1
|
Meyer EJ, Correa ET, Monuteaux MC, Mannix R, Hatoun J, Vernacchio L, Lyons TW. Patterns and Predictors of Health Care Utilization After Pediatric Concussion: A Retrospective Cohort Study. Acad Pediatr 2024; 24:51-58. [PMID: 37148968 DOI: 10.1016/j.acap.2023.04.010] [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: 10/20/2022] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To characterize types, duration, and intensity of health care utilization following pediatric concussion and to identify risk factors for increased post-concussion utilization. METHODS A retrospective cohort study of children 5 to 17 years old diagnosed with acute concussion at a quaternary center pediatric emergency department or network of associated primary care clinics. Index concussion visits were identified using International Classification of Diseases, Tenth Revision, Clinical Modification codes. We analyzed patterns of health care visits 6 months before and after the index visit using interrupted time-series analyses. The primary outcome was prolonged concussion-related utilization, defined as having ≥1 follow-up visits with a concussion diagnosis more than 28 days after the index visit. We used logistic regressions to identify predictors of prolonged concussion-related utilization. RESULTS Eight hundred nineteen index visits (median [interquartile range] age, 14 [11-16] years; 395 [48.2%] female) were included. There was a spike in utilization during the first 28 days after the index visit compared to the pre-injury period. Premorbid headache/migraine disorder (adjusted odds ratio (aOR) 2.05, 95% confidence interval [CI] 1.09-3.89) and top quartile pre-injury utilization (aOR 1.90, 95% CI 1.02-3.52) predicted prolonged concussion-related utilization. Premorbid depression/anxiety (aOR 1.55, 95% CI 1.31-1.83) and top quartile pre-injury utilization (aOR 2.29, 95% CI 1.95-2.69) predicted increased utilization intensity. CONCLUSIONS Health care utilization is increased during the first 28 days after pediatric concussion. Children with premorbid headache/migraine disorders, premorbid depression/anxiety, and high baseline utilization are more likely to have increased post-injury health care utilization. This study will inform patient-centered treatment but may be limited by incomplete capture of post-injury utilization and generalizability.
Collapse
Affiliation(s)
- Erin J Meyer
- Division of Emergency Medicine (EJ Meyer, MC Monuteaux, R Mannix, and TW Lyons), Boston Children's Hospital and Harvard Medical School, Mass.
| | - Emily Trudell Correa
- Pediatric Physicians' Organization at Children's (ET Correa, J Hatoun, and L Vernacchio), Wellesley, Mass
| | - Michael C Monuteaux
- Division of Emergency Medicine (EJ Meyer, MC Monuteaux, R Mannix, and TW Lyons), Boston Children's Hospital and Harvard Medical School, Mass
| | - Rebekah Mannix
- Division of Emergency Medicine (EJ Meyer, MC Monuteaux, R Mannix, and TW Lyons), Boston Children's Hospital and Harvard Medical School, Mass
| | - Jonathan Hatoun
- Pediatric Physicians' Organization at Children's (ET Correa, J Hatoun, and L Vernacchio), Wellesley, Mass; Department of Pediatrics (J Hatoun and L Vernacchio), Boston Children's Hospital and Harvard Medical School, Mass
| | - Louis Vernacchio
- Pediatric Physicians' Organization at Children's (ET Correa, J Hatoun, and L Vernacchio), Wellesley, Mass; Department of Pediatrics (J Hatoun and L Vernacchio), Boston Children's Hospital and Harvard Medical School, Mass
| | - Todd W Lyons
- Division of Emergency Medicine (EJ Meyer, MC Monuteaux, R Mannix, and TW Lyons), Boston Children's Hospital and Harvard Medical School, Mass
| |
Collapse
|
2
|
Meyer EJ, Stout JN, Chung AW, Grant PE, Mannix R, Gagoski B. Longitudinal Changes in Magnetic Resonance Spectroscopy in Pediatric Concussion: A Pilot Study. Front Neurol 2019; 10:556. [PMID: 31231298 PMCID: PMC6566128 DOI: 10.3389/fneur.2019.00556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 02/26/2019] [Accepted: 05/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Nearly 20% of US adolescents report at least one lifetime concussion. Pathophysiologic models suggest that traumatic biomechanical forces caused by rotational deceleration lead to shear stress, which triggers a neurometabolic cascade beginning with excitotoxicity and leading to significant energy demands and a period of metabolic crisis for the injured brain. Proton magnetic resonance spectroscopy (1H MRS) offers a means for non-invasive measurement of neurometabolic changes after concussion. Objective: Describe longitudinal changes in metabolites measured in vivo in the brains of adolescent patients with concussion. Methods: We prospectively recruited 9 patients ages 11 to 20 who presented to a pediatric Emergency Department within 24 h of concussion. Patients underwent MRI scanning within 72 h (acute, n = 8), 2 weeks (subacute, n = 7), and at approximately 1 year (chronic, n = 7). Healthy, age and sex-matched controls were recruited and scanned once (n = 9). 1H MRS was used to measure N-acetyl-aspartate, choline, creatine, glutamate + glutamine, and myo-inositol concentrations in six regions of interest: left and right frontal white matter, posterior white matter and thalamus. Results: There was a significant increase in total thalamus glutamate+glutamine/choline at the subacute (p = 0.010) and chronic (p = 0.010) time points, and a significant decrease in total white matter myo-inositol/choline (p = 0.030) at the chronic time point as compared to controls. Conclusion: There are no differences in 1H MRS measurements in the acute concussive period; however, changes in glutamate+glutamine and myo-inositol concentrations detectable by 1H MRS may develop beyond the acute period.
Collapse
Affiliation(s)
- Erin J Meyer
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Jeffrey N Stout
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Ai Wern Chung
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - P Ellen Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Department of Emergency Medicine, Harvard Medical School, Boston, MA, United States
| | - Borjan Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
3
|
Nanjappa N, Jesudason D, Thiruvenkatarajan V, Meyer EJ. Perioperative management of sodium-glucose cotransporter-2 inhibitors: importance of a nuanced approach. Anaesth Intensive Care 2018; 46:424-425. [PMID: 29966117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- N Nanjappa
- Clinical Senior Lecturer Discipline of Acute Care medicine The University of Adelaide South Australia
| | - D Jesudason
- Discipline of Medicine. The University of Adelaide, Adelaide
| | | | | |
Collapse
|
4
|
Meyer EJ, Gaggl W, Gilloon B, Swan B, Greenstein M, Voss J, Hussain N, Holdsworth RL, Nair VA, Meyerand ME, Kuo JS, Baskaya MK, Field AS, Prabhakaran V. The Impact of Intracranial Tumor Proximity to White Matter Tracts on Morbidity and Mortality: A Retrospective Diffusion Tensor Imaging Study. Neurosurgery 2018; 80:193-200. [PMID: 28173590 DOI: 10.1093/neuros/nyw040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 09/20/2015] [Accepted: 11/18/2016] [Indexed: 02/02/2023] Open
Abstract
Background Using diffusion tensor imaging (DTI) in neurosurgical planning allows identification of white matter tracts and has been associated with a reduction in postoperative functional deficits. Objective This study explores the relationship between the lesion-to-tract distance (LTD) and postoperative morbidity and mortality in patients with brain tumors in order to evaluate the role of DTI in predicting postoperative outcomes. Methods Adult patients with brain tumors (n = 60) underwent preoperative DTI. Three major white matter pathways (superior longitudinal fasciculi [SLF], cingulum, and corticospinal tract) were identified using DTI images, and the shortest LTD was measured for each tract. Postoperative morbidity and mortality information was collected from electronic medical records. Results The ipsilesional corticospinal tract LTD and left SLF LTD were significantly associated with the occurrence rate of total postoperative motor (P = .018) and language (P < .001) deficits, respectively. The left SLF LTD was also significantly associated with the occurrence rate of new postoperative language deficits (P = .003), and the LTD threshold that best predicted this occurrence was 1 cm (P < .001). Kaplan–Meier log-rank survival analyses in patients having high-grade tumors demonstrated a significantly higher mortality for patients with a left SLF LTD <1 cm (P = .01). Conclusion Measuring tumor proximity to major white matter tracts using DTI can inform clinicians of the likelihood of postoperative functional deficits. A distance of 1 cm or less from eloquent white matter structures most significantly predicts the occurrence of new deficits with current surgical and imaging techniques.
Collapse
Affiliation(s)
- Erin J Meyer
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Wolfgang Gaggl
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA
| | - Benjamin Gilloon
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA
| | - Benjamin Swan
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA
| | - Max Greenstein
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA
| | - Jed Voss
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA
| | - Namath Hussain
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Ryan L Holdsworth
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.,University of Wisconsin Madison Hospital and Clinics, Madison, Wisconsin, USA
| | - Veena A Nair
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA
| | - M Elizabeth Meyerand
- Medical Physics, School of Health, University of Wisconsin, Madison, USA.,Biomedical Engineering, University of Wisconsin, Madison, USA
| | - John S Kuo
- Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, USA
| | - Mustafa K Baskaya
- University of Wisconsin Madison Hospital and Clinics, Madison, Wisconsin, USA.,Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, USA
| | - Aaron S Field
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.,Biomedical Engineering, University of Wisconsin, Madison, USA
| | - Vivek Prabhakaran
- Departments of Radiology, Case Western Reserve Medical School Cleveland, Ohio, USA.,Medical Physics, School of Health, University of Wisconsin, Madison, USA
| |
Collapse
|
5
|
Meyer EJ, Kirov II, Tal A, Davitz MS, Babb JS, Lazar M, Malaspina D, Gonen O. Metabolic Abnormalities in the Hippocampus of Patients with Schizophrenia: A 3D Multivoxel MR Spectroscopic Imaging Study at 3T. AJNR Am J Neuroradiol 2016; 37:2273-2279. [PMID: 27444940 DOI: 10.3174/ajnr.a4886] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/03/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Schizophrenia is well-known to be associated with hippocampal structural abnormalities. We used 1H-MR spectroscopy to test the hypothesis that these abnormalities are accompanied by NAA deficits, reflecting neuronal dysfunction, in patients compared with healthy controls. MATERIALS AND METHODS Nineteen patients with schizophrenia (11 men; mean age, 40.6 ± 10.1 years; mean disease duration, 19.5 ± 10.5 years) and 11 matched healthy controls (5 men; mean age, 33.7 ± 10.1 years) underwent MR imaging and multivoxel point-resolved spectroscopy (TE/TR, 35/1400 ms) 1H-MRS at 3T to obtain their hippocampal GM absolute NAA, Cr, Cho, and mIns concentrations. Unequal variance t tests and ANCOVA were used to compare patients with controls. Bilateral volumes from manually outlined hippocampal masks were compared by using unequal variance t tests. RESULTS Patients' average hippocampal GM Cr concentrations were 19% higher than that of controls, 8.7 ± 2.2 versus 7.4 ± 1.2 mmol/L (P < .05); showing no differences, concentrations in NAA were 8.8 ± 1.6 versus 8.7 ± 1.2 mmol/L; in Cho, 2.3 ± 0.7 versus 2.1 ± 0.3 mmol/L; and in mIns, 6.1 ± 1.5 versus 5.2 ± 0.9 (all P > .1). There was a positive correlation between mIns and Cr in patients (r = 0.57, P = .05) but not in controls. The mean bilateral hippocampal volume was ∼10% lower in patients: 7.5 ± 0.9 versus 8.4 ± 0.7 cm3 (P < .05). CONCLUSIONS These findings suggest that the hippocampal volume deficit in schizophrenia is not due to net loss of neurons, in agreement with histopathology studies but not with prior 1H-MR spectroscopy reports. Elevated Cr is consistent with hippocampal hypermetabolism, and its correlation with mIns may also suggest an inflammatory process affecting some cases; these findings may suggest treatment targets and markers to monitor them.
Collapse
Affiliation(s)
- E J Meyer
- From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging
| | - I I Kirov
- From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging
| | - A Tal
- Department of Chemical Physics (A.T.), Weizmann Institute of Science, Rehovot, Israel
| | - M S Davitz
- From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging
| | - J S Babb
- From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging
| | - M Lazar
- From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging
| | - D Malaspina
- Department of Psychiatry (D.M.), Institute for Social and Psychiatric Initiatives, New York University School of Medicine, New York, New York
| | - O Gonen
- From the Department of Radiology (E.J.M., I.I.K., M.S.D., J.S.B., M.L., O.G.), Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging
| |
Collapse
|
6
|
Abstract
Corticosteroid-binding globulin (CBG, transcortin) is the primary cortisol binding protein. It is a non-inhibitory serine protease inhibitor, capable of conformational change from a high cortisol-binding affinity form to a low affinity form upon cleavage of its reactive centre loop by various proteases, such as neutrophil elastase. The burgeoning inflammatory role of CBG applies to acute, severe inflammation where depletion is associated with mortality, and to chronic inflammation where defects in cortisol delivery may perpetuate inflammation. Naturally occurring human mutations influence a wide range of CBG properties and point toward a role in hitherto unexplained chronic musculoskeletal pain and fatigue disorders as well as potentially affecting fertility outcomes including offspring gender. In vitro and knock-out animal models of CBG propose a role for CBG in cortisol transport to the brain, providing a foundation for understanding the human observations in those with CBG mutations and sex differences in stress-related mood and behaviour. Finally, CBG measurement has a practical role in the estimation of free cortisol, useful in clinical circumstances where CBG levels or cortisol binding affinity is reduced. Taken together, novel data suggest a role for cortisol in targeted cortisol delivery, with implications in acute and chronic inflammation, as well as roles in metabolism and neurocognitive function, implying that CBG is a multifaceted component in the mechanisms of hypothalamic-pituitary-adrenal axis related homeostasis.
Collapse
Affiliation(s)
- E J Meyer
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - M A Nenke
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - W Rankin
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - J G Lewis
- Steroid & Immunobiochemistry Laboratory, Canterbury Health Laboratories, Christchurch, New Zealand
| | - D J Torpy
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| |
Collapse
|
7
|
Paul RA, Smyser CD, Rogers CE, English I, Wallendorf M, Alexopoulos D, Meyer EJ, Van Essen DC, Neil JJ, Inder TE. An allometric scaling relationship in the brain of preterm infants. Ann Clin Transl Neurol 2014; 1:933-7. [PMID: 25540808 PMCID: PMC4265065 DOI: 10.1002/acn3.130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 09/03/2014] [Accepted: 09/05/2014] [Indexed: 11/07/2022] Open
Abstract
Allometry has been used to demonstrate a power–law scaling relationship in the brain of premature born infants. Forty-nine preterm infants underwent neonatal MRI scans and neurodevelopmental testing at age 2. Measures of cortical surface area and total cerebral volume demonstrated a power–law scaling relationship (α = 1.27). No associations were identified between these measures and investigated clinical variables. Term equivalent cortical surface area and total cerebral volume measures and scaling exponents were not related to outcome. These findings confirm a previously reported allometric scaling relationship in the preterm brain, and suggest that scaling is not a sensitive indicator of aberrant cortical maturation.
Collapse
Affiliation(s)
- Rachel A Paul
- Department of Psychiatry, Washington University School of Medicine St. Louis, Missouri
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine St. Louis, Missouri ; Department of Pediatrics, Washington University School of Medicine St. Louis, Missouri
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine St. Louis, Missouri ; Department of Pediatrics, Washington University School of Medicine St. Louis, Missouri
| | - Ian English
- Medical College of Wisconsin Milwaukee, Wisconsin
| | - Michael Wallendorf
- Division of Biostatistics, Washington University School of Medicine St. Louis, Missouri
| | - Dimitrios Alexopoulos
- Department of Neurology, Washington University School of Medicine St. Louis, Missouri
| | - Erin J Meyer
- Case Western Reserve Medical School Cleveland, Ohio
| | - David C Van Essen
- Department of Anatomy and Neurobiology, Washington University School of Medicine St. Louis, Missouri
| | - Jeffrey J Neil
- Department of Neurology, Boston Children's Hospital Boston, Massachusetts
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital Boston, Massachusetts
| |
Collapse
|
8
|
Kirchhoff BA, Lugar HM, Smith SE, Meyer EJ, Perantie DC, Kolody BC, Koller JM, Arbelaez AM, Shimony JS, Hershey T. Hypoglycaemia-induced changes in regional brain volume and memory function. Diabet Med 2013; 30:e151-6. [PMID: 23330574 PMCID: PMC3651610 DOI: 10.1111/dme.12135] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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] [Received: 07/13/2012] [Revised: 09/07/2012] [Accepted: 01/10/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hypoglycaemic events can be a serious complication of insulin therapy in Type 1 diabetes mellitus. Severe hypoglycaemic exposure can lead to episodic memory impairments, including anterograde amnesia. However, relatively little is known regarding the long-term impact of severe hypoglycaemia on brain structure in Type 1 diabetes mellitus. The goals of the present study were to gain a greater understanding of the long-term effects of severe hypoglycaemia exposure on brain structure and the neural correlates of memory impairments in Type 1 diabetes mellitus. CASE REPORT Regional grey and white matter volume and total white matter lesion volume were quantified in an individual with long-standing hypoglycaemia-induced anterograde amnesia and compared with age- and gender-matched healthy controls. Our patient has significant reductions in grey matter volume in the hippocampus, thalamus and pallidum, and significant reductions in white matter volume in the splenium, isthmus of the cingulate and cerebellum. He also has a significantly larger total white matter lesion volume than controls. CONCLUSION This case study highlights the potential of hypoglycaemia for permanent deleterious effects on brain structure and memory function. Our results suggest that subcortical grey matter, periventricular white matter and posterior white matter may be most susceptible to injury from hypoglycaemia exposure, and that structural damage to the hippocampus and isthmus of the cingulate may play a central role in hypoglycaemia-induced memory impairments.
Collapse
Affiliation(s)
- B A Kirchhoff
- Department of Psychology, University of Missouri - St. Louis, St. Louis, MO, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Spencer MM, Pantalone VR, Meyer EJ, Landau-Ellis D, Hyten DL. Mapping the Fas locus controlling stearic acid content in soybean. Theor Appl Genet 2003; 106:615-9. [PMID: 12595989 DOI: 10.1007/s00122-002-1086-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2002] [Accepted: 07/08/2002] [Indexed: 05/24/2023]
Abstract
Increasing the stearic acid content to improve soybean [ Glycine max (L) Merr] oil quality is a desirable breeding objective for food-processing applications. Although a saturated fatty acid, stearic acid has been shown to reduce total levels of blood cholesterol and offers the potential for the production of solid fat products (such as margarine) without hydrogenation. This would result in the reduction of the level of trans fat in food products and alleviate some current health concerns. A segregating F(2) population was developed from the cross between Dare, a normal stearic acid content cultivar, and FAM94-41, a high stearic acid content line. This population was used to assess linkage between the Fas locus and simple sequence repeat (SSR) markers. Three SSR markers, Satt070, Satt474 and Satt556, were identified to be associated with stearic acid (P < 0.0001, r(2) > 0.61). A linkage map consisting of the three SSR markers and the Fas locus was then constructed in map order, Fas, Satt070, Satt474 and Satt556, with a LOD score of 3.0. Identification of these markers may be useful in molecular marker-assisted breeding programs targeting modifications in soybean fatty acids.
Collapse
Affiliation(s)
- M M Spencer
- The University of Tennessee, Department of Plant Sciences and Landscape Systems, 252 Ellington Plant Science Building, 2431 Center Drive, Knoxville 37996-4561, USA.
| | | | | | | | | |
Collapse
|
10
|
Mercolino TJ, Connelly MC, Meyer EJ, Knight MD, Parker JW, Stelzer GT, DeChirico G. Immunologic differentiation of absolute lymphocyte count with an integrated flow cytometric system: a new concept for absolute T cell subset determinations. Cytometry 1995; 22:48-59. [PMID: 7587734 DOI: 10.1002/cyto.990220110] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We describe a method to obtain results for immune status monitoring that uses a three-test panel, comprised of isotype control and 2 specific Mab tests (CD4/CD8/CD3 and CD16/CD19/CD3), in conjunction with a flow cytometer that directly measures absolute counts. Automated software is used for lineage-specific gating of three-color immunofluorescence to determine lymphocyte and lymphocyte subset counts. The autogating function of this software is shown to yield equivalent results to manual analysis by an expert user, and to be effective when as few as 25 target cells are present. The software is also shown to perform automatic quality control checks of the sample preparation, reagent, and automated analysis. We demonstrate that the sum of T (CD3+), B (CD19+), and natural killer (NK, CD16 + CD3-) cells, as a determination of all lymphocytes, correlates well with lymphocytes measured using a light scatter differential. Moreover, T + B + NK lymphocyte count is shown to be less error-prone than lymphocyte count from light scatter differential, and to minimize errors that arise from between-technician variation in sample preparation. Our data suggest that the new approach that we describe could offer an alternative to the traditional two-stage methods for measuring absolute counts of lymphocyte subsets for immune status monitoring. As such this method could reduce, through objective automated analysis, testing cost and complexity, without sacrificing the quality of results.
Collapse
Affiliation(s)
- T J Mercolino
- Ortho Diagnostic Systems, Raritan, New Jersey 08869-0606, USA
| | | | | | | | | | | | | |
Collapse
|
11
|
Meyer EJ, Lorenzi M, Bohannon NV, Amend W, Feduska NJ, Salvatierra O, Forsham PH. Diabetic management by insulin infusion during major surgery. Am J Surg 1979; 137:323-7. [PMID: 373474 DOI: 10.1016/0002-9610(79)90059-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In five insulin-requiring, uremic diabetic patients undergoing renal transplantation, we infused insulin intravenously at a low rate to maintain plasma glucose levels between 100 and 200 mg/100 ml. In those patients receiving 100 mg or more of prednisone per day and 5 per cent dextrose solution, the hourly infusion rate was determined from tthe following equation: insulin (U) = plasma glucose value divided by 100. When prednisone was not given or when the patient was thin, the ratio became: plasma glucose value divided by 150. Results were compared with those of nineteen similar transplant patients treated with conventional subcutaneous insulin therapy during surgery, and significantly better glucose control was achieved with the low dosage, intravenous infusion.
Collapse
|
12
|
Trentelman EF, Meyer EJ. The reactions of cord blood with saline agglutinating anti-Rho(D) serum. Am J Med Technol 1970; 36:64-6. [PMID: 4983917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
13
|
Meyer EJ. Lawyer in a mental hospital: the New York experiment. Ment Hyg 1969; 53:14-6. [PMID: 5398896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
14
|
|
15
|
Meyer EJ, Roberts CR, Leibowitz HM, McGowan B, Houle RE. Influence of norethynodrel with mestranol on intraocular pressure in glaucoma. II. A controlled double-blind study. Arch Ophthalmol 1966; 75:771-3. [PMID: 5327793 DOI: 10.1001/archopht.1966.00970050773011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
16
|
Meyer EJ, Leibowitz H, Christman EH, Niffenegger JA. Influence of norethynodrel with mestranol on intraocular pressure in glaucoma. Arch Ophthalmol 1966; 75:157-61. [PMID: 5903799 DOI: 10.1001/archopht.1966.00970050159003] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|