Sangi-Haghpeykar
- Department of Obstetrics and Gynecology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - T C Lee
- Michael E. DeBakey Department of Surgery, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - N A Ayres
- Department of Pediatrics, Division of Cardiology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - A Mehollin-Ray
- Department of Radiology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - C I Cassady
- Department of Radiology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - C Fernandes
- Department of Pediatrics, Division of Neonatology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - S Welty
- Department of Pediatrics, Division of Neonatology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - M A Belfort
- Department of Obstetrics and Gynecology, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
| | - O O Olutoye
- Michael E. DeBakey Department of Surgery, Texas Children's Fetal Center and Baylor College of Medicine, Houston, TX, USA
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Pastorek M, Gronesova P, Cholujova D, Hunakova L, Bujnakova Z, Balaz P, Duraj J, Lee TC, Sedlak J. Realgar (As4S4) nanoparticles and arsenic trioxide (As2O3) induced autophagy and apoptosis in human melanoma cells in vitro. Neoplasma 2015; 61:700-9. [PMID: 25150315 DOI: 10.4149/neo_2014_085] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of the present study was to compare the effect of realgar nanoparticles and arsenic trioxide (ATO) on viability, DNA damage, proliferation, autophagy and apoptosis in the human melanoma cell lines BOWES and A375. The application of various flow cytometric methods for measurements cell viability, DNA cell cycle, mitochondrial potential, lysosomal activity, and intracellular content of glutathione was used. In addition, quantitative PCR, western blotting and multiplex bead array analyses were applied for evaluation of redox stress, autophagic flux, and cell signaling alterations.The results showed that realgar treatment of studied cells caused modulation of cell proliferation, induced a block in G2/M phase of the cell cycle and altered phosphorylation of IκB, Akt, ERK1/2, p38, and JNK kinases, as well as decreased mitochondrial membrane potential. Additionally, it appeared that induction of cell death by both realgar and ATO was dose-dependent, when lower (0.3 µM) dosage increased lysosomal activity and induced autophagy and higher (1.25 µM) concentration resulted in the appearance of apoptosis, while pan-caspase inhibitor attenuated more efficiently realgar- than ATO-induced cell death. Furthermore, low concentrations of ATO and realgar nanoparticles increased the content of intracellular glutathione and elevated γ-H2AX expression confirmed DNA damage preferentially at higher concentrations of both drugs used. Further analysis revealed slight differences in time-dependent phosphorylation pattern due to both realgar and ATO treatments, while significant differences were noticed between cell lines. In conclusion, realgar nanoparticles and ATO treatment induced dose-dependent activation of autophagy and apoptosis in both melanoma cell lines, when autophagy flux was determined at lower drug concentrations and the switch to apoptosis occurred at higher concentrations of both arsenic forms.
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Wong HT, Chiu MYL, Wu CST, Lee TC. The influence of weather on health-related help-seeking behavior of senior citizens in Hong Kong. Int J Biometeorol 2015; 59:373-376. [PMID: 24760371 DOI: 10.1007/s00484-014-0831-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 04/03/2014] [Accepted: 04/05/2014] [Indexed: 06/03/2023]
Abstract
It is believed that extreme hot and cold weather has a negative impact on general health conditions. Much research focuses on mortality, but there is relatively little community health research. This study is aimed at identifying high-risk groups who are sensitive to extreme weather conditions, in particular, very hot and cold days, through an analysis of the health-related help-seeking patterns of over 60,000 Personal Emergency Link (PE-link) users in Hong Kong relative to weather conditions. In the study, 1,659,716 PE-link calls to the help center were analyzed. Results showed that females, older elderly, people who did not live alone, non-subsidized (relatively high-income) users, and those without medical histories of heart disease, hypertension, stroke, and diabetes were more sensitive to extreme weather condition. The results suggest that using official government weather forecast reports to predict health-related help-seeking behavior is feasible. An evidence-based strategic plan could be formulated by using a method similar to that used in this study to identify high-risk groups. Preventive measures could be established for protecting the target groups when extreme weather conditions are forecasted.
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Affiliation(s)
- Ho Ting Wong
- Department of Social Work, Hong Kong Baptist University, Hong Kong, SAR, China,
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Lee TC, Chansakul T, Huang RY, Wrubel GL, Mukundan S, Annino DJ, Pribaz JJ, Pomahac B. Early postoperative imaging and image-guided procedures on patients with face transplants. AJNR Am J Neuroradiol 2014; 36:568-74. [PMID: 25339651 DOI: 10.3174/ajnr.a4141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Face transplantation is being performed with increasing frequency. Facial edema, fluid collections, and lymphadenopathy are common postoperative findings and may be due to various etiologies, some of which are particular to face transplantation. The purpose of this study was to demonstrate how postoperative imaging and image-guided minimally invasive procedures can assist in diagnosing and treating complications arising from face transplantation. Retrospective evaluation of 6 consecutive cases of face transplantation performed at Brigham and Women's Hospital between April 2009 and March 2014 was performed with assessment of postoperative imaging and image-guided procedures, including aspiration of postoperative fluid collection, lymph node biopsy, and treatment of salivary gland leak. Through these cases, we demonstrate that early postoperative imaging and image-guided procedures are key components for the management of complications following face transplantation.
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Affiliation(s)
- T C Lee
- From the Section of Neuroradiology, Department of Radiology (T.C.L., T.C., R.Y.H., G.L.W., S.M.)
| | - T Chansakul
- From the Section of Neuroradiology, Department of Radiology (T.C.L., T.C., R.Y.H., G.L.W., S.M.)
| | - R Y Huang
- From the Section of Neuroradiology, Department of Radiology (T.C.L., T.C., R.Y.H., G.L.W., S.M.)
| | - G L Wrubel
- From the Section of Neuroradiology, Department of Radiology (T.C.L., T.C., R.Y.H., G.L.W., S.M.)
| | - S Mukundan
- From the Section of Neuroradiology, Department of Radiology (T.C.L., T.C., R.Y.H., G.L.W., S.M.)
| | - D J Annino
- Division of Otolaryngology, Department of Surgery (D.J.A.)
| | - J J Pribaz
- Division of Plastic Surgery, Department of Surgery (J.J.P., B.P.), Brigham and Women's Hospital, Boston, Massachusetts
| | - B Pomahac
- Division of Plastic Surgery, Department of Surgery (J.J.P., B.P.), Brigham and Women's Hospital, Boston, Massachusetts
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Ruano R, Lazar DA, Cass DL, Zamora IJ, Lee TC, Cassady CI, Mehollin-Ray A, Welty S, Fernandes CJ, Haeri S, Belfort MA, Olutoye OO. Fetal lung volume and quantification of liver herniation by magnetic resonance imaging in isolated congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2014; 43:662-669. [PMID: 24127326 DOI: 10.1002/uog.13223] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/20/2013] [Accepted: 10/01/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To determine associations between fetal lung and liver herniation volumes measured by magnetic resonance imaging (MRI) and mortality/need for extracorporeal membrane oxygenation (ECMO) in cases of isolated congenital diaphragmatic hernia (CDH). A secondary objective was to compare prenatal MRI parameters with two-dimensional ultrasound lung measurements. METHODS A retrospective review of medical records of all fetuses with isolated CDH evaluated between January 2004 and July 2012 was performed. The following MRI parameters were measured at 20-32 weeks: observed/expected total fetal lung volume (o/e-TLV), predicted pulmonary volume (PPV), percentage of liver herniated into the fetal thorax (%LH) and the liver/thoracic volume ratio (LiTR). These were compared with the ultrasound-determined lung-to-head ratio (LHR) and the observed/expected LHR (o/e-LHR) in the same cohort. The predictive value of MRI and ultrasound parameters for mortality and the need for ECMO was evaluated by univariate, multivariate and factor analysis and by receiver-operating characteristics curves. RESULTS Eighty fetuses with isolated CDH were evaluated. Overall mortality was 18/80 (22.5%). Two newborns died a few hours after birth. ECMO was performed in 29/78 (37.2%) newborns, with a survival rate of 48.3% (14/29). The side of the diaphragmatic defect was not associated with mortality (P = 0.99) or the need for ECMO (P = 0.48). Good correlation was observed among o/e-TLV, PPV, LHR and o/e-LHR as well as between %LH and LiTR (r = 0.89; P < 0.01); however, fetal lung measurements and measures of liver herniation were not correlated (all P > 0.05). All parameters were statistically associated with mortality or the need for ECMO. The best combination of measurements to predict mortality was o/e-TLV and %LH, with 83% accuracy. CONCLUSION Mortality and the need for ECMO in neonates with isolated CDH can be best predicted using a combination of MRI o/e-TLV and %LH.
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Affiliation(s)
- R Ruano
- Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
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Stidham RW, Lee TC, Higgins PD, Deshpande AR, Sussman DA, Singal AG, Elmunzer BJ, Saini SD, Vijan S, Waljee AK. Systematic review with network meta-analysis: the efficacy of anti-TNF agents for the treatment of Crohn's disease. Aliment Pharmacol Ther 2014; 39:1349-62. [PMID: 24749763 PMCID: PMC7006346 DOI: 10.1111/apt.12749] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 03/12/2014] [Accepted: 03/24/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anti-tumour necrosis factor-alpha agents (anti-TNF) are effective therapies for the treatment of Crohn's disease (CD), but their comparative efficacy is unknown. AIM To perform a network meta-analysis comparing the efficacy of anti-TNF therapies in CD. METHODS After screening 506 studies, reviewers extracted information on 10 studies. Traditional meta-analysis (TMA) was used to compare each anti-TNF agent to placebo. Bayesian network meta-analysis (NMA) was performed to compare the effects of anti-TNF agents to placebo. In addition, sample sizes for comparative efficacy trials were calculated. RESULTS Compared to placebo, TMA revealed that anti-TNF agents result in a higher likelihood of induction of remission and response (RR: 1.66, 95% CI: 1.17-2.36 and RR: 1.43, 95% CI: 1.17-1.73, respectively) as well as maintenance of remission and response (RR: 1.78, 95% CI: 1.51-2.09 and RR: 1.68, 95% CI: 1.46-1.93, respectively). NMA found nonsignificant trends between infliximab and adalimumab or certolizumab pegol. Among subcutaneous therapies, NMA demonstrated superiority of adalimumab to certolizumab pegol for induction of remission (RR: 2.93, 95% CrI: 1.21-7.75). Sample size calculations suggest that adequately powered head-to-head comparative efficacy trials would require greater than 3000 patients. CONCLUSIONS All anti-TNF agents are effective for induction and maintenance of response and remission in the treatment of CD. Although adalimumab is superior to certolizumab pegol for induction of remission, there is no evidence of clinical superiority among anti-TNF agents. Head-to-head trials among the anti-TNF agents are impractical in terms of size and cost.
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Affiliation(s)
- RW Stidham
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - TC Lee
- Division of General Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - PD Higgins
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - AR Deshpande
- Division of Gastroenterology, Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - DA Sussman
- Division of Gastroenterology, Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - AG Singal
- Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - BJ Elmunzer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - SD Saini
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - S Vijan
- Division of General Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - AK Waljee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
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Abstract
The physical effects of fatigue failure caused by cyclic strain are important and for most materials well understood. However, nothing is known about this mode of failure in living cells. We developed a novel method that allowed us to apply controlled levels of cyclic displacement to networks of osteocytes in bone. We showed that under cyclic loading, fatigue failure takes place in the dendritic processes of osteocytes at cyclic strain levels as low as one tenth of the strain needed for instantaneous rupture. The number of cycles to failure was inversely correlated with the strain level. Further experiments demonstrated that these failures were not artefacts of our methods of sample preparation and testing, and that fatigue failure of cell processes also occurs in vivo. This work is significant as it is the first time it has been possible to conduct fatigue testing on cellular material of any kind. Many types of cells experience repetitive loading which may cause failure or damage requiring repair. It is clinically important to determine how cyclic strain affects cells and how they respond in order to gain a deeper understanding of the physiological processes stimulated in this manner. The more we understand about the natural repair process in bone the more targeted the intervention methods may become if disruption of the repair process occurred. Our results will help to understand how the osteocyte cell network is disrupted in the vicinity of matrix damage, a crucial step in bone remodelling.
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Affiliation(s)
- C Dooley
- Centre for Microscopy and Analysis, Trinity College Dublin, Dublin 2,
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Murli NL, Lee TC, Beh ML. Holistic management of venous ulcers especially with endovenous laser treatment using 980nm laser in an ethnically diverse society. Med J Malaysia 2013; 68:453-458. [PMID: 24632912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Chronic venous ulcers usually occur as an occupational hazard due to venous insufficiency with venous hypertension. Endovenous laser treatment (EVT) is used to treat varicose veins with venous ulcers and outcome including demography assessed in the different races. PROCEDURE 145 lower limbs(right 39.3%, left 60.7%) with venous ulcers involving reflux of the great saphenous (132 cases) and / or small saphenous (57 cases) veins underwent EVT with 980 nm diode laser for single (123 cases) or both (11 cases) legs intervention. Supplementary procedures required multiple avulsions and / or sclerotherapy. Holistic advice of multilayered bandaging, graduated compression stockings, weight reduction and lifestyle changes enforced. RESULT The average age with venous ulcers was 53.6 years.The mean BMI was 26.8 : the Chinese, Indian and Malay BMIs were 25.1, 28.1 and 31.3 respectively. Symptoms that included pain, swelling, heaviness and cramps assessed pre- and postsurgically were significantly reduced (<0.0001), using the Wilcoxan signed rank test. Of the occupations involved by race, the Chinese were mostly salespersons, Indians blue collar workers and Malays foodrelated workers. Young overweight Indians with sedentary occupations were most predisposed to venous ulcers. Gram negative organisms 63.4% and gram positive organisms 36.6% were isolated in the ulcers. Most ulcers 63.5% measured <2 cm and majority 73.8% localised in the gaiter area. DISCUSSION Results of EVT in healing ulcers with no recurrences more than 2 years were successful in 89.7% (130/145). Complications included numbness foot 7.5% and DVT 1.4%. 10.3% (15 cases) had recurrence of venous ulcers within 2 years. In terms of satisfaction 32.3% experienced as very satisfied while 63.4% were satisfied and 4.3% unsatisfied. In conclusion EVT is a useful adjunct with with minimal invasion in managing venous ulcers holistically.
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Affiliation(s)
- N L Murli
- Penang Adventist Hospital, 465 Burma Rd,10350 Penang, Malaysia.
| | - T C Lee
- Gleaneagles CRC, 3rd Floor Gleaneagles Medical Centre, Pangkor Rd, 10050 Penang, Malaysia
| | - M L Beh
- Gleaneagles CRC, 3rd Floor Gleaneagles Medical Centre, Pangkor Rd, 10050 Penang, Malaysia
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Chan MCW, Mok HY, Lee TC, Nelson EAS, Leung TF, Tam WWS, Chan PKS. Rotavirus activity and meteorological variations in an Asian subtropical city, Hong Kong, 1995-2009. J Med Virol 2013; 85:2026-33. [PMID: 23852875 DOI: 10.1002/jmv.23686] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2013] [Indexed: 11/06/2022]
Abstract
Rotavirus is a leading cause of severe infectious diarrhea in infants and young children aged <5 years. Rotavirus infections have minimal to strong seasonality depending on geographical locations. In this study, a comprehensive retrospective analysis was performed to evaluate the association between rotavirus admission and multiple key meteorological variables, including air temperature, relative humidity, atmospheric pressure, and solar radiation over a 15-year period from 1995 to 2009 in Hong Kong. Rotavirus infections were found to show a distinct cyclical pattern with an annual peak in cold season. The weekly number of cases showed the strongest correlation with average air temperature of the previous 7 days (rho=-0.69; P<0.0001), followed by atmospheric pressure (rho=+0.67; P<0.0001); whereas only weak correlation with relative humidity (rho=-0.252; P<0.0001) and solar radiation (rho=-0.312; P<0.0001) was observed. Curve fitting regression analysis suggested that the correlation was nonlinear in nature in which the effect was more profound towards lower air temperature and higher atmospheric pressure conditions. In binary logistic regression analysis, a final model that included air temperature (≤ 20°C) and atmospheric pressure (≥ 1,013 hPa) predicted correctly 85.3% and 82.6% of weeks with rotavirus activity above and below the baseline level, respectively. In multivariate Poisson model, air temperature and solar radiation were independent factors associated with the weekly number of rotavirus cases, adjusted for seasonal variation. In summary, the current study provides evidence suggesting that local seasonal activity of rotavirus correlated strongly with air temperature, followed by atmospheric pressure but only minimally with relative humidity in pre-vaccine era.
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Affiliation(s)
- Martin C W Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Holland JC, Brennan O, Kennedy OD, Mahony NJ, Rackard S, O'Brien FJ, Lee TC. Examination of osteoarthritis and subchondral bone alterations within the stifle joint of an ovariectomised ovine model. J Anat 2013; 222:588-97. [PMID: 23634692 DOI: 10.1111/joa.12051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2013] [Indexed: 01/22/2023] Open
Abstract
The exact relationship between osteoporosis and osteoarthritis is still a matter for debate for many. The ovariectomised ewe is frequently used as a model for osteoporosis, resulting in significant alterations in bone morphometry and turnover in both trabecular and subchondral bone after 1 year. This study examines whether ovariectomy has any impact on development of osteoarthritis within the ovine stifle joint at the same time point. In addition, we investigate whether there are any significant correlations present between articular cartilage degeneration and alterations in microstructural parameters or turnover rates in the underlying bone. Twenty-two sheep were examined in this study; 10 of the sheep underwent ovariectomy and 12 were kept as controls. Five distinctive fluorochrome dyes were administered intravenously at 12-week intervals to both groups, to label sites of bone turnover. All animals were then sacrificed 12 months postoperatively. Although most specimens showed some evidence of osteoarthritis, no measurable difference between the two study groups was detected. Osteoarthritis was associated with a thinning of the subchondral plate, specifically the subchondral cortical bone; however, whereas previous studies have suggested a link between trabecular thinning and osteoarthritis, this was not confirmed. No correlation was found between osteoarthritis and bone turnover rates of either the subchondral trabecular bone or bone plate. In conclusion, despite the fact that ovariectomy results in marked morphological and structural changes in the ovine stifle joint at 1-year postoperatively, no evidence was found to suggest that it plays a direct role in the aetiology of osteoarthritis.
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Affiliation(s)
- J C Holland
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Holland JC, Brennan O, Kennedy OD, Rackard S, O'Brien FJ, Lee TC. Subchondral osteopenia and accelerated bone remodelling post-ovariectomy - a possible mechanism for subchondral microfractures in the aetiology of spontaneous osteonecrosis of the knee? J Anat 2012; 222:231-8. [PMID: 23171138 DOI: 10.1111/joa.12007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 12/01/2022] Open
Abstract
Osteopenia and subchondral microfractures are implicated in the aetiology of spontaneous osteonecrosis of the knee (SPONK). The ovine tibia shows significant alterations of the trabecular architecture within the subchondral bone of the medial tibial plateau post-ovariectomy (OVX), including reduced trabecular bone volume fraction. We hypothesise that accelerated subchondral bone resorption may also play a role in increasing microfracture risk at this site. Twenty-two sheep were examined in this study; 10 of the sheep underwent OVX, while the remainder (n = 13) were kept as controls (CON). Five fluorochrome dyes were administered intravenously at 12-week intervals via the jugular vein to both groups, to label sites of bone turnover. These animals were then killed at 12 months post-operatively. Bone turnover was significantly increased in the OVX group in both trabecular bone (2.024 vs. 1.047 no. mm(-2) ; P = 0.05) and within the subchondral bone plate (4.68 vs. 0.69 no. mm(-2) ; P < 0.001). In addition to the classically described turnover visible along trabecular surfaces, we also found visual evidence of intra-trabecular osteonal remodelling. In conclusion, this study shows significant alterations in bone turnover in both trabecular bone and within the subchondral bone plate at 1 year post-OVX. Remodelling of trabecular bone was due to both classically described hemi-osteonal and intra-trabecular osteonal remodelling. The presence of both localised osteopenia and accelerated bone remodelling within the medial tibial plateau provide a possible mechanism for subchondral microfractures in the aetiology of SPONK. Further utilisation of the OVX ewe may be useful for further study in this field.
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Affiliation(s)
- J C Holland
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Lee TC, Selvarajan SK, Curtin H, Mukundan S. Zuckerkandl tubercle of the thyroid: a common imaging finding that may mimic pathology. AJNR Am J Neuroradiol 2012; 33:1134-8. [PMID: 22300934 DOI: 10.3174/ajnr.a2914] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The posterior thyroid tubercle, also known as ZT, is an important surgical landmark due to its close proximity to the recurrent laryngeal nerve. A recent case of ZT with a nodular configuration caused clinical concern but was shown on biopsy to be normal thyroid tissue. The purpose of this study was to review a series of CT neck studies to identify how often ZT-specifically, a nodular subtype-was present. MATERIALS AND METHODS A total of 96 neck CTs from sequential patients were retrospectively identified from January 2010 to July 2010. ZT was defined on imaging as a thyroid lobe extending posterior to the tracheoesophageal groove. A nodular subtype was defined as having a narrowed neck at the level of the tracheoesophageal groove. RESULTS There were 31 women and 45 men (mean age of 56.1 years, range 22-100 years) who met inclusion criteria. Sixty-seven patients had thyroid glands that extended posterior to the tracheoesophageal groove at CT imaging; this finding was bilateral in 43 patients, more commonly on the right (60 versus 49). Thirty-two of these patients (42.1%; 16 male, 16 female) had a nodular subtype. CONCLUSIONS ZT is an important surgical landmark of the thyroid that has important radiologic variations. It has a nodular shape in over a third of CT neck studies in our series. Recognition of this feature of the thyroid gland at CT imaging can obviate the need for biopsy and avoid potential recurrent laryngeal nerve injury.
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Affiliation(s)
- T C Lee
- Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA.
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Sato K, Moy OJ, Peimer CA, Nakamura T, Howard C, Ko SH, Lee TC, Nishiwaki Y. An experimental study on costal osteochondral graft. Osteoarthritis Cartilage 2012; 20:172-83. [PMID: 22179032 DOI: 10.1016/j.joca.2011.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 12/01/2011] [Accepted: 12/06/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate usefulness of osteochondral grafting from the costo-osteochondral junction as a repair technique for articular cartilage defects histologic and biochemical analysis of grafted cartilage in rabbit knees was evaluated up to 48 weeks after transplantation. METHODS Twenty New Zealand White rabbits were used. A costal osteochondral plug was harvested from a middle rib. After trimming, it was transplanted into a cylindrical osteochondral 2.5 mm diameter and 5 mm deep defect created in the knee. The animals were sacrificed at 6, 12, 24, and 48 weeks after transplantation. Defect sites were inspected macroscopically, and then by light microscopy. Samples were evaluated for cell viability using a fluorescent in situ double-staining protocol with confocal laser microscopic analysis. Samples were also processed to assess type I & II collagen and aggrecan mRNA expression using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS Histologically, bone union was achieved in all plugs. Confocal microscopic analysis revealed chondrocyte viability in the 48-week grafts; the distribution of chondrocytes was similar to surrounding articular cartilage. The expression of type II collagen and aggrecan mRNA in the grafted cartilage was consistent with normal articular cartilage and normal costal cartilage. These results were observed over 6-48 weeks. CONCLUSIONS Our study revealed that chondrocytes in the grafted cartilage were viable at least up to 48 weeks and that mRNA expression of type II collagen and aggrecan was also similar to that of normal articular cartilage. These results suggest that costal osteochondral grafting can be a useful alternative in the treatment of osteochondral defects.
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Affiliation(s)
- K Sato
- Hand and Shoulder Center of Western New York, Department of Orthopaedic Surgery, University at Buffalo, State University of New York, USA.
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38
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Tashkin DP, Rennard S, Taylor Hays J, Lawrence D, Marton JP, Lee TC. Lung function and respiratory symptoms in a 1-year randomized smoking cessation trial of varenicline in COPD patients. Respir Med 2011; 105:1682-90. [PMID: 21621992 DOI: 10.1016/j.rmed.2011.04.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 04/28/2011] [Indexed: 10/18/2022]
Abstract
UNLABELLED There are few data concerning changes in lung function and respiratory symptoms in smokers with chronic obstructive pulmonary disease (COPD) weeks to months after quitting smoking. We examined serial changes in spirometry and Clinical COPD Questionnaire (CCQ) scores (measuring respiratory symptoms and health-related quality of life) in COPD participants by smoking status during a smoking cessation trial. In this randomized, double-blind trial, smokers with mild-to-moderate COPD were treated with varenicline 1 mg b.i.d. or placebo for 12 weeks and followed to Week 52. Primary endpoints of abstinence were previously reported. Secondary endpoints were mean changes from baseline in post-bronchodilator forced expired volume in 1 s (FEV(1)) and CCQ scores. Change from baseline in post-bronchodilator FEV(1) was significantly improved in continuous abstainers (121.8 mL) vs. continuous smokers (37.9 mL) at Week 12 (P = 0.0069), but not at Weeks 24 or 52. Mean change from baseline at Week 12 in CCQ Total Score was significantly better in continuous abstainers (-1.04) vs. continuous smokers (-0.53; P < 0.0001): this improvement was sustained at Weeks 24 and 52. In a 1-year cessation trial of smokers with COPD, continuous abstinence compared with continuous smoking significantly improved post-bronchodilator FEV(1) at Week 12 (although the difference narrowed subsequently) and CCQ Total Scores at Week 12, with sustained improvement thereafter. ( TRIAL REGISTRY http://www.clinicaltrials.gov; trial identifier: NCT00285012).
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Affiliation(s)
- D P Tashkin
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1690, USA
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39
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Holland JC, Brennan O, Kennedy OD, Rackard SM, O'Brien FJ, Lee TC. Subchondral trabecular structural changes in the proximal tibia in an ovine model of increased bone turnover. J Anat 2011; 218:619-24. [PMID: 21477184 DOI: 10.1111/j.1469-7580.2011.01376.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Ovariectomized (OVX) sheep are now considered to be useful models for a variety of metabolic bone disorders. The specific aim of this study was to determine the effects of ovariectomy on the structural parameters and material density of the subchondral bone of the ovine tibial plateau as measured by microcomputed tomography (MicroCT). Twenty-three sheep were examined in this study; 10 of the sheep underwent ovariectomy (OVX), and the remainder (n=13) were kept as controls (CON). These animals were then sacrificed at 12 months post-operatively. Three-dimensional analyses were performed of osteochondral samples (15 mm deep) which were obtained from the medial tibial plateau using MicroCT. Bone volume fraction of the subchondral trabecular bone was reduced in the ovariectomized sheep as compared to control animals (0.439 vs. 0.483, P=0.038). Trabeculae were also significantly thinner in the OVX group (0.220 vs. 0.252 mm, P=0.010), with reduced connectivity density (7.947 vs. 11.524 mm(-3) , P=0.014). There was a trend towards lower numbers of individual trabeculae present in the OVX group as compared to controls, but this did not reach significance (2.817 vs. 3.288 mm(-1) , P=0.1). There was also increased trabecular separation in the OVX group, which again fell short of significance (0.426 vs. 0.387 mm, P=0.251). There was no difference in hydroxyapatite concentration (HA) between the two groups (929 vs. 932 mgHA cm(-3) , P=0.687). In conclusion, significant alterations of the trabecular architecture under the tibial plateau were observed following 12 months of oestrogen-deficiency in this ovine model. Despite these marked morphological and structural density differences, the material densities were equal in the two groups.
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Affiliation(s)
- J C Holland
- Department of Anatomy, Royal College of Surgeons, Dublin, Ireland.
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Brennan O, Kennedy OD, Lee TC, Rackard SM, O'Brien FJ, McNamara LM. The effects of estrogen deficiency and bisphosphonate treatment on tissue mineralisation and stiffness in an ovine model of osteoporosis. J Biomech 2010; 44:386-90. [PMID: 21093863 DOI: 10.1016/j.jbiomech.2010.10.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 10/14/2010] [Accepted: 10/15/2010] [Indexed: 01/28/2023]
Abstract
While much research has been dedicated to understanding osteoporosis, the nature of mineral distribution and the mechanical property variation in diseased bone is poorly understood. The current study aimed to determine the effect of estrogen deficiency and bisphosphonate therapy on bone tissue properties using an ovine model of osteoporosis. Skeletally mature animals (4+ years) were divided into an ovariectomy group (ovx, n=20) and a non treatment control group (control, n=20). A zoledronic acid treated group was also included in which animals were estrogen deficient for 20 months prior to receiving treatment (Zol, n=4). Half of the control and ovx groups were euthanized 12 or 31 months post-operatively and all Zol animals were euthanised at 31 months. Individual trabeculae were removed from the proximal femur and were analysed at specific locations across the width of the trabeculae. The mineral content was measured using quantitative backscatter electron imaging and the modulus was measured using nanoindentation. The spatial distribution of tissue modulus and mineral content in bone from ovariectomised animals was similar to control. However, ovariectomy significantly reduced the overall mineral content and tissue modulus relative to the control group after 12 months. Interestingly, significant differences were not maintained 31 months post-OVX. Treatment with zoledronic acid increased the mineral content and tissue modulus relative to both the ovariectomised and control groups. Zoledronic acid was also found to alter the mineral and modulus gradients normally associated with healthy bone tissue. The current study provides evidence that both estrogen deficiency and zoledronic acid therapy significantly alter mineral content and the mechanical properties of trabecular tissue.
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Affiliation(s)
- O Brennan
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Lin KL, Huang WJ, Shie JL, Lee TC, Wang KS, Lee CH. The utilization of thin film transistor liquid crystal display waste glass as a pozzolanic material. J Hazard Mater 2009; 163:916-921. [PMID: 18755540 DOI: 10.1016/j.jhazmat.2008.07.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Revised: 07/09/2008] [Accepted: 07/09/2008] [Indexed: 05/26/2023]
Abstract
This investigation elucidates the pozzolanic behavior of waste glass blended cement (WGBC) paste used in thin film transistor liquid crystal displays (TFT-LCD). X-ray diffraction (XRD) results demonstrate that the TFT-LCD waste glass was entirely non-crystalline. The leaching concentrations of the clay and TFT-LCD waste glass all met the current regulatory thresholds of the Taiwan EPA. The pozzolanic strength activity indices of TFT-LCD waste glass at 28 days and 56 days were 89% and 92%, respectively. Accordingly, this material can be regarded as a good pozzolanic material. The amount of TFT-LCD waste glass that is mixed into WGBC pastes affects the strength of the pastes. The strength of the paste clearly declined as the amount of TFT-LCD waste glass increased. XRD patterns indicated that the major difference was the presence of hydrates of calcium silicate (CSH, 2 theta=32.1 degrees), aluminate and aluminosilicate, which was present in WGBC pastes. Portland cement may have increased the alkalinity of the solution and induced the decomposition of the glass phase network. WGBC pastes that contained 40% TFT-LCD waste glass have markedly lower gel/space ratios and exhibit less degree of hydration than ordinary Portland cement (OPC) pastes. The most satisfactory characteristics of the strength were observed when the mixing ratio of the TFT-LCD waste glass was 10%.
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Affiliation(s)
- K L Lin
- Department of Environmental Engineering, National Ilan University 1, Section 1, Shen Lung Road, Yi-Lan City 26047, Taiwan, ROC.
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Abstract
BACKGROUND AND PURPOSE The CT grading system for otosclerosis was proposed by Symons and Fanning in 2005. The purpose of this study was to determine if this CT grading system has high interobserver and intraobserver agreement. MATERIALS AND METHODS All 997 petrous bone CTs performed between December 2000 and September 2007 were reviewed. A total of 81 subjects had CT evidence of otosclerosis on at least 1 side; 68 (84%) had bilateral disease. Because otosclerosis was clinically suspected in both ears of all 81 subjects even if CT evidence was only unilateral, both petrous bones (162 in total) were included. Two blinded neuroradiologists independently graded disease severity using the Symons/Fanning grading system: grade 1, solely fenestral; grade 2, patchy localized cochlear disease (with or without fenestral involvement) to either the basal cochlear turn (grade 2A), or the middle/apical turns (grade 2B), or both the basal turn and the middle/apical turns (grade 2C); and grade 3, diffuse confluent cochlear involvement (with or without fenestral involvement). One reviewer repeat-graded the petrous bone CTs to determine intraobserver agreement with a 7-month intervening delay to mitigate recall bias. RESULTS There were 154 agreements (95%) comparing the first grading of reviewer 1 with that of reviewer 2 (kappa = 0.93). When the repeat 7-month delayed grading of reviewer 1 was compared with that of reviewer 2, there were 151 (93%) agreements (kappa = 0.90). Therefore, mean interobserver agreement was excellent (mean kappa = 0.92). There were 155 agreements (96%) comparing the original grading of reviewer 1 with the delayed grading (kappa = 0.94), demonstrating excellent intraobserver agreement. CONCLUSIONS A recently published CT grading for otosclerosis on the basis of location of involvement yielded excellent interobserver and intraobserver agreement.
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Affiliation(s)
- T C Lee
- Division of Neuroradiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Brennan O, Kennedy OD, Lee TC, Rackard SM, O'Brien FJ. Biomechanical properties across trabeculae from the proximal femur of normal and ovariectomised sheep. J Biomech 2009; 42:498-503. [PMID: 19171344 DOI: 10.1016/j.jbiomech.2008.11.032] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 11/03/2008] [Accepted: 11/13/2008] [Indexed: 10/21/2022]
Abstract
The elastic behaviour of trabecular bone is a function not only of bone volume and architecture, but also of tissue material properties. Variation in tissue modulus can have a substantial effect on the biomechanical properties of trabecular bone. However, the nature of tissue property variation within a single trabecula is poorly understood. This study uses nanoindentation to determine the mechanical properties of bone tissue in individual trabeculae. Using an ovariectomised ovine model, the modulus and hardness distribution across trabeculae were measured. In both normal and ovariectomised bone, the modulus and hardness were found to increase towards the core of the trabeculae. Across the width of the trabeculae, the modulus was significantly less in the ovariectomised bone than in the control bone. However, in contrast to this hardness was found not to differ significantly between the two groups. This study provides valuable information on the variation of mechanical material properties in healthy and diseased trabecular bone tissue. The results of the current study will be useful in finite element modelling where more accurate values of trabecular bone modulus will enable the prediction of the macroscale behaviour of trabecular bone.
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Affiliation(s)
- O Brennan
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Verkerke GJ, Lee TC. Basic biomechanics. Technol Health Care 2008; 16:219-221. [PMID: 18641440] [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: 05/26/2023]
Affiliation(s)
- G J Verkerke
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Verkerke GJ, Lee TC. Section 1: statics. Technol Health Care 2008; 16:223-231. [PMID: 18641441] [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: 05/26/2023]
Affiliation(s)
- G J Verkerke
- University Medical Center Groningen, University of Groningen, Dept of Biomedical Engineering, P.O. Box 196, 9700 AD Groningen, The Netherlands.
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Huang SM, Lee TC, Akimoto H, Kono K, Lin JJ. Observation of strong electron dephasing in highly disordered Cu93Ge4Au3 thin films. Phys Rev Lett 2007; 99:046601. [PMID: 17678384 DOI: 10.1103/physrevlett.99.046601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Indexed: 05/16/2023]
Abstract
We report the observation of strong electron dephasing in a series of disordered Cu93Ge4Au3 thin films. A very short electron dephasing time possessing very weak temperature dependence around 6 K, followed by an upturn with further decrease in temperature below 4 K, is found. The upturn is progressively more pronounced in more disordered samples. Moreover, a lnT-dependent, but high-magnetic-field-insensitive, resistance rise persisting from above 10 K down to 30 mK is observed in the films. These results suggest a nonmagnetic dephasing process which is stronger than any known mechanism and may originate from the coupling of conduction electrons to dynamic defects.
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Affiliation(s)
- S M Huang
- Institute of Physics, National Chiao Tung University, Hsinchu 30010, Taiwan
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Chen CC, Lee TC, Liu KL, Lin JT, Wang HP. Pus from the pylorus: an unusual endoscopic finding suggestive of periduodenal abscess. Endoscopy 2007; 39 Suppl 1:E235-6. [PMID: 17674289 DOI: 10.1055/s-2006-944900] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C C Chen
- Dept. of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
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Abstract
Microcracks have been implicated in the loss of bone quality for osteoporosis. In order to detect and monitor their growth, and to use these data to predict fractures, it is essential to obtain quantitative data regarding their shape in three dimensions. Beam-shaped bone samples from sheep radii were prepared and stained with fluorochrome dyes and tested in cyclical fatigue under four-point bending in a servo-hydraulic fatigue-testing machine. Samples were tested at a frequency of 30 Hz under load control at a stress range of 100 MPa. Holes were drilled into bone samples and used as reference points for reconstructions. A series of thin longitudinal sections were cut using a sledge macrotome. A two-dimensional image of each section was examined using an epifluorescence microscope and images transferred to a PC via a CCD low-light colour video camera. A three-dimensional image of each microcrack was reconstructed using computer software, and its dimensions measured. Cracks were elliptical in shape, longer in the longitudinal direction and with a mean aspect ratio of 5.5 +/- 1.05. The mean (+/- SD) length and width of labelled microcracks were 488 +/- 151 and 88 +/- 21 microm, respectively.
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Affiliation(s)
- S Mohsin
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland
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Abstract
Biomechanics is a subject that draws on knowledge from many disciplines. One of its great practitioners in the last century was the Irish anatomist M.A. MacConaill. In this paper, we review some of MacConaill's fundamental contributions to biomechanics, namely: the hydrodynamic theory of synovial joint lubrication, the kinematics of joint motion and conjunct rotations; and the theory of spurt and shunt muscles. The aim is to revisit these topics in the light of current research, and to draw some conclusions about the import of his research in the context of recent developments in the field. The paper concludes with a discussion of science in Ireland, the development of the field of biomechanics since MacConaill's time, and some other matters.
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Affiliation(s)
- P J Prendergast
- Trinity Centre for Bioengineering, School of Engineering, Trinity College, Dublin.
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Abstract
Methylmethacrylate (MMA) is the most commonly used embedding medium for sectioning undecalcified bone; however, a number of problems exist with its use in a research laboratory. MMA requires a long infiltration time and temperature control, and it reacts with many polymers. We used Kleer Set resin as an alternative embedding medium for sectioning undecalcified bone specimens. Fluorochrome labeled bone specimens were sectioned transversely using a ground section technique and longitudinally on a sledge macrotome. The slides were viewed using both transmitted light and epifluorescence microscopy. High quality sections were obtained using Kleer Set resin for both sectioning techniques. We have shown that this new embedding medium is simpler, safer, quicker to use and does not interfere with visualization of fluorochromes.
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Affiliation(s)
- S Mohsin
- Department of Anatomy, Royal College of Surgeons in Ireland, Dublin.
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