Cervical diskography: analysis of provoked responses at C2-C3, C3-C4, and C4-C5.
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Cervical Vertebrae↗
Biomedical subjects
W Wong
Publications and source records attributed to W Wong.
Use of donepezil in elderly patients with Alzheimer's disease--a Hawaii based study.
Donepezil (Aricept) is a reversible acetylcholinesterase inhibitor which is indicated for the treatment of mild to moderate dementia of the Alzheimer's type. We did a retrospective analysis of 41 elderly Alzheimer's subjects of different ethnic groups including a large number of Asian and Hawaiian patients. Donepezil appears to be clinically effective in patients of different ethnicities with mild to moderate Alzheimer's disease, even at advanced age.
Aged↗
HIV risk behaviors among Asian drug users in San Francisco.
This study identified patterns of drug use and HIV risk behaviors in relation to cultural factors among Asian drug users in San Francisco. A sample of 92 Asian drug users (35 Chinese, 31 Filipino, 26 Vietnamese) who were not currently enrolled in drug treatment programs were recruited through targeted sampling methods and interviewed using a questionnaire with open-ended questions. The study evaluated responses of the participants based on content analyses. Compared with Chinese and Vietnamese, Filipino drug users had engaged in riskier behaviors in terms of injection drug use, having sex while on drugs, and having sex with injection drug users (IDUs). Cultural factors such as stigma of injection drug use and fear of needles were cited as reasons for not injecting drugs. Among IDUs, half cited trust as a reason for having shared needles. AIDS prevention programs targeting Asian drug users should consider specific cultural factors among high-risk groups (i.e., Filipinos, immigrants, women, and IDUs).
Adult↗
[Improved liposome encapsulated hemoglobin by electret technology and its influence on the blood rheologic behavior in vitro].
To study the influence of different electret properties of Liposome Encapsulated Hemoglobin(LEH) on the blood rheologic behavior in vitro, four kinds of LEH have been prepared. Their electret properties have been determined by using Thermally Stimulated Depolarization Current(TSDC). The results show that 4# LEH, whose Ta is 12 degrees C and Ia is -5.6 x 10(-9) A, has the best electret property, furthermore, the results of the thrombus formation in vitro also show that the addition of 4# LEH induces the lightest thrombus figuration in vitro. It is obvious that the rational improvement of the electret property of LEH can meliorate the surface charge of blood and effectively inhibit the formation of thrombus.
Blood Viscosity↗
Angiotensin receptor antagonists.
BACKGROUND: Angiotensin receptor antagonists are a relatively new class of cardiovascular drugs for which the clinical application has not yet been completely defined. OBJECTIVE: This article reviews the pharmacology of the various angiotensin receptor antagonists available in Australia, including their mode of action, side effects and potential drug interactions. DISCUSSION: Angiotensin receptor antagonists are effective drugs for the treatment of mild to moderate hypertension which have a side effect profile similar to placebo. Their role in the management of hypertension remains to be defined, but they are of particular use to patients who are intolerant of ACE inhibitors because of cough. It is uncertain at the present time whether the benefits of ACE inhibition in other disorders such as congestive heart failure and following myocardial infarction will be similar for angiotensin receptor blockers.
Angiotensin II↗
Antigen presenting cell function is enhanced in healthy elderly.
Aging is associated with a progressive decline in T cell-mediated immune responses. Little is known about the effect of aging on antigen presenting cells (APC). We have recently reported an age-related decline in proliferative response of peripheral blood mononuclear cells from elderly volunteers to Staphylococcus enterotoxin B (SEB). Since SEB-induced stimulation of T cells is not restricted by major histocompatibility complex, experiments were conducted in which T cells and APC from young and healthy elderly subjects were combined. We initially demonstrated the decreased SEB-induced proliferative capacity of elderly T cell elderly APC co-cultures when compared with young T cell young APC co-cultures. Combination of purified T cells from elderly donors with APC from young donors maintained a reduced T cell proliferative response. Age-related decline in T cell function was also established by the reduced proliferative capacity of elderly T cells co-cultured with a reference monocyte cell line. Surprisingly, co-culture of APC from healthy elderly donors with purified T cells from young donors enhanced T cell proliferation. APC from elderly donors also marginally enhanced the proliferative response of an SEB-specific T cell line.
Adult↗
Age-related impaired proliferation of peripheral blood mononuclear cells is associated with an increase in both IL-10 and IL-12.
Reflective of age-associated decline in immune function among elderly individuals is a decrease in in vitro T cell proliferative ability. Impaired T cell proliferation in the elderly may result from disruption of the well-balanced network of regulatory cytokines produced during an immune response. The purpose of this study was to identify age-related changes in the production of interleukin (IL)-10 and IL-12, and to determine whether in vitro T cell proliferation can be enhanced in the elderly by modulation of these two key cytokines. The superantigen Staphyloccocus entertoxin B (SEB) was used to stimulate proliferation and IL-10 and IL-12 production in peripheral blood mononuclear cells (PBMC) in vitro. Proliferation was determined by standard tritiated thymidine uptake. Cytokine levels in culture supernatants were measured by ELISA. We observed impaired SEB-induced proliferation of PBMC in the elderly that is comparable to that seen with the polyclonal mitogen Con A. This age-related decline in proliferation was associated with increased production of both IL-10 and IL-12. Modulation of PBMC proliferative response with either recombinant IL-12 or IL-10-neutralizing antibodies can boost proliferation of elderly PBMC to the levels seen in unmodulated young controls.
Adult↗
A catalytic mechanism for caspase-1 and for bimodal inhibition of caspase-1 by activated aspartic ketones.
We have evaluated 619 aspartic ketones with 9 different types of prime-side groups (acyloxymethyl, aryloxymethyl, arylthiomethyl, alkylthiomethyl, acylamino-oxymethyl, sulfonylaminomethyl, alpha-ketoamide, alpha-(1-phenyl-3-trifluoromethyl-pyrazol-5-yl)oxymethyl (PTP), and aliphatic ketones) as inhibitors of caspase-1. The inhibitory behaviors could be classified as reversible, inactivating, or bimodal (i.e. reversible inhibition followed by slow inactivation) based on the kinetically observed formation of reversible thiohemiketal complexes and conversion to an irreversible thioether adduct, and the mechanism of any given ketone was only poorly predictable on the basis of leaving group structure and chemistry. Among 201 bimodal inhibitors, the rate of conversion of the reversible thiohemiketal complex to the inactive thioether (k(i)) was strictly first-order, consistent with direct conversion of the thiohemiketal to the thioether with no intermediate collapse to free ketone and thiolate. We have examined 22 crystallographic structures of caspase-1 complexed as a thiohemiketal with the inhibitors from 8 different ketone classes, and found the Cys285S-C-C(alpha)-leaving group dihedral angle to be near either to 60 degrees or to 180 degrees. Only the 180 degrees conformation was permissive for SN2 displacement of the leaving group and, furthermore, positioned His237Ndelta to stabilize developing charge on the leaving group. Among these structures and 19 additional complexes, all showed a strong interaction between His237Ndelta and the ketone or thiohemiketal oxygen. We therefore propose a proteolytic mechanism for caspase-1 involving polarization of the scissile carbonyl by the His237 imidazolium group. During thiohemiketal/thioether conversion (but probably not during peptide hydrolysis), the leaving group is stabilized by the His237 imidazolium.
Caspase 1↗
Early onset of hypernatraemic dehydration and fever in exclusively breast-fed infants.
Five cases of moderately severe hypernatraemic dehydration were identified within a 5-month period between two regional hospitals in Hong Kong. Unlike previous reported cases, these exclusively breast-fed infants presented with the unusual triad of fever, absence of overt signs of dehydration and within the first week of life. Three of the cases also had high serum bilirubin concentrations at presentation. The fever subsided quickly and the serum bilirubin concentration fell rapidly within a few hours of rehydration. All infants made an uneventful recovery without permanent neurological sequelae. Fever, presumably secondary to dehydration, is an useful early warning sign. These cases emphasize the importance of early and regular measurement of bodyweight in exclusively breast-fed infants so that prompt identification of affected cases may prevent potentially detrimental complications.
Age of Onset↗
The neonatal implications of a high placental ratio in small-for-gestational age infants.
An increased placental ratio has been associated with small-for-gestational age (SGA) infants. A retrospective study on 252 singleton SGA infants without major anomalies born within a 1-year period was performed to determine the relationship between placental ratio and maternal/infant characteristics, and perinatal complications. The cases were categorized into three groups according to the placental ratio (<1 sd below the mean, within 1 sd of the mean, >1 sd above the mean) based on our previous data. There were more infants with a high ratio (32.9 per cent) than with a low ratio (15.5 per cent). While there was no difference in the maternal characteristics or antenatal complications, there was a significant trend in decreasing birthweight and an increasing placental weight in relation to an increasing placental ratio. The infants with a high ratio had increased incidence of meconium stained liquor, hypocalcaemia, hypomagnesaemia and phototherapy, a trend that was consistent even after exclusion of the preterm infants. Our data indicated that a high placental ratio in SGA infants was due to both increased placental size and decreased birthweight, and this was associated with increased neonatal morbidity.
Adult↗
Fat mass in infants and toddlers: comparability of total body water, total body potassium, total body electrical conductivity, and dual-energy X-ray absorptiometry.
BACKGROUND: Accurate assessment of body composition in infants and children is fundamental to understanding normal growth and development. Validation of methods applicable to pediatric populations is needed. In the absence of a gold standard, this study was conducted to compare methods using total body water, total body potassium, total body electrical conductivity, and dual-energy x-ray absorptiometry measurements for the estimation of body fat mass in infants and toddlers. METHODS: Repeated body composition measurements were performed on 76 healthy term infants at 0.5, 3, 6, 9, 12, 18, and 24 months of age. Total body water was determined by deuterium dilution and converted to fat-free mass. Total body electrical conductivity was used to measure fat mass. Total body potassium was estimated by whole-body counting and converted to fat-free mass. Dual-energy x-ray absorptiometry was used to estimate fat mass at 0.5, 12, and 24 months only. Data were analyzed by repeated measures analysis of variance, followed by Bonferroni multiple comparisons at 5%. RESULTS: Significant differences among methods were encountered at each age (p = 0.001-0.05). The rank order of the methods and the magnitude of the method differences were a function of age, not of gender or infant feeding mode. Wide limits of agreement imply that the methods are not interchangeable for group or individual measurements. CONCLUSIONS: Methods using total body water, total body potassium, total body electrical conductivity, and dual-energy x-ray absorptiometry to estimate body fat mass in infants and toddlers are not interchangeable and require further development and validation.
Absorptiometry, Photon↗
Congenital nephrotic syndrome responsive to captopril and indometacin.
Two children with congenital nephrotic syndrome are described (one with Finnish-type nephrosis, the other with diffuse mesangial sclerosis). Both children have had a prolonged and sustained clinical response with good physical health and normal growth patterns using captopril and indometacin as their sole treatment. No adverse effects have been noted. We recommend a trial of indometacin and captopril treatment in cases of congenital nephrotic syndrome.
Angiotensin-Converting Enzyme Inhibitors↗
Randomised controlled study of early use of inhaled corticosteroid in preterm infants with respiratory distress syndrome.
AIM: To investigate the therapeutic efficacy of inhaled fluticasone propionate, started on day 1 of age, on ventilated preterm infants with respiratory distress syndrome. METHODS: Starting within 24 hours of age, ventilated preterm infants (gestation < 32 weeks, birthweight < 1.5 kg) with respiratory distress syndrome were given a 14 day course (two puffs, 12 hourly) of either fluticasone propionate (250 microg/puff) (group 1, n=27) or placebo (group 2, n=26) with a metered dose inhaler-spacer device. Response to treatment was assessed by the rate of successful extubation by days 7 and 14 of age, changes in respiratory system mechanics, death, occurrence of chronic lung disease, and other neonatal complications. RESULTS: More infants in the treatment group were successfully extubated by 14 days of age than those in the placebo group (17/27 vs 8/26; p = 0.038). The treated infants also showed a more significant improvement in respiratory system compliance during the first 14 days of life. The two groups, however, did not differ significantly in their need for systemic steroids after day 14 of age, death, or the occurrence of chronic lung disease. The treatment was not associated with any increase in neonatal complications, including those attributable to steroid induced side effects. CONCLUSION: These results provide preliminary evidence that early treatment with inhaled corticosteroids may be beneficial to ventilated preterm infants with respiratory distress. Further study of its use in a large scale randomised trial is warranted.
Administration, Inhalation↗
Influence of warfarin regimen type on clinical and monitoring outcomes in stable patients in an anticoagulation management services.
Options for dosing warfarin include same daily dosing, such as 7 mg/day, and alternate-day dosing, such as 5 mg Monday and Thursday, and 7.5 mg all other days. Some practitioners favor same daily dosing because it is simple, whereas others prefer alternate-day dosing because it requires a single tablet size. Computerized records of patients followed by an anticoagulation management service were reviewed retrospectively to identify those whose anticoagulation was stable with one of these two dosing methods. Clinical and monitoring outcomes were compared between groups. Rates of hemorrhagic and thromboembolic complications were similar in the two groups, as were monitoring outcomes, including clinic visits/year, warfarin dosage adjustments/year, and percentage of international normalized ratios within range. Patients receiving the same daily dose reported lower rates of confusion (0% vs 7%) and dosing errors (3.3% vs 14%) that those receiving alternate-day dosing, and expressed a stronger preference for their regimen (40% vs 1.5%). When selecting a regimen, consideration must be given to patient-specific risk of confusion and dosing errors, associated costs, practicality and precision of dosing adjustments, and patient preference.
Adult↗
Long-term renal sodium handling in patients with cirrhosis treated with transjugular intrahepatic portosystemic shunts for refractory ascites.
PURPOSE: The long-term effects of transjugular intrahepatic portosystemic shunts on renal sodium excretion are not known. We sought to determine these long-term effects, as well as to measure the effects of a sodium load in patients who are free of ascites. SUBJECTS AND METHODS: Ten patients with cirrhosis who had been successfully treated with transjugular intrahepatic portosystemic stent shunt for refractory ascites were studied before the shunt and again at 6 and 14 months after the shunt while on a 22 mmol sodium/day diet. At 14 months they were also studied on a 200 mmol sodium/day diet for 7 days without diuretics. Renal sodium handling, central blood volume, neurohumoral factors, and hepatic function were measured. RESULTS: Sodium balance was negative at 6 months (urinary sodium excretion [mean +/- SD] 51 +/- 11 mmol/day versus 7 +/- 2 mmol/day pre-shunt; P < 0.05), was maintained at 14 months (22 +/- 4 mmol/day; P < 0.05 versus pre-shunt), and was associated with normalization of renin activity and aldosterone levels, but not norepinephrine levels, as well as significantly improved renal hemodynamic measurements. Sodium loading with 200 mmol/day resulted in weight gain associated with increased central blood volume and appropriate renal sodium handling in most but not all patients (urinary sodium excretion 188 +/- 14 mmol/day), despite persistent nonsuppressibility of sympathetic hyperactivity. CONCLUSIONS: In cirrhotic patients with refractory ascites treated with a transjugular intrahepatic portosystemic stent shunt, long-term renal sodium handling is improved. Adequate intravascular filling in ascites-free cirrhotic patients with normal portal pressure permits an improved but not normalized renal response to a sodium load, possibly due to persistently elevated sympathetic activity. Therefore, these patients should increase their sodium intake cautiously.
Adult↗
Severe congenital absence of skin in a preterm infant.
A severe case of aplasia cutis congenita in a preterm infant is described. Although major problems with thermoregulation and fluid balance were anticipated, these parameters were relatively easy to control once the patient was stabilized. Meticulous skin care and rapid formation of a membranous-like fibrous tissue layer covering the denuded areas probably played an important role in minimizing excessive fluid and heat loss. The prognosis in aplasia cutis congenita is determined by the underlying associated anomalies, the severity of skin lesions and, in our case, the maturity of the infant who died from complications of prematurity.
Ectodermal Dysplasia↗
Classical galactosaemia in Chinese: A case report and review of disease incidence.
We report a case of galactose-1-phosphate uridyl transferase (GALT) deficiency in a full-term Chinese neonate, who presented with atypical biochemical features of hyperammonaemia in addition to the classical presenting features of jaundice and lethargy after feeding. Red cell GALT activity was virtually absent in the patient while 50% of normal activity was found in parents and a sibling. Mutation screening excluded both Q188R and N314D as the causative mutation in GALT gene, which suggested a possible genetic segregation among ethnic groups. Data from a Taiwan screening program suggested that the incidence of the disease was approximately 1 in 400 000 in the Chinese population which was a sixth of that in Caucasian populations.
Ammonia↗