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Chong W, Li H, Wang J. Therapeutic efficacy of omalizumab in children with moderate-to-severe allergic asthma combined with chronic sinusitis. Front Allergy 2023; 4:1236798. [PMID: 37908372 PMCID: PMC10613665 DOI: 10.3389/falgy.2023.1236798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/25/2023] [Indexed: 11/02/2023] Open
Abstract
Background Omalizumab has been approved for treating moderate-to-severe asthma in children aged over 6 years. Its application to asthmatic children with other allergic diseases has been rarely explored. The present study aims to explore the therapeutic efficacy of omalizumab in children with moderate-to-severe allergic asthma combined with chronic sinusitis. Methods The clinical data of children diagnosed with moderate-to-severe allergic asthma combined with chronic sinusitis and treated with omalizumab between September 2020 and April 2022 were retrospectively analyzed. Lung function indexes such as Childhood Asthma Control Test (C-ACT) scores, fractional exhaled nitric oxide (FeNO), and forced expiratory volume in the first second (FEV1) percent predicted (FEV1%pred), small airway function indexes, and the clinical symptoms of chronic sinusitis were analyzed. Results A total of 26 children were observed for 16 weeks. After 16 weeks of omalizumab treatment, the significantly increased C-ACT scores (15.57 ± 3.25 points vs. 24.98 ± 5.21 points, F = 15.7112, P < 0.001) and decreased FeNO (31.55 ± 15.57 ppb vs. 19.86 ± 9.80 ppb, F = 4.4265, P = 0.0022), compared with those at baseline, were suggestive of well-controlled symptoms of asthma and improved lung function. FEV1%pred and FEV1/forced vital capacity (FVC) ratio (the ratio of the forced expiratory volume in the first 1 s to the forced vital capacity) increased after omalizumab treatment, although no significant differences were detected (P = 0.9954 and 0.9382, respectively). Peak expiratory flow (PEF) percent predicted (PEF%pred) and forced expiratory flow at 75% of FVC (FEF75%), 50% of FVC (FEF50%), and 25%-75% of FVC (FEF25%-75%) significantly increased after omalizumab treatment (P = 0.0477, <0.001, <0.001, and <0.001, respectively). Visual analog scale scores significantly decreased after omalizumab treatment (6.40 ± 2.98 points vs. 0.85 ± 0.40 points, t = 27.2419, P < 0.001), suggesting alleviation in the clinical symptoms of chronic sinusitis. Conclusion In this study, it was found that omalizumab can effectively alleviate clinical symptoms and improve lung function and quality of life in children with moderate-to-severe allergic asthma combined with chronic sinusitis.
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Affiliation(s)
| | | | - Juan Wang
- Department of Pediatrics, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China
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Bhatti N, Ramchandani J, Chong W, August S. 552 Benign Pilomatricoma with Osseous Metaplasia: A Rare Case. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Pilomatricomas are a frequently misdiagnosed benign neoplasm of the skin derived from hair matrix cells. Pilomatricomas may undergo calcification and ossification although the latter is rare and poorly documented, with only eight cases reported since 2006. We present a case of pilomatricoma with osseous metaplasia arising from the scalp in an 87-year-old female patient. She was referred by her general practitioner via the two-week pathway, for a suspicious lesion.
On examination, there was a 2×1cm nodule, with protruding hardened yellow sebaceous material, on the right side of the patient's occipital scalp. The lump was hard, non-tender and had been present for 17 years. The surrounding area was bleeding and slightly ulcerated. A clinical diagnosis of a ruptured epidermal cyst was made, and the patient was prepared for excision under local anaesthetic.
The excised lesion of 23×18×10mm with 22×9mm of skin was sent for histology. This revealed a partially ulcerated dermal lesion composed of islands of keratin with ‘ghost cell’ outlines. Foreign body granulomas, transition to mature lamellar bone and foci of calcification were noted. There were no definite populations of basaloid cells and features of malignancy were not seen. These findings are consistent with benign pilomatricoma with osseous metaplasia. The patient was discharged 4 weeks later with satisfactory wound healing.
Differentiating this tumour from other commonly encountered benign masses remains a challenge, as seen in this case which was initially mis-diagnosed as a ruptured epidermal cyst.
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Affiliation(s)
- N Bhatti
- King's College London , London , United Kingdom
| | | | - W Chong
- Poole General Hospital , Poole , United Kingdom
| | - S August
- Poole General Hospital , Poole , United Kingdom
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Ma KSK, Wang LT, Chong W, Lin CL, Li H, Chen A, Wei JCC. Exposure to environmental air pollutants as a risk factor for primary Sjögren's syndrome. Front Immunol 2022; 13:1044462. [PMID: 36865525 PMCID: PMC9972220 DOI: 10.3389/fimmu.2022.1044462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/14/2022] [Indexed: 02/16/2023] Open
Abstract
Background Environmental etiology of primary Sjögren's syndrome (pSS), an autoimmune disease, has been proposed. This study determined whether the exposure to air pollutants was an independent risk factor for pSS. Methods Participants were enrolled from a population-based cohort registry. Daily average concentrations of air pollutants from 2000 to 2011 were divided into 4 quartiles. Adjusted hazard ratios (aHRs) of pSS for exposure to air pollutants were estimated in a Cox proportional regression model adjusting for age, sex, socioeconomic status, and residential areas. A subgroup analysis stratified by sex was conducted to validate the findings. Windows of susceptibility indicated years of exposure which contributed the most to the observed association. Ingenuity Pathway Analysis was used to identify underlying pathways of air pollutant-associated pSS pathogenesis, using Z-score visualization. Results Two hundred patients among 177,307 participants developed pSS, with a mean age of 53.1 years at acumulative incidence of 0.11% from 2000 to 2011. Exposure to carbon monoxide (CO), nitric oxide (NO), and methane (CH4) was associated with a higher risk of pSS. Compared to those exposed to the lowest concentration level, the aHRs for pSS were 2.04 (95%CI=1.29-3.25), 1.86 (95%CI=1.22-2.85), and 2.21 (95%CI=1.47-3.31) for those exposed to high levels of CO, NO, and CH4, respectively. The findings persisted in the subgroup analysis, in which females exposed to high levels of CO, NO, and CH4 and males exposed to high levels of CO were associated with significantly great risk of pSS. The cumulative effect of air pollution on pSS was time-dependent. The underlying cellular mechanisms involved chronic inflammatory pathways including the interleukin-6 signaling pathway. Conclusion Exposure to CO, NO, and CH4 was associated with a high risk of pSS, which was biologically plausible.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Department of Pediatrics, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.,Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Orthodontics and Dentofacial Orthopedics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, United States
| | - Li-Tzu Wang
- Department of Obstetrics & Gynecology, National Taiwan University Hospital & College of Medicine, Taipei, Taiwan
| | - Weikun Chong
- Department of Pediatrics, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Cheng-Li Lin
- Clinical Trial Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Hailang Li
- Department of Pediatrics, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, United States.,Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Bhogal P, Makalanda H, Wong K, Keston P, Downer J, Du Plessis JC, Nania A, Simonato D, Fuschi M, Chong W, O'Reilly S, Rennie I. The Silk Vista Baby - The UK experience. Interv Neuroradiol 2021; 28:201-212. [PMID: 34078155 DOI: 10.1177/15910199211024061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Silk Vista Baby (SVB) flow diverter (FDS) is the only FDS deliverable via a 0.017 inch microcatheter and is specifically designed for the distal vasculature. We sought to evaluate the safety and efficacy of the SVB. MATERIALS AND METHODS We performed a retrospective review to identify SVB cases at 4 tertiary neurosurgical centres within the U.K. Clinical, procedural, angiographic and follow-up data were collected. RESULTS We identified 60 patients (35 female, 58%) of average age 54 ± 10.5 (range 30-72) with 61 aneurysms, 50 (81.9%) located in the anterior circulation. The majority of the aneurysms treated were unruptured (46, 75.4%) and saccular (46, 75.4%). Dome size was 6.2 ± 6.2 mm (range 1-36mm) and parent vessel diameter was 2.3 ± 0.4 mm (range 1.2-3.3 mm).An average number of 1.07 devices were implanted. Coils or other devices were implanted in 14 aneurysms (23.3%). At last angiographic follow-up (n = 55), 7.5 ± 4.2 months post-procedure, 32 aneurysms (57.1%) were graded as RRC I, 7 (12.5%) RRC II, and 17 RRC III (30.4%).Clinical complications, excluding death, were seen in 4 patients (6.8%) including 1 delayed aneurysm rupture and 3 symptomatic ischaemic events. Only one patient had permanent morbidity (mRS 1). 3 patients died during follow-up (5.1%); 2 deaths were related to the aneurysms (3.4%) - one ruptured dissecting MCA aneurysm, and one giant partially thrombosed posterior circulation aneurysm. 93% of patients were mRS ≤ 2 at last follow-up. CONCLUSION The SVB has high rates of technical success and an acceptable safety profile. Distal aneurysms may occlude slower due to relative oversizing of the devices.
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Affiliation(s)
- P Bhogal
- The Royal London Hospital, London, UK
| | | | - K Wong
- The Royal London Hospital, London, UK
| | - P Keston
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - J Downer
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - J C Du Plessis
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - A Nania
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - D Simonato
- Department of Interventional Neuroradiology, John Radcliffe Hospital, Oxford, UK
| | - M Fuschi
- Department of Interventional Neuroradiology, John Radcliffe Hospital, Oxford, UK
| | - W Chong
- Department of Interventional Neuroradiology, University Hospitals Coventry and Warwickshire, Warwickshire, UK
| | - S O'Reilly
- Department of Interventional Neuroradiology, The Royal Victoria Hospital, Belfast, UK
| | - I Rennie
- Department of Interventional Neuroradiology, The Royal Victoria Hospital, Belfast, UK
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Li L, Zhang Y, Tan H, Bai Y, Fang F, Faramand A, Chong W, Hai Y. Effect of progestogen for women with threatened miscarriage: a systematic review and meta‐analysis. BJOG 2020; 127:1055-1063. [PMID: 32324957 DOI: 10.1111/1471-0528.16261] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2020] [Indexed: 02/05/2023]
Affiliation(s)
- L Li
- West China Hospital Sichuan University Chengdu Sichuan China
| | - Y Zhang
- West China Hospital Sichuan University Chengdu Sichuan China
- Clinical Research Centre Affiliated Hospital of Chengdu University Chengdu Sichuan China
| | - H Tan
- West China Hospital Sichuan University Chengdu Sichuan China
| | - Y Bai
- West China Second University Hospital Sichuan University Chengdu Sichuan China
| | - F Fang
- West China Hospital Sichuan University Chengdu Sichuan China
| | - A Faramand
- University of Pittsburgh Medical Center University of Pittsburgh Pittsburgh PA USA
| | - W Chong
- Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA
| | - Y Hai
- Department of Surgery Zucker School of Medicine at Hofstra/Northwell New York NY USA
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Jones L, Tee S, Horsfall M, Swan A, Wollaston F, Hecker T, De Pasquale C, Ilyas F, Thomas S, Chong W, Mangoni A, Selvanayagam J, Chew D, De Pasquale C. 174 The Acute Effects of SGLT2-inhibitors in Type 2 Diabetic Patients With HFrEF: A Crossover Trial. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chong W, Hua P, Gaigbe-Togbe B, Overbey J, Ascher-Walsh C. 28: Incidence and predictors of explantation of sacral neuromodulator in a single urban medical center. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Quispe LT, Menezes JW, Chong W, Zegarra LBR, Armas LEG. Influence of gold nanoholes and nanoslits arrays on Raman spectra and optical reflectance of graphene oxide. Opt Express 2018; 26:31253-31263. [PMID: 30650714 DOI: 10.1364/oe.26.031253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/26/2018] [Indexed: 06/09/2023]
Abstract
We report the effect of gold nanostructured substrates, fabricated by interference lithography technique (IL), on the Raman spectra and optical reflectance of graphene oxide (GO) layers. For purposes of comparison two gold nanostructured substrates, nanoslits (AuNSs) and circular nanoholes (AuNHs) were compared with a non-nanostructured gold substrate. Effects induced by the gold nanostructured substrates are discussed in terms of the ID/IG ratio and the FWHM of the G band (FWHM(G)) as a function of the G band intensity (IG), showing that both ID/IG and FWHM(G) parameters are highly sensitive to the number of GO layers (nGO), which would allow to identify the number of GO layers in a reliable way. Optical reflectance spectra (R(λ)) reveal that plasmons are generated on the surface of nanostructured substrates by the incident radiation. Dips in R(λ) are ascribed as coupling by surface plasmon polaritons described by Bloch waves (BW-SPP). A peak in R(λ) is also observed and it is ascribed to visible radiation produced by Förster resonance energy transfer and Purcell effect. The relevance of these results lies in the possibility of designing colorimetric plasmonic sensors, based on few layers of GO with an excellent control of nGO and with potential in detection of molecules by fluorescent absorption.
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Chong W, Ho R, Luo N, Koh G. THE INFLUENCE OF CAREGIVER-PATIENT RELATIONSHIP QUALITY AND CAREGIVER BURDEN ON LONG-TERM CARE USE IN SINGAPORE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- W Chong
- Nanyang Technological University
| | - R Ho
- Nanyang Technological University
| | - N Luo
- National University of Singapore
| | - G Koh
- National University of Singapore
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Chong W, Dabney L, Kiernan M, Oliva M, Ascher-Walsh C. 22: Comparison of postoperative voiding dysfunction in two different voiding trials after tension-free vaginal tape with or without concomitant surgery. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chong W, Ibrahim E, Aballa TC, Lynne CM, Brackett NL. Comparison of three methods of penile vibratory stimulation for semen retrieval in men with spinal cord injury. Spinal Cord 2017; 55:921-925. [DOI: 10.1038/sc.2017.60] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 11/10/2022]
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Chong W, Fantl J, Kocur B. 35: Iliococcygeus vaginal suspension technique without dissection. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chong W, Mehta S, Fantl J. 49: Does a phone call reminder influence the “no-show” rate at a diagnostic urogynecology clinic? Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fridman D, Chong W, Rotenberg O, Dar P, Mehta S, Hawkins E, Chudnoff S, Levie M. 28: Administration of methotrexate to patients with intrauterine pregnancies misdiagnosed as ectopic. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heah N, Leow J, Chong W, Tan R. 287 Low Intensity Extracorporeal Shockwave Therapy in the Treatment of Erectile Dysfunction: Early Experience at Tan Tock Seng Hospital. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heah N, Leow J, Chong W, Gruenwald I, Tan R. 226 Low Intensity Extracorporeal Shockwave Therapy in the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.11.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Seven isoforms of histone deacetylase Class III have been reported - Sirtuin (SIRT) 1-7. We recently demonstrated that EX-527, an inhibitor of SIRT1, reduces mortality in a mouse model of lethal-cecal-ligationand- puncture (CLP)-induced septic shock. Our present study was aimed at determining whether selective inhibition of SIRT2, with AGK2, would decrease animal death and attenuate the inflammatory response in a septic model. METHODS Experiment I: C57BL/6J mice were intraperitoneally given either AGK2 (82 mg/kg) in dimethyl sulfoxide (DMSO) or DMSO alone, and 2 h later subjected to CLP. Survival was monitored for 240 hours. Experiment II: mice treated the same way as Experiment I, were grouped into (i) DMSO vehicle, and (ii) AGK2, with sham mice (operating but without any treatment) serving as controls. Peritoneal fluid and peripheral blood were examined at 24 and 48 hours for cytokine production. Samples of blood at 48 h were also allocated to assess coagulability using Thrombelastography (TEG). Morphological changes of bone marrow were evaluated from long bones (femurs and tibias) with hematoxylin and eosin (H&E) staining. Bone marrow atrophy was quantified by a blinded pathologist. Experiment III: cytokines in supernatant of the cultured normal primary splenocytes were measured after the cells were stimulated by lipopolysaccharide and treated with or without AGK2 (10 µM) for 6 hours. RESULTS AGK2 significantly reduced mortality and decreased levels of cytokines in blood (TNF-α: 298.3±24.6 vs 26.8±2.8 pg/ml, p=0.0034; IL-6: 633.4±82.8 vs 232.6±133.0 pg/ml, p=0.0344) and peritoneal fluid (IL-6: 704.8±67.7 vs 391.4±98.5 pg/ml, p=0.033) compared to vehicle control. Also, AGK2 suppressed the TNF-α and IL-6 production in the cultured splenocytes (TNF-α: 68.1±6.4 vs 23.9±2.8 pg/ml, p=0.0009; IL-6: 73.1±4.2 vs 49.6±3.0 pg/ml; p=0.0051). The TEG data showed that the mice subjected to CLP displayed prolonged fibrin formation and fibrin cross-linkage time, slower clot formation, decreased platelet function, and clot rigidity. AGK2 treatment was associated with dramatic improvements in fibrin cross-linkage and clot formation times, without a significant impact on the clot initiation parameters or platelet function. Additionally, AGK2 significantly attenuated the bone marrow atrophy (58.3±6.5 vs 30.0±8.2%, p=0.0262). CONCLUSION Selective inhibition of SIRT2 significantly improves survival, and attenuates sepsis-associated "cytokine storm", coagulopathy, and bone marrow atrophy in a mouse model of lethal septic shock.
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Affiliation(s)
| | | | | | | | | | | | - W Chong
- Department of Emergency, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning 110001, China.
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Lavine SD, Cockroft K, Hoh B, Bambakidis N, Khalessi AA, Woo H, Riina H, Siddiqui A, Hirsch JA, Chong W, Rice H, Wenderoth J, Mitchell P, Coulthard A, Signh TJ, Phatorous C, Khangure M, Klurfan P, Ter Brugge K, Iancu D, Gunnarsson T, Jansen O, Muto M, Szikora I, Pierot L, Brouwer P, Gralla J, Renowden S, Andersson T, Fiehler J, Turjman F, White P, Januel AC, Spelle L, Kulcsar Z, Chapot R, Biondi A, Dima S, Taschner C, Szajner M, Krajina A, Sakai N, Matsumaru Y, Yoshimura S, Diaz O, Lylyk P, Jayaraman MV, Patsalides A, Gandhi CD, Lee SK, Abruzzo T, Albani B, Ansari SA, Arthur AS, Baxter BW, Bulsara KR, Chen M, Almandoz JED, Fraser JF, Heck DV, Hetts SW, Hussain MS, Klucznik RP, Leslie-Mawzi TM, Mack WJ, McTaggart RA, Meyers PM, Mocco J, Prestigiacomo CJ, Pride GL, Rasmussen PA, Starke RM, Sunenshine PJ, Tarr RW, Frei DF, Ribo M, Nogueira RG, Zaidat OO, Jovin T, Linfante I, Yavagal D, Liebeskind D, Novakovic R, Pongpech S, Rodesch G, Soderman M, Ter Brugge K, Taylor A, Krings T, Orbach D, Biondi A, Picard L, Suh DC, Tanaka M, Zhang HQ. Training Guidelines for Endovascular Stroke Intervention: An International Multi-Society Consensus Document. Interv Neurol 2016; 5:51-6. [PMID: 27610121 DOI: 10.1159/000444945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Lavine SD, Cockroft K, Hoh B, Bambakidis N, Khalessi AA, Woo H, Riina H, Siddiqui A, Hirsch JA, Chong W, Rice H, Wenderoth J, Mitchell P, Coulthard A, Signh TJ, Phatorous C, Khangure M, Klurfan P, terBrugge K, Iancu D, Gunnarsson T, Jansen O, Muto M, Szikora I, Pierot L, Brouwer P, Gralla J, Renowden S, Andersson T, Fiehler J, Turjman F, White P, Januel AC, Spelle L, Kulcsar Z, Chapot R, Spelle L, Biondi A, Dima S, Taschner C, Szajner M, Krajina A, Sakai N, Matsumaru Y, Yoshimura S, Ezura M, Fujinaka T, Iihara K, Ishii A, Higashi T, Hirohata M, Hyodo A, Ito Y, Kawanishi M, Kiyosue H, Kobayashi E, Kobayashi S, Kuwayama N, Matsumoto Y, Miyachi S, Murayama Y, Nagata I, Nakahara I, Nemoto S, Niimi Y, Oishi H, Satomi J, Satow T, Sugiu K, Tanaka M, Terada T, Yamagami H, Diaz O, Lylyk P, Jayaraman MV, Patsalides A, Gandhi CD, Lee SK, Abruzzo T, Albani B, Ansari SA, Arthur AS, Baxter BW, Bulsara KR, Chen M, Delgado Almandoz JE, Fraser JF, Heck DV, Hetts SW, Hussain MS, Klucznik RP, Leslie-Mawzi TM, Mack WJ, McTaggart RA, Meyers PM, Mocco J, Prestigiacomo CJ, Pride GL, Rasmussen PA, Starke RM, Sunenshine PJ, Tarr RW, Frei DF, Ribo M, Nogueira RG, Zaidat OO, Jovin T, Linfante I, Yavagal D, Liebeskind D, Novakovic R, Pongpech S, Rodesch G, Soderman M, terBrugge K, Taylor A, Krings T, Orbach D, Biondi A, Picard L, Suh DC, Tanaka M, Zhang HQ. Training Guidelines for Endovascular Ischemic Stroke Intervention: An International Multi-Society Consensus Document. AJNR Am J Neuroradiol 2016; 37:E31-4. [PMID: 26892982 DOI: 10.3174/ajnr.a4766] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Teng J, Hutchinson ME, Doery JCG, Choy KW, Chong W, Fuller PJ, Yang J. Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience. Intern Med J 2015; 45:1141-6. [DOI: 10.1111/imj.12873] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 08/06/2015] [Indexed: 11/27/2022]
Affiliation(s)
- J. Teng
- Department of Endocrinology; Monash Medical Centre; Melbourne Victoria Australia
| | - M. E. Hutchinson
- Department of Endocrinology; Monash Medical Centre; Melbourne Victoria Australia
| | - J. C. G. Doery
- Monash Pathology; Monash Medical Centre; Melbourne Victoria Australia
- Department of Medicine; Monash University; Melbourne Victoria Australia
| | - K. W. Choy
- Monash Pathology; Monash Medical Centre; Melbourne Victoria Australia
| | - W. Chong
- Monash Imaging; Monash Medical Centre; Melbourne Victoria Australia
| | - P. J. Fuller
- Department of Endocrinology; Monash Medical Centre; Melbourne Victoria Australia
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Melbourne Victoria Australia
| | - J. Yang
- Department of Endocrinology; Monash Medical Centre; Melbourne Victoria Australia
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Melbourne Victoria Australia
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Chong W, Fridman D, Rotenberg O, Hawkins E, Mehta S, Chudnoff S, Levie M. Factors Predicting the Success Rate of a Single Dose of Systemic Methotrexate for the Treatment of Ectopic Pregnancy. J Minim Invasive Gynecol 2015; 22:S89-S90. [DOI: 10.1016/j.jmig.2015.08.241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fridman D, Chong W, Rotenberg O, Chudnoff S, Hawkins E, Mehta S, Levie M. Compliance With Follow-Up Among Patients Treated With Methotrexate for Suspected Ectopic Pregnancy in an Urban Community Setting. J Minim Invasive Gynecol 2015; 22:S158. [DOI: 10.1016/j.jmig.2015.08.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zhao T, Alam H, Liu B, Bronson R, Nikolian V, Wu E, Chong W, Li Y. Selective Inhibition of SIRT2 Improves Outcomes in a Lethal Septic Model. Curr Mol Med 2015. [DOI: 10.2174/1566524015666150824143857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Fontão-Wendel R, Bertrand G, Chong W, Sachs UJ, Kaplan C, Tsuno N, Santoso S. Report on the 16th international society of blood transfusion platelet immunology workshop. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/voxs.12110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - G. Bertrand
- Institut National de la Transfusion Sanguine; Paris France
| | - W. Chong
- National Health Service Blood and Transplant (NHSBT) Colindale; London UK
| | - U. J. Sachs
- Institute for Clinical Immunology and Transfusion Medicine; Justus Liebig University; Giessen Germany
| | - C. Kaplan
- Institut National de la Transfusion Sanguine; Paris France
| | - N. Tsuno
- Department of Transfusion Medicine; The University of Tokyo; Tokyo Japan
| | - S. Santoso
- Institute for Clinical Immunology and Transfusion Medicine; Justus Liebig University; Giessen Germany
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Slater L, Hadley C, Soufan C, Yu H, Holt M, Chong W, Maroulis H, Stuckey S, Chandra R. O-010 Radiation Safety in Neurointervention: Is it Time for Dose Reference Levels? J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chong W, Zhang Y, Qian Y, Lai L, Parker G, Mitchell K. Computational hemodynamics analysis of intracranial aneurysms treated with flow diverters: correlation with clinical outcomes. AJNR Am J Neuroradiol 2013; 35:136-42. [PMID: 24287091 DOI: 10.3174/ajnr.a3790] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Recent studies have shown promising results regarding intracranial aneurysms treated with flow diverters. However, these have had adverse effects, including delayed aneurysm occlusion, posttreatment symptoms, and rupture. The hemodynamic profiles of aneurysms treated with flow diverters were analyzed to determine the ones associated with successful and failed treatments. MATERIALS AND METHODS Patient-specific computational fluid dynamics were used to simulate hemodynamic profiles, including the presence of jet flow, energy loss, volume flow, and wall shear stress in 4 successful occlusions of aneurysms and 4 failed cases after flow-diverter deployment. In these 4 failed cases, hemodynamic profiles were examined again after a hypothetic second intervention. This involved replacing the failed flow diverter with a hypothetic optimally deployed flow diverter or simulated placement of a second flow diverter within the first (double hypothetic optimally deployed). RESULTS Where successful occlusions were achieved, a marked obliteration of jet flow was observed. Flow entering the aneurysm sac was diverted via the center of the flow diverter and joined smoothly with the continuation of flow leaving the aneurysm sac into the parent arteries. These observations were supplemented by a reduction in the other hemodynamic profiles. Aneurysm neck geometry might influence the efficacy of the flow diverter. CONCLUSIONS Hemodynamic indices, as calculated by using computational fluid dynamics techniques, have close correlation with flow-diverter treatment outcome. Computational fluid dynamics could be potentially useful as a planning tool for neurointerventionists by simulating an optimized flow-diverter deployment strategy before the procedure and evaluating posttreatment outcome.
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Affiliation(s)
- W Chong
- Monash Medical Centre, Melbourne, Victoria, Australia
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Zhang Y, Chong W, Qian Y. Investigation of intracranial aneurysm hemodynamics following flow diverter stent treatment. Med Eng Phys 2013; 35:608-15. [DOI: 10.1016/j.medengphy.2012.07.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 07/16/2012] [Accepted: 07/16/2012] [Indexed: 11/29/2022]
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Cardoso SP, Chong W, Lucas G, Green A, Navarrete C. Determination of human neutrophil antigen-1, -3, -4 and -5 allele frequencies in English Caucasoid blood donors using a multiplex fluorescent DNA-based assay. Vox Sang 2013; 105:65-72. [PMID: 23398146 DOI: 10.1111/vox.12016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 10/26/2012] [Accepted: 11/06/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES A number of DNA-based methods to genotype the alleles coding for HNA have been described, but all require the separate amplification and analysis of each allele. The aim was to develop a DNA-based method for simultaneous detection of HNA-1, HNA-3, HNA-4 and HNA-5 alleles. MATERIALS AND METHODS An allele-specific primer extension method was used in combination with magnetic beads from Luminex technology. PCR-sequence-specific primers (SSP) was used to resolve the presence of the HNA-1b allele in samples assigned by the Luminex bead assay as HNA-1a/-1b/-1c or HNA-1b/-1c. HNA allele frequencies were determined in a panel of 140 randomly selected English Caucasoid blood donors. RESULTS HNA allelic types were compared with historical results, and 100% concordance was found. Only eight of the 97 samples used in the validation required additional testing by PCR-SSP. Allele frequencies were determined in the blood donor population as follows: 0·318 for HNA-1a, 0·668 for HNA-1b, 0·014 for HNA-1c, 0·768 for HNA-3a, 0·232 for HNA-3b, 0·882 for HNA-4a, 0·118 for HNA-4b, 0·736 for HNA-5a and 0·264 for HNA-5b. CONCLUSION A multiplex Luminex bead assay for the simultaneous detection of HNA-1, HNA-3, HNA-4 and HNA-5 alleles is described that enables rapid typing of donors to support HNA alloimmunized patients who require HNA-compatible blood products.
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Affiliation(s)
- S P Cardoso
- Histocompatibility and Immunogenetics (H&I) laboratory, National Health Service Blood and Transplant (NHSBT), Colindale Centre, London, UK
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Chong W, Fukudome E, Li Y, Liu B, Velmahos G, DeMoya M, Liu Z, King D, Fagenholz P, Alam H. Anti-Inflammatory Effects of Valproic ACID in a Rodent Model of Hemorrhagic Shock. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Leung TY, Vogel I, Lau TK, Chong W, Hyett JA, Petersen OB, Choy KW. Identification of submicroscopic chromosomal aberrations in fetuses with increased nuchal translucency and apparently normal karyotype. Ultrasound Obstet Gynecol 2011; 38:314-319. [PMID: 21400624 DOI: 10.1002/uog.8988] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/28/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Fetal nuchal translucency (NT) is assessed by ultrasonography as a screening tool for aneuploidy at 11 to 13 + 6 weeks' gestation. Fetuses with increased NT but apparently normal karyotype are still at higher risk of structural abnormality and a range of genetic syndromes, which may be related to major and submicroscopic chromosomal abnormalities. The aim of this study was to report the prevalence of submicroscopic chromosomal abnormalities in a cohort of apparently euploid fetuses that presented with increased NT. METHODS DNA was extracted from stored chorionic villus samples from fetuses found to have increased NT (> 3.5 mm) during first-trimester screening. These samples were examined by microarray-based comparative genomic hybridization (aCGH) using a 44K oligonucleotide array specifically constructed for prenatal screening. Variations in copy number (CNVs) were reported after excluding known non-pathogenic variants and after validation with multiplex ligation-dependent probe amplification (MLPA) or real-time quantitative polymerase chain reaction (qPCR). The prevalence of pathogenic CNVs is reported and the association with NT and other ultrasound findings described. RESULTS CNVs were reported in 6/48 (12.5%) cases by aCGH and the microdeletions or microduplications ranged from 1.1 to 7.9 Mb. Five of these were validated by MLPA/real-time qPCR and four (8.3%) were considered to be pathogenic and clinically significant. The incidence of pathogenic CNVs was 20.0% (2/10) among those cases with other sonographic anomalies and 5.3% (2/38) among those without. CONCLUSION aCGH allows detection of submicroscopic chromosomal abnormalities, the prevalence of which may be increased in fetuses with NT > 3.5 mm and an apparently normal karyotype.
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Affiliation(s)
- T Y Leung
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
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Jin G, Bausch D, Li Y, Liu B, Lu J, Fukudome E, Chong W, Velmahos G, Thayer S, Alam H. Valproic Acid Promotes Endothelial Cell Sprouting And Angiogenesis In-Vitro. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Purpose: The aim of this paper is to analyse the pathophysiology of 3 DVA cases from our institution, review the literature and propose a classification of these lesions. Materials & Methods: The pathophysiology of DVAs were analysed with CT perfusion (CTP), 4 dimensional dynamic computed tomography angiography (4D CTA) and catheter digital subtraction angiography. Results: Symptomatic DVAs may be caused by associated lesions and compression of neural structures by the DVAs. The imbalance between the inflow and outflow of these lesions, including venous ischaemia, has also been postulated as a cause. Our analysis showed that increased cerebral blood flow (CBF) and cerebral blood volume (CBV) and decreased mean transit time (MTT) and time to peak (TTP) were found in DVAs with micro arteriovenous shunting. DVAs without shunting had raised MTT and TTP instead. Conclusion: We postulate that the arteriovenous shunting resulted in arterial steal and chronic hypoxia which could be a pathophysiological mechanism for symptomatic DVAs. CTP and 4D CTA are effective non invasive tools to study DVAs. A classification is proposed.
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Affiliation(s)
- W. Chong
- Interventional Neuroradiology Unit, Diagnostic Imaging, Monash Medical Centre; Melbourne, Australia
| | - H. Patel
- Interventional Neuroradiology Unit, Diagnostic Imaging, Monash Medical Centre; Melbourne, Australia
| | - M. Holt
- Interventional Neuroradiology Unit, Diagnostic Imaging, Monash Medical Centre; Melbourne, Australia
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Li Y, Liu B, Fukudome E, Lu J, Chong W, Jin G, Velmahos G, DeMoya M, King D, Alam H. Early Measurement Of Circulating Proteins Can Predict Survival In Lethal Septic Shock. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kim K, Jin G, Li Y, Liu B, Liu J, Lee K, Chong W, Velmahos G, King D, Alam H. Treatment With Valproic Acid After Lethal Intentinal Ischemia-Reperfusion Can Prolong Survival And Attenuate Pulmonary Damage In A Rodent Model. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Boo NY, Chia GJQ, Wong LC, Chew RM, Chong W, Loo RCN. The prevalence of obesity among clinical students in a Malaysian medical school. Singapore Med J 2010; 51:126-132. [PMID: 20358151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities. METHODS This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake. RESULTS The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors. CONCLUSION Obesity remains a common problem among medical students in their clinical years.
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Affiliation(s)
- N Y Boo
- Department of Paediatrics, Clinical School, International Medical University, Jalan Rasah, Seremban, Malaysia.
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Fong W, Wong K, Cheng K, Tse C, Chan H, Chong W, Li C. PO12-TU-01 The benefit of the intraoperative transcranial Doppler and electroencephalography for carotid endarterectomy. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70848-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Adams ME, Aylett SE, Squier W, Chong W. A spectrum of unusual neuroimaging findings in patients with suspected Sturge-Weber syndrome. AJNR Am J Neuroradiol 2008; 30:276-81. [PMID: 19050205 DOI: 10.3174/ajnr.a1350] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Sturge-Weber syndrome (SWS) is frequently associated with neurologic complications such as seizures, so diagnosing this condition has important implications for patient management. The purpose of this study was to report unusual neuroimaging findings in patients with facial port-wine stain (PWS) and clinically suspected SWS. MATERIALS AND METHODS Cranial MR imaging was reviewed for all children with facial port-wine stain (PWS) involving the upper face and eyelids who were referred to Great Ormond Street Hospital between 2003 and 2007 for investigation of suspected SWS. Patients were excluded from further analysis if the imaging findings were normal on initial and subsequent scans and the subject remained free of neurologic disease, or if the imaging showed the well-recognized pattern of exclusively supratentorial pial enhancement representing the pial angioma of SWS. For the remaining patients, the neurologic, dermatologic, and ophthalmologic records were examined and all available imaging was reviewed by a neuroradiologist. We documented the presence and distribution of pial enhancement; corroborative features of SWS, such as atrophy, calcification, choroid plexus changes, and ocular abnormalities; and all other intracranial abnormalities. RESULTS Of the 62 patients referred for assessment, imaging findings were considered typical of SWS in 32 (52%) and were normal or showed abnormalities attributable to an unrelated pathology in 20 (32%). Of the remaining 10 patients, in 7 (11%), there was evidence of a pial angioma in an unusual distribution involving infratentorial structures, with the angioma in 1 patient being diagnosed at postmortem only; in 2 (3%), there were imaging abnormalities with some features in common with typical SWS, such as subcortical calcification, but with no evidence of pial enhancement; in 1 (1.6%), the initial MR imaging finding was normal, but repeat imaging subsequently revealed pial enhancement. CONCLUSIONS Involvement of infratentorial structures is common but may be relatively subtle and should be actively sought. Cases in which there are certain patterns of imaging abnormalities but an apparent absence of supratentorial pial enhancement on MR imaging may represent formes frustes of SWS; visualization of pial angiomatosis may also be delayed until later in childhood than expected.
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Affiliation(s)
- M E Adams
- Department of Radiology, Great Ormond Street Hospital, London, UK.
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Yu X, Fan C, Shan Z, Teng X, Guan H, Li Y, Teng D, Jin Y, Chong W, Yang F, Dai H, Yu Y, Li J, Chen Y, Zhao D, Shi X, Hu F, Mao J, Gu X, Yang R, Tong Y, Wang W, Gao T, Li C, Teng W. A five-year follow-up study of goiter and thyroid nodules in three regions with different iodine intakes in China. J Endocrinol Invest 2008; 31:243-50. [PMID: 18401207 DOI: 10.1007/bf03345597] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The association between iodine status and the prevalence of goiter and thyroid nodules has been well established but the extent to which different iodine intake levels influence the incidence of goiter and thyroid nodules is unclear. The aim of the study was to determine the incidence of goiter and thyroid nodules in 3 regions with different iodine intake levels: mildly deficient, more than adequate, and excessive. DESIGN, PATIENTS AND MEASUREMENTS Of the 3385 unselected subjects enrolled in 1999 in Panshan, Zhangwu, and Huanghua where median urinary iodine excretion (UIE) was 83.5 microg/l, 242.9 microg/l, and 650.9 microg/l, respectively, 2708 (80.0%) participated in the follow-up study in 2004. The examinations of thyroid ultrasonography, thyroid function, thyroid autoantibodies and UIE were performed at baseline and follow-up. RESULTS The cumulative incidence of diffuse goiter was 7.1%, 4.4%, and 6.9%, respectively, higher in Panshan and Huanghua than in Zhangwu (p=0.013 and p=0.015) and that of nodular goiter was 5.0%, 2.4%, and 0.8%, respectively, declining with increasing iodine intake levels (p<0.001). Mild iodine deficiency, chronic iodine excess as well as positive thyroid autoantibodies were associated with the occurrence of goiter [Logistic regression: odds ratio (OR)=1.83 (95% confidence interval (CI) 1.26-2.65), OR=1.46 (95% CI 1.01-2.11) and OR=1.68 (95% CI 1.14-2.48), respectively]. The cumulative incidence of single nodule was 4.0%, 5.7%, and 5.6%, respectively and that of multiple nodules was 0.4%, 1.2%, and 1.0%, respectively. CONCLUSIONS The relationship between iodine and the risk for the occurrence of diffuse goiter shows a U-shaped curve. Nodular goiters are more prevalent in iodine-deficient areas.
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Affiliation(s)
- X Yu
- Institute of Endocrinology, First Hospital Affiliated to China Medical University, Shenyang, Liaoning Province, PR China
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Abstract
The management of symptomatic and asymptomatic carotid stenosis has been a hotly debated topic for decades. The publication of four randomized controlled trials of carotid endarterectomy has clarified many of the issues. Patients with symptomatic carotid stenosis >70% benefit most with an absolute risk reduction of 17% over 2 years with numbers needed to treat of 3-6, whereas in patients with asymptomatic carotid stenosis >60%, the absolute risk reduction is 1% per annum (numbers needed to treat = 14-17). There is doubt about the benefit in women >70 years of age with asymptomatic stenosis. Carotid angioplasty and stenting is in its infancy and may one day supplant carotid endarterectomy as the treatment of choice; however, currently indications for this procedure include participation in randomized controlled trials, surgically inaccessible stenosis, in patients with combined symptomatic carotid and symptomatic coronary artery disease or in patients with severe co-morbidities that preclude formal carotid endarterectomy.
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Affiliation(s)
- P C Gates
- Neuroscience Department, Geelong Hospital, Geelong, Australia.
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Kim MK, Kim HD, Park JH, Lim JI, Yang JS, Kwak WY, Sung SY, Kim HJ, Kim SH, Lee CH, Shim JY, Bae MH, Shin YA, Huh Y, Han TD, Chong W, Choi H, Ahn BN, Yang SO, Son MH. An orally active cathepsin K inhibitor, furan-2-carboxylic acid, 1-{1-[4-fluoro-2-(2-oxo-pyrrolidin-1-yl)-phenyl]-3-oxo-piperidin-4-ylcarbamoyl}-cyclohexyl)-amide (OST-4077), inhibits osteoclast activity in vitro and bone loss in ovariectomized rats. J Pharmacol Exp Ther 2006; 318:555-62. [PMID: 16699068 DOI: 10.1124/jpet.106.102798] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Human cathepsin K, a cysteine proteinase of the papain family, has been recognized as a potential drug target for the treatment of osteoporosis. The predominant expression of cathepsin K in osteoclasts has rendered the enzyme into a major target for the development of novel antiresorptive drugs. Now, we report the pharmacological properties of OST-4077 [furan-2-carboxylic acid (1-{1-[4-fluoro-2-(2-oxo-pyrrolidin-1-yl)-phenyl]-3-oxo-piperidin-4-ylcarbamoyl}-cyclohexyl)-amide] as a novel selective cathepsin K inhibitor. Human and rat cathepsin K were inhibited in vitro by OST-4077 with the IC50 values of 11 and 427 nM, respectively. OST-4077 suppressed bone resorption induced by rabbit osteoclasts (IC50, 37 nM) but did not affect bone mineralization or cellular alkaline phosphatase activity in MC3T3-E1 cells. Parathyroid hormone-induced bone resorption was inhibited in a dose-dependent manner in thyroparathyroidectomized rats gavaged with a single dose of OST-4077 (ED50, 69 mg/kg). When given orally twice daily for 4 weeks to 3-month-old ovariectomized (OVX) rats, OST-4077 dose-dependently prevented bone loss, as monitored by bone densitometry, ash content, and urinary excretion of deoxypyridinoline. No change in serum osteocalcin in the OVX rats by OST-4077 suggested that bone formation might not be affected by the agent. In summary, OST-4077 selectively inhibited bone resorbing activities of osteoclasts and prevented bone loss induced by estrogen deficiency but did not affect bone formation. OST-4077, an orally active selective human cathepsin K inhibitor, may have the therapeutic potential for the treatment of diseases characterized by excessive bone loss including osteoporosis.
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Affiliation(s)
- M K Kim
- Dong-A Research Laboratories, Dong-A Pharmaceutical Co., Ltd., Gyeonggi-do, Republic of Korea
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Abstract
Thoracic ventral dural defect, and resultant idiopathic spinal cord herniation, is a rare but increasingly recognized cause of a chronic progressive thoracic myelopathy, particularly in middle-aged women. A neurosurgically confirmed case is presented, together with a review of the pathogenesis, clinical presentation, imaging features, treatment options and progress of this entity post-treatment.
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Affiliation(s)
- S Morley
- Department of Diagnostic Imaging, Monash Medical Centre, Melbourne, Victoria, Australia
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Chong W, Li LH, Lee K, Lee MH, Park JB, Ryu PD. Subtypes of alpha1- and alpha2-adrenoceptors mediating noradrenergic modulation of spontaneous inhibitory postsynaptic currents in the hypothalamic paraventricular nucleus. J Neuroendocrinol 2004; 16:450-7. [PMID: 15117338 DOI: 10.1111/j.1365-2826.2004.01180.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Noradrenergic inputs to the hypothalamic paraventricular nucleus (PVN) play important roles in the regulation of neuroendocrine and autonomic functions. Previous reports show that noradrenaline increases the frequency of spontaneous inhibitory postsynaptic currents (sIPSCs) in a subpopulation of type II neurones, acting via alpha(1)-adrenoceptors (ARs), but reduces this frequency in most type I and another subpopulation of type II neurones, via alpha(2)-ARs on presynaptic GABA neurones. Here, we identified the subtypes of alpha-ARs mediating noradrenaline-induced increases and decreases in the sIPSC frequency of PVN neurones, by using slice patch recordings from PVN neurones. In both type I and II neurones, the noradrenaline-induced decrease in sIPSC frequency was completely blocked by BRL44408 (alpha(2A)-AR antagonist) at 1-3 micro M, which is approximately 1/100 of its equilibrium dissociation constant (pA(2) = 8.0), but not by prazosin (20-100 micro M, alpha(2B/C)-AR antagonist; pA(2) = 7.5). The effect of noradrenaline was mimicked by guanfacine (alpha(2A)-AR agonist) with an EC(50) of 0.1 micro M. In type II neurones, the noradrenaline-induced increase in sIPSC frequency was not blocked by any of the following antagonists: RS17053 (10 micro M, alpha(1A)-AR antagonist), BMY7378 (2 micro M, alpha(1D)-AR antagonist), prazosin (0.1 micro M, alpha(1)-AR antagonist; pA(2) = 10.5), or chloroethylclonidine (10 micro M, alpha(1B/D)-AR antagonist). However, the effect of noradrenaline was blocked by higher concentrations of prazosin (1 micro M) or RS17053 (100 micro M), suggesting the involvement of alpha(1L)-subtype, a low affinity form of alpha(1A)-ARs. Collectively, our results indicate that the alpha(2A)-, or alpha(1L)-ARs on the GABA neurones mediate the noradrenaline-induced decreases, or increases in the frequencies of the sIPSCs of PVN neurones, respectively.
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MESH Headings
- Adrenergic alpha-Agonists/pharmacology
- Adrenergic alpha-Antagonists/pharmacology
- Animals
- Male
- Neural Inhibition/drug effects
- Neural Inhibition/physiology
- Neurons/drug effects
- Neurons/metabolism
- Norepinephrine/metabolism
- Organ Culture Techniques
- Paraventricular Hypothalamic Nucleus/cytology
- Paraventricular Hypothalamic Nucleus/drug effects
- Paraventricular Hypothalamic Nucleus/metabolism
- Patch-Clamp Techniques
- Rats
- Rats, Sprague-Dawley
- Receptors, Adrenergic, alpha-1/classification
- Receptors, Adrenergic, alpha-1/drug effects
- Receptors, Adrenergic, alpha-1/metabolism
- Receptors, Adrenergic, alpha-2/classification
- Receptors, Adrenergic, alpha-2/drug effects
- Receptors, Adrenergic, alpha-2/metabolism
- Synaptic Transmission/drug effects
- Synaptic Transmission/physiology
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Affiliation(s)
- W Chong
- Department of Pharmacology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
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Chong W, Kim YJ, Kim SD, Han SK, Ryu PD. Lack of bioequivalence of two oxytetracycline formulations in the rabbit. J Vet Sci 2002; 3:25-30. [PMID: 14614269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Oxytetracycline (OTC) has been used for over 40 years in veterinary medical field. Various forms of oxytetracycline preparations have been marketed, but little information is available on the bioequivalence of OTC preparations. This study was conducted to evaluate the bioequivalence of two OTC powder preparations available in Korea. Fourteen rabbits were randomly allocated into two groups. During the first period, a dose (200 mg/kg) of reference product was orally administered to the rabbits in Group A and test product to those in Group B. After 7-day washout period the reference and test products were given in group B and A, respectively. Blood samples were drawn at 17 points during 48 hours after administration and plasma OTC concentrations were measured by using HPLC. The solution concentrations of OTC dissolved from two products were not significantly different in the dissolution test. The mean area under the curve (AUC0- infinity ) and peak plasma concentration (C(max)) values for test and reference OTCs were 7.22 +/- 3.90 and 11.04 +/- 7.37 microg h/ml, 1.11 +/- 0.65 and 1.85 +/- 1.15 microg/ml, respectively. The relative bioavailability and C(max) of test product to those of reference product was 65.4% and 60.0%, respectively. The ranges of AUC and C(max) of test drug compared to those of reference drug under 90% confidence limits were 27 104% and 28 91.5%, respectively. The results of statistical analysis indicate that the two pivotal pharmacokinetic parameters, AUC and C(max) of test product are not within the 20% of those of the reference, suggesting that the test OTC is not bioequivalent to the reference OTC.
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Affiliation(s)
- W Chong
- Department of Pharmacology, College of Veterinary Medicine and School of Agricultural Biotechnolog, Seoul National University, Suwon, 441-744, Korea
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Affiliation(s)
- W Chong
- Department of Pharmacology, College of Veterinary Medicine and School of Agricultural Biotechnolog, Seoul National University, Suwon, 441-744, Korea
| | - YJ Kim
- Department of Pharmacology, College of Veterinary Medicine and School of Agricultural Biotechnolog, Seoul National University, Suwon, 441-744, Korea
| | - SD Kim
- Department of Pharmacology, College of Veterinary Medicine and School of Agricultural Biotechnolog, Seoul National University, Suwon, 441-744, Korea
| | - SK Han
- Department of Pharmacology, College of Veterinary Medicine and School of Agricultural Biotechnolog, Seoul National University, Suwon, 441-744, Korea
| | - PD Ryu
- Department of Pharmacology, College of Veterinary Medicine and School of Agricultural Biotechnolog, Seoul National University, Suwon, 441-744, Korea
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Zhao X, Li J, He Y, Lan F, Fu L, Guo J, Zhao R, Ye Y, He M, Chong W, Chen J, Zhang L, Yang N, Xu B, Wu M, Wan D, Gu J. A novel growth suppressor gene on chromosome 17p13.3 with a high frequency of mutation in human hepatocellular carcinoma. Cancer Res 2001; 61:7383-7. [PMID: 11606366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Previous studies have shown that there is a high frequency of loss of heterozygosity (LOH) on chromosome 17p13.3 in hepatocellular carcinoma [HCC (M. Fujimori et al., Cancer Res., 51: 89-93, 1991; H. Nagai et al., Oncogene, 14: 2927-2933, 1997; V. Boige et al., Cancer Res., 57: 1986-1990, 1997; Z. Piao et al., Int. J. Cancer, 75: 29-33, 1998; and B. Charroux et al., J. Cell Biol., 148: 1177-1186, 2000)]. The minimum region of LOH on chromosome 17p13.3 in HCC has been defined within the region between D17S643 and D17S1574. Moreover, D17S926 in the minimum region of LOH has the highest frequency of LOH, and its sequencing analysis has been accomplished. In this region, 6 of 13 novel genes have been characterized (X. Zhao, D. Wan, M. He, Yu. Ye, Yi. He, L. Han, M. Guo, Y. Huang, W. Qin, M-W. Wang, W. Chong, J. Chen, L. Zhang, N. Yang, B. Xu, M. Wu, L. Zuo, and J. Gu. A high frequency LOH region on chromosome 17p13.3 in human HCC with densely clustered genes identified, submitted for publication). Here we describe the cloning and characterization of one of these novel genes, designated HCC suppressor 1 (HCCS1), located at this region. HCCS1 had 18 exons, and its full-length cDNA was 2.0 kb. The protein expression product of HCCS1 was located in mitochondria. HCCS1 had a high frequency of mutations in HCC samples, whereas no alteration has been found in matched noncancerous liver tissues. Immunohistochemistry revealed a significantly higher expression of HCCS1 in the noncancerous liver tissues (33 of 35 samples) than in the HCC samples (2 of 35 samples). Transfection of HCCS1 cDNA into the HCC cell line remarkably reduced the efficiency of its colony formation and inhibited tumor growth in nude mice. Taken together, these findings strongly suggest a potential role of HCCS1 as a HCC putative suppressor gene.
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Affiliation(s)
- X Zhao
- National Laboratory for Oncogenes and Related Genes, Shanghai Cancer Institute, Shanghai 200032, China
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Affiliation(s)
- K M Hender
- Centre for Clinical Effectiveness, Southern Health/Monash Institute of Public Health, Melbourne, VIC
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Abstract
Glutamate is known to increase neuronal excitability in the subfornical organ, a circumventricular organ devoid of the blood-brain barrier. To understand the synaptic mechanism of neuronal excitation by glutamate in this nucleus, we examined the effects of glutamate on GABAergic spontaneous inhibitory postsynaptic currents recorded from subfornical organ neurons in the rat brain slice. The baseline frequency, amplitude and decay time-constant of such spontaneous synaptic currents were 5.60 Hz, 119 pA and 17.3 ms, respectively. Glutamate (10-1000 microM) selectively inhibited the frequency of spontaneous GABAergic inhibitory postsynaptic currents (half-maximal effective concentration=47 microM) with little effects on their amplitudes and decay time constants. The inhibitory effect of glutamate on the frequency of spontaneous GABAergic postsynaptic currents was not blocked by tetrodotoxin (1 microM), or by the antagonists of ionotropic glutamate receptors. In contrast, such inhibitory effect of glutamate was mimicked by general or group II selective metabotropic glutamate receptor agonists such as DCGIV (2S,1'R,2'R,3'R)-2-(2',3'-dicarboxycyclopropyl)glycine (half-maximal effective concentration=112 nM), but not by the agonists for group I or group III metabotropic glutamate receptors. Under current clamp mode, glutamate reduced the frequencies of spontaneous inhibitory postsynaptic potentials and action potentials in subfornical organ neurons. Our data indicate that glutamate decreases the frequency of spontaneous inhibitory postsynaptic currents by acting on the group II metabotropic glutamate receptors on axonal terminals in the subfornical organ. From these results we suggest that the glutamate-induced modulation of tonic GABAergic inhibitory synaptic activity can influence the excitability of subfornical organ neurons.
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Affiliation(s)
- H S Lee
- Department of Veterinary Pharmacology, College of Veterinary Medicine, Seoul National University, 103 Seodun-dong Kwonsun-ku, 441-744, Suwon, South Korea
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Abstract
This report describes three women with hyperemesis gravidarum caused by previously undiagnosed thyrotoxicosis. All three women were eight weeks pregnant and only one woman had typical features of thyrotoxicosis. Hyperemesis could not be controlled by anti-emetics. The patients were successfully treated with antithyroid drugs. Anti-thyroid treatment does not need to be continued once resolution of symptoms and thyrotoxicosis have occurred.
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Affiliation(s)
- W Chong
- Department of Endocrinology and Diabetes, St Albans and Hemel Hempstead NHS Trust, Hertfordshire, UK
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Wei K, Hua H, Chong W. [Cell kinetics of experimental premalignant lesions of the oral mucosa by Brdu labelling]. Zhonghua Kou Qiang Yi Xue Za Zhi 1995; 30:86-8. [PMID: 7648925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
The main risks associated with endoscopic stone removal arise from the sphincterotomy that is performed to facilitate stone extraction. The complication rate may be higher when the bile duct is not dilated. Between January 30, 1990, and March 30, 1993, we attempted to remove stones up to 8 mm in diameter through the intact papilla, without performing sphincterotomy, in 24 patients. Nine patients underwent balloon dilation of the sphincter or of a low duct stricture to facilitate stone removal. All patients were treated successfully and are well at follow-up. Two patients (one having had balloon dilation of the sphincter) had mild pancreatitis that required 2 days in the hospital. During the same period, 215 patients were treated for duct stones 8 mm or less through a standard sphincterotomy. Complications occurred in 11 of these patients: five episodes of pancreatitis, three infections, one perforation, and two other complications. Although these two groups of patients are not directly comparable, it appears that selected stones can be extracted from the bile duct without sphincterotomy with relative safety. This technique should be studied further, especially in younger persons where sphincter preservation may be desirable.
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Affiliation(s)
- G R May
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710
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