1
|
Shah NS, Kanhere AP, Dowell E, Sabbagh RS, Bonamer J, Franklin A, Sanders DT, Sagi HC. Risk Factors and Characteristics of Recalcitrant Osteomyelitis After Initial Surgical and Antibiotic Treatment. J Orthop Trauma 2023; 37:423. [PMID: 37053120 DOI: 10.1097/bot.0000000000002616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To evaluate the injury, patient, and microbiological characteristics that place patients at risk for recalcitrant fracture-related infection and osteomyelitis despite appropriate initial treatment. DESIGN Retrospective chart review. SETTING Three level I trauma centers. PATIENTS AND PARTICIPANTS Two hundred and fifty-seven patients undergoing surgical debridement and antibiotic therapy for osteomyelitis from 2003 to 2019. MAIN OUTCOME MEASUREMENTS Patients were categorized as having undergone serial bone debridement if they had 2 separate procedures a minimum of 6 weeks apart with a full course of appropriate antibiotics in between. Patient records were reviewed for age, injury location, body mass index, smoking status, comorbidities, and culture results including the presence of multidrug-resistant organisms and culture-negative osteomyelitis. RESULTS A total of 257 patients were identified; 49% (n = 125) had a successful single course of treatment, and 51% (n = 132) required repeat debridement for recalcitrant osteomyelitis. At the index treatment for osteomyelitis, the most common organisms in both groups were methicillin-resistant (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA). There was no significant difference in incidence of polymicrobial infection between the 2 groups (25% vs. 20%, P = 0.49). The most common organisms cultured at the time of repeat saucerization remained MRSA and MSSA; however, the same organism was cultured from both the index and repeat procedures in only 28% (n = 37) of cases. Diabetic patients, intravenous drug use status, delay to diagnosis, and open fractures of the lower leg are independent risk factors for failure of initial treatment of posttraumatic osteomyelitis. CONCLUSIONS Successful eradication of fracture-related infection and posttraumatic osteomyelitis is difficult and fails 51% of the time despite standard surgical and antimicrobial therapy. Although MRSA and MSSA remain the most common organisms cultured, patients who fail initial treatment for osteomyelitis often do not culture the same organisms as those obtained at the index procedure. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- Nihar S Shah
- Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH
| | - Arun P Kanhere
- Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH
| | - Evan Dowell
- Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH
| | - Ramsey S Sabbagh
- Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH
| | - John Bonamer
- Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH
| | - Austin Franklin
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Parkland Health and Hospital System, Dallas, TX; and
| | - Drew T Sanders
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Parkland Health and Hospital System, Dallas, TX; and
| | - H Claude Sagi
- Department of Orthopaedics and Sports Medicine, University of Cincinnati Medical Center, Cincinnati, OH
- Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, FL
| |
Collapse
|
2
|
Devico Marciano N, Beyer RS, Nguyen A, Paladugu A, Hatter MH, Franklin A, Brown NJ, Willhuber GC, Bhatia N, Oh MY, Lee YP. Primary Spinal Infections in Patients With Hematologic Immunocompromising Conditions: A Systematic Literature Review. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202305000-00012. [PMID: 37159278 PMCID: PMC10168528 DOI: 10.5435/jaaosglobal-d-22-00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/24/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Primary spinal infections (PSIs) are a group of infectious diseases characterized by inflammation of the end plate-disk unit or its surroundings. PSI is considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSIs, immunocompromising cancers, and hemoglobinopathies has not been systematically analyzed. We conducted a systematic review to study characteristics, clinical presentation, and mortality of patients with PSI in the setting of hematologic disease. METHODS A systematic literature search in PubMed, Web of Science, and Scopus was conducted in April 2022 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included retrospective case series and individual case reports. RESULTS On careful review, 28 articles published between 1970 and 2022 were selected. These studies featured 29 patients who met inclusion criteria (mean age 29 years, age range 1.5 to 67 years; 63.3% male). Lumbar infection was the most common location (65.5%), with Salmonella (24.1%) as the main causative microorganism. Neurologic compromise was present in 41% of patients, and surgical intervention occurred in 48.3%. Average antibiotic duration was 13 weeks. The postoperative complication rate was 21.4%, with a mortality of 6.9%. CONCLUSION PSI in patients with hematologic disease, while having shorter periods to diagnosis, presents increased rates of neurologic deficit, surgical intervention, and complications.
Collapse
Affiliation(s)
- Naomie Devico Marciano
- From the University of California, Irvine School of Medicine, Irvine, CL, (Dr. Marciano and Ms. Paladugu); the Department of Orthopaedic Surgery, University of California, Irvine, CL, (Mr. Beyer, Mr. Hatter, Mr. Franklin, Dr. Willhuber, Dr. Bhatia, and Dr. Lee); and the Department of Neurological Surgery, University of California, Irvine, CL, (Mr. Nguyen, Mr. Brown, and Dr. Oh)
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Patel N, Franklin A, Yaxley J, Hemamali S, Roberts M. Mri and psma in the primary staging of ductal variant prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01031-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
4
|
Oda H, Kaizawa Y, Franklin A, Sanchez Rangel U, Storaci H, Min JG, Wang Z, Abrams GD, Chang J, Fox PM. Assessment of a Synergistic Effect of Platelet-Rich Plasma and Stem Cell-Seeded Hydrogel for Healing of Rat Chronic Rotator Cuff Injuries. Cell Transplant 2023; 32:9636897231190174. [PMID: 37592455 PMCID: PMC10467370 DOI: 10.1177/09636897231190174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 08/19/2023] Open
Abstract
Outcomes after repair of chronic rotator cuff injuries remain suboptimal. Type-1 collagen-rich tendon hydrogel was previously reported to improve healing in a rat chronic rotator cuff injury model. Stem cell seeding of the tendon hydrogel improved bone quality in the same model. This study aimed to examine whether there was a synergistic and dose-dependent effect of platelet-rich plasma (PRP) on tendon-bone interface healing by combining PRP with stem cell-seeded tendon hydrogel. Human cadaveric tendons were processed into a hydrogel. PRP was prepared at two different platelet concentrations: an initial concentration (initial PRP group) and a higher concentration (concentrated PRP group). Tendon hydrogel was mixed with adipose-derived stem cells and one of the platelet concentrations. Methylcellulose, as opposed to saline, was used as a negative control due to comparable viscosity. The supraspinatus tendon was detached bilaterally in 33 Sprague-Dawley rats (66 shoulders). Eight weeks later, each detached tendon was repaired, and a hydrogel mixture or control was injected at the repair site. Eight weeks after repair, shoulder samples were harvested and assigned for biomechanical testing (n = 42 shoulders) or a combination of bone morphological and histological assessment (n = 24 shoulders). Biomechanical testing showed significantly higher failure load and stiffness in the concentrated PRP group than in control. Yield load in the initial and concentrated PRP groups were significantly higher than that in the control. There were no statistically significant differences between the initial and concentrated PRP groups. The addition of the highly concentrated PRP to stem cells-seeded tendon hydrogel improved healing biomechanically after chronic rotator cuff injury in rats compared to control. However, synergistic and dose-dependent effects were not seen.
Collapse
Affiliation(s)
- Hiroki Oda
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Yukitoshi Kaizawa
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Austin Franklin
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Uriel Sanchez Rangel
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Hunter Storaci
- Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - Jung Gi Min
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Zhen Wang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Geoffrey D. Abrams
- Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA, USA
| | - James Chang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Paige M. Fox
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| |
Collapse
|
5
|
Oda H, Kaizawa Y, Franklin A, Rangel US, Min JG, Akerman J, Storaci H, Wang Z, Abrams GD, Chang J, Fox PM. Biomechanical, Histologic, and Micro-Computed Tomography Characterization of Partial-Width Full-Thickness Supraspinatus Tendon Injury in Rats. J Hand Surg Am 2022:S0363-5023(22)00510-X. [PMID: 36280554 DOI: 10.1016/j.jhsa.2022.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 07/08/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Partial rotator cuff tears can cause shoulder pain and dysfunction and are more common than complete tears. However, few studies examine partial injuries in small animals and, therefore a robust, clinically relevant model may be lacking. This study aimed to fully characterize the established rat model of partial rotator cuff injury over time and determine if it models human partial rotator cuff tears. METHODS We created a full-thickness, partial-width injury at the supraspinatus tendon-bone interface bilaterally in 31 Sprague-Dawley rats. Rats were euthanized immediately, and at 2-, 3-, 4-, and 8-weeks after surgery. Fourteen intact shoulders were used as controls. Samples were assessed biomechanically, histologically, and morphologically. RESULTS Biomechanically, load to failure in controls and 8 weeks after injury was significantly greater than immediately and 3 weeks after injury. Load to failure at 8 weeks was comparable to control. However, the locations of failure were different between intact shoulders and partially injured samples. Bone mineral density at 8 weeks was significantly greater than that at 2 and 3 weeks. Although no animals demonstrated propagation to complete tear and the injury site remodeled histologically, the appearance at 8 weeks was not identical to that in the controls. CONCLUSIONS The biomechanical properties and bone quality decreased after the injury and was restored gradually over time with full restoration by 8 weeks after injury. However, the findings were not equivalent to the intact shoulder. This study demonstrated the limitations of the current model in its application to long-term outcome studies, and the need for better models that can be used to assess chronic partial rotator cuff injuries. CLINICAL RELEVANCE There is no small animal model that mimics human chronic partial rotator cuff tears, which limits our ability to improve care for this common condition.
Collapse
Affiliation(s)
- Hiroki Oda
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Yukitoshi Kaizawa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Austin Franklin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Uriel Sanchez Rangel
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jung Gi Min
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jack Akerman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Hunter Storaci
- Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Zhen Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Geoffrey D Abrams
- Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - James Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Paige M Fox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
| |
Collapse
|
6
|
Sun Myint A, Dhadda A, Stewart A, Mills J, Sripadam R, Rao C, Hunter A, Hershman M, Franklin A, Chadwick E, Banerjee A, Rockall T, Pritchard D, Gerard J. The Role of Contact X-Ray Brachytherapy in Early Rectal Cancer – Who, when and How? Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
7
|
Hatter MJ, Beyer RS, Camino-Willhuber G, Franklin A, Brown NJ, Hashmi S, Oh M, Bhatia N, Lee YP. Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case. Journal of Neurosurgery: Case Lessons 2022; 3:CASE22157. [PMID: 35855206 PMCID: PMC9237658 DOI: 10.3171/case22157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/22/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSI and solid organ transplant has not been systematically analyzed. The authors performed a systematic review analyzing clinical presentation and mortality of patients with PSI in the setting of solid organ transplant. OBSERVATIONS PSIs in patients with immunosuppressive therapy, such as those with solid organ transplant, may behave differently in terms of epidemiology, clinical presentation, and outcomes compared with nonimmunosuppressed patients. Overall PSI in solid organ transplant patients is associated with a high rate of neurological compromise, postoperative complications, and mortality. LESSONS Accurate diagnosis and appropriate treatment of PSI require a multidisciplinary effort. Localized pain is the most frequently reported symptom associated with PSI. As opposed to PSI in patients without transplant, inflammatory and infectious markers such as white blood cells and C-reactive protein are often not elevated. Furthermore, the causative microorganism profile varies significantly when compared to pyogenic spinal infection in patients without transplant. Aspergillus species was responsible for spondylodiscitis in transplant patients in more than 50% of cases, and the incidence of Aspergillus infection is projected to rise in the coming years.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Michael Oh
- Neurosurgery, University of California, Irvine, Irvine, California
| | | | | |
Collapse
|
8
|
Camino-Willhuber G, Franklin A, Rosecrance K, Oyadomari S, Chan J, Holc F, Hashmi S, Oh M, Bhatia N, Emmerich J, Lee YP. Preoperative hypoalbuminemia and dialysis increase morbidity/mortality after spine surgery for primary pyogenic spinal infections (ACS-NSQIP Study). Surg Neurol Int 2022; 13:193. [PMID: 35673646 PMCID: PMC9168331 DOI: 10.25259/sni_330_2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/20/2022] [Indexed: 12/16/2022] Open
Abstract
Background: We analyzed the role of hypoalbuminemia, dialysis, and other risk factors that increase morbidity/ mortality following surgery for primary pyogenic spinal infections (PSIs). The American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) that included 627 patients was utilized as our database. Methods: Primary spinal surgery for spondylodiscitis was evaluated in a ACS-NSQIP database involving 627 patients between 2010 and 2019. Outcome assessment included evaluation of 30-day postoperative morbidity, and mortality rates. Results: Within 30 postoperative days, complications occurred in 14.6% (92/627) of patients; 59 (9.4%) required readmission, and 39 (6.2%) required additional surgery. The most common complications were: wound infections, pneumonia, septic shock, and death (1.8%). Hypoalbuminemia (i.e., significantly associated with unplanned readmission and reoperation), and dialysis were the two major risk factors contributing to increased perioperative morbidity and mortality. Conclusion: Among 627 ACS-NSQIP patients undergoing primary surgery for PSIs, hypoalbuminemia and dialysis were associated with higher risks of major perioperative morbidity (i.e., within 30 postoperative days – mostly readmissions and reoperations) and mortality.
Collapse
Affiliation(s)
- Gaston Camino-Willhuber
- Department of Orthopedics, Institute of Orthopedics “Carlos E. Ottolenghi,” Hospital Italiano de Buenos Aires, Buenos Aires, Argentina,
| | | | | | | | - Justin Chan
- Department of Orthopaedics, University of California Irvine, Orange, California, United States,
| | - Fernando Holc
- Department of Orthopedics, Institute of Orthopedics “Carlos E. Ottolenghi,” Hospital Italiano de Buenos Aires, Buenos Aires, Argentina,
| | - Sohaib Hashmi
- Department of Orthopaedics, University of California Irvine, Orange, California, United States,
| | - Michael Oh
- Department of Neurosurgery, University of California Irvine, Orange, California, United States,
| | - Nitin Bhatia
- Department of Orthopaedics, University of California Irvine, Orange, California, United States,
| | - Juan Emmerich
- Department of Neurological Surgery, Children’s Hospital La Plata, La Plata, Argentina
| | - Yu-Po Lee
- Department of Orthopaedics, University of California Irvine, Orange, California, United States,
| |
Collapse
|
9
|
Zhu H, Odu A, Franklin A, Yang X, Lamus D, Xi Y, Pillai A. Abstract No. 511 Impact of practicing clinical interventional radiology: nephrostomy tube care in cancer patients, a quality improvement initiative. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
10
|
Franklin A, Odu A, Quadri R, Pillai A, Kolber M. Abstract No. 173 Cystic duct stenting via percutaneous cholecystostomy in non-operative calculous cholecystitis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
11
|
Howell L, Osborne E, Franklin A, Hébrard É. Pattern Recognition of Chemical Waves: Finding the Activation Energy of the Autocatalytic Step in the Belousov-Zhabotinsky Reaction. J Phys Chem B 2021; 125:1667-1673. [PMID: 33534567 PMCID: PMC7898267 DOI: 10.1021/acs.jpcb.0c11079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
![]()
The Belousov–Zhabotinsky
(BZ) reaction is an example of
a homogeneous, nonequilibrium reaction used commonly as a model for
the study of biological structure and morphogenesis. We report the
experimental effects of temperature on spontaneously nucleated trigger
waves in a quasi-two-dimensional BZ reaction–diffusion system,
conducted isothermally at temperatures between 9.9 and 43.3 °C.
Novel application of filter-coupled circle finding and localized pattern
analysis is shown to allow the highly accurate extraction of average
radial wave velocity and nucleation period. Using this, it is possible
to verify a strong Arrhenius dependence of average wave velocity with
temperature, which is used to find the effective activation energy
of the reaction in accordance with predictions elaborated from the
widely used Oregonator model of the BZ reaction. On the basis of our
experimental results and existing theoretical models, the value for
activation energy of the important self-catalyzed step in the Oregonator
model is determined to be 86.58 ± 4.86 kJ mol–1, within range of previous theoretical prediction.
Collapse
Affiliation(s)
- L Howell
- Natural Sciences, University of Exeter, EX4 4QF Exeter, U.K
| | - E Osborne
- Natural Sciences, University of Exeter, EX4 4QF Exeter, U.K
| | - A Franklin
- Natural Sciences, University of Exeter, EX4 4QF Exeter, U.K
| | - É Hébrard
- Natural Sciences, University of Exeter, EX4 4QF Exeter, U.K.,Astrophysics Group, University of Exeter, EX4 4QL Exeter, U.K
| |
Collapse
|
12
|
Franklin A, Gi Min J, Oda H, Kaizawa Y, Leyden J, Wang Z, Chang J, Fox PM. Homing of Adipose-Derived Stem Cells to a Tendon-Derived Hydrogel: A Potential Mechanism for Improved Tendon-Bone Interface and Tendon Healing. J Hand Surg Am 2020; 45:1180.e1-1180.e12. [PMID: 32605739 DOI: 10.1016/j.jhsa.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 01/29/2020] [Accepted: 05/07/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Tendons are difficult to heal owing to their hypocellularity and hypovascularity. Our laboratory has developed a tendon-derived hydrogel (tHG) that significantly improves tendon healing in an animal model. We hypothesized that a potential mechanism for improved healing with tHG is through the attraction of systemic stem cells. METHODS Homing of systemic adipose-derived stem cells (ADSCs) to tendon injuries was assessed with acute and chronic injury models. Injury sites were treated with saline or tHG, and animals given a tail vein injection (TVI) of labeled ADSCs 1 week after treatment. One week following TVI, rats were harvested for histology. To further evaluate a potential difference in homing to tHG, a subcutaneous injection (SQI) model was used. Rats were treated with an SQI of saline, silicone, ADSCs in media, tHG, tHG + fibroblasts (FBs), or tHG + ADSCs on day 0. One week after SQI, rats underwent TVI with labeled ADSCs. Samples were harvested 2 or 3 weeks after SQI for analysis. Flow cytometry confirmed homing in the SQI model. RESULTS Systemically delivered ADSCs homed to both acute tendon and chronic tendon-bone interface (TBI) injury sites. Despite their presence at the injury site, there was no difference in the number of macrophages, amount of cell proliferation, or angiogenesis 1 week after stem cell delivery. In an SQI model, ADSCs homed to tHG. There was no difference in the number of ADSCs homing to tHG alone versus tHG + ADSCs. However, there was an increase in the number of living cells, general immune cells, and T-cells present at tHG + ADSC versus tHG alone. CONCLUSIONS The ADSCs home to tendon injury sites and tHG. We believe the attraction of additional systemic ADSCs is one mechanism for improved tendon and TBI healing with tHG. CLINICAL RELEVANCE Treatment of tendon and TBI injuries with tHG can augment healing via homing of systemic stem cells.
Collapse
Affiliation(s)
- Austin Franklin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jung Gi Min
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Hiroki Oda
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Yukitoshi Kaizawa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jacinta Leyden
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Zhen Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - James Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Paige M Fox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
| |
Collapse
|
13
|
Min JG, Sanchez Rangel UJ, Franklin A, Oda H, Wang Z, Chang J, Fox PM. Topical Antibiotic Elution in a Collagen-Rich Hydrogel Successfully Inhibits Bacterial Growth and Biofilm Formation In Vitro. Antimicrob Agents Chemother 2020; 64:e00136-20. [PMID: 32690648 PMCID: PMC7508589 DOI: 10.1128/aac.00136-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/01/2020] [Indexed: 01/24/2023] Open
Abstract
Chronic wounds are a prominent concern, accounting for $25 billion of health care costs annually. Biofilms have been implicated in delayed wound closure, but they are susceptible to developing antibiotic resistance and treatment options continue to be limited. A novel collagen-rich hydrogel derived from human extracellular matrix presents an avenue for treating chronic wounds by providing appropriate extracellular proteins for healing and promoting neovascularization. Using the hydrogel as a delivery system for localized secretion of a therapeutic dosage of antibiotics presents an attractive means of maximizing delivery while minimizing systemic side effects. We hypothesize that the hydrogel can provide controlled elution of antibiotics leading to inhibition of bacterial growth and disruption of biofilm formation. The rate of antibiotic elution from the collagen-rich hydrogel and the efficacy of biofilm disruption was assessed with Pseudomonas aeruginosa Bacterial growth inhibition, biofilm disruption, and mammalian cell cytotoxicity were quantified using in vitro models. The antibiotic-loaded hydrogel showed sustained release of antibiotics for up to 24 h at therapeutic levels. The treatment inhibited bacterial growth and disrupted biofilm formation at multiple time points. The hydrogel was capable of accommodating various classes of antibiotics and did not result in cytotoxicity in mammalian fibroblasts or adipose stem cells. The antibiotic-loaded collagen-rich hydrogel is capable of controlled antibiotic release effective for bacteria cell death without native cell death. A human-derived hydrogel that is capable of eluting therapeutic levels of antibiotic is an exciting prospect in the field of chronic wound healing.
Collapse
Affiliation(s)
- Jung Gi Min
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Uriel J Sanchez Rangel
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Austin Franklin
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Hiroki Oda
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Zhen Wang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - James Chang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Paige M Fox
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Plastic & Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| |
Collapse
|
14
|
Mikropoulos C, Otter S, Perna C, Khaksar S, Franklin A, Laing R, Uribe J, Lewis S, Langley S. Low Dose Rate Brachytherapy Boost for High-risk Prostate Cancer: An Evidence-based Approach. Clin Oncol (R Coll Radiol) 2020; 32:e162. [DOI: 10.1016/j.clon.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
|
15
|
Oda H, Beker L, Kaizawa Y, Franklin A, Min JG, Leyden J, Wang Z, Chang J, Bao Z, Fox PM. A Novel Technology for Free Flap Monitoring: Pilot Study of a Wireless, Biodegradable Sensor. J Reconstr Microsurg 2019; 36:182-190. [PMID: 31675757 DOI: 10.1055/s-0039-1700539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Accurate monitoring of free flap perfusion after complex reconstruction is critical for early recognition of flap compromise. Surgeons use a variety of subjective and objective measures to evaluate flap perfusion postoperatively. However, these measures have some limitations. We have developed a wireless, biodegradable, and flexible sensor that can be applied to real-time postoperative free flap monitoring. Here we assess the biocompatibility and function of our novel sensor. METHODS Seven Sprague-Dawley (SD) rats were used for biocompatibility studies. The sensor was implanted around the femoral artery near the inguinal ligament on one leg (implant side) and sham surgery was performed on the contralateral leg (control side). At 6 and 12 weeks, samples were harvested to assess the inflammation within and around the implant and artery. Two animals were used to assess sensor function. Sensor function was evaluated at implantation and 7 days after the implantation. Signal changes after venous occlusion were also assessed in an epigastric artery island flap model. RESULTS In biocompatibility studies, the diameter of the arterial lumen and intima thickness in the implant group were not significantly different than the control group at the 12-week time point. The number of CD-68 positive cells that infiltrated into the soft tissue, surrounding the femoral artery, was also not significantly different between groups at the 12-week time point. For sensor function, accurate signaling could be recorded at implantation and 7 days later. A change in arterial signal was noted immediately after venous occlusion in a flap model. CONCLUSION The novel wireless, biodegradable sensor presented here is biocompatible and capable of detecting arterial blood flow and venous occlusion with high sensitivity. This promising new technology could combat the complications of wired sensors, while improving the survival rate of flaps with vessel compromise due to its responsive nature.
Collapse
Affiliation(s)
- Hiroki Oda
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Levent Beker
- Department of Chemical Engineering, Stanford University, Stanford, California
| | - Yukitoshi Kaizawa
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Austin Franklin
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Jung Gi Min
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Jacinta Leyden
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Zhen Wang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - James Chang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Zhenan Bao
- Department of Chemical Engineering, Stanford University, Stanford, California
| | - Paige M Fox
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| |
Collapse
|
16
|
Kaizawa Y, Leyden J, Behn AW, Tulu US, Franklin A, Wang Z, Abrams G, Chang J, Fox PM. Human Tendon-Derived Collagen Hydrogel Significantly Improves Biomechanical Properties of the Tendon-Bone Interface in a Chronic Rotator Cuff Injury Model. J Hand Surg Am 2019; 44:899.e1-899.e11. [PMID: 30685142 DOI: 10.1016/j.jhsa.2018.11.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/10/2018] [Accepted: 11/28/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE Poor healing of the tendon-bone interface (TBI) after rotator cuff (RTC) tears leads to high rates of recurrent tear following repair. Previously, we demonstrated that an injectable, thermoresponsive, type I collagen-rich, decellularized human tendon-derived hydrogel (tHG) improved healing in an acute rat Achilles tendon injury model. The purpose of this study was to investigate whether tHG enhances the biomechanical properties of the regenerated TBI in a rat model of chronic RTC injury and repair. METHODS Tendon hydrogel was prepared from chemically decellularized human cadaveric flexor tendons. Eight weeks after bilateral resection of supraspinatus tendons, repair of both shoulders was performed. One shoulder was treated with a transosseous suture (control group) and the other was treated with a transosseous suture plus tHG injection at the repair site (tHG group). Eight weeks after repair, the TBIs were evaluated biomechanically, histologically, and via micro-computed tomography (CT). RESULTS Biomechanical testing revealed a larger load to failure, higher stiffness, higher energy to failure, larger strain at failure, and higher toughness in the tHG group versus control. The area of new cartilage formation was significantly larger in the tHG group. Micro-CT revealed no significant difference between groups in bone morphometry at the supraspinatus tendon insertion, although the tHG group was superior to the control. CONCLUSIONS Injection of tHG at the RTC repair site enhanced biomechanical properties and increased fibrocartilage formation at the TBI in a chronic injury model. CLINICAL RELEVANCE Treatment of chronic RTC injuries with tHG at the time of surgical treatment may improve outcomes after surgical repair.
Collapse
Affiliation(s)
- Yukitoshi Kaizawa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jacinta Leyden
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Anthony W Behn
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - U Serdar Tulu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA
| | - Austin Franklin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Zhen Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Geoffrey Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - James Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Paige M Fox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
| |
Collapse
|
17
|
Otter S, Franklin A, Evans P, Stewart A. EP-1479 The use of CT texture analysis in cervical cancer to predict response to chemoradiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31899-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
18
|
Kaizawa Y, Franklin A, Leyden J, Behn AW, Tulu US, Sotelo Leon D, Wang Z, Abrams GD, Chang J, Fox PM. Augmentation of chronic rotator cuff healing using adipose-derived stem cell-seeded human tendon-derived hydrogel. J Orthop Res 2019; 37:877-886. [PMID: 30747435 DOI: 10.1002/jor.24250] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 01/24/2019] [Indexed: 02/04/2023]
Abstract
Rotator cuff (RTC) repair outcomes are unsatisfactory due to the poor healing capacity of the tendon bone interface (TBI). In our preceding study, tendon hydrogel (tHG), which is a type I collagen rich gel derived from human tendons, improved biomechanical properties of the TBI in a rat chronic RTC injury model. Here we investigated whether adipose-derived stem cell (ASC)-seeded tHG injection at the repair site would further improve RTC healing. Rats underwent bilateral supraspinatus tendon detachment. Eight weeks later injured supraspinatus tendons were repaired with one of four treatments. In the control group, standard transosseous suture repair was performed. In the ASC, tHG, tHGASC groups, ASC in media, tHG, and ASC-seeded tHG were injected at repair site after transosseous suture repair, respectively. Eight weeks after repair, the TBI was evaluated biomechanically, histologically, and via micro CT. Implanted ASCs were detected in ASC and tHGASC groups 7 weeks after implantation. ACS implantation improved bone morphometry at the supraspinatus insertion on the humerus. Injection of tHG improved biomechanical properties of the repaired TBI. RTC healing in tHGASC group was significantly better than control but statistically equivalent to the tHG group based on biomechanical properties, fibrocartilage area at the TBI, and bone morphometry at the supraspinatus insertion. In a rat RTC chronic injury model, no biomechanical advantage was gained with ASC augmentation of tHG. Clinical Significance: Tendon hydrogel augmentation with adipose derived stem cells does not significantly improve TBI healing over tHG alone in a chronic rotator cuff injury model. © 2019 Orthopaedic Research Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
Collapse
Affiliation(s)
- Yukitoshi Kaizawa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| | - Austin Franklin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| | - Jacinta Leyden
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| | - Anthony W Behn
- Department of Orthopaedic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, California, 94305
| | - Ustun S Tulu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304
| | - Daniel Sotelo Leon
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| | - Zhen Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| | - Geoffrey D Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, California, 94305
| | - James Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| | - Paige M Fox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, 770 Welch Rd., Suite 400, Palo Alto, California, 94304.,Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, California, 94304
| |
Collapse
|
19
|
Sun Myint A, Stewart A, Mills J, Sripadam R, Whitmarsh K, Roy R, Franklin A, Dhadda A. Treatment: the role of contact X-ray brachytherapy (Papillon) in the management of early rectal cancer. Colorectal Dis 2019; 21 Suppl 1:45-52. [PMID: 30809905 DOI: 10.1111/codi.14507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/26/2018] [Indexed: 12/13/2022]
Affiliation(s)
- A Sun Myint
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK.,Translational Medicine Department, University of Liverpool, Liverpool, UK
| | - A Stewart
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK.,University of Surrey, Guildford, UK
| | - J Mills
- Nottingham University Hospital, Nottingham, UK
| | - R Sripadam
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - K Whitmarsh
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - R Roy
- Queen's Centre for Oncology and Haematology, Hull, UK
| | - A Franklin
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - A Dhadda
- Queen's Centre for Oncology and Haematology, Hull, UK
| | | |
Collapse
|
20
|
Hakansson S, Jones M, Ristov M, Marcos L, Clark T, Ram A, Morey R, Franklin A, McCarthy C, Carli L, Ward R, Keech A. Intensity-dependent effects of aerobic training on pressure pain threshold in overweight men: A randomized trial. Eur J Pain 2018; 22:1813-1823. [DOI: 10.1002/ejp.1277] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2018] [Indexed: 12/12/2022]
Affiliation(s)
- S. Hakansson
- School of Medical Sciences; University of New South Wales; Sydney Australia
- Department of Biomedicine; Karolinska Institutet; Stockholm Sweden
| | - M.D. Jones
- School of Medical Sciences; University of New South Wales; Sydney Australia
- Kirby Institute; University of New South Wales; Sydney Australia
- Neuroscience Research Australia; Sydney Australia
| | - M. Ristov
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - L. Marcos
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - T. Clark
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - A. Ram
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - R. Morey
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - A. Franklin
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - C. McCarthy
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - L.D. Carli
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - R. Ward
- School of Medical Sciences; University of New South Wales; Sydney Australia
| | - A. Keech
- School of Medical Sciences; University of New South Wales; Sydney Australia
| |
Collapse
|
21
|
Webb K, Franklin A, Stewart A, Otter S. Implementing Radiographer-led Online Soft Tissue Verification in Cervical Cancer IMRT to Improve Planning Target Volume Coverage. Clin Oncol (R Coll Radiol) 2018. [DOI: 10.1016/j.clon.2018.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Otter S, Coates A, Franklin A, Brennan C, Cunningham M, Stewart A. EP-2216: The dosimetric impact of interstitial needles in HDR brachytherapy for cervical cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32525-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
23
|
Martin R, Kim M, Franklin A, Bian Y, Asthagiri A, Weaver JF. Adsorption and oxidation of propane and cyclopropane on IrO2(110). Phys Chem Chem Phys 2018; 20:29264-29273. [DOI: 10.1039/c8cp06125d] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Initial activation by ring-opening enables cyclopropane to achieve higher reaction yields than n-propane on IrO2(110).
Collapse
Affiliation(s)
- Rachel Martin
- Department of Chemical Engineering
- University of Florida
- Gainesville
- USA
| | - Minkyu Kim
- William G. Lowrie Chemical & Biomolecular Engineering
- The Ohio State University
- Columbus
- USA
| | - Austin Franklin
- Department of Chemical Engineering
- University of Florida
- Gainesville
- USA
| | - Yingxue Bian
- Department of Chemical Engineering
- University of Florida
- Gainesville
- USA
| | - Aravind Asthagiri
- William G. Lowrie Chemical & Biomolecular Engineering
- The Ohio State University
- Columbus
- USA
| | - Jason F. Weaver
- Department of Chemical Engineering
- University of Florida
- Gainesville
- USA
| |
Collapse
|
24
|
Brown SMN, Rae J, Franklin A, Mapazire E, Bettencourt J. P209 Characteristics of east london children with severe obesity requiring non-invasive ventilation for sleep disordered breathing. Sleep Breath 2017. [DOI: 10.1136/thoraxjnl-2017-210983.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
25
|
Otter S, Coates A, Brennan C, Franklin A, Cunningham M, Stewart A. The use of MRI and interstitial needles to achieve dose targets in image guided brachytherapy for cervical cancer at the Royal Surrey County Hospital. Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Otter S, Hussein M, Why S, Franklin A, Stewart A. PO-0719: The use of ultrasound bladder scanning in cervical IMRT to reduce variability of uterine motion. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31156-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
27
|
Halling-Brown M, Franklin A, Essapen S, Stewart A. EP-1219: A bespoke, flexible clinical database system for multicentre rectal carcinoma registry. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
28
|
Franklin A, Sritharan K, Bates A, Ewan C, Essapen S, Stewart A. PO-1052: External beam radiotherapy and contact radiotherapy for operable low rectal cancer: response at 3 months. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
29
|
Franklin A, Berens S, Bird CM. Left middle frontal gyrus represents color categories but not metric differences in color; evidence from fMRI adaptation. J Vis 2013. [DOI: 10.1167/13.9.468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
30
|
|
31
|
|
32
|
Szot P, Knight L, Franklin A, Sikkema C, Foster S, Wilkinson CW, White SS, Raskind MA. Lesioning noradrenergic neurons of the locus coeruleus in C57Bl/6 mice with unilateral 6-hydroxydopamine injection, to assess molecular, electrophysiological and biochemical changes in noradrenergic signaling. Neuroscience 2012; 216:143-57. [PMID: 22542679 DOI: 10.1016/j.neuroscience.2012.04.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
The locus coeruleus (LC) is the major loci of noradrenergic innervation to the forebrain. Due to the extensive central nervous system innervation of the LC noradrenergic system, a reduction in the number of LC neurons could result in significant changes in noradrenergic function in many forebrain regions. LC noradrenergic neurons were lesioned in adult male C57Bl/6 mice with the unilateral administration of 6-hydroxydopamine (6OHDA) (vehicle on the alternate side). Noradrenergic markers were measured 3 weeks later to determine the consequence of LC loss in the forebrain. Direct administration of 6OHDA into the LC results in the specific reduction of noradrenergic neurons in the LC (as measured by electrophysiology, immunoreactivity and in situ hybridization), the lateral tegmental neurons and dopaminergic neurons in the substantia nigra (SN) and ventral tegmental region were unaffected. The loss of LC noradrenergic neurons did not result in compensatory changes in the expression of mRNA for norepinephrine (NE)-synthesizing enzymes. The loss of LC noradrenergic neurons is associated with reduced NE tissue concentration and NE transporter (NET) binding sites in the frontal cortex and hippocampus, as well as other forebrain regions such as the amygdala and SN. Adrenoreceptor (AR) binding sites (α(1)- and α(2)-AR) were not significantly affected on the 6OHDA-treated side compared to the vehicle-treated side, although there is a reduction of AR binding sites on both the vehicle- and 6OHDA-treated side in specific forebrain regions. These studies indicate that unilateral stereotaxic injection of 6OHDA into mice reduces noradrenergic LC neurons and reduces noradrenergic innervation to many forebrain regions, including the contralateral side.
Collapse
Affiliation(s)
- P Szot
- Northwest Network for Mental Illness Research, Education, and Clinical Center, Veterans Administration Puget Sound Health Care System, Seattle, WA 98108, USA. szot@u. washington. edu
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Turner E, Franklin A, Robinson D, Patel V. 345 Categorizing Work Activity in the Emergency Department: Are We Underestimating Effort? Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
34
|
Franklin A, Taylor C, Al-Rasheed A, Clifford A, Alvarez J. Biological Components of Color Preference are not Universal. J Vis 2011. [DOI: 10.1167/11.11.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
35
|
Taylor C, Clifford A, Franklin A. Mere exposure influences male colour preference, yet female colour preference is resistant to change. J Vis 2011. [DOI: 10.1167/11.11.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
36
|
Killingsworth S, Franklin A, Levin D. Change Detection is Better Specifically for Object Properties that Change More Frequently in the Real World. J Vis 2011. [DOI: 10.1167/11.11.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
37
|
Franklin A. Color categories in infancy. J Vis 2010. [DOI: 10.1167/10.15.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
38
|
Franklin A, Catherwood D, Axelsson E, Alvarez J. Lateralization of visual categories in infancy. J Vis 2010. [DOI: 10.1167/10.7.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
39
|
Williams M, Adams E, Mittal R, Petrosyan M, Franklin A, Vendryes C, Grishin A, Ford H, Nemani P. Outer Membrane Protein A Expression Is Required for Enterobacter Sakazakii (ES)-Mediated Enterocyte Apoptosis. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
40
|
Gustafsson A, Båverud V, Gunnarsson A, Pringle J, Franklin A. Study of faecal shedding of Clostridium difficile in horses treated with penicillin. Equine Vet J 2010; 36:180-2. [PMID: 15038443 DOI: 10.2746/0425164044868657] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- A Gustafsson
- Department of Large Animal Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Box 7018, S-750 07 Uppsala, Sweden
| | | | | | | | | |
Collapse
|
41
|
Szot P, Miguelez C, White SS, Franklin A, Sikkema C, Wilkinson CW, Ugedo L, Raskind MA. A comprehensive analysis of the effect of DSP4 on the locus coeruleus noradrenergic system in the rat. Neuroscience 2010; 166:279-91. [PMID: 20045445 DOI: 10.1016/j.neuroscience.2009.12.027] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 11/30/2009] [Accepted: 12/10/2009] [Indexed: 11/19/2022]
Abstract
Degeneration of the noradrenergic neurons in the locus coeruleus (LC) is a major component of Alzheimer's (AD) and Parkinson's disease (PD), but the consequence of noradrenergic neuronal loss has different effects on the surviving neurons in the two disorders. Therefore, understanding the consequence of noradrenergic neuronal loss is important in determining the role of this neurotransmitter in these neurodegenerative disorders. The goal of the study was to determine if the neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP4) could be used as a model for either (or both) AD or PD. Rats were administered DSP4 and sacrificed 3 days 2 weeks and 3 months later. DSP4-treatment resulted in a rapid, though transient reduction in norepinephrine (NE) and NE transporter (NET) in many brain regions receiving variable innervation from the LC. Alpha(1)-adrenoreceptors binding site concentrations were unchanged in all brain regions at all three time points. However, an increase in alpha(2)-AR was observed in many different brain regions 2 weeks and 3 months after DSP4. These changes observed in forebrain regions occurred without a loss in LC noradrenergic neurons. Expression of synthesizing enzymes or NET did not change in amount of expression/neuron despite the reduction in NE tissue content and NET binding site concentrations at early time points, suggesting no compensatory response. In addition, DSP4 did not affect basal activity of LC at any time point in anesthetized animals, but 2 weeks after DSP4 there is a significant increase in irregular firing of noradrenergic neurons. These data indicate that DSP4 is not a selective LC noradrenergic neurotoxin, but does affect noradrenergic neuron terminals locally, as evident by the changes in transmitter and markers at terminal regions. However, since DSP4 did not result in a loss of noradrenergic neurons, it is not considered an adequate model for noradrenergic neuronal loss observed in AD and PD.
Collapse
Affiliation(s)
- P Szot
- Northwest Network for Mental Illness Research, Education, and Clinical Center, Veterans Administration Puget Sound Health Care System, Seattle, WA 98108, USA.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Lu Y, Liu P, James M, Vikis HG, Liu H, Wen W, Franklin A, You M. Genetic variants cis-regulating Xrn2 expression contribute to the risk of spontaneous lung tumor. Oncogene 2009; 29:1041-9. [PMID: 19915612 DOI: 10.1038/onc.2009.396] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Gene expression variation is an important mechanism underlying susceptibility to complex disease. In comparison with tobacco-related lung carcinogenesis, lung cancer in nonsmokers may involve important and etiologically distinct causal pathways. In this study, we conducted a genome-wide association study on spontaneous lung tumor incidence in inbred mice and identified a major susceptibility locus on mouse chromosome 2 (rs27328255, P=6.68 x 10(-7)). We then evaluated the correlations of polymorphisms with the transcription of positional candidate genes in normal lungs. Single-nucleotide polymorphism rs27328255 was consistently and strongly associated (P=7.42 x 10(-9)) in cis with transcript levels of Xrn2. We further showed that Xrn2 promotes proliferation and inhibits squamous differentiation in human lung epithelial cells and polymorphisms in human homolog XRN2 are associated with human lung cancer (rs2025811, P=1.90 x 10(-3), OR=1.20). We conclude that genetic variants regulating Xrn2 expression in cis are determinants of spontaneous lung tumor susceptibility in mice and have genetic equivalents in lung cancer susceptibility in human beings. Identifying Xrn2 as a major candidate for spontaneous lung cancer has important implications for the diagnosis and treatment of lung cancer as well as delineation of the mechanisms underlying the genesis of lung cancer in nonsmokers.
Collapse
Affiliation(s)
- Y Lu
- Department of Surgery and the Alvin J Siteman Cancer Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Nilsson O, Greko C, Top J, Franklin A, Bengtsson B. Spread without known selective pressure of a vancomycin-resistant clone of Enterococcus faecium among broilers. J Antimicrob Chemother 2009; 63:868-72. [DOI: 10.1093/jac/dkp045] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
44
|
McKenzie SA, Bhattacharya A, Sureshkumar R, Joshi B, Franklin A, Pickering R, Dundas I. Which obese children should have a sleep study? Respir Med 2008; 102:1581-5. [PMID: 18640017 DOI: 10.1016/j.rmed.2008.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 05/28/2008] [Accepted: 06/04/2008] [Indexed: 12/12/2022]
Abstract
BACKGROUND The UK government has recommended the development of obesity services for children. As obesity is common, studying every obese child for obstructive sleep apnoea (OSA) would be challenging and full paediatric sleep services are not available in every area in Europe. The purpose of this study was to consider how well clinical features predict significant OSA in obese children in order to help prioritise the need for sleep studies and subsequent treatment. METHODS Consecutive children referred for obesity management aged 2-16 years with a body mass index (BMI) of >2.5 z scores for age were offered a sleep study using overnight oximetry and audiovisual recordings. Significant OSA was defined as > or = 5 dips/h of >4% oxygen saturation or > or = 5 respiratory-event related arousals/h. RESULTS Forty-one of 158 (26%) children (mean BMI z score 3.7) had significant OSA and 95% of these had either reported apnoea, restless sleep or tonsillar hypertrophy (TH). Nineteen percent of all children had none of these features. BMI was not related to OSA. CONCLUSION If only obese children with reported apnoea, restless sleep or TH have a sleep study, 95% of all obese children with significant OSA will be identified using this method.
Collapse
Affiliation(s)
- S A McKenzie
- 2nd floor, Fielden House, Royal London Hospital, Barts and the London NHS Trust, Whitechapel, London E1 1BB, UK.
| | | | | | | | | | | | | |
Collapse
|
45
|
Andersson U, Bengtsson B, Franklin A, Thyselius S. R2133 Antimicrobial resistance in Escherichia coli from pigs in relation to incidence of post-weaning diarrhoea and antimicrobial use. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71972-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
46
|
Abstract
AbstractThe pleuromutilins are the only antimicrobial agents with sufficient minimum inhibitory concentration (MIC) values left to treat swine dysentery in Sweden. Other antimicrobials are either not approved for use against swine dysentery or only partly active againstBrachyspira hyodysenteriae. To date, in Sweden two pleuromutilins, tiamulin and valnemulin, are authorized for use in pigs. This study includes a comparison between MICs of tiamulin and valnemulin for Swedish field isolates ofB. hyodysenteriae, as determined by broth dilution. For different isolates the MIC of tiamulin was between 0 and 8 times higher than that of valnemulin. No resistance to pleuromutilins was recorded (tiamulin MIC range 0.031–2 μg/ml, valnemulin MIC range ≤0.016–1 μg/ml).In vitrodevelopment of tiamulin resistance was also studied. TwoB. hyodysenteriaeand twoB. pilosicolistrains became resistant to tiamulin following reiterated passages on agar containing tiamulin in increasing concentrations. The resistance emerged slowly and three of the strains that went through more than 60 passages increased their tiamulin MICs from 0.031–0.25 to more than 128 μg/ml. The tiamulin MIC for oneB. hyodysenteriaestrain that went through 29 passages increased from 0.0125 to 4 μg/ml. OneB. pilosicolistrain developed cross-resistance to valnemulin; the MIC increased from 0.25 to more than 64 μg/ml. The valnemulin MIC for oneB. hyodysenteriaestrain increased from 0.031 μg/ml to 32 μg/ml. Valnemulin MIC was not determined for theB. hyodysenteriaestrain that only went through 29 passages. The valnemulin MIC of the otherB. pilosicolistrain increased from 0.031 to 4 μg/ml.
Collapse
|
47
|
Drivonikou GV, Kay P, Regier T, Ivry RB, Gilbert AL, Franklin A, Davies IRL. Further evidence that Whorfian effects are stronger in the right visual field than the left. Proc Natl Acad Sci U S A 2007; 104:1097-102. [PMID: 17213312 PMCID: PMC1783370 DOI: 10.1073/pnas.0610132104] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The Whorf hypothesis holds that differences between languages induce differences in perception and/or cognition in their speakers. Much of the experimental work pursuing this idea has focused on the domain of color and has centered on the issue of whether linguistically coded color categories influence color discrimination. A new perspective has been cast on the debate by recent results that suggest that language influences color discrimination strongly in the right visual field but not in the left visual field (LVF). This asymmetry is likely related to the contralateral projection of visual fields to cerebral hemispheres and the specialization of the left hemisphere for language. The current study presents three independent experiments that replicate and extend these earlier results by using different tasks and testing across different color category boundaries. Our results differ in one respect: although we find that Whorfian effects on color are stronger for stimuli in the right visual field than in the LVF, we find that there are significant category effects in the LVF as well. The origin of the significant category effect in the LVF is considered, and two factors that might account for the pattern of results are proposed.
Collapse
Affiliation(s)
- G. V. Drivonikou
- Department of Psychology, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
| | - P. Kay
- International Computer Science Institute, 1947 Center Street, Berkeley, CA 94704
- Department of Linguistics and
- To whom correspondence may be addressed. E-mail:
or
| | - T. Regier
- Helen Wills Neuroscience Institute and Department of Psychology, University of Calfornia, Berkeley, CA 94720; and
| | - R. B. Ivry
- Department of Psychology, The University of Chicago, Chicago, IL 60637
| | - A. L. Gilbert
- Department of Psychology, The University of Chicago, Chicago, IL 60637
| | - A. Franklin
- Department of Psychology, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
| | - I. R. L. Davies
- Department of Psychology, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
- To whom correspondence may be addressed. E-mail:
or
| |
Collapse
|
48
|
Pringle M, Aarestrup FM, Bergsjø B, Fossi M, Jouy E, Landén A, Mevius D, Perry K, Teale C, Thomson J, Skrzypczak T, Veldman K, Franklin A. Quality-control ranges for antimicrobial susceptibility testing by broth dilution of the Brachyspira hyodysenteriae type strain (ATCC 27164T). Microb Drug Resist 2006; 12:219-21. [PMID: 17002550 DOI: 10.1089/mdr.2006.12.219] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There are no approved standards for antimicrobial susceptibility testing of the fastidious spirochete Brachyspira hyodysenteriae. An interlaboratory study was performed to establish MIC quality control ranges for six antimicrobial agents for the type strain of B. hyodysenteriae using broth dilution. The results showed that B. hyodysenteriae B78T ATCC 27164T is a suitable quality control strain. This is a first step toward standardization of methods regarding this anaerobe.
Collapse
Affiliation(s)
- M Pringle
- National Veterinary Institute, Uppsala, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Czito B, Bendell J, Willett C, Vaccaro G, Morse M, Yu D, Honeycutt W, Franklin A, Hurwitz H. Preliminary results of a phase I study of external beam radiation therapy (EBRT), oxaliplatin (OX), bevacizumab (BV), and capecitabine (CAP) for locally advanced or metastatic adenocarcinoma of the rectum. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3543 Background: BV, a monoclonal antibody against vascular endothelial growth factor, increases survival when added to first and second line chemotherapy for metastatic colorectal cancer. Preclinical studies suggest BV may enhance tumoral radiation sensitivity. Preliminary studies of OX and 5-FU based chemoradiation therapy for rectal cancer have suggested improved pathologic CR rates compared to 5-FU/ radiation alone. CAP allows fluoropyrimidine treatment without the inconvenience of an infusion pump. We investigated CAP + BV + OX + EBRT for pts with rectal cancer to evaluate for the MTD and preliminary efficacy results. Methods: Pts with adenocarcinoma of the rectum and no prior pelvic irradiation received 5040 cGy EBRT (180 cGy/fx), CAP (625–825 mg/m2 PO BID on EBRT days), BEV (15 mg/kg d1 and 10 mg/kg d8 and d22), and OX (50–75 mg/m2/week during radiation, weeks 1–5) in dose-escalating fashion. DLT was defined as any grade 3 heme tox ≥ 7d, grade 4 heme tox, grade 4 non-heme tox during chemoradiation, or inability to deliver >85% of planned treatment. Pts eligible for surgical resection could have surgery 6–8 wks after treatment completion. After recovery from surgery, patients could be treated with CAP, BV, and OX. Results: 11 patients (5 men/6 women) have been enrolled. All have completed chemoradiation and resection. At dose level 1 (CAP 625 mg/m2 BID, OX 50mg/m2) there were no DLT’s in 3 pts. 1/3 pts had G3 subarachnoid hemorrhage during adjuvant chemotherapy. At dose level 2 (CAP 825 mg/m2, OX 50 mg/m2) 2/2 pts had DLT (1 G4 diarrhea; 1 G2 rectal pain, causing treatment hold for study-defined DLT). 6 more pts were treated at dose level 1. 1pt had DLT of G3 diarrhea. G2 toxicities included diarrhea (3/11), fatigue (2/11), skin changes (2/11), and pain (2/11). 9/11 patients were downstaged. 2/11 patients had pCR at surgery and 2/11 microscopic disease only. Conclusions: CAP + BEV + OX + EBRT is a well-tolerated, active regimen for the treatment of rectal cancer. MTD was determined to be CAP 625 mg/m2 BID + BEV 15 mg/kg d1 + 10 mg/kg d 8 and 22 + OX 50 mg/m2/week. Further study of efficacy at the MTD is warranted. [Table: see text]
Collapse
Affiliation(s)
- B. Czito
- Duke University Medical Center, Durham, NC
| | - J. Bendell
- Duke University Medical Center, Durham, NC
| | - C. Willett
- Duke University Medical Center, Durham, NC
| | - G. Vaccaro
- Duke University Medical Center, Durham, NC
| | - M. Morse
- Duke University Medical Center, Durham, NC
| | - D. Yu
- Duke University Medical Center, Durham, NC
| | | | | | - H. Hurwitz
- Duke University Medical Center, Durham, NC
| |
Collapse
|
50
|
Bendell JC, Fernando N, Morse M, Blobe G, Yu D, Sutton L, Schaffer S, Honeycutt W, Franklin A, Hurwitz H. A phase II study of oxaliplatin (OX), capecitabine (CAP), and bevacizumab (BV) in the treatment of metastatic colorectal cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3541 Background: BV, a monoclonal antibody against vascular endothelial growth factor, provides a survival advantage when added to first line therapy for metastatic colorectal cancer. CAP allows for fluoropyrimide treatment without the inconvenience of an infusion pump. We aimed to investigate the combination of OX, CAP, and BV (XeloxA) as a more convenient and active regimen. Methods: Pts with untreated metastatic colorectal cancer received OX 85 mg/m2 d1, CAP 1000 mg/m2 BID d1–5 and 8–12, and BV 10 mg/kg d1. Cycles were repeated every two weeks. The starting dose of CAP was changed to 850 mg/m2 BID due to toxicity in the first 28 patients. Data were analyzed under an intention to treat method. Results: 50 pts received therapy (28M, 22F), median age 55 (range 24–81). Data were available on 49 pts. The most common toxicity was diarrhea, with 12/49 (24%) having grade 3 diarrhea, and 22% with grade 2. After the dose reduction of CAP, 3/21 (14%) pts had grade 3 diarrhea and 2/21 (10%) with grade 2 as compared to 32% grade 3 and 32% grade 2 at the higher dose. At the higher dose of CAP 4% of pts had grade 3 hand-foot syndrome (HFS) and 39% had grade 2. At the lower dose, 10% had grade 3 and 5% had grade 2. Other grade 3 toxicities were minimal, including neurotoxicity (8%), vomiting (6%), and neutropenia (4%). There were 23 responses, 1 CR and 22 PR (RR=47%; 95% CI: 33%-62%). 21 pts had stable disease (43%). Median progression free survival (PFS) was 10.7 months (95% CI: 8.6–13.6). Conclusions: XeloxA is a well tolerated, active regimen in the first line treatment of metastatic colorectal cancer. RR and PFS data approximate that of infusional 5-FU regimens in combination with BV without the necessity of an infusion pump. [Table: see text]
Collapse
Affiliation(s)
- J. C. Bendell
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - N. Fernando
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - M. Morse
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - G. Blobe
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - D. Yu
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - L. Sutton
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - S. Schaffer
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - W. Honeycutt
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - A. Franklin
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| | - H. Hurwitz
- Duke University Medical Center, Durham, NC; Georgia Cancer Specialists, Atlanta, GA
| |
Collapse
|