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Rogers MS, Chung T, Baldwin S. A reappraisal of second trimester mean arterial pressure as a predictor of pregnancy induced hypertension. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619409027835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Saleh H, Williamson J, Dogan N, Chung T. SU-FF-J-120: Assessing Intrafraction Motion for Cranial Tumor Patients Treated with Hypofractionated Radiation Therapy Using Repeated Imaging. Med Phys 2009. [DOI: 10.1118/1.3181412] [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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Rosu M, Chung T, Addesa A, Mahoney B, Weiss E. SU-FF-J-123: 4D Prone Vs. Supine Scanning: Modifications in the Breathing Motion Characteristics and Image Data Quality. Med Phys 2009. [DOI: 10.1118/1.3181415] [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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Isacson D, Sy R, Yong A, Chung T, Kritharides L. The Impact of Renal Dysfunction on Mortality in Patients with Infective Endocarditis. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chung T, Yiannikas J, Freedman S, Kritharides L. Apical Hypertrophic Cardiomyopathy is a Morbid Disease Characterised by Late Morphological Evolution and Coronary-Fistulae. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ng A, Wong H, Chung T, Kritharides L. Cardiovascular Mortality during Long-term Follow-up of 1112 Patients with Acute Pulmonary Embolism. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chung T, Kritharides L, Govindan M, Yiannikas J. Increased vascular endothelial growth factor (VEGF) expression in patients with pulmonary arterial hypertension. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhao W, Chung T, Costa B, Kritharides L. Noninvasive Estimation of Mean Pulmonary Arterial Pressure and Capacitance in Elderly Patients with Pulmonary Hypertension. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yong A, Pennings G, Chung T, Brieger D, Lowe H, Kritharides L. Intravascular blood sampling using the Export catheter does not induce artifactual platelet activation. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wong CK, Hung P, Lee KLH, Mok T, Chung T, Kam KM. Features of ciguatera fish poisoning cases in Hong Kong 2004-2007. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2008; 21:521-527. [PMID: 19263809 DOI: 10.1016/s0895-3988(09)60012-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To review the clinical features and laboratory investigations of ciguatera patients in Hong Kong between 2004 and 2007 in order to show the timely sampling of implicated fish from ciguatera victims and application of validated mouse bioassay for confirming suspected clinical cases of ciguatera. METHODS Diagnosis of the ciguatera victims was based on history of coral fish consumption and clinical presentations stated in official guidelines for clinical diagnosis of ciguatera fish poisoning in Hong Kong. Food remnants of coral fish samples were collected swiftly from ciguatera victims between 2004 and 2007 for ciguatoxins (CTXs) analysis. RESULTS Major clinical symptoms in ciguatera patients included gastrointestinal and neurological effects including limb numbness and diarrhoea, which developed at 0.5 to 15 hours after consumption of fish. In most cases, neurological symptoms were more common than gastrointestinal symptoms. A broad range of attack rate (10%-100%) was observed in each ciguatera outbreak. Validated mouse bioassay on ether extracts of the food remnant samples confirmed that all were CTXs-positive (<0.5 - 4.3 MU/20 mg ether extract) and directly linked to the corresponding ciguatera cases. CONCLUSION Consistency between clinical and laboratory analysis for ciguatera poisoning illustrates the application of laboratory mouse bioassay in a timely fashion for confirming ciguatera poisoning cases and implementing effective public health measures. With further improvement in laboratory techniques, features of ciguatera fish poisoning cases can be better defined. Further studies are needed to determine the risk of each class of CTXs (Pacific-, Indian- and Caribbean-CTXs) in Hong Kong.
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Chung T, Lee J, Kim S, Choa M. 319: Can the Exact Mortality in Emergency Department Patients With Infection Be Assumed from Serum Lactate Level? Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chung T, Lim WC, Sy R, Cunningham I, Trotman J, Kritharides L. Subacute cardiac toxicity following autologous haematopoietic stem cell transplantation in patients with normal cardiac function. Heart 2008; 94:911-8. [DOI: 10.1136/hrt.2007.123299] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kelley J, Cameron B, Benedict S, Broaddus W, Chung T. The Effect of Timing and Dose Fractionation on Stereotactic Radiation Therapy for Lung Cancer Metastatic to the Brain. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Patsios D, Roberts HC, Paul NS, Chung T, Herman SJ, Pereira A, Weisbrod G. Pictorial review of the many faces of bronchioloalveolar cell carcinoma. Br J Radiol 2007; 80:1015-23. [PMID: 17940131 DOI: 10.1259/bjr/52225107] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Bronchioloalveolar cell carcinoma (BAC) has a varied appearance on CT that often leads to an incorrect or delayed diagnosis. The purpose of this pictorial review is to define common CT characteristics that are specific to BAC. A retrospective review was undertaken of 20 CT scans of pathologically proven cases of BAC; tumours were categorized as focal or diffuse, single or multiple, and infiltrative or well defined. Additional radiological features noted include the density (solid, part solid, non-solid), the presence of unaffected vessels within the tumour(s), and the presence of internal air bronchograms. We illustrate cases of localized and diffuse BAC presenting as (i) solitary or multiple pulmonary nodules, with and without air bronchograms, (ii) bubble-like lucencies of pseudocavitation associated with nodules of varying density, (iii) unifocal or multifocal ground-glass opacities, (iv) crazy paving, (v) nodules and airspace opacities with unaffected vessels coursing through them and (vi) lobar or multilobar consolidation and cavitating nodules. In conclusion, BAC may present with a variety of CT appearances. However, there are typical features such as the CT-angiogram sign or air-brochochograms in solitary nodules and in the periphery of larger consolidations, persisting pure ground-glass opacities, unresolving consolidation and the combination of diffuse nodules and consolidation. These features should alert the radiologist to the diagnosis of BAC.
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Holton LH, Chung T, Silverman RP, Haerian H, Goldberg NH, Burrows WM, Gobin A, Butler CE. Comparison of acellular dermal matrix and synthetic mesh for lateral chest wall reconstruction in a rabbit model. Plast Reconstr Surg 2007; 119:1238-1246. [PMID: 17496596 DOI: 10.1097/01.prs.0000254347.36092.9c] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Synthetic mesh is used for chest wall reconstruction, but infection or exposure can occur and necessitate removal. Human acellular dermal matrix (AlloDerm) has been used to reconstruct musculofascial defects in the trunk with low infection and herniation rates. AlloDerm may have advantages over synthetic mesh for chest wall reconstruction. This study compared outcomes and repair strengths of AlloDerm to expanded polytetrafluoroethylene mesh used for repair of rib cage defects. METHODS A 3 x 3-cm, full-thickness, lateral rib cage defect was created in each rabbit and repaired with expanded polytetrafluoroethylene (n = 8) or acellular dermal matrix (n = 9). At 4 weeks, the animals were euthanized and evaluated for lung herniation/dehiscence, strength of adhesions between the implant and intrapleural structures, and breaking strength of the implant materials and the implant-fascia interface. Tissue sections were analyzed with histologic and immunohistochemical staining to evaluate cellular infiltration and vascularization. RESULTS No herniation or dehiscence occurred with either material. The incidence and strength of adhesions was similar between materials. The mean breaking strength of the AlloDerm-fascia interface (14.5 +/- 8.9 N) was greater than the expanded polytetrafluoroethylene-fascia interface (8.7 +/- 4.4 N; p = 0.027) and similar to the rib-intercostal-rib interface of the contralateral native chest wall (14.0 +/- 5.6 N). The AlloDerm grafts became infiltrated with cells and vascularized after implantation. CONCLUSIONS AlloDerm used for chest wall reconstruction results in greater implant-defect interface strength than expanded polytetrafluoroethylene. The ability of AlloDerm to become vascularized and remodeled by autologous cells and to resist infection may be advantageous for chest wall reconstruction.
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Chung T, Connor D, Joseph J, Emmett L, Mansberg R, Peters M, Ma D, Kritharides L. Platelet activation in acute pulmonary embolism. J Thromb Haemost 2007; 5:918-24. [PMID: 17371486 DOI: 10.1111/j.1538-7836.2007.02461.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Platelet activation is implicated in thrombotic disorders, but has not been described in acute clinical pulmonary embolism (PE). OBJECTIVES To investigate the natural history of platelet activation in PE and associated markers of inflammation, thrombosis and cardiac dysfunction. METHODS Thirty-five consecutive patients (age 62 +/-17 years) with acute PE were prospectively enrolled and followed for 6 months. Platelet activation was assessed by flow cytometry [measuring expression of platelet P-selectin, conformational activation of glycoprotein IIb/IIIa complex (PAC-1) and formation of platelet-leukocyte complexes] and by plasma soluble P-selectin. Platelet activation, right ventricular (RV) function (assessed as RV ejection area by transthoracic echocardiography), D-dimer and high-sensitivity C-reactive protein (hs-CRP) were measured at presentation and repeated over 6 months follow-up. RESULTS Soluble P-selectin (56 +/-19 ng mL(-1), anovaP < 0.0001) and PAC-1 (1.5 +/- 1.8%, anovaP = 0.005) were mildly but significantly increased in patients with acute PE relative to healthy young men (soluble P-selectin 33 +/- 13 ng mL(-1), P < 0.001; PAC-1 binding 0.5 +/- 0.6%, P < 0.01) and age-matched controls (soluble P-selectin 31 +/- 9 ng mL(-1), P < 0.001; PAC-1 binding 0.4 +/-0.4%, P < 0.05). Platelet P-selectin expression and platelet-leukocyte complexes were not increased during acute PE. Echocardiographic RV ejection area correlated inversely with soluble P-selectin (r = -0.47, P = 0.007) and positively with platelet P-selectin (r = 0.49, P = 0.0007), suggesting P-selectin is shed from activated platelets in proportion to the severity of RV dysfunction. Elevated soluble P-selectin, D-dimer and hs-CRP demonstrated a time-dependent return to normal during 6 months follow-up. CONCLUSION Platelet activation is evident after acute PE. Platelet activation correlates with the severity of RV dysfunction, and can persist for several months after acute PE.
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Chung T, Kelleher S, Liu PY, Conway AJ, Kritharides L, Handelsman DJ. Effects of testosterone and nandrolone on cardiac function: a randomized, placebo-controlled study. Clin Endocrinol (Oxf) 2007; 66:235-45. [PMID: 17223994 DOI: 10.1111/j.1365-2265.2006.02715.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Androgens have striking effects on skeletal muscle, but the effects on human cardiac muscle function are not well defined, neither has the role of metabolic activation (aromatization, 5alpha reduction) of testosterone on cardiac muscle been directly studied. OBJECTIVE To assess the effects of testosterone and nandrolone, a non-amplifiable and non-aromatizable pure androgen, on cardiac muscle function in healthy young men. DESIGN Double-blind, randomized, placebo-controlled, three-arm parallel group clinical trial. SETTING Ambulatory care research centre. PARTICIPANTS Healthy young men randomized into three groups of 10 men. INTERVENTION Weekly intramuscular injections of testosterone (200 mg mixed esters), nandrolone (200 mg nandrolone decanoate) or matching (2 ml arachis oil vehicle) placebo for 4 weeks. MAIN OUTCOME MEASURES Comprehensive measures of cardiac muscle function involving transthoracic cardiac echocardiography measuring myocardial tissue velocity, peak systolic strain and strain rates, and bioimpedance measurement of cardiac output and systematic vascular resistance. RESULTS Left ventricular (LV) function (LV ejection fraction, LV modified TEI index), right ventricular (RV) function (ejection area, tricuspid annular systolic planar motion, RV modified TEI index) as well as cardiac afterload (mean arterial pressure, systemic vascular resistance) and overall cardiac contractility (stroke volume, cardiac output) were within age- and gender-specific reference ranges and were not significantly (P < 0.05) altered by either androgen or placebo over 4 weeks of treatment. Minor changes remaining within normal range were observed solely within the testosterone group for: increased LV end-systolic diameter (30 +/- 7 vs. 33 +/- 5 mm, P = 0.04) and RV end-systolic area (12.8 +/- 1.3 vs. 14.6 +/- 3.3 cm(2), P = 0.04), reduced LV diastolic septal velocity (Em, 9.5 +/- 2.6 vs. 8.7 +/- 2.0 cm/s, P = 0.006), increased LV filling pressure (E/Em ratio, 7.1 +/- 1.6 vs. 8.3 +/- 1.8, P = 0.02) and shortened PR interval on the electrocardiogram (167 +/- 13 vs. 154 +/- 12, P = 0.03). CONCLUSION Four weeks of treatment with testosterone or nandrolone had no beneficial or adverse effects compared with placebo on cardiac function in healthy young men.
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Chung T, Connor D, Joseph J, Emmett L, Mansberg R, Ma D, Kritharides L. Shedding of P-selectin from Activated Platelets Correlates with the Severity of Right Ventricular Dysfunction During Acute Pulmonary Embolism. Heart Lung Circ 2007. [DOI: 10.1016/j.hlc.2007.06.157] [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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Chung T, Kritharides L. Left Ventricular Diastolic Dysfunction Persists After the Normalisation of Right Ventricular Function Following Acute Pulmonary Embolism. Heart Lung Circ 2007. [DOI: 10.1016/j.hlc.2007.06.161] [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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Chung T, Holton L, Taylor J, Rodriguez E, Silverman R. Effect of the Glycoprotein IIb/IIIa Inhibitor Tirofiban on Microsurgical Anastomotic Thrombosis. J Reconstr Microsurg 2006. [DOI: 10.1055/s-2006-955139] [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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71
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Robinson G, Chung T, Finlay K, Friedman L. Axial oblique MR imaging of the intrinsic ligaments of the wrist: initial experience. Skeletal Radiol 2006; 35:765-73. [PMID: 16609846 DOI: 10.1007/s00256-006-0117-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 02/12/2006] [Accepted: 02/13/2006] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate two separate MR sequences acquired in the axial oblique plane, parallel to the long axis of the scapholunate (SL) and lunotriquetral (LT) ligaments, to determine whether the addition of these sequences to the standard MR wrist examination improves visualization of the intrinsic ligaments, and the evaluation of their integrity. To our knowledge, this plane has not been described in the literature previously. DESIGN AND PATIENTS In total we evaluated 26 patients with chronic wrist pain or instability, referred for MR imaging following assessment by an orthopedic surgeon or physiatrist. All patients underwent initial conventional tri-compartment wrist arthrography, which served as the reference standard. This was immediately followed by MR arthrography, in the standard coronal and true axial planes, as well as in the axial oblique plane. The SL and LT ligaments were initially assessed for the presence or absence of tear, using the standard coronal and true axial sequences, and subsequently re-evaluated with the addition of the axial oblique planes. RESULTS A total of ten intrinsic ligament tears were identified with conventional arthrography: six SL and four LT tears. Five of the six SL tears were identified on the standard sequences. All six were diagnosed with the addition of the oblique sequences. There were three false-positive SL tears identified using standard MR imaging, and two false-positives with the addition of the oblique sequences. No LT tear was identified on standard sequences, whereas all four were confidently seen with the addition of oblique images. No false-positives of the LT ligament were recorded with either standard or axial oblique sequences. CONCLUSION The study suggests that the addition of axial oblique MR sequences helps identify tears to the intrinsic ligaments of the wrist, particularly the LT ligament. In addition, the axial oblique images assist in localization of the tear.
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Whelihan WM, Thompson JA, Piatt AL, Caron MD, Chung T. The relation of neuropsychological measures to levels of cognitive functioning in elderly individuals: a discriminant analysis approach. ACTA ACUST UNITED AC 2006; 4:160-4. [PMID: 16318479 DOI: 10.1207/s15324826an0403_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study addresses the question of which tests in a comprehensive neuropsychologicaI test battery best discriminate normal, mildly, and moderate to severely cognitiveIy impaired older participants. Sixty-six geriatric participants were administered a battery of neuropsychological tests as part of an outpatient geriatric clinic evaluation. A discriminant analysis procedure using a consensus rating of global cognitive impairment as the grouping variable was employed to analyze the data. From 15 neuropsychological test measures, five representing the domains of learning and memory, visuospatial and executive functioning were identified as the best predictors of level of cognitive impairment. Findings demonstrate the utility of discriminant function analysis (DFA) procedures for developing reduced-length cognitive batteries that accurately classify participants in terms of levels of cognitive impairment and identify mild dysfunction in participants at risk of cognitive impairment. Further cross-validation studies are needed to confirm the utility of these more circumscribed batteries.
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Chen Y, Chung T, Lin C, Wu J. P.378 Overexpression of Nek2 in hepatocellular carcinoma. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80552-4] [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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Chung T, Wallace T, Cardinale R, Broaddus W, Benedict S, Ramekrishnan V, Schmidt-Ullrich R. A Phase I Study of Accelerated Radiotherapy for Glioblastoma Multiforme Using Stereotactic Concomitant Boosts for Dose Escalation. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lee K, Kim K, Yoon S, Baik Y, Chung T, Cha K. Involvement of Ion Transport-Related Genes in the Regulation of Mouse Ovarian Folliculogenesis. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.1161] [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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