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Biomedical subjects

A Fung

Publications and source records attributed to A Fung.

32 records · Page 2Linked to original sources
PubMed1996

PROTECT (Prospective Reinfarction Outcomes in the Thrombolytic Era Cardizem CD Trial): a randomized, double-blind clinical trial of diltiazem versus atenolol in secondary prophylaxis post non-Q wave myocardial infarction.

OBJECTIVE: To describe the rationale and design of the Prospective Reinfarction Outcomes in the Thrombolytic Era Cardizem CD Trial (PROTECT). DESIGN: A multicentre, randomized, double-blind, parallel-group comparison of once daily beta-therapy versus heart rate lowering calcium channel blocker therapy, in the reduction of one-year nonfatal reinfarction and cardiovascular death (combined primary end-point) initiated 24 to 96 h post non-Q wave myocardial infarction. SETTING: One hundred and twenty hospitals across Canada. PATIENTS: Over 7500 women and men aged 21 years or older with enzyme-confirmed non-Q wave infarction and without significant left ventricular systolic dysfunction will be recruited over two years. INTERVENTIONS: Once daily beta-blocker therapy (oral atenolol, 50 to 200 mg) versus once daily calcium channel blocker therapy (oral diltiazem 120 to 360 mg) with follow-up for up to three years. CONCLUSIONS: The PROTECT will be the largest all-Canadian cardiovascular trial to date and will compare two commonly prescribed agents for secondary prophylaxis following non-Q wave infarction. The scientific question addressed by the PROTECT is of major public health importance and the results of the study will directly affect current clinical practice.

Adrenergic beta-Antagonists↗
PubMed1994

Charged-particle transport in biomolecular media: the third generation.

We describe Monte Carlo codes that simulate, event by event, the interaction of energetic electrons with a double-stranded DNA molecule and with the condensed water surrounding it. Both direct and indirect effects are treated explicitly . The cross-sectional input necessary in the transport codes was obtained via quantum-mechanical calculations of the dielectric response function epsilon(q, omega), of polycytidine. For each inelastic event on DNA we score the energy deposited locally, the position of the event and the moiety that underwent that event. This information provides a detailed picture of the spatial disposition of molecular alterations for DNA exposed to ionizing radiation.

DNA↗
PubMed1994

Magnetic resonance imaging of nerve root inflammation in the Guillain-Barré syndrome.

We report gadolinium-enhancing nerve root lesions in a 52-year-old man with typical Guillain-Barré syndrome (GBS). This enhancement correlates well with the perineurial inflammatory and demyelinating processes known to characterize GBS and other inflammatory neuropathies. MRI should enable further exploration of patterns of disease in GBS and, with further study, perhaps assist in evaluating therapy.

Cauda Equina↗
PubMed1994

Molecular damage induced directly and indirectly by ionizing radiation in DNA.

We describe the interaction of radiation with a double-stranded DNA molecule and with the structural water surrounding it. The results, which include a detailed picture of DNA molecular alterations, as well as their yield and spatial disposition, were obtained with the aid of Monte Carlo codes that simulate, event-by-event and simultaneously, direct and indirect effects. These calculations make use of explicit quantum-mechanical descriptions of the electronic structure of condensed water and of a homopolynucleotide chain. From these we obtain, via the dielectric response function of the two systems, epsilon (q, omega), the interaction probabilities necessary in the transport codes.

DNA↗
PubMed1992

Inguinal herniotomy in young infants.

Ninety-two consecutive infants aged up to 12 months underwent primary inguinal herniotomy over a 5-year period. All were treated in a district hospital paediatric surgical unit according to recommendations of the British Association of Paediatric Surgeons. After a mean follow-up of 45.8 months, one patient had a failed repair and four (4 per cent) a hernia recurrence. One infant developed a wound infection. Infantile hernia can be managed safely and efficiently in a district hospital.

Female↗
PubMed1992

Clinical and hemodynamic evaluation of the 19-mm Carpentier-Edwards supraannular aortic valve.

The clinical and hemodynamic performance of the 19-mm Carpentier-Edwards supraannular aortic valve is largely unknown compared with that of the larger valves. Over 4 years we implanted the 19-mm Carpentier-Edwards supraannular aortic valve into 21 patients (20 female) with a mean age of 75 +/- 1.2 years (range, 59 to 86 years) and a mean body surface area of 1.6 +/- 0.03 m2 (range, 1.3 to 1.7 m2). There were four deaths, one operative and three late noncardiac deaths. Follow-up of the 17 survivors for a mean of 20 +/- 3.1 months (range, 2 to 42 months) demonstrated symptomatic improvement in all 17 (all are now in New York Heart Association functional class I or II). There were no valve-related complications and no patient required long-term anticoagulation. Doppler echocardiographic studies were used to assess the in vivo hemodynamic profile of the valve. Mean postoperative aortic valve gradient was 34.1 +/- 2.7 mm Hg (range, 19 to 52 mm Hg). Functional valve orifice area was 1.1 +/- 0.09 cm2 (range, 0.6 to 1.8 cm2). Mean cardiac output was 3.92 +/- 0.17 L/min (range, 3.2 to 5.1 L/min) with a mean cardiac index of 2.5 +/- 0.11 L.min-1 x m-2 (range, 2.1 to 3.2 L.min-1 x m-2). In conclusion, we have demonstrated that aortic valve replacement with the 19-mm Carpentier-Edwards supraannular aortic valve has a low operative mortality and offers major clinical benefits despite moderate transprosthetic gradients. This approach provides an alternative management strategy in elderly patients who would otherwise require low-profile mechanical valves or aortic root enlargement.

Aged↗
PubMed1990

Preoperative cytology and mammography in patients with single-duct nipple discharge treated by surgery.

Microdochectomy has been the routine management for single-duct nipple discharge. Our review of 176 consecutive patients surgically treated between 1975 and 1988 revealed eight patients with in situ carcinomas and seven with infiltrative carcinomas. Seventeen patients had multiple papillomas, two had atypical hyperplasia and two had atypical epitheliosis. Case selection for surgery has recently been advocated. In our study, nipple discharge cytology was helpful in 67 per cent of cases with underlying malignant pathology. Mammography was found to be unreliable, alerting suspicion in only two of 15 cases.

Adolescent↗
PubMed1980

Modification of the 5' position of purine nucleosides. 2. Synthesis and some cardiovascular properties of adenosine-5'-(N-substituted)carboxamides.

We have shown previously that the esters of adenosine-5'-carboxylic acid (10) represent a new class of potent nontoxic coronary vasodilators. For example, the ethyl ester (12), which is active by an intraduodenal or intravenous route in dogs, causes a large increase in coronary sinus PO2 and coronary blood flow. Because of the pronounced vasoactive properties of the esters of adenosine-5'-carboxylic acid, a systematic study of the corresponding amides (14--50) was undertaken. In addition, several other analogues containing the N1-oxide function (51--52) or 2',3' substituents (3--9, 53--54) were studied.

Adenosine↗
PubMed1976

Modification of the 5' position of purine nucleosides. 1. Synthesis and biological properties of alkyladenosine-5'-carboxylates.

A series of esters of adenosine-5'-carboxylic acid has been prepared. Most of the compounds were nontoxic, causing prolonged increases in coronary sinus PO2 when administered to anesthetized dogs; the ethyl ester was most active. Nitrosation and oxidation of the ethyl ester 12 gave respectively inactive inosine ethyl ester 30 and the fairly active N1-oxide ethyl ester 29.

Adenosine↗
PubMedDate not supplied

Treatment planning for asymmetric jaws on a commercial TP system.

In this work, the accuracy of the asymmetric jaws planning feature in a commercial treatment planning (TP) system is assessed. In the latest version of this software, the off-axis beam quality variation is handled by a function g(d,r), which is derived from measured horizontal beam profiles at four different depths. The calculated and measured isodoses for a 6-MV linear accelerator with asymmetric jaws agree to +/- 0.5% along the central axis and to within 2 mm at the beam edge. Formulas for treatment time calculations using the output data reported by the computer program are described, as well as formulas for manual calculations based on pregenerated data tables. Doses calculated based on these formulas are compared to measurement and the accuracy is +/- 1% and +/- 2% for the computer and manual calculations, respectively. It is concluded that this version of the treatment planning system as well as the treatment time calculation formulas can be used adequately for asymmetric jaw computerized and manual treatment planning.

Humans↗
PubMedDate not supplied

Large vessel dysfunction in diabetic adolescents and its relationship to small vessel complications.

Endothelial dysfunction is considered a key early event in atherosclerosis. Using a novel ultrasound method, brachial artery endothelial and smooth muscle physiology were studied in 20 adolescents with IDDM and compared to that in 20 nondiabetic subjects matched for age (13-22 years), gender and vessel size. Endothelium-dependent dilatation (EDD) was assessed in response to flow (EDD) and endothelium-independent vasodilatation after sublingual glyceryl trinitrate (GTN). Both EDD and GTN were reduced in those with IDDM compared with controls: 5% vs 9%, (p = 0.0002) and 14% vs 21% (p = 0.002). Abnormal EDD was found in 12 IDDM adolescents (diabetes duration 3.3-14.9 years). The maximum albumin excretion rate of the diabetic group was 17 micrograms/min. Four adolescents had retinopathy assessed by stereoscopic fundus photography. Three had at least one of four cardiovascular autonomic test abnormalities. There was no significant correlation observed between the test for early large vessel disease and those for diabetic microangiopathy. Large vessel dysfunction was the most common abnormality.

Adolescent↗