826
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Park RJ, Lee A, Woolley H, Murray L, Stein A. Children's representation of family mealtime in the context of maternal eating disorders. Child Care Health Dev 2003; 29:111-9. [PMID: 12603356 DOI: 10.1046/j.1365-2214.2003.00320.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Recent research provides evidence for specific disturbance in feeding and growth in children of mothers with eating disorders. AIM To investigate the impact of maternal eating disorders during the post-natal year on the internal world of children, as expressed in children's representations of self and their mother in pretend mealtime play at 5 years of age. METHODS Children of mothers with eating disorders (n = 33) and a comparison group (n = 24) were videotaped enacting a family mealtime in pretend play. Specific classes of children's play representations were coded blind to group membership. Univariate analyses compared the groups on representations of mother and self. Logistic regression explored factors predicting pretend play representations. RESULTS Positive representations of the mother expressed as feeding, eating or body shape themes were more frequent in the index group. There were no other significant group differences in representations. In a logistic regression analysis, current maternal eating psychopathology was the principal predictor of these positive maternal representations. Marital criticism was associated with negative representations of the mother. CONCLUSIONS These findings suggest that maternal eating disorders may influence the development of a child's internal world, such that they are more preoccupied with maternal eating concerns. However, more extensive research on larger samples is required to replicate these preliminary findings.
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827
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Singleton N, Bumpstead R, O'Brien M, Lee A, Meltzer H. Psychiatric morbidity among adults living in private households, 2000. Int Rev Psychiatry 2003; 15:65-73. [PMID: 12745312 DOI: 10.1080/0954026021000045967] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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828
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Ngan Kee WD, Lee A. Multivariate analysis of factors associated with umbilical arterial pH and standard base excess after Caesarean section under spinal anaesthesia. Anaesthesia 2003; 58:125-30. [PMID: 12562407 DOI: 10.1046/j.1365-2044.2003.02888.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We have investigated the factors predicting umbilical arterial pH (UA pH) and standard base excess (UA BE) in 337 consecutive elective Caesarean sections performed under spinal anaesthesia. Multiple linear regression analysis was performed with UA pH and UA BE as the dependent factors. We found that the significant factors predicting UA pH were: use of ephedrine, uterine incision-to-delivery time, maximum decrease in systolic arterial pressure and the interaction between ephedrine use and duration of hypotension (adjusted R2 = 0.39, F15,321 = 15.4, p < 0.0001). The significant factors predicting UA BE were: use of ephedrine and the interaction between ephedrine use and duration of hypotension (adjusted R2 = 0.52, F15,321 = 25.0, p < 0.0001). We conclude that, in order to minimise the risk of fetal acidosis, ephedrine should not be used before delivery, uterine incision-to-delivery time should be as short as possible, and alpha-agonists such as metaraminol or phenylephrine should be used to minimise both the magnitude and duration of hypotension.
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829
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Lee A, Wu HY. Diagnosis disclosure in cancer patients--when the family says "no!". Singapore Med J 2002; 43:533-8. [PMID: 12587710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
It is not uncommon for family members to thwart a doctor's attempt at disclosure of cancer diagnosis to the patient. This stems from concern and love as well as fear of the negative psychological impact of such revelation. Indeed, collusion of this nature was the norm in medical practice till the not too distant past. In this era of patient autonomy and the right to information, we must be careful not to allow attitudes of medical staff or patients' families, language difficulties and organisational issues become barriers to patient's access to information and their psychological coping of the illness. At the same time, we also need to be acutely aware of the unique cultural environment we work in and the families' emotional needs even as we aim to match the patient's desire for information.
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830
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Yau TK, Lau Y, Kong J, Yeung MW, Chan M, Sze WM, Cheung P, Lim BH, Lee A. Breast conservation treatment in Hong Kong-early results of 203 patients: retrospective study. Hong Kong Med J 2002; 8:322-8. [PMID: 12376708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVE To study the clinical outcomes of patients with invasive or non-invasive breast cancer after breast conservation treatment. DESIGN Retrospective study. SETTING Clinical oncology department of a public hospital, Hong Kong. PATIENTS Two hundred and three patients who received postlumpectomy radiotherapy at the Pamela Youde Nethersole Eastern Hospital between January 1994 and June 1999. INTERVENTIONS Adjuvant radiotherapy with or without systemic adjuvant treatment. MAIN OUTCOME MEASURES Actuarial local control rate, progression-free survival rate, disease-specific survival rate, and cosmetic score. RESULTS The median follow-up was 3.5 years. Two of the 25 patients with carcinoma in situ only developed local recurrence; the 5-year actuarial local control rate was 91.3%. Among the 178 patients with invasive cancer, seven had a local recurrence and 12 developed distant metastases without local failure. The 5-year actuarial local control, progression-free survival, and disease-specific survival rates for patients with invasive cancer were 95.5%, 85.8%, and 95.2%, respectively. The risk of local recurrence was significantly increased for younger patients (age <40 years) and those with positive final margins. Cosmetic scores were rated good to excellent by 95.6% of patients. CONCLUSIONS The early clinical outcomes of these patients are comparable to those in large overseas trials, which have demonstrated the equivalence of mastectomy and breast conservation treatment in terms of survival. In addition to mastectomy, with or without breast reconstruction, breast conservation treatment should be offered as an alternative to suitable Chinese women. To maximise local control, further excision or mastectomy is recommended for patients with positive final margins.
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831
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Boone KB, Lu P, Back C, King C, Lee A, Philpott L, Shamieh E, Warner-Chacon K. Sensitivity and specificity of the Rey Dot Counting Test in patients with suspect effort and various clinical samples. Arch Clin Neuropsychol 2002. [DOI: 10.1093/arclin/17.7.625] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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832
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Chen IH, Yang KL, Lee A, Huang HH, Lin PY, Lee TD. Low frequency of HLA-B*2706 in Taiwanese patients with ankylosing spondylitis. EUROPEAN JOURNAL OF IMMUNOGENETICS : OFFICIAL JOURNAL OF THE BRITISH SOCIETY FOR HISTOCOMPATIBILITY AND IMMUNOGENETICS 2002; 29:435-8. [PMID: 12358855 DOI: 10.1046/j.1365-2370.2002.00353.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The presence of HLA-B27 in patients affected with ankylosing spondylitis (AS) was well established prior to the advent of DNA typing of various genes within the major histocompatibility complex (MHC) in humans. However, molecular typing of the MHC genes revealed that B27 comprises a motley assortment of alleles, some of which are strongly positively associated with the disease and some of which are negatively associated with the disease. B*2706 was reported to have a negative association with AS in the Thai population and in Chinese Singaporeans. We report here our finding of an absence of B*2706 in 184 Taiwanese AS patients.
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833
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Lee A, Patrick P, Wishart J, Horowitz M, Morley JE. The effects of miglitol on glucagon-like peptide-1 secretion and appetite sensations in obese type 2 diabetics. Diabetes Obes Metab 2002; 4:329-35. [PMID: 12190996 DOI: 10.1046/j.1463-1326.2002.00219.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous studies reported that administration of first generation alpha-glucosidase inhibitors (AGIs), such as voglibose or acarbose, produced exaggerated and sustained postprandial responses of glucagon-like peptide-1 (GLP-1), an incretin hormone from the enteroinsular axis, in healthy humans. Little is known about the postprandial release of GLP-1 after AGI therapy in diabetics. GLP-1 plays a role to mediate satiety. Any agent that substantially elevates GLP-1 levels may theoretically reduce hunger, increase satiation and limit food intake. OBJECTIVES This study was performed to analyse the effect of miglitol, a more potent second generation AGI with fewer gastrointestinal side-effects, on the regulation of meal-related GLP-1 secretion and on the change of insulin-glucose dynamics as well as the release of gastric inhibitory polypeptide (GIP), another incretin hormone, after stimulation by an ordinary meal in obese type-2-diabetic subjects. Miglitol's subsequent influences on appetite sensations and food intake were also measured. DESIGN In total, 8 obese type-2-diabetic women were randomized to receive treatment with 100 mg of miglitol or placebo three times a day for 2 days (six doses total) in a double-blind fashion. On day 3 of each treatment period (miglitol or placebo), measurements of GLP-1, GIP, insulin and glucose were taken periodically during 3 h after eating a 720 kcal breakfast. Appetite ratings with visual analogue scales (VASs) were used to assess ingestive behaviour hourly just before breakfast and hourly after for 6 h until immediately before lunch. The number of tuna sandwiches eaten at lunch was used to measure food consumption. RESULTS The plasma GLP-1, glucose, insulin and GIP levels in response to the mixed meal were compared after the miglitol and placebo treatment. Miglitol effectively enhanced postprandial GLP-1 release and suppressed plasma GIP secretion. The ingestion of a mixed meal induced a remarkable rise in GLP-1 after miglitol as compared with placebo in overweight diabetic subjects. The meal-related rise in GLP-1 after miglitol was significantly greater at all time-points between 30 and 180 min than after the placebo. The postprandial incremental area under the curve for GLP-1 with miglitol treatment was about twofold that with the placebo. The GLP-1 level reached a maximum at 120 min after the mixed meal and steadily rose throughout the rest of the 3-h study period. In the miglitol-treated condition, the average caloric intake at lunch during a 30-min eating period was 12% lower (p < 0.05) as compared with that after the placebo in six out of the eight subjects who exhibited a GLP-1 rise after the breakfast meal by greater than 30% from the placebo-treated condition. Correspondingly, the average rating scores were significantly lower for hunger feelings and markedly greater for sensations of satiety under the miglitol treatment; beginning 2 and 3 h, respectively, before the lunch test. CONCLUSIONS Miglitol induced an enhanced and prolonged GLP-1 release at high physiological concentrations after ingesting an ordinary meal in glycaemic-controlled diabetics. The excessive postprandial GLP-1 elevation after miglitol therapy modified feeding behaviour and food intake, and thereby has potential value in regulating appetite and stabilizing body weight in obese type-2-diabetic patients.
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834
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Abstract
We report the appearance of multiple milia in a 61 year old woman appearing 7 years after irradiation for breast cancer. The lesions were confined to the irradiated field.
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835
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Lee A, Wils D, Zumbé A, Storey DM. The comparative gastrointestinal responses of children and adults following consumption of sweets formulated with sucrose, isomalt and lycasin HBC. Eur J Clin Nutr 2002; 56:755-64. [PMID: 12122552 DOI: 10.1038/sj.ejcn.1601389] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2000] [Revised: 09/17/2001] [Accepted: 09/24/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine the gastrointestinal responses of children and adults following consumption of sucrose, isomalt and lycasin HBC and to compare these at two different dose levels in adults. DESIGN Both studies were randomised, double-blind, cross-over designs. SUBJECTS Fifty-one children aged 6-9 y were recruited from primary schools in the Salford area of Greater Manchester. Forty-eight children completed the study. Fifty healthy adult volunteers aged 18-24 y were recruited from the student population of the University of Salford. All subjects completed the study. INTERVENTIONS Children consumed either 25 g of sucrose, isomalt or lycasin HBC and adults 25 and 40 g in hard boiled sweets per day for two consecutive test days. Test periods of 2 days were separated by 7 day washout periods. Children consumed sweets throughout test days and adults in no less than 30 min but no more than 90 min. Subjects reported the prevalence and magnitude of flatulence, borborygmi, bloating, colic, bowel movements and watery faeces. RESULTS Consumption of 25 g isomalt provoked a mild laxative effect in children but not in adults. Consumption of 25 g isomalt significantly increased the prevalence and magnitude of gastrointestinal responses in both children and adults. Consumption of 25 g lycasin HBC significantly increased borborygml in children and adults but no other gastrointestinal responses. Consumption of 40 g lycasin HBC or isomalt by adults significantly increased the mean frequency of bowel movements and the number of subjects passing watery faeces. In adults, 40 g isomalt and lycasin HBC provoked significantly more gastrointestinal responses compared to 25 g of either product. CONCLUSIONS Consumption of 25 g lycasin HBC does not provoke an unacceptable laxative effect or gastrointestinal response in children or adults compared to 25 g isomalt, which is associated with a mild laxative effect and increase in gastrointestinal responses. In adults gastrointestinal responses following consumption of products were found to be dose dependent.
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836
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Mittermayer C, Bernaschek G, Lee A. Diagnosis of ectopia cordis with three-dimensional power Doppler ultrasound in first-trimester pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2002; 20:203-205. [PMID: 12153676 DOI: 10.1046/j.1469-0705.2002.00750_1.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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837
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Lee A, Cheng FF, Chan CS, Lau LC, Lo AS. Sero-epidemiology and risk factors of positive hepatitis B surface antigen amongst Chinese adolescents. Asia Pac J Public Health 2002; 13:30-5. [PMID: 12109258 DOI: 10.1177/101053950101300107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper reports the prevalence rate of hepatitis B antigen (HBsAg) amongst the Hong Kong Chinese adolescents (age 11 to 19), and the risk factors associated with HBsAg positive. The study is cross sectional and 1,580 students were randomly selected from 12 secondary schools in four regions of Hong Kong. For those subjects who agreed to participate and were randomly selected, their blood was tested for HBsAg and anti-HBs. The overall prevalence of HBsAg positive was reported to be 5.8% (7.9% in male and 4.1% in female), lower than 8.1% in 1978. Males, those born in Mainland China and family history of carriers had higher prevalence of HBsAg positive (7.9% vs 4.1%, 12.2% vs 4.7%, 52.9% vs 3.8% respectively) with statistical significance. Males and those born in mainland China were found to have significantly higher odds ratio 1.8 (95% CI. 0.98-3.52) and 4.4 (95% CI. 2.2-8.8) respectively of HBsAg positive by multivariate analysis. Findings suggest that family history of carriers and those born in endemic area are at a higher risk. Therefore it is worthwhile to consider vaccination programme for adolescents to reduce the carrier rate, and to also reduce the injection amongst the adults by horizontal transmission.
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838
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McLellan S, Walsh T, Burdess A, Lee A. Comparison between the Datex-Ohmeda M-COVX metabolic monitor and the Deltatrac II in mechanically ventilated patients. Intensive Care Med 2002; 28:870-6. [PMID: 12122524 DOI: 10.1007/s00134-002-1323-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2001] [Accepted: 04/02/2002] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To compare the M-COVX and the Deltatrac II metabolic monitors under clinical conditions. DESIGN Prospective clinical comparison. SETTING A general Intensive Care Unit of a university hospital. PATIENTS Twenty mechanically ventilated critically ill patients. INTERVENTIONS The monitors were compared at FiO(2) 0.3, 0.5, and 0.7 in each patient where possible. MEASUREMENTS AND RESULTS Pulmonary gas exchange measurements were recorded using the two monitors sequentially (Deltatrac(before), M-COVX, Deltatrac(after)). Each measurement consisted of five consecutive 1-min readings of VO(2) and VCO(2). We compared the Deltatrac(before) with the Deltatrac(after) and the mean of the Deltatrac with the M-COVX. There was no clinically significant bias between the two monitors for VO(2) or VCO(2) but the limits of agreement (LOA) were wide (bias +/-95% LOA: VCO(2) -13 +/- 30 ml/min, -8 +/- 36 ml/min, 7 +/- 50 ml/min; VO(2) -7 +/- 50 ml/min, -5 +/- 56 ml/min, 6 +/- 64 ml/min, at FiO(2) 0.3, 0.5, and 0.7, respectively). The Deltatrac before and after measurements displayed good agreement for VCO(2) but poorer agreement for VO(2) (bias +/- 95% LOA: VCO(2) 0 +/- 18 ml/min, -6 +/- 16 ml/min, -1 +/- 12 ml/min; VO(2) 2 +/- 12 ml/min, 3 +/- 38 ml/min, 10 +/- 42 ml/min, at FiO(2) 0.3, 0.5, and 0.7, respectively). Using within-patient standard deviation as a measure of reproducibility suggested that for VO(2) the M-COVX performed better than the Deltatrac at high FiO(2), and for VCO(2) Deltatrac was better at lower FiO(2). CONCLUSIONS The M-COVX is a suitable integrated device for measuring metabolic gas exchange in ventilated patients.
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839
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Hong GH, Kim YI, Lee SH, Cooper LW, Choe SM, Tkalin AV, Lee A, Kim SH, Chung CS, Hirose K. 239+240Pu and 137Cs concentrations for zooplankton and nekton in the Northwest Pacific and Antarctic Oceans (1993-1996). MARINE POLLUTION BULLETIN 2002; 44:660-665. [PMID: 12222889 DOI: 10.1016/s0025-326x(01)00322-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The concentrations of 239+240Pu and 137Cs in zooplankton and nekton in the Northwest Pacific and Southern Oceans were measured during the period 1993-1996. The object of the sampling was to assess the potential impacts of existing submerged anthropogenic-radioactive materials in the western North Pacific as well as the East China Sea. Samples from the Bransfield Strait of the Antarctic Ocean provided a control source impacted by only atmospheric bomb fallout. No particularly elevated levels of 239+240Pu were found in zooplankton samples from the Northwest Pacific, although significantly lower levels of 239+240Pu were found in three mixed zooplankton samples from the Bransfield Strait. The body burden of 239+240Pu in zooplankton appears to reflect concentrations in ambient seawater with some variation. Some additional measurements of 137Cs in fish are also reported here to complement existing databases and for future reference in the regional marine environmental radioactivity monitoring effort.
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840
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Abstract
Primary bovine chondrocytes were encapsulated in alginate and alginate combined with cartilage matrix extract, Cartrigel, for the purpose of cartilage tissue engineering. The cell constructs were incubated in vitro and gene expression of cartilage-specific extracellular matrix molecules was quantitated and localized with in situ hybridization with a decrease in expression observed in the alginate-Cartrigel constructs. Further understanding of cell response to scaffolds will allow rational design and development of hydrogels for cartilage tissue engineering.
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841
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Lu Y, Shansky J, Del Tatto M, Ferland P, McGuire S, Marszalkowski J, Maish M, Hopkins R, Wang X, Kosnik P, Nackman M, Lee A, Creswick B, Vandenburgh H. Therapeutic potential of implanted tissue-engineered bioartificial muscles delivering recombinant proteins to the sheep heart. Ann N Y Acad Sci 2002; 961:78-82. [PMID: 12081871 DOI: 10.1111/j.1749-6632.2002.tb03055.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tissue-engineered primary adult sheep muscle cells genetically engineered to express either rhVEGF or rhIGF-1 secreted the bioactive proteins locally in the sheep heart for at least 30 days.
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842
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Buzdar A, Hayes D, El-Khoudary A, Yan S, Lønning P, Lichinitser M, Gopal R, Falkson G, Pritchard K, Lipton A, Wolter K, Lee A, Fly K, Chew R, Alderdice M, Burke K, Eisenber P. Phase III randomized trial of droloxifene and tamoxifen as first-line endocrine treatment of ER/PgR-positive advanced breast cancer. Breast Cancer Res Treat 2002; 73:161-75. [PMID: 12088118 DOI: 10.1023/a:1015229630260] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE This trial was designed to demonstrate equivalence between droloxifene 40 mg/d and tamoxifen 20 mg/d as first-line treatment in pre- and post-menopausal women with ER+ and/or PgR+ advanced breast cancer based on time to disease progression and tumor response. MATERIALS AND METHODS One thousand three hundred fifty four women with measurable disease, previously untreated by hormonal or chemotherapy for advanced or recurrent breast cancer, were enrolled by 179 institutions in 35 countries. Patients were stratified at baseline for menopausal status. Patients receiving adjuvant hormonal therapy within I year were excluded. All patients gave written informed consent, were randomized to 40mg droloxifene or 20 mg tamoxifen daily as single-agent therapy and underwent tumor assessment every 3 months. A central committee reviewed digitized images for all cases of tumor progression or objective response. RESULTS The hazard ratio (droloxifene/tamoxifen) for the primary endpoint, time to disease progression, was 1.287 favoring tamoxifen (95% C.I.: 1.114-1.487; p <.001). The objective response rate (CR+PR) was 22.4% for droloxifene and 28.6% for tamoxifen (p = .02). Tamoxifen was superior to droloxifene overall, among both pre- and postmenopausal patients and among patients < or =65 years; there was no difference among women >65 years. The hazard ratio for all-cause mortality was 0.871 (95% C.I.: 0.672-1.129; p = .29), favoring droloxifene but not statistically significant. CONCLUSIONS Droloxifene was significantly less effective than tamoxifen overall and particularly among women under 65 years. Tamoxifen and droloxifene were both less effective in pre-menopausal women with receptor-positive disease compared to post-menopausal women. Further clinical development of droloxifene was stopped.
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843
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844
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Schalwig J, Bosch- V. Braunmühl C, Müller G, Lee A. Semiconductor Gas Sensors as Control Monitors for NOx Storage Catalytic Converters. ACTA ACUST UNITED AC 2002. [DOI: 10.4271/2002-01-1095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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845
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Lee A. The role of dynamic imaging in sentinel lymph node biopsy in breast cancer. Eur J Cancer 2002. [DOI: 10.1016/s0959-8049(02)80169-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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846
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Jarernsiripornkul N, Krska J, Capps PAG, Richards RME, Lee A. Patient reporting of potential adverse drug reactions: a methodological study. Br J Clin Pharmacol 2002; 53:318-25. [PMID: 11874396 PMCID: PMC1874308 DOI: 10.1046/j.0306-5251.2001.01547.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS To develop a systematic generic method of enabling patients to report symptoms which they believe to be due to a particular prescribed drug. METHODS A piloted body system-based questionnaire was distributed to patients registered with 79 medical practices in Grampian prescribed one of nine recently marketed 'black triangle' drugs. These comprised four antidepressants, three antiepileptics and two analgesics. This requested respondents to identify any symptoms experienced over the previous year which they thought could be due to the 'black triangle' drug they had used. A sample of medical records was examined to compare symptoms recorded with those reported by patients. A classification system was developed for the study to enable the assessment of symptoms reported for their potential relationship to patients' drug therapy. All symptoms reported were classified, taking into account information provided by patients on their concomitant drugs and diseases. A specialist pharmacist independently re-classified a sample of the symptoms to validate the process. RESULTS A 36.3% response rate was obtained (837/2307) with 742 respondents (88.6%) reporting at least one symptom. The median per patient was 6.0 (range 0--71), with almost half (406, 48.5%) reporting fewer than five symptoms. Most symptoms (71.0%) were classified as being probably or possibly related to the drugs studied. Agreement between researcher and specialist on the classification of 75.3% of 716 symptoms was obtained (Kappa=0.563). Responses from patients prescribed antidepressant drugs were more likely to include symptoms potentially caused by these drugs (74.5% of all symptoms reported) than those from patients prescribed analgesics (67.4%) or antiepileptics (65.1%, chi2 = 23.858, d.f. = 2, P < 0.001). Patients reporting large numbers of symptoms were more likely to report some which were classed as unlikely to be an ADR or unattributable (chi2 = 80.587, d.f. = 3, P < 0.001). Of the 742 reporting symptoms in questionnaires, 402 (54.2%) claimed to have reported some or all of these to their doctor. Only 162 (22.6%) of 716 patient-reported symptoms were documented in the primary care medical records of 103 patients prescribed tramadol or venlafaxine. CONCLUSIONS Respondents were clearly willing to report symptoms, the majority of which were classed as possibly/probably related to the drugs studied. The results suggest that patients do not report all symptoms they suspect to be ADRs to their GP and that GPs do not record all symptoms which may be reported to them. The method could help to identify problems which patients perceive as being related to their drug therapy and contribute to increased ADR reporting.
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847
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Lyou JY, Yang KL, Lee A, Lin PY, Lee TD. Confirmation of a recombinant allele B*5603 and a hypothetical reciprocal hybrid. EUROPEAN JOURNAL OF IMMUNOGENETICS : OFFICIAL JOURNAL OF THE BRITISH SOCIETY FOR HISTOCOMPATIBILITY AND IMMUNOGENETICS 2002; 29:69-71. [PMID: 11841493 DOI: 10.1046/j.1365-2370.2002.00259.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
From its DNA sequence, B*5603 is thought to be a product of gene conversion. We present here serological evidence of such an event and further speculate on a possible reciprocal hybrid yet to be identified. In addition, we report the allelic frequency of B*5603 in the Taiwanese population and its association with A*1101, Cw*01 and DRB1*1201.
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848
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Ren XS, Kazis LE, Lee A, Zhang H, Miller DR. Identifying patient and physician characteristics that affect compliance with antihypertensive medications. J Clin Pharm Ther 2002; 27:47-56. [PMID: 11846861 DOI: 10.1046/j.1365-2710.2002.00387.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Compliance with antihypertensive medications is essential to the clinical management of hypertension. Poor compliance with antihypertensive medications has often been associated with treatment failure and disease progression. OBJECTIVE To identify patient and prescriber characteristics that may influence compliance with antihypertensive medications. METHOD We used pharmacy records within the Veterans Health Administration, a database which included 1292 patients and 656 physicians over a 2-year time period from April 1, 1996, to April 1, 1998. The level of compliance with antihypertensive medications was assessed using a measure developed for this purpose within the Administration. Three separate ordinary least squares regression models were conducted to ascertain the effects of patient and physician characteristics on compliance. RESULTS Despite the importance of compliance in the clinical management of hypertension, poor compliance with antihypertensive drug treatment was still widespread. Patients who were younger and less active in their treatment decisions tended to be less compliant (P < 0.05 and 0.05, respectively). Health care providers who were older, residents in speciality care, and physicians (as compared with non-physicians) had patients who were also less likely to be compliant (P < 0.01, 0.01, and 0.05, respectively). CONCLUSION These findings suggest that in order to increase the effectiveness of medical care for hypertension, it is important to improve compliance with antihypertensive agents.
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Vinereanu D, Fraser AG, Robinson M, Lee A, Tweddel A. Adenosine provokes diastolic dysfunction in microvascular angina. Postgrad Med J 2002; 78:40-2. [PMID: 11796872 PMCID: PMC1742231 DOI: 10.1136/pmj.78.915.40] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Adenosine stress echocardiography was performed in nine patients (58 (+/-3) years, eight women) with documented microvascular angina. Global ventricular function was assessed by Tc(99m) blood pool imaging and Doppler, whereas longitudinal ventricular function was assessed by simultaneous tissue Doppler echocardiography of the lateral mitral annulus. Adenosine was infused incrementally to onset of chest pain in all patients. There was no significant change in global or longitudinal systolic function. Adenosine induced global diastolic dysfunction, demonstrated by blood pool imaging and by Doppler of the transmitral flow. All patients had long axis diastolic dysfunction at peak adenosine, revealed by a ratio of early to late diastolic velocity of lateral mitral annulus <1, which was absent at rest. Adenosine, as a stress agent, provokes regional and global diastolic dysfunction in microvascular angina, which may be a consequence of subendocardial ischaemia. Long axis diastolic dysfunction can be easily revealed by tissue Doppler of the lateral annular motion.
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Teh SH, Hill ADK, Young L, Fleming F, Lee A, Bagley M, McDermott E, O’Higgins N. Modulation of survivin expression in breast cancer. Ir J Med Sci 2002. [DOI: 10.1007/bf03170351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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