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Gregory G, Timmerman J, Lavie D, Borchmann P, Herrera AF, Minuk L, Vucinic V, Armand P, Avigdor A, Gasiorowski R, Herishanu Y, Keane C, Kuruvilla J, Palcza J, Pillai P, Marinello P, Johnson NA. P1086: FAVEZELIMAB (ANTI–LAG-3) AND PEMBROLIZUMAB CO-BLOCKADE IN ANTI–PD-1–NAIVE PATIENTS WITH RELAPSED OR REFRACTORY CLASSICAL HODGKIN LYMPHOMA: AN OPEN-LABEL PHASE 1/2 STUDY. Hemasphere 2022. [PMCID: PMC9428990 DOI: 10.1097/01.hs9.0000847212.00073.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tatarczuch M, Waltham M, Shortt J, Hawkes E, Ho SJ, Trotman J, Brasacchio D, Co M, Li J, Ramakrishnan V, Dunne K, Opat S, Gregory G. P1261: ALLG LABORATORY SCIENCE STUDY LS21: MOLECULAR CORRELATES OF RESPONSE IN RELAPSED/REFRACTORY MARGINAL ZONE LYMPHOMA (RRMZL) PATIENTS TREATED WITH ZANUBRUTINIB IN THE MAGNOLIA TRIAL. Hemasphere 2022. [PMCID: PMC9430053 DOI: 10.1097/01.hs9.0000847908.60002.1c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Purpose
This paper aims to examine the influence of intrinsic motives (self-efficacy, reputation and reciprocity) on online knowledge sharing behaviour. Additionally, this research investigates the moderating role of individual innovation capability and top management support.
Design/methodology/approach
The methodology adopted was a questionnaire survey of employees working in Vietnamese telecommunications companies. A total of 501 employees completed a self-administered anonymous survey using a cross-sectional design. Confirmatory factor analysis and ordinary least squared – based hierarchical regression was used to test the conceptual framework.
Findings
Self-efficacy, reputation and reciprocity significantly impact online knowledge sharing behaviour. Specifically, self-efficacy has an inverted U-shape association while reputation and reciprocity have a positively, returns-to-scale association with online knowledge sharing behaviour. Individual innovation capability moderates the effect on these associations as does top management support, but to a lesser extent.
Research limitations/implications
Data were obtained at a single point in time and self-reported. Furthermore, this study was conducted in a specific industry in Vietnam, i.e. telecommunications, which limits the generalisability of the research.
Practical implications
Organisations need to create a favourable environment for online knowledge sharing to foster reciprocal relationships and interpersonal interactions of employees. Encouraging and rewarding employees to actively engage in knowledge exchange will help facilitate reciprocal online knowledge sharing behaviour.
Originality/value
This study contributes to knowledge-sharing behaviour by uncovering an inverted U-shape association and positively, returns-to-scale associations between intrinsic antecedents and online knowledge sharing behaviour. Additionally, individual innovation capability was an important moderator which has been overlooked in past research.
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Gupta M, Sherrow C, Krone ME, Blais EM, Pishvaian MJ, Petricoin EF, Matrisian LM, DeArbeloa P, Gregory G, Brown A, Zalewski O, Prinzing G, Roche C, Kanehira K, Mukherjee S, Iyer R, Fountzilas C. Targeting the NTRK Fusion Gene in Pancreatic Acinar Cell Carcinoma: A Case Report and Review of the Literature. J Natl Compr Canc Netw 2021; 19:10-15. [PMID: 33406492 PMCID: PMC8765083 DOI: 10.6004/jnccn.2020.7641] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 05/18/2020] [Accepted: 08/14/2020] [Indexed: 11/17/2022]
Abstract
Pancreatic acinar cell carcinoma (PACC) is a rare pancreatic exocrine malignancy. Compared with the more common pancreatic ductal adenocarcinoma (PDAC), PACC is more common in younger White men, has earlier stages and a lower mean age (56 vs 70 years) at the time of presentation, and has a better prognosis. In addition to differences in demographic, histologic, and clinical characteristics, PACC has a genomic profile distinct from PDAC, with only rare mutations in TP53, KRAS, and p16 that are commonly found in PDAC. This case report presents a man aged 81 years who presented with a pancreatic body mass with peripancreatic lymph node enlargement. Biopsy of the mass showed acinar cell carcinoma. The patient underwent upfront surgical resection, followed by one cycle of adjuvant gemcitabine, with stoppage of therapy due to poor tolerance. Lower-dose gemcitabine was reintroduced after disease progression 6 months later. Nab-paclitaxel was added to gemcitabine after 6 cycles because of a continued increase in the size of peripancreatic lymph nodes. Combination chemotherapy was stopped after 4 cycles because of further disease progression with new liver metastasis. Molecular testing showed the presence of an SEL1L-NTRK1 fusion. Targeted therapy was started with the oral neurotrophic tropomyosin receptor kinase (NTRK) inhibitor larotrectinib at a dosage of 100 mg twice daily. At the time of writing, the patient has been on therapy for 13 months with an exceptional radiographic response and has not experienced any grade 3 adverse effects. To our knowledge, this is the first clinical report of an NTRK gene fusion in a patient with PACC. This case study highlights the significance of tumor molecular profiling in patients with pancreatic tumors, especially rare histologies.
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Affiliation(s)
- Medhavi Gupta
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Christopher Sherrow
- Department of Pharmacy, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Maghan E. Krone
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Michael J. Pishvaian
- Perthera, Inc., Holliston, Massachusetts
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Emanuel F. Petricoin
- Perthera, Inc., Holliston, Massachusetts
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Fairfax, Virginia
| | | | | | | | - Alyson Brown
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Olivia Zalewski
- Department of Pharmacy, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Gillian Prinzing
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Charles Roche
- Department of Radiology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Kazunori Kanehira
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Sarbajit Mukherjee
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Renuka Iyer
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Christos Fountzilas
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Hendifar AE, Blais EM, Ng C, Thach D, Gong J, Sohal D, Chung V, Sahai V, Fountzilas C, Mikhail S, Gregory G, Brody JR, Lyons E, DeArbeloa P, Matrisian LM, Petricoin E, Pishvaian MJ. Comprehensive analysis of KRAS variants in patients (pts) with pancreatic cancer (PDAC): Clinical/molecular correlations and real-world outcomes across standard therapies. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.4641] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4641 Background: Approximately 90% of PDAC tumors are driven by activating KRAS mutations. The biological and clinical impact of common KRAS variants (e.g. G12D, G12V, G12R) and less common variants (e.g. G12C, Q61H, Q61R) remains largely unknown despite the emergence of variant-specific treatment strategies. Methods: We retrospectively analyzed real-world outcomes from 1475 PDAC pts who underwent molecular profiling via the Know Your Tumor program. Overall survival (OS) and progression-free survival (PFS) were analyzed by choice of 1st line standard therapies. Outcomes in pts with specific KRAS mutations were compared against the KRAS G12D cohort using Cox regression. Based on our prior data, tumor profiles with actionable molecular findings (DDR mutations or other drivers) were evaluated separately. Results: The prognostic/predictive value of specific KRAS variants revealed differences in real-world outcomes (Table). OS was greater in pts with KRAS G12V and G12R variants, as was PFS on 5FU-Based Therapy (e.g. FOLFIRINOX) but not for Gemcitabine/nab-Paclitaxel. Opposing trends were noted for KRAS Q61. Pts with KRAS wild type tumors as well as both actionable subgroups also had an improved OS. Conclusions: In this large national dataset, we demonstrate that KRAS mutation status and specific variants appear to be prognostic as well as predictive in pancreatic cancer. [Table: see text]
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Affiliation(s)
| | | | - Camille Ng
- Cedars-Sinai Medical Center, Los Angeles, CA
| | | | | | | | | | | | | | - Sameh Mikhail
- The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital, Columbus, OH
| | | | | | - Emily Lyons
- Pancreatic Cancer Action Network, Manhattan Beach, CA
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Gong J, Blais EM, Bender JR, Guan M, Placencio-Hickok V, Petricoin EF, Pishvaian MJ, Gregory G, Tuli R, Hendifar AE. Multiplatform profiling of pancreatic neuroendocrine tumors: Correlative analyses of clinicopathologic factors and identification of co-occurring pathogenic alterations. Oncotarget 2019; 10:6260-6268. [PMID: 31692857 PMCID: PMC6817448 DOI: 10.18632/oncotarget.27265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/24/2019] [Indexed: 12/11/2022] Open
Abstract
Background Multi-omic profiling of pancreatic neuroendocrine tumors (PanNETs) was performed to correlate genomic, proteomic, and molecular pathway alterations with clinicopathologic factors and identify novel co-occurring pathogenic alterations of potential clinical relevance to PanNET management. Methods PanNETs referred to Perthera, Inc. having undergone molecular profiling for precision matched therapeutic purposes were screened. Correlative analyses were performed using Fisher’s exact test across individual pathogenic alterations or altered molecular pathways and clinicopathologic variables. Associations were visualized by hierarchical clustering. Prognostic associations with overall survival (OS) were identified using Cox regression for pathogenic alterations and pathway-level alterations. Hazard ratios (HR) and odds ratios (OR) were reported with 95% confidence intervals (CI). Results From 12/2014–1/2019, 46 patients with predominantly locally advanced and metastatic PanNETs were included. MEN1 alterations by next-generation sequencing (NGS) were less associated with having high-grade PanNETs and metastatic disease at diagnosis (p ≤ 0.05). Genomic alterations associated with increased replicative stress (primarily driven by RB1 and TP53) correlated with higher grade (OR 6.87 [95% CI: 1.57-35.18], p = 0.0043) and worse OS (HR 13.62 [95% CI: 1.51-122.5], p = 0.0198). Other significant associations included: ERCC1 protein expression with DAXX or MEN1 alterations (NGS), PTEN (NGS) with ARID1A or TP53 alterations (NGS), and history of diabetes coincided with cell cycle pathway alterations but was mutually exclusive with replicative stress pathway alterations. Conclusions We identified several molecular signatures of potential clinical significance for therapeutic targeting and prognostication in PanNETs warranting prospective validation. Our findings are hypothesis generating and can inform larger molecular profiling efforts in PanNETs.
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Affiliation(s)
- Jun Gong
- Gastrointestinal and Neuroendocrine Malignancies, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | | | | | - Michelle Guan
- Gastrointestinal and Neuroendocrine Malignancies, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Veronica Placencio-Hickok
- Gastrointestinal and Neuroendocrine Malignancies, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Emanuel F Petricoin
- Perthera, Inc, McLean, VA 22102, USA.,George Mason University, Fairfax, VA 22030, USA
| | - Michael J Pishvaian
- Perthera, Inc, McLean, VA 22102, USA.,Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington D.C. 20007, USA
| | | | - Richard Tuli
- Gastrointestinal and Neuroendocrine Malignancies, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Andrew E Hendifar
- Gastrointestinal and Neuroendocrine Malignancies, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Casan J, Wolyncewicz G, Alam W, Opat S, Gregory G, Shortt J, Patil S, Gilbertson M. R-IVAC SALVAGE THERAPY IN RELAPSED AND REFRACTORY DLBCL. Hematol Oncol 2019. [DOI: 10.1002/hon.110_2631] [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] [Indexed: 11/06/2022]
Affiliation(s)
- J. Casan
- Haematology; Monash Health; Clayton Australia
| | | | - W. Alam
- Haematology; Monash Health; Clayton Australia
| | - S. Opat
- School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
| | - G. Gregory
- School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
| | - J. Shortt
- School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
| | - S. Patil
- Haematology; The Alfred Hospital; Melbourne Australia
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8
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Gregory G, Walker P, Mahadevan D, Wang D, Chang J, Hernandez-Ilizaliturri F, Klein A, Rybka W, Wagner-Johnston N, Escobar C, Pagel J, Mohrbacher A, Opat S, Shortt J, Ma H, Gwo J, Farooqui M, Quach H. ANTITUMOR ACTIVITY OF PEMBROLIZUMAB PLUS DINACICLIB IN PATIENTS WITH DIFFUSE LARGE B CELL LYMPHOMA: THE PHASE 1B KEYNOTE-155 STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.140_2630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G. Gregory
- Hematology; School of Clinical Sciences at Monash Health, Monash University; Clayton Australia
| | - P. Walker
- Clinical; Peninsula Health; Frankston Australia
| | - D. Mahadevan
- Medicine; The University of Arizona Cancer Center; Tucson United States
| | - D. Wang
- Hematology/Oncology; Henry Ford Hospital; Detroit United States
| | - J. Chang
- Oncology; Wisconsin Institute of Medical Research; Madison United States
| | | | - A. Klein
- Hematology/Oncology; Tufts Medical Center; Boston United States
| | - W. Rybka
- Oncology; Penn State Hershey Cancer Institute; Hershey United States
| | - N. Wagner-Johnston
- Oncology; Johns Hopkins Sidney Kimmel Cancer Center; Baltimore United States
| | - C. Escobar
- Oncology; Baylor University Medical Center; Dallas United States
| | - J.M. Pagel
- Hematology; Swedish Cancer Institute; Seattle United States
| | - A. Mohrbacher
- Hematology; Keck School of Medicine of USC; Los Angeles United States
| | - S. Opat
- Hematology; School of Clinical Sciences at Monash Health, Monash University; Clayton Australia
| | - J. Shortt
- Hematology; School of Clinical Sciences at Monash Health, Monash University; Clayton Australia
| | - H. Ma
- Biostatistics; Merck & Co., Inc.; Kenilworth NJ United States
| | - J. Gwo
- Biostatistics; Merck & Co., Inc.; Kenilworth NJ United States
| | - M. Farooqui
- Clinical Research; Merck & Co., Inc.; Kenilworth United States
| | - H. Quach
- Hematology; University of Melbourne, St. Vincent's Hospital; Fitzroy Australia
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Affiliation(s)
- G. Gregory
- Word Therapy, Paraparaumu Beach, New Zealand
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10
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Chameides WL, Davis DD, Bradshaw J, Sandholm S, Rodgers M, Baum B, Ridley B, Madronich S, Carroll MA, Gregory G, Schiff HI, Hastie DR, Torres A, Condon E. Observed and model-calculated NO2/NO ratios in tropospheric air sampled during the NASA GTE/CITE-2 field study. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/jd095id07p10235] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Forster GM, Hill D, Gregory G, Weishaar KM, Lana S, Bauer JE, Ryan EP. Effects of cooked navy bean powder on apparent total tract nutrient digestibility and safety in healthy adult dogs. J Anim Sci 2012; 90:2631-8. [PMID: 22367072 DOI: 10.2527/jas.2011-4324] [Citation(s) in RCA: 11] [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: 11/13/2022] Open
Abstract
Dry beans (Phaseolus vulgaris L., Fabaceae) are a low glycemic index food containing protein, fiber, minerals, essential vitamins, and bioactive compounds and have not been evaluated for inclusion in commercial canine diets. The objective of this study was to establish the apparent total tract digestibility and safety of cooked navy bean powder when incorporated into a canine diet formulation at 25% (wt/wt) compared with a macro- and micro-nutrient matched control. Twenty-one healthy, free-living, male and female adult dogs of different breeds were used in a randomized, blinded, placebo controlled, 28-d dietary intervention study. Apparent total tract energy and nutrient digestibility of the navy bean powder diet were compared with the control diet. Digestibilities and ME content were 68.58 and 68.89% DM, 78.22 and 79.49% CP, 77.57 and 74.91% OM, 94.49 and 93.85% acid hydrolyzed fat, and 3,313 and 3,195 kcal ME/kg for the navy bean diet and control diet, respectively. No differences were observed between the groups. No increased flatulence or major change in fecal consistency was observed. Navy bean powder at 25% (wt/wt) of total diet was determined to be palatable (on the basis of intake and observation) and digestible in a variety of dog breeds. No changes were detected in clinical laboratory values, including complete blood counts, blood biochemical profiles, and urinalysis in either the bean or control diet groups. These results indicate that cooked navy bean powder can be safely included as a major food ingredient in canine diet formulations and provide a novel quality protein source, and its use warrants further investigation as a functional food for chronic disease control and prevention.
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Affiliation(s)
- G M Forster
- Department of Clinical Sciences, Colorado State University, Fort Collins, C0 80523, USA
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13
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Garber L, Hill G, Rodriguez J, Gregory G, Voelker L. Non-commercial poultry industries: Surveys of backyard and gamefowl breeder flocks in the United States. Prev Vet Med 2007; 80:120-8. [PMID: 17337307 DOI: 10.1016/j.prevetmed.2007.01.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Revised: 01/30/2007] [Accepted: 01/31/2007] [Indexed: 11/27/2022]
Abstract
The National Animal Health Monitoring System (NAHMS) Poultry '04 study was conducted to better describe non-commercial United States poultry populations, in particular, backyard and gamefowl breeder flocks. To estimate the density of backyard flocks in close proximity to commercial operations, a sample of 350 commercial poultry operations in 18 top poultry producing states was selected from the National Agricultural Statistics Service (NASS) list of poultry operations. A 1 mile radius circle was drawn around each operation, and door-to-door canvassing was conducted within these circles to enumerate premises with all species of birds. Premises with backyard poultry flocks completed a questionnaire focusing on bird health, bird movement, and biosecurity practices. A similar questionnaire, provided in both English and Spanish, was mailed to all members of State affiliates of the United Gamefowl Breeders Association (UGBA) as well as to members of State associations not affiliated with UGBA. An average of 29.4 residences was found within a 1 mile radius of commercial operations, of which 1.9 residences per circle had backyard poultry flocks. Gamefowl breeder flocks were larger, used more health care and biosecurity practices, and moved birds more frequently compared to backyard flocks.
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Affiliation(s)
- L Garber
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, Centers for Epidemiology and Animal Health, Fort Collins, CO 80526, USA.
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Gregory G. Slaughtering methods and equipment. Vet Hist 2001; 6:73-84. [PMID: 11622714] [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: 02/21/2023]
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15
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Fujii E, Kodama Y, Takahashi N, Roman C, Ferriero D, Gregory G, Parer JT. Fructose- 1,6-bisphosphate did not affect hippocampal neuronal damage caused by 10 min of complete umbilical cord occlusion in fetal sheep. Neurosci Lett 2001; 309:49-52. [PMID: 11489544 DOI: 10.1016/s0304-3940(01)02026-2] [Citation(s) in RCA: 6] [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: 11/25/2022]
Abstract
Fructose-1, 6-bisphosphate (FBP) has a neuroprotective effect in neonatal and adult rats. The purpose of this study was to examine the effects of FBP on hippocampal neuronal damage in fetal sheep asphyxiated by 10 min of complete umbilical cord occlusion. Thirteen fetal sheep at 124 days of gestation were surgically instrumented with catheters. Cardiorespiratory parameters were monitored, and biochemical analyses were performed with the blood samples. During the insult seven fetuses were given FBP (500 mg/kg) and six were given iso-osmotic saline, and hippocampal neuronal damage was examined histologically and scored. Cardiorespiratory changes were the same in both groups, and there was no neuroprotective effect of FBP in this study. However the decrease of serum total Ca level implied the Ca- chelating effect of FBP.
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Affiliation(s)
- E Fujii
- Department of Obstetrics, Gynecology, University of California, San Francisco, CA, USA.
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16
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Vigneron DB, Barkovich AJ, Noworolski SM, von dem Bussche M, Henry RG, Lu Y, Partridge JC, Gregory G, Ferriero DM. Three-dimensional proton MR spectroscopic imaging of premature and term neonates. AJNR Am J Neuroradiol 2001; 22:1424-33. [PMID: 11498441 PMCID: PMC7975213] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND AND PURPOSE Previous studies have primarily used single-voxel techniques to obtain MR spectra from the neonatal brain. In this study, we applied 3D MR spectroscopic imaging techniques to detect the spatial distribution of MR spectroscopic imaging-detectable compounds in premature and term infants. The goals were to test the feasibility of obtaining 3D MR spectroscopic images of newborns, assess the spatial variations of metabolite levels, and determine age-dependent differences in MR spectroscopic imaging data. METHODS MR spectroscopic imaging data were acquired from nine premature (postconceptional age, 30-34 weeks) and eight term (postconceptional age, 38-42 weeks) neonates, all with normal clinical and neurologic outcomes. A specialized point-resolved spectroscopy sequence with very selective saturation pulses was used to select a region encompassing the majority of the brain. Phase encoding in three dimensions was performed in a 17-minute acquisition time to obtain 3D spectral arrays with a 1.0 cm(3) nominal spatial resolution. RESULTS This study showed the feasibility of detecting the 3D distributions of choline, creatine, and N-acetylaspartate resonances in the neonatal brain. Significant spectral differences were detected among anatomic locations and between the premature and term groups. CONCLUSION This initial study indicates that 3D MR spectroscopic imaging of the neonatal brain can detect anatomic and age-dependent variations in metabolite levels. This technique seems to be a powerful tool to assess the metabolic differences between anatomic regions and to follow the changes in cellular metabolites with brain maturation. This study also indicates the need for determining topologic and age-matched normative values before metabolic abnormalities in neonates can be accurately assessed by MR spectroscopy.
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Affiliation(s)
- D B Vigneron
- Department of Radiology, Magnetic Resonance Science Center, University of California, San Francisco, CA 94143, USA
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17
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Russell IA, Miller Hance WC, Gregory G, Balea MC, Cassorla L, DeSilva A, Hickey RF, Reynolds LM, Rouine-Rapp K, Hanley FL, Reddy VM, Cahalan MK. The safety and efficacy of sevoflurane anesthesia in infants and children with congenital heart disease. Anesth Analg 2001; 92:1152-8. [PMID: 11323338 DOI: 10.1097/00000539-200105000-00014] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.2] [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
UNLABELLED We tested the hypothesis that sevoflurane is a safer and more effective anesthetic than halothane during the induction and maintenance of anesthesia for infants and children with congenital heart disease undergoing cardiac surgery. With a background of fentanyl (5 microg/kg bolus, then 5 microg. kg(-1). h(-1)), the two inhaled anesthetics were directly compared in a randomized, double-blinded, open-label study involving 180 infants and children. Primary outcome variables included severe hypotension, bradycardia, and oxygen desaturation, defined as a 30% decrease in the resting mean arterial blood pressure or heart rate, or a 20% decrease in the resting arterial oxygen saturation, for at least 30 s. There were no differences in the incidence of these variables; however, patients receiving halothane experienced twice as many episodes of severe hypotension as those who received sevoflurane (P = 0.03). These recurrences of hypotension occurred despite an increased incidence of vasopressor use in the halothane-treated patients than in the sevoflurane-treated patients. Multivariate stepwise logistic regression demonstrated that patients less than 1 yr old were at increased risk for hypotension compared with older children (P = 0.0004), and patients with preoperative cyanosis were at increased risk for developing severe desaturation (P = 0.049). Sevoflurane may have hemodynamic advantages over halothane in infants and children with congenital heart disease. IMPLICATIONS In infants and children with congenital heart disease, anesthesia with sevoflurane may result in fewer episodes of severe hypotension and less emergent drug use than anesthesia with halothane.
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Affiliation(s)
- I A Russell
- Department of Anesthesia and Perioperative Care, Division of Pediatric Cardiac Surgery, University of California-San Francisco, 521 Parnassus Ave., C450, San Francisco, CA 94143-0648, USA
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18
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Liniger R, Popovic R, Sullivan B, Gregory G, Bickler PE. Effects of neuroprotective cocktails on hippocampal neuron death in an in vitro model of cerebral ischemia. J Neurosurg Anesthesiol 2001; 13:19-25. [PMID: 11145473 DOI: 10.1097/00008506-200101000-00004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cocktails of neuroprotectants acting at different parts of the ischemic injury cascade may have advantages over single agents. This study investigated, singly and in combination, the neuroprotective efficacy of an energy substrate (3.5 mM fructose 1,6-bisphosphate, FBP), an antagonist of NMDA receptors (1 and 10 microM MK-801), a free-radical scavenger (100 microM ascorbate), an adenosine A1 receptor agonist (10 microM 2-chloroadenosine), and an inhibitor of neurotransmission (2% isoflurane). These agents were evaluated for their ability to prevent loss and morphologic damage of CA1 neurons in rat hippocampal slices when these agents were administered during 30 minutes in vitro ischemia (combined oxygen/glucose deprivation at 37 degrees C) followed by 5 hours of recovery. Ten microM MK-801, alone or in combination with the other compounds, prevented loss of CA1 neurons and preserved their histologic appearance. Isoflurane, which prevents glutamate receptor-dependent cell death in this model, was also protective. Protection against neuron loss was also found when a subtherapeutic concentration of MK-801 (1 microM) was combined with 2-chloroadenosine (which indirectly causes NMDA receptor suppression), but not FBP or ascorbate. The authors conclude that in this model, the strategy of antagonizing NMDA receptors appears more protective than fructose-1,6-bisphosphate, 2-chloroadenosine or ascorbate.
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Affiliation(s)
- R Liniger
- Department of Anesthesia, University of California at San Francisco, USA
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Field P, Gregory G. Non-government organisations to combine for work on chronic disease in Aboriginal peoples, Torres Strait Islanders and rural and remote populations. Aust J Rural Health 2000; 8:239-42. [PMID: 11894292 DOI: 10.1046/j.1440-1584.2000.00326.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
As a result of the National Health Priority Area Report on Cardiovascular Health and in particular, its remote and indigenous section, a consortium of five organisations ran a national workshop in Townsville in October 1999 on heart disease in Aboriginal peoples, Torres Strait Islanders and rural and remote populations. One of the priority areas identified at this workshop was the need for a more coordinated approach to chronic diseases and for the formation of an alliance of non-government organisations (NGOs) to work towards this and to undertake a lobbying and advocacy role. A meeting of a wide range of NGOs working in chronic disease, led by the National Heart Foundation of Australia, was held in Sydney in May 2000. At the Sydney meeting it was agreed that an alliance of NGOs could be formed for the development of a chronic disease strategy for Aboriginal peoples, Torres Strait Islanders and rural and remote populations. The NGOs drafted a 'Statement of Intent', which would inform their work on both heart disease and on broader work to address chronic preventable disease in the target populations. There is a considerable amount of procedural work to be done before the proposed alliance becomes a reality but the prospect of closer collaboration between the NGOs working in chronic disease has much to offer, especially for the population groups that were the focus of the Townsville workshop. This 'alliance' initiative comes at a time when there are national and State/Territory moves on broader aspects of what could become a 'national chronic disease prevention and management strategy'.
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Affiliation(s)
- P Field
- Rural, Remote, Aboriginal and Torres Strait Islander Programs, National Heart Foundation of Australia, Deakin West, Australian Capital Territory, Australia
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Crawford J, Davis D, Olson J, Chen G, Liu S, Fuelberg H, Hannan J, Kondo Y, Anderson B, Gregory G, Sachse G, Talbot R, Viggiano A, Heikes B, Snow J, Singh H, Blake D. Evolution and chemical consequences of lightning-produced NOxobserved in the North Atlantic upper troposphere. ACTA ACUST UNITED AC 2000. [DOI: 10.1029/2000jd900183] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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21
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Derugin N, Wendland M, Muramatsu K, Roberts TP, Gregory G, Ferriero DM, Vexler ZS. Evolution of brain injury after transient middle cerebral artery occlusion in neonatal rats. Stroke 2000; 31:1752-61. [PMID: 10884483 DOI: 10.1161/01.str.31.7.1752] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Stroke in preterm and term babies is common and results in significant morbidity. The vulnerability and pathophysiological mechanisms of neonatal cerebral ischemia-reperfusion may differ from those in the mature cerebral nervous system because of the immaturity of many receptor systems and differences in metabolism in neonatal brain. This study details the neuropathological sequelae of reperfusion-induced brain injury after transient middle cerebral artery (MCA) occlusion in the postnatal day 7 (P7) rat. METHODS P7 rats were subjected to 3 hours of MCA occlusion followed by reperfusion or sham surgery. Diffusion-weighted MRI was performed during MCA occlusion, and maps of the apparent diffusion coefficient (ADC) were constructed. Contrast-enhanced MRI was performed in a subset of animals before and 20 minutes after reperfusion. Triphenyltetrazolium chloride (TTC) staining of the brain was performed 24 hours after reperfusion. Immunohistochemistry to identify astrocytes (glial fibrillary acidic protein), reactive microglia (ED-1), and neurons (microtubule-associated protein 2) and cresyl violet staining were done 4, 8, 24, and 72 hours after reperfusion. RESULTS On contrast-enhanced MRI, nearly complete disruption of cerebral blood flow was evident in the vascular territory of the MCA during occlusion. Partial restoration of blood flow occurred after removal of the suture. A significant decrease of the ADC, indicative of early cytotoxic edema, occurred in anatomic regions with a disrupted blood supply. The decline in ADC was associated with TTC- and cresyl violet-determined brain injury in these regions 24 hours later. The ischemic core was rapidly infiltrated with reactive microglia and was surrounded by reactive astroglia. CONCLUSIONS In P7 rats, transient MCA occlusion causes acute cytotoxic edema and severe unilateral brain injury. The presence of a prominent inflammatory response suggests that both the ischemic episode and the reperfusion contribute to the neuropathological outcome.
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Affiliation(s)
- N Derugin
- Departments of Neurosurgery, University of California at San Francisco,San Francisco, CA 94143-0114, USA
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22
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Fitzpatrick L, Gregory G, Harris B. 'Infront outback' goes national. Aust J Rural Health 2000; 8:180-2. [PMID: 11249408 DOI: 10.1046/j.1440-1584.2000.00315.x] [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] [Indexed: 11/20/2022] Open
Abstract
The National Rural Health Alliance, the Toowoomba Hospital Foundation and the Cunningham Centre have agreed to merge the two biennial conferences for rural and remote health that have been running in alternate years since 1991. This means that in March 2001, the National Rural Health Conference will, for the first time, incorporate 'Infront Outback', the Australian Rural and Remote Health Scientific Conference. There will, therefore, be one major biennial rural heath conference, dealing coherently with health scientific research and policy development. The recommendations to governments and national bodies that result should be even stronger and more highly regarded than has been the case to date.
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Abstract
Actions to improve the health of people in rural and remote areas are supported by people's ability as individuals and as a community to take part actively in the design, management and evaluation of their own health services. To do this successfully, people need information about their health, resources to support their actions and political support or legitimacy. This article focuses on the third requirement. At the beginning of 2000, there seems to be strong political interest in improving the status of rural communities and rural services overall, including rural health and health services. The constellation of events that contribute to this encouraging state of affairs includes the Regional Australia Summit that was held in October 1999, the existence of a strategic framework for rural health that was agreed on by all health jurisdictions (Healthy Horizons), improved clarity about the relative state of health and health service utilisation in rural and remote areas, and the Prime Minister's recent commitment to improve rural services. The next major national opportunity to convert these positive signs into action comes with the Federal Budget in May 2000, the content of which will be closely watched by people concerned about improving health in country areas.
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Affiliation(s)
- J Lipscombe
- National Rural Health Alliance, Australian Capital Territory, Australia
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Singh H, Chen Y, Tabazadeh A, Fukui Y, Bey I, Yantosca R, Jacob D, Arnold F, Wohlfrom K, Atlas E, Flocke F, Blake D, Blake N, Heikes B, Snow J, Talbot R, Gregory G, Sachse G, Vay S, Kondo Y. Distribution and fate of selected oxygenated organic species in the troposphere and lower stratosphere over the Atlantic. ACTA ACUST UNITED AC 2000. [DOI: 10.1029/1999jd900779] [Citation(s) in RCA: 227] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Crawford J, Davis D, Olson J, Chen G, Liu S, Gregory G, Barrick J, Sachse G, Sandholm S, Heikes B, Singh H, Blake D. Assessment of upper tropospheric HOxsources over the tropical Pacific based on NASA GTE/PEM data: Net effect on HOxand other photochemical parameters. ACTA ACUST UNITED AC 1999. [DOI: 10.1029/1999jd900106] [Citation(s) in RCA: 111] [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: 11/09/2022]
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26
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Smyth S, Sandholm S, Shumaker B, Mitch W, Kanvinde A, Bradshaw J, Liu S, McKeen S, Gregory G, Anderson B, Talbot R, Blake D, Rowland S, Browell E, Fenn M, Merrill J, Bachmeier S, Sachse G, Collins J. Characterization of the chemical signatures of air masses observed during the PEM experiments over the western Pacific. ACTA ACUST UNITED AC 1999. [DOI: 10.1029/1999jd900115] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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27
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Gregory G, Das Gupta R, Morgan B, Bounds G. Polyvinylsiloxane dental bite registration material used to splint a composite graft of the nasal rim. Br J Oral Maxillofac Surg 1999; 37:139-41. [PMID: 10371322 DOI: 10.1054/bjom.1998.0094] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe the construction of a nostril splint made from heavy body silicone-based dental impression material. This bio-compatible material supported a large chondrocutaneous auricular graft during early healing. The splint immobilized and maintained the shape of the alar rim and was further used nightly during the expected period of wound contraction.
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Affiliation(s)
- G Gregory
- Mount Vernon Hospital, Northwood, Middlesex, UK
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28
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Pearson JT, Critz W, McKell D, Enriquez J, Gregory G, Brady K, Baker T, Casey T. Pharmacologic hemoglobin reversal: the importance of lipid intermediaries and the proposed involvement of the cAMP and phosphatidylinositol second messenger systems. Hemoglobin 1998; 22:245-61. [PMID: 9629499 DOI: 10.3109/03630269809113138] [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] [Indexed: 11/13/2022]
Abstract
Humoral and microenvironmental influences have played a major role in recent research into reversing the Hb F to Hb A switch. Early research in this area focused on hormonal influences and showed both thyroid hormone and prolactin could induce small but statistically significant reversals in hemoglobin phenotype. Recent research has focused on the effect of certain lipids in this process. The current study shows a synergy between thyroid hormone and prolactin in inducing a significant switch in adult rat hemoglobin patterns toward the neonatal pattern. Further, it is hypothesized that this synergy is due to the hormones' effect on lipid intermediaries whose effect in turn are proposed to be mediated by the cAMP and phosphatidylinositol second messenger systems.
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Affiliation(s)
- J T Pearson
- Department of Pathology, William Beaumont Army Medical Center, El Paso, TX 79920, USA
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29
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Espanol MT, Litt L, Hasegawa K, Chang LH, Macdonald JM, Gregory G, James TL, Chan PH. Fructose-1,6-bisphosphate preserves adenosine triphosphate but not intracellular pH during hypoxia in respiring neonatal rat brain slices. Anesthesiology 1998; 88:461-72. [PMID: 9477067 DOI: 10.1097/00000542-199802000-00025] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fructose-1,6-bisphosphate (FBP) sometimes provides substantial cerebral protection during hypoxia or ischemia. 31P/1H nuclear magnetic resonance spectroscopy of cerebrocortical slices was used to study the effects of FBP on hypoxia-induced metabolic changes. In addition, 13C-labeled glucose was administered and 13C nuclear magnetic resonance spectroscopy was used to search for FBP-induced modulations in glycolysis and the pentose-phosphate pathway. METHODS In each experiment, 80 slices (350 microm) obtained from ten 7-day-old Sprague-Dawley rat litter mates were placed together in a 20-mm nuclear magnetic resonance tube, perfused, and subjected to 30 min of hypoxia (PO2 < 3 mmHg). Nine experiments were performed, with n = 3 in each of three groups: (1) no treatment with FBP; (2) 60 min of prehypoxia treatment with FBP (2 mM); and (3) 60 min of posthypoxia treatment with FBP (2 mM). 31P/1H Interleaved nuclear magnetic resonance spectra at 4.7 T provided average adenosine triphosphate, intracellular pH, and lactate. Cresyl violet stains of random slices taken at predetermined time points were studied histologically. Some experiments had [2-13C]glucose in the perfusate. Slices from these studies were frozen for perchloric acid extraction of intracellular metabolites and studied with high-resolution 13C nuclear magnetic resonance spectroscopy at 11.75 T. RESULTS With no pretreatment with FBP, hypoxia caused an approximately 50% loss of adenosine triphosphate, an approximately 700% increase in lactate, and a decrease in intracellular pH to approximately 6.4. Pretreatment with FBP resulted in no detectable loss of adenosine triphosphate, no increase in lactate, and minimal morphologic changes but did not alter decreases in intracellular pH. 13C Nuclear magnetic resonance spectra of extracted metabolites showed that pretreatment caused accumulation of [1-13C]fructose-6-phosphate, an early pentose-phosphate pathway metabolite. Posthypoxic treatment with FBP had no effects compared with no treatment. CONCLUSIONS During severe hypoxia, pretreatment with FBP completely preserves adenosine triphosphate and almost completely preserves cell morphology but does not alter hypoxia-induced decreases in intracellular pH. Pretreatment also substantially augments the flux of glucose into the pentose-phosphate pathway.
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Affiliation(s)
- M T Espanol
- Department of Anesthesia, Cardiovascular Research Institute, The University of California, San Francisco, 94143-0648, USA
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Svanberg K, Wang I, Colleen S, Idvall I, Ingvar C, Rydell R, Jocham D, Diddens H, Bown S, Gregory G, Montan S, Andersson-Engels S, Svanberg S. Clinical multi-colour fluorescence imaging of malignant tumours - initial experience. Acta Radiol 1998. [DOI: 10.3109/02841859809172141] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Svanberg K, Wang I, Colleen S, Idvall I, Ingvar C, Rydell R, Jocham D, Diddens H, Bown S, Gregory G, Montán S, Andersson-Engels S, Svanberg S. Clinical multi-colour fluorescence imaging of malignant tumours--initial experience. Acta Radiol 1998; 39:2-9. [PMID: 9498864 DOI: 10.1080/02841859809172141] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The detection of malignant tumours relies on a variety of diagnostic procedures including X-ray images and, for hollow organs, endoscopy. The purpose of this study was to present a new technique for non-invasive tumour detection based on tissue fluorescence imaging. MATERIAL AND METHODS A clinically adapted multi-colour fluorescence system was employed in the real-time imaging of malignant tumours of the skin, breast, head and neck region, and urinary bladder. Tumour detection was based on the contrast displayed in fluorescence between normal and malignant tissue, related to the selective uptake of tumour-marking agents, such as haematoporphyrin derivative (HPD) and delta-amino levulinic acid (ALA), and natural chromophore differences between various tissues. In order to demarcate basal cell carcinomas of the skin, ALA was applied topically 4-6 h before the fluorescence investigation. For urinary bladder tumour visualisation (transitional cell carcinoma of different stages including carcinoma in situ), ALA was instilled into the bladder 1-2 h prior to the study. Malignant and premalignant lesions in the head and neck region were imaged after i.v. injection of HPD (Photofrin). Finally, the extent of in situ and invasive carcinomas of the breast was investigated in surgically excised specimens from patients that received a low-dose injection of HPD 24 h prior to the study. The tumour imaging system was coupled to an endoscope. Fluorescence light emission from the tissue surface was induced with 100-ns-long optical pulses at 390 nm, generated from a frequency-doubled alexandrite laser. With the use of special image-splitting optics, the tumour fluorescence, intensified in a micro-channel plate, was imaged in 3 selected wavelength bands. These 3 images were processed together to form a new optimised-contrast image of the tumour. This image, updated at a rate of about 3 frames/s, was mixed with a normal colour video image of the tissue. RESULTS A clear demarcation from normal surrounding tissue was found during in vivo measurements of superficial bladder carcinoma, basal cell carcinoma of the skin, and leukoplakia with dysplasia of the lip, and in in vitro investigations of resected breast cancer. CONCLUSIONS The initial clinical experience of using multi-colour fluorescence imaging has shown that the technique has the potential to reveal malignant tumour tissue, including non-invasive early carcinoma and also precancerous tissue. Further investigations are needed to fully develop the method.
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Affiliation(s)
- K Svanberg
- Lund Medical Laser Centre and Department of Oncology, Lund University Hospital, Sweden
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Crawford J, Davis D, Chen G, Bradshaw J, Sandholm S, Kondo Y, Liu S, Browell E, Gregory G, Anderson B, Sachse G, Collins J, Barrick J, Blake D, Talbot R, Singh H. An assessment of ozone photochemistry in the extratropical western North Pacific: Impact of continental outflow during the late winter/early spring. ACTA ACUST UNITED AC 1997. [DOI: 10.1029/97jd02600] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Crawford JH, Davis DD, Chen G, Bradshaw J, Sandholm S, Kondo Y, Merrill J, Liu S, Browell E, Gregory G, Anderson B, Sachse G, Barrick J, Blake D, Talbot R, Pueschel R. Implications of large scale shifts in tropospheric NOxlevels in the remote tropical Pacific. ACTA ACUST UNITED AC 1997. [DOI: 10.1029/97jd00011] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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34
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Kotamarthi VR, Rodriguez JM, Sze ND, Kondo Y, Pueschel R, Ferry G, Bradshaw J, Sandholm S, Gregory G, Davis D, Liu S. Evidence of heterogeneous chemistry on sulfate aerosols in stratospherically influenced air masses sampled during PEM-West B. ACTA ACUST UNITED AC 1997. [DOI: 10.1029/97jd02511] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
The biennial National Rural Health Conference has become as essential feature on the calendar of events for rural and remote health professionals, researchers, public servants and consumers. Since the first conference held in 1991, attendance has grown significantly, factors hindering the achievement of optimal health for all rural and remote Australia have been clearly identified, and recommendations for action have been endorsed by the broad rural health constituency. These recommendations have provided valuable input to the National Rural Health Strategy and many programs and policies of Commonwealth and State departments of health. Significantly, too, the first four conferences have facilitated greater collaboration among rural and remote health professionals and provided a major catalyst in fostering cooperation between consumers, health workers, service providers and governments.
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Affiliation(s)
- G Gregory
- National Rural Health Alliance, Deakin West, Australia
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36
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Emond JC, Rosenthal P, Roberts JP, Stock P, Kelley S, Gregory G, Lim RC, Ascher NL. Living related donor liver transplantation: the UCSF experience. Transplant Proc 1996; 28:2375-7. [PMID: 8769256] [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: 02/02/2023]
Affiliation(s)
- J C Emond
- Department of Surgery, University of California, San Francisco, USA
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Gregory G. Life can go on after a serious back injury. Interview by Andrew Cole. Nurs Times 1996; 92:17. [PMID: 8716454] [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: 05/22/2023]
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38
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Smyth S, Bradshaw J, Sandholm S, Liu S, McKeen S, Gregory G, Anderson B, Talbot R, Blake D, Rowland S, Browell E, Fenn M, Merrill J, Bachmeier S, Sachse G, Collins J, Thornton D, Davis D, Singh H. Comparison of free tropospheric western Pacific air mass classification schemes for the PEM-West A experiment. ACTA ACUST UNITED AC 1996. [DOI: 10.1029/95jd02861] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Heikes BG, Lee M, Bradshaw J, Sandholm S, Davis DD, Crawford J, Rodriguez J, Liu S, McKeen S, Thornton D, Bandy A, Gregory G, Talbot R, Blake D. Hydrogen peroxide and methylhydroperoxide distributions related to ozone and odd hydrogen over the North Pacific in the fall of 1991. ACTA ACUST UNITED AC 1996. [DOI: 10.1029/95jd01364] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Crawford J, Davis D, Chen G, Bradshaw J, Sandholm S, Gregory G, Sachse G, Anderson B, Collins J, Blake D, Singh H, Heikes B, Talbot R, Rodriguez J. Photostationary state analysis of the NO2-NO system based on airborne observations from the western and central North Pacific. ACTA ACUST UNITED AC 1996. [DOI: 10.1029/95jd02201] [Citation(s) in RCA: 80] [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: 11/09/2022]
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Davis DD, Crawford J, Chen G, Chameides W, Liu S, Bradshaw J, Sandholm S, Sachse G, Gregory G, Anderson B, Barrick J, Bachmeier A, Collins J, Browell E, Blake D, Rowland S, Kondo Y, Singh H, Talbot R, Heikes B, Merrill J, Rodriguez J, Newell RE. Assessment of ozone photochemistry in the western North Pacific as inferred from PEM-West A observations during the fall 1991. ACTA ACUST UNITED AC 1996. [DOI: 10.1029/95jd02755] [Citation(s) in RCA: 134] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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42
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Abstract
The electrocardiograms of 28 volunteers with sickle cell trait were compared to those of 28 control subjects. Tracings were recorded at rest, at peak exercise, at simulated sea level, and at a simulated altitude of 4,000 m. No differences between the subjects with sickle cell trait and control subjects were observed for the majority of electrocardiographic measurements. Several measurements had statistically significant differences that persisted after correcting for body surface area and physical fitness. The magnitude of the differences does not appear to have physiologic or clinical significance. The observation that the differences were greatest for resting and sea level recordings indicates that sickling is probably not responsible. Further investigation will be needed to substantiate these differences and determine whether these electrical observations have any physiologic implication.
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Affiliation(s)
- W Pearl
- Division of Cardiology, William Beaumont Army Medical Center, El Paso 79920
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Abstract
An instance of permanent neuropathy that affected the mandibular nerve after a vaso-occlusive crisis in a patient with homozygous sickle cell disease and G6PD deficiency. A local factor of molar periapical inflammation may have provoked this phenomenon.
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Affiliation(s)
- G Gregory
- Eastman Dental Hospital, London, England
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44
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Sandholm S, Olson J, Bradshaw J, Talbot R, Singh H, Gregory G, Blake D, Anderson B, Sachse G, Barrick J, Collins J, Klemm K, Lefer B, Klemm O, Gorzelska K, Herlth D, O'Hara D. Summertime partitioning and budget of NOycompounds in the troposphere over Alaska and Canada: ABLE 3B. ACTA ACUST UNITED AC 1994. [DOI: 10.1029/93jd02458] [Citation(s) in RCA: 66] [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: 11/10/2022]
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Torres RA, Barr M, Thorn M, Gregory G, Kiely S, Chanin E, Carlo C, Martin M, Thornton J. Randomized trial of dapsone and aerosolized pentamidine for the prophylaxis of Pneumocystis carinii pneumonia and toxoplasmic encephalitis. Am J Med 1993; 95:573-83. [PMID: 8018144 DOI: 10.1016/0002-9343(93)90352-p] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE Pneumocystis carinii pneumonia (PCP) and toxoplasmic encephalitis are the most frequent pulmonary and central nervous system opportunistic infections associated with human immunodeficiency virus (HIV) infection. We designed a prospective study to compare the effects of aerosolized pentamidine and dapsone in the prophylaxis of these infections in HIV-infected persons with CD4+ lymphocyte counts less than 250/mm3. PATIENTS AND METHODS Two hundred seventy-eight patients seropositive for HIV who had acquired immunodeficiency syndrome (AIDS) or advanced AIDS-related complex were randomly assigned to receive intermittent dapsone (100 mg twice weekly) or aerosolized pentamidine (100 mg every 2 weeks). The proportion of patients remaining free of PCP or toxoplasmosis was analyzed with the log-rank test as a function of time, as were the effects of zidovudine or prophylaxis on survival. RESULTS Dapsone and aerosolized pentamidine demonstrated similar efficacy in the primary and secondary prophylaxis of PCP, with 15 (18%) failures among patients receiving dapsone compared to 15 (14%) among those receiving aerosolized pentamidine (p = 0.4), after a mean length of follow-up of 42 and 44 weeks, respectively. Dapsone was more effective in the primary prophylaxis of toxoplasmic encephalitis, with six toxoplasmic encephalitis events occurring among those receiving aerosolized pentamidine, compared to none among those taking dapsone (p = 0.01). Primary prophylaxis for PCP was more effective than secondary prophylaxis with either therapy. Zidovudine therapy did not prevent PCP yet prolonged the PCP-free interval for those in whom either prophylactic therapy failed. Kaplan-Meier estimates did not show a difference in survival between the patients receiving either therapy, yet zidovudine use was associated with improved survival, independent of race and risk factor (Cox proportional hazards model, p = 0.001). The 1-month survival for patients developing PCP despite prophylaxis was better with those in whom dapsone failed than it was for those in whom aerosolized pentamidine failed (p = 0.08). CONCLUSION Dapsone is as effective as aerosolized pentamidine in preventing PCP and has the advantage of a lower cost, easier administration, and possibly an additional preventive effect against toxoplasmosis. Zidovudine prolongs the PCP-free interval for patients receiving prophylaxis, regardless of which prophylactic agent is used.
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Affiliation(s)
- R A Torres
- Department of Medicine St. Vincent's Hospital, New York, New York 10011
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46
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Davis DD, Chen G, Chameides W, Bradshaw J, Sandholm S, Rodgers M, Schendal J, Madronich S, Sachse G, Gregory G, Anderson B, Barrick J, Shipham M, Collins J, Wade L, Blake D. A photostationary state analysis of the NO2-NO system based on airborne observations from the subtropical/tropical North and South Atlantic. ACTA ACUST UNITED AC 1993. [DOI: 10.1029/93jd02412] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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47
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Abstract
Twenty-five healthy black men between 17 and 21 years of age were evaluated. Their resting and exercise electrocardiograms were recorded at simulated sea level and at a simulated altitude of 4,000 m. Sea level exercise caused a reduction in the amplitudes of R waves and a lowering of J points. Exercise at a simulated altitude of 4,000 m caused a lowering of the J point in several leads and a reduction of the R wave amplitude in lead aVF. Hypoxia caused a reduction in the amplitudes of the T waves and a lowering of the J points in several leads. These effects of exercise and altitude, to a great extent, eliminated the appearance of "early repolarization," which is very common among young black men.
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Affiliation(s)
- W Pearl
- Department of Pediatrics, William Beaumont Army Medical Center, El Paso, TX 79920
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48
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Pearl W, Weir MR, Stafford EM, Gregory G, Imai W, Schydlower M. Maximizing the informational content of vectorial data in the electrocardiogram. Mil Med 1991; 156:233-5. [PMID: 2057075] [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: 12/30/2022] Open
Abstract
Scalar electrocardiograms contain a great deal of vectorial data. The informational content of these data can be maximized by treating each angle as a point on a plane whose distance from the origin is equal to the magnitude of its vector. These points can be resolved into their horizontal and vertical coordinates. The coordinates are linear values and can therefore be subjected to standard statistical methodology.
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Affiliation(s)
- W Pearl
- William Beaumont Army Medical Center, El Paso, TX 79920
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49
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Stafford EM, Weir MR, Pearl W, Imai W, Schydlower M, Gregory G. Sexual maturity rating: a marker for effects of pubertal maturation on the adolescent electrocardiogram. Pediatrics 1989; 83:565-9. [PMID: 2927998] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The heart is known to participate in the adolescent growth spurt. A peak increase in transverse diameter coincides with peak height velocity during pubertal maturation. The effects of maturation on the adolescent ECG were explored using sexual maturity rating (SMR) as a marker. ECGs were obtained from 751 patients 8 to 20 years of age seen for routine physical examinations. A total of 33 standard ECG measures were analyzed, with subjects separated by sex and SMR. Different trends were seen in boys and girls during the course of maturation for the majority of R and S wave amplitude measurements. Lower mean amplitudes were seen consistently in more mature (SMR 4 and 5) girls than less mature girls and all boys. The clinical implication of these findings is illustrated by analysis of the sum of RV5 and SV2, one of the criteria for left ventricular hypertrophy, by sex and SMR. No significant difference in the sum is noted for boys across five SMR groups. Girls, in contrast, show a steady decrease in the sum with advancing maturation. These trends are not as clearly shown when subjects are grouped by broad chronologic age ranges, as had been the practice in developing current adolescent ECG tables. These findings suggest that development of standard ECG tables in which SMR and sex have been taken into account might enhance interpretation during adolescence.
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Affiliation(s)
- E M Stafford
- Department of Clinical Investigation, William Beaumont Army Medical Center, El Paso, TX 79920-5001
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50
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Weir MR, Stafford EM, Gregory G, Lawson MA, Pearl W. The relationship between sexual maturity rating, age, and increased blood pressure in adolescents. J Adolesc Health Care 1988; 9:465-9. [PMID: 3182359 DOI: 10.1016/s0197-0070(88)80002-0] [Citation(s) in RCA: 13] [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] [Indexed: 01/04/2023]
Abstract
Blood pressure values are known to vary with age and body size. The effect of sexual maturity was explored in 746 patients in an adolescent clinic. Systolic blood pressure for boys and girls showed an increase with a change from Tanner stage 2 to 3. Diastolic blood pressure did not increase. Both systolic and diastolic blood pressures showed a weight effect that was generally maintained within the Tanner stages. The gradual increase in blood pressure for large groups of adolescents would appear to be the result of the aggregate increase in size (weight) resulting from the asynchronous growth spurts of individuals studied. Consequently, those individuals with a strikingly early or late onset of maturation may have erroneous interpretations of their blood pressure. As biologic outliers, the borderline hypertensive who matures early may be overidentified, while the late maturer might go unrecognized.
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Affiliation(s)
- M R Weir
- Department of Clinical Investigation, William Beaumont Army Medical Center, El Paso, Texas
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