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Quintero L, Wong S, Parra R, Cruz J, Antepara N, Almeida D, Ng F, Passariello G. Stress ECG and laboratory database for the assessment of diabetic cardiovascular autonomic neuropathy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2007; 2007:4339-4342. [PMID: 18002963 DOI: 10.1109/iembs.2007.4353297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Development of a diabetic patient database in order to study Cardiovascular Autonomic Neuropathy (CAN) using as a primary source, stress ECG is presented. The selected platform (ecgML) allows user-friendly environment to analyze and interpret graphs, signals and data. It also allows the ability to perform annotations and reports done by users from different fields. In order to feed the database, the input data is codify using MatLab. The database is composed by two populations: 1) Type 2 Diabetes mellitus group and 2) a control group with no medical history of cardiovascular disease. At the present, there are 62 records available from these two groups. The database also contains laboratory parameters, concurrent medical diagnoses reports verified by cardiologists and other clinicians, automatic annotations for each beat and trend series from parameters extracted from the ECG signals such as RR intervals and ST segment measurements. All this information will become very useful for CAN investigations.
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Sheng B, Mak VWM, Lee HKK, Li HL, Lee IPO, Wong S. Multiple myeloma presenting with acute disseminated encephalomyelitis: Causal or chance link? Neurology 2006; 67:1893-4. [PMID: 17130436 DOI: 10.1212/01.wnl.0000244469.26356.45] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Huda MSB, Boyd A, Skagen K, Wile D, van Heyningen C, Watson I, Wong S, Gill G. Investigation and management of severe hyponatraemia in a hospital setting. Postgrad Med J 2006; 82:216-9. [PMID: 16517805 PMCID: PMC2563697 DOI: 10.1136/pmj.2005.036947] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To evaluate the assessment and management of severe hyponatraemia in a large teaching hospital. METHODS Inpatients with serum sodium <125 mmol/l were identified prospectively from a laboratory database over a six month period. Notes were examined and data extracted. Case notes were carefully reviewed retrospectively by a consultant endocrinologist with regard to accuracy of the diagnosis and the appropriateness of investigations and management. RESULTS 104 patients with a serum sodium <125 mmol/l were identified. Mean (SD) age was 69 (14), 52% were female, mean hospital stay was 16 (12) days, and overall mortality 27%. Adequate investigations were rarely performed. Only 28 (26%) had plasma osmolality measured, 29 (27%) urine osmolality, 11 (10%) urinary sodium, 8 (8%) plasma cortisol, and 2 (2%) a short Synacthen test. Comparing the "ward" and "specialist review" diagnoses, there were significant discrepancies for "no cause found" (49% v 27%, p<0.001), alcohol (6% v 11% p<0.01), and syndrome of inappropriate antidiuresis (20% v 32%, p = 0.001). Treatment was often illogical with significant management errors in 33%. These included fluid restriction and intravenous saline given together (4%) and fluid restriction in diuretic induced hyponatraemia (6%). Mortality was higher in the group with management errors (41% v 20% p = 0.002). CONCLUSION Severe hyponatraemia is a serious condition, but its investigation and evaluation is often inadequate. Some treatment patterns seem to be arbitrary and illogical, and are associated with higher mortality.
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Wang D, Schultz C, Michel M, Wong S, Campbell B. 2380. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wong S, Springer J, Fox D, Venkatesan N, Head C. 601 POSTER Head and neck squamous carcinoma cell lines exhibit an intact EGFR signaling pathway and variable response to EGFR agonist and antagonist. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70606-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bailey C, Venn R, Panayiotou S, Chojnowska E, Gorst-Unsworth C, Cavanagh R, Caldwell G, Wong S. Electroconvulsive therapy for catatonia resulting in cardiac arrest. Eur J Anaesthesiol 2006; 23:812-4. [PMID: 16884558 DOI: 10.1017/s0265021506241255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2006] [Indexed: 11/07/2022]
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Lin YR, Young GS, Chen NK, Dillon WP, Wong S. Creutzfeldt-jakob disease involvement of rolandic cortex: a quantitative apparent diffusion coefficient evaluation. AJNR Am J Neuroradiol 2006; 27:1755-9. [PMID: 16971630 PMCID: PMC8139790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Previous reports have suggested that abnormally reduced water diffusivity and T2 prolongation involving cerebral gray matter in patients with early sporadic Creutzfeldt-Jakob disease (sCJD) involves all areas of neocortex with similar frequency, except for primary sensorimotor cortex (Rolandic cortex) and visual cortex. Rolandic cortex often appears to be spared even in the presence of extensive surrounding neocortical signal intensity abnormality in adjacent frontal and parietal gray matter. A quantitative apparent diffusion coefficient (ADC) analysis was designed to investigate whether this unusual pattern results from pathophysiologic sparing of Rolandic cortex or from reduced conspicuity of signal intensity abnormality on MR imaging echo-planar diffusion-weighted images (epiDWI) related to unknown underlying features of Rolandic cortex. METHODS ADC maps were derived from epiDWI of 6 patients with sCJD and 8 control patients. Bilateral regions of interest were manually selected in precentral gyri, superior frontal gyri, postcentral gyri, supramarginal gyri, thalamus, putamen, and caudate nuclei. ADC and relative ADC (rADC) values were calculated for each region of interest. RESULTS Patients with CJD had significantly lower ADC values than control patients in all areas (P < or = 0.05). The trend toward decreased ADC values in the deep nuclei correlates well with previously published reports. rADC were not significantly different between CJD and control groups in any area (P > 0.25 in all cases). CONCLUSION Quantitative ADC measurements in patients with early sCJD demonstrate a similar degree of reduced water diffusivity in the primary somatosensory cortex as in other neocortical areas, despite the normal appearance of these areas on visual inspection of epiDWI.
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Zhu SH, Nguyen QB, Cummins S, Wong S, Wightman V. Non-smokers seeking help for smokers: a preliminary study. Tob Control 2006; 15:107-13. [PMID: 16565458 PMCID: PMC2563557 DOI: 10.1136/tc.2005.012401] [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: 11/04/2022]
Abstract
OBJECTIVES To examine the phenomenon of non-smokers spontaneously taking action to seek help for smokers; to provide profiles of non-smoking helpers by language and ethnic groups. SETTING A large, statewide tobacco quitline (California Smokers' Helpline) in operation since 1992 in California, providing free cessation services in English, Spanish, Mandarin, Cantonese, Korean, and Vietnamese. SUBJECTS Callers between August 1992 and September 2005 who identified themselves as either white, black, Hispanic, American Indian, or Asian (n = 349,110). A subset of these were "proxies": callers seeking help for someone else. For more detailed analysis, n = 2143 non-smoking proxies calling from October 2004 through September 2005. MAIN OUTCOME MEASURES Proportions of proxies among all callers in each of seven language/ethnic groups; demographics of proxies; and proxies' relationships to smokers on whose behalf they called. RESULTS Over 22 000 non-smoking proxies called. Proportions differed dramatically across language/ethnic groups, from mean (+/-95% confidence interval) 2.7 (0.3)% among English-speaking American Indians through 9.3 (0.3)% among English-speaking Hispanics to 35.3 (0.7)% among Asian-speaking Asians. Beyond the differences in proportion, however, remarkable similarities emerged across all groups. Proxies were primarily women (79.2 (1.7)%), living in the same household as the smokers (65.0 (2.1)%), and having either explicit or implicit understandings with the smokers that calling on their behalf was acceptable (90.0 (1.3)%). CONCLUSIONS The willingness of non-smokers to seek help for smokers holds promise for tobacco cessation and may help address ethnic and language disparities. Non-smoking women in smokers' households may be the first group to target.
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Paiva MB, Bublik M, Wong S, Blackwell KE, Sercarz JA. Minimally invasive laser-induced thermal therapy (LITT) for head and neck cancer: A comprehensive review. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5572 Background: Laser induced thermal therapy (LITT) has been developed in a step-wise fashion at UCLA as a minimally invasive treatment for head and neck cancer. Initial Phase-I studies demonstrated the feasibility and safety of using the Nd:YAG laser (near infra-red nm) for thermal ablation of tumors as a palliative treatment in 62 patients. This was followed by the current Phase II study that confirmed such finding using higher laser power densities (P.D. = 1,600–2,200 J/cm2). Patients and Methods: This was a single group study in patients with recurrent carcinoma of the head and neck, who failed at least one treatment modality, and had a Karnofsky performance status ≥ 70%, and ECOG performance status ≤ 2. The primary end points of the study were objective tumor response, and survival. Prognostic values were assessed by uni- and multivariate analysis using the Kaplan-Meier method and Cox model, respectively. Results: In this Phase II study, we review our results on 104 patients with recurrent head and neck cancer that were treated by LITT. Best results were seen in oral cavity tumors where Kaplan Meyer curves showed average survival of 20.3 months (10.7–30 mo; 95% CI) compared to neck (avg. = 14.4 months, 7.5–20.7 mo; 95% CI) and other tumor sites, (avg. = 18 months, 13.8–22.3 mo; 95% CI). Further analysis of neck treatments showed that tumors away from the common carotid in cervical lymph nodes located in levels I, IV, and V had median survival of 25.9 months (mean = 37.7 mo), compared to 11.4 months (mean = 10.9 mo) in patients with tumors near, or encroaching the carotid in upper and lower jugular levels II and III. In univariate analysis, a trend toward a better survival was observed when tumor proximity to carotid artery was considered prognostic categories (log-rank P = .0007). However, in multivariate analysis, TNM stage, and reconstruction using free flap transfer, but not age and histology, were retained as independent prognostic variables (P < .001). Conclusion: LITT Patients tolerated LITT well on an outpatient basis, and were successfully palliated for periods ranging from 39 days to 90 months post-treatment. Based on the findings of this study it was possible to show that proximity to the carotid artery was the most relevant factor in projecting patient survival. No significant financial relationships to disclose.
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Curran W, Chen A, Harari P, Murphy B, Wong S, Bellm L, Gamber D, Dawson D, Ang K. Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN), a new national cancer registry. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5583 Background: Registries can be invaluable for describing patterns of care for a population of patients (pts). Most cancer registries, however, do not possess sufficient breadth or depth to provide a complete and reliable picture of clinical practice. We report the launch of LORHAN, a new national registry of head and neck carcinoma (HNC) pts. LORHAN is designed to extend current cancer registries by providing detailed data on radiation and/or cancer drugs delivered to HNC pts in all practice settings. Methods: This is a prospective, multi-center, longitudinal, observational registry. Pts with newly diagnosed HNC, scheduled to receive radiotherapy or drug therapy, ≥18 years of age and providing written informed consent are being enrolled. Patients participating in clinical trials are eligible for LORHAN. The primary objective of the registry is to describe, in detail, patterns of care for HNC pts. The secondary objectives are to document outcome by treatment regimen, determine the incidence and severity of major toxicities and to identify supportive care received for managing treatment-related complications. Pts are entered in the registry from the time of initial diagnosis and are followed for at least 2 years and up to 10 years. Detailed information on initial treatment and re-treatment is collected. Data entry is electronic and incorporates encrypted point-to-point data transfer via secure HTTP protocols. Physician and patient confidentiality are strictly maintained. Participating practitioners can review and compare their data on a real-time basis to the database. Registry pts may be linked to the NDI to minimize lost to follow-up. Analyses of data are primarily descriptive. Results: LORHAN was launched in Oct. 2005, and as of Dec., 7 sites have received IRB approval and 3 pts have been enrolled. Of the 7 sites, 1 is an academic site and the remaining are community-based practices. An additional 21 sites (17 academic, 4 community) are at various stages of participation. More than 100 medical oncologists and radiation oncologists are anticipated to participate and approximately 26,000 pts will be eligible each year. Accrual status will be updated. Conclusions: LORHAN is a new national initiative that may further the understanding of the care of HNC pts across practice settings. [Table: see text]
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Pignol J, Mihai A, Beachey D, Rakovitch E, Wong S. SU-FF-T-236: Experimental Validation of the Inner Shell Ionisation Model to Predict the Radiosensitisation Induced by the IDU and BrDU Halogenated Pyrimidine. Med Phys 2006. [DOI: 10.1118/1.2241159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Altuve M, Wong S, Passariello G, Carrault G, Hernandez A. LF/(LF+HF) index in ventricular repolarization variability correlated and uncorrelated with heart rate variability. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2006; 2006:1363-1366. [PMID: 17946042 PMCID: PMC3386901 DOI: 10.1109/iembs.2006.259821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The purpose of this study, was to asses whether LF/(LF+HF) obtained from ventricular repolarization variability (VRV) reflects the state of sympathovagal balance. The VRV time series and heart rate variability (HRV) time series from seventy two electrocardiogram (ECG) records in four different autonomic nervous system (ANS) profiles (athletes, cardiac transplant patient, heart failure patients and normal subjects) were extracted. A dynamic linear parametric model was applied to separate the VRV in two parts, VRV correlated with HRV (VRV(r)) and VRV uncorrelated with HRV (VRV(u)). Spectral indices were obtained from HRV, VRV, VRV(u) and VRV(u) time series. Changes of these indicators from rest to tilt position were analyzed. Results showed that: i) only LF/(LF+HF) from HRV time series increases significantly from rest to tilt in all ANS profiles, this information could not be retrieved in the other three series (VRV, VRV (u) and VRV(u)) ii) LF/(LF+HF) index in HRV series are significantly different between normal subjects and heart failure patients, while cardiac transplant patients show a low coherence between HRV and VRV power spectra and iii) HF rhythm in VRV series seem to be related to the mechanical effect of respiration.
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Wong S, Pabbaraju K, Khurana V, Pang X, Fox J. Nucleic acid amplification assays for investigation of respiratory viruses. J Clin Virol 2006. [PMCID: PMC7128877 DOI: 10.1016/s1386-6532(06)80763-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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314
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Wong S, Pabbaraju K, Ho K, Khurana V, Fox J. Influenza A detection, typing and assessment of antiviral resistance. J Clin Virol 2006. [PMCID: PMC7128773 DOI: 10.1016/s1386-6532(06)80762-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wong S, Lo M. 157 Attitude of midwives towards the recommendation of exercise during pregnancy. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30652-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lindsay M, Lee A, Chan K, Poon P, Han LK, Wong WCW, Wong S. Does pulmonary rehabilitation give additional benefit over tiotropium therapy in primary care management of chronic obstructive pulmonary disease? Randomized controlled clinical trial in Hong Kong Chinese. J Clin Pharm Ther 2005; 30:567-73. [PMID: 16336289 DOI: 10.1111/j.1365-2710.2005.00686.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate whether multidisciplinary pulmonary rehabilitation programme (PRP) provides additional benefit over tiotropium therapy in managing chronic obstructive pulmonary disease (COPD) in primary care. DESIGN A randomized controlled trial to analyse the difference in outcomes of COPD patients receiving tiotropium plus PRP vs. tiotropium treatment alone. SETTING Two primary care teaching clinics affiliated with a university which serves a population of 600,000. PARTICIPANTS Fifty primary care COPD patients. METHODS Fifty subjects underwent spirometry and their status of COPD was confirmed by using the Vitalograph Gold Standard. They were then assessed by the 6-min walking distance (6MWD), Peak Visual Analogue Scale (Peak VAS) and Chronic Respiratory Disease Questionnaire (CRQ). All subjects were given tiotropium to optimize their treatment. After a 6-week period, half were randomized to the intervention group (i.e. receiving PRP), whereas the rest were randomized to control group which received only medication. Spirometry, 6MWD, Peak VAS and CRQ were performed in both groups at 6 weeks, 12 weeks and 3 months. OUTCOMES Spirometry, 6MWD, Peak VAS and CRQ. RESULTS Significant improvement (P < 0.05) was seen in 6MWD, symptoms of dyspnoea measured by Peak VAS and CRQ. The improvement was sustained at 3-month follow-up. However, no additional significant improvement was seen in the intervention group when compared with control. CONCLUSION Tiotropium therapy has improved health outcomes in COPD patients in primary care settings. A 6 weekly PRP did not give any additional benefits in patients already given tiotropium.
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Lee RS, Ng DK, Wong S, Tong T, Chan C. Follow-up study on contamination rate of expressed breast milk samples and necrotizing enterocolitis in Chinese mothers. J Hosp Infect 2005; 61:359-60. [PMID: 16246461 DOI: 10.1016/j.jhin.2005.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Accepted: 05/05/2005] [Indexed: 11/19/2022]
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Lu F, Wong S. 117 Long term regeneration capacity of neural stem cells in irradiated adult rat spinal cord: In vivo/in vitro clonogenic assay. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Atkinso S, Tu B, Wong S. 62 Erythropoietin reduces inflammatory gene expression after irradiation in the mouse brain. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Burstein ES, Ma J, Wong S, Gao Y, Pham E, Knapp AE, Nash NR, Olsson R, Davis RE, Hacksell U, Weiner DM, Brann MR. Intrinsic efficacy of antipsychotics at human D2, D3, and D4 dopamine receptors: identification of the clozapine metabolite N-desmethylclozapine as a D2/D3 partial agonist. J Pharmacol Exp Ther 2005; 315:1278-87. [PMID: 16135699 DOI: 10.1124/jpet.105.092155] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Drugs that antagonize D2-like receptors are effective antipsychotics, but the debilitating movement disorder side effects associated with these drugs cannot be dissociated from dopamine receptor blockade. The "atypical" antipsychotics have a lower propensity to cause extrapyramidal symptoms (EPS), but the molecular basis for this is not fully understood nor is the impact of inverse agonism upon their clinical properties. Using a cell-based functional assay, we demonstrate that overexpression of Galphao induces constitutive activity in the human D2-like receptors (D2, D3, and D4). A large collection of typical and atypical antipsychotics was profiled for activity at these receptors. Virtually all were D2 and D3 inverse agonists, whereas none was D4 inverse agonist, although many were potent D4 antagonists. The inverse agonist activity of haloperidol at D2 and D3 receptors could be reversed by mesoridazine demonstrating that there were significant differences in the degrees of inverse agonism among the compounds tested. Aripiprazole and the principle active metabolite of clozapine NDMC [8-chloro-11-(1-piperazinyl)-5H-dibenzo [b,e] [1,4] diazepine] were identified as partial agonists at D2 and D3 receptors, although clozapine itself was an inverse agonist at these receptors. NDMC-induced functional responses could be reversed by clozapine. It is proposed that the low incidence of EPS associated with clozapine and aripiprazole used may be due, in part, to these partial agonist properties of NDMC and aripiprazole and that bypassing clozapine blockade through direct administration of NDMC to patients may provide superior antipsychotic efficacy.
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Hui ACF, Wong S, Leung CH, Tong P, Mok V, Poon D, Li-Tsang CW, Wong LK, Boet R. A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome. Neurology 2005; 64:2074-8. [PMID: 15985575 DOI: 10.1212/01.wnl.0000169017.79374.93] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Decompressive surgery and steroid injection are widely used forms of treatment for carpal tunnel syndrome (CTS) but there is no consensus on their effectiveness in comparison to each other. The authors evaluated the efficacy of surgery vs steroid injection in relieving symptoms in patients with CTS. METHODS The authors conducted a randomized, single blind, controlled trial. Fifty patients with electrophysiologically confirmed idiopathic CTS were randomized and assigned to open carpal tunnel release (25 patients) or to a single injection of steroid (25 patients). Patients were followed up at 6 and 20 weeks. The primary outcome was symptom relief in terms of the Global Symptom Score (GSS), which rates symptoms on a scale of 0 (no symptoms) to 50 (most severe). Nerve conduction studies and grip strength measurements were used as secondary outcome assessments. RESULTS At 20 weeks after randomization, patients who underwent surgery had greater symptomatic improvement than those who were injected. The mean improvement in GSS after 20 weeks was 24.2 (SD 11.0) in the surgery group vs 8.7 (SD 13.0) in the injection group (p < 0.001); surgical decompression also resulted in greater improvement in median nerve distal motor latencies and sensory nerve conduction velocity. Mean grip strength in the surgical group was reduced by 1.7 kg (SD 5.1) compared with a gain of 2.4 kg (SD 5.5) in the injection group. CONCLUSION Compared with steroid injection, open carpal tunnel release resulted in better symptomatic and neurophysiologic outcome but not grip strength in patients with idiopathic carpal tunnel syndrome over a 20-week period.
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Smith SM, Pro B, van Besien K, Conner K, Karrison T, Wong S, Stiff P, Vokes E. A phase II study of Epothilone B analog BMS-247550 (NSC 710428) in patients with relapsed aggressive non-Hodgkin’s lymphomas. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6625] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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323
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Wong S, Yan L, Wathen L, Cauchon N, Ingram M, Chang D, Rosen L. Predictive value of using beagle dog in assessing relative bioavailability between solid dosage formulations of AMG 706 in patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Anzick SL, Winter J, Wong S, Davis S, McCall M, Meltzer PS, Choti MA. Use of genetic profiling to discover molecular signatures of the pattern of metastatic spread in human colorectal cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yan L, Wong S, Wathen L, Chang D, Ni L, Ingram M, Parson M, Rosen L. The pharmacokinetic (PK) effect of AMG 706 on CYP3A activity evaluated by use of oral midazolam as probe in patients with advanced solid tumors. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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