Zian Tseng, MD, MAS

TitleAssociate Professor
SchoolUCSF School of Medicine
Address500 Parnassus Avenue
San Francisco CA 94143
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    Collapse Biography 
    Collapse Education and Training
    University of California, San FranciscoM.A.S. in Clinical Research2008 Graduate Division (Advance Training in Clinical Research)
    University of California, San Francisco Clinical Fellowship
    University of California, San Francisco Residency School of Medicine
    University of California, San FranciscoM.D.1998School of Medicine

    Collapse Overview 
    Collapse Overview
    Zian H. Tseng, M.D., M.A.S., a cardiologist and a cardiac electrophysiologist, joined the faculty in 2004, bringing expertise in risk stratification of patients prone to sudden death and ventricular arrhythmias. Dr. Tseng, a Bay Area native, was the top 1998 graduate from the UCSF School of Medicine, where he also completed a year of graduate studies in Biomedical Sciences and a Master's in Advanced Studies in Clinical Research. He completed his clinical training in internal medicine, cardiology, and cardiac electrophysiology at UCSF.

    1) Treatment of complex supraventricular arrhythmias, including catheter ablation of atrial fibrillation and left atrial tachycardias occurring after atrial fibrillation ablation
    2) Treatment and catheter ablation of ventricular tachycardia, including epicardial mapping and ablation
    3) Treatment, risk stratification, and catheter ablation of arrhythmias in adult patients with congenital heart disease
    4) Risk stratification and treatment of patients with high risk arrhythmia syndromes
    5) Implantation of intracardiac devices for treatment of heart failure (resynchronization) and risk of sudden cardiac death (defibrillators)
    6) Application of new device technologies, such as performing percutaneous epicardial left atrial appendage (LAA) ligation in patients with atrial fibrillation in conjunction with Dr. Randall Lee

    1) Principal Investigator for the Comprehensive Characterization of Sudden Cardiac Death in San Francisco, a 5-year NIH/NHLBI grant awarded in 2010 aiming to more accurately define sudden cardiac death (SCD), arrhythmic sudden death, and its risk factors, in collaboration with the County Medical Examiner
    2) Genetic epidemiology and risk factors for sudden cardiac arrest
    3) Sudden cardiac death and ventricular arrhythmias in the setting of HIV disease
    4) Sudden neurologic death
    5) Sudden death risk and public/health policy for use of Tasers (electrical conductive devices) by law enforcement agencies

    Collapse Research 
    Collapse Research Activities and Funding
    Cardiac Pathology and Risk Prediction for Sudden Cardiac Death in Patients with HIV
    NIH/NHLBI R01HL126555Sep 15, 2014 - Jun 30, 2018
    Role: Principal Investigator
    Comprehensive autopsy characterization of sudden cardiac death
    NIH/NHLBI R01HL102090Aug 1, 2010 - May 31, 2015
    Role: Principal Investigator

    Collapse ORNG Applications 
    Collapse Websites
    Collapse In The News

    Collapse Bibliographic 
    Collapse Publications
    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
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    1. Devinsky O, Friedman D, Cheng JY, Moffatt E, Kim A, Tseng Z. Underestimation of sudden deaths among patients with seizures and epilepsy. Neurology. 2017 Aug 29; 89(9):886-892. PMID: 28768851.
      View in: PubMed
    2. Nascimento FA, Tseng Z, Palmiere C, Maleszewski JJ, Shiomi T, McCrillis A, Devinsky O. Pulmonary and cardiac pathology in sudden unexpected death in epilepsy (SUDEP). Epilepsy Behav. 2017 Aug; 73:119-125. PMID: 28633090.
      View in: PubMed
    3. Hayward RM, Foster E, Tseng Z. Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease. JAMA Cardiol. 2017 Jun 01; 2(6):664-671. PMID: 28403428.
      View in: PubMed
    4. Moffatt E, Tseng Z. Commentary on: Mauf S, Jentzsch T, Laberke PJ, Thali MJ, Bartsch C. Why we need postmortem analysis of cardiac implantable electronic devices. J Forensic Sci 2016;61(4):988-92. J Forensic Sci. 2017 Jan; 62(1):274. PMID: 28087994.
      View in: PubMed
    5. Nguyen KT, Gladstone RA, Dukes JW, Nazer B, Vittinghoff E, Badhwar N, Vedantham V, Gerstenfeld EP, Lee BK, Lee RJ, Tseng Z, Olgin JE, Scheinman MM, Marcus GM. The QT Interval as a Noninvasive Marker of Atrial Refractoriness. Pacing Clin Electrophysiol. 2016 Dec; 39(12):1366-1372. PMID: 27753113.
      View in: PubMed
    6. Kim AS, Moffatt E, Ursell PC, Devinsky O, Olgin J, Tseng Z. Sudden neurologic death masquerading as out-of-hospital sudden cardiac death. Neurology. 2016 Oct 18; 87(16):1669-1673. PMID: 27638923.
      View in: PubMed
    7. Kawamura M, Scheinman MM, Tseng Z, Lee BK, Marcus GM, Badhwar N. Comparison of remote magnetic navigation ablation and manual ablation of idiopathic ventricular arrhythmia after failed manual ablation. J Interv Card Electrophysiol. 2017 Jan; 48(1):35-42. PMID: 27314679.
      View in: PubMed
    8. Tseng Z. Risk of Cardiovascular Implantable Electronic Device Malfunction With Radiation Therapy: Location, Dose, or Energy? JAMA Intern Med. 2015 Oct; 175(10):1698-9. PMID: 26280759.
      View in: PubMed
    9. Tseng Z, Hayward RM, Clark NM, Mulvanny CG, Colburn BJ, Ursell PC, Olgin JE, Hart AP, Moffatt E. Sudden Death in Patients With Cardiac Implantable Electronic Devices. JAMA Intern Med. 2015 Aug; 175(8):1342-50. PMID: 26098676.
      View in: PubMed
    10. Ito H, Kawamura M, Badhwar N, Vedantham V, Tseng Z, Lee BK, Lee RJ, Marcus GM, Gerstenfeld EP, Scheinman MM. The Effect of Direct Current Stimulation versus T-Wave Shock on Defibrillation Threshold Testing. Pacing Clin Electrophysiol. 2015 Oct; 38(10):1173-80. PMID: 26137999.
      View in: PubMed
    11. Bhatt AB, Foster E, Kuehl K, Alpert J, Brabeck S, Crumb S, Davidson WR, Earing MG, Ghoshhajra BB, Karamlou T, Mital S, Ting J, Tseng Z. Congenital heart disease in the older adult: a scientific statement from the American Heart Association. Circulation. 2015 May 26; 131(21):1884-931. PMID: 25896865.
      View in: PubMed
    12. Hayward RM, Dewland TA, Moyers B, Vittinghoff E, Tanel RE, Marcus GM, Tseng Z. Device complications in adult congenital heart disease. Heart Rhythm. 2015 Feb; 12(2):338-44. PMID: 25460176.
      View in: PubMed
    13. Hayward RM, Tseng Z. Arrhythmias in Complex Congenital Heart Disease. Card Electrophysiol Clin. 2014 Sep 01; 6(3):623-634. PMID: 25197326.
      View in: PubMed
    14. Refaat MM, Hotait M, Tseng Z. Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification. Ann Noninvasive Electrocardiol. 2014 Jul; 19(4):311-8. PMID: 25040480.
      View in: PubMed
    15. Singh DK, Viswanathan MN, Tanel RE, Lee RJ, Lee BK, Marcus GM, Olgin JE, Han F, Vedantham V, Tseng Z, Pellegrini C, Kawamura M, Gerstenfeld EP, Badhwar N, Scheinman M. His overdrive pacing during supraventricular tachycardia: a novel maneuver for distinguishing atrioventricular nodal reentrant tachycardia from atrioventricular reciprocating tachycardia. Heart Rhythm. 2014 Aug; 11(8):1327-35. PMID: 24793458.
      View in: PubMed
    16. Hoffmayer KS, Dewland TA, Hsia HH, Badhwar N, Hsu JC, Tseng Z, Marcus GM, Scheinman MM, Gerstenfeld EP. Safety of radiofrequency catheter ablation without coronary angiography in aortic cusp ventricular arrhythmias. Heart Rhythm. 2014 Jul; 11(7):1117-21. PMID: 24732373.
      View in: PubMed
    17. Stepanyan G, Badhwar N, Lee RJ, Marcus GM, Lee BK, Tseng Z, Vedantham V, Olgin J, Scheinman M, Gerstenfeld EP. Safety of new oral anticoagulants for patients undergoing atrial fibrillation ablation. J Interv Card Electrophysiol. 2014 Jun; 40(1):33-8. PMID: 24643666.
      View in: PubMed
    18. Kawamura M, Badhwar N, Vedantham V, Tseng Z, Lee BK, Lee RJ, Marcus GM, Olgin JE, Gerstenfeld EP, Scheinman MM. Coupling interval dispersion and body mass index are independent predictors of idiopathic premature ventricular complex-induced cardiomyopathy. J Cardiovasc Electrophysiol. 2014 Jul; 25(7):756-62. PMID: 24612052.
      View in: PubMed
    19. Refaat MM, Aouizerat BE, Pullinger CR, Malloy M, Kane J, Tseng Z. Association of CASQ2 polymorphisms with sudden cardiac arrest and heart failure in patients with coronary artery disease. Heart Rhythm. 2014 Apr; 11(4):646-52. PMID: 24444446; PMCID: PMC3989347.
    20. Moyers BS, Secemsky EA, Vittinghoff E, Wong JK, Havlir DV, Hsue PY, Tseng Z. Effect of left ventricular dysfunction and viral load on risk of sudden cardiac death in patients with human immunodeficiency virus. Am J Cardiol. 2014 Apr 01; 113(7):1260-5. PMID: 24521717; PMCID: PMC3959566.
    21. Hayward RM, Ursell PC, Foster E, Tseng Z. Sudden death due to nonarrhythmic cause in a patient with L-TGA. Ann Noninvasive Electrocardiol. 2014 May; 19(3):293-7. PMID: 24118753; PMCID: PMC4033714.
    22. Hsu JC, Badhwar N, Gerstenfeld EP, Lee RJ, Mandyam MC, Dewland TA, Imburgia KE, Hoffmayer KS, Vedantham V, Lee BK, Tseng Z, Scheinman MM, Olgin JE, Marcus GM. Randomized trial of conventional transseptal needle versus radiofrequency energy needle puncture for left atrial access (the TRAVERSE-LA study). J Am Heart Assoc. 2013 Sep 17; 2(5):e000428. PMID: 24045120; PMCID: PMC3835257.
    23. Tseng Z, Moyers B, Secemsky EA, Havlir DV, Hsue PY. PR Interval and sudden cardiac death in patients with HIV infection. J Infect Dis. 2013 Jan 01; 207(1):199-200. PMID: 23186784; PMCID: PMC3523799.
    24. Sung RK, Kim AM, Tseng Z, Han F, Inada K, Tedrow UB, Viswanathan MN, Badhwar N, Varosy PD, Tanel R, Olgin JE, Stephenson WG, Scheinman M. Diagnosis and ablation of multiform fascicular tachycardia. J Cardiovasc Electrophysiol. 2013 Mar; 24(3):297-304. PMID: 23110306.
      View in: PubMed
    25. Tseng Z, Secemsky EA, Dowdy D, Vittinghoff E, Moyers B, Wong JK, Havlir DV, Hsue PY. Sudden cardiac death in patients with human immunodeficiency virus infection. J Am Coll Cardiol. 2012 May 22; 59(21):1891-6. PMID: 22595409; PMCID: PMC3356565.
    26. Mandyam MC, Vedantham V, Scheinman MM, Tseng Z, Badhwar N, Lee BK, Lee RJ, Gerstenfeld EP, Olgin JE, Marcus GM. Alcohol and vagal tone as triggers for paroxysmal atrial fibrillation. Am J Cardiol. 2012 Aug 01; 110(3):364-8. PMID: 22521307; PMCID: PMC3398200.
    27. Hsu JC, Badhwar N, Lee BK, Vedantham V, Tseng Z, Marcus GM. Predictors of fluoroscopy time and procedural failure during biventricular device implantation. Am J Cardiol. 2012 Jul 15; 110(2):240-5. PMID: 22483384; PMCID: PMC3383869.
    28. Hong TT, Cogswell R, James CA, Kang G, Pullinger CR, Malloy MJ, Kane JP, Wojciak J, Calkins H, Scheinman MM, Tseng Z, Ganz P, De Marco T, Judge DP, Shaw RM. Plasma BIN1 correlates with heart failure and predicts arrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy. Heart Rhythm. 2012 Jun; 9(6):961-7. PMID: 22300662; PMCID: PMC3349006.
    29. Steinhaus DA, Vittinghoff E, Moffatt E, Hart AP, Ursell P, Tseng Z. Characteristics of sudden arrhythmic death in a diverse, urban community. Am Heart J. 2012 Jan; 163(1):125-31. PMID: 22172446; PMCID: PMC3241924.
    30. Azadani PN, Tseng Z, Ermakov S, Marcus GM, Lee BK. Funding source and author affiliation in TASER research are strongly associated with a conclusion of device safety. Am Heart J. 2011 Sep; 162(3):533-7. PMID: 21884872.
      View in: PubMed
    31. Hsu JC, Friday J, Lee BK, Azadani PN, Lee RJ, Badhwar N, Tseng Z, Olgin JE, Marcus GM. Predictors of axillary vein location for vascular access during pacemaker and defibrillator lead implantation. Pacing Clin Electrophysiol. 2011 Dec; 34(12):1585-92. PMID: 21819433.
      View in: PubMed
    32. Deo R, Vittinghoff E, Lin F, Tseng Z, Hulley SB, Shlipak MG. Risk factor and prediction modeling for sudden cardiac death in women with coronary artery disease. Arch Intern Med. 2011 Oct 24; 171(19):1703-9. PMID: 21788534; PMCID: PMC3547327.
    33. Aouizerat BE, Vittinghoff E, Musone SL, Pawlikowska L, Kwok PY, Olgin JE, Tseng Z. GWAS for discovery and replication of genetic loci associated with sudden cardiac arrest in patients with coronary artery disease. BMC Cardiovasc Disord. 2011 Jun 10; 11:29. PMID: 21658281; PMCID: PMC3141757.
    34. Hoffmayer KS, Yang Y, Joseph S, McCabe JM, Bhave P, Hsu J, Ng RK, Lee BK, Badhwar N, Lee RJ, Tseng Z, Olgin JE, Narayan SM, Marcus GM, Scheinman MM. Predictors of unusual ECG characteristics in cavotricuspid isthmus-dependent atrial flutter ablation. Pacing Clin Electrophysiol. 2011 Oct; 34(10):1251-7. PMID: 21605144; PMCID: PMC3395429.
    35. Yang Y, Varma N, Badhwar N, Tanel RE, Sundara S, Lee RJ, Lee BK, Tseng Z, Marcus GM, Kim AM, Olgin JE, Scheinman MM. Prospective observations in the clinical and electrophysiological characteristics of intra-isthmus reentry. J Cardiovasc Electrophysiol. 2010 Oct; 21(10):1099-106. PMID: 20455984.
      View in: PubMed
    36. Vedantham V, Tseng Z. Changing QRS Morphology in a Patient with Wolff-Parkinson-White Syndrome. Card Electrophysiol Clin. 2010 Jun; 2(2):239-243. PMID: 28770758.
      View in: PubMed
    37. Nguyen DT, Tseng Z, Lee BK, Badhwar N. Ventricular Tachycardia After Implantable Cardioverter-Defibrillator Placement. Card Electrophysiol Clin. 2010 Jun; 2(2):277-280. PMID: 28770763.
      View in: PubMed
    38. Nguyen DT, Lee R, Tseng Z. Supraventricular Tachycardia After Atrial Fibrillation Ablation. Card Electrophysiol Clin. 2010 Jun; 2(2):313-316. PMID: 28770772.
      View in: PubMed
    39. Tseng Z, Scheinman M. Persistent Long R-P Tachycardia. Card Electrophysiol Clin. 2010 Jun; 2(2):225-229. PMID: 28770755.
      View in: PubMed
    40. Marcus GM, Smith LM, Ordovas K, Scheinman MM, Kim AM, Badhwar N, Lee RJ, Tseng Z, Lee BK, Olgin JE. Intracardiac and extracardiac markers of inflammation during atrial fibrillation. Heart Rhythm. 2010; 7(2):149-54. PMID: 20022819; PMCID: PMC2900773.
    41. Hsu JC, Tanel RE, Lee BK, Scheinman MM, Badhwar N, Lee RJ, Tseng Z, Olgin JE, Marcus GM. Differences in accessory pathway location by sex and race. Heart Rhythm. 2010 Jan; 7(1):52-6. PMID: 19914144; PMCID: PMC2818171.
    42. Tseng Z, Vittinghoff E, Musone SL, Lin F, Whiteman D, Pawlikowska L, Kwok PY, Olgin JE, Aouizerat BE. Association of TGFBR2 polymorphism with risk of sudden cardiac arrest in patients with coronary artery disease. Heart Rhythm. 2009 Dec; 6(12):1745-50. PMID: 19959123; PMCID: PMC2789271.
    43. Sakhuja R, Smith LM, Tseng Z, Badhwar N, Lee BK, Lee RJ, Scheinman MM, Olgin JE, Marcus GM. Test characteristics of neck fullness and witnessed neck pulsations in the diagnosis of typical AV nodal reentrant tachycardia. Clin Cardiol. 2009 Aug; 32(8):E13-8. PMID: 19479968; PMCID: PMC3200305.
    44. Tseng Z. Genetic association studies of sudden cardiac death/arrest: the importance of context. Heart Rhythm. 2009 Sep; 6(9):1315-7. PMID: 19716088; PMCID: PMC2755515.
    45. Lee BK, Vittinghoff E, Whiteman D, Park M, Lau LL, Tseng Z. Relation of Taser (electrical stun gun) deployment to increase in in-custody sudden deaths. Am J Cardiol. 2009 Mar 15; 103(6):877-80. PMID: 19268749.
      View in: PubMed
    46. Kim AM, Turakhia M, Lu J, Badhwar N, Lee BK, Lee RJ, Marcus GM, Tseng Z, Scheinman M, Olgin JE. Impact of remote magnetic catheter navigation on ablation fluoroscopy and procedure time. Pacing Clin Electrophysiol. 2008 Nov; 31(11):1399-404. PMID: 18950296.
      View in: PubMed
    47. Turakhia M, Prasad M, Olgin J, Badhwar N, Tseng Z, Lee R, Marcus GM, Lee BK. Rates and severity of perforation from implantable cardioverter-defibrillator leads: a 4-year study. J Interv Card Electrophysiol. 2009 Jan; 24(1):47-52. PMID: 18855128.
      View in: PubMed
    48. Pellegrini CN, Lee K, Olgin JE, Turakhia MP, Tseng Z, Lee R, Badhwar N, Lee B, Varosy PD. Impact of advanced age on survival in patients with implantable cardioverter defibrillators. Europace. 2008 Nov; 10(11):1296-301. PMID: 18818212; PMCID: PMC2721725.
    49. McCabe JM, Smith LM, Tseng Z, Badhwar N, Lee BK, Lee RJ, Scheinman MM, Olgin JE, Marcus GM. Protracted CRP elevation after atrial fibrillation ablation. Pacing Clin Electrophysiol. 2008 Sep; 31(9):1146-51. PMID: 18834466; PMCID: PMC2596767.
    50. Deo R, Lin F, Vittinghoff E, Tseng Z, Hulley SB, Shlipak MG. Kidney dysfunction and sudden cardiac death among women with coronary heart disease. Hypertension. 2008 Jun; 51(6):1578-82. PMID: 18391103.
      View in: PubMed
    51. Tseng Z, Aouizerat BE, Pawlikowska L, Vittinghoff E, Lin F, Whiteman D, Poon A, Herrington D, Howard TD, Varosy PD, Hulley SB, Malloy M, Kane J, Kwok PY, Olgin JE. Common beta-adrenergic receptor polymorphisms are not associated with risk of sudden cardiac death in patients with coronary artery disease. Heart Rhythm. 2008 Jun; 5(6):814-21. PMID: 18534365; PMCID: PMC2743540.
    52. Marcus GM, Smith LM, Whiteman D, Tseng Z, Badhwar N, Lee BK, Lee RJ, Scheinman MM, Olgin JE. Alcohol intake is significantly associated with atrial flutter in patients under 60 years of age and a shorter right atrial effective refractory period. Pacing Clin Electrophysiol. 2008 Mar; 31(3):266-72. PMID: 18307620.
      View in: PubMed
    53. Marcus GM, Smith LM, Vittinghoff E, Tseng Z, Badhwar N, Lee BK, Lee RJ, Scheinman MM, Olgin JE. A first-degree family history in lone atrial fibrillation patients. Heart Rhythm. 2008 Jun; 5(6):826-30. PMID: 18468961; PMCID: PMC2474569.
    54. Marcus GM, Smith LM, Glidden DV, Wilson E, McCabe JM, Whiteman D, Tseng Z, Badhwar N, Lee BK, Lee RJ, Scheinman MM, Olgin JE. Markers of inflammation before and after curative ablation of atrial flutter. Heart Rhythm. 2008 Feb; 5(2):215-21. PMID: 18242542; PMCID: PMC2247371.
    55. Turakhia M, Tseng Z. Sudden cardiac death: epidemiology, mechanisms, and therapy. Curr Probl Cardiol. 2007 Sep; 32(9):501-46. PMID: 17723906.
      View in: PubMed
    56. Turakhia MP, Varosy PD, Lee K, Tseng Z, Lee R, Badhwar N, Scheinman M, Lee BK, Olgin JE. Impact of renal function on survival in patients with implantable cardioverter-defibrillators. Pacing Clin Electrophysiol. 2007 Mar; 30(3):377-84. PMID: 17367357.
      View in: PubMed
    57. Viswanathan MN, Tseng Z, Goldschlager N, Lee BK. Unusual atrial-paced tachycardia after pacemaker implantation: what is the mechanism? Heart Rhythm. 2007 Jun; 4(6):800-2. PMID: 17556209.
      View in: PubMed
    58. Marcus GM, Ren X, Tseng Z, Badhwar N, Lee BK, Lee RJ, Foster E, Olgin JE. Repeat transseptal catheterization after ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2007 Jan; 18(1):55-9. PMID: 17081207.
      View in: PubMed
    59. Marcus GM, Yang Y, Varosy PD, Ordovas K, Tseng Z, Badhwar N, Lee BK, Lee RJ, Scheinman MM, Olgin JE. Regional left atrial voltage in patients with atrial fibrillation. Heart Rhythm. 2007 Feb; 4(2):138-44. PMID: 17275746; PMCID: PMC1868443.
    60. Marcus GM, Tseng Z. Three leads via the coronary sinus. Heart Rhythm. 2006 Aug; 3(8):985-6. PMID: 16876754.
      View in: PubMed
    61. Marcus GM, Varosy PD, Scheinman MM, Tseng Z. Threentry: what is the mechanism? Heart Rhythm. 2006 Jun; 3(6):746-7. PMID: 16731483.
      View in: PubMed
    62. O'Connell JW, Schreck C, Moles M, Badwar N, DeMarco T, Olgin J, Lee B, Tseng Z, Kumar U, Botvinick EH. A unique method by which to quantitate synchrony with equilibrium radionuclide angiography. J Nucl Cardiol. 2005 Jul-Aug; 12(4):441-50. PMID: 16084433.
      View in: PubMed
    63. Horwich T, Foster E, De Marco T, Tseng Z, Saxon L. Effects of resynchronization therapy on cardiac function in pacemaker patients "upgraded" to biventricular devices. J Cardiovasc Electrophysiol. 2004 Nov; 15(11):1284-9. PMID: 15574179.
      View in: PubMed
    64. Tseng Z, Yadav AV, Scheinman MM. Catecholamine dependent accessory pathway automaticity. Pacing Clin Electrophysiol. 2004 Jul; 27(7):1005-7. PMID: 15271025.
      View in: PubMed
    65. Lee KW, Kayser SR, Hongo RH, Tseng Z, Scheinman MM. Famotidine and long QT syndrome. Am J Cardiol. 2004 May 15; 93(10):1325-7. PMID: 15135720.
      View in: PubMed
    66. Veal E, Eisenstein M, Tseng Z, Gill G. A cellular repressor of E1A-stimulated genes that inhibits activation by E2F. Mol Cell Biol. 1998 Sep; 18(9):5032-41. PMID: 9710587; PMCID: PMC109088.
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