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Wong JC, Savsani E, Mahmoudzadeh R, Salabati M, Razeghinejad R, Lee D, Shukla AG, Myers JS, Pro MJ, Moster MR, Dunn JP, Kolomeyer NN. Glaucoma Surgical Outcomes in Patients with a History of Scleritis. Ocul Immunol Inflamm 2024; 32:987-993. [PMID: 36802353 DOI: 10.1080/09273948.2023.2177678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To assess the outcomes of glaucoma surgery in patients with a history of scleritis at a tertiary medical center. METHODS The retrospective case series included patients with a history of scleritis who required glaucoma surgery between 4/2006 and 8/2021. RESULTS Two hundred and eighty-one eyes of 259 patients had glaucoma and scleritis with 28 eyes (10%) of 25 patients requiring glaucoma surgery. Post-operatively, one eye (4%) had infectious scleritis. Eleven (39%) surgeries failed: 5 tube shunts, 5 cyclophotocoagulation, and 1 gonioscopy-assisted transluminal trabeculotomy. Five (18%) eyes required tube revisions due to tube exposures without infection (3), iris blocking the tube (1), or to shorten tube length (1). CONCLUSIONS Patients with a history of scleritis have a low risk of scleritis recurrence or scleral perforation after glaucoma surgery but should be counseled appropriately on the higher risk of reoperation.
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Hallaj S, Wong JC, Hock LE, Kolomeyer NN, Shukla AG, Pro MJ, Moster MR, Myers JS, Razeghinejad R, Lee D. Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg. J Ophthalmol 2024; 2024:6624021. [PMID: 38304290 PMCID: PMC10830923 DOI: 10.1155/2024/6624021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/02/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Background This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Methods Clinical data of 67 eyes of 67 patients were collected from patients' charts, and the outcomes of GDI were evaluated until 7 years. GDI failure was defined as IOP reduction of less than 20% from the baseline at two consecutive visits three months after surgery, decline to no light perception, or if additional glaucoma surgery was performed. Results The average age was 65.9 ± 13.2 years. Most cases were male (52.2%), White (53.7%), and had primary open-angle glaucoma (62.7%). Forty-four eyes had prior glaucoma surgery (68.6%) and 46 (68.6%) had severe glaucoma. Though postoperative (postop) IOP changes were insignificant, the average postop number of medications dropped from 2.4 ± 1.4 to 1.9 ± 1.2 medications two years after surgery (p = 0.0451). Postop complications (23.9%) included GDI exposure (7.5%), inflammation (4.5%), shallow anterior chamber (4.5%), and strabismus (1.5%). Hypotony was observed in 4 eyes (5.9%), none of which developed hypotony maculopathy. The cumulative one-year failure rate was 56.7%, most of which were due to failure to lower IOP. Conclusion In patients with baseline IOP ≤18 mmHg who had GDI surgery, though the change in IOP was not statistically significant, the number of medications dropped and visual field progression slowed in a subset of patients with adequate perimetric data. Due to a relatively high rate of complications and limited effectiveness in lowering IOP, GDI should be cautiously used in these eyes.
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Shalaby WS, Wong JC, Zhang TZ, Hallaj S, Lam SS, Dale EA, Pro MJ, Kolomeyer NN, Shukla AG, Lee D, Myers JS, Razeghinejad R, Moster MR. Early Postoperative Aqueous Suppression Therapy and Surgical Outcomes of Ahmed Tube Shunts in Refractory Glaucoma. Ophthalmol Glaucoma 2024; 7:47-53. [PMID: 37558051 DOI: 10.1016/j.ogla.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE To compare early vs. delayed use of aqueous suppressants on Ahmed glaucoma valve (AGV) outcomes. DESIGN Single-center retrospective comparative case series. PARTICIPANTS Patients who underwent AGV surgery at Wills Eye Hospital in the period between 2016 and 2021. METHODS Retrospective review of AGV surgery at Wills Eye Hospital 2016 to 2021 for refractory glaucoma. Two groups were created: group 1 or those who received early aqueous suppressant therapy in the first 2 weeks postoperatively whenever the intraocular pressure (IOP) was > 10 mmHg, and group 2 or those who received delayed treatment after 2 weeks whenever the IOP exceeded the target pressure. Aqueous suppressant therapy included topical beta blockers, carbonic anhydrase inhibitors, and/or alpha agonists. MAIN OUTCOME MEASURES The primary outcome measures were the frequency of hypertensive phase (HP) defined as IOP > 21 mmHg in first 3 months after an initial reduction to 21 mmHg or less in the first postoperative week not caused by tube obstruction or retraction, and month-12 surgical failure defined as 5 ≥ IOP > 21 mmHg on 2 consecutive visits, vision decline to no light perception (NLP), or glaucoma reoperation. Secondary outcome measures included changes in visual acuity (VA), IOP, and glaucoma medications at 12 months. Predictive factors for surgical failure were also identified. RESULTS A total of 407 eyes of 391 patients (260 in group 1, 147 in group 2) with similar baseline characteristics were included. Hypertensive phase was more common in group 2 than 1 (41.5% vs. 18.5%; P < 0.001). At month 12 (N = 303 eyes), group 1 was less likely to fail than group 2 (21.2% vs. 36.8%, P = 0.003). Multivariate regression analysis showed that HP (odds ratio [OR] = 10.47, P < 0.001), delayed aqueous suppression use (OR = 2.17, P = 0.003), and lower baseline VA (OR = 1.56, P = 0.015) were the strongest predictors of month-12 failure. CONCLUSIONS Early use of aqueous suppressants may lower the risk of HP and improve AGV outcomes. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Hallaj S, Wong JC, Shalaby WS, Ayres BD, Moster MR. Persistent Mydriasis Following Gonioscopy-Assisted Transluminal Trabeculotomy. J Glaucoma 2024; 33:55-58. [PMID: 37523651 DOI: 10.1097/ijg.0000000000002283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/08/2023] [Indexed: 08/02/2023]
Abstract
Herein we describe 2 cases of persistent mydriasis after gonioscopy-assisted transluminal trabeculotomy for open angle glaucoma. Both surgeries were uneventful, but the patients experienced postoperative hyphema and intraocular pressure elevation. They then developed persistent fixed and dilated pupils resistant to pilocarpine that led to intolerable photosensitivity and glare. An iris cerclage pupilloplasty was performed with adequate relief of symptoms in one case.
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Myers JS, Lamrani R, Hallaj S, Lee D, Wong JC. 10-Year Clinical Outcomes of Tube Shunt Surgery at a Tertiary Care Center. Am J Ophthalmol 2023; 253:132-141. [PMID: 37072075 DOI: 10.1016/j.ajo.2023.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE To report 10-year clinical outcomes of tube shunt (TS) surgery at a tertiary care center. DESIGN Retrospective cohort study. METHODS Eyes were included that underwent a first TS surgery between January 2005 and December 2011 at a tertiary referral eye hospital and with at least 10 years of follow-up. Demographic and clinical data were collected. Failure was defined as reoperation to lower intraocular pressure (IOP), IOP > 80% of baseline for two consecutive visits, or progression to no light perception. RESULTS Eighty-five eyes of 78 patients were included in the Study Group; 89 eyes were selected as a Comparison Group. Mean follow-up was 11.9 ± 1.7 years. Fifty-one valved (60%), 25 non-valved (29%), and nine unknown (11%) TS were placed. At the final visit, mean IOP was reduced from 29.2 ± 10.4 mmHg on 3.1 ± 1.2 medications to 12.6 ± 5.8 mmHg on 2.2 ± 1.4 (p<0.001 for each). Forty-eight eyes (56%) failed; 29 eyes (34%) underwent additional glaucoma surgery; eight eyes (10%) progressed to no light perception; and 34 eyes (40%) also required TS revision. Best corrected visual acuity (BCVA) logMAR (minimal angle of resolution) worsened from 0.8 ± 0.7 (20/125) to 1.4 ± 1.0 (20/500) at the last visit (p<0.001). Average visual field MD was -13.9 ± 7.5 dB at baseline and -17.0 ± 7.0 dB at last follow-up (P=0.0605). CONCLUSIONS Many eyes maintained IOP control 10 years following TS, but 56% met failure criteria, 39% had substantial vision loss, and 34% underwent additional surgery. Outcomes did not differ with TS model. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Wu CM, Zheng CX, Kuley B, Wong JC, Lin MM, Moster SJ, Moster MR, Schmidt C, Pro MJ, Lee D. Outcomes of Selective Laser Trabeculoplasty After Prior Incisional Surgery for Open Angle Glaucoma. J Glaucoma 2023; 32:474-479. [PMID: 36847694 DOI: 10.1097/ijg.0000000000002196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/12/2023] [Indexed: 03/01/2023]
Abstract
PRCIS This retrospective case series of patients with open angle glaucoma and prior trabeculectomy or tube shunt surgery found that selective laser trabeculoplasty (SLT) resulted in significant intraocular pressure (IOP) reductions in the intermediate follow-up period in select cases. PURPOSE The purpose of this study was to assess the IOP-lowering effect and tolerability of SLT after prior trabeculectomy or tube shunt surgery. MATERIALS AND METHODS Open angle glaucoma patients at Wills Eye Hospital who previously underwent incisional glaucoma surgery and subsequently received SLT between 2013 and 2018 were included, along with an age-matched control group. Baseline characteristics, procedural data, and post-SLT data were recorded at 1, 3, 6, 12 months, and most recent visit. The primary success of SLT treatment was defined as IOP reduction of 20% or greater without the use of additional glaucoma medications compared to pre-SLT IOP. Secondary success was defined as IOP reduction ≥20% with the use of additional glaucoma medications compared to pre-SLT IOP. RESULTS There were 45 eyes in the study group and 45 eyes in the control group. In the study group, IOP decreased from a baseline of 19.5±4.7 mm Hg on 2.2±1.2 medications to 16.7±5.2 mm Hg ( P =0.002) on 2.2±1.1 glaucoma medications ( P =0.57). In the control group, IOP decreased from 19.5±4.2 mm Hg on 2.4±1.0 medications to 16.4±5.2 mm Hg ( P =0.003) on 2.1±1.3 medications ( P =0.36). There was no difference in IOP reduction or change in number of glaucoma medications after SLT at any postoperative visit between the 2 groups ( P ≥0.12 for all). Primary success rates at 12 months were 24.4% for the control group and 26.7% for the prior incisional glaucoma surgery group with no significant difference between the groups ( P =0.92). There were no persistent complications after SLT treatment in either group. CONCLUSION SLT may effectively lower IOP in patients with open angle glaucoma who have had previous incisional glaucoma surgery and should be considered in select cases.
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Wong JC, Shiuey EJ, Razeghinejad R, Shukla AG, Kolomeyer NN, Myers JS, Pro MJ, Lee D. The effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% at a tertiary glaucoma center. Graefes Arch Clin Exp Ophthalmol 2023; 261:193-200. [PMID: 35904596 DOI: 10.1007/s00417-022-05780-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To assess real-world effectiveness and tolerability of fixed-dose combination netarsudil 0.02%/latanoprost 0.005% (FCNL) in management of glaucoma patients in a tertiary eye care center. METHODS This retrospective cohort study included glaucoma patients initiated on FCNL from January 2018 to July 2021 with at least 1-month follow-up. Demographic and clinical data were collected at baseline and at follow-up visits through 12 months. Patient-solicited side effects were recorded at each visit. Maximum glaucoma pharmacotherapy was defined as surgery/laser being the next treatment option following an intensive pharmacotherapy regimen, or when pharmacotherapy could not be increased due to allergy/intolerance or all pharmacologic mechanisms already being in use. RESULTS Seventy-nine eyes of 47 patients were included. Mean age was 67.7 ± 14.7 years. Baseline IOP was 18.7 ± 4.9 mmHg; mean change in IOP (∆IOP) each study visit compared to baseline ranged from - 1.6 ± 3.5 to - 4.4 ± 4.1 mmHg (all p < 0.05). The eyes on maximum glaucoma pharmacotherapy (73.4%) had similar ∆IOP compared to those on non-maximal therapy at each visit (p > 0.2 for all). Forty-three (54.4%) eyes were switched from a prostaglandin analog alone, producing a 1-month IOP reduction of - 4.7 ± 3.9 mmHg at 1 month which remained significant at each visit for the 12-month study period (all p < 0.05). Across all study visits, conjunctival hyperemia was documented in 26 (32.9%) eyes. Subjective blurry vision was reported in 22 (27.8%) eyes without significant worsening of visual acuity at any visit (all p > 0.05). Six (7.6%) and 7 (8.9%) eyes required further medical or surgical/laser intervention, respectively. Kaplan-Meier analysis revealed no significant difference in the need for subsequent medical or surgical intervention between those on maximum and non-maximal pharmacotherapy (p > 0.4). CONCLUSION FCNL was well-tolerated and demonstrated a significant and sustained reduction in IOP, even as last-line therapy before incisional or laser surgery in those on maximum glaucoma pharmacotherapy. FCNL is a viable treatment option for glaucomatous eyes before consideration of surgical intervention.
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Salabati M, Mahmoudzadeh R, Wong JC, Patel D, Patel SN, Obeid A, Sivalingam A, Vander JF, Garg SJ, Ho AC, Regillo CD, Hsu J. Outcomes of eyes with retinal vein occlusion that are lost to follow-up after antivascular endothelial growth factor therapy. Br J Ophthalmol 2021; 106:1742-1747. [PMID: 34183325 DOI: 10.1136/bjophthalmol-2021-319180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/15/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To evaluate the outcomes of eyes with macular oedema due to retinal vein occlusion (RVO) that are lost to follow-up (LTFU) after antivascular endothelial growth factor (VEGF) injections. METHOD A retrospective, single-centre, consecutive case series of RVO patients receiving injections who were LTFU >6 months was conducted. Data were collected from the visit before LTFU; return visit; 3 months, 6 months and 12 months after return; and the final visit. RESULTS Ninety eyes of 83 patients were included. Fifty (55.5%) eyes had branch RVO and 40 (44.5%) had central RVO. Mean LTFU duration was 277.8 days with additional mean follow-up for 748.1 days after return. Mean logarithm of the minimum angle of resolution visual acuity (VA) (Snellen) at the visit before LTFU was 0.72 (20/105) which worsened on return [1.04 (20/219), p<0.001) and remained worse at all timepoints after return: 0.92 (20/166) at 3 months (p<0.001), 0.97 (20/187) at 6 months (p<0.001), 0.94 (20/174) at 12 months (p<0.001) and 1.01 (20/205) at final visit (p<0.001). Mean central foveal thickness (CFT) increased from 252 µm at the visit before LTFU to 396 µm at the return visit (p<0.001). No difference in CFT was noted by 3 months (258 µm, p=0.71), 6 months (241 µm, p=0.54) or 12 months after return (250 µm, p=0.95). CFT was thinner at the final visit (215 µm, p=0.018). CONCLUSION RVO patients receiving anti-VEGF injections who were LTFU experienced a decline in VA that did not return to the levels seen before LTFU despite improvement in CFT after restarting therapy, underscoring the importance of ongoing treatment.
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DiMeglio LA, Kanapka LG, DeSalvo DJ, Anderson BJ, Harrington KR, Hilliard ME, Laffel LM, Tamborlane WV, Van Name MA, Wadwa RP, Willi SM, Woerner S, Wong JC, Miller KM. Time spent outside of target glucose range for young children with type 1 diabetes: a continuous glucose monitor study. Diabet Med 2020; 37:1308-1315. [PMID: 32096282 PMCID: PMC9065795 DOI: 10.1111/dme.14276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2020] [Indexed: 12/19/2022]
Abstract
AIM To assess the associations between demographic and clinical characteristics and sensor glucose metrics in young children with type 1 diabetes, using masked, continuous glucose monitoring data from children aged 2 to < 8 years. RESEARCH DESIGN AND METHODS The analysis included 143 children across 14 sites in the USA, enrolled in a separate clinical trial. Eligibility criteria were: age 2 to <8 years; type 1 diabetes duration ≥3 months; no continuous glucose monitoring use for past 30 days; and HbA1c concentration 53 to <86 mmol/mol (7.0 to <10.0%). All participants wore masked continuous glucose monitors up to 14 days. RESULTS On average, participants spent the majority (13 h) of the day in hyperglycaemia (>10.0 mmol/l) and a median of ~1 h/day in hypoglycaemia (<3.9 mmol/l). Participants with minority race/ethnicity and higher parent education levels spent more time in target range, 3.9-10.0 mmol/l, and less time in hyperglycaemia. More time in hypoglycaemia was associated with minority race/ethnicity and younger age at diagnosis. Continuous glucose monitoring metrics were similar in pump and injection users. CONCLUSIONS Given that both hypo- and hyperglycaemia negatively impact neurocognitive development, strategies to increase time in target glucose range for young children are needed.
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Varni JW, Delamater AM, Hood KK, Raymond JK, Chang NT, Driscoll KA, Wong JC, Yi-Frazier JP, Grishman EK, Faith MA, Corathers SD, Kichler JC, Miller JL, Doskey EM, Aguirre VP, Heffer RW, Wilson DP. Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module for youth with Type 2 diabetes: reliability and validity. Diabet Med 2019; 36:465-472. [PMID: 30343524 DOI: 10.1111/dme.13841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2018] [Indexed: 12/26/2022]
Abstract
AIM To test the measurement properties of the revised and updated Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module originally developed in Type 1 diabetes in youth with Type 2 diabetes. METHODS The PedsQL 3.2 Diabetes Module and PedsQL Generic Core Scales were administered in a field test study to 100 young people aged 9-25 years with Type 2 diabetes. Factor analysis was conducted to determine the factor structure of the items. RESULTS The 15-item Diabetes Symptoms Summary Score and 12-item Type 2-specific Diabetes Management Summary Score were empirically derived through factor analysis. The Diabetes Symptoms and Type 2-specific Diabetes Management Summary Scores showed acceptable to excellent reliability across the age groups tested (α = 0.85-0.94). The Diabetes Symptoms and Type 2-specific Diabetes Management Summary Scores evidenced construct validity through large effect size correlations with the Generic Core Scales Total Scale Score (r = 0.67 and 0.57, respectively). HbA1c was correlated with the Diabetes Symptoms and Type 2-specific Diabetes Management Summary Scores (r = -0.13 and -0.22). Minimal clinically important difference (MCID) scores were 5.91 and 7.39 for the Diabetes Symptoms and Type 2-specific Diabetes Management Summary Scores. CONCLUSIONS The PedsQL 3.2 Diabetes Module Diabetes Symptoms Summary Score and Type 2-specific Diabetes Management Summary Score exhibited satisfactory measurement properties for use as youth self-reported diabetes symptoms and diabetes management outcomes for clinical research and clinical practice for young people with Type 2 diabetes.
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Wong JC, Visanji NP, Dabek MK, Laposa RR, Hazrati LN. Dendritic spine density is altered in a mouse model of Cockayne syndrome. Neuropathol Appl Neurobiol 2013; 39:437-40. [PMID: 23039087 DOI: 10.1111/j.1365-2990.2012.01305.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/26/2012] [Indexed: 01/13/2023]
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Yuan R, Hogg JC, Paré PD, Sin DD, Wong JC, Nakano Y, McWilliams AM, Lam S, Coxson HO. Prediction of the rate of decline in FEV(1) in smokers using quantitative Computed Tomography. Thorax 2009; 64:944-9. [PMID: 19734130 DOI: 10.1136/thx.2008.112433] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A study was undertaken to determine if quantitative CT estimates of lung parenchymal overinflation and airway dimensions in smokers with a normal forced expiratory volume in 1 s (FEV(1)) can predict the rapid decline in FEV(1) that leads to chronic obstructive pulmonary disease (COPD). METHODS Study participants (n = 143; age 45-72 years; 54% male) were part of a lung cancer screening trial, had a smoking history of >30 pack years and a normal FEV(1) and FEV(1)/forced vital capacity (FVC) at baseline (mean (SD) FEV(1) 99.4 (12.8)%, range 80.2-140.7%; mean (SD) FEV(1)/FVC 77.9 (4.4), range 70.0-88.0%). An inspiratory multislice CT scan was acquired for each subject at baseline. Custom software was used to measure airway lumen and wall dimensions; the percentage of the lung inflated beyond a predicted maximal lung inflation, the low attenuation lung area with an x ray attenuation lower than -950 HU and the size distribution of the overinflated lung areas and the low attenuation area were described using a cluster analysis. Multiple regression analysis was used to test the hypothesis that these CT measurements combined with other baseline characteristics might identify those who would develop an excessive annual decline in FEV(1). RESULTS The mean (SD) annual change in FEV(1) was -2.3 (4.7)% predicted (range -23.0% to +8.3%). Multiple regression analysis revealed that the annual change in FEV(1)%predicted was significantly associated with baseline percentage overinflated lung area measured on quantitative CT, FEV(1)% predicted, FEV(1)/FVC and gender. CONCLUSION Quantitative CT scan evidence of overinflation of the lung predicts a rapid annual decline in FEV(1) in smokers with normal FEV(1).
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de Jong PA, Long FR, Wong JC, Merkus PJ, Tiddens HA, Hogg JC, Coxson HO. Computed tomographic estimation of lung dimensions throughout the growth period. Eur Respir J 2006; 27:261-7. [PMID: 16452578 DOI: 10.1183/09031936.06.00070805] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the current study was to use computed tomography (CT) to estimate airway wall and lumen, and arterial and parenchyma dimensions in children throughout the growth period, and to provide normative data to study alterations caused by pulmonary disease. Clinical CT scans reported as normal that were performed in children for nonpulmonary and noncardiac reasons were analysed for lung weight, gas volume, lung expansion, lung surface/volume ratio, airway wall area, airway lumen area, airway lumen perimeter, arterial area and airway surface length/area ratio. The age range of the 50 subjects was 0-17.2 yrs. The data showed only little increase in lung expansion throughout childhood (n = 32). There was substantial variability in lung expansion between subjects. Airway wall and lumen and arterial area were exponentially associated with subjects' height (n = 50). Airway surface length/area ratio was linearly associated to alveolar surface/volume ratio. The data from the current study provide normative computed tomography estimates of airway wall and lumen, and arterial and parenchyma dimensions throughout the growth period that may be useful for the study of alterations in disease.
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Wong JC, Lambert RJ, Wurtzel ET, Rocheford TR. QTL and candidate genes phytoene synthase and zeta-carotene desaturase associated with the accumulation of carotenoids in maize. TAG. THEORETICAL AND APPLIED GENETICS. THEORETISCHE UND ANGEWANDTE GENETIK 2004; 108:349-59. [PMID: 14523521 DOI: 10.1007/s00122-003-1436-4] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2003] [Accepted: 08/12/2003] [Indexed: 05/23/2023]
Abstract
Carotenoids are a class of fat-soluble antioxidant vitamin compounds present in maize ( Zea mays L.) that may provide health benefits to animals or humans. Four carotenoid compounds are predominant in maize grain: beta-carotene, beta-cryptoxanthin, zeaxanthin, and lutein. Although beta-carotene has the highest pro-vitamin A activity, it is present in a relatively low concentration in maize kernels. We set out to identify quantitative trait loci (QTL) affecting carotenoid accumulation in maize kernels. Two sets of segregating families were evaluated-a set of F2:3 lines derived from a cross of W64a x A632, and their testcross progeny with AE335. Molecular markers were evaluated on the F2:3 lines and a genetic linkage map created. High-performance liquid chromatography was performed to measure beta-carotene, beta-cryptoxanthin, zeaxanthin, and lutein on both sets of materials. Composite interval mapping identified chromosome regions with QTL for one or more individual carotenoids in the per se and testcross progenies. Notably QTL in the per se population map to regions with candidate genes, yellow 1 and viviparous 9, which may be responsible for quantitative variation in carotenoids. The yellow 1 gene maps to chromosome six and is associated with phytoene synthase, the enzyme catalyzing the first dedicated step in the carotenoid biosynthetic pathway. The viviparous 9 gene maps to chromosome seven and is associated with zeta-carotene desaturase, an enzyme catalyzing an early step in the carotenoid biosynthetic pathway. If the QTL identified in this study are confirmed, particularly those associated with candidates genes, they could be used in an efficient marker-assisted selection program to facilitate increasing levels of carotenoids in maize grain.
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Sternson SM, Wong JC, Grozinger CM, Schreiber SL. Synthesis of 7200 small molecules based on a substructural analysis of the histone deacetylase inhibitors trichostatin and trapoxin. Org Lett 2001; 3:4239-42. [PMID: 11784187 DOI: 10.1021/ol016915f] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Seventy-two hundred potential inhibitors of the histone deacetylase (HDAC) enzyme family, based on a 1,3-dioxane diversity structure, were synthesized on polystyrene macrobeads. The compounds were arrayed for biological assays in a "one bead-one stock solution" format. Metal-chelating functional groups were used to direct the 1,3-dioxanes to HDAC enzymes, which are zinc hydrolases. Representative structures from this library were tested for inhibitory activity and the 1,3-dioxane structure was shown to be compatible with HDAC inhibition. [structure: see text]
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Vishvakarman D, Wong JC, Boreham BW. Annual occupational exposure to ultraviolet radiation in central Queensland. HEALTH PHYSICS 2001; 81:536-544. [PMID: 11669207 DOI: 10.1097/00004032-200111000-00008] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of this study was to determine annual occupational exposure to UV radiation by measurement and derive ambient exposure fractions for an entire year that could be applied in the human exposure model. Using polysulphone the daily occupational erythema effective solar ultraviolet radiation exposure at selected body sites of Australia Post mail delivery personnel and physical education teachers were measured over an 18-mo period on a daily basis in the Rockhampton (lat. 23.5 degrees S) region. The daily exposures were summed to estimate an annual exposure for these occupations in this region. For the Australia Post mail delivery personnel, who had very little change to the posture or route during delivery, the annual mean estimates of exposure to erythema effective solar irradiance for the chest, hands, and back were in the range of 192+/-27 kJ m(-2), 388+/-45 kJ m(-2), and 283+/-32 kJ m(-2), respectively. Physical education teachers had varied duties on a day-to-day basis and many changes in their posture and outdoor locations where the exposure occurred. Their annual mean exposure on the vertex (hat), chest, shoulder, thigh, and back were in the range 340+/-71 kJ m(-2), 140+/-28 kJ m(-2), 180+/-40 kJ m(-2), 129+/-24 kJ m(-2), and 212+/-42 kJ m(-2), respectively. The annual exposure range for erythema effective solar irradiance at different body sites during the experimental period was between 120 and 440 kJ m(-2) for the two occupational groups. These exposures greatly exceed the National Health and Medical Research Council occupational standard limit of 30 J m(-2) for daily exposure, which indicates the need for additional protective measures. The ambient exposure was also measured and used to compute ambient exposure fractions for the different body sites over an entire year, which are useful for model calculations on human exposure and assess increase in risk of n on melanoma skin cancer.
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Provenzale JM, Petrella JR, Cruz LC, Wong JC, Engelter S, Barboriak DP. Quantitative assessment of diffusion abnormalities in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol 2001; 22:1455-61. [PMID: 11559490 PMCID: PMC7974581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND AND PURPOSE Previous studies have shown that lesions in posterior reversible encephalopathy syndrome are often isointense on diffusion-weighted MR images. We hypothesized that 1) apparent diffusion coefficient (ADC) maps using various thresholds would show larger abnormalities in posterior white matter (WM) and 2) isointense appearance of lesions on isotropic diffusion-weighted images results from a balance of T2 prolongation effects and diffusibility effects. METHODS T2-weighted MR images from 11 patients were reviewed. Hyperintense lesions were located in both anterior and posterior WM in eight patients and solely in posterior WM in three patients. The ADC maps were produced by use of ADC values > or = 3 SD and > or = 10 SD above the mean value of normal WM. Lesions on diffusion-weighted images were classified as isointense or hypointense. ADC values within lesions (ADC(L)) were compared with those of normal WM (ADC(N)), and compared for isointense lesions and hypointense lesions. RESULTS The distribution of lesions with ADC values > or = 3 SD was essentially identical to that on T2-weighted images. Regions with ADC values > or = 10 SD were found in both anterior WM and posterior WM in two patients and solely in posterior WM in nine patients. On diffusion-weighted images, lesions appeared isointense in seven patients and hypointense in four patients. Mean ADC(L)/ADC(N) for all lesions was 1.81; for hypointense lesions, 2.30. CONCLUSION Vasogenic edema was more severe in posterior WM. Isointense lesions result from a balance of T2 effects and increased water diffusibility. Hypointense lesions have higher ADC values, which are not balanced by T2 effects.
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Haynes SL, Wong JC, Torella F, Dalrymple K, Pilsworth L, McCollum CN. The influence of homologous blood transfusion on immunity and clinical outcome in aortic surgery. Eur J Vasc Endovasc Surg 2001; 22:244-50. [PMID: 11506518 DOI: 10.1053/ejvs.2001.1408] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To evaluate the influence of homologous blood transfusion on immune responses and post-operative morbidity in aortic surgery. DESIGN Analysis of the effects of homologous blood transfusion in 128 patients in a prospective randomised trial evaluating homologous and autologous blood transfusion in aortic surgery. MATERIALS AND METHODS Blood sampled before and at five times after surgery was assayed for C-reactive protein (CRP), neutrophil elastase, TNF-alpha and IL-6. Transfusions, morbidity and mortality were recorded; factors associated with poor outcome were identified by logistic regression. RESULTS homologous transfusion during surgery was required in 32 patients and precipitated an increase in neutrophil elastase (p=0.008) and TNF-alpha (p=0.015) but not IL-6 and CRP. Elastase peaked early in transfused patients at 41.27 (13.92-52.11) Deltang/ml by 2 h compared to a peak of 21.51 (10.64-31.13) Deltang/ml by 24 h in those who were not transfused. TNF-alpha peaked at 1.2 (0-4.33) Deltapg/ml by wound closure in transfused patients and at -0.1 (-2.05-2.52) Deltapg/ml by 2 h without transfusion. Intra-operative homologous transfusion was associated with increased mortality (p=0.01) and prolonged intensive care stay (p=0.03). Mortality increased with age (p=0.003) and was inversely related to the CRP peak (p=0.007). Prolonged surgery predicted post-operative complications (p=0.025). CONCLUSION Homologous transfusion increased the inflammatory response to aortic surgery and was associated with mortality.
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Parisi AV, Kimlin MG, Wong JC, Wilson M. Solar ultraviolet exposures at ground level in tree shade during summer in south east Queensland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2001; 11:117-127. [PMID: 11382345 DOI: 10.1080/09603120020047500] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Data are presented on the effect of the tree canopy transmittance in the visible waveband (VT), canopy width, height and height of the start of the tree canopy (CH) on the solar UV in tree shade on a horizontal plane at ground level during a Southern Hemisphere summer. Of these factors, the VT and CH have an influence on the UV irradiances in the tree shade. The shade ratios (UV in tree shade to that in full sun) for erythemal UV ranged from 0.71 to 0.42, 0.54 to 0.29 and 0.63 to 0.41 for morning, noon and afternoon, respectively, for the VT range of 0.4-1.0. Over the same VT range, the shade ratios for UVA ranged from 0.61 to 0.28, 0.50 to 0.22 and 0.49 to 0.29 for morning, noon and afternoon, respectively. The UV exposures in the tree shade decreased with the VT with a marginally higher decrease in the irradiances for the UVA compared to the erythemal UV. Despite the protection by the tree shade, significant UV in the tree shade of approximately 4 MED (minimum erythemal dose) were received for the latitude in this research on a cloud free summer day on a horizontal plane over a 2-h period centred about solar noon.
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Parisi AV, Wong JC, Kimlin MG, Turnbull D, Lester R. Comparison between seasons of the ultraviolet environment in the shade of trees in Australia. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2001; 17:55-9. [PMID: 11338402 DOI: 10.1034/j.1600-0781.2001.017002055.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/PURPOSE This paper has considered the erythemal UV (UVery), UVA and visible irradiances in the shade of Australian trees for each season at a sub-tropical southern hemisphere site. METHODS The irradiances in tree shade have been measured with radiometers as a percentage of the irradiances in the sun for each season of the year. RESULTS Although the solar irradiances are lower in winter, the percentages of the UV in tree shade compared to the UV in full sun are marginally higher (by up to 7%) in the winter compared to summer. The range of percentages for UVery was up to double that of the percentages of the visible waveband. The percentages for UVery were also higher than for the UVA waveband. The percentages of the irradiances in the tree shade compared to full sun are 8-14% lower at noon compared to the morning and afternoon for the UVery waveband. The ratio of UVA to UVery is lower in the tree shade compared to the full sun. CONCLUSIONS The UVA to UVery ratio is expected to be even lower in the tree shade as a result of ozone depletion. This, combined with the visible irradiances in the tree shade not being a reliable indication of the biologically damaging UV irradiances, has consequences for public health and skin cancer prevention.
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Chen YM, Huang KL, Jen I, Chen SC, Liu YC, Chuang YC, Wong JC, Tsai JJ, Lan YC. Temporal trends and molecular epidemiology of HIV-1 infection in Taiwan from 1988 to 1998. J Acquir Immune Defic Syndr 2001; 26:274-82. [PMID: 11242201 DOI: 10.1097/00042560-200103010-00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Eight hundred and seventy-nine HIV-1-infected patients (comprising 46% of reported HIV-1/AIDS cases in Taiwan) were recruited for this study of the molecular epidemiology of HIV-1 in Taiwan from 1988 to 1998. HIV-1 subtypes were determined using a modified peptide-enzyme immunoassay complemented with DNA sequencing and phylogenetic analysis. Of the 807 HIV-1 infected men, 68.2% were infected with HIV-1B, 29.5% with HIV-1 circulating recombinant form (CRF)01_AE and 2.3% with other subtypes. Of the 72 HIV-1-infected women, 72.2% were infected with HIV-1 CRF01_AE, 13.9% with HIV-1B, and 13.9% with other subtypes. All of 8 foreign-born, Southeast Asian women and 6 of 7 (85.7%) Taiwan-native female commercial sex workers were infected with HIV-1 CRF01_AE. Fourteen of the 33 (42.4%) heterosexual married men with CRF01_AE had transmitted HIV-1 to their wives, whereas only 1 of 17 (5.9%) men with HIV-1 B had transmitted HIV-1 to their spouses (p < .01). Of 18 heterosexual male injecting drug users, 1 of 12 (8.5%) with HIV-1B and 5 of 6 (83.3%) with HIV-1 CRF01_AE had had sexual contact with female commercial sex workers (p < .01). Therefore, in this population, CRF01_AE was preferentially associated with heterosexual risk groups, a finding compatible with differences in transmission capability between B and non-B subtypes.
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Sternson SM, Louca JB, Wong JC, Schreiber SL. Split--pool synthesis of 1,3-dioxanes leading to arrayed stock solutions of single compounds sufficient for multiple phenotypic and protein-binding assays. J Am Chem Soc 2001; 123:1740-7. [PMID: 11456775 DOI: 10.1021/ja0036108] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Diversity-oriented organic synthesis offers the promise of advancing chemical genetics, where small molecules are used to explore biology. While the split--pool synthetic method is theoretically the most effective approach for the production of large collections of small molecules, it has not been widely adopted due to numerous technical and analytical hurdles. We have developed a split--pool synthesis leading to an array of stock solutions of single 1,3-dioxanes. The quantities of compounds are sufficient for hundreds of phenotypic and protein-binding assays. The average concentration of these stock solutions derived from a single synthesis bead was determined to be 5.4 mM in 5 microL of DMSO. A mass spectrometric strategy to identify the structure of molecules from a split--pool synthesis was shown to be highly accurate. Individual members of the 1,3-dioxane library have activity in a variety of phenotypic and protein-binding assays. The procedure developed in this study allows many assays to be performed with compounds derived from individual synthesis beads. The synthetic compounds identified in these assays should serve as useful probes of cellular and organismal processes.
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Khamsi F, Yavas Y, Roberge S, Wong JC, Lacanna IC, Endman M. Intracytoplasmic sperm injection increased fertilization and good-quality embryo formation in patients with non-male factor indications for in vitro fertilization: a prospective randomized study. Fertil Steril 2001; 75:342-7. [PMID: 11172837 DOI: 10.1016/s0015-0282(00)01674-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the fertilization rate and formation of good-quality embryos with conventional IVF and ICSI in patients with non-male factor infertility. DESIGN Prospective controlled study. SETTING Infertility clinic. PATIENT(S) Thirty-five patients with non-male factor infertility. INTERVENTION(S) Retrieved sibling oocytes were randomly assigned to conventional IVF or ICSI. Of sibling oocytes assigned to ICSI, only metaphase II oocytes were injected with sperm. MAIN OUTCOME MEASURE(S) Fertilization rate and formation of good-quality embryos per retrieved oocyte. RESULT(S) Per retrieved oocyte, ICSI resulted in better fertilization rate compared with conventional IVF (71.3% [134 of 188] vs. 57.2% [107 of 187]). Per retrieved oocyte, ICSI also resulted in better formation of good-quality embryos at 48 hours after retrieval compared with conventional IVF (64.4% [121 of 188] vs. 47.1% [88 of 187]). CONCLUSION(S) In IVF patients with non-male factor infertility, subjecting some sibling oocytes to ICSI increased the fertilization rate and formation of good-quality embryos per retrieved oocyte. It also avoided the problem of total fertilization failure in almost all cases.
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Khamsi F, Yavas Y, Lacanna IC, Roberge S, Endman M, Wong JC. Exposure of human oocytes to endometrioma fluid does not alter fertilization or early embryo development. J Assist Reprod Genet 2001; 18:106-9. [PMID: 11285976 PMCID: PMC3455555 DOI: 10.1023/a:1026586709554] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Extensive endometriosis causes a mechanical disturbance in the pelvis leading to obstructive-type infertility. However, minimal or mild endometriosis is suspected to cause infertility, possibly through a humoral agent. Previous studies reported the presence of a factor in the serum of patients with endometriosis which reduced fertilization and early embryo formation in a rat IVF model. METHODS In the present article, we report a comparison of oocytes exposed to endometrioma fluid and oocytes not exposed (controls) in the context of a human IVF setting. We have been in the practice of aspirating oocytes into prewarmed 60-ml syringes containing culture medium. We have shown previously that this technique reduces the length of oocyte retrieval without compromising success. In 14 women undergoing oocyte retrieval, we inadvertently entered an endometrioma. This resulted in retrieved oocytes that were either exposed or not exposed to endometrioma fluid. RESULTS In contrast to previous reports, we found no difference in fertilization or early embryo development between the two groups. The fertilization rate for oocytes exposed to an endometrioma was 60%, versus 56% for controls. The good-quality embryo formation rate for oocytes exposed to an endometrioma was 45%, versus 46% for controls.
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Abstract
UNLABELLED Anorexia nervosa (AN) can lead to osteoporosis and fractures. OBJECTIVE This study evaluated adolescent females with AN diagnosed within the previous 12 months to determine whether there is bone mass reduction and to investigate relationships between nutritional indices (weight, body mass index [BMI], lean mass, fat mass, and percentage fat) and total body (TB) and lumbar spine (LS) bone mineral densities (BMD) and content (BMC). METHOD TB and LS BMD and BMC and body composition were measured in 24 adolescent females with AN. RESULTS There was no significant reduction in TB or LS BMD. Regression analysis shows significant correlation (p < 0.001) between lean mass and TB BMD (r = +0.83), TB BMC (r = +0.92), LS BMD (r = +0.81), and LS BMC (r = +0.92). There was also a significant relationship between weight percentile and LS BMD z score (p < 0.005; r = +0.60). DISCUSSION Adolescent females with early AN do not appear to have reduced bone mass. Lean mass is correlated to BMD and BMC.
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