Dr Noelyn Hung
Position | Senior Lecturer |
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Department | Department of Pathology (Dunedin) |
Qualifications | BSc MB ChB FRCPA |
Research summary | Anatomical pathologist with subspecialist interest in perinatal medicine, oncology, and autoimmunity |
Teaching | Dr Hung teaches into the disciplines of undergraduate and postgraduate medicine, dentistry, pharmacy, physiotherapy, medical laboratory science, and pathology at the University of Otago and Southern District Health Board. Through the Otago Polytechnic she also contributes to midwifery education. Dr Hung is Curator of the Pathology Department Museum of Human Disease. |
Clinical | Anatomical pathologist with subspecialist interest in perinatal medicine, oncology, and autoimmunity. |
Research
Since joining the university in late 2004, Dr Hung has continued clinical practice, developed a research programme, enjoyed teaching, and continued her work in the biotechnology industry which emphasises 'good clinical practice' and 'good laboratory practice' (according to International Conference on Harmonisation Guidelines for GCP and GLP standards, and European Medicines Agency Guidelines). Dr Hung has led (as PI) over 500 PK/PD phase 1 and 2 studies.
As an anatomical pathologist Dr Hung's expertise is in the interpretation of human disease, and readily takes the 'bedside to the bench'. Anatomical pathology emerged from morbid anatomy, which in turn emerged from normal anatomy in the 17th century, and embraces all disease with a morphological tissue manifestation. This now extends to the microscopic, proteonomic, epigenetic and genetic levels and as such is a broad discipline in the 'big picture' of human disease.
Oncology, autoimmunity and reproductive medicine may seem disparate interests but a unifying feature is the regulation of cell death, survival and growth. The need to understand the regulation of growth at the start of life in inversely reflected in the need to conquer the immortality of cancer cell growth. Between these are chronic diseases (such as autoimmunity), which also involve deregulated cell death, survival and growth.
Dr Hung works closely with Drs Tania Slatter and Janice Royds as a member of the Molecular Pathology Group. Local collaborators include Dr Celia Devenish (Women's and Children's Health), Professor Rob Walker (Medicine), Dr Ahmad Taha (Neurosurgery), Dr William Clow (Women's and Children's Health), and Professor John Highton (Medicine). Collaborators from outside Dunedin are at the University of Otago, Christchurch; and the universities of Hong Kong, Sydney, Oxford, Manchester, and Umea.
Publications
Fabre, M.-S., Stanton, N. M., Slatter, T. L., Lee, S., Senanayake, D., Gordon, R. M. A., … Taha, A., Royds, J. A., Hung, N., … McConnell, M. J. (2020). The oncogene BCL6 is up-regulated in glioblastoma in response to DNA damage, and drives survival after therapy. PLoS ONE, 15(4), e0231470. doi: 10.1371/journal.pone.0231470
Eiholzer, R. A., Mehta, S., Kazantseva, M., Drummond, C. J., McKinney, C., Young, K., … Fleming, N., Morrin, H. R., Reader, K., Royds, J. A., Landmann, M., Petrich, S., … Taha, A., Hung, N. A., Slatter, T. L., & Braithwaite, A. W. (2020). Intronic TP53 polymorphisms are associated with increased Δ133TP53 transcript, immune infiltration and cancer risk. Cancers, 12(9), 2472. doi: 10.3390/cancers12092472
Glue, P., Medlicott, N. J., Surman, P., Lam, F., Hung, N., & Hung, C. T. (2020). Ascending-dose study of controlled-release ketamine tablets in healthy volunteers: Pharmacokinetics, pharmacodynamics, safety, and tolerability. Journal of Clinical Pharmacology, 60(6), 751-757. doi: 10.1002/jcph.1573
Reily-Bell, A. L., Fisher, A., Harrison, B., Bowie, S., Ray, S., Hawkes, M., … Fukuzawa, R., Macaulay, E. C., Devenish, C. J., Hung, N. A., & Slatter, T. L. (2020). Human papillomavirus E6/E7 expression in preeclampsia-affected placentae. Pathogens, 9(3), 239. doi: 10.3390/pathogens9030239
Glue, P., Medlicott, N. J., Neehoff, S., Surman, P., Lam, F., Hung, N., & Hung, C.-T. (2020). Safety and efficacy of extended release ketamine tablets in patients with treatment-resistant depression and anxiety: Open label pilot study. Therapeutic Advances in Psychopharmacology, 10, 1-6. doi: 10.1177/2045125320922474
Chapter in Book - Research
Hung, N., & Slatter, T. (2013). Histopathology in biomolecular research. In A. Divan & J. Royds (Eds.), Tools and techniques in biomolecular science. (pp. 418-437). Oxford, UK: Oxford University Press.
Journal - Research Article
Fabre, M.-S., Stanton, N. M., Slatter, T. L., Lee, S., Senanayake, D., Gordon, R. M. A., … Taha, A., Royds, J. A., Hung, N., … McConnell, M. J. (2020). The oncogene BCL6 is up-regulated in glioblastoma in response to DNA damage, and drives survival after therapy. PLoS ONE, 15(4), e0231470. doi: 10.1371/journal.pone.0231470
Glue, P., Medlicott, N. J., Neehoff, S., Surman, P., Lam, F., Hung, N., & Hung, C.-T. (2020). Safety and efficacy of extended release ketamine tablets in patients with treatment-resistant depression and anxiety: Open label pilot study. Therapeutic Advances in Psychopharmacology, 10, 1-6. doi: 10.1177/2045125320922474
Reily-Bell, A. L., Fisher, A., Harrison, B., Bowie, S., Ray, S., Hawkes, M., … Fukuzawa, R., Macaulay, E. C., Devenish, C. J., Hung, N. A., & Slatter, T. L. (2020). Human papillomavirus E6/E7 expression in preeclampsia-affected placentae. Pathogens, 9(3), 239. doi: 10.3390/pathogens9030239
Glue, P., Medlicott, N. J., Surman, P., Lam, F., Hung, N., & Hung, C. T. (2020). Ascending-dose study of controlled-release ketamine tablets in healthy volunteers: Pharmacokinetics, pharmacodynamics, safety, and tolerability. Journal of Clinical Pharmacology, 60(6), 751-757. doi: 10.1002/jcph.1573
Eiholzer, R. A., Mehta, S., Kazantseva, M., Drummond, C. J., McKinney, C., Young, K., … Fleming, N., Morrin, H. R., Reader, K., Royds, J. A., Landmann, M., Petrich, S., … Taha, A., Hung, N. A., Slatter, T. L., & Braithwaite, A. W. (2020). Intronic TP53 polymorphisms are associated with increased Δ133TP53 transcript, immune infiltration and cancer risk. Cancers, 12(9), 2472. doi: 10.3390/cancers12092472
Kazantseva, M., Mehta, S., Eiholzer, R. A., Gimenez, G., Bowie, S., Campbell, H., Reily-Bell, A. L., … Ray, S., Drummond, C. J., Reid, G., … Wiles, A., Morrin, H. R., Reader, K. L., Hung, N. A., Baird, M. A., Slatter, T. L., & Braithwaite, A. W. (2019). The Δ133p53β isoform promotes an immunosuppressive environment leading to aggressive prostate cancer. Cell Death & Disease, 10, 631. doi: 10.1038/s41419-019-1861-1
Mehta-Mujoo, P. P., Cunliffe, H. E., Hung, N. A., & Slatter, T. L. (2019). Long non-coding RNA ANRIL in the nucleus associates with periostin expression in breast cancer. Frontiers in Oncology, 9, 885. doi: 10.3389/fonc.2019.00885
Kazantseva, M., Eiholzer, R. A., Mehta, S., Taha, A., Bowie, S., Roth, I., Zhou, J., … Royds, J. A., Hung, N. A., Slatter, T. L., & Braithwaite, A. W. (2018). Elevation of the TP53 isoform Δ133p53β in glioblastomas: An alternative to mutant p53 in promoting tumour development. Journal of Pathology, 246(1), 77-88. doi: 10.1002/path.5111
Kazantseva, M., Mehta, S., Eiholzer, R. A., Hung, N., Wiles, A., Slatter, T. L., & Braithwaite, A. W. (2018). A mouse model of the Δ133p53 isoform: Roles in cancer progression and inflammation. Mammalian Genome, 29, 831-842. doi: 10.1007/s00335-018-9758-3
Zhou, J., Reddy, M. V., Wilson, B. K. J., Blair, D. A., Taha, A., Frampton, C. M., Eiholzer, R. A., … Hung, N. A., Royds, J. A., & Slatter, T. L. (2018). MR imaging characteristics associate with tumor-associated macrophages in glioblastoma and provide an improved signature for survival prognostication. American Journal of Neuroradiology, 39(2), 252-259. doi: 10.3174/ajnr.A5441
Menkes, D. B., Glue, P., Gale, C., Lam, F., Hung, C.-T., & Hung, N. (2018). Steady-state clozapine and norclozapine pharmacokinetics in Maori and European patients. EBioMedicine, 27, 134-137. doi: 10.1016/j.ebiom.2017.11.030
Dias, G. J., Mahoney, P., Hung, N. A., Sharma, L. A., Kalita, P., Smith, R. A., … Ali, A. (2017). Osteoconduction in keratin-hydroxyapatite composite bone-graft substitutes. Journal of Biomedical Materials Research Part B, 105(7), 2034-2044. doi: 10.1002/jbm.b.33735
Kazantseva, M., Hung, N. A., Mehta, S., Roth, I., Eiholzer, R., Rich, A. M., Seo, B., Baird, M. A., Braithwaite, A. W., & Slatter, T. L. (2017). Tumor protein 53 mutations are enriched in diffuse large B-cell lymphoma with irregular CD19 marker expression. Scientific Reports, 7, 1566. doi: 10.1038/s41598-017-01800-6
Glue, P., Cape, G., Tunnicliff, D., Lockhart, M., Lam, F., Hung, N., … Harland, S., … Friedhoff, L. (2016). Ascending single-dose, double-blind, placebo-controlled safety study of noribogaine in opioid-dependent patients. Clinical Pharmacology in Drug Development, 5(6), 460-468. doi: 10.1002/cpdd.254
Chatterjee, A., Macaulay, E. C., Rodger, E. J., Stockwell, P. A., Parry, M. F., Roberts, H. E., Slatter, T. L., Hung, N. A., Devenish, C. J., & Morison, I. M. (2016). Placental hypomethylation is more pronounced in genomic loci devoid of retroelements. Genes Genomes Genetics, 6(7), 1911-1921. doi: 10.1534/g3.116.030379
Royds, J. A., Pilbrow, A. P., Morrin, H. R., Frampton, C., Russell, I. A., Moravec, C. S., … Currie, M. J., Hung, N. A., & Slatter, T. L. (2016). The rs11515 polymorphism is more frequent and associated with aggressive breast tumors with increased ANRIL and decreased p16INK4a expression. Frontiers in Oncology, 5, 306. doi: 10.3389/fonc.2015.00306
Glue, P., Cape, G., Tunnicliff, D., Lockhart, M., Lam, F., Gray, A., Hung, N., … Harland, S., … Friedhoff, L. (2016). Switching opioid-dependent patients from methadone to morphine: Safety, tolerability, and methadone pharmacokinetics. Journal of Clinical Pharmacology, 56(8), 960-965. doi: 10.1002/jcph.704
Hung, N. A., Eiholzer, R. A., Kirs, S., Zhou, J., Ward-Hartstonge, K., Wiles, A. K., Frampton, C. M., Taha, A., Royds, J. A., & Slatter, T. L. (2016). Telomere profiles and tumor-associated macrophages with different immune signatures affect prognosis in glioblastoma. Modern Pathology, 29, 212-226. doi: 10.1038/modpathol.2015.156
Glue, P., Lockhart, M., Lam, F., Hung, N., Hung, C.-T., & Friedhoff, L. (2015). Ascending-dose study of noribogaine in healthy volunteers: Pharmacokinetics, pharmacodynamics, safety, and tolerability. Journal of Clinical Pharmacology, 55(2), 189-194. doi: 10.1002/jcph.404
Slatter, T. L., Hung, N., Bowie, S., Campbell, H., Rubio, C., Speidel, D., Wilson, M., Baird, M., Royds, J. A., & Braithwaite, A. W. (2015). Δ122p53, a mouse model of Δ133p53α, enhances the tumor-suppressor activities of an attenuated p53 mutant. Cell Death & Disease, 6, e1783. doi: 10.1038/cddis.2015.149
Sawhney, S., Hood, K., Shaw, A., Braithwaite, A. W., Stubbs, R., Hung, N. A., Royds, J. A., & Slatter, T. L. (2015). Alpha-enolase is upregulated on the cell surface and responds to plasminogen activation in mice expressing a Δ133p53α mimic. PLoS ONE, 10(2), e0116270. doi: 10.1371/journal.pone.0116270
Slatter, T. L., Hung, N. G. L. Y., Clow, W. M., Royds, J. A., Devenish, C. J., & Hung, N. A. (2015). A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications. Modern Pathology, 28, 1369-1382. doi: 10.1038/modpathol.2015.88
Slatter, T. L., Hsia, H., Samaranayaka, A., Sykes, P., Clow, W., Devenish, C. J., … Royds, J. A., … Hung, N. A. (2015). Loss of ATRX and DAXX expression identifies poor prognosis for smooth muscle tumours of uncertain malignant potential and early stage uterine leiomyosarcoma. Journal of Pathology: Clinical Research, 1(2), 95-105. doi: 10.1002/cjp2.11
Slatter, T. L., Park, L., Anderson, K., Lailai-Tasmania, V., Herbison, P., Clow, W., Royds, J. A., Devenish, C., & Hung, N. A. (2014). Smoking during pregnancy causes double-strand DNA break damage to the placenta. Human Pathology, 45(1), 17-26. doi: 10.1016/j.humpath.2013.07.024
Hung, N., Chen, Y.-J., Taha, A., Olivecrona, M., Boet, R., Wiles, A., … Shaw, A., Eiholzer, R., Baguley, B. C., Eccles, M. R., Braithwaite, A. W., MacFarlane, M., Royds, J. A., & Slatter, T. (2014). Increased paired box transcription factor 8 has a survival function in Glioma. BMC Cancer, 14, 159. doi: 10.1186/1471-2407-14-159
Berney-Meyer, L., Hung, N., Slatter, T., Schollum, J. B. W., Kitching, A. R., & Walker, R. J. (2014). Omeprazole-induced acute interstitial nephritis: A possible Th1–Th17-mediated injury? Nephrology, 19(6), 359-365. doi: 10.1111/nep.12226
Ferrandon, S., Saultier, P., Carras, J., Battiston-Montagne, P., Alphonse, G., Beuve, M., … Slatter, T., Hung, N., Royds, J., … Poncet, D. (2013). Telomere profiling: Toward glioblastoma personalized medicine. Molecular Neurobiology, 47(1), 64-76. doi: 10.1007/s12035-012-8363-9
Kazantseva, M. G., Hung, N. A., Highton, J., & Hessian, P. A. (2013). MMP expression in rheumatoid inflammation: The rs11568818 polymorphism is associated with MMP-7 expression at an extra-articular site. Genes & Immunity, 14(3), 162-169. doi: 10.1038/gene.2012.65
Awasthi, A., Woolley, A. G., Lecomte, F. J., Hung, N., Baguley, B. C., Wilbanks, S. M., Jeffs, A. R., & Tyndall, J. D. A. (2013). Variable expression of GLIPR1 correlates with invasive potential in melanoma cells. Frontiers in Oncology, 3, 225. doi: 10.3389/fonc.2013.00225
Hung, N. A., Royds, J. A., & Slatter, T. L. (2013). Molecular markers of glioblastoma and the potential for integration with imaging: The future for assigning prognosis and best treatment strategy. Current Molecular Imaging, 2(2), 107-116. doi: 10.2174/2211555211302020001
Hung, N. A., Hsia, H., Royds, J. A., & Slatter, T. L. (2013). Telomere maintenance mechanisms: Prognostic and therapeutic implications for the pathologist and oncologist. Open Journal of Pathology, 3(1), 10-20. doi: 10.4236/ojpathology.2013.31003
Slatter, T. L., Tan, X., Yuen, Y. C., Gunningham, S., Ma, S. S., Daly, E., Packer, S., Devenish, C., Royds, J. A., & Hung, N. A. (2012). The alternative lengthening of telomeres pathway operates in non-neoplastic human cells. Journal of Pathology, 226(3), 509-518. doi: 10.1002/path.2981
Glue, P., Gale, C., Menkes, D. B., & Hung, N. (2012). Evaluation of bioequivalence between clozapine suspension and tablet formulations : A multiple-dose, fed and fasted Study. Clinical Drug Investigation, 32(11), 723-727. doi: 10.1007/s40261-012-0004-6
Royds, J. A., Al Nadaf, S., Wiles, A. K., Chen, Y.-J., Ahn, A., Shaw, A., Bowie, S., … Braithwaite, A. W., … Hung, N. A., & Slatter, T. L. (2011). The CDKN2A G500 allele is more frequent in GBM patients with no defined telomere maintenance mechanism tumors and is associated with poorer survival. PLoS ONE, 6(10), e26737. doi: 10.1371/journal.pone.0026737
Slatter, T. L., Hung, N., Campbell, H., Rubio, C., Mehta, R., Renshaw, P., Williams, G., Wilson, M., … Jeffs, A., Royds, J. A., Baird, M. A., & Braithwaite, A. W. (2011). Hyperproliferation, cancer, and inflammation in mice expressing a Δ133p53-like isoform. Blood, 117(19), 5166-5177. doi: 10.1182/blood-2010-11-321851
Woolley, A. G., Algie, M., Samuel, W., Harfoot, R., Wiles, A., Hung, N. A., … Royds, J. A., Perez, D., Yoon, H.-S., … Braithwaite, A. W. (2011). Prognostic association of YB-1 expression in breast cancers: A matter of antibody. PLoS ONE, 6(6), e20603. doi: 10.1371/journal.pone.0020603
Slatter, T., Gifford-Garner, J., Wiles, A., Tan, X., Chen, Y.-J., MacFarlane, M., Sullivan, M., Royds, J., & Hung, N. (2010). Pilocytic astrocytomas have telomere-associated promyelocytic leukemia bodies without alternatively lengthened telomeres. American Journal of Pathology, 177(6), 2694-2700. doi: 10.2353/ajpath.2010.100468
Fitches, A. C., Yousem, S., Cieply, K., Stebbings, S., Highton, J., & Hung, N. A. (2010). PCR detectable Y chromosome-specific DNA but no intact Y chromosome-bearing cells in polymyositis biopsies of two women with male offspring. Pathology, 42(2), 160-164. doi: 10.3109/00313020903494953
Gwynne-Jones, D., Lyall, P., Hung, N. A., & Meikle, G. (2008). Accidental human injection of Excenel RTUTM: Ceftiofur hydrochloride in cottonseed oil. Clinical Toxicology, 46, 908-910. doi: 10.1080/15563650801955278
Leigh, W., O'Grady, P., Lawson, E. M., Hung, N. A., Theis, J.-C., & Matheson, J. (2008). Pelvic pseudotumor: An unusual presentation of an extra-articular granuloma in a well-fixed total hip arthroplasty. Journal of Arthroplasty, 23(6), 934-938. doi: 10.1016/j.arth.2007.08.003
Highton, J., Hung, N., Hessian, P., & Wilsher, M. (2007). Pulmonary rheumatoid nodules demonstrating features usually associated with rheumatoid synovial membrane. Rheumatology, 46, 811-814.
Connor, A., Stebbings, S., Hung, N. A., Hammond-Tooke, G., Meikle, G., & Highton, J. (2007). STIR MRI to direct muscle biopsy in suspected idiopathic inflammatory myopathy. Journal of Clinical Rheumatology, 13(6), 341-345.
Hung, N. A., Jackson, C., Nicholson, M., & Highton, J. (2006). Pregnancy-related polymyositis and massive perivillous fibrin deposition in the placenta: Are they pathogenetically related? Arthritis & Rheumatism, 55(1), 154-156. doi: 10.1002/art.21710
Gwynne-Jones, D. P., Theis, J. C., Jeffery, A. K., & Hung, N. A. (2005). Long-term follow-up of a recurrent multifocal desmoid tumour treated with tamoxifen: A case report. Journal of Orthopaedic Surgery, 13(2), 174-177.
Hung, N. A. (2005). Congenital ″clear cell sarcoma of the kidney″. Virchows Archiv, 446(5), 566-568.
Teixeira, F., Devlin, M., Hung, N., & Yun, K. (2002). An atrophic plaque on the chest. Australian Family Physician, 31, 359-360.
Thomas, M. C., Walker, R. J., & Hung, N. (1999). Tuberculosis: Still the great pretender. Hospital Medicine, 60, 214-215.
Holmes, M., Hung, N., & Hunter, M. (1998). Hematuria and death secondary to aortoureteric fistula. Urology, 52(4), 720-722.
IJsselstijn, H., Hung, N., de Jongste, J. C., Tibboel, D., & Cutz, D. (1998). Calcitonin gene-related peptide expression is altered in pulmonary neuroendocrine cells in developing lungs of rats with congenital diaphragmatic hernia. American Journal of Respiratory Cell & Molecular Biology, 19(2), 278-285. doi: 10.1165/ajrcmb.19.2.2853
Hung, N. A., Silver, M. M., Chitayat, D., Provias, J., Toi, A., Jay, V., & Becker, L. E. (1998). Gonadoblastoid testicular dysplasia in Walker-Warburg syndrome. Pediatric & Developmental Pathology, 1(5), 393-404. doi: 10.1007/s100249900054
Frizelle, F. A., Hung, N. A., Heslop, J. H., & Parry, B. R. (1991). Obscure gastrointestinal bleeding: Idiopathic aortoduodenal fistula. Journal of the Royal College of Surgeons of Edinburgh, 36(5), 331-333.
Buisman, N., Mow, A. C., Currie, T., Devereux, F., Hawkins, T., & Holden, H. (1988). AIDS: Knowledge and attitudes in Otago. New Zealand Medical Journal, 101(845), 241-243.
Journal - Research Other
Jackson, C. G. C. A., Morris, T., Hung, N., & Hung, T. (2019). Breast milk paclitaxel excretion following intravenous chemotherapy: A case report. British Journal of Cancer, 121, 421-424. doi: 10.1038/s41416-019-0529-z
Vardi, L., Paterson, H., & Hung, N. A. (2017). Successful pregnancy following treatment of recurrent chronic histiocytic intervillositis. BMJ Case Reports. doi: 10.1136/bcr-2016-217886
Lindström, A.-C., Hung, N. A., Duncan, W., & Kieser, J. (2014). Detection of gunshot residues (GSR) on a self-inflicted gunshot wound. Pathology, 46(3), 260-263. doi: 10.1097/pat.0000000000000083
Hung, N. A. (2013). A difficult conversation: Dusting off the bedside manner of pathologists. BJOG, 120(5), 649. doi: 10.1111/1471-0528.12084
Connor, A., Highton, J., Hung, N. A., Dunbar, J., MacGinley, R., & Walker, R. (2007). Multicentric carpal-tarsal osteolysis with nephropathy treated successfully with cyclosporine A: A case report and literature review. American Journal of Kidney Diseases, 50(4), 649-654. doi: 10.1053/j.ajkd.2007.06.014
Stott, V., Manning, P., & Hung, N. (2005). Idiopathic granulomatous hypophysitis [Case report]. New Zealand Medical Journal, 118(1211). Retrieved from http://journal.nzma.org.nz/journal/118-1211/1355/content.pdf
Hung, N. A., Strack, M., van Rij, A., North, C. J., & Blennerhassett, J. B. (2004). Spontaneous acroangiodermatitis in a young woman. Dermatology Online Journal, 10(2), 8. Retrieved from http://dermatology.cdlib.org/102/case_reports/acroangiodermatitis/hung.html
Gwynne Jones, D. P., Hodgson, B. F., & Hung, N. A. (2004). Bilateral, uncemented total hip arthroplasty in osteopetrosis. Journal of Bone & Joint Surgery (Br), 86-B(2), 276-278.
Mathur, S., Law, A. J. J., & Hung, N. (2000). Late intramedullary spinal cord metastasis in a patient with lymphoblastic lymphoma: Case report. Journal of Clinical Neuroscience, 7(3), 264-268. doi: 10.1054/jocn.1999.0197
Parry, B. R., Hung, N. A., McCall, J. L., & Phipps, R. F. (1993). Apparent regression of rectal polyps in a patient with Gardner's syndrome receiving concomitant tamoxifen therapy [Case report]. Australian & New Zealand Journal of Surgery, 63(7), 578-579. doi: 10.1111/j.1445-2197.1993.tb00460.x
Delany, S. G., Doyle, T. C. A., Bunton, R. W., Hung, N. A., Joblin, L. U., & Taylor, D. R. (1993). Pulmonary artery sarcoma mimicking pulmonary embolism [Case report]. Chest, 103(5), 1631-1633. doi: 10.1378/chest.103.5.1631