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Hayes E, Wallace D, O'Donnell C, Greene D, Hennessy D, O'Shea N, Tobin JT, Fenelon MA. Trend analysis and prediction of seasonal changes in milk composition from a pasture-based dairy research herd. J Dairy Sci 2023; 106:2326-2337. [PMID: 36759275 DOI: 10.3168/jds.2021-21483] [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] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 09/09/2022] [Indexed: 02/10/2023]
Abstract
The composition of seasonal pasture-produced milk is influenced by stage of lactation, animal genetics, and nutrition, which affects milk nutritional profile and processing characteristics. The objective was to study the effect of lactation stage (early, mid, and late lactation) and diet on milk composition in an Irish spring calving dairy research herd from 2012 to 2020 using principal component and predictive analytics. Crude protein, casein, fat, and solids increased from 2012 to 2020, whereas lactose concentration peaked in 2017, then decreased. Based on seasonal data from 2013 to 2016, forecasting models were successfully created to predict milk composition for 2017 to 2020. The diet of cows in this study is dependent upon grass growth rates across the milk production season, which in turn, are influenced by weather patterns, whereby extreme weather conditions (rainfall and temperature) were correlated with decreasing grass growth and increasing nonprotein nitrogen levels in milk. The study demonstrates a significant change in milk composition since 2012 and highlights the effect that seasonal changes such as weather and grass growth have on milk composition of pasture-based systems. The potential to forecast milk composition at different stages of lactation benefits processers by facilitating the optimization of in-process and supply logistics of dairy products.
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Affiliation(s)
- E Hayes
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland, P61C996; School of Biosystems and Food Engineering, University College Dublin, Ireland, D04V1W8
| | - D Wallace
- School of Computer Science, University College Dublin, Ireland, D04V1W8
| | - C O'Donnell
- School of Biosystems and Food Engineering, University College Dublin, Ireland, D04V1W8
| | - D Greene
- School of Computer Science, University College Dublin, Ireland, D04V1W8
| | - D Hennessy
- Teagasc Animal and Grassland Centre, Moorepark, Fermoy, Co. Cork, Ireland, P61C996
| | - N O'Shea
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland, P61C996
| | - J T Tobin
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland, P61C996
| | - M A Fenelon
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland, P61C996; School of Biosystems and Food Engineering, University College Dublin, Ireland, D04V1W8.
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Greene D, Barton M, Luchko T, Shiferaw Y. Molecular Dynamics Simulations of the Cardiac Ryanodine Receptor Type 2 (RyR2) Gating Mechanism. J Phys Chem B 2022; 126:9790-9809. [PMID: 36384028 PMCID: PMC9720719 DOI: 10.1021/acs.jpcb.2c03031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mutations in the cardiac ryanodine receptor type 2 (RyR2) have been linked to fatal cardiac arrhythmias such as catecholaminergic polymorphic ventricular tachycardia (CPVT). While many CPVT mutations are associated with an increase in Ca2+ leak from the sarcoplasmic reticulum, the mechanistic details of RyR2 channel gating are not well understood, and this poses a barrier in the development of new pharmacological treatments. To address this, we explore the gating mechanism of the RyR2 using molecular dynamics (MD) simulations. We test the effect of changing the conformation of certain structural elements by constructing chimera RyR2 structures that are derived from the currently available closed and open cryo-electron microscopy (cryo-EM) structures, and we then use MD simulations to relax the system. Our key finding is that the position of the S4-S5 linker (S4S5L) on a single subunit can determine whether the channel as a whole is open or closed. Our analysis reveals that the position of the S4S5L is regulated by interactions with the U-motif on the same subunit and with the S6 helix on an adjacent subunit. We find that, in general, channel gating is crucially dependent on high percent occupancy interactions between adjacent subunits. We compare our interaction analysis to 49 CPVT1 mutations in the literature and find that 73% appear near a high percent occupancy interaction between adjacent subunits. This suggests that disruption of cooperative, high percent occupancy interactions between adjacent subunits is a primary cause of channel leak and CPVT in mutant RyR2 channels.
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Reddy D, Peters M, Shah T, Van Son M, Bertoncelli Tanaka M, Huber P, Lomas D, Rakauskas A, Miah S, Eldred-Evans D, Hosking-Jervis F, Engle R, Dudderidge T, Mccracken S, Greene D, Nigam R, Mccartan N, Valerio M, Orczyk C, Virdi J, Arya M, Ahmed H. Primary focal cryotherapy for non-metastatic prostate cancer: Update from the UK ICE registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00406-7] [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: 11/30/2022]
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Baetens I, Greene D, Van Hove L, Van Leeuwen K, Wiersema JR, Desoete A, Roelants M. Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors. J Adolesc 2021; 90:100-108. [PMID: 34182197 DOI: 10.1016/j.adolescence.2021.06.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Numerous life, peer, and school-related factors have been found to be associated with non-suicidal self-injury (NSSI) among adolescents; however, most studies have not explored the possible reciprocal nature of these associations. The aim of the current study was to examine bidirectional and longitudinal associations between NSSI and several life, peer, and school-related factors (i.e., stressful life events, peer relationships, academic achievement, and attitudes towards school). METHOD Community-based adolescents completed questionnaires assessing the variables of interest at three time points; age 12 (T1; 55.09% girls), age 13 (T2; 56.95% girls), and ages 14-15 (T3; 57.41% girls). In total, 529 adolescents provided complete data across all three-time points. RESULTS Analyses showed a bidirectional association between NSSI and both attitudes towards school and stressful life events. Specifically, stressful life events at T2 predicted engagement in NSSI at T3, and NSSI at T2 predicted increased risk of stressful life events at T3. Similarly, having negative attitudes towards school predicted NSSI at T2, which, in turn, predicted negative attitudes towards school at T3. Further, academic achievement at T1 was negatively associated with NSSI at T2. Peer relationships were neither a predictor nor a consequence of NSSI. CONCLUSIONS Our results suggest that NSSI can be both a predictor and a consequence of various life, and school factors. Focus on these factors in prevention and intervention efforts for NSSI among adolescents may be warranted.
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Affiliation(s)
- I Baetens
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
| | - D Greene
- School of Psychology, Curtin University, Australia
| | - L Van Hove
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - K Van Leeuwen
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - J R Wiersema
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - A Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - M Roelants
- Department of Public Health and Primary Care, KU Leuven, Belgium
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Abstract
UNLABELLED The prevention as well as the treatment of atypical femur fractures (AFFs) remains controversial but there have been many clinical recommendations suggested. We have summarized these recommendations as well as expanded upon them in this paper. INTRODUCTION The purpose of the paper was to develop a clinical practice guideline that both treats AFF and decreases the risk of AFF in patients requiring antiresorptive medications. Examples of these medications include bisphosphonates and denosumab for the treatment of osteoporosis. METHODS A literature review looking for recommendations on AFF identification, management, and prevention was done. We also performed an updated review of clinical guidelines on AFF prevention and treatment that were developed for the Kaiser Permanente osteoporosis/fracture prevention team. RESULTS Concise clinical practice guidelines are presented that can be applied in treatment of AFF as well as help reduce the risk of developing an AFF in patients requiring antiresorptive medications. These guidelines are based on using both typical fracture and AFF risk assessment to determine duration of antiresorptive of 3 to 5 years before consideration if a drug holiday is needed. Specific groups such as younger Asian women should be reassessed at 3 years with DXA and FRAX to see if a drug holiday is needed whereas patients at higher risk for typical fractures may be reassessed at 5 years of treatment. The DXA rescreening can now be accessed if focal or generalized lateral cortex changes are present that may indicate incomplete AFFs are present. If an incomplete AFF is discovered either by DXA or by other imaging studies, it is imperative to stop antiresorptive medications and to take additional measures to lower the risk of progression to a complete AFF. If complete AFF does occur, then antiresorptive medications should be stopped and additional measures should be taken to decrease the risk of developing an AFF on the contralateral femur. CONCLUSIONS Clinical practice guidelines for the treatment and prevention of AFF will benefit clinicians who are frequently faced with having to make clinical decisions in patients requiring antiresorptive medications.
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Affiliation(s)
- R Dell
- Kaiser Downey Southern California, 9353 Imperial Hwy, Downey, CA, 90242, USA.
| | - D Greene
- Kaiser Downey Southern California, 9353 Imperial Hwy, Downey, CA, 90242, USA
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Affiliation(s)
- D Greene
- Christie Hospital and Holt Radium Institute, Manchester
| | - P D Lomer
- Services Electronic Research Laboratory, Baldock, Herts
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Affiliation(s)
- E T Cheng
- Division of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California 94305-5328, USA
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Leydon P, O’Connell M, Greene D, Curran K. Automatic bone marrow segmentation for PETCT imaging in multiple myeloma. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.508] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
The clinical diagnosis or sapheno-femoral incompetence is frequently inaccurate. Using a simple Doppler technique described below 94% of 155 limbs in 107 patients were correctly diagnosed. In the same group of patients the cough impulse test gave an accurate positive result in only 79%, while in the first 100 limbs of the series tourniquet and tap tests were even less reliable. Since the Doppler technique is readily applicable to large numbers of patients it is concluded that it will be of use in distinguishing those in whom surgery is required from others in whom compression sclerotherapy will be effective.
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Affiliation(s)
| | - E. Dinn
- Sir Patrick Dun's Hospital, Dublin 2, Ireland
| | - R. O'Connor
- Sir Patrick Dun's Hospital, Dublin 2, Ireland
| | - D. Greene
- Sir Patrick Dun's Hospital, Dublin 2, Ireland
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Salji M, Jones R, Paul J, Birrell F, Dixon-Hughes J, Hutchison C, Johansen TEB, Greene D, Parr N, Leung HY. Feasibility study of a randomised controlled trial to compare (deferred) androgen deprivation therapy and cryotherapy in men with localised radiation-recurrent prostate cancer. Br J Cancer 2014; 111:424-9. [PMID: 24946001 PMCID: PMC4119985 DOI: 10.1038/bjc.2014.316] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/09/2014] [Accepted: 05/12/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Salvage therapeutic options for biochemical failure after primary radiation-based therapy include radical prostatectomy, cryoablation, high-intensity focused ultrasound (HIFU), brachytherapy (for post-EBRT patients) and androgen deprivation therapy (ADT). ADT and salvage prostate cryoablation (SPC) are two commonly considered treatment options for RRPC. However, there is an urgent need for high-quality clinical studies to support evidence-based decisions on treatment choice. Our study aims to determine the feasibility of randomising men with RRPC for treatment with ADT and SPC. METHODS The randomised controlled trial (CROP) was developed, which incorporated protocols to assess parameters relating to cryotherapy procedures and provide training workshops for optimising patient recruitment. Analysis of data from the recruitment phase and patient questionnaires was performed. RESULTS Over a period of 18 months, 39 patients were screened for eligibility. Overall 28 patients were offered entry into the trial, but only 7 agreed to randomisation. The majority reason for declining entry into the trial was an unwillingness to be randomised into the study. 'Having the chance of getting cryotherapy' was the major reason for accepting the trial. Despite difficulty in retrieving cryotherapy temperature parameters from prior cases, 9 of 11 cryotherapy centres progressed through the Cryotherapists Qualification Process (CQP) and were approved for recruiting into the CROP study. CONCLUSIONS Conveying equipoise between the two study arms for a salvage therapy was challenging. The use of delayed androgen therapy may have been seen as an inferior option. Future cohort studies into available salvage options (including prostate cryotherapy) for RRPC may be more acceptable to patients than randomisation within an RCT.
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Affiliation(s)
- M Salji
- Department of Urology, NHS Greater Glasgow and Clyde, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - R Jones
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Cancer Research UK Glasgow Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
- CRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - J Paul
- Cancer Research UK Glasgow Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
- CRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - F Birrell
- Department of Urology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Dixon-Hughes
- Cancer Research UK Glasgow Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
- CRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - C Hutchison
- Cancer Research UK Glasgow Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
- CRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - T E B Johansen
- Department of Urology, Oslo University Hospital, Oslo, Norway
| | - D Greene
- Sunderland Royal Hospital, City Hospitals Sunderland, Sunderland, UK
| | - N Parr
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - H Y Leung
- Department of Urology, NHS Greater Glasgow and Clyde, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Sunderland Royal Hospital, City Hospitals Sunderland, Sunderland, UK
- Beatson Institute, Glasgow, UK
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McCleery R, Oli MK, Hostetler JA, Karmacharya B, Greene D, Winchester C, Gore J, Sneckenberger S, Castleberry SB, Mengak MT. Are declines of an endangered mammal predation‐driven, and can a captive‐breeding and release program aid their recovery? J Zool (1987) 2013. [DOI: 10.1111/jzo.12046] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. McCleery
- Department of Wildlife Ecology and Conservation University of Florida Gainesville FL USA
| | - M. K. Oli
- Department of Wildlife Ecology and Conservation University of Florida Gainesville FL USA
| | | | - B. Karmacharya
- Department of Biology University of Louisiana at Lafayette Lafayette LA USA
| | - D. Greene
- Department of Wildlife Ecology and Conservation University of Florida Gainesville FL USA
| | - C. Winchester
- Florida Fish and Wildlife Conservation Commission Panama City FL USA
| | - J. Gore
- Florida Fish and Wildlife Conservation Commission Panama City FL USA
| | - S. Sneckenberger
- South Florida Ecological Services Office United States Fish and Wildlife Service Vero Beach FL USA
| | - S. B. Castleberry
- Warnell School of Forestry and Natural Resources University of Georgia Athens GA USA
| | - M. T. Mengak
- Warnell School of Forestry and Natural Resources University of Georgia Athens GA USA
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Greene D, Naughton G, Jander C, Cullen SJ. Bone Health of Apprentice Jockeys Using Peripheral Quantitative Computed Tomography. Int J Sports Med 2013; 34:688-94. [DOI: 10.1055/s-0032-1333213] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- D. Greene
- School of Exercise Science, Australian Catholic University, Strathfield, Australia
| | - G. Naughton
- School of Exercise Science, Australian Catholic University, Strathfield, Australia
| | - C. Jander
- Australian Racing Board, Sydney, Australia
| | - S.-J. Cullen
- School of Health & Human Performance, Dublin City University, Dublin, Ireland
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Greene D, Naughton G, Moresi M, Bradshaw E. Cortical bone distribution at the tibial shaft in adolescent female athletes. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.551] [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: 11/16/2022]
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de la Rosette J, Ahmed H, Barentsz J, Johansen TB, Brausi M, Emberton M, Frauscher F, Greene D, Harisinghani M, Haustermans K, Heidenreich A, Kovacs G, Mason M, Montironi R, Mouraviev V, de Reijke T, Taneja S, Thuroff S, Tombal B, Trachtenberg J, Wijkstra H, Polascik T. Focal therapy in prostate cancer-report from a consensus panel. J Endourol 2010; 24:775-80. [PMID: 20477543 DOI: 10.1089/end.2009.0596] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To establish a consensus in relation to case selection, conduct of therapy, and outcomes that are associated with focal therapy for men with localized prostate cancer. MATERIAL AND METHODS Urologic surgeons, radiation oncologists, radiologists, and histopathologists from North America and Europe participated in a consensus workshop on focal therapy for prostate cancer. The consensus process was face to face within a structured meeting, in which pertinent clinical issues were raised, discussed, and agreement sought. Where no agreement was possible, this was acknowledged, and the nature of the disagreement noted. RESULTS Candidates for focal treatment should have unilateral low- to intermediate-risk disease with clinical stage <or=cT(2a). Prostate size and both tumor volume and tumor topography are important case selection criteria that depend on the ablative technology used. Currently, the best method to ascertain the key characteristics for men who are considering focal therapy is exposure to transperineal template mapping biopsies. MRI of the prostate using novel techniques such as dynamic contrast enhancement and diffusion weighed imaging are increasingly being used to diagnose and stage primary prostate cancer with excellent results. For general use, however, these new techniques require validation in prospective clinical trials. Until such are performed, MRI will, in most centers, continue to be an investigative tool in assessing eligibility of patients for focal therapy. CONCLUSIONS Consensus was derived for most of the key aspects of case selection, conduct of treatment, and outcome measures for men who are undergoing focal therapy for localized prostate cancer. The level of agreement achieved will pave the way for future collaborative trials.
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Affiliation(s)
- J de la Rosette
- Department of Urology, AMC University Hospital, Amsterdam, The Netherlands.
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Burf L, Ducher G, Naughton G, Greene D. Upper body bone and muscle profiles in non-elite prepubertal female gymnasts. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2009.10.041] [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]
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Greene D, Naughton G, Bradshaw E, Moresi M. Musculoskeletal profile of elite adolescent female athletes in weight-loaded and weight-supported sports. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2009.10.026] [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]
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Crendal E, Naughton G, Climstein M, Greene D, McDonald I. Relationships between bone parameters and physical health measures in independent-living Veterans. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2009.10.299] [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: 11/27/2022]
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Moran J, Bowyer S, Manoharan A, Mason K, Tepley N, Smith B, Barkley G, Greene D, Morrell M. MEG coherence imaging compared to electrocortical recordings from NeuroPace implants to determine the location of ictal onset in epilepsy patients. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.ics.2007.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hong DS, Galsky M, Chiorean E, Mulkerian D, Greene D, Nathan FE, Petrone M, Camacho LH. Phase I study of the effects of renal impairment on the pharmacokinetic (PK) and safety of satraplatin in patients (Pts) with refractory non-hematologic cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2044] [Citation(s) in RCA: 1] [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
2044 Background: Satraplatin (S) is a novel oral platinum analog with demonstrated activity in the treatment of pts with platinum-sensitive malignancies. A worldwide, double-blind, placebo-controlled randomized trial evaluating S as 2nd line therapy for hormone refractory prostate cancer (HRPC) has recently completed enrollment. The current study wasis designed to understand the effect of varying degrees of renal impairiment on the safety and PK of satraplatin. Methods: The study includes 4 levels of renal dysfunction, and 8 pts/cohort: Group 1 (G1) = Normal Renal Controls; G2 = Mild renal impairment (CrCl 50–80 mL/min); G3 = Mod. impairment (CrCl 30-<50 ml/min); G4 = Severe impairment (CrCl <30 mL/min). S was administered orally at 80mg/m2/d on d1–5 every 35 days. Results: 21 pts (of a planned total of 32) have been enrolled (13M/8F), median age 63 (range 45–72). Tumor types: Bladder (6), Renal (3), Breast (2), Prostate (2), Colon (2), Other (6). Among 15 evaluable pts, the cohort distribution is G1: 6 pts, G2: 4, G3: 4, and G4: 1. Twenty-six cycles of S have been delivered, and 11 pts have completed at least 2 cycles of therapy. Hematologic toxicities during the first 2 cycles include grade (G) 3/4 neutropenia (0 pts), G 3/4 thrombocytopenia (1), and G 3/4 anemia (1). No significant cardiac, renal, hepatic, or neurologic toxicity has been observed. Nausea, vomiting, and diarrhea were mild to moderate, and controlled with oral therapy. Of 4 pts with evaluable disease, 1 has stable disease, and 3 have progressed. Conclusions: S is well tolerated in pts with varying degrees of renal dysfunction. Updated safety and PK data will be presented at the meeting. [Table: see text]
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Affiliation(s)
- D. S. Hong
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - M. Galsky
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - E. Chiorean
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - D. Mulkerian
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - D. Greene
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - F. E. Nathan
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - M. Petrone
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
| | - L. H. Camacho
- M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Indiana University, Indianapolis, IN; University of Wisconsin, Madison, WI; GPC Biotech, Princeton, NJ
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George BJ, Ricart AD, Calvo E, Chu Q, Sarantopoulos J, Greene D, Nathan FE, Petrone ME, Tolcher AW, Papadopoulos KP. Phase I pharmacokinetic(PK)/food effect and safety study of satraplatin in patients (pts) with advanced solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.12014] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12014 Background: Satraplatin (S) is a novel oral platinum analog that has demonstrated preliminary activity in hormone refractory prostate cancer (HRPC). A large (950 pts) worldwide, randomized phase III trial evaluating S as 2nd line therapy for HRPC recently completed enrollment. The current study was designed to determine the PKs of S under fasted and fed conditions, as well as treatment efficacy and toxicity. Methods: S was administered orally at 80 mg/m2/day (d) on d1–5 q 35 days, with prophylactic antiemetics. For the 1st cycle, pts were randomized to receive d1 and d5 doses of S in either the fed or fasted state when PK sampling was performed. The fed/fasted state was reversed for the 2nd cycle. Subsequent doses of S were given in the fasted state. Results: 17 pts were enrolled (9M/8F), median age 62 (range 33–78) and tumor types: HRPC (7), breast (3), 1 each with anal, parotid, leiomyosarcoma, Merkel cell, ovarian, mesothelioma, and neuroendocrine tumor. The median no. of prior regimens was 3 (range 1–8). A total of 58 cycles of S were given. Grade 3–4 hematologic toxicities (1st 2 cycles) included: neutropenia (11%), thrombocytopenia (24%) and anemia (24%). The hematologic nadir occurred during week 4. There was no grade 3–4 nausea, vomiting or diarrhea. No significant cardiac, renal, hepatic, or neurologic toxicity was observed. The peak plasma concentration (Cmax) for platinum in plasma ultrafiltrate (PUF) was decreased by 20% when S was administered following a high fat meal compared to the fasting condition. There was no effect of food on AUC0–24 hr. The time of Cmax (Tmax) was delayed in the fed state. Table shows PK parameters. One PR (HRPC) and 4 SD ≥ 5 months (breast, ovarian, parotid and HRPC) were confirmed. Conclusions: There is an effect of food on the Cmax, however the clinical implications are unknown at this time. For this reason, it is recommended that S be administered to pts in the fasting state. At the dose of 80 mg/m2/day, S was well tolerated in this group of heavily pretreated patients. [Table: see text] [Table: see text]
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Affiliation(s)
- B. J. George
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - A. D. Ricart
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - E. Calvo
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - Q. Chu
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - J. Sarantopoulos
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - D. Greene
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - F. E. Nathan
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - M. E. Petrone
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - A. W. Tolcher
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - K. P. Papadopoulos
- Brooke Army Medical Center, Fort Sam Houston, TX; Institute for Drug Development/CTRC, San Antonio, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
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Setlik RF, Preston G, Jones CB, Sarantopoulos J, Dufresne T, Petrone ME, Nathan FE, Greene D, Anthony T, Takemoto C. Phase I study of the effects of hepatic impairment on the pharmacokinetic (PK) and safety of satraplatin in patients with refractory non-hematologic cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2045] [Citation(s) in RCA: 1] [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
2045 Background: Satraplatin (S) is a third-generation oral platinum analog that has demonstrated activity in the treatment of patients with platinum-sensitive malignancies. A worldwide double-blind, placebo controlled randomized phase III trial evaluating S as 2nd line therapy for HRPC has recently completed enrollment. The current study was designed to determine the effect of hepatic impairment on S pharmacokinetics in patients with refractory cancer, as well as treatment efficacy and toxicity. Methods: S was administered orally at a dose of 80mg/m2/day (d) on d1–5 every 35 days. Study groups (cohorts) were defined at 4 levels of hepatic impairment - Group 1 (G1) = control; G2 = Child-Pugh Class A; G3 = Child-Pugh Class B; and Group 4 = Child-Pugh Class C. Results: 19 pts have been enrolled to date (11 M/ 8 F); median age is 57 (range 44–80). Pts with prostate (2), pancreas (4), colorectal (3), adenocystic (2), and 1 each neuroendocrine, hepatocellular, melanoma, breast, ovarian, SCLC, and anal cancers were enrolled. 8 pts were in G1, 3 pts in G2, 4 pts in G3, and 5 pts in G4. Accrual is ongoing in this study with a total of 8 pts planned for each group. The median number of prior regimens was 5 (range 2–8). A total of 35 cycles of S have been given: median 2/pt (range 1–4). 9 pts have completed 2 cycles of S. Hematologic toxicities during the first 2 cycles included grade (G) 3/4 thrombocytopenia in 15 %. There were no cases of G 3/4 neutropenia or anemia. One case of G3 hypokalemia, was reported. Two patients developed acute renal failure; one of which was due to uncontrolled nausea (N) and vomiting (V) and the other was associated with rapid disease progression in the liver. Both were G4 patients. Otherwise, N, V, and diarrhea were mild to moderate, and controlled with oral therapy. Conclusions: S is, in general, well tolerated in patients with mild or moderate liver impairment. Severe thrombocytopenia is the most common side-effect. Of the patients enrolled to date 15% did not have progression of disease. PK data will also be presented. [Table: see text]
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Affiliation(s)
- R. F. Setlik
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - G. Preston
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - C. B. Jones
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - J. Sarantopoulos
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - T. Dufresne
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - M. E. Petrone
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - F. E. Nathan
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - D. Greene
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - T. Anthony
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
| | - C. Takemoto
- Brooke Army Medical Center, Fort Sam Houston, TX; Cancer Therapy & Research Center, San Antonio, TX; GPC Biotech, Princeton, NJ
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Chaudhary M, Sheikh N, Asterling S, Ahmad I, Greene D. Peyronie's disease with erectile dysfunction: penile modeling over inflatable penile prostheses. Urology 2005; 65:760-4. [PMID: 15833523 DOI: 10.1016/j.urology.2004.10.039] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2004] [Revised: 09/27/2004] [Accepted: 10/20/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate, retrospectively, the impact of penile correction by modeling of the penis over an inflatable penile prosthesis and the subsequent improvement in erectile function. Advanced Peyronie's disease with severe penile curvature and poor quality erections presents a challenge to the urologist. METHODS In our series, 46 patients with advanced Peyronie's disease and associated erectile dysfunction underwent insertion of an inflatable penile prosthesis between 1998 and 2003. Of the 46 patients, 28 (61%) underwent a standard modeling procedure; the other 18 patients (39%) did not need additional modeling, because their curvature was corrected by inflation of the prosthesis alone. Patients were evaluated postoperatively in the clinic, as well as by a postal questionnaire. RESULTS Of the 46 patients, 44 were satisfied with the penile correction and 2 (4.4%) underwent removal of their prosthesis because of infection. These 2 patients underwent revision surgery; subsequently both prostheses had to be removed, one for severe pain and the other for urethral erosion. None of the patients underwent reoperation for additional straightening. Of the 44 patients with intact prostheses, erectile function significantly improved in 41 (93%). CONCLUSIONS The results of our study have indicated that patients with severe Peyronie's disease and erectile dysfunction should be offered the choice of penile modeling over an inflatable penile implant to correct the curvature, as well as improve erectile function.
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Affiliation(s)
- M Chaudhary
- Department of Urology, Sunderland Royal Hospital, Sunderland, United Kingdom.
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Greene D, Naughton G, Briody J, Kemp A, Woodhead H. 29 Assessment of bone strength at differentially-loaded skeletal regions in adolescent middle-distance runners. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30524-8] [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: 10/19/2022]
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Moffett SP, Zmuda JM, Oakley JI, Beck TJ, Cauley JA, Stone KL, Lui LY, Ensrud KE, Hillier TA, Hochberg MC, Morin P, Peltz G, Greene D, Cummings SR. Tumor necrosis factor-alpha polymorphism, bone strength phenotypes, and the risk of fracture in older women. J Clin Endocrinol Metab 2005; 90:3491-7. [PMID: 15797957 DOI: 10.1210/jc.2004-2235] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
TNFalpha is a proinflammatory cytokine that promotes osteoclastic bone resorption. We evaluated the association between a G-308A polymorphism (rs1800629) at the TNFA locus and osteoporosis phenotypes in 4306 older women participating in the Study of Osteoporotic Fractures. Femoral neck bone mineral density (BMD) and structural geometry were measured using dual-energy x-ray absorptiometry and hip structural analysis. Incident fractures were confirmed by physician adjudication of radiology reports. Despite similar femoral neck BMD, women with the A/A genotype had greater subperiosteal width (P = 0.01) and endocortical diameter (P = 0.03) than those with the G/G genotype. The net result of these structural differences was that there was a greater distribution of bone mass away from the neutral axis of the femoral neck in women with the A/A genotype, resulting in greater indices of bone bending strength (cross-sectional moment of inertia: P = 0.004; section modulus: P = 0.003). Among 376 incident hip fractures during 12.1 yr of follow-up, a 22% decrease in the risk of hip fracture was seen per copy of the A allele (relative risk 0.78; 95% confidence interval 0.63, 0.96), which was not influenced by adjustments for potential confounding factors, BMD, or bone strength indices. The G-308A polymorphism was not associated with a reduced risk of other fractures. These results suggest a potential role of genetic variation in TNFalpha in the etiology of osteoporosis.
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Affiliation(s)
- S P Moffett
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261, USA.
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Lian K, Zmuda JM, Nevitt MC, Lui L, Hochberg MC, Greene D, Li J, Wang J, Lane NE. Type I collagen α1 Sp1 transcription factor binding site polymorphism is associated with reduced risk of hip osteoarthritis defined by severe joint space narrowing in elderly women. ACTA ACUST UNITED AC 2005; 52:1431-6. [PMID: 15880349 DOI: 10.1002/art.21011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A common G/T substitution at an Sp1 binding site in intron 1 of the COL1A1 gene has been reported to be associated with reduced bone mineral density and increased risk of osteoporotic fracture. The purpose of this study was to examine whether there is an association between COL1A1 Sp1 polymorphism and radiographic osteoarthritis (OA) of the hip in elderly women in the Study of Osteoporotic Fractures. METHODS Radiographic hip OA status of subjects was defined by the presence of 1 of the following criteria in either hip: a joint space narrowing (JSN) score of >/=3, a Croft summary grade of >/=3, or both definite (score >/=2) osteophytes and JSN in the same hip. Cases of radiographic OA of the hip were further subdivided into those with JSN score >/=3 and those with a femoral osteophyte score >/=2 and JSN score </=2. The COL1A1 Sp1 polymorphism was genotyped using allele-specific kinetic polymerase chain reaction in 4,746 women. Multivariate logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS Radiographic OA of the hip was present in 571 women (12%). Of these patients, 325 (57%) had severe JSN (score >/=3), and 131 (23%) had moderate or moderate-to-severe femoral osteophytosis (score >/=2). There was no association of the T/T genotype with either radiographic hip OA or radiographic hip OA characterized by osteophytosis. For radiographic OA of the hip characterized by moderate-to-severe JSN, the odds of disease were significantly reduced among subjects with the T/T compared with the G/G genotype (OR 0.30, 95% CI 0.11-0.81, P = 0.02) and did not change after adjustment for potential confounders (OR 0.36, 95% CI 0.13-0.99, P = 0.048). CONCLUSION The T/T genotype of the COL1A1 Sp1 polymorphism was associated with a reduced risk of radiographic OA of the hip characterized by JSN. This association should be confirmed in other populations to determine if mechanistic studies are warranted.
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Affiliation(s)
- K Lian
- University of California at San Francisco, USA
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Nabi G, Greene D, O'Donnell MO, Donnel MO. Suspicious urinary cytology with negative evaluation for malignancy in the diagnostic investigation of haematuria: how to follow up? J Clin Pathol 2004; 57:365-8. [PMID: 15047737 PMCID: PMC1770277 DOI: 10.1136/jcp.2003.009696] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [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: 11/04/2022]
Abstract
AIMS To define the natural history of patients with suspicious urinary cytology and negative initial evaluation for malignancy in the investigation of haematuria. PATIENTS AND METHODS Data from the hospital information support system on urinary cytology examinations carried out at one centre were audited over a period of 24 months. There were 102 patients who had suspicious urinary cytology for malignant cells with negative initial evaluation. Follow up investigations, treatment, and final outcome were noted. RESULTS There were 102 patients with suspicious urinary cytology and negative initial evaluation for malignancy in 24 months, with a mean follow up of 15.7 months. Seventy patients had no obvious pathology on initial investigations. Forty one patients were found to have urological malignancies (29 bladder, eight ureteric, and four prostate) on follow up. All patients diagnosed as having urothelial malignancies on follow up had either persistent suspicious cytology (29) or recurrent haematuria (eight). The mean duration for appearance of lesions was 5.6 months (range, 3-12 months). Three patients had suspicious digital rectal examination and biopsies confirmed adenocarcinoma of the prostate. One patient had urinary retention and transurethral resection of prostate showed prostatic adenocarcinoma. The presence of suspicious cells on repeat urine analysis was the only significant factor in predicting the presence of urothelial tumours (p = 0.002). CONCLUSION Patients with persistent suspicious/positive cytology or recurrent haematuria need further evaluation and follow up. Asymptomatic patients or patients with obvious benign pathology do not require repeat evaluation. Careful urological evaluation, including prostate, should be carried out in these patients.
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Affiliation(s)
- G Nabi
- Academic Urology Unit, Department of Surgery, University of Aberdeen, Aberdeen AB25 2ZD, UK.
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Greene D. Handbook of TRUS and Biopsy of the Prostate. Prostate Cancer Prostatic Dis 2003. [DOI: 10.1038/sj.pcan.4500677] [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: 11/09/2022]
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Nabi G, Greene D, Marsh R, Viljoen A. A rare co-existence of focal xanthogranulomatous pyelonepheritis, angiomyolipoma and renal cysts simulating renal cell carcinoma. Int Urol Nephrol 2003; 34:465-6. [PMID: 14577486 DOI: 10.1023/a:1025658716927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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]
Abstract
A 70-year-old male presented with left flank pain and history of gross, total painless haematuria of 6 months duration. Investigations revealed a large solid and cystic mass suggestive of renal cell carcinoma in left kidney with possible infiltration of left psoas muscle. Histology of radical nephrectomy showed angiomyolipoma with multiple cysts lined by columnar epithelium suggestive of tuberous sclerosis and focal area of xanthogranulomatous pyelonepheritis. The rare combination of such lesions leading to diagnostic dilemma has not been reported in medical literature to the best of our knowledge.
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Affiliation(s)
- G Nabi
- Department of Urology, Royal Sunderland City Hospital, Sunderland, UK.
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Nabi G, Sheikh N, Greene D, Marsh R. Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies: preliminary experience and long-term follow-up. BJU Int 2003; 92:245-7. [PMID: 12887476 DOI: 10.1046/j.1464-410x.2003.04328.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [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: 11/20/2022]
Abstract
OBJECTIVE To evaluate the feasibility, efficacy and complications of internal iliac artery embolization as a palliative measure in the control of intractable haemorrhage from advanced pelvic urological malignancies. PATIENTS AND METHODS Six patients (mean age 80 years, range 76-87) with advanced pelvic malignancies (three each with bladder carcinoma and prostate carcinoma) underwent embolization between September 1997 and July 2001, using permanent coils in the anterior division of internal iliac artery bilaterally. RESULTS All patients had undergone conservative treatment before embolization for a mean of 2 days. The mean requirement for transfusion before embolization was 3.2 units. All patients except one were successfully embolized in a single setting with no complications. Bleeding was successfully controlled in one patient at the second attempt of embolization. There were minor complications, e.g. nausea, vomiting or fever, for a mean of 2 days, responding well to conservative treatment. At a mean follow-up of 22 months, no patient had a recurrence of bleeding. CONCLUSION Internal iliac artery embolization is a feasible, effective and minimally invasive option in managing advanced pelvic urological malignancies presenting with intractable bleeding; it should be bilateral and permanent.
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Affiliation(s)
- G Nabi
- Departments of Urology and Radiology, City Hospital Sunderland, Sunderland, UK.
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Affiliation(s)
- D S Inman
- Sunderland Royal Hospital, Sunderland, UK.
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Lillicrap SC, Burns JE, Greene D, Williams PC. Revised Code of Practice for the dosimetry of 2 to 35 MV x-ray, and of caesium-137 and cobalt-60 gamma-ray beams. Phys Med Biol 2002. [DOI: 10.1088/0031-9155/28/12/514] [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: 11/12/2022]
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Greene D, Egbert BM, Utley DS, Koch RJ. In vivo model of histologic changes after treatment with the superpulsed CO(2) laser, erbium:YAG laser, and blended lasers: a 4- to 6-month prospective histologic and clinical study. Lasers Surg Med 2001; 27:362-72. [PMID: 11074514 DOI: 10.1002/1096-9101(2000)27:4<362::aid-lsm10>3.0.co;2-h] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [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: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare the in vivo histologic effects of the pulsed carbon dioxide (CO(2)) and erbium:ytrium aluminum garnet (Er:YAG) lasers and to assess the effects of combining CO(2) and Er:YAG laser modalities during a single treatment session. We previously reported 10 patients treated with four laser regimens: CO(2) alone, CO(2)/Er:YAG, Er:YAG alone, Er:YAG/CO(2) with time points at 1 hour and 7 days between laser treatment and histologic analysis. This study found that the optimal treatment consisted of limited CO(2) laser passes followed by Er:YAG. This treatment produced less collagen injury, less thermal necrosis, and more robust epithelial and dermal fibrous tissue regeneration in the acute phase of healing. The present study examines the histologic changes resulting from the host healing response to laser treatment on long-term follow-up of 4-6 months. STUDY DESIGN/MATERIALS AND METHODS The Stanford University Committee on Human Subjects in Medical Research approved this study. Nine patients with actinic damage and indications for rhytidectomy volunteered for this interventional study in which each patient served as both experimental and control. The right preauricular area was treated at five sites with the following: (1) CO(2), (2) CO(2) followed by Er:YAG, (3) Er:YAG, (4) blended CO(2)/Er:YAG (Derma-Ktrade mark), (5) phenol. Each was subjected to full-face or sub-unit treatment. Each patient was followed up initially daily then weekly for healing of the full-face laser and for differences in healing of the five treatment areas. Five patients were selected for histologic evaluation. At 4-6 months, these patients underwent rhytidectomy with immediate removal of laser-treated skin, which was evaluated histologically by the study dermatopathologist, who was blinded to the treatment at each site. RESULTS CO(2) laser treatment produced the greatest thickness of neocollagen (0.27 mm; P < 0.05), the highest neocollagen density (P < 0.05), the greatest decrease in elastosis (27%), but took the longest time for healing and resolution of erythema and inflammation (up to 6 months). Er:YAG used alone produced the least collagen density, with the thinnest band of neocollagen (0.08 mm), but the most rapid resolution of erythema and inflammation (within 10 days). Combined CO(2)/Er:YAG treatments, including Derma-Ktrade mark and CO(2) followed by Er:YAG produced histologic changes that were intermediate, as well as recovery that was intermediate (resolution of erythema within 1 month); the development of neocollagen was greater in CO(2)-containing modalities than Er:YAG used alone by a statistically significant margin (P = 0.001). These histologic findings were corroborated by clinical correlation by examination of the five treatment spots in nine patients and in full-face treatments in 100 patients. CONCLUSION Collagenesis is greatest with CO(2) and least with Er:YAG. Elastosis decreased to the greatest degree with CO(2), least with erbium, and to an intermediate extent with blended CO(2)/Er:YAG regimens (sequential and Derma-K). These changes from control are statistically significant with all regimens (P < 0.05). Blended CO(2)/Er:YAG treatments provide an optimal combination of the benefits of CO(2) but with lesser erythema and healing delay. Clinical and histologic findings change over time for different treatments. Thus, long-term histology is critical for predicting results of treatment.
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Affiliation(s)
- D Greene
- Division of Otolaryngology / Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California 94305, USA.
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Abstract
The purpose of this study was to assess the impact of using a dual-test blood glucose/fructosamine home monitoring system to assist individuals identified as having the potential for poor glycemic control to achieve values closer to normal. Forty-eight subjects found to have a fasting blood glucose value of > or = 126 mg/dL, casual blood glucose value of > or = 140 mg/dL, and/or blood fructosamine value of > or = 310 micromol/L, agreed to perform daily self testing for 90 days and were provided a dual-test blood glucose/fructosamine home monitoring system and testing supplies at no charge to them. Medication changes/compliance along with dietary and exercise habits were compared to testing results by the principle investigator at approximate 30-day intervals. The desired goal of this project was to achieve and/or maintain a fasting blood glucose value of < or = 110 mg/dL, a casual blood glucose value of < or = 140 mg/dL and a blood fructosamine value of < or = 310 micromol/L by encouraging each individual to realize the effect of dietary intake and exercise habits, and understand the importance of medication compliance, if appropriate, in achieving better overall glycemic control. Four subjects withdrew from the study prior to completion, 11 of the remaining 44 completed 60 days of testing and 33 of 44 completed 90 days of testing. Regular monitoring and counseling achieved an average reduction in blood glucose of 27.5% and a 16.6% reduction in average blood fructosamine when compared to original screening results of these 44 individuals. This study indicates that the addition of weekly fructosamine values to daily blood glucose values provides both the patient and clinician valuable information to evaluate the impact of dietary, exercise, and medication therapy changes on glycemic control by bridging the existing gap between daily blood glucose values and quarterly HbA1c confirmation of intervention results.
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Affiliation(s)
- A W Carter
- Cosentino Service Co., Kansas City, MO, USA.
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Krithivas A, Young DB, Liao G, Greene D, Hayward SD. Human herpesvirus 8 LANA interacts with proteins of the mSin3 corepressor complex and negatively regulates Epstein-Barr virus gene expression in dually infected PEL cells. J Virol 2000; 74:9637-45. [PMID: 11000236 PMCID: PMC112396 DOI: 10.1128/jvi.74.20.9637-9645.2000] [Citation(s) in RCA: 160] [Impact Index Per Article: 6.7] [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] [Indexed: 11/20/2022] Open
Abstract
The human herpesvirus 8 (HHV-8) latency-associated nuclear antigen (LANA) is expressed in all latently HHV-8 infected cells and in HHV-8-associated tumors, including primary effusion lymphoma (PEL). To better understand the contribution of LANA to tumorigenesis and to the PEL phenotype, we performed a yeast two-hybrid screen which identified the corepressor protein SAP30 as a LANA binding protein. SAP30 is a constituent of a large multicomponent complex that brings histone deacetylases to the promoter. Glutathione S-transferase affinity assays confirmed interaction between LANA and SAP30 and also demonstrated interactions between LANA and two other members of the corepressor complex, mSin3A and CIR. The corepressors bound to the amino-terminal 340-amino-acid domain of LANA. In transient expression assays, this same domain of LANA mediated repression when targeted to a 5xGal4tk-CAT reporter as a GAL4-LANA fusion. PEL cells have the unusual feature that they are frequently dually infected with both HHV-8 and Epstein-Barr virus (EBV). We found that EBV EBNA-1 expression is downregulated in PEL cells at both the RNA and protein levels. In transient expression assays, LANA repressed activated expression from the EBV Qp and Cp latency promoters. Reduction of endogenous Qp activity could also be demonstrated in EBV-infected Rael cells transfected with a LANA expression plasmid. In contrast to the effect of LANA on EBV latency promoters, LANA activated expression from its own promoter. The data indicate that LANA can mediate transcriptional repression through recruitment of an mSin3 corepressor complex and further that LANA-mediated repression is likely to contribute to the low level of EBV latency gene expression seen in dually infected PEL cells.
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Affiliation(s)
- A Krithivas
- Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21231, USA
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Greene D. Metabolic vs. Vascular Abnormalities In Diabetic Neuropathy. J Peripher Nerv Syst 2000. [DOI: 10.1046/j.1529-8027.2000abstracts-13.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: 11/20/2022]
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Pop‐Busui R, Sullivan K, Russel J, Feldman E, Stockert C, Larkin D, Greene D, Stevens M. Taurine Replacement Prevents Apoptosis In Experimental Diabetic Neuropathy. J Peripher Nerv Syst 2000. [DOI: 10.1046/j.1529-8027.2000abstracts-37.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - K Sullivan
- University of Michigan, Ann Arbor, MI USA
| | - J Russel
- University of Michigan, Ann Arbor, MI USA
| | - E Feldman
- University of Michigan, Ann Arbor, MI USA
| | - C Stockert
- University of Michigan, Ann Arbor, MI USA
| | - D Larkin
- University of Michigan, Ann Arbor, MI USA
| | - D Greene
- University of Michigan, Ann Arbor, MI USA
| | - M. Stevens
- University of Michigan, Ann Arbor, MI USA
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Harati Y, Gooch C, Swenson M, Edelman SV, Greene D, Raskin P, Donofrio P, Cornblath D, Olson WH, Kamin M. Maintenance of the long-term effectiveness of tramadol in treatment of the pain of diabetic neuropathy. J Diabetes Complications 2000; 14:65-70. [PMID: 10959067 DOI: 10.1016/s1056-8727(00)00060-x] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.6] [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] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the efficacy and safety of tramadol in a 6-month open extension following a 6-week double-blind randomized trial. RESEARCH DESIGN AND METHODS Patients with painful diabetic neuropathy who completed the double-blind study were eligible for enrollment in an open extension of up to 6 months. All patients received tramadol 50-400 mg/day. Self-administered pain intensity scores (scale 0-4; none to extreme pain) and pain relief scores (scale -1-4; worse to complete relief) were recorded the first day of the open extension (last day of the double-blind phase) and at 30, 90, and 180 days. RESULTS A total of 117 patients (56 former tramadol and 61 former placebo) entered the study. On the first day of the study, patients formerly treated with placebo had a significantly higher mean pain intensity score (2. 2+/-1.02 vs. 1.4+/-0.93, P<0.001) and a lower pain relief score (0. 9+/-1.43 vs. 2.2+/-1.27, P<0.001) than former tramadol patients. By Day 90, both groups had mean pain intensity scores of 1.4, which were maintained throughout the study. Mean pain relief scores (2. 4+/-1.09 vs. 2.2+/-1.14) were similar after 30 days in the former placebo and former tramadol groups, respectively and were maintained for the duration of the study. Four patients discontinued therapy due to ineffective pain relief; 13 patients discontinued due to adverse events. The most common adverse events were constipation, nausea, and headache. CONCLUSIONS Tramadol provides long-term relief of the pain of diabetic neuropathy.
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Affiliation(s)
- Y Harati
- Baylor College of Medicine and Veterans Affairs Medical Center, Houston, TX 77030, USA.
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Affiliation(s)
- E T Cheng
- Division of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California 94305-5328, USA
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Abstract
The objective of this study was to assess the efficacy of a dual test blood glucose/fructosamine home monitoring system to screen individuals in the workplace for poor glycemic control. Screening values qualifying individuals for 90 days of additional monitoring were as follows: fasting blood glucose > or =126 mg/dL, casual blood glucose > or =140 mg/dL, and/or fructosamine <310 micromol/L. Subjects with positive values were provided access to classroom instruction by a Certified Diabetes Educator. The population consisted of 100 males and 177 females, ages 22-71 years, mean 49.7 years, with 12 males and 22 females reporting diabetes. Their ethnic backgrounds were 17.7% African American, 0.4% Asian, 1.8% Hispanic, 0.4% mixed, and 79.8% Caucasian reflecting the general United States population. A total of 26 males and 27 females had results indicating poor glycemic control. Of the known individuals with diabetes, seven of 12 males and 15 of 22 females had positive results. More males than females were unaware of their potential for diabetes but of those previously diagnosed with diabetes more females than males had poor glycemic control. A total of 31 subjects tested positive for blood glucose, 39 tested positive for fructosamine, indicating a 15.1% (p < 0.005) improvement in detection chances with fructosamine. Cost per subject including equipment, supplies, and labor was $18.13. Study results indicate that the addition of a fructosamine test improves screening accuracy for large groups of people while retaining ease of use and affordability.
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Affiliation(s)
- A W Carter
- Oak Valley Price Chopper, Shawnee, Kansas 66226, USA.
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Abstract
Family dynamics, parental-fetal attachment and infant temperament The purpose of this longitudinal study of families having their first or second baby was to explore relationships among family dynamics, paternal- and maternal-fetal attachment, and infant temperament. Data were collected from 156 women and 62 of their partners during the third trimester of pregnancy. One year later, when the infant was 8-9 months old, 75 of the women and 30 of their partners participated. In a hierarchical multiple regression analysis, after controlling for demographic variables, mutuality in the family was associated with greater maternal- and paternal-fetal attachment. Family dynamics were stable across the transition to parenthood except for an increase in role conflict reported by mothers. Sensitivity to specific family experiences by clinicians can provide assistance to families during these periods.
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Affiliation(s)
- M E Wilson
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska 68198-5330, USA
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Northridge ME, Vallone D, Merzel C, Greene D, Shepard P, Cohall AT, Healton CG. The adolescent years: an academic-community partnership in Harlem comes of age. J Public Health Manag Pract 2000; 6:53-60. [PMID: 10724693 DOI: 10.1097/00124784-200006010-00009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/26/2022]
Abstract
Much has been written about the potential benefits in health promotion that are possible through partnerships between academic institutions and community-based organizations, but little practical advice has been provided on how to sustain these relationships when the original grant funds have been exhausted. Here we document our experiences in Harlem, New York City, a community with grave social, structural, and physical environmental inequities, and describe the successes and failings of a partnership now in its "adolescence" between researchers at the Joseph L. Mailman School of Public Health of Columbia University and community activists at West Harlem Environmental Action (WE ACT).
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Greene D, Koch RJ, Goode RL. Efficacy of octyl-2-cyanoacrylate tissue glue in blepharoplasty. A prospective controlled study of wound-healing characteristics. Arch Facial Plast Surg 1999; 1:292-6. [PMID: 10937118 DOI: 10.1001/archfaci.1.4.292] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To compare the surgical efficacy and wound-healing characteristics of the tissue adhesive octyl-2-cyanoacrylate (approved by the Food and Drug Administration) with traditional suture closure in upper blepharoplasty. METHODS Prospective, randomized, blinded study comparing cosmetic and functional outcome and time efficiency. Twenty subjects underwent upper eyelid blepharoplasty. Each patient had a control side and an experimental side determined randomly. One eyelid incision was closed with octyl-2-cyanoacrylate (Dermabond; Ethicon Inc, Somerville, NJ) tissue glue, and the other with 6.0 suture (polypropylene or fast-absorbing gut). Comparisons were performed for the time for closure by each method, wound healing, and patient satisfaction. Macrophotographs of the wounds at 1, 2, and 4 weeks after surgery were graded by 5 observers blinded to the closure method, using a 10-point scale and a modified Hollander wound evaluation scale. RESULTS No statistically significant difference was found between the quality of octyl-2-cyanoacrylate closure and suture closure at 1 month. There were no differences in wound complications, duration of healing, inflammation, or final incision appearance. By 2 weeks, the sides were indistinguishable in 15 (75%) of the patients. Time for closure averaged 7 minutes with suture and 8 minutes with glue. CONCLUSIONS Octyl-2-cyanoacrylate glue is an excellent alternative to suture closure, producing equivalent quality of closure at all time points and no difference in appearance. This adhesive was sufficient to withstand the forces of closure in upper eyelid blepharoplasty without dehiscence in the absence of sutures.
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Affiliation(s)
- D Greene
- Division of Otolaryngology-Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, Stanford University Medical Center, Calif., USA.
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Abstract
BACKGROUND Etiology of trauma in the female population differs from that of the male population. To date, domestic violence has been researched extensively, but little has been published about the epidemiology of facial injury in the female population. OBJECTIVES To analyze the differences in the circumstances under which males and females are injured, to identify gender-specific patterns of injury, and to assess whether differences in the demographics, health status, and drug-use profile exist between female and male assault cases and whether these factors lead to a difference in outcome. METHODS A cohort of 91 female assault cases was compared with a control group of 706 males with similar injuries resulting from blunt assault trauma. Information was gathered by retrospective review of 797 consecutive cases requiring admission for facial injuries resulting from blunt assault trauma. Fisher exact, chi 2, and t tests were used to assess statistically significant differences between the male and female cohorts. RESULTS The female cohort comprised 12% of all cases admitted for blunt assault facial trauma. One third of female blunt assault facial trauma patients were subjects of domestic violence. Statistically significant differences were found between males and females for the type of assault (rape, domestic violence, altercation, etc) with P < .0001. Females were more likely to be admitted with soft tissue injury only but no fracture (P < .05), less likely to be assaulted with a weapon, and unlikely to be involved in an altercation, gang violence, arrest, or robbery. Females were also less likely than males to be injured while intoxicated (P < .05). Incidence of specific injury patterns and outcomes, however, were similar between the 2 groups. CONCLUSION The present data support the hypothesis that the female blunt assault facial trauma population represents a distinct epidemiological entity, with significant differences in the circumstances of injury, mechanism of assault, and role of intoxication in the incidence of injury. The prevalence of facial trauma in female assault cases makes it critical for the facial plastic surgeon to be vigilant in the evaluation and treatment of these patients.
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Affiliation(s)
- D Greene
- Department of Otolaryngology, Cleveland Clinic Florida, Fort Lauderdale, USA.
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Greene D, Egbert BM, Utley DS, Koch RJ. The validity of ex vivo laser skin treatment for histological analysis. A prospective controlled study. Arch Facial Plast Surg 1999; 1:159-64. [PMID: 10937097 DOI: 10.1001/archfaci.1.3.159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Laser treatment of skin following removal from human subjects has been the staple of laser research. However, no study has been done to assess the efficacy of ex vivo skin for predicting the behavior of laser treatments in living human tissue. OBJECTIVE To assess the validity of the ex vivo model by comparing histological characteristics of skin treated with laser prior to and following its removal in rhytidectomy. STUDY DESIGN Nonrandomized controlled intervention study in which each patient served as both experimental subject and control for different skin sites. PATIENTS Ten patients with actinic skin changes. INTERVENTIONS Patients underwent laser treatment to 4 left preauricular sites 1 hour prior to rhytidectomy as follows: carbon dioxide laser treatment alone, carbon dioxide laser treatment followed by erbium:YAG laser treatment, erbium:YAG laser treatment alone, and erbium:YAG laser treatment followed by carbon dioxide laser treatment. The skin was examined by a dermatopathologist blinded to the identity of each specimen. Untreated skin was also removed and immediately subjected to laser treatment identical to that employed in the in vivo skin. This skin was examined histologically. MAIN OUTCOME MEASURES Regularity of ablation, depth of the necrotic zone, amount of skin removed, degree of collagen injury, and degree of inflammation. RESULTS There were significant differences between the ex vivo and in vivo groups. The ex vivo specimens demonstrated more than 10 times the irregularity of ablation of the in vivo specimens (irregularity index of 3.0 for the ex vivo group vs 0.25 for the in vivo specimens; P < .05). The incidence of collagen injury was slightly lower for the ex vivo group (1.0 vs 1.3), as was the degree of inflammation (1.4 vs 1.5). The greatest differences were the significantly smaller necrotic zone in the ex vivo specimens (51 vs 71 microns) and the smaller amount of skin removed (118 vs 234 microns). These findings were consistent for all 4 laser treatment regimens studied. CONCLUSIONS Significant differences were found between the in vivo and ex vivo models. Irregularity of ablation in the ex vivo specimens was 10 times that in the living specimens, limiting histological accuracy in the ex vivo model. The ex vivo skin model underestimated the amount of tissue ablation. This suggests that an in vivo model should be adopted as the standard for laser research.
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Affiliation(s)
- D Greene
- Division of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Palo Alto, Calif., USA.
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