1
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Lam T, Levi E, Shen J, Wilks D, Alexander W. Radial forearm free flap reconstruction in a 3-month-old patient with undifferentiated pharyngeal sarcoma. Microsurgery 2024; 44:e31149. [PMID: 38363100 DOI: 10.1002/micr.31149] [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] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/01/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024]
Abstract
There is minimal information regarding free tissue transfers in very young infants, especially those less than a year old. It is often thought that that age remains a limit to free tissue transfers, with younger patients having smaller vessels, making the operation technically challenging. In this case report, we discuss the youngest and smallest recorded case of a free flap reconstruction. A 3-month-old patient with a malignant parapharyngeal undifferentiated round cell sarcoma underwent a resection and reconstruction with a radial forearm free flap (RFFF). The defect was 35 by 20 by 15 mm, and required a pharyngeal "patch," as opposed to a "tube," reconstruction. The defect was templated, and the RFFF then raised in a standard subfascial fashion, and inset with resorbable sutures. The patient was observed in the ICU postoperatively. The patient was subsequently diagnosed with Stage IV primary undifferentiated sarcoma with regional metastasis and received adjuvant chemotherapy. Fifteen-month follow up revealed no signs of recurrence, full oral intake, a well-reconstructed pharynx on nasoendoscopic examination, and minimal donor site morbidity. This report illustrates several unique adaptations of free flap transfer in infants and adds to the emerging body of evidence that age is not a contraindication for head and neck reconstruction.
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Affiliation(s)
- Theodore Lam
- Department of Plastics and Reconstructive Surgery, The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Eric Levi
- Department of Otolaryngology, The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Jacson Shen
- Department of Plastics and Reconstructive Surgery, The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Daniel Wilks
- Department of Plastics and Reconstructive Surgery, The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - William Alexander
- Department of Plastics and Reconstructive Surgery, The Royal Children's Hospital Melbourne, Melbourne, Australia
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2
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Baird SM, Wong D, Levi E, Robinson P. Otolaryngological burden of disease in children with primary ciliary dyskinesia in Victoria, Australia. Int J Pediatr Otorhinolaryngol 2023; 173:111722. [PMID: 37699305 DOI: 10.1016/j.ijporl.2023.111722] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES The aim of this study was to summarize the otolaryngological manifestations amongst children with primary ciliary dyskinesia (cwPCD) to improve diagnosis, investigations and management amongst otolaryngologists. METHODS A retrospective review of primary ciliary dyskinesia (PCD) diagnoses at our institution over an 8-year period between January 2014 and October 2022 was conducted. Patient characteristics, diagnosis, otolaryngological symptomatology, treatment and outcomes were recorded. RESULTS 24 patients were identified. Thirteen patients (54%) had documented conductive hearing loss on audiological evaluation; with 11 (85%) requiring hearing aids. Six patients (25%) underwent middle ear ventilation tube (MEVT) insertion with 67% experiencing post-MEVT otorrhoea. Twenty children (83%) reported chronic nasal discharge however only 3 (13%) reported nasal obstruction. Nine patients (38%) had symptoms consistent with sleep disordered breathing with 79% of them requiring operative management with adenotonsillectomy. CONCLUSION Middle ear effusion is common amongst cwPCD and should be managed with conservative measures due to the significant burden of post-MEVT otorrhoea. Sinonasal symptoms rarely need surgical intervention. Many otolaryngological symptoms of PCD are often underreported, particularly sleep-disordered breathing. Paediatric PCD patients should be managed in a multidisciplinary team with routine and tailored therapies to manage all aspects of the condition.
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Affiliation(s)
- Samantha M Baird
- Department of Otolaryngology, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
| | - Daniel Wong
- Department of Otolaryngology, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
| | - Eric Levi
- Department of Otolaryngology, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
| | - Philip Robinson
- Department of Respiratory Medicine, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
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3
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Levi E, Nisa L. Laryngeal myxedema as a cause of reversible subglottic stenosis in a newborn. Int J Pediatr Otorhinolaryngol 2022; 162:111294. [PMID: 36084478 DOI: 10.1016/j.ijporl.2022.111294] [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: 02/14/2022] [Revised: 08/01/2022] [Accepted: 08/27/2022] [Indexed: 11/29/2022]
Abstract
Myxedema is a manifestation of severe hypothyroidism, and when affecting the larynx it constitutes a rare cause of upper airway obstruction. We present a case of laryngeal myxedema in a newborn causing subglottic stenosis. The atypical aspect of the stenosis along with a thyroid goiter and a positive screening for neonatal hypothyroidism allowed the diagnosis of laryngeal myxedema. Thyroid hormone replacement and non-invasive ventilation led to quick resolution while avoiding invasive approaches. Laryngeal myxedema is possibly underdiagnosed. Physician awareness is essential to avoid pitfalls in such children with reversible airway obstruction.
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Affiliation(s)
- Eric Levi
- Department of Otolaryngology, The Royal Children's Hospital Melbourne, 3052, Parkville, Victoria, Australia
| | - Lluís Nisa
- Department of Otolaryngology, The Royal Children's Hospital Melbourne, 3052, Parkville, Victoria, Australia.
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4
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Banai A, Lupu L, Borohovitz A, Levi E, Banai S, Konigstein M. Microvascular dysfunction in patients with angina and non-obstructive coronary artery disease – preliminary data from a single center registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2095] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
About 50% of patients referred for coronary angiography because of angina and/or myocardial ischemia are found to have non-obstructive coronary artery disease (CAD). The role of microvascular dysfunction as the cause of angina or ischemia is becoming increasingly recognized.
Purpose
Our aim was to describe coronary physiology and microvascular function in patients with angina and ischemia and non-obstructive CAD (ANOCA/INOCA).
Methods
Patients with angina, referred for coronary angiography and found to have non-obstructive CAD enter a prospective registry and undergo invasive coronary physiology evaluation. Fractional flow reserve (FFR), coronary flow reserve (CFR), index of myocardial resistance (IMR) and resistive reserve ratio (RRR) are recorded. Patients with obstructive CAD (≥50% diameter stenosis and/or FFR≤0.8), acute coronary syndrome and/or hemodynamic instability are excluded. Microvascular dysfunction is considered significant if either CFR<2.5, IMR≥25 and/or RRR≤3.5.
Results
58 patients with ANOCA or INOCA were studied. Mean age was 64.8±10.4 and 65.5% were females. Hyperlipidemia, hypertension, and obesity were the most frequent cardiovascular risk factors (65.5%, 55.1% and 39%, respectively), and approximately 25% had known ischemic heart disease with a previous percutaneous coronary intervention. Microvascular dysfunction was found in 29 (52.7%) of the patients. 10 (18.2%) had CFR<2.5, 20 (34.5%), had IMR≥25, and 27 (50%) had RRR≤3.5. Among patients with IMR≥25, mean CFR and RRR were 2.1±0.5 and 2.4±6.8, respectively.
Conclusion
Microvascular dysfunction is present in approximately half of the patients with angina and/or ischemia referred for coronary angiography and found to have non-obstructive CAD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Banai
- Tel Aviv Sourasky Medical Center, Cardiology, Tel Aviv, Israel
| | - L Lupu
- Tel Aviv Sourasky Medical Center, Cardiology, Tel Aviv, Israel
| | - A Borohovitz
- Tel Aviv Sourasky Medical Center, Cardiology, Tel Aviv, Israel
| | - E Levi
- Tel Aviv Sourasky Medical Center, Cardiology, Tel Aviv, Israel
| | - S Banai
- Tel Aviv Sourasky Medical Center, Cardiology, Tel Aviv, Israel
| | - M Konigstein
- Tel Aviv Sourasky Medical Center, Cardiology, Tel Aviv, Israel
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5
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Cooper MS, Levi E, Desai M, Downey E, James S, Chong D. Making decisions about surgical intervention for drooling in children with neurodisability. Dev Med Child Neurol 2021; 63:1127-1128. [PMID: 34133026 DOI: 10.1111/dmcn.14961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Monica S Cooper
- Neurodevelopment & Disability, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Eric Levi
- Department of Otolaryngology, Head & Neck Surgery, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Mala Desai
- Department of Dentistry, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Emilie Downey
- Department of Speech Pathology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sarah James
- Department of Speech Pathology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - David Chong
- Royal Children's Hospital - Plastic and Maxillofacial Surgery, Melbourne, Victoria, Australia
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6
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Levi E, Alvo A, Anderson BJ, Mahadevan M. Postoperative admission to paediatric intensive care after tonsillectomy. SAGE Open Med 2020; 8:2050312120922027. [PMID: 32547746 PMCID: PMC7249556 DOI: 10.1177/2050312120922027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/03/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives: To review interventions required by children admitted for intensive care management following tonsillectomy or adenotonsillectomy either as elective or unplanned admission in a tertiary children’s hospital. Methods: A retrospective chart review over a 10-year period between April 2007 and March 2017 was performed. Charts were interrogated for treatments that were administered in the paediatric intensive care unit. Respiratory support therapies such as supplemental oxygen administration, high-flow nasal oxygen, positive pressure ventilation, continuous positive airway pressure, airway interventions and tracheal intubation were reviewed. Results: There were 103 children admitted to the paediatric intensive care unit following tonsillectomy or adenotonsillectomy. The average age was 6.2 years (range 7 months–17 years). The main indications for the procedure were sleep disordered breathing or obstructive sleep apnoea syndrome. In all, 53 children had syndromes with medical comorbidities, 31 were current continuous positive airway pressure users and 5 had a tracheostomy in situ. Forty children admitted to paediatric intensive care unit did not require any high-level care. Ten children who had an unplanned admission had their respiratory interventions started in the theatre or in the post-anaesthetic care unit, before paediatric intensive care unit admission, and did not require escalation of care. Conclusion: Children may not require admission for intensive care after tonsillectomy if they have had an incident-free period in the post-anaesthetic care unit. Some of those who required high-flow nasal oxygen could have been managed on the ward provided with adequate training and monitoring facilities. The level of care they require in post-anaesthetic care unit reflected the level of care for the immediate postoperative period in the paediatric intensive care unit.
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Affiliation(s)
- Eric Levi
- Department of Paediatric Otolaryngology, Starship Children's Hospital, Auckland, New Zealand
| | - Andrés Alvo
- Department of Paediatric Otolaryngology, Starship Children's Hospital, Auckland, New Zealand
| | - Brian J Anderson
- Department of Paediatric Intensive Care, Starship Children's Hospital, Auckland, New Zealand
| | - Murali Mahadevan
- Department of Paediatric Otolaryngology, Starship Children's Hospital, Auckland, New Zealand.,Department of Surgery, The University of Auckland, Auckland, New Zealand
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7
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Levi E. Managing oneself before managing others: a health advocacy core competency. ANZ J Surg 2019; 89:1494-1496. [PMID: 31679178 DOI: 10.1111/ans.15545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Eric Levi
- Department of Otolaryngology Head and Neck Surgery, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.,Head and Neck Surgery Unit, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
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8
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Wade CG, Marcuzzi M, Levi E, Kondo JM, Lesanovsky I, Adams CS, Weatherill KJ. A terahertz-driven non-equilibrium phase transition in a room temperature atomic vapour. Nat Commun 2018; 9:3567. [PMID: 30177716 PMCID: PMC6120943 DOI: 10.1038/s41467-018-05597-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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] [Received: 03/06/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022] Open
Abstract
There are few demonstrated examples of phase transitions that may be driven directly by terahertz frequency electric fields, and those that are known require field strengths exceeding 1 MV cm-1. Here we report a non-equilibrium phase transition driven by a weak (≪1 V cm-1), continuous-wave terahertz electric field. The system consists of room temperature caesium vapour under continuous optical excitation to a high-lying Rydberg state, which is resonantly coupled to a nearby level by the terahertz electric field. We use a simple model to understand the underlying physical behaviour, and we demonstrate two protocols to exploit the phase transition as a narrowband terahertz detector: the first with a fast (20 μs) non-linear response to nano-Watts of incident radiation, and the second with a linearised response and effective noise equivalent power ≤1 pW Hz-1/2. The work opens the door to a class of terahertz devices controlled with low-field intensities and operating in a room temperature environment.
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Affiliation(s)
- C G Wade
- Joint Quantum Centre (JQC) Durham-Newcastle, Department of Physics, Durham University, Durham, DH1 3LE, UK.
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford, OX1 3PU, UK.
| | - M Marcuzzi
- School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
- Centre for the Mathematics and Theoretical Physics of Quantum Non-equilibrium Systems, University of Nottingham, Nottingham, NG7 2RD, UK
| | - E Levi
- School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
- Centre for the Mathematics and Theoretical Physics of Quantum Non-equilibrium Systems, University of Nottingham, Nottingham, NG7 2RD, UK
| | - J M Kondo
- Joint Quantum Centre (JQC) Durham-Newcastle, Department of Physics, Durham University, Durham, DH1 3LE, UK
| | - I Lesanovsky
- School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
- Centre for the Mathematics and Theoretical Physics of Quantum Non-equilibrium Systems, University of Nottingham, Nottingham, NG7 2RD, UK
| | - C S Adams
- Joint Quantum Centre (JQC) Durham-Newcastle, Department of Physics, Durham University, Durham, DH1 3LE, UK
| | - K J Weatherill
- Joint Quantum Centre (JQC) Durham-Newcastle, Department of Physics, Durham University, Durham, DH1 3LE, UK
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9
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Littlehales E, Levi E, Mills N, Metcalfe R, Hamill J. Double button battery ingestion – The “macaroon” sign. Journal of Pediatric Surgery Case Reports 2018. [DOI: 10.1016/j.epsc.2018.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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10
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Stratta P, Canavese C, Valmaggia P, Rotunno M, Levi E, Bulla A, Vercellone A. Coagulation and Fibrinolysis Study in Systemic Lupus erythematosus: Haematological, Urinary and Tissue Parameters. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryHaematochemical, urinary and tissue parameters were examined in the elaboration of the coagulation and fibrinolysis profile in 33 cases of systemic lupus erythematosus in different stages of the disease. Coagulation abnormalities varied from hypo- to hyper-coagulabitity, these being often associated in the same patient, either simultaneously or at different stages of the disease. Activation of coagulation, closely related to the immunological activity of the disease, was present in 80% cases in the acute stage, and 36% of those in the remission stage. The lupus-like anticoagulant was not much involved, and platelets were the prime figures in the haemostatic abnormalities of lupus, those being the preferred target of direct antibody activities, or possibly of immune complexes as well. Activation of the coagulatory cascade is not uncommonly accompanied by a thrombophilic tendency coupled with signs of consumption, this being the expression of a continuously stimulated haemostatic balance.
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Affiliation(s)
- P Stratta
- Cattedra di Nefrologia Medica dell’Università di Torino, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
| | - C Canavese
- Cattedra di Nefrologia Medica dell’Università di Torino, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
| | - P Valmaggia
- Cattedra di Nefrologia Medica dell’Università di Torino, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
| | - M Rotunno
- Cattedra di Nefrologia Medica dell’Università di Torino, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
| | - E Levi
- Banca del Sangue e del Plasma della Città di Torino, Fondazione G. Strumia, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
| | - A Bulla
- Banca del Sangue e del Plasma della Città di Torino, Fondazione G. Strumia, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
| | - A Vercellone
- Cattedra di Nefrologia Medica dell’Università di Torino, Ospedale Maggiore di S. Giovanni Battista e dellaa Città di Torino, Italy
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11
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Alamoudi U, Levi E, Rigby MH, Taylor SM, Trites JRB, Hart RD. The Incidental Thyroid Lesion in Parathyroid Disease Management. OTO Open 2017; 1:2473974X17701084. [PMID: 30480179 PMCID: PMC6239042 DOI: 10.1177/2473974x17701084] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/27/2017] [Accepted: 03/03/2017] [Indexed: 11/27/2022] Open
Abstract
Objective The incidental thyroid lesion is a common finding during general imaging
studies. Their management has been the subject of numerous studies and
recommendations. Parathyroid disease workup necessitates imaging
investigation of the adjacent thyroid gland and therefore provides a unique
window to the perioperative management of thyroid incidentaloma. The
specific prevalence of incidental thyroid lesions in the context of
parathyroid disease is unknown. We seek to investigate its prevalence during
parathyroid workup and surgery and to ascertain if there was a change in
management of these patients. Study Design Five-year retrospective database review. Setting Tertiary care medical center. Subjects and Methods The source and indication for referral, preoperative investigation findings,
and management of the incidental thyroid lesions were examined. The actual
procedure performed and final pathology results were assessed. Results A total of 98 patients and 106 operations, including revision surgeries, were
identified. There were 21 incidental thyroid lesions (21.4%) detected,
whereby 15 patients underwent fine-needle aspirations and 12 subsequently
had diagnostic hemithyroidectomies. This decision was made preoperatively in
5 patients and intraoperatively in 7 patients at the time of parathyroid
surgery. Along with other pathologies, there were 7 patients with
micropapillary thyroid carcinoma identified. Conclusions In our series, the prevalence of incidental thyroid lesion and thyroid
malignancy is comparable to the general population. The management of the
initial parathyroid disease in our patients was altered by the imaging and
cytological findings of these thyroid lesions. This has implications on
perioperative counseling of the thyroid and parathyroid disease.
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Affiliation(s)
- Uthman Alamoudi
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eric Levi
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Matthew H Rigby
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S Mark Taylor
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jonathan R B Trites
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert D Hart
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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12
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Başkurt O, Levi E, Andaç S, Çağlayan S. Effect of sulfur dioxide inhalation on erythrocyte deformability. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1990-10504] [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: 11/15/2022]
Affiliation(s)
- O.K. Başkurt
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - E. Levi
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - S.O. Andaç
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - S. Çağlayan
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
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13
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Levi E, Başkurt O, Çağlayan S, Tahta K, Dikmenoğlu N, Andaç S. Erythrocyte deformability does not change due to experimental hypothyroidism. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1990-10211] [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: 11/15/2022]
Affiliation(s)
- E. Levi
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - O.K. Başkurt
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - S.S. Çağlayan
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - K. Tahta
- Institute of Neurological Sciences, University of Hacettepe, Ankara, Turkey
| | - N. Dikmenoğlu
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - S.O. Andaç
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
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14
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Levi E, Başkurt O, Kahdemir N, Aidaç S, Kutman M, Üçer O. Changes in erythrocyte deformability during experimental hyperthyroidism. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1989-9405] [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: 11/15/2022]
Affiliation(s)
- E. Levi
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - O.K. Başkurt
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - N. Kahdemir
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - S.O. Aidaç
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
| | - M.N. Kutman
- Department of Physiology, Gülhane Military Medical Academy, Ankara, Turkey
| | - O. Üçer
- Department of Physiology, Medical Faculty, University of Hacettepe, Ankara, Turkey
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15
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Thaçi D, Kimball A, Foley P, Poulin Y, Levi E, Chen R, Feldman SR. Apremilast, an oral phosphodiesterase 4 inhibitor, improves patient-reported outcomes in the treatment of moderate to severe psoriasis: results of two phase III randomized, controlled trials. J Eur Acad Dermatol Venereol 2016; 31:498-506. [PMID: 27538241 PMCID: PMC5363239 DOI: 10.1111/jdv.13918] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 04/21/2016] [Accepted: 06/23/2016] [Indexed: 01/21/2023]
Abstract
Background Apremilast, an oral phosphodiesterase 4 inhibitor, has an acceptable safety profile and is effective for treatment of plaque psoriasis and psoriatic arthritis. Objectives To evaluate the impact of apremilast on health‐related quality of life (HRQOL), general functioning and mental health using patient‐reported outcome (PRO) assessments among patients with moderate to severe plaque psoriasis in the ESTEEM 1 and 2 trials. Methods A total of 1255 patients were randomized (2 : 1) to apremilast 30 mg BID or placebo for 16 weeks; all received apremilast through Week 32. PRO assessments included the Dermatology Life Quality Index (DLQI), 36‐Item Short‐Form Health Survey version 2 mental/physical component summary scores (SF‐36v2 MCS/PCS), Patient Health Questionnaire‐8 (PHQ‐8), EuroQol‐5D (EQ‐5D) and Work Limitations Questionnaire‐25 (WLQ‐25). Post hoc analyses examined relationships between Psoriasis Area and Severity Index (PASI) scores and PHQ‐8 in the apremilast‐treated population at Week 16. Results Treatment with apremilast improved all HRQOL PROs at Week 16 (vs. placebo), except the SF‐36v2 PCS, and improvements were sustained through Week 32. Mean DLQI and SF‐36v2 MCS improvements exceeded minimal clinically important differences. Changes at Week 16 in PHQ‐8 and PASI were weakly correlated, and only 35.8% of patients who achieved a ≥75% reduction from baseline in PASI score (PASI‐75) with apremilast treatment also achieved PHQ‐8 scores of 0–4. Conclusions Apremilast led to improvements in HRQOL PROs vs. placebo in patients with moderate to severe plaque psoriasis.
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Affiliation(s)
- D Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - A Kimball
- Harvard Medical School, Boston, MA, USA
| | - P Foley
- Skin & Cancer Foundation Inc., St. Vincent's Hospital, The University of Melbourne, Melbourne, Vic., Australia
| | - Y Poulin
- Centre de Recherche Dermatologique du Québec métropolitain, Québec, QC, Canada
| | - E Levi
- Celgene Corporation, Summit, NJ, USA
| | - R Chen
- Celgene Corporation, Summit, NJ, USA
| | - S R Feldman
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Benfield N, Hawkins F, McGowan A, Floyd K, Castro C, Levi E. Routine availability of immediate postpartum LARC methods: effect on nursing attitudes and practices. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.099] [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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Yang L, Levi E, Du JH, Zhou HH, Miller R, Majumdar APN. Associations between markers of colorectal cancer stem cells, mutation, microRNA and the clinical features of ulcerative colitis. Colorectal Dis 2016; 18:O185-93. [PMID: 27153478 DOI: 10.1111/codi.13371] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 11/19/2015] [Accepted: 02/25/2016] [Indexed: 02/08/2023]
Abstract
AIM Several factors have been implicated in the pathogenesis of colorectal cancer (CRC) associated with ulcerative colitis (UC). We investigated markers of cancer cell pluripotency, including CD44 and CD166, microRNA-21 (miR-21) and microRNA-215 (miR-215), and APC, K-ras and DCC mutations in biopsy specimens from patients with UC to evaluate any correlations with clinical risk factors. METHOD We observed 18 patients with UC and collected two biopsy specimens from each patient at diagnosis and at a follow-up end-point. We examined the expression of CD44, CD166, miR-21 and miR-215, and APC, K-ras and DCC mutations. We compared these markers at the two time points and assessed their associations with clinical characteristics, including the duration of colitis, histological alterations and the age of the patient at the onset of UC. RESULTS Most (16/18) patients had alleviation of mucosal inflammation or remained stable during follow-up; one patient developed dysplasia and one had severe aggravation of the lesion during follow-up. Enhanced expression of CD44, CD166 and miR-21 with miR-215 was found in the specimens obtained at follow-up, despite alleviation of mucosal lesions. Coherence of cancer stem cell markers and miRNAs was seen in patients who had significant worsening of inflammation, dysplasia and a long duration of colitis. APC mutation occurred in only one patient; this patient had the longest duration of UC (23 years). CONCLUSION Enhanced markers of CRC in follow-up colonic mucosal samples support the conclusion that the duration of UC plays the most important role in UC-related carcinogenesis.
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Affiliation(s)
- L Yang
- Department of Gastroenterology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - E Levi
- Division of Gastroenterology and Department of Internal Medicine, Veterans Administration Medical Center, Detroit, Michigan, USA
| | - J H Du
- Division of Gastroenterology and Department of Internal Medicine, Veterans Administration Medical Center, Detroit, Michigan, USA.,Wayne State University School of Medicine, Detroit, Michigan, USA
| | - H H Zhou
- Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - R Miller
- Division of Gastroenterology and Department of Internal Medicine, Veterans Administration Medical Center, Detroit, Michigan, USA.,Wayne State University School of Medicine, Detroit, Michigan, USA
| | - A P N Majumdar
- Division of Gastroenterology and Department of Internal Medicine, Veterans Administration Medical Center, Detroit, Michigan, USA.,Wayne State University School of Medicine, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
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Wilcox A, Levi E, J Garrett J. Predictors of non-attendance at the postpartum follow-up visit. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.149] [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]
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Affiliation(s)
- R. Brouwer
- Institute for Biological and Chemical Research on Field Crops and Herbage, contribution nr. 380
| | - E. Levi
- Association Euratom - ITAL, contribution Euratom Biology Division nr. 444
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Abstract
Objective: Tinnitus in adults is generally investigated by contrast-enhanced magnetic resonance imaging (MRI) to rule out the diagnosis of acoustic neuroma. Acoustic neuroma is rare in children and, therefore, the role of MRI in children with tinnitus is unclear. This study was undertaken to determine the value of MRI in the investigation of tinnitus in children. Methods: Retrospective study of children younger than 18 years who underwent MRI for the investigation of tinnitus over a 10-year period. Results: Sixty-five patients were identified, but there were only 34 who had also undergone audiologic assessment. Among the 25 patients with normal audiology, MRI abnormalities were present in 9, but these were all thought to be nonspecific. Nine patients had abnormal audiograms and the MRI was abnormal in 4 of these cases, which included 3 children who were found to have multiple sclerosis. Conclusion: Magnetic resonance imaging would appear to be mandatory in the investigation of tinnitus in children who are found to have sensorineural hearing loss, particularly to rule out the diagnosis of multiple sclerosis. Although our study does not support the routine use of MRI in children with normal audiology, the numbers in our series are too small for a conclusive recommendation.
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Affiliation(s)
- Eric Levi
- Department of Otolaryngology, Royal Children’s Hospital Melbourne, Victoria, Australia
| | - Elhamy K. Bekhit
- Department of Medical Imaging, Royal Children’s Hospital Melbourne, Victoria, Australia
- Department of Radiology, The University of Melbourne, Melbourne, Australia
| | - Robert G. Berkowitz
- Department of Otolaryngology, Royal Children’s Hospital Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, The University of Melbourne, Melbourne, Australia
- Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
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Badloo K, Levi E, Downie L, Rose E, Wagner T, Lubitz L. Mycotic pseudoaneurysm of the lingual artery: a rare complication of parapharyngeal abscess. J Paediatr Child Health 2012; 48:1045-6. [PMID: 23126396 DOI: 10.1111/j.1440-1754.2012.02599.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Druyan S, Levi E. Reduced O2 concentration during CAM development--its effect on angiogenesis and gene expression in the broiler embryo CAM. Gene Expr Patterns 2012; 12:236-44. [PMID: 22609957 DOI: 10.1016/j.gep.2012.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 04/05/2012] [Accepted: 05/08/2012] [Indexed: 01/07/2023]
Abstract
Hypoxia during embryogenesis may induce changes in the development of some physiological regulatory systems, thereby causing permanent phenotypic changes in the embryo. Various levels of hypoxia at different time points during embryogenesis were found to affect both anatomical and physiological morphogenesis. These changes and adaptations depended on the timing, intensity, and duration of the hypoxic exposure and, moreover, were regulated by differential expression of developmentally important genes, mostly expressed in a stage- and time-dependent manner. Eggs incubated in a 17%-oxygen atmosphere for 12 h/d from E5 through E12 exhibited a clear and significant increase in the vascular area of the chorioallantoic membrane (CAM); an increase that was already significant within 12 h after the end of the 1st hypoxic exposures (E6). We used the combination of the genes, β-actin, RPLP0 and HPRT as a reference for gene expression profiling, in studying the expression levels of hypoxia-inducible factor 1-alpha (HIF1α), vascular endothelial growth factor alpha-2 (VEGF α 2), vascular endothelial growth factor receptor 2 (KDR), matrix metalloproteinase-2 (MMP2), and fibroblast growth factor 2 (FGF2), under normal and hypoxic conditions. In general, expression of all five investigated genes throughout the embryonic day of development had similar patterns of hypoxia-induced alterations. In E5.5 embryos, expression of HIF1α, MMP2, VEGFα2, and KDR was significantly higher in hypoxic embryos than in controls. In E6 embryos expression of HIF1α, VEGFα2, and FGF2 was significantly higher in hypoxic embryos than in controls. From E6.5 onward expression levels of the examined genes did not show any differences between hypoxic and control embryos. It can be concluded that in this experimental model, exposing broiler embryos to 17% O(2) from E5 to E7 induced significant angiogenesis, as expressed by the above genes. Further studies to examine whether this early exposure to hypoxic condition affects the chick's ability to withstand a post-hatch hypoxic environment is still required.
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Affiliation(s)
- S Druyan
- Institute of Animal Science, ARO, the Volcani Center, P.O. Box 6, Bet Dagan 50250, Israel.
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Druyan S, Levi E, Shinder D, Stern T. Reduced O2 concentration during CAM development—Its effect on physiological parameters of broiler embryos. Poult Sci 2012; 91:987-97. [DOI: 10.3382/ps.2011-01727] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Aurbach D, Levi MD, Levi E, Markovsky B, Salitra G, Teller H, Heider U, Heider L. On the Electroanalytical Characterization of LixCoO2, LixNiO2 and LiMn2O4 (Spinel) Electrodes in Repeated Lithium Intercalation-Deintercalation Processes. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-496-435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTThis paper reports on electroanalytical studies of the intercalation-deintercalation of lithium into lithiated transition metal oxides which are used as cathodes for Li ion batteries. These include LixCoO2 LixNiO2 and LixMn2O4 spinel. The basic electroanalytical response of these systems in LiAsF6 1M/EC-DMC solutions was obtained from the simultaneous use of slow and fast scan cyclic voltammetry (SSCV), potentiostatic intermittent titration (PITT) (from which D vs. E was calculated), and impedance spectroscopy (EIS). Surface sensitive FTIR spectroscopy and XRD were also used for surface and 3D characterization, respectively. A large and important denominator was found in the electrochemical behavior of lithium intercalation-deintercalation into these transition metal oxides and graphite. The use of the electroanalytical response of these systems as a tool for the study of stabilization and failure mechanisms of these materials as cathodes in rechargeable Li batteries is demonstrated and discussed.
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Levi E, Gershinsky G, Aurbach D, Isnard O. Crystallography of Chevrel Phases, MMo6T8 (M = Cd, Na, Mn, and Zn, T = S, Se) and Their Cation Mobility. Inorg Chem 2009; 48:8751-8. [DOI: 10.1021/ic900805g] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E. Levi
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel 52900
| | - G. Gershinsky
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel 52900
| | - D. Aurbach
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel 52900
| | - O. Isnard
- Institut Néel, CNRS & Université de Grenoble J. Fourier, BP166X, 38042 Grenoble cédex 9, France
- Institut Laue Langevin, BP 156 X, 38042 Grenoble cédex 9, France
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Losanoff JE, Antaki F, Salwen WA, Edelman D, Reddy A, Levi E, Basson MD. Amyloid tumor of the stomach simulating an obstructing gastric carcinoma: case report and review of the literature. Endoscopy 2009; 41 Suppl 2:E45-6. [PMID: 19288419 DOI: 10.1055/s-0028-1119470] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J E Losanoff
- Department of Surgery, John D. Dingell VAMC and Wayne State University, Detroit, Michigan 48201, USA.
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Levi E, Mitelman A, Isnard O, Brunelli M, Aurbach D. Phase diagram of Mg insertion into Chevrel phases, MgxMo6T8 (T = S, Se). 3. The crystal structure of triclinic Mg2Mo6Se8. Inorg Chem 2008; 47:1975-83. [PMID: 18290612 DOI: 10.1021/ic702311f] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This series of papers is devoted to unique cathode materials for Mg batteries, MgxMo6T8 (T = S, Se, x = 1 and 2) Chevrel phases (CPs). In this part, a combination of neutron and high-resolution synchrotron X-ray diffractions was used to study the crystal structure of Mg2Mo6Se8, which is triclinic at room temperature (space group P1, a = 6.868 A, b = 6.921 A, c = 6.880 A, alpha = 93.00 degrees , beta = 94.40 degrees , gamma = 96.22 degrees ). In contrast to other members of the MgxMo6T8 family, this compound does not follow the classic scheme of successive cation insertion into so-called inner and outer sites: Both the Mg(2+) ions per formula are located in the tetrahedral sites of the outer ring. This surprising cation location, predicted previously for Mg-containing CPs by ab initio calculations, provides the uniform distribution of the cation charge in the triclinic structure, which is similar to that of rhombohedral CPs. A mapping of the cation sites was widely used to demonstrate the variety of cation arrangement in CPs and the factors affecting this arrangement, as well as to clarify the origin of the exceptionally high mobility of the Mg(2+) ions in Mg2Mo6Se8.
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Affiliation(s)
- E Levi
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel 52900.
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Levi E, Mitelman A, Aurbach D, Isnard O. On the Mechanism of Triclinic Distortion in Chevrel Phase as Probed by In-Situ Neutron Diffraction. Inorg Chem 2007; 46:7528-35. [PMID: 17661459 DOI: 10.1021/ic7008573] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This work presents, for the first time, a general mechanism of a rhombohedral (R)-triclinic (T) phase transition in Chevrel Phases (CPs) with small cations (radius<1 A), which was unclear in spite of intensive studies of these important materials in the past. In contrast to previous interpretation of the R<-->T transition in some CPs as cation ordering, T-distortion is regarded here as a particular case of general adaptation of the framework to cation insertion, which includes the deformations of the coordination polyhedra and their tilting. The research is based on a combination of experimental studies (in-situ neutron diffraction at different temperatures) for one model compound, MgMo6Se8, and structural analysis for a variety of known CPs. This analysis shows that the structure flexibility is fundamentally different for the R and T forms. As a result of the lower flexibility, in the R form, a strict correlation exists between the compression of the framework along the -3 symmetry axis and the cation position in the structure (the so-called 'delocalization'). The decreasing delocalization in the R-CPs, which occurs on cooling, leads to excessive repulsion within the cations pairs (R-Cu1.8Mo6S8 case) or undesirable asymmetry in the cation polyhedra (R-MgMo6Se8 case). The higher flexibility of the T framework allows for relaxation of these structural strains by increasing the cation-cation distances and forming a more symmetric cation environment, sometimes with higher coordination number (CN), like CN=5 in the T-Fe2Mo6S8 type. Thus, this work also proposes possible driving forces for T-distortion in CPs.
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Affiliation(s)
- E Levi
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel.
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Kacar F, Meteoğlu I, Yasa H, Levi E. Helicobacter pylori-induced changes in the gastric mucosa are associated with mitogen-activated protein kinase (MAPK) activation. Appl Immunohistochem Mol Morphol 2007; 15:224-8. [PMID: 17525639 DOI: 10.1097/01.pai.0000209863.35828.dd] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gastric cancers are usually associated with and preceded by Helicobacter pylori (HP) infection, gastric atrophy, intestinal metaplasia, and dysplasia. HP infection alters cell kinetics of the gastric mucosa. Both proliferation and apoptosis are increased. Proinflammatory cytokines are responsible for some of these alterations. The mitogen-activated protein kinase (MAPK) signaling pathway has been implicated as a causative factor in these alterations based on in vitro studies. In this study, we investigated the effects of HP infection on gastric mucosal proliferation, apoptotic mechanisms, and the activation status of the MAPK signaling pathway at various stages of gastric carcinogenesis, especially intestinal metaplasia and dysplasia caused by HP infection. DESIGN Stomach biopsies representing normal (n=20), HP+ (n=25), HP+ with intestinal metaplasia (n=25), HP+ with dysplasia (n=15) and gastric adenocarcinoma (n=30; 20 HP+ and 10 HP-) cases were selected. Cell proliferation was assessed by proliferating cell nuclear antigen immunostaining. Apoptosis and survival-related markers; cleaved caspase-3, and phospho-MAPK extracellular signal-regulated kinase (ERK) were detected by immunohistochemical methods. RESULTS Proliferation index (proliferating cell nuclear antigen) and cleaved caspase-3 expression were higher in the HP+, HP+ with intestinal metaplasia, and HP+ with dysplasia groups than in normal controls (P<0.05). Cleaved caspase-3 activity was also high in the adenocarcinomas. Phospho-MAPK(ERK) expression was increased in the HP+, HP+ with intestinal metaplasia, HP+ with dysplasia and adenocarcinomas compared with the normal control group. Whereas HP- gastric carcinomas had a lower expression of phospho-MAPK. CONCLUSIONS HP infection increases the proliferative rate of gastric foveolar cells in conjunction with an increased apoptotic rate and activation of MAPK(ERK). MAPK activation seems to be a significant and persistent event in the HP-induced neoplastic transformation.
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Affiliation(s)
- Furuzan Kacar
- Department of Pathology, Adnan Menderes University, Aydin, Turkey
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Petrakou E, Mouchtouri A, Levi E, Lipsou N, Xanthou M, Fotopoulos S. Interleukin-8 and monocyte chemotactic protein-1 mRNA expression in perinatally infected and asphyxiated preterm neonates. Neonatology 2007; 91:107-13. [PMID: 17344660 DOI: 10.1159/000097127] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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] [Received: 09/19/2005] [Accepted: 05/08/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Inflammation due to perinatal infection (PI) and perinatal asphyxia (PA) may cause damage to various tissues and very often to the immature brain of the fetus and the newborn. Previously, we have shown that the neonatal immune system has the ability to produce increased chemokine protein levels in the serum during the inflammatory response caused by PI and PA. AIM The aim of our present study was to investigate mRNA levels of the proinflammatory chemokines interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) in peripheral blood leukocytes from infected and asphyxiated neonates. METHODS Forty-two premature neonates were studied; 11 with PI, 16 with PA and 15 without PA and PI, were used as controls. IL-8 and MCP-1 mRNA levels were investigated in whole blood and in phytohemagglutinin-activated lymphocytes using semi-quantitative polymerase chain reaction and real-time polymerase chain reaction, respectively. RESULTS IL-8 mRNA levels were significantly increased in whole blood both during PA and PI, while MCP-1 mRNA levels were not. In vitro activated lymphocytes expressed significantly increased IL-8 mRNA levels during PI, whereas no increase was observed during PA. MCP-1 mRNA levels were significantly increased in activated lymphocytes during PA, while no increase was observed during PI. CONCLUSIONS Our data show that chemokine mRNA levels expressed by activated lymphocytes during inflammation caused by PIs are different to those expressed during PAs. These findings might have important implications during the administration of specific chemokine antagonists in order to prevent or reduce tissue damage caused by inflammation.
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Affiliation(s)
- E Petrakou
- Neonatal Immunology Laboratory of B Neonatal Intensive Care Unit, Aghia Sophia Children's Hospital, Athens, Greece
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Mitelman A, Levi MD, Lancry E, Levi E, Aurbach D. New cathode materials for rechargeable Mg batteries: fast Mg ion transport and reversible copper extrusion in CuyMo6S8 compounds. Chem Commun (Camb) 2007:4212-4. [DOI: 10.1039/b710743a] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lim H, Cheng P, Chen A, Levi E, Maskey A, Hare D, Farouque O. Prevalence of Cardiac Murmurs and Acute Rheumatic Fever in Schoolchildren in Rural Nepal. Heart Lung Circ 2007. [DOI: 10.1016/j.hlc.2007.06.174] [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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Goiburu ME, Alfonzo LF, Aranda AL, Riveros MF, Ughelli MA, Dallman D, Rolón R, Balbuena C, Ibáñz D, Bordón C, Ruiz Díaz L, Reyes E, Levi E, Cáceres S, Machi A, Stais S, Peña P, Pereira T, Doncell E, Jure GMM, Waitzberg DL. [Clinical nutrition knowledge in health care members of University Hospitals of Paraguay]. NUTR HOSP 2006; 21:591-5. [PMID: 17044605] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Adequate clinical nutrition care is an integral part of the complete treatment of hospitalised patients, requiring specific knowledge from the health care team. The aim of this study is to assess, in Paraguay, the health care team ability in clinical care nutrition. MATERIALS AND METHODS A survey was made including 174 people of Paraguay university hospitals (29% physicians, 29% medicine graduating students, 11% pharmaceutics, 24% nurses, 7% dieticians), by answering voluntarily a multiple choice questionnaire of 20 items. RESULTS The median score of the 20 questions was 6 (0-15). Physicians obtained a median of 6 (2-15), graduating students 7 (2-14), pharmaceutics 7 (0-15), nurses 3 (0-11), and dieticians 9 (4-13). The dieticians obtained a significantly higher score than the other groups (p < 0.005). CONCLUSIONS The knowledge about clinical nutrition in the health care members from university hospitals is not adequate. The level of education in clinical nutrition is better in the dietician.
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Affiliation(s)
- M E Goiburu
- Nutrición I, Facultad de Ciencias Químicas, Universidad Nacional de Asunción (UNA), Paraguay.
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Lancry E, Levi E, Mitelman A, Malovany S, Aurbach D. Molten salt synthesis (MSS) of Cu2Mo6S8—New way for large-scale production of Chevrel phases. J SOLID STATE CHEM 2006. [DOI: 10.1016/j.jssc.2006.02.032] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Levi MD, Lancry E, Gizbar H, Lu Z, Levi E, Gofer Y, Aurbach D. Kinetic and Thermodynamic Studies of Mg2+ and Li+ Ion Insertion into the Mo6S8 Chevrel Phase. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/chin.200439023] [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: 11/07/2022]
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Levi M, Gizbar H, Lancry E, Gofer Y, Levi E, Aurbach D. A comparative study of Mg2+ and Li+ ion insertions into the Mo6S8 Chevrel phase using electrochemical impedance spectroscopy. J Electroanal Chem (Lausanne) 2004. [DOI: 10.1016/j.jelechem.2004.03.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Levi M, Lancry E, Gizbar H, Gofer Y, Levi E, Aurbach D. Phase transitions and diffusion kinetics during Mg2+- and Li+-ion insertions into the Mo6S8 chevrel phase compound studied by PITT. Electrochim Acta 2004. [DOI: 10.1016/j.electacta.2004.02.034] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
MUCs are glycoproteins with various roles in homeostasis and carcinogenesis. Among other actions, MUC1 may inhibit cell-cell and cell-stroma interactions and function as a signal transducer, participating in cancer progression. In contrast, MUC2 is normally found only in goblet cells, where it contributes to the protective barrier function of these cells. Recently, a tumour suppressor role has been demonstrated for MUC2, and both MUC1 and MUC2 appear to have important roles in pancreatic neoplasia. MUC1 appears to be a marker of aggressive phenotype and may facilitate the vascular spread of carcinoma cells. In contrast, MUC2 is rarely detectable in aggressive pancreatic tumours, but is commonly expressed in intraductal papillary mucinous neoplasms (IPMNs), which are rare, indolent tumours, in intestinal IPMNs, and in indolent colloid carcinomas. MUC2 appears to be not only a marker of this indolent pathway, but also partly responsible for its less aggressive nature. Thus, in pancreatic neoplasia, MUC1 and MUC2 have potential diagnostic and prognostic value as markers of aggressive and indolent phenotypes, respectively, and have potential as therapeutic targets.
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Affiliation(s)
- E Levi
- John Dingell Veterans Administration Medical Center, 4646 John Road, Detroit, MI 48201, USA
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Amiel A, Levi E, Reish O, Sharony R, Fejgin MD. Replication status as a possible marker for genomic instability in cells originating from genotypes with balanced rearrangements. Chromosome Res 2002; 9:611-6. [PMID: 11778683 DOI: 10.1023/a:1012966221692] [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: 11/12/2022]
Abstract
Most allelic pairs of DNA replicate synchronously during the S phase of the cell cycle. However, some genes frequently replicate asynchronously, i.e. genes on the X chromosome and imprinted genes. Earlier studies demonstrated an asynchronous pattern of replication in some precancerous and invasive squamous carcinoma of the cervix as well as in multiple myeloma. A high rate of asynchronous pattern was found in: (1) lymphocytes of individuals with solid tumors as well as in other malignancies; (2) amniocytes of genotypes with an extra chromosome 13, 18 and 21; (3) lymphocytes of young mothers of a Down syndrome pregnancy. The asynchronic pattern was not locus specific and was found in all loci analyzed. These findings suggested that the mechanism controlling the temporal order of replication could be altered in cells with a genetic predisposition to cancer or aneuploidy. In this study, we found a higher rate of asynchronous pattern in genotypes carrying inversions 2 and 9 and in balanced heritable translocations (p < 0.01) and an even higher rate in cases with a de-novo balanced translocation. The process of tumorigenesis may begin with a change in cell cycle regulation which includes the duplication, replication and segregation of genetic information. However, it remains unknown whether individuals with balanced chromosome rearrangements are at increased risk of developing cancer later in life.
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Affiliation(s)
- A Amiel
- Genetic Institute, Meir Hospital, Kfar Saba, Israel.
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Levi E, Pfeifer WM, Kadin ME. CD30-activation-mediated growth inhibition of anaplastic large-cell lymphoma cell lines: apoptosis or cell-cycle arrest? Blood 2001; 98:1630-2. [PMID: 11547770 DOI: 10.1182/blood.v98.5.1630] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
MESH Headings
- Antibodies, Monoclonal/pharmacology
- Apoptosis
- Cell Cycle
- Cyclin-Dependent Kinase Inhibitor p21
- Cyclins/metabolism
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Ki-1 Antigen/immunology
- Ki-1 Antigen/physiology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- NF-kappa B/physiology
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Oligonucleotide Array Sequence Analysis
- Peptides/pharmacology
- Phosphorylation
- Protein Processing, Post-Translational
- Retinoblastoma Protein/metabolism
- Signal Transduction/drug effects
- Time Factors
- Transcription, Genetic
- Tumor Cells, Cultured/drug effects
- Tumor Cells, Cultured/metabolism
- Tumor Cells, Cultured/pathology
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Kadin ME, Levi E, Kempf W. Progression of lymphomatoid papulosis to systemic lymphoma is associated with escape from growth inhibition by transforming growth factor-beta and CD30 ligand. Ann N Y Acad Sci 2001; 941:59-68. [PMID: 11594583 DOI: 10.1111/j.1749-6632.2001.tb03711.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [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
Our objective is to understand the mechanism of progression of lymphomatoid papulosis (LyP) to CD30+ systemic lymphoma. LyP lesions appear in recurrent crops that regress, only to reappear at a later date in the same or different locations. About 10% of patients develop systemic lymphoma. Because transforming growth factor-beta (TGF-beta) and CD30 ligand inhibit the growth of normal lymphocytes and can be detected in regressing lesions of LyP, we tested the effect of these cytokines on cell lines clonally derived from LyP in the progression to systemic lymphoma. TGF-beta failed to inhibit the growth of lymphoma cells from advanced disease due to mutations of the TGF-beta receptor complex that prevented binding of the ligand to tumor cells. A CD30 ligand agonist antibody caused proliferation of tumor cells from one patient and had no effect on tumor cells of another. In contrast, a Fas agonist antibody caused significant growth inhibition of all cell lines. The results suggest that progression of LyP to lymphoma is associated with escape of lymphoma cells from growth regulation by TGF-beta and CD30 ligand.
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Affiliation(s)
- M E Kadin
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
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Abstract
Whereas retinoic acids control nuclear events, a second class of retinol metabolites, that is, the hydroxylated forms exemplified by 14-hydroxy-retro-retinol (HRR), operate primarily in the cytoplasm. They function as regulatory cofactors for cell survival/cell death decisions. In accordance with these biological aspects, we demonstrate that these retinoids bound protein kinase C (PKC) alpha with nanomolar affinity and markedly enhance the activation of PKC alpha and the entire downstream MAP kinase pathway by reactive oxygen species. HRR was 10 times more efficient than retinol, and the optimum doses are 10-7 and 10-6 M, respectively. PKC alpha activation was reversed rapidly by imposition of reducing conditions. The retinoid binding site was mapped to the first cysteine-rich region in the regulatory domain, C1A, yet was distinct from the binding sites of diacylglycerol and phorbol esters. The C1B domain bound retinoids poorly. The emerging theme is that retinoids serve as redox regulators of protein kinase C.
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Affiliation(s)
- A Imam
- Program in Immunology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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Abstract
BACKGROUND Cutaneous lesions of pityriasis lichenoides et varioliformis acuta (PLEVA), a T cell-mediated cutaneous inflammatory condition, are clinically similar to lymphomatoid papulosis (LyP), leading some authors to hypothesize that they are part of the same spectrum of lymphoproliferative disorders, although reports of the development of cutaneous lymphoma in patients with PLEVA are not as frequent as they are for patients with LyP. Furthermore, unlike in cases of LyP, no systematic search for a dominant T-cell clone has been carried out in cases of PLEVA, whereas clones have been detected in a few cases of PLEVA using mainly Southern blot analysis. OBJECTIVE To investigate T-cell clonality in a series of archival PLEVA lesions. TISSUES: Archival paraffin-embedded biopsy specimens from 20 clinically and pathologically typical cases of PLEVA were selected. MAIN OUTCOME MEASURE Identification of a dominant T-cell clone by polymerase chain reaction and heteroduplex analysis targeted on the TCRgamma gene. Peripheral blood mononuclear cells (PBMCs) and Jurkat cells were used as negative and positive controls. Serial dilutions of Jurkat T-cell lymphoma DNA in PBMC DNA were used to assess the sensitivity of the method. RESULTS Analysis of 13 (65%) of 20 PLEVA biopsy specimens revealed the presence of a dominant T-cell clone. Positive and negative controls confirmed the specificity of the procedure. The sensitivity was determined to be between 1% and 5% of the total T-cell infiltrate. CONCLUSIONS This study provides further evidence for the presence of a dominant T-cell clone in skin lesions of some patients with PLEVA and supports the hypothesis that PLEVA is part of the spectrum of clonal-T-cell cutaneous lymphoproliferative disorders.
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Affiliation(s)
- O Dereure
- Department of Pathology, Division of Laboratory Medicine, Beth Israel Hospital, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA
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Levi E, Wang Z, Petrogiannis-Haliotis T, Pfeifer WM, Kempf W, Drews R, Kadin ME. Distinct effects of CD30 and Fas signaling in cutaneous anaplastic lymphomas: a possible mechanism for disease progression. J Invest Dermatol 2000; 115:1034-40. [PMID: 11121138 DOI: 10.1046/j.1523-1747.2000.00175.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [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
Lymphomatoid papulosis is part of a spectrum of CD30+ cutaneous lymphoproliferative disorders characterized by spontaneous tumor regression. The mechanism(s) of regression is unknown. In a recent study, a selective increase in CD30 ligand expression in regressing lesions of lymphomatoid papulosis and cutaneous CD30+ anaplastic large cell lymphoma was shown, suggesting that activation of the CD30 signaling pathway may be responsible for tumor regression, whereas no difference in Fas/Fas ligand expression was found between regressing and nonregressing lesions. Therefore we tested the effects of CD30 and Fas activation on three CD30+ cutaneous lymphoma cell lines (Mac-1, Mac-2 A, JK) derived from nonregressing tumors of two patients who had progressed from lymphomatoid papulosis to systemic anaplastic large cell lymphoma. To evaluate the effects of CD30 signaling, the cell lines were incubated with a CD30 agonistic antibody, HeFi-1. Proliferative responses, mitogen-activated protein kinase, and nuclear factor kappa B activities were determined with and without CD30 activation. Mac-1 and Mac-2 A showed increased proliferative responses to incubation with CD30 activating antibody, HeFi-1. Inhibition of the mitogen-activated protein kinase activity caused growth inhibition of the Mac-1, Mac-2 A, and JK cell lines. Activation of the Fas pathway induced apoptosis in all three cell lines. Taken together, these findings suggest that resistance to CD30-mediated growth inhibition provides a possible mechanism for escape of cutaneous anaplastic large cell lymphoma from tumor regression. Mitogen-activated protein kinase inhibitors are potential therapeutic agents for the treatment of advanced cutaneous anaplastic large cell lymphoma. J Invest Dermatol 115:1034-1040, 2000
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Affiliation(s)
- E Levi
- Department of Pathology, Beth Israel-Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA
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Aurbach D, Lu Z, Schechter A, Gofer Y, Gizbar H, Turgeman R, Cohen Y, Moshkovich M, Levi E. Prototype systems for rechargeable magnesium batteries. Nature 2000; 407:724-7. [PMID: 11048714 DOI: 10.1038/35037553] [Citation(s) in RCA: 802] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The thermodynamic properties of magnesium make it a natural choice for use as an anode material in rechargeable batteries, because it may provide a considerably higher energy density than the commonly used lead-acid and nickel-cadmium systems. Moreover, in contrast to lead and cadmium, magnesium is inexpensive, environmentally friendly and safe to handle. But the development of Mg batteries has been hindered by two problems. First, owing to the chemical activity of Mg, only solutions that neither donate nor accept protons are suitable as electrolytes; but most of these solutions allow the growth of passivating surface films, which inhibit any electrochemical reaction. Second, the choice of cathode materials has been limited by the difficulty of intercalating Mg ions in many hosts. Following previous studies of the electrochemistry of Mg electrodes in various non-aqueous solutions, and of a variety of intercalation electrodes, we have now developed rechargeable Mg battery systems that show promise for applications. The systems comprise electrolyte solutions based on Mg organohaloaluminate salts, and Mg(x)Mo3S4 cathodes, into which Mg ions can be intercalated reversibly, and with relatively fast kinetics. We expect that further improvements in the energy density will make these batteries a viable alternative to existing systems.
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Affiliation(s)
- D Aurbach
- Department of Chemistry, Bar-Ilan University, Ramat Gan, Israel.
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