1
|
MGMT Promoter Methylation Predicts Survival in 1p19q-Codeleted Gliomas after Chemotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e117. [PMID: 37784660 DOI: 10.1016/j.ijrobp.2023.06.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) MGMT promoter methylation (mMGMT) is predictive of response to alkylating chemotherapy in glioblastomas and used to guide treatment decisions. However, the role of MGMT promoter status in low-grade and anaplastic gliomas remains unclear due to molecular heterogeneity and the lack of sufficiently large datasets. We recently found that MGMT promoter methylation predicts progression-free survival in 1p19q-codeleted gliomas after alkylating chemotherapy in a meta-analysis of three prospective cohorts. There were not enough deaths to determine the effect on overall survival. Here, we query a large national database to determine the association between MGMT promoter methylation and overall survival in patients with 1p19q-codeleted gliomas. MATERIALS/METHODS We identified all patients with newly diagnosed gliomas in the National Cancer Database (NCDB) from 2010-2016 with 1p19q-codeletion and information on MGMT promoter methylation status. The cohort was stratified based on receipt of chemotherapy. Multivariable Cox proportional hazards regression modeling was used to assess the effect of MGMT promoter methylation status on overall survival after adjusting for age, sex, race, co-morbidity, grade, extent of resection, chemotherapy, and radiotherapy. RESULTS We identified 530 eligible patients, 373 (70.4%) of whom received chemotherapy in their initial course of treatment. The MGMT promoter was methylated in 400 (75.5%) patients. For all patients, unmethylated MGMT (uMGMT) was associated with poorer survival compared to mMGMT (75% survival time [75%ST] 45 months vs. not reached, P = .003, adjusted hazard ratio [aHR] 2.36 [95% confidence interval (95% CI) 1.53-3.62]). uMGMT was associated with poorer survival in patients who received chemotherapy (75%ST 22 vs. 66 months, P<.001, aHR 2.55 [95% CI 1.60-4.06]) but not in patients who did not receive chemotherapy (75%ST 110 months vs. not reached, P = 0.7, HR 1.24 [95% CI 0.40-3.81]). CONCLUSION To our knowledge, this is the first study to demonstrate an association between overall survival and MGMT promoter status in 1p19q-codeleted gliomas. MGMT promoter status should be used as a stratification factor in future clinical trials of 1p19q-codeleted gliomas that use overall survival as an endpoint.
Collapse
|
2
|
A gamma ray spectrometer with Compton suppression on the HL-2A tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2022; 93:123509. [PMID: 36586945 DOI: 10.1063/5.0117186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
A new broad-energy, high-resolution gamma ray spectrometer (GRS) with Compton suppression function has been developed recently in the HL-2A tokamak to obtain the gamma ray information in the energy range of 0.1-10 MeV. This is the first time to develop an anti-Compton GRS for a magnetic confinement fusion device. The anticoincidence detector consists of a large-volume high purity germanium (HPGe) crystal (Φ63 × 63 mm2) as the primary detector and eight trapezoidal bismuth germinate (BGO) scintillators (trapezoid crystal with 30 mm thickness) as the secondary detector. The anti-coincidence data processing is implemented by a digital-based data acquisition system with fast digitization and software signal processing technology. Using radioisotope gamma ray sources and Monte Carlo N-Particle code, the energy and efficiency of the spectrometer have been calibrated and quantitatively tested. The Compton continuum suppression factor reaches 4.2, and the energy resolution (Full Width at Half Maximum) of the 1.332 MeV full energy peak for 60Co is 2.1 keV. Measurements of gamma ray spectra with Compton suppression using the spectrometer have been successfully performed during HL-2A discharges with different conditions. The performance of the spectrometer and the first experimental results are presented in this paper.
Collapse
|
3
|
CHOROIDAL LESIONS UNRESPONSIVE TO FLUOCINOLONE ACETONIDE INTRAVITREAL IMPLANT IN BIRDSHOT CHORIORETINOPATHY. Retin Cases Brief Rep 2022; 16:56-58. [PMID: 31688672 PMCID: PMC7190444 DOI: 10.1097/icb.0000000000000909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To report the persistence of choroidal lesions despite fluocinolone acetonide intravitreal implants and their resolution with oral prednisone treatment. METHODS Retrospective chart review of a birdshot chorioretinopathy patient at a tertiary referral clinic. RESULTS Indocyanine angiography revealed resolution of choroidal lesions with oral prednisone and recurrence after discontinuation of oral prednisone. CONCLUSION Choroidal lesions responded to oral prednisone despite bilateral active fluocinolone acetonide intravitreal implant in a birdshot chorioretinopathy patient.
Collapse
|
4
|
The Association between QuantiFERON-TB Gold Test and Clinical Manifestations of Uveitis in the United States. Am J Ophthalmol 2021; 230:181-187. [PMID: 33945821 DOI: 10.1016/j.ajo.2021.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/10/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To report the prevalence of QuantiFERON-TB Gold (QFT-G) positivity among uveitis patients compared to general population and to evaluate the differences in clinical features of uveitis. DESIGN Retrospective cohort study. METHODS SETTING: Institutional. PATIENT POPULATION 418 consecutive new uveitis patients, regardless of clinical suspicion, were tested for QFT-G. OBSERVATION PROCEDURES Demographics, TB risk factors, clinical characteristics of uveitis were collected. MAIN OUTCOME MEASURES The frequency of QFT-G positivity among uveitis patients and characteristic clinical features among QFT-G positive patients. RESULTS QFT-G positivity was found in 60/418 patients with uveitis (14.4%, 95% CI: 11.18 - 18.14) higher than the general US population (5%, 95% CI: 4.2 - 5.8, p<.001). Age, gender and residence were similar between QFT-G positive and negative groups. Uveitis patients with positive QFT-G were more likely to be foreign born or have a recent travel history (OR:5.84; 95% CI: 2.83 - 12.05; p<.001). QFT-G positive patients were more likely to present with granulomatous uveitis (OR 2.90; 95%CI 1.36 - 6.21; p=.006). No significant association was found with specific clinical features such as choroiditis, retinal vasculitis, occlusive vasculitis, and serpiginoid choroiditis (p>.05 for each). Prevalence of TB-uveitis based on treatment response was 1.19%. CONCLUSIONS Our study demonstrates significantly higher prevalence of QFT-G positivity among uveitis patients compared to average US population. Characteristic signs of TB uveitis reported in endemic countries were not seen in this cohort. Implications of higher prevalence of QFT-G positivity among uveitis patients require further investigation.
Collapse
|
5
|
Time resolved absolute extreme ultraviolet radiation measurement on the ENN XuanLong-50 spherical tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2021; 92:083507. [PMID: 34470401 DOI: 10.1063/5.0040648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
A plasma radiation measurement system for a wide spectral range, based on compact Absolute eXtreme UltraViolet (AXUV) silicon photodiodes, has been implemented on the newly constructed ENN XuanLong-50 (EXL-50) spherical tokamak. The system consists of two 16-channel AXUV16ELG arrays and one AXUV63HS1 single-cell detector mounted on ceramic sockets. The two arrays, facing toward the EXL-50 slim central post from two locations inside a top and a side ConFlat 400 port, have 32 view chords covering the interested plasma region in a poloidal cross section at toroidal 330°. The single-cell detector, seated on a retractable feedthrough, could be arranged flexibly with the help of an ultra-high vacuum compatible gate valve. The design details together with considerations on the EXL-50 specific engineering realities and physics requirements are described. Preliminary results from the EXL-50 2020 experimental campaign are presented.
Collapse
|
6
|
Toroidal soft x-ray array on the EXL-50 spherical tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2021; 92:053501. [PMID: 34243359 DOI: 10.1063/5.0040511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/12/2021] [Indexed: 06/13/2023]
Abstract
A toroidal soft x-ray array system for spectrum and intensity measurements on the EXL-50 spherical tokamak is described. Silicon drift detectors and digital multichannel analyzers are adopted for all 21 channels of the array, and an average energy resolution of 147 eV at 5.89 keV has been achieved at count rates over 500 kcps. In total, 20 channels of the array are symmetrically observed in both co- and counter-current directions on the EXL-50 mid-plane with a spatial resolution of around 10 cm, and the remaining one serves as a background reference channel. Tungsten emissions from tungsten coating of the limiters on the central post are observed. The influence of hard x rays on measured soft x-ray spectra and system operation is discussed.
Collapse
|
7
|
Tangential hard x-ray diagnostic array on the EXL-50 spherical tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2021; 92:043513. [PMID: 34243380 DOI: 10.1063/5.0040636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/15/2021] [Indexed: 06/13/2023]
Abstract
A tangential hard x-ray (HXR) diagnostic on the newly constructed ENN XuanLong-50 (EXL-50) spherical tokamak for fast electron emission studies is presented. The HXR detection system consists of a symmetrical CdZnTe semiconductor detector array with a spectral sensitivity range of 20-300 keV. 25 channels have been designed on the 270° horizontal vacuum port with 12 sight lines to observe the forward emission, 12 sight lines to observe the backward emission of fast electrons, and 1 for viewing the central. Currently, ten channels have been in operation in the EXL-50 experiments. The systems are designed to measure the x-ray spectra for the estimation of fast electron temperature and electron velocity distribution in the EXL-50 experiment, which will be useful for understanding the dynamics of fast electrons generated by electron cyclotron resonance heating, for plasma instability and transport studies and for the analysis of plasma heating efficiency.
Collapse
|
8
|
Reproducibility of Full-field Electroretinogram Measurements in Birdshot Chorioretinopathy Patients: An Intra- and Inter-visit Analysis. Ocul Immunol Inflamm 2020; 29:848-853. [PMID: 31902265 DOI: 10.1080/09273948.2019.1697824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Aims to determine the variability of ffERG measurements in patients with clinically stable birdshot chorioretinopathy (BCR).Methods: Repeatability coefficients (RC) of ffERG amplitudes and implicit times were calculated from 11 BCR patients. Jackknife resampling estimated 95% confidence intervals of each ERG parameter's RC and the percentage change explained by variability alone was calculated.Results: Intra-visit variability in ffERG parameters was lower than inter-visit. Intravisit RCs demonstrated that for intravisit ERG testing, there was less than 30% variation in ERG amplitude for most parameters. For inter-visit ERG testing, a greater than 40% reduction in ERG amplitude may be clinically meaningful for 6 of 8 ERG parameters. Photopic single flash responses have <2 msec of test-retest variability both within and across visits.Conclusions: A 40% reduction in ERG amplitude and/or a delay of >2 msec in the photopic single flash response may be suitable criteria for meaningful change in BCR patients.
Collapse
|
9
|
Repeatability of Optical Coherence Tomography Angiography in Uveitic Eyes. Transl Vis Sci Technol 2019; 8:17. [PMID: 31772828 PMCID: PMC6859831 DOI: 10.1167/tvst.8.6.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/23/2019] [Indexed: 12/30/2022] Open
Abstract
Purpose To investigate the intravisit repeatability of optical coherence tomography angiography (OCTA) in a cohort of uveitis patients. Methods One hundred ten patients were imaged twice per eye, per visit, using the Zeiss Cirrus HD-OCT Model 5000 device. To calculate choriocapillaris flow void area (CC FV) 6 × 6-mm images were used, and 3 × 3-mm images were used to calculate vessel density (VD) and the foveal avascular zone area (FAZ) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Repeatability was measured using Bland-Altman analyses and intraclass correlation coefficients (ICC) with associated coefficient of variation (CV). Results The level of intravisit repeatability differed across indices ranging from moderate to excellent. CC FV had the highest intravisit repeatability with an ICC of 0.980 (95%CI, 0.966–0.989), a CV of 15.9% and Bland-Altman limits of agreement from −0.398 to 0.411 mm2. DCP FAZ had the lowest intravisit repeatability with an ICC of 0.677 (95%CI, 0.510–0.796), a CV of 17.4% and Bland-Altman limits of agreement from −0.395 to −0.355 mm2. Intraoperator repeatability was excellent across all indices. Conclusions This study demonstrates that OCTA is a reliable tool to quantitatively assess specific indices of vascular structure in uveitis patients with good intravisit repeatability. However, the range of variability for each index should be taken into account when evaluating clinically meaningful changes. Translational Relevance The repeatability of the metrics we have described has implications in supporting the development of OCTA-derived quantitative assessments of the retinal and choroidal vasculature in uveitis patients as potential imaging biomarkers.
Collapse
|
10
|
Reciprocal regulation of ARPP-16 by PKA and MAST3 kinases provides a cAMP-regulated switch in protein phosphatase 2A inhibition. eLife 2017; 6. [PMID: 28613156 PMCID: PMC5515580 DOI: 10.7554/elife.24998] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/13/2017] [Indexed: 12/17/2022] Open
Abstract
ARPP-16, ARPP-19, and ENSA are inhibitors of protein phosphatase PP2A. ARPP-19 and ENSA phosphorylated by Greatwall kinase inhibit PP2A during mitosis. ARPP-16 is expressed in striatal neurons where basal phosphorylation by MAST3 kinase inhibits PP2A and regulates key components of striatal signaling. The ARPP-16/19 proteins were discovered as substrates for PKA, but the function of PKA phosphorylation is unknown. We find that phosphorylation by PKA or MAST3 mutually suppresses the ability of the other kinase to act on ARPP-16. Phosphorylation by PKA also acts to prevent inhibition of PP2A by ARPP-16 phosphorylated by MAST3. Moreover, PKA phosphorylates MAST3 at multiple sites resulting in its inhibition. Mathematical modeling highlights the role of these three regulatory interactions to create a switch-like response to cAMP. Together, the results suggest a complex antagonistic interplay between the control of ARPP-16 by MAST3 and PKA that creates a mechanism whereby cAMP mediates PP2A disinhibition. DOI:http://dx.doi.org/10.7554/eLife.24998.001
Collapse
|
11
|
Repressed SIRT1/PGC-1α pathway and mitochondrial disintegration in iPSC-derived RPE disease model of age-related macular degeneration. J Transl Med 2016; 14:344. [PMID: 27998274 PMCID: PMC5175395 DOI: 10.1186/s12967-016-1101-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Study of age related macular degeneration (AMD) has been hampered by lack of human models that represent the complexity of the disease. Here we have developed a human in vitro disease model of AMD to investigate the underlying AMD disease mechanisms. METHODS Generation of iPSCs from retinal pigment epithelium (RPE) of AMD donors, age-matched normal donors, skin fibroblasts of a dry AMD patient, and differentiation of iPSCs into RPE (AMD RPE-iPSC-RPE, normal RPE-iPSC-RPE and AMD Skin-iPSC-RPE, respectively). Immunostaining, cell viability assay and reactive oxygen species (ROS) production under oxidative stress conditions, electron microscopy (EM) imaging, ATP production and glycogen concentration assays, quantitative real time PCR, western blot, karyotyping. RESULTS The AMD RPE-iPSC-RPE and AMD Skin-iPSC-RPE present functional impairment and exhibit distinct disease phenotypes compared to RPE-iPSC-RPE generated from normal donors (Normal RPE-iPSC-RPE). The AMD RPE-iPSC-RPE and AMD Skin-iPSC-RPE show increased susceptibility to oxidative stress and produced higher levels of reactive oxygen species (ROS) under stress in accordance with recent reports. The susceptibility to oxidative stress-induced cell death in AMD RPE-iPSC-RPE and Skin-iPSC-RPE was consistent with inability of the AMD RPE-iPSC-RPE and Skin-iPSC-RPE to increase SOD2 expression under oxidative stress. Phenotypic analysis revealed disintegrated mitochondria, accumulation of autophagosomes and lipid droplets in AMD RPE-iPSC-RPE and AMD Skin-iPSC-RPE. Mitochondrial activity was significantly lower in AMD RPE-iPSC-RPE and AMD Skin-iPSC-RPE compared to normal cells and glycogen concentration was significantly increased in the diseased cells. Furthermore, Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), a regulator of mitochondrial biogenesis and function was repressed, and lower expression levels of NAD-dependent deacetylase sirtuin1 (SIRT1) were found in AMD RPE-iPSC-RPE and AMD Skin-iPSC-RPE as compared to normal RPE-iPSC-RPE. CONCLUSIONS Our studies suggest SIRT1/PGC-1α as underlying pathways contributing to AMD pathophysiology, and open new avenues for development of targeted drugs for treatment of this devastating neurodegenerative disease of the visual system.
Collapse
|
12
|
Current progress of human trials using stem cell therapy as a treatment for diabetes mellitus. AMERICAN JOURNAL OF STEM CELLS 2016; 5:74-86. [PMID: 27853629 PMCID: PMC5107652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/22/2016] [Indexed: 06/06/2023]
Abstract
Diabetes mellitus affects millions of people worldwide, and is associated with serious complications that affect nearly all body systems. Because of the severity of this global health concern, there is a great deal of research being performed on alternative treatments and possible cures. Previous treatments for diabetes have included exogenous insulin injection and pancreatic islet transplantations. These treatment methods have several limitations; thus, the use of stem cells in treating diabetes is currently a significant area of research. This review outlines current research on stem cell therapy for diabetes mellitus. Numerous studies have been performed on animals using various types of stem cells, including mesenchymal stem cells and embryonic stem cells. Moreover, results and limitations of animal studies have been confirmed in various clinical trials. Overall, stem cell treatment shows prospective advantages over insulin injections and other current treatment options, and ongoing clinical trials suggest that this therapy may be a viable treatment option for diabetics in the near future.
Collapse
|
13
|
Prevalence of symptoms of childhood asthma, allergic rhinoconjunctivitis and eczema in the Pacific: the International Study of Asthma and Allergies in Childhood (ISAAC). Allergy 2007; 62:259-64. [PMID: 17298342 DOI: 10.1111/j.1398-9995.2007.01343.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The International Study of Asthma and Allergies in Childhood (ISAAC) has provided valuable information regarding international prevalence patterns and potential risk factors for asthma, allergic rhinoconjunctivitis and eczema. However, the only Pacific countries that participated in ISAAC Phase I were Australia and New Zealand, and these included only a small number of Pacific children. Phase III has involved not only repeating the Phase I survey to examine time trends, but also to include centres and countries which are of interest but did not participate in Phase I. The ISAAC Phase III study was therefore conducted in the Pacific (in French Polynesia, New Caledonia, Tonga, Fiji Islands, Samoa, Cook Islands, Tokelau Islands and Niue). The overall prevalence rates of current symptoms (in the last 12 months) were 9.9% for asthma, 16.4% for allergic rhinoconjunctivitis and 10.7% for atopic eczema. The prevalence of current wheezing (9.9%) was generally much lower than that has been observed in Pacific children in New Zealand (31%), but there was considerable variation between the various Pacific centres: Tokelau Islands (19.7%), Tonga (16.2%), Niue (12.7%), French Polynesia (11.3%), Cook Islands (10.6%), Fiji Islands (10.4%), New Caledonia (8.2%) and Samoa (5.8%). The reasons for these differences in prevalence across the Pacific are unclear and require further research. The finding that prevalence levels are generally considerably lower than those in Pacific children in New Zealand adds to previous evidence that children who migrate experience an altered risk of asthma as a result of exposure to a new environment during childhood.
Collapse
|
14
|
Serum mannose-binding lectin levels and mbl2 gene polymorphisms in different age and gender groups of southern Chinese adults. Scand J Immunol 2004; 59:310-4. [PMID: 15030583 DOI: 10.1111/j.0300-9475.2004.01392.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Mannose-binding lectin (MBL) is an acute-phase serum protein, and its inherited deficiency has been shown to predispose to infections. The developmental profile of serum MBL in preterm infants has been demonstrated previously. To determine the profiles of serum MBL levels and mbl2 polymorphisms over age and genders in an adult population, samples from 689 southern Chinese (age range 16-57 years; 382 males and 307 females) were studied using enzyme-linked immunosorbent assay and high-throughput genotyping of mbl2. Serum MBL levels maintained within a narrow range from age groups of 16-20 years old to 31-40 years old (mean of 2050-2160 micro g/l) and declined to a mean of 1466 micro g/l in the last age group 41-57 years old. No significant differences were found in the distributions of mbl2 haplotypes (YA, XA and YB) among all these age groups. Between gender groups, no significant imbalance of MBL profile in terms of serum MBL levels and distribution of mbl2 haplotypes was found. Results suggest an important role of circulating MBL in first-line host defence because MBL maintains at fairly constant levels after childhood and no gender influence on the MBL profile.
Collapse
|
15
|
Internal fixation of valgus-impacted humeral head fractures using the screw-wiring technique. INTERNATIONAL ORTHOPAEDICS 2002; 26:13-6. [PMID: 11954840 PMCID: PMC3620854 DOI: 10.1007/s002640100298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Between February 1996 and July 2000 eight patients (ages 35-74 years) with nine severely impacted humeral head fractures were operated on with the aim of preserving the humeral heads. Patients were treated surgically with open reduction, autologous bone grafting, and internal fixation with a screw-wiring technique. There were no complications and all patients were satisfied with the results. After 10-63 months there was no evidence of nonunion, arthritis, avascular necrosis, or loosening of implants. The mean Constant score was 83 (66-97) points. Results of this study support the observation that four-part valgus-impacted humeral head fractures without significant lateral displacement have a low incidence of avascular necrosis.
Collapse
|
16
|
[Study on the relationship of high hematocrit with changes of the blood viscosity during in the environment of altitude hypoxia]. ZHONGGUO YING YONG SHENG LI XUE ZA ZHI = ZHONGGUO YINGYONG SHENGLIXUE ZAZHI = CHINESE JOURNAL OF APPLIED PHYSIOLOGY 2001; 17:231-235. [PMID: 21189617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To investigate the relationship of high hematocrit with changes of the blood viscosity during in the environment of altitude hypoxia. METHODS Index of hemorheology was determined from populations with different time of inhabit highland and normal controls. RESULTS (1) Hematocrit and RBC deformability were higher in all highland populations than that in normal controls, these increase were time-dependent. (2) The blood viscosity was increased significantly during the early stage of inhabit highland, and restored normal in late stage. (3) RBC aggregability was reduced significantly with time-dependent in highland populations. (4) The oxygen content of tissue was reduced significantly during the early stage of inhabit highland, and restored normal in late stage. CONCLUSIONS In the environment of altitude hypoxia, RBC deformability increase and RBC aggregability decrease can suppress blood viscosity increase induced by erythrocytosis, these compensatory regulation is help to maintain the normal oxygen content of tissue.
Collapse
|
17
|
Parallel synthesis of 3-aryloxy-2-propanolamines and evaluation as dual affinity 5-HT(1A) and 5-HT re-uptake ligands. Bioorg Med Chem Lett 1999; 9:3243-8. [PMID: 10576696 DOI: 10.1016/s0960-894x(99)00570-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A solution phase synthesis for the preparation of 3-aryloxy-2-propanolamine libraries has been developed. This resulted in the identification of 5 as a ligand with dual affinity for 5-HT1A and serotonin reuptake receptors which shows excellent pharmacokinetic parameters.
Collapse
|
18
|
Abstract
Recent research has shown that perfectionism is an important psychological variable in explaining various disorders. This study evaluated (a) the factor structure and psychometric properties of the Chinese Frost Multidimensional Perfectionism Scale (CFMPS) and (b) the relative predictive power of its subscales for self-esteem and psychological distress, including depressive, anxiety, and stress symptoms. Nine hundred and forty-seven Chinese adolescents from Hong Kong between 13 and 18 years of age participated in the study. Results indicated that five of the original six factors emerged in the factor analysis. The CFMPS and its subscales were found to have satisfactory internal consistencies. Replicating and extending previous findings, the factors "Concern over Mistakes" and "Doubt about Action" accounted for most of the variances of self-esteem and psychological distress. The factor "Organization" might have positive value on psychological health. Possible cultural influence on the development of perfectionism and limitations of the study are discussed.
Collapse
|
19
|
Fluorination of 3-(3-(piperidin-1-yl)propyl)indoles and 3-(3-(piperazin-1-yl)propyl)indoles gives selective human 5-HT1D receptor ligands with improved pharmacokinetic profiles. J Med Chem 1999; 42:2087-104. [PMID: 10377215 DOI: 10.1021/jm981133m] [Citation(s) in RCA: 121] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
It has previously been reported that a 3-(3-(piperazin-1-yl)propyl)indole series of 5-HT1D receptor ligands have pharmacokinetic advantages over the corresponding 3-(3-(piperidin-1-yl)propyl)indole series and that the reduced pKa of the piperazines compared to the piperidines may be one possible explanation for these differences. To investigate this proposal we have developed versatile synthetic strategies for the incorporation of fluorine into these ligands, producing novel series of 4-fluoropiperidines, 3-fluoro-4-aminopiperidines, and both piperazine and piperidine derivatives with one or two fluorines in the propyl linker. Ligands were identified which maintained high affinity and selectivity for the 5-HT1D receptor and showed agonist efficacy in vitro. The incorporation of fluorine was found to significantly reduce the pKa of the compounds, and this reduction of basicity was shown to have a dramatic, beneficial influence on oral absorption, although the effect on oral bioavailability could not always be accurately predicted.
Collapse
|
20
|
Abstract
We compared the measurement of anti-dsDNA by a commercial ELISA test (DIASTAT), an in-house ELISA and the Crithidia luciliae assay in cross-sectional sera samples of 209 systemic lupus erythematosus (SLE) patients and 64 patients with a variety of rheumatological, autoimmune and non-autoimmune diseases in Hong Kong. The Crithidia assay was found to be the least sensitive (17%) but most specific (95%) method for detection of a positive result in SLE patients. The DIASTAT assay has a higher sensitivity (68%) but lower specificity (80%) than the in-house ELISA test (32% sensitivity and 89% specificity). The positive predictive value of the three assays are comparable at 90-92% while DIASTAT had the highest negative predictive value (44%). There was good linear correlation (r = 0.7) between the two ELISAs. ELISA can serve as a useful screening test for anti-dsDNA in SLE patients and doubtful cases can then be confirmed by another method such as radio-immunoassay.
Collapse
|
21
|
Haemophilus parainfluenzae infective endocarditis. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 1996; 25:761-2. [PMID: 8924025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Gram-negative endocarditis was uncommon in the past, accounting for 1% to 3% of cases. With the advent of antibiotics, immunosuppressive agents and narcotic abuse, the number has increased to 5% to 10% in the native valves and as high as 17% in the prosthetic valves, with Haemophilus species as the commonest aetiological agent, accounting for about 1% of the cases. We report a case of Haemophilus parainfluenzae endocarditis in a 39-year-old man who presented with heart failure and persistent fever. Echocardiography showed bi-leaflet mitral valve prolapse and severe mitral regurgitation. A small vegetation was seen at the flail anterior valve leaflet. He responded well to 4 weeks of intravenous ampicillin at 9 g/day and 2 weeks of gentamicin at 4 mg/kg/day, and subsequently underwent valve replacement.
Collapse
|
22
|
Abstract
OBJECTIVES To examine the prevalence of hyperhomocysteinaemia and compare it with the classic risk factors and vitamin status in Hong Kong Chinese patients with premature atherosclerotic coronary artery disease. DESIGN Case-control study. SETTING General hospital and community. SUBJECTS Forty five patients (39 males) with significant coronary artery disease confirmed by angiography (32 post myocardial infarction) and 23 healthy volunteers (17 male), all aged less than 55 years. INTERVENTION Standardised methionine-loading test. MAIN OUTCOME MEASURES Coronary artery disease, risk factors. RESULTS More patients than controls had fasting hyperhomocysteinaemia (10/45 v 2/23, P = 0.122), post-methionine hyperhomocysteinaemia (17/45 v 1/23, P = 0.008), and an abnormal response to methionine (15/45 v 1/23, P = 0.015). A history of smoking was more frequent in patients (3/23 v 25/45, P = 0.002). Sixteen of 17 patients with hyperhomocysteinaemia but only nine of 28 with normohomocysteinaemia were smokers (P = 0.0002). Fasting plasma cholesterol concentrations (mean (SD)) were higher in hyperhomocysteinaemic patients (6.41 (1.58) mmol/l) than in controls (5.53 (0.90) mmol/l) (P = 0.042). Serum vitamin B-12 was not reduced and serum folate was higher in hyperhomocysteinaemic patients (35 (4) nmol/l) than normohomocysteinaemic patients (26 (9) nmol/l) (P = 0.009). CONCLUSIONS Although the prevalence of hyperhomocysteinaemia in Hong Kong Chinese is similar to that in white subjects, hyperhomocysteinaemia is not an independent risk factor for coronary artery disease and is associated with smoking. This may be of some consequence in view of the change to a more Western diet with more animal protein, and therefore methionine, coupled with a high frequency of cigarette smokers in this region. The causes of the hyperhomocysteinaemia are multifactorial but in this pilot study a deficiency of folate and/or vitamin B-12 did not seem to be one of them.
Collapse
|
23
|
Abstract
The economic miracle of East Asia is followed by the emergence of a new common identity in Confucianism among the nations in the region. Being the predominant cultural determining force in East Asia, Confucianism has deeply influenced East Asian behaviour. Three behavioural traits in East Asians are discussed. First, the East Asian's lack of "personality" is traced to the Confucian social institution of Li-rules of propriety. Second, the East Asian's lack of principled moral thinking is linked to the dyadic, relation-based character of the Confucian ethic, its lack of hypothetical reasoning and its hierarchical view of human relationships. Third, the East Asian's lack of assertiveness is rooted in the Confucian ideal of man as a reflection of harmony in the cosmos and the Confucian ideal of society as based on the fulfillment of duties rather than the assertion of rights. The implications of these Confucian traits suggest the need to re-formulate Western conceptions of and approaches to East Asian behaviour.
Collapse
|
24
|
Abstract
This case report concerns a Malaysian-born Chinese woman living in the outback of Australia who was diagnosed as 'psychotic' and who recovered without drug treatment. A knowledge of her cultural background threw doubt on the assumption that her complaints were psychotic. The case shows the need to adopt cultural sensitivity in the practice of psychiatry.
Collapse
|
25
|
Effects of pulse exposure to sublethal levels of hydrogen cyanide on reproduction of American flagfish. ARCHIVES OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 1981; 10:105-116. [PMID: 6263192 DOI: 10.1007/bf01057579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
American flagfish (Jordanella floridae) were exposed to intermittent cyanide concentrations ranging from 0.065 to 0.15 mg/L hydrogen cyanide to determine the effects upon the embryonic, juvenile, and adult stages of development along with hatching success and fry survival of the subsequent F1 generation. The most significant effect was observed following embryonic exposure to levels as low as 0.075 mg/L hydrogen cyanide from fertilization to hatching. Hatching success was reduced to 37% when compared with controls while egg production among those embryos which successfully completed hatching and reached sexual maturity was subsequently reduced by 30%. A 5-day exposure to levels as low as 0.065 mg/L during the embryonic and juvenile stage produced a 40% reduction in egg production at sexual maturity and a further 33% reduction in the hatching success of the F1 generation. Exposure during the embryonic and adult stage produced a 27% reduction in fecundity. The results also suggest that exposure during embryonic development is responsible for the identical but shortened estrous cycle and delayed sexual maturity observed following embryonic (Group A), embryonic and juvenile (Group B) and embryonic and adult (Group C) exposure to hydrogen cyanide.
Collapse
|
26
|
Oesophageal atresia: triumph and tragedy. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1977; 47:138-43. [PMID: 267453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
An enormous amount has been written about oesophageal atresia during the last 30 years. This is not surprising because it is not so long ago that the condition was uniformly fatal, and even today, a generation after the first successful operations, many problems associated with its management have not been completely solved. This lecture discusses past and present management, past and present results and future prospects of infants suffering from this malformation.
Collapse
|
27
|
[Thrombocytosis in bronchial carcinoma]. SCHWEIZERISCHE RUNDSCHAU FUR MEDIZIN PRAXIS = REVUE SUISSE DE MEDECINE PRAXIS 1971; 60:743-6. [PMID: 5092310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
28
|
[Thrombocytosis in bronchial carcinoma]. SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT 1970; 100:2003. [PMID: 5507851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|