Win-KuangShenMD

PubMed

• Prevalence and Incidence of Type 1 Brugada Pattern: A 30-Year Experience at Mayo Clinic.
  Pattara Rattanawong, Carolyn Mead-Harvey, Olubadewa A Fatunde, Charles Van Der Walt, Nway Ko Ko
  Mayo Clinic Proceedings. 2024-12-06
• To the Editor - Validation and predictive performance of the PAT score.
  Pattara Rattanawong, Dan Sorajja, Win-Kuang Shen
  Heart Rhythm. 2024-10-24
• Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ...
  Tolga Aksu, Michele Brignole, Leonardo Calo, Philippe Debruyne, Luigi Di Biase
  Europace. 2024-08-03

Journal Articles

• Selective Modulation of the Cardiac Autonomic Nervous System: A New Strategy for Treatment of Cardiohibitory Syncope  
  Mulpuru SK, Shen WK, Circ Arrhythm Electrophysiol, 1/1/2017
• AHA/ACC guideline for the management of patients with valvular heart disease : A report of the American College of Cardiology/American Heart Association task force on ...  
  Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD, Anderson JL, Halperin JL, Albert NM,..., Circulation, 1/1/2014
• AHA/ACC guideline for the management of patients with valvular heart disease: Executive summary :A report of the American College of Cardiology/American Heart Associat...  
  Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD, Anderson JL, Halperin JL, Albert NM,..., Circulation, 1/1/2014
• ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: A report of the American college of cardiology/American heart ass...  
  Anderson JL, Heidenreich PA, Barnett PG, Creager MA, Fonarow GC, Gibbons RJ, Halperin JL, Hlatky MA, Jacobs AK, Mark DB, Masoudi FA, Peterson ED, Shaw LJ, Albert NM, C..., Circulation, 1/1/2014
• CCF/AHA Guideline for the Management of Heart Failure: Executive Summary  
  Yancy CW, Jessup M, et al, ACCF/AHA Task Force, Heart Rhythm Society, Heart Rhythm, 1/1/2013
• Hiatal Hernia is associated with an increased prevalence of atrial fibrillation in young patients  
  Roy RR, Sagar S, Bunch TJ, Aman W, Crusan DJ, Srivathsan K, Asirvatham SJ, Shen WK, Jahangir A, Journal of Atrial Fibrillation, 1/1/2013
• Reply to the editor-atrial fibrillation: an inflammatory and autoimmune disorder  
  Lee HC, Wang XL, Huang KT, Shen WK, Pittelkow MR, Heart Rhythm, 1/1/2012
• Efficacy and safety of Firebird sirolimus-eluting stent in treatment of complex coronary lesions in Chinese patients: one-year clinical and eight-month angiographic ou...  
  Li Y, Li CX, Wang HC, Xu B, Fang WY, Ge JB, Wang WM, Qiao SB, Chen JP, Shen WK, Jiang H, Cong HL, Pu XQ, Qin YW, Jin HG, Cao Y, Huang H, Chin Med J, 1/1/2011
• Role of atrioventricular nodal ablation and pacemaker therapy in elderly patients with recurrent atrial fibrillation  
  Eleid MF, Shen WK, Interventional Cardiology, 1/1/2011
• Head up tilt testing: An appraisal of its current role in the management of patients with syncope  
  Macedo P, Leite LR, Asirvatham SJ, Hachul DT, Dos Santos-Neto LL, Shen WK, Journal of Atrial Fibrillation, 1/1/2011
• In response to "A prospective, randomized trial of an emergency department observation unit for acute onset atrial fibrillation"  
  Decker WW, Smars PA, Goyal DG, Vaidyanathan L, Stead LG, Shen WK, Ann Emerg Med, 1/1/2009
• Letter to the editor  
  Decker WW, Smars PA, Goyal DG, Vaidyanathan L, Stead LG, Shen WK, Annals of Internal Medicine, 1/1/2009
• The ACCF/AHA scientific statement on syncope: A document in need of thoughtful revision  
  Benditt DG, Wieling W, Olshansky B, Abe H, Alboni P, Andresen D, Axelrod FB, Bennaroch E, Bergfeldt L, Blanc JJ, Brignole M, Camm AJ, Chelimsky T, Cortelli P, Van Dijk..., Clin Auton Res, 1/1/2006
• Atrial fibrillation and ventricular dysfunction - A vicious electromechanical cycle  
  Cha YM, Redfield MM, Shen WK, Gersh BJ, Circulation, 1/15/2004
• Prevention of sudden death in hypertrophic cardiomyopathy - But which defibrillator for which patient?  
  Boriani G, Maron BJ, Shen WK, Spirito P, Circulation, 1/12/2004
• Long-term outcome and quality of life following out-of-hospital cardiac arrest resuscitated by early responder defibrillation in a population-based study  
  Bunch TJ, White RD, Gersh BJ, Meverden RA, Hodge DO, Ballman KV, Hammill SC, Shen WK, Packer DL, Resuscitation, 1/1/2004
• Heart rate-dependent electrocardiogram abnormalities in patients with postural tachycardia syndrome  
  Singer W, Shen WK, Opfer-Gehrking TL, McPhee BR, Hilz MJ, Low PA, Auton Neurosci, 1/31/2003
• Pacing in elderly patients  
  Jahangir A, Shen WK, Am Heart J, 1/1/2003
• Heart rate dependent EKG-abnormalities in patients with postural tachycardia syndrome  
  Singer W, Shen W, Opfer-Gehrking T, McPhee B, Hilz M, Low P, Autonomic Neuroscience: Basic and Clinical, 1/1/2003
• Sudden death after ablation and pacing in atrial fibrillation  
  Ozcan C, Shen WK, Cardiology Review, 1/1/2003
• Bioenergetic deficits associated with atrial structural and electrophysiological remodeling in experimental congestive heart failure  
  Cha Y, Dzeja P, Shen W, Jahangir A, Hart C, Terzic A, Redfield M, AJP, 1/1/2003
• Atrial fibrillation  
  Asirvatham SJ, Shen WK, Conn's Current Therapy, 1/1/2002
• Do existing databases answer clinical questions about geriatric cardiovascular disease and stroke?  
  Cheitlin MD, Gerstenblith G, Hazzard WR, Pasternak R, Fried LP, Rich MW, Krumholz HM, Peterson E, Reves JG, McKay C, Saksena S, Shen WK, Akhtar M, Brass LM, Biller J, Am J Geriatr Cardiol, 1/1/2001
• Is sinus node modification appropriate for inappropriate sinus tachycardia with features of postural orthostatic tachycardia syndrome?  
  Shen WK, Low PA, Jahangir A, Munger TM, Friedman PA, Osborn MJ, Stanton MS, Packer DL, Rea RF, Hammill SC, Pacing Clin Electrophysiol, 1/1/2001
• Epidemiology and natural history of atrial fibrillation: clinical implications  
  Chugh SS, Blackshear JL, Shen WK, Hammill SC, Gersh BJ, J Am Coll Cardiol, 1/1/2001
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Books/Book Chapters

• Supraventricular Tachycardia - Ventricular Pacing Maneuvers 
  Chapter: Practical Cardiac Electrophysiology 
  Munro J, Sorajja D, Shen WEditors: Bhargava K, Asirvatham SJ.Jaypee Brothers Medical PubEdition 1st,2016
• Geriatrics Review Syllabus; A Core Curriculum in Geriatric Medicine 
  Chapter: Syncope 
  Page 254 - 261Schleifer JW, Shen WKEditors: Medina-Walpole A, Pacella JT, Potter JF.New York, NYEdition 9th,2016
• Mayo Clinic electrophysiology manual 
  Chapter: Reentry, transient entrainment, and concealed entrainment 
  Page 129 - 135Shen WKEditors: Asirvatham SJ; Cha YM; Friedman PA.Mayo Clinic Scientific Press/Oxford University Press, Oxford, NY2014
• Geriatrics Review 
  Chapter: Arrhythmias: Approach to Syncope 
  Sheldon RS, Raj SR, Shen WEditors: Durso, SC, Sullivan GM.American Geriatrics SocietyEdition 9th,2014
• Electrical diseases of the heart. Vol. 1 
  Chapter: Senescence and arrhythmogenesis 
  Page 317 - 332Mirza M, Shen WK, Jahangir A2013
• Electrical diseases of the heart 
  Chapter: Heart failure and Sudden death 
  Page 395 - 412Cha YM, Shen WKEditors: Gussak I, Antzelevitch C.Springer2013
• Electrical Diseases of the Heart. Volume 2: Diagnosis and Treatment 
  Chapter: Invasive Electrophysiologic Testing: Role in Sudden Death Prediction 
  Page 271 - 287Nemec J, Shen WKEditors: Gussak I, Antzelevitch C.SpringerEdition 2nd,2013
• Cardiac Rhythm Disorders in Older Adults 
  Rich MW, Shen WKEditors: Rich MW, Shen WK.SaundersEdition 1st,2013
• Electrical Diseases of the Heart, Volume 2: Diagnosis and Treatment 
  Gussak I, Antzelevitch C, Wilde AAM, Powell BD, Ackerman MJ, Shen WKEditors: Gussak I, Antzelevitch C, Wilde AAM; Friedman PA, Ackerman MJ, Shen WK.Springer-Verlag, London, EnglandEdition 2nd,2013
• Electrical Diseases of the Heart: Volume 1: Basic Foundations and Primary Electrical Diseases 
  Gussak I, Antzelevitch C, Wilde AAM, Powell BD, Ackerman MJ, Shen WKEditors: Gussak I, Antzelevitch C, Wilde AAM; Friedman PA, Ackerman MJ, Shen WK.Springer-Verlag, London, EnglandEdition 2nd,2013
• Electrical diseases of the heart 
  Gussak I, Antzelevitch C, Wilde AAM, Ackerman MJ, Powell BD, Shen WK2013
• Hazzard's geriatric medicine and gerontology 
  Chapter: Cardiac arrhythmias 
  Page 951 - 965Liu XK, Jahangir A, Shen WKEditors: Halter JB; et al.McGraw-Hill Medical, New York, NYEdition 6th,2009
• Electrical Diseases of the Heart: Genetics, Mechanisms, Treatment, Prevention 
  Gussak I, Antzelevitch C, Wilde AAM, Friedman PA, Ackerman MJ, Shen WK, et alEditors: Gussak I, Antzelevitch C, Wilde AAM; Friedman PA, Ackerman MJ, Shen WK.Springer-Verlag, London, England2008
• Clinical Autonomic Disorders 
  Chapter: Syncope: Approach to Management 
  Page 493 - 514Wieling W, Shen WKEditors: Philip A. Low, MD, FRACP, FRCP (Hon); Eduardo E. Benarroch, MD, DSc.Wolters Kluwer/Lippencott Williams & Wilkins, Philadelphia, PAEdition 3rd,2008
• Electrical diseases of the heart: genetics, mechanisms, treatment, prevention 
  Chapter: Senescence and arrhythmogenesis 
  Page 247 - 260Jahangir A, Sattiraju S, Shen WKEditors: Gussak I, Antzelevitch C.Springer, London, England2008
• Clinical autonomic disorders 
  Chapter: Postural tachycardia syndrome. 
  Page 515 - 533Low PA, Sandroni P, Joyner MJ, Shen WKEditors: Low PA, Benarroch EE.Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, PAEdition 3rd,2008
• Electrical diseases of the heart: genetics, mechanisms, treatment, prevention 
  Chapter: Invasive elecgrophysiologic testing: role in sudden death prediction 
  Page 409 - 423Nemec J, Shen WKEditors: Gussak I, Antzelevitch C.Springer, London, England2008
• Electrical diseases of the heart: genetics, mechanisms, treatment, prevention 
  Chapter: Heart faliure and sudden death 
  Page 873 - 887Cha YM, Shen WKEditors: Gussak I, Antzelevitch C.Springer, London, England2008
• Syncope and Transient Loss of Consciousness: Multidisciplinary Management 
  Chapter: Role of syncope management units 
  Page 140 - 147Shen WK, Brignole M2007
• Mayo Clinic cardiology: concise textbook 
  Chapter: Syncope: diagnosis and treatment 
  Page 443 - 454Shen WKEditors: Murphy JG, Lloyd MA.Mayo Clinic Scientific Press : Informa Healthcare, Rochester, NYEdition 3rd,2007
• ACCSAP for Geriatric Cardiology 
  Chapter: Cardiac Arrhythmias in the Elderly 
  Shen WK2004
• Diagnosis and management of hypertrophic cardiomyopathy 
  Chapter: Implantable defibrillator for prevention of sudden death in hypertrophic cardiomyopathy 
  Page 327 - 344Maron BJ, Shen WK, Spirito PEditors: Maron BJ.Blackwell Futura, Malden, MA2004
• Cardiac repolarization: bridging basic and clinical science 
  Gussak I, Antzelevitch C, Hammill SC, Shen WK, Bjerregaard PHumana Press, Totowa, NJ2003
• Cardiac repolarization: bridging basic and clinical science 
  Chapter: Antiarrhythmic drugs and future direction 
  Page 387 - 404Jahangir A, Terzic A, Shen WKEditors: Gussak I, Antzelevitch C, Hammill SC, Shen WK, Bjerregaard P.Humana Press, Totowa, NJ2003
• Contemporary Cardiology: Cardiac Repolarization: Bridging Basic and Clinical Science 
  Chapter: Evaluation of ventricular repolarization 
  Page 255 - 289Nemec J, Hammill SC, Shen WKEditors: I. Gussak, S. Antzelevitch.Humana Press2003
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Abstracts/Posters

• Down-regulation of the small-conductance calcium-activated potassium channels in diabetic mouse atria promotes arrhythmia induction
  Yi F, Lu T, Wang XL, Shen WK, Lee HC, Cardiology, 1/1/2014
• Influence of lung volume, fluid and capillary recruitment during positional changes and exercise on thoracic impedance in heart failure
  Kim CH, Fuglestad MA, Ceridon Richert ML, Shen WK, Johnson BD, FASEB J, 1/1/2013
• Performance of surface electrocardiographic vectors in differentiating ventricular arrhythmia originating from coronary cusp, peri-pulmonic valve and right ventricular...
  Syed F, Chandra V, Munoz FD, Cha Y, Friedman P, Hammill S, Munger T, Shen W, Packer D, Asirvatham S, Eur Heart J, 1/1/2013
• Atrial mechanical abnormalities on speckle tracking echocardiography correlate with degree of fibrosis in patients with atrial fibrillation
  Mirza M, Jiamsripong P, Belohlavek M, Lanza L, Arabia F, Shen WK, Jahangir A, J Am Coll Cardiol, 1/27/2012
• Fragmented sleep due to frequent leg movement is associated with left ventricular hypertrophy and poor cardiovascular outcomes
  Mirza M, Sofi A, Mori N, Tran C, Murarka S, Khan U, Jahangir A, Viqar M, Shen WK, Jahangir A, J Am Coll Cardiol, 1/5/2011
• Impact of atrial fibrillation on platelet-predominate gene expression
  Wysokinski WE, Tafur A, McLeod TG, Ammash N, Shen WK, Grill DD, Sonbert J, Whelan SL, Mruk J, McBane RD, J Am Coll Cardiol, 1/5/2011
• Treatment for severe restless legs syndrome in the elderly reduces the risk of progression of atrial fibrillation
  Mirza M, Sofi A, Mori N, Tran C, Jahangir A, Khan U, Shen W, Jahangir A, Clin Pharmacol Ther, 1/1/2011
• Age- related transcriptional changes of genes regulating pathways promoting fibrosis in the human atria
  Preston CC, Gupta A, Sultan S, Maria V, Sundt TM, Shen W, Jahangir A, Clin Pharmacol Ther, 1/1/2010
• Transcriptional differences in genes regulating mitochondrial energetics identifies those at risk
  Preston CC, Gupta A, Sultan S, Tran C, Maria V, Matloobi A, Sundt TM, Shen W, Jahangir A, Clin Pharmacol Ther, 1/1/2010
• Duration of new-onset postoperative atrial fibrillation following cardiac surgery predicts the development of late atrial fibrillation
  Melduni RM, Suri RM, Shen WK, Ammash NM, Li Z, Schaff HV, Gersh BJ, Eur Heart J, 1/1/2010
• Impact of radiofrequency ablation on the percentage of circulating young platelets of patients with atrial fibrillation
  Tafur A, McBane R II, Maruk J, Ammash NM, Shen WK, Whyte OG, Shelly W, Wysokinski WE, Arterioscler Thromb Vasc Biol, 1/1/2010
• Cardiac resynchronization therapy reverses sympathetic remodeling and up-regulates cardiac autonomic control
  Cha YM, Oh J, Miyazaki C, Webster T, Hayes D, Rea R, Shen WK, Asirvatham S, Chen PS, Chaareonthaitawee, Heart Rhythm, 1/1/2008
• Is there a comparable benefit of cardiac resynchronization therapy in patients receiving an upgrade vs De Novo device
  Wokhlu A, Webster TA, Rea, Rf, Asirvatham S, Shen WK, Munger TM, Friedman PA, Brady PA, Bradley DJ, Hodge DO, Wiste H, Hayes DL, Heart Rhythm, 1/1/2008
• Long term outcomes after ventricular tachycardia ablation in older elderly
  Ahmad SM, Maria V, Bunch TJ, Buescher TL, Sagar S, Hodge D, Asirvatham S, Friedman PA, Cha YM, Brady PA, Munger TM, Hammill SC, Rea RF, Packer DL, Shen WK, Jahangir A, Heart Rhythm, 1/1/2008
• Does long-QT syndrome involve the sinus node?
  Shusterman V, Nemec J, Buncova M, Winter B, Shen WK, Ackerman MJ, Circulation, 1/1/2008
• Obstructive sleep apnea increases the risk of sudden cardiac death: a longitudinal study of 10,701 adults
  Gami AS, Olson EJ, Shen WK, Wright AS, Ballman KV, Hodge D, Herges RM, Howard DE, Somers VK, Circulation, 1/1/2008
• A multidisciplinary approach to syncope
  Serrano LA, Decker WW, Smars P, Shen WK, Cardiology management, 1/1/2008
• Cardiac resynchronization therapy up-regulates cardiac sympathetic function in heart failure
  Cha YM, Chareonthaitawee P, Rea RF, Shen WK, Asirvatham SJ, Friedman PA, Munger TM, Miyazaki C, Oh JK, Webster T, Dalzell C, Li H, Chen LS, Chen PS, Heart Rhythm, 1/1/2007
• Changing ablation paradigm for AF treatment: Opposite trends in a large clinical practice
  Monahan KH, Packer DL, Munger TM, Asirvatham SJ, Shen WK, Friedman PA, Bunch TJ, Heart Rhythm, 1/1/2007
• Dual chamber pacing with implantable defibrillators compared with single chamber devices is not associated with worsening HF in octogenarians and nonagenarians at high...
  Sagar S, Shen WK, Quershi YM, Singla A, Siddiqui S, Fuque G, Bradley DJ, Friedman PA, Jahangir A, Heart Rhythm, 1/1/2007
• Economic analysis of the syncope evaluation in the emergency department (SEEDS) randomized trial
  Bradley DJ, Anderson S, Decker W, Smars P, Long K, Shen WK, Heart Rhythm, 1/1/2007
• Efficacy and quality of life outcomes with catheter ablation for atrial fibrillation in obese patients
  Cha YM, Munger TM, Asirvatham SJ, Friedman PA, Shen WK, Rea RF, Brady PA, Monahan KH, Packer DL, Heart Rhythm, 1/1/2007
• Experience with autologous blood recovery system during emergency pericardiocentesis in the electrophysiology laboratory
  Venkatachalam KL, Fanning LJ, Beinborn DS, Bradley DJ, Cha YM, Shen WK, Packer DL, Munger TM, Santrach PJ, Friedman PA, Heart Rhythm, 1/1/2007
• Is there a differential efficacy of resynchronization therapy between intrinsic and previously paced left bundle branch block?
  Cha YM, Rea RF, Asirvatham SJ, Shen WK, Munger TM, Espinosa RE, Friedman PA, Brady PA, Bradley DJ, Wokhlu A, Webster T, Hayes DL, Heart Rhythm, 1/1/2007
• Long-term mode of death in patients with an implantable cardioverter-defibrillator undergoing ablation for ventricular tachycardia
  Bunch TJ, Gersh BJ, Friedman PA, Brady PA, Cha YM, Jahangir A, Hammill SC, Munger TM, Rea RF, Shen WK, Monahan KH, Tabatabaei N, Packer DL, Heart Rhythm, 1/1/2007
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Lectures

• ACC/AHA/HRS and ESC Guidelines on Syncope: Case-based Studies 
  2019 ACC Scientific Session & Expo, New Orleans - 3/16/2019
• Preventing and Treating Atrial Fibrillation 
  Miami Beach, FL - 1/1/2016
• Atrial Fibrillation Screening: How, What Benefit, and In Which Patients? 
  Cancun, Mexico - 1/1/2016
• Syncope: Identifying the High Risk Patient 
  Cancun, Mexico - 1/1/2016
• Primary Prevention for SCA and the Impact of 1.5 Prevention in Asian Countries: Evidence and Future Directions 
  San Francisco, CA - 1/1/2016
• Who should be evaluated after fainting? 
  Pheonix, CA - 1/1/2016
• Does Dronedarone (Multaq) + Ranolizine = Amiodarone? 
  Seattle, WA - 1/1/2016
• Drug Therapy for Atrial Fibrillation: Does Rate Control Matter Anymore? 
  Seattle, WA - 1/1/2016
• Latest Advances in Cardiovascular Care 
  Palomar Health, Escondido, CA - 1/1/2016
• Achieving Rate Control for AF: Medications vs. AVN Ablation 
  Waimea, HI - 1/1/2014
• Drugs, Devices, and Ablation in the Elderly: How to Approach Those Over 75 Years of Age? 
  Waimea, HI - 1/1/2014
• Catheter Ablation for AF 2014: Ablation for All? 
  Cancun, Mexico - 1/1/2014
• CRT and Heart Failure: Current Practice and Future Directions 
  Nanjing, China - 1/1/2014
• Management of Recurrent Syncope: A Cardiologist's View 
  Cancun, Mexico - 1/1/2014
• Prophylactic VT Ablation in ICD Recipients: Who, When and How? 
  Nanjing, China - 1/1/2014
• ICD Implantation: Doc, When Can I Drive Again? 
  Washington, DC - 1/1/2014
• Who Should be Admitted to Hospital: Risk Stratification and Syncope Management Unit 
  Washington, DC - 1/1/2014
• Atrial Fibrillation: Case Studies - Which Drug for Which Patient? 
  New York, NY - 1/1/2014
• Management of Atrial Fibrillation in 2014: Why Age Matters 
  Shenyang, China - 1/1/2014
• Prophylactic VT Ablation in ICD Recipients: Is It Ready for Prime Time? 
  Shenyang, China - 1/1/2014
• Athletes, Early Repolarization, ARVD, HCM 
  1/1/2014
• Medical Therapy is Best for PAF 
  Seoul, South Korea - 1/1/2014
• Syncope and Autonomic Syndromes: Inappropriate Sinus Tachycardia (IAST) Postural Orthostatic Tachycardia Syndrome (POTS) 
  Shanghai, China - 1/1/2014
• Who Develops AF? How to Treat? Guidelines 
  Seoul, South Korea - 1/1/2014
• Why Do We Get Atrial Fibrillation: A Multi-factorial and Dynamic Pyridine 
  Shanghai, China - 1/1/2014
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Other

• Role of AVN Ablation and Pacemaker Therapy in the Elderly ACCEL 
  Shen WK, Audio Journal
  http://www.audio-digest.org/pages/htmlos/offers/tracking.html?trackpage=accelfeature&tracktype=w
  1/1/2017
• Journal Interview: Complex Causes of Syncope 
  Shen WK, Emergency Medicine
  1/1/2003
• SEEDS: Syncope unit improved diagnostic yield 
  Shen WK, Today in Cardiology
  1/1/2003
• Sudden Cardiac Death and Long QT Syndrome 
  Terzic A, Moore AG, McGoon M, Shen WK, Cardiovascular Grand Rounds, Mayo Foundation
  1/1/1997
• Atrial fibrillation: to control or to convert? 
  Shen WK, Stanton MS, Primary Practice
  1/1/1994
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