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Bernstein JD, Lin GY, Yan C, DeConde A. Negative Sinus Biopsy Does Not Rule Out Orbital Invasive Fungal Sinusitis. Ear Nose Throat J 2024:1455613241235540. [PMID: 38409750 DOI: 10.1177/01455613241235540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Affiliation(s)
- Jeffrey D Bernstein
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA
| | - Grace Y Lin
- Department of Pathology, UC San Diego Health, La Jolla, CA, USA
| | - Carol Yan
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA
| | - Adam DeConde
- Department of Otolaryngology-Head and Neck Surgery, UC San Diego Health, La Jolla, CA, USA
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2
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Nachmanson D, Pagadala M, Steward J, Cheung C, Bruce LK, Lee NQ, O'Keefe TJ, Lin GY, Hasteh F, Morris GP, Carter H, Harismendy O. Accurate genome-wide genotyping from archival tissue to explore the contribution of common genetic variants to pre-cancer outcomes. J Transl Med 2022; 20:623. [PMID: 36575447 PMCID: PMC9793518 DOI: 10.1186/s12967-022-03810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/05/2022] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The contribution of common genetic variants to pre-cancer progression is understudied due to long follow-up time, rarity of poor outcomes and lack of available germline DNA collection. Alternatively, DNA from diagnostic archival tissue is available, but its somatic nature, limited quantity and suboptimal quality would require an accurate cost-effective genome-wide germline genotyping methodology. EXPERIMENTAL DESIGN Blood and tissue DNA from 10 individuals were used to benchmark the accuracy of Single Nucleotide Polymorphisms (SNP) genotypes, Polygenic Risk Scores (PRS) or HLA haplotypes using low-coverage whole-genome sequencing (lc-WGS) and genotype imputation. Tissue-derived PRS were further evaluated for 36 breast cancer patients (11.7 years median follow-up time) diagnosed with DCIS and used to model the risk of Breast Cancer Subsequent Events (BCSE). RESULTS Tissue-derived germline DNA profiling resulted in accurate genotypes at common SNPs (blood correlation r2 > 0.94) and across 22 disease-related polygenic risk scores (PRS, mean correlation r = 0.93). Imputed Class I and II HLA haplotypes were 96.7% and 82.5% concordant with clinical-grade blood HLA haplotypes, respectively. In DCIS patients, tissue-derived PRS was significantly associated with BCSE (HR = 2, 95% CI 1.2-3.8). The top and bottom decile patients had an estimated 28% and 5% chance of BCSE at 10 years, respectively. CONCLUSIONS Archival tissue DNA germline profiling using lc-WGS and imputation, represents a cost and resource-effective alternative in the retrospective design of long-term disease genetic studies. Initial results in breast cancer suggest that common risk variants contribute to pre-cancer progression.
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Affiliation(s)
- Daniela Nachmanson
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Meghana Pagadala
- Biomedical Science Graduate Program, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Joseph Steward
- Moores Cancer Center, University of California San Diego, 3855 Health Science Drive, San Diego, CA, 92093, USA
| | - Callie Cheung
- Moores Cancer Center, University of California San Diego, 3855 Health Science Drive, San Diego, CA, 92093, USA
| | - Lauryn Keeler Bruce
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Nicole Q Lee
- Moores Cancer Center, University of California San Diego, 3855 Health Science Drive, San Diego, CA, 92093, USA
| | - Thomas J O'Keefe
- Department of Surgery, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Grace Y Lin
- Department of Pathology, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Farnaz Hasteh
- Department of Pathology, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Gerald P Morris
- Department of Pathology, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Hannah Carter
- Moores Cancer Center, University of California San Diego, 3855 Health Science Drive, San Diego, CA, 92093, USA
- Division of Medical Genetics, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Olivier Harismendy
- Moores Cancer Center, University of California San Diego, 3855 Health Science Drive, San Diego, CA, 92093, USA.
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, 9500 Gilman Drive, San Diego, CA, 92093, USA.
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3
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Kalavacherla S, Sanghvi P, Lin GY, Guo T. Updates in the management of unknown primary of the head and neck. Front Oncol 2022; 12:991838. [PMID: 36185196 PMCID: PMC9521035 DOI: 10.3389/fonc.2022.991838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
Squamous cell carcinoma (SCC) from an unknown primary tumor (SCCUP) accounts for 2.0%–5.0% of all head and neck cancers. SCCUP presents as enlarged cervical lymph nodes without evidence of a primary tumor upon physical examination. Primary site detection is important to target treatment and avoid treatment-related morbidity. In this review, we discuss updates in SCCUP management. Diagnostic workup should focus on localization of the primary tumor in SCCUP. Initial workup centers on neck biopsy to confirm the presence of SCC. Given the increasing incidence of HPV-related SCC in the oropharynx, HPV testing is crucial. An HPV-positive status can localize the tumor to the oropharynx, a common site for occult tumors. Imaging includes neck CT and/or MRI, and PET/CT. After imaging, panendoscopy, palatine tonsillectomy or diagnostic transoral robotic surgery can facilitate high rates of primary tumor localization. Primary tumor localization influences treatments administered. SCCUP has traditionally been treated aggressively with large treatment fields to all potential disease sites, which can induce weight loss and swallowing dysfunction. As a result, primary localization can reduce radiation fields and provide possible de-escalation to primary surgical management. Advances in intensity-modulated radiation therapy and dose management also have the potential to improve functional outcomes in SCCUP patients. Given the improved prognosis associated with HPV-positive SCCs, HPV tumor status may also inform future treatment de-intensification to reduce treatment-related toxicity.
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Affiliation(s)
- Sandhya Kalavacherla
- School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Parag Sanghvi
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, San Diego, CA, United States
| | - Grace Y. Lin
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - Theresa Guo
- Department of Otolaryngology – Head & Neck Surgery, University of California, San Diego, San Diego, CA, United States
- *Correspondence: Theresa Guo,
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4
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Masso-Silva JA, Moshensky A, Lam MTY, Odish M, Patel A, Xu L, Hansen E, Trescott S, Nguyen C, Kim R, Perofsky K, Perera S, Ma L, Pham J, Rolfsen M, Olay J, Shin J, Dan J, Abbott R, Ramirez S, Alexander TH, Lin GY, Fuentes AL, Advani I, Gunge D, Pretorius V, Malhotra A, Sun X, Duran J, Hepokoski M, Crotty S, Coufal NG, Meier A, Crotty Alexander LE. Correction to: Increased Peripheral Blood Neutrophil Activation Phenotypes and Neutrophil Extracellular Trap Formation in Critically Ill Coronavirus Disease 2019 Patients: A Case Series and Review of the Literature. Clin Infect Dis 2022; 74:1889-1890. [PMID: 35416961 PMCID: PMC9327099 DOI: 10.1093/cid/ciac216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jorge A Masso-Silva
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Alexander Moshensky
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Michael T Y Lam
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
- The Salk Institute, La Jolla, California, USA
| | - Mazen Odish
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Arjun Patel
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Le Xu
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Emily Hansen
- Rady Children’s Hospital, San Diego, California, USA
| | | | - Celina Nguyen
- Rady Children’s Hospital, San Diego, California, USA
| | - Roy Kim
- Rady Children’s Hospital, San Diego, California, USA
| | - Katherine Perofsky
- Rady Children’s Hospital, San Diego, California, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Samantha Perera
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Lauren Ma
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Josephine Pham
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Mark Rolfsen
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Jarod Olay
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - John Shin
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Jennifer M Dan
- Division of Infectious Disease, Department of Medicine, University of California, San Diego, La Jolla, California, USA
- La Jolla Institute of Allergy and Immunology, La Jolla, California, USA
| | - Robert Abbott
- La Jolla Institute of Allergy and Immunology, La Jolla, California, USA
| | - Sydney Ramirez
- Division of Infectious Disease, Department of Medicine, University of California, San Diego, La Jolla, California, USA
- La Jolla Institute of Allergy and Immunology, La Jolla, California, USA
| | - Thomas H Alexander
- Division of Head and Neck Surgery, Scripps Clinic, La Jolla, California, USA
| | - Grace Y Lin
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Ana Lucia Fuentes
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Ira Advani
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Deepti Gunge
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Victor Pretorius
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of California, San Diego, La Jolla, California, USA
| | - Atul Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Xin Sun
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Jason Duran
- Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, California, USAand
| | - Mark Hepokoski
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Shane Crotty
- La Jolla Institute of Allergy and Immunology, La Jolla, California, USA
| | | | - Angela Meier
- Department of Anesthesiology, Division of Critical Care, University of California, San Diego, La Jolla, California, USA
| | - Laura E Crotty Alexander
- Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
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5
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Masso-Silva JA, Moshensky A, Lam MTY, Odish M, Patel A, Xu L, Hansen E, Trescott S, Nguyen C, Kim R, Perofsky K, Perera S, Ma L, Pham J, Rolfsen M, Olay J, Shin J, Dan JM, Abbott R, Ramirez S, Alexander TH, Lin GY, Fuentes AL, Advani I, Gunge D, Pretorius V, Malhotra A, Sun X, Duran J, Hepokoski M, Crotty S, Coufal NG, Meier A, Alexander LEC. Increased Peripheral Blood Neutrophil Activation Phenotypes and Neutrophil Extracellular Trap Formation in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients: A Case Series and Review of the Literature. Clin Infect Dis 2022; 74:479-489. [PMID: 33988226 PMCID: PMC8241438 DOI: 10.1093/cid/ciab437] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Increased inflammation has been well defined in coronavirus disease 2019 (COVID-19), while definitive pathways driving severe forms of this disease remain uncertain. Neutrophils are known to contribute to immunopathology in infections, inflammatory diseases, and acute respiratory distress syndrome, a primary cause of morbidity and mortality in COVID-19. Changes in neutrophil function in COVID-19 may give insight into disease pathogenesis and identify therapeutic targets. METHODS Blood was obtained serially from critically ill COVID-19 patients for 11 days. Neutrophil extracellular trap formation (NETosis), oxidative burst, phagocytosis, and cytokine levels were assessed. Lung tissue was obtained immediately postmortem for immunostaining. PubMed searches for neutrophils, lung, and COVID-19 yielded 10 peer-reviewed research articles in English. RESULTS Elevations in neutrophil-associated cytokines interleukin 8 (IL-8) and interleukin 6, and general inflammatory cytokines IFN-inducible protien-19, granulocyte macrophage colony-stimulating factor (GM-CSF), interleukin 1β, interleukin 10, and tumor necrosis factor, were identified both at first measurement and across hospitalization (P < .0001). COVID-19 neutrophils had exaggerated oxidative burst (P < .0001), NETosis (P < .0001), and phagocytosis (P < .0001) relative to controls. Increased NETosis correlated with leukocytosis and neutrophilia, and neutrophils and NETs were identified within airways and alveoli in lung parenchyma of 40% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected lungs available for examination (2 of 5). While elevations in IL-8 and absolute neutrophil count correlated with disease severity, plasma IL-8 levels alone correlated with death. CONCLUSIONS Literature to date demonstrates compelling evidence of increased neutrophils in the circulation and lungs of COVID-19 patients. Importantly, neutrophil quantity and activation correlates with severity of disease. Similarly, our data show that circulating neutrophils in COVID-19 exhibit an activated phenotype with enhanced NETosis and oxidative burst.
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Affiliation(s)
- Jorge A Masso-Silva
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Alexander Moshensky
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Michael T Y Lam
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
- The Salk Institute, La Jolla, CA, USA
| | - Mazen Odish
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Arjun Patel
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Le Xu
- Department of Pathology, UCSD, La Jolla, CA
92093, USA
| | | | | | | | - Roy Kim
- Rady Children’s Hospital, San Diego, CA,
USA
| | - Katherine Perofsky
- Rady Children’s Hospital, San Diego, CA,
USA
- Department of Pediatrics, UCSD, La Jolla, CA
92093, USA
| | - Samantha Perera
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Lauren Ma
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Josephine Pham
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Mark Rolfsen
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Jarod Olay
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - John Shin
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Jennifer M Dan
- Division of Infectious Disease, Department of Medicine,
UCSD, La Jolla, CA 92093, USA
- La Jolla Institute of Allergy and Immunology, La
Jolla, CA, USA
| | - Robert Abbott
- La Jolla Institute of Allergy and Immunology, La
Jolla, CA, USA
| | - Sydney Ramirez
- Division of Infectious Disease, Department of Medicine,
UCSD, La Jolla, CA 92093, USA
- La Jolla Institute of Allergy and Immunology, La
Jolla, CA, USA
| | | | - Grace Y Lin
- Department of Pathology, UCSD, La Jolla, CA
92093, USA
| | - Ana Lucia Fuentes
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Ira Advani
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Deepti Gunge
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Victor Pretorius
- Division of Cardiovascular and Thoracic Surgery,
Department of Surgery, UCSD, La Jolla, CA 92093, USA
| | - Atul Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Xin Sun
- Department of Pediatrics, UCSD, La Jolla, CA
92093, USA
| | - Jason Duran
- Division of Cardiology, Department of Medicine,
UCSD, La Jolla, CA 92093, USA
| | - Mark Hepokoski
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
| | - Shane Crotty
- La Jolla Institute of Allergy and Immunology, La
Jolla, CA, USA
| | | | - Angela Meier
- Department of Anesthesiology, Division of Critical Care,
UCSD, La Jolla, CA 92093, USA
| | - Laura E Crotty Alexander
- Pulmonary and Critical Care Section, VA San Diego
Healthcare System, La Jolla, CA 92161, USA
- Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, University of California San Diego (UCSD),
La Jolla, CA 92093, USA
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6
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Liao X, Bojanowski CM, Yen A, Kerr KM, Dumouchel J, Auger WR, Madani MM, Pretorius V, Wang H, Yi ES, Lin GY. Inflammatory pseudotumor mimicking chronic pulmonary embolism or pulmonary artery sarcoma: Report of five cases. Pulm Circ 2021; 12:e12004. [PMID: 35506111 PMCID: PMC9053012 DOI: 10.1002/pul2.12004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 11/11/2022] Open
Abstract
Inflammatory pseudotumor (IPT), also known as plasma cell granuloma, is a rare lesion of unknown etiology that occurs in many organs, especially in the lung. Here we report five cases of IPT arising in pulmonary artery mimicking chronic thromboembolic disease, not previously documented in the literature. Those cases were identified at our institute among over 2500 pulmonary endarterectomy (PEA) specimens acquired from 2000 to 2017. The cohort included three men and two women with a median age of 41 years (range: 23–54). All patients presented with dyspnea and radiologic findings of pulmonary artery thromboembolism, some concerning for intimal sarcoma. The duration between disease onset and PEA ranged from 6 months to approximately 3 years. Histologically, all cases showed proliferation of spindle cells with marked inflammatory infiltrates composed predominantly of plasma cells, histiocytes, and small lymphocytes. Ancillary studies were performed in each case and ruled out other possibilities, such as sarcoma, lymphoma, plasmacytoma, IgG4‐related disease, and infection. IPT arising in pulmonary artery presenting clinically as acute or chronic thromboembolic disease is very unusual, in which clinical data, radiographic findings, and histopathologic features have to be integrated for reaching the proper diagnosis.
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Affiliation(s)
- Xiaoyan Liao
- Department of Pathology and Laboratory Medicine University of California San Diego La Jolla California USA
| | - Christine M. Bojanowski
- Department of Pulmonary Medicine University of California San Diego La Jolla California USA
- Section of Pulmonary Diseases, Critical Care and Environmental Medicine Tulane University School of Medicine New Orleans Louisiana USA
| | - Andrew Yen
- Department of Radiology University of California San Diego La Jolla California USA
| | - Kim M. Kerr
- Department of Pulmonary Medicine University of California San Diego La Jolla California USA
| | - Justin Dumouchel
- Department of Pulmonary Medicine University of California San Diego La Jolla California USA
| | - William R. Auger
- Department of Pulmonary Medicine University of California San Diego La Jolla California USA
| | - Michael M. Madani
- Department of Surgery University of California San Diego La Jolla California USA
| | - Victor Pretorius
- Department of Surgery University of California San Diego La Jolla California USA
| | - Huan‐You Wang
- Department of Pathology and Laboratory Medicine University of California San Diego La Jolla California USA
| | - Eunhee S. Yi
- Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Grace Y. Lin
- Department of Pathology and Laboratory Medicine University of California San Diego La Jolla California USA
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7
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Ho G, Atwood TF, Bruggeman AR, Moore KL, McVeigh E, Villongco CT, Han FT, Hsu JC, Hoffmayer KS, Raissi F, Lin GY, Schricker A, Woods CE, Cheung JP, Taira AV, McCulloch A, Birgersdotter-Green U, Feld GK, Mundt AJ, Krummen DE. Computational ECG mapping and respiratory gating to optimize stereotactic ablative radiotherapy workflow for refractory ventricular tachycardia. Heart Rhythm O2 2021; 2:511-520. [PMID: 34667967 PMCID: PMC8505208 DOI: 10.1016/j.hroo.2021.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background Stereotactic ablative radiotherapy (SAbR) is an emerging therapy for refractory ventricular tachycardia (VT). However, the current workflow is complicated, and the precision and safety in patients with significant cardiorespiratory motion and VT targets near the stomach may be suboptimal. Objective We hypothesized that automated 12-lead electrocardiogram (ECG) mapping and respiratory-gated therapy may improve the ease and precision of SAbR planning and facilitate safe radiation delivery in patients with refractory VT. Methods Consecutive patients with refractory VT were studied at 2 hospitals. VT exit sites were localized using a 3-D computational ECG algorithm noninvasively and compared to available prior invasive mapping. Radiotherapy (25 Gy) was delivered at end-expiration when cardiac respiratory motion was ≥0.6 cm or targets were ≤2 cm from the stomach. Results In 6 patients (ejection fraction 29% ± 13%), 4.2 ± 2.3 VT morphologies per patient were mapped. Overall, 7 out of 7 computational ECG mappings (100%) colocalized to the identical cardiac segment when prior invasive electrophysiology study was available. Respiratory gating was associated with smaller planning target volumes compared to nongated volumes (71 ± 7 vs 153 ± 35 cc, P < .01). In 2 patients with inferior wall VT targets close to the stomach (6 mm proximity) or significant respiratory motion (22 mm excursion), no GI complications were observed at 9- and 12-month follow-up. Implantable cardioverter-defibrillator shocks decreased from 23 ± 12 shocks/patient to 0.67 ± 1.0 (P < .001) post-SAbR at 6.0 ± 4.9 months follow-up. Conclusions A workflow including computational ECG mapping and protocol-guided respiratory gating is feasible, is safe, and may improve the ease of SAbR planning. Studies to validate this workflow in larger populations are required.
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Affiliation(s)
- Gordon Ho
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
| | - Todd F Atwood
- Department of Radiation Medicine, University of California San Diego, La Jolla, California
| | - Andrew R Bruggeman
- Department of Radiation Medicine, University of California San Diego, La Jolla, California
| | - Kevin L Moore
- Department of Radiation Medicine, University of California San Diego, La Jolla, California
| | - Elliot McVeigh
- Department of Bioengineering, University of California San Diego, La Jolla, California
| | | | - Frederick T Han
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
| | - Jonathan C Hsu
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
| | - Kurt S Hoffmayer
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
| | - Farshad Raissi
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
| | - Grace Y Lin
- Department of Pathology, University of California San Diego, La Jolla, California
| | - Amir Schricker
- Department of Cardiac Electrophysiology, Mills-Peninsula Medical Center, Sutter Health, Burlingame, California
| | - Christopher E Woods
- Department of Cardiac Electrophysiology, Mills-Peninsula Medical Center, Sutter Health, Burlingame, California
| | - Joey P Cheung
- Department of Radiation Oncology, Mills-Peninsula Medical Center, Sutter Health, Burlingame, California
| | - Al V Taira
- Department of Radiation Oncology, Mills-Peninsula Medical Center, Sutter Health, Burlingame, California
| | - Andrew McCulloch
- Department of Bioengineering, University of California San Diego, La Jolla, California
| | | | - Gregory K Feld
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
| | - Arno J Mundt
- Department of Radiation Medicine, University of California San Diego, La Jolla, California
| | - David E Krummen
- Department of Medicine-Cardiology, University of California San Diego, La Jolla, California
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8
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Chaturvedi R, Lin GY, Wang W, Smitaman E. Osteochondroma of the temporal styloid process: a common disease in a rare but vulnerable location. Clin Imaging 2020; 65:5-7. [PMID: 32344289 DOI: 10.1016/j.clinimag.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/25/2020] [Revised: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 01/12/2023]
Abstract
Osteochondromas, the most common benign bone tumor, are typically asymptomatic and discovered incidentally by imaging. Most frequently, osteochondromas occur at the metaphyses of long bones, and rarely involve the head and neck. We report the first case of a symptomatic osteochondroma of the temporal styloid process causing facial nerve paralysis.
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Affiliation(s)
- Rahul Chaturvedi
- University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA 92093, United States of America
| | - Grace Y Lin
- Department of Pathology, University of California San Diego, San Diego, CA 92103, USA
| | - Wilbur Wang
- Department of Radiology, University of California San Diego, 408 Dickinson Street, Mail code 8226, San Diego, CA 92103, USA
| | - Edward Smitaman
- Department of Radiology, University of California San Diego, 408 Dickinson Street, Mail code 8226, San Diego, CA 92103, USA.
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9
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Feng XG, Lin GY, Tang YS, Wu PF. Cytomegalovirus-associated acute respiratory failure in lupus patients: case reports in relation to cytomegalovirus biology. Lupus 2019; 28:1354-1359. [PMID: 31551032 DOI: 10.1177/0961203319876990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
With the wide use of immunosuppressive agents, life-threatening cytomegalovirus-associated acute respiratory failure occurs frequently. However, this condition is yet to be fully recognized and the therapeutic approach to it can only be based on comprehensive protocols rather than the biological characteristics of cytomegalovirus. We describe three acute respiratory failure events that were related to the pathogenicity of cytomegalovirus, the primary cytopathic effect and secondary antiviral immunity-mediated damage. All cytomegalovirus infection occurred after immunosuppressive usage while the acute respiratory failure events took place in different clinical settings. The first acute respiratory failure event originated from the immunoinflammatory response after cytomegalovirus infection was circumscribed, while the second resulted from cytomegalovirus reactivation and the third was caused by the combined effect of acute cytomegalovirus infection and the subsequent immunoinflammatory response. According to the clinical setting, corresponding therapeutic approaches (sequential or combined strategy) were carried out. All the patients here presented were responsive to the above therapeutic strategies. Consequently, cytomegalovirus-associated acute respiratory failure in systemic lupus erythematosus patients should be carefully differentiated and a sequential or combined strategy should be carried out according to the clinical setting. Overall, we find that there are three patterns of cytomegalovirus-associated acute respiratory failure in systemic lupus erythematosus patients and propose a novel therapeutic strategy in relation to cytomegalovirus biology.
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Affiliation(s)
- X G Feng
- Department of Rheumatology, 900th Hospital, Fujian Medical University, Fuzhou, China
| | - G Y Lin
- Department of Rheumatology, 900th Hospital, Fujian Medical University, Fuzhou, China
| | - Y S Tang
- Department of Rheumatology, 900th Hospital, Fujian Medical University, Fuzhou, China
| | - P F Wu
- Department of Rheumatology, 900th Hospital, Fujian Medical University, Fuzhou, China
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10
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Melnik AV, Vázquez-Baeza Y, Aksenov AA, Hyde E, McAvoy AC, Wang M, da Silva RR, Protsyuk I, Wu JV, Bouslimani A, Lim YW, Luzzatto-Knaan T, Comstock W, Quinn RA, Wong R, Humphrey G, Ackermann G, Spivey T, Brouha SS, Bandeira N, Lin GY, Rohwer F, Conrad DJ, Alexandrov T, Knight R, Dorrestein PC, Garg N. Molecular and Microbial Microenvironments in Chronically Diseased Lungs Associated with Cystic Fibrosis. mSystems 2019; 4:e00375-19. [PMID: 31551401 PMCID: PMC6759567 DOI: 10.1128/msystems.00375-19] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023] Open
Abstract
To visualize the personalized distributions of pathogens and chemical environments, including microbial metabolites, pharmaceuticals, and their metabolic products, within and between human lungs afflicted with cystic fibrosis (CF), we generated three-dimensional (3D) microbiome and metabolome maps of six explanted lungs from three cystic fibrosis patients. These 3D spatial maps revealed that the chemical environments differ between patients and within the lungs of each patient. Although the microbial ecosystems of the patients were defined by the dominant pathogen, their chemical diversity was not. Additionally, the chemical diversity between locales in the lungs of the same individual sometimes exceeded interindividual variation. Thus, the chemistry and microbiome of the explanted lungs appear to be not only personalized but also regiospecific. Previously undescribed analogs of microbial quinolones and antibiotic metabolites were also detected. Furthermore, mapping the chemical and microbial distributions allowed visualization of microbial community interactions, such as increased production of quorum sensing quinolones in locations where Pseudomonas was in contact with Staphylococcus and Granulicatella, consistent with in vitro observations of bacteria isolated from these patients. Visualization of microbe-metabolite associations within a host organ in early-stage CF disease in animal models will help elucidate the complex interplay between the presence of a given microbial structure, antibiotics, metabolism of antibiotics, microbial virulence factors, and host responses.IMPORTANCE Microbial infections are now recognized to be polymicrobial and personalized in nature. Comprehensive analysis and understanding of the factors underlying the polymicrobial and personalized nature of infections remain limited, especially in the context of the host. By visualizing microbiomes and metabolomes of diseased human lungs, we reveal how different the chemical environments are between hosts that are dominated by the same pathogen and how community interactions shape the chemical environment or vice versa. We highlight that three-dimensional organ mapping methods represent hypothesis-building tools that allow us to design mechanistic studies aimed at addressing microbial responses to other microbes, the host, and pharmaceutical drugs.
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Affiliation(s)
- Alexey V Melnik
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Yoshiki Vázquez-Baeza
- Jacobs School of Engineering, University of California, San Diego, La Jolla, California, USA
- UC San Diego Center for Microbiome Innovation, University of California, San Diego, La Jolla, California, USA
| | - Alexander A Aksenov
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Embriette Hyde
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Andrew C McAvoy
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Mingxun Wang
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, California, USA
| | - Ricardo R da Silva
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Ivan Protsyuk
- Structural and Computational Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Jason V Wu
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Amina Bouslimani
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Yan Wei Lim
- Biology Department, San Diego State University, San Diego, California, USA
| | - Tal Luzzatto-Knaan
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - William Comstock
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Robert A Quinn
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Richard Wong
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Greg Humphrey
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Gail Ackermann
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Timothy Spivey
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
| | - Sharon S Brouha
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Nuno Bandeira
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, California, USA
| | - Grace Y Lin
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Forest Rohwer
- Biology Department, San Diego State University, San Diego, California, USA
| | - Douglas J Conrad
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Theodore Alexandrov
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
- Structural and Computational Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Rob Knight
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, California, USA
- UC San Diego Center for Microbiome Innovation, University of California, San Diego, La Jolla, California, USA
- Department of Bioengineering, University of California, San Diego, La Jolla, California, USA
| | - Pieter C Dorrestein
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
| | - Neha Garg
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia, USA
- Emory-Children's Center for Cystic Fibrosis and Airways Disease Research, Atlanta, Georgia, USA
- Center for Microbial Dynamics and Infection, Georgia Institute of Technology, Atlanta, Georgia, USA
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11
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de la Torre J, Banerjee S, Baumgartner J, Lin GY, Burgoyne AM, Kirane A, Sicklick J. Tumor Symbiosis: Gastrointestinal Stromal Tumor as a Host for Primary Peritoneal Mesothelioma. J Gastrointest Surg 2019; 23:879-881. [PMID: 30132292 PMCID: PMC6384158 DOI: 10.1007/s11605-018-3918-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/06/2018] [Indexed: 01/31/2023]
Affiliation(s)
- Jorge de la Torre
- Division of Surgical Oncology, Department of Surgery, Moores Cancer Center, University of California, San Diego, UC San Diego Health Sciences, 3855 Health Sciences Drive, Room 2313, Mail Code 0987, La Jolla, CA, 92093-0987, USA
| | - Sudeep Banerjee
- Division of Surgical Oncology, Department of Surgery, Moores Cancer Center, University of California, San Diego, UC San Diego Health Sciences, 3855 Health Sciences Drive, Room 2313, Mail Code 0987, La Jolla, CA, 92093-0987, USA
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Joel Baumgartner
- Division of Surgical Oncology, Department of Surgery, Moores Cancer Center, University of California, San Diego, UC San Diego Health Sciences, 3855 Health Sciences Drive, Room 2313, Mail Code 0987, La Jolla, CA, 92093-0987, USA
| | - Grace Y Lin
- Division of Anatomic Pathology, Department of Pathology, University of California, San Diego, La Jolla, CA, USA
| | - Adam M Burgoyne
- Division of Hematology Oncology, Department of Medicine, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Amanda Kirane
- Division of Surgical Oncology, Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Jason Sicklick
- Division of Surgical Oncology, Department of Surgery, Moores Cancer Center, University of California, San Diego, UC San Diego Health Sciences, 3855 Health Sciences Drive, Room 2313, Mail Code 0987, La Jolla, CA, 92093-0987, USA.
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12
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Xie BS, Ye L, Li GP, Lin GY, He YH, Zheng GY, Lai GX. [Effects of different time of cryoablation on the proliferation of airway traumatic granuloma and its mechanism in rabbits]. Zhonghua Yi Xue Za Zhi 2019; 98:3587-3591. [PMID: 30486575 DOI: 10.3760/cma.j.issn.0376-2491.2018.44.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of different cryoablation time on tracheal traumatic granulation formation and its mechanism. Methods: A total of 32 rabbits were randomly assigned into four groups (A-D). Group A underwent tracheotomy alone. Group B, C and D received intra-tracheal brush rubbing to establish airway granulation model. Group C and D underwent 30 s and 2-minute cryoablation respectively. Tracheal specimens of all groups were collected to examine pathological changes using HE staining. Levels of transforming growth factor beta 1 (TGF-β(1)) and CD34 in tracheal granulation were evaluated using immunohistochemistry (IHC) and real-time quantitative reverse transcription polymerase chain reaction (RT-qCR). Results: Tracheal lumens of group A were smooth without granulation. While the growth of granulation and luminal stenosis were most severe in Group B, followed by Group D and C. Submucosa thickness of Group B was largest as compared with other groups (0.20±0.07, 0.77±0.28, 0.44±0.13 and 0.55±0.18 mm for Group A to D, respectively. P<0.05). And the submucosa layer of Group C was thinner than Group D (P<0.05). The expression and transcription levels of TGF-β(1) of trachea were highest in Group B as detected by IHC and RT-qPCR (P<0.05), followed by Group D and C (IHC: 0.48±0.01 vs 0.43±0.01, P<0.05; RT-qPCR: 12.61±2.14 vs 2.38±0.10, P<0.05). Both protein and mRNA levels of CD34 were highest in Group B as detected by IHC and RT-qPCR (P<0.05). Tracheal mRNA levels of CD34 were more abundant in Group D than Group C (4.92±0.90 vs 2.09±0.10, P<0.05), while no significant difference was found between groups regarding protein levels measured by IHC. Conclusions: Cryoablation could alleviate the hyperplasia of tracheal traumatic granulation, possibly due to the inhibition of TGF-β(1) and CD34 expression. The effect of 30 s cryoablation for tracheal traumatic granulation is better.
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Affiliation(s)
- B S Xie
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, China
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13
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Carlin AF, Abeles S, Chin NA, Lin GY, Young M, Vinetz JM. Case Report: A Common Source Outbreak of Anisakidosis in the United States and Postexposure Prophylaxis of Family Collaterals. Am J Trop Med Hyg 2018; 99:1219-1221. [PMID: 30226150 DOI: 10.4269/ajtmh.18-0586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We present a case of intussusception with complete small bowel obstruction caused by intestinal anisakidosis requiring surgical resection. A 30-year-old man presented with acute onset of severe abdominal pain 3 days after eating home-cured salmon gravlax. Despite surgery, the patient developed recurrent abdominal pain on two occasions with evidence of continued inflammation proximal to the surgical anastomosis. He was then treated with albendazole and prednisone, and symptoms improved. A decision was made to prophylactically treat two asymptomatic family members who also consumed home-cured gravlax with albendazole, resulting in one individual passing an intact Anisakis worm in her stool. We suggest that albendazole therapy could be considered as a therapy for continued symptoms of anisakidosis and postexposure prophylaxis of Anisakis larvae ingestion from a common source.
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Affiliation(s)
- Aaron F Carlin
- Department of Medicine, School of Medicine, University of California, San Diego, California
| | - Shira Abeles
- Department of Medicine, School of Medicine, University of California, San Diego, California
| | - Nathaniel A Chin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Grace Y Lin
- Department of Pathology, UC San Diego Health, University of California, San Diego, California
| | - Maile Young
- Department of Medicine, School of Medicine, University of California, San Diego, California
| | - Joseph M Vinetz
- Department of Medicine, School of Medicine, University of California, San Diego, California
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14
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Garg N, Wang M, Hyde E, da Silva RR, Melnik AV, Protsyuk I, Bouslimani A, Lim YW, Wong R, Humphrey G, Ackermann G, Spivey T, Brouha SS, Bandeira N, Lin GY, Rohwer F, Conrad DJ, Alexandrov T, Knight R, Dorrestein PC. Three-Dimensional Microbiome and Metabolome Cartography of a Diseased Human Lung. Cell Host Microbe 2017; 22:705-716.e4. [PMID: 29056429 DOI: 10.1016/j.chom.2017.10.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [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: 04/07/2017] [Revised: 07/12/2017] [Accepted: 09/14/2017] [Indexed: 12/12/2022]
Abstract
Our understanding of the spatial variation in the chemical and microbial makeup of an entire human organ remains limited, in part due to the size and heterogeneity of human organs and the complexity of the associated metabolome and microbiome. To address this challenge, we developed a workflow to enable the cartography of metabolomic and microbiome data onto a three-dimensional (3D) organ reconstruction built off radiological images. This enabled the direct visualization of the microbial and chemical makeup of a human lung from a cystic fibrosis patient. We detected host-derived molecules, microbial metabolites, medications, and region-specific metabolism of medications and placed it in the context of microbial distributions in the lung. Our tool further created browsable maps of a 3D microbiome/metabolome reconstruction map on a radiological image of a human lung and forms an interactive resource for the scientific community.
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Affiliation(s)
- Neha Garg
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Mingxun Wang
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Embriette Hyde
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Ricardo R da Silva
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Alexey V Melnik
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Ivan Protsyuk
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg 69117, Germany
| | - Amina Bouslimani
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Yan Wei Lim
- Biology Department, San Diego State University, San Diego, CA, USA
| | - Richard Wong
- Department of Pathology, University of California, San Diego Health, San Diego, CA 92103, USA
| | - Greg Humphrey
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Gail Ackermann
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Timothy Spivey
- Department of Radiology, University of California, San Diego Health, San Diego, CA 92103, USA
| | - Sharon S Brouha
- Department of Radiology, University of California, San Diego Health, San Diego, CA 92103, USA
| | - Nuno Bandeira
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Grace Y Lin
- Department of Pathology, University of California, San Diego Health, San Diego, CA 92103, USA
| | - Forest Rohwer
- Biology Department, San Diego State University, San Diego, CA, USA
| | - Douglas J Conrad
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
| | - Theodore Alexandrov
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg 69117, Germany.
| | - Rob Knight
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA.
| | - Pieter C Dorrestein
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Department of Computer Science & Engineering, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA.
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15
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Lowenthal BM, Saenz NC, Lin GY, Newbury RO. Giant Bullous Emphysema With Placental Transmogrification: A Case Report of a 14-Year-Old With Right Middle- and Lower-Lobe Involvement. Int J Surg Pathol 2017. [PMID: 28633553 DOI: 10.1177/1066896917714889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Giant bullous emphysema with placental transmogrification is an extremely rare entity, with 30 previously reported cases. Of these reported cases, it is typically identified with varied clinical and radiological impressions, presents in young adulthood to elderly, is always unilateral, and usually involves just one lobe. Despite the unknown pathogenesis, this diagnosis carries an excellent prognosis and is curative with complete resection. The pulmonary placental transmogrification is histologically indistinguishable from placental origin. Although not necessary to utilize because of the male predominance and no reported association, immunohistochemical stains can be used to prove lung origin. We report an extremely rare case of 2-lobe involvement of giant bullous emphysema with placental transmogrification in a boy 14 years of age, who is the youngest diagnosed patient with this lung abnormality.
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Affiliation(s)
- Brett M Lowenthal
- 1 University of California San Diego Health System, San Diego, CA, USA
| | - Nicholas C Saenz
- 1 University of California San Diego Health System, San Diego, CA, USA.,2 Rady Children's Hospital-San Diego, CA, USA
| | - Grace Y Lin
- 1 University of California San Diego Health System, San Diego, CA, USA
| | - Robert O Newbury
- 1 University of California San Diego Health System, San Diego, CA, USA.,2 Rady Children's Hospital-San Diego, CA, USA
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16
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Valasek MA, Thung I, Gollapalle E, Hodkoff AA, Kelly KJ, Baumgartner JM, Vavinskaya V, Lin GY, Tipps AP, Hosseini MV, Lowy AM. Overinterpretation is common in pathological diagnosis of appendix cancer during patient referral for oncologic care. PLoS One 2017; 12:e0179216. [PMID: 28591173 PMCID: PMC5462425 DOI: 10.1371/journal.pone.0179216] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 05/25/2017] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Low-grade appendiceal mucinous neoplasm (LAMN) and appendiceal adenocarcinoma are known to cause the majority of pseudomyxoma peritonei (PMP, i.e. mucinous ascites); however, recognition and proper classification of these neoplasms can be difficult despite established diagnostic criteria. OBJECTIVE To determine the pathological diagnostic concordance for appendix neoplasia and related lesions during patient referral to an academic medical center specialized in treating patients with PMP. DESIGN The anatomic pathology laboratory information system was searched to identify cases over a two-year period containing appendix specimens with mucinous neoplasia evaluated by an outside pathology group and by in-house slide review at a single large academic medical center during patient referral. RESULTS 161 cases containing appendix specimens were identified over this period. Forty-six of 161 cases (28.6%) contained appendiceal primary neoplasia or lesions. Of these, the originating pathologist diagnosed 23 cases (50%) as adenocarcinoma and 23 cases (50%) as LAMN; however, the reference pathologist diagnosed 29 cases (63.0%) as LAMN, 13 cases (28.3%) as adenocarcinoma, and 4 cases (8.7%) as ruptured simple mucocele. Importantly, for cases in which the originating pathologist rendered a diagnosis of adenocarcinoma, the reference pathologist rendered a diagnosis of adenocarcinoma (56.5%, 13 of 23), LAMN (39.1%, 9 of 23), or simple mucocele (4.3%, 1 of 23). The overall diagnostic concordance rate for these major classifications was 71.7% (33 of 46) with an unweighted observed kappa value of 0.48 (95% CI, 0.27-0.69), consistent with moderate interobserver agreement. All of the observed discordance (28.3%) for major classifications could be attributed to over-interpretation. In addition, the majority of LAMN cases (65.5%) had potential diagnostic deficiencies including over-interpretation as adenocarcinoma and lacking or discordant risk stratification (i.e. documentation of extra-appendiceal neoplastic epithelium). CONCLUSIONS Appendiceal mucinous lesions remain a difficult area for appropriate pathological classification with substantial discordance due to over-interpretation in this study. The findings highlight the critical need for recognition and application of diagnostic criteria regarding these tumors. Recently published consensus guidelines and a checklist provided herein may help facilitate improvement of diagnostic concordance and thereby reduce over-interpretation and potential overtreatment. Further studies are needed to determine the extent of this phenomenon and its potential clinical impact.
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Affiliation(s)
- Mark A. Valasek
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
- * E-mail:
| | - Irene Thung
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Esha Gollapalle
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Alexey A. Hodkoff
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Kaitlyn J. Kelly
- Department of Surgery, Division of Surgical Oncology, University of California San Diego Moores Cancer Center, La Jolla, California, United States of America
| | - Joel M. Baumgartner
- Department of Surgery, Division of Surgical Oncology, University of California San Diego Moores Cancer Center, La Jolla, California, United States of America
| | - Vera Vavinskaya
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Grace Y. Lin
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Ann P. Tipps
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Mojgan V. Hosseini
- Department of Pathology, Division of Anatomic Pathology, University of California San Diego Medical Center, San Diego, California, United States of America
| | - Andrew M. Lowy
- Department of Surgery, Division of Surgical Oncology, University of California San Diego Moores Cancer Center, La Jolla, California, United States of America
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17
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He CH, Liu CY, Lin GY, Peng Q, Liao JY, Lin JH, Zhang T, Zheng XF, Lin CX, Wang SJ, Chen RS, Deng L, Chen YM. [Efficacy and safety of oseltamivir in children with suspected influenza: a multicenter randomized open-label trial]. Zhonghua Er Ke Za Zhi 2017; 55:462-467. [PMID: 28592016 DOI: 10.3760/cma.j.issn.0578-1310.2017.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza in children. Method: A multicenter, randomized and open-label trial was conducted among 229 individuals with suspected influenza which were collected from the clinic of 5 hospitals in Guangdong province (Guangzhou Women and Children's Medical Center, Shenzhen Baoan District Maternity and Child Care Service Center, the Second Affiliated Hospital of Shantou University Medical College, Dongguan Maternity and Child Care Service Centre, Yuexiu District Children's Hospital of Guangzhou) from April to July 2015. They were randomized either to oseltamivir group (oseltamivir 30-75 mg, twice daily for 5 days) or control group who were given symptom relief medicines for 5 days. Result: No significant difference was found between two groups in influenza symptoms of the patients before the treatment(P>0.05). Altogether 229 individuals (114 in oseltamivir group, 115 in control group) were analyzed for efficacy, in which 73 individuals (42 oseltamivir, 31 control), 31.9%, were identified as influenza-infected through laboratory test. No significant difference was found between the two groups in the duration of fever although shortened. In the 229 individuals , the cumulative alleviation proportion between oseltamivir and control group was not significantly different (P>0.05): the median duration of illness was 69.9 hours (95% CI 65.3-91.5) in oseltamivir group and 75.4 hours (95%CI 63.9-91. 7) in control group; the median duration of fever was 40.4 hours (95%CI 31.5-53.4) in oseltamivir group and 44.0 hours (95%CI 33.2-50.0) in control group. In the 73 individuals, the cumulative alleviation proportion between oseltamivir and control group was significantly different (P<0.05). The median duration of illness was 61.2 hours (95%CI 48.0-121. 0) in oseltamivir group, being significantly shorter than that of 116.0 hours (95%CI 91.5-175.0) in control group. But it was not significantly different that the median duration of fever was 32.8 hours (95%CI 24.0-47.0 ) in oseltamivir group and 55.8 hours (95%CI 43.6-78.3 ) in control group (P>0.05). And the median duration of fever in 60 individuals (38 oseltamivir, 22 control) was significantly different between two groups(P<0.05), who had finished a course of taking oseltamivir in the 73 individuals, 34.8 hours (95%CI 24.0-48.5 ) in oseltamivir group being significantly shorter than that of 53.3 hours (95%CI 43.6-104.0 ) in control group. There was certain difference in side effects rate between the two groups (oseltamivir 10%, control 2%, P<0.05). The main side-effects were gastrointestinal symptoms (stomachache, diarrhea, poor appetite, vomiting). Conclusion: The duration of illness and fever in suspected influenza patients treated with oseltamivir was shorter than those in the patients treated with no oseltamivir, the difference was not statistically significant, when 31.9% was confirmed with positive result of virus test in suspected influenza in children. But in these patients with positive result of virus test, the duration of illness was significantly shortened with treatment with oseltamivir as compared with no treatment with oseltamivir, and it would be better if full oseltamivir course was completed for reducing the duration of fever. Oseltamivir treatment was safe with mild side effects.
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Affiliation(s)
- C H He
- Department of Respiratory Diseases, Guangzhou Women and Children's Medical Center, Guangzhou 510120, China; He Chunhui contributed equally to this article
| | - C Y Liu
- Department of Pediatrics, Shenzhen Baoan District Maternity and Child Care Service Centre, Shenzhen 518133, China; Liu Chunyi contributed equally to this article
| | - G Y Lin
- Department of Pediatrics, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China; Lin Guangyu contributed equally to this article
| | - Q Peng
- Department of Pediatrics, Dongguan Maternity and Child Care Service Centre, Dongguan 523700, China; Peng Qian contributed equally to this article
| | - J Y Liao
- Department of Respiratory Diseases, Yuexiu District Children's Hospital of Guangzhou, Guangzhou 510115, China; Liao Jiayi contributed equally to this article
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18
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Lowenthal BM, Lin GY, Tipps AMP, Hosseini M. Adenocarcinoma Ex-Goblet Cell Carcinoid of the Appendix With Metastatic Peritoneal Spread to Meckel's Diverticulum and Endometriosis. Int J Surg Pathol 2017; 25:623-628. [PMID: 28449607 DOI: 10.1177/1066896917707042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Adenocarcinoma ex-goblet cell carcinoid is a very rare and histologically unique appendiceal malignancy with dual glandular and neuroendocrine differentiation. There is a high incidence of this tumor among middle-aged women with metastasis to the gynecologic tract with the mode of metastasis following peritoneal spread rather than hematogenous distribution. Adenocarcinoma ex-goblet cell carcinoid can spread to any peritoneal site including ovaries or omentum. We report a 37-year-old healthy woman who initially presented with right lower quadrant abdominal pain and pseudomyxoma peritonei. Histopathology of the appendectomy specimen revealed an adenocarcinoma ex-goblet cell carcinoid, signet ring cell type. Follow-up right hemicolectomy, omentectomy, bilateral salpingo-oophorectomy, and regional peritoneal resections revealed metastatic involvement by adenocarcinoma ex-goblet cell carcinoid, signet ring cell type. In this report, we describe a case of appendiceal adenocarcinoma ex goblet cell carcinoid with metastases to Meckel's diverticulum and areas of pelvic endometriosis, which have not been previously reported.
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Affiliation(s)
| | - Grace Y Lin
- 1 University of California San Diego Health System, San Diego, CA, USA
| | | | - Mojgan Hosseini
- 1 University of California San Diego Health System, San Diego, CA, USA
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19
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Lin SC, Heba E, Bettencourt R, Lin GY, Valasek MA, Lunde O, Hamilton G, Sirlin CB, Loomba R. Assessment of treatment response in non-alcoholic steatohepatitis using advanced magnetic resonance imaging. Aliment Pharmacol Ther 2017; 45:844-854. [PMID: 28116801 PMCID: PMC5346270 DOI: 10.1111/apt.13951] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 11/10/2016] [Accepted: 12/30/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Magnetic resonance imaging-derived measures of liver fat and volume are emerging as accurate, non-invasive imaging biomarkers in non-alcoholic steatohepatitis (NASH). Little is known about these measures in relation to histology longitudinally. AIM To examine any relationship between MRI-derived proton-density fat-fraction (PDFF), total liver volume (TLV), total liver fat index (TLFI), vs. histology in a NASH trial. METHODS This is a secondary analysis of a 24-week randomised, double-blind, placebo-controlled trial of 50 patients with biopsy-proven NASH randomised to oral ezetimibe 10 mg daily (n = 25) vs. placebo (n = 25). Baseline and post-treatment anthropometrics, biochemical profiling, MRI and biopsies were obtained. RESULTS Baseline mean PDFF correlated strongly with TLFI (Spearman's ρ = 0.94, n = 45, P < 0.0001) and had good correlation with TLV (ρ = 0.57, n = 45, P < 0.0001). Mean TLV correlated strongly with TLFI (ρ = 0.78, n = 45, P < 0.0001). After 24 weeks, PDFF remained strongly correlated with TLFI (ρ = 0.94, n = 45, P < 0.0001), maintaining good correlation with TLV (ρ = 0.51, n = 45, P = 0.0004). TLV remained strongly correlated with TLFI (ρ = 0.74, n = 45, P < 0.0001). Patients with Grade 1 vs. 3 steatosis had lower PDFF, TLV, and TLFI (P < 0.0001, P = 0.0003, P < 0.0001 respectively). Regression analysis of changes in MRI-PDFF vs. TLV indicates that 10% reduction in MRI-PDFF predicts 257 mL reduction in TLV. CONCLUSIONS The MRI-PDFF and TLV strongly correlated with TLFI. Decreases in steatosis were associated with an improvement in hepatomegaly. Lower values of these measures reflect lower histologic steatosis grades. MRI-derived measures of liver fat and volume may be used as dynamic and more responsive imaging biomarkers in a NASH trial, than histology.
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Affiliation(s)
- Steven C. Lin
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,NAFLD Research Center, University of California at San Diego, La Jolla, CA
| | - Elhamy Heba
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Ricki Bettencourt
- NAFLD Research Center, University of California at San Diego, La Jolla, CA,Division of Epidemiology, Department of Family Medicine and Public Health, University of California at San Diego, La Jolla, CA
| | - Grace Y. Lin
- Department of Pathology, University of California at San Diego, La Jolla, CA
| | - Mark A. Valasek
- Department of Pathology, University of California at San Diego, La Jolla, CA
| | - Ottar Lunde
- Department of Medicine, University of California at San Diego, La Jolla, CA
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Rohit Loomba
- NAFLD Research Center, University of California at San Diego, La Jolla, CA,Division of Epidemiology, Department of Family Medicine and Public Health, University of California at San Diego, La Jolla, CA,Division of Gastroenterology, University of California at San Diego, La Jolla, CA
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20
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Yek JLJ, Lee AKY, Tan JAD, Lin GY, Thamotharampillai T, Abdullah HR. Defining reasonable patient standard and preference for shared decision making among patients undergoing anaesthesia in Singapore. BMC Med Ethics 2017; 18:6. [PMID: 28148256 PMCID: PMC5288849 DOI: 10.1186/s12910-017-0172-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 08/04/2016] [Accepted: 01/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients' perception of material risks, by trained interviewers. Patients' demographics were obtained. Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. RESULTS Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education (p < 0.007), being employed (p < 0.046) and younger age group (p < 0.003) are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea (64.8%), Drowsiness (62.4%) and Surgical Wound Pain (58.8%). Patients ranked Heart Attack (59.3%), Death (53.8%) and Stroke (52.7%) as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist (52.2%), instead of letting the doctor decide (37.1%) or deciding for themselves (10.7%). Discussion with the anaesthetist (61.3%) is the preferred medium of communication compared to reading a pamphlet (23.4%) or watching a video (15.4%). CONCLUSION Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship.
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Affiliation(s)
- J L J Yek
- Department of Anaesthesiology, Singapore General Hospital, Singapore, 169608, Singapore
| | - A K Y Lee
- Department of Anaesthesiology, Singapore General Hospital, Singapore, 169608, Singapore
| | - J A D Tan
- Duke-NUS Medical School, Singapore, 169608, Singapore
| | - G Y Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - T Thamotharampillai
- Department of Dermatology, Singapore General Hospital, Singapore, 169608, Singapore.,Centre for Medical Ethics and Professionalism, Singapore Medical Association, Singapore, 169850, Singapore
| | - H R Abdullah
- Department of Anaesthesiology, Singapore General Hospital, Singapore, 169608, Singapore. .,Centre for Medical Ethics and Professionalism, Singapore Medical Association, Singapore, 169850, Singapore.
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21
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Liao X, Reed SL, Lin GY. Immunostaining Detection of Cytomegalovirus in Gastrointestinal Biopsies: Clinicopathological Correlation at a Large Academic Health System. Gastroenterology Res 2016; 9:92-98. [PMID: 28058077 PMCID: PMC5191896 DOI: 10.14740/gr725e] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) infection can be asymptomatic in healthy individuals but may cause serious complications in immunocompromised patients. We investigated the clinicopathological correlation of CMV in gastrointestinal (GI) biopsies at our institute between January 1, 2013 and December 31, 2015. METHODS A total of 105 non-neoplastic GI biopsies tested positive for CMV by immunohistochemistry (IHC). The IHC results were stratified as "true positive" if > 2 cells stained, or "rare positive" if only 1 - 2 cells stained. Clinical information including comorbidities, serum CMV viral loads, and treatment was reviewed and correlated. RESULTS Overall 1% of all GI biopsies were positive for CMV by immunostaining. The most frequently involved organ was colon, followed by esophagus, stomach, ileum and duodenum. When > 2 cells were stained positive, serum CMV viral loads were positive in 52.2%, negative in 17.2%, and not tested in 27.6% of cases. When only 1 - 2 cells stained positive, CMV viral loads were positive in 23.4%, negative in 25.5%, and not tested in 51.1% of cases. We further showed that clinical management of CMV differs based on both pathological findings and underlying diseases. CONCLUSIONS The role of CMV in GI biopsies remains controversial. We propose an algorithm of performing CMV immunostaining based on clinicopathological correlation.
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Affiliation(s)
- Xiaoyan Liao
- Department of Pathology, University of California, San Diego, CA, USA
| | - Sharon L. Reed
- Department of Pathology, University of California, San Diego, CA, USA
- Department of Medicine, University of California, San Diego, CA, USA
| | - Grace Y. Lin
- Department of Pathology, University of California, San Diego, CA, USA
- Corresponding Author: Grace Y. Lin, Department of Pathology and Laboratory Medicine, UC San Diego Health System, 200 W. Arbor Dr., San Diego, CA 92103, USA.
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22
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Liao X, Thorson JA, Hughes T, Nguyen JC, Wang HY, Lin GY. Erdheim-Chester disease with novel gene mutations discovered as an incidental finding in explanted liver of a patient with hepatitis C cirrhosis: A case report and literature review. Pathol Res Pract 2016; 212:849-54. [PMID: 27445228 DOI: 10.1016/j.prp.2016.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 05/06/2016] [Accepted: 07/01/2016] [Indexed: 11/19/2022]
Abstract
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis characterized by xanthogranulomatous infiltration of foamy histiocytes frequently involving bone and other organ systems. We herein report a unique case of ECD discovered incidentally in an explanted liver in a 65-year-old male with end-stage liver disease secondary to hepatitis C cirrhosis. Histological examination and immunohistochemical studies in the explanted liver revealed prominent foamy histiocytes that were CD68 positive, but CD1a and S100 negative. Mutational hotspot analysis of the explanted liver using a panel of 47 most common cancer-related genes performed by next generation sequencing (NGS) revealed likely somatic mutations in the PDGFRA, PTEN, and HNF1A genes, but no BRAF codon 600 mutations were detected. The bone marrow showed similar findings as in the liver. Whole body PET and bone scans demonstrated increased heterogeneous uptake in bilateral humeral and femoral diaphysis, most compatible with ECD. To our knowledge, this is the first case report of ECD that involves mainly bone marrow and liver with novel genomic alterations. Our case highlights the diversity and complexity of this disease entity and the importance of multi-modality approach integrating clinical and radiologic features with histopathologic and molecular/genomic findings.
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Affiliation(s)
- Xiaoyan Liao
- Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA
| | - John A Thorson
- Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA
| | - Tudor Hughes
- Department of Radiology, University of California San Diego Health System, La Jolla, CA, USA
| | - John C Nguyen
- Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA
| | - Huan-You Wang
- Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA.
| | - Grace Y Lin
- Department of Pathology, University of California San Diego Health System, La Jolla, CA, USA.
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23
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Loomba R, Cui J, Wolfson T, Haufe W, Hooker J, Szeverenyi N, Ang B, Bhatt A, Wang K, Aryafar H, Behling C, Valasek MA, Lin GY, Gamst A, Brenner DA, Yin M, Glaser KJ, Ehman RL, Sirlin CB. Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study. Am J Gastroenterol 2016; 111:986-94. [PMID: 27002798 PMCID: PMC5001170 DOI: 10.1038/ajg.2016.65] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 02/01/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD. METHODS This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D- and 3D-MRE in diagnosing advanced fibrosis. RESULTS The mean (±s.d.) of age and body mass index were 50.2 (±13.6) years and 32.1 (±5.0) kg/m(2), respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P<0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis. CONCLUSIONS Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D- and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.
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Affiliation(s)
- Rohit Loomba
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA,NAFLD Translational Research Unit, Department of Medicine, University of California at San Diego, La Jolla, CA,Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA
| | - Jeffrey Cui
- NAFLD Translational Research Unit, Department of Medicine, University of California at San Diego, La Jolla, CA
| | - Tanya Wolfson
- Department of Mathematics, University of California at San Diego, La Jolla, CA
| | - William Haufe
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Jonathan Hooker
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Nikolaus Szeverenyi
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Brandon Ang
- NAFLD Translational Research Unit, Department of Medicine, University of California at San Diego, La Jolla, CA
| | - Archana Bhatt
- NAFLD Translational Research Unit, Department of Medicine, University of California at San Diego, La Jolla, CA
| | - Kang Wang
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Hamed Aryafar
- Department of Radiology, University of California at San Diego, La Jolla, CA
| | - Cindy Behling
- Department of Pathology, Sharp Health System, San Diego, CA
| | - Mark A. Valasek
- Department of Pathology, University of California at San Diego, La Jolla, CA
| | - Grace Y. Lin
- Department of Pathology, University of California at San Diego, La Jolla, CA
| | - Anthony Gamst
- Department of Mathematics, University of California at San Diego, La Jolla, CA
| | - David A. Brenner
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA
| | - Meng Yin
- Department of Radiology, Mayo Clinic, Rochester, MN
| | | | | | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, CA
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24
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Lin SC, Ang B, Hernandez C, Bettencourt R, Jain R, Salotti J, Richards L, Kono Y, Bhatt A, Aryafar H, Lin GY, Valasek MA, Sirlin CB, Brouha S, Loomba R. Cardiovascular risk assessment in the treatment of nonalcoholic steatohepatitis: a secondary analysis of the MOZART trial. Therap Adv Gastroenterol 2016; 9:152-61. [PMID: 26929777 PMCID: PMC4749859 DOI: 10.1177/1756283x15621232] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Nonalcoholic steatohepatitis (NASH) is associated with increased cardiovascular risk and mortality. No US Food and Drug Administration (FDA) approved therapies for NASH are available; clinical trials to date have not yet systematically assessed for changes in cardiovascular risk. This study examines the prospective utility of cardiovascular risk assessments, the Framingham risk score (FRS) and coronary artery calcium (CAC) score, as endpoints in a NASH randomized clinical trial, and assesses whether histologic improvements lead to lower cardiovascular risk. METHODS Secondary analysis of a 24-week randomized, double-blind, placebo-controlled trial (MOZART) in which 50 biopsy-proven NASH patients received oral ezetimibe 10 mg daily (n = 25) versus placebo (n = 25). Biochemical profiling, FRS, CAC scores, liver biopsies were obtained at baseline and endpoint. RESULTS Ezetimibe improved FRS whereas placebo did not (4.4 ± 6.2 to 2.9 ± 4.8, p = 0.038; 3.0 ± 4.4 to 2.9 ± 4.2, p = 0.794). CAC scores did not change with ezetimibe or placebo (180.4 ± 577.2 to 194.1 ± 623.9, p = 0.293; 151.4 ± 448.9 to 183.3 ± 555.7, p = 0.256). Ezetimibe improved FRS and CAC scores in more patients than placebo (48% versus 23%, p = 0.079, and 21% versus 0%, p = 0.090, respectively), though not significantly. No differences were noted in cardiovascular risk scores among histologic responders versus nonresponders. CONCLUSIONS Ezetimibe improved FRS whereas placebo did not. FRS and CAC scores improved in a greater proportion of patients with ezetimibe; this trend did not reach significance. These findings indicate the utility and feasibility of monitoring cardiovascular risk in a NASH trial. The utility of CAC scores may be higher in trials of longer duration (⩾52 weeks) and with older patients (age ⩾45). ClinicalTrials.gov registration: NCT01766713.
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Affiliation(s)
- Steven C. Lin
- NAFLD Translational Research Unit, Division of Gastroenterology, University of California at San Diego, La Jolla, CA, USA
| | - Brandon Ang
- NAFLD Translational Research Unit, Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA
| | - Carolyn Hernandez
- NAFLD Translational Research Unit, Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA
| | - Ricki Bettencourt
- NAFLD Translational Research Unit, Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA
| | - Rashmi Jain
- NAFLD Translational Research Unit, Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA
| | - Joanie Salotti
- NAFLD Translational Research Unit, Division of Gastroenterology, University of California at San Diego, La Jolla, CA, USA
| | - Lisa Richards
- NAFLD Translational Research Unit, Division of Gastroenterology, University of California at San Diego, La Jolla, CA, USA
| | - Yuko Kono
- Division of Gastroenterology, University of California at San Diego, La Jolla, CA, USA
| | - Archana Bhatt
- NAFLD Translational Research Unit, Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA
| | - Hamed Aryafar
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA
| | - Grace Y. Lin
- Department of Pathology, University of California at San Diego, La Jolla, CA, USA
| | - Mark A. Valasek
- Department of Pathology, University of California at San Diego, La Jolla, CA, USA
| | - Claude B. Sirlin
- Department of Pathology and Liver Imaging Group, University of California at San Diego, La Jolla, CA, USA
| | - Sharon Brouha
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA
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25
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Abstract
Blood culture-negative endocarditis presents a clinical and diagnostic challenge. Here, we describe a patient with a delayed diagnosis of Bartonella henselae endocarditis. <Learning objective: The aim of this report is to highlight the importance of Bartonella species as a cause of culture-negative endocarditis and to illustrate the challenges it poses in diagnosis and treatment.>.
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Affiliation(s)
- Roxana Ghashghaei
- University of California San Diego Medical Center, San Diego, CA, USA
| | - Irene Thung
- University of California San Diego Medical Center, San Diego, CA, USA
| | - Grace Y Lin
- University of California San Diego Medical Center, San Diego, CA, USA
| | - Rebecca E Sell
- University of California San Diego Medical Center, San Diego, CA, USA
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Arulanandan A, Ang B, Bettencourt R, Hooker J, Behling C, Lin GY, Valasek MA, Ix JH, Schnabl B, Sirlin CB, Loomba R. Association Between Quantity of Liver Fat and Cardiovascular Risk in Patients With Nonalcoholic Fatty Liver Disease Independent of Nonalcoholic Steatohepatitis. Clin Gastroenterol Hepatol 2015; 13:1513-20.e1. [PMID: 25661453 DOI: 10.1016/j.cgh.2015.01.027] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/30/2014] [Accepted: 01/19/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The association between quantity of liver fat and the presence of metabolic syndrome needs to be assessed systematically. We aimed to determine the association between the quantity of liver fat and the presence of the metabolic syndrome in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD), independent of nonalcoholic steatohepatitis (NASH). METHODS We recruited 146 patients with well-characterized biopsy-proven NAFLD and 50 individuals without NAFLD (controls) to participate in a case-control study at the NAFLD Translational Research Unit at the University of California San Diego. Liver fat was quantified in patients with NAFLD and controls using an advanced magnetic resonance imaging-based biomarker, the proton-density-fat-fraction (MRI-PDFF). Patients with NAFLD were divided into groups based on whether they were above or below the median MRI-PDFF value (15.4% in patients with NAFLD); the MRI-PDFF value for controls was less than 5%. The primary outcome was the presence of the metabolic syndrome using Adult Treatment Panel III criteria without and with adjustment for the presence of NASH. RESULTS Compared with NAFLD patients with MRI-PDFF values below the median, and compared with controls, NAFLD patients with MRI-PDFF values above the median were more likely to have abdominal obesity (P < .0001), lower levels of high-density cholesterol (P < .0001), higher levels of triglycerides (P < .0001), and higher fasting glucose levels (P < .001). Compared with NAFLD patients with MRI-PDFF values below the median, NAFLD patients with MRI-PDFF above the median were more likely to have the metabolic syndrome (60.3% vs. 44.4%; P < .04), independent of biopsy-detected NASH. CONCLUSIONS Increased liver fat content in patients with NAFLD is associated with increased rates of the metabolic syndrome, independent of NASH. There appears to be an association between the quantity of liver fat and the risk for cardiovascular disease in patients with NAFLD.
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Affiliation(s)
- Ahilan Arulanandan
- Division of Internal Medicine, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California
| | - Brandon Ang
- NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California
| | - Ricki Bettencourt
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego School of Medicine, La Jolla, California
| | - Jonathan Hooker
- Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California
| | - Cynthia Behling
- Department of Pathology, University of California San Diego School of Medicine, La Jolla, California
| | - Grace Y Lin
- Department of Pathology, University of California San Diego School of Medicine, La Jolla, California
| | - Mark A Valasek
- Department of Pathology, University of California San Diego School of Medicine, La Jolla, California
| | - Joachim H Ix
- Division of Nephrology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California
| | - Bernd Schnabl
- NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California
| | - Rohit Loomba
- NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego School of Medicine, La Jolla, California.
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Harismendy O, Alakus H, Yost S, Woo B, French R, Lin GY, Jepsen K, Frazer KA, Lowy AM. Abstract 4803: BAP1 mutation is a frequent somatic event in peritoneal malignant mesothelioma. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-4803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Malignant mesothelioma (MM) arises from mesothelial cells that line the pleural, peritoneal and pericardial surfaces. The majority of MMs are pleural and have been associated with asbestos exposure. Previously, pleural MMs have been genetically characterized by the loss of BAP1 (40-60%) as well as loss of NF2 (75%) and CDKN2A (60%). The rare peritoneal form of MM occurs in ∼10% cases. With only ∼300 cases diagnosed in the US per year, its link to asbestos exposure is not clear and its mutational landscape unknown. We analyzed the somatic mutational landscape of 12 peritoneal MM of epitheloid subtype using copy number analysis (N = 9), whole exome sequencing (N = 7) and targeted sequencing (N = 12). Peritoneal MM display few copy number alterations, with most samples having less than 10 Mbp total changes, mostly through deletions and no high copy number amplification. Chromosome band 3p21 encoding BAP1 is the most recurrently deleted region (5/9), while, in contrast to pleural MM, NF2 and CDKN2A are not affected. We further identified 87 non-silent mutations across 7 sequenced tumors, with a median of 8 mutated genes per tumor, resulting in a very low mutation rate (median 1.3 10-6). BAP1 was the only recurrently mutated gene (N = 3/7). In one additional case, loss of the entire chromosome 3 leaves a non-functional copy of BAP1 carrying a rare nonsense germline variant, thus suggesting a potential genetic predisposition in this patient. Finally, with targeted sequencing of BAP1 in 3 additional cases, we conclude that BAP1 is frequently altered through copy number losses (N = 3/12), mutations (N = 3/12) or both (N = 2/12) sometimes at a sub-clonal level. Our findings suggest a major role for BAP1 in peritoneal MM susceptibility and oncogenesis and indicate important molecular differences to pleural MM as well as potential strategies for therapy and prevention.
Citation Format: Olivier Harismendy, Hakan Alakus, Shawn Yost, Brian Woo, Randall French, Grace Y. Lin, Kristen Jepsen, Kelly A. Frazer, Andrew M. Lowy. BAP1 mutation is a frequent somatic event in peritoneal malignant mesothelioma. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4803. doi:10.1158/1538-7445.AM2015-4803
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Alakus H, Yost SE, Woo B, French R, Lin GY, Jepsen K, Frazer KA, Lowy AM, Harismendy O. BAP1 mutation is a frequent somatic event in peritoneal malignant mesothelioma. J Transl Med 2015; 13:122. [PMID: 25889843 PMCID: PMC4422481 DOI: 10.1186/s12967-015-0485-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [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: 01/20/2015] [Accepted: 04/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant mesothelioma (MM) arises from mesothelial cells that line the pleural, peritoneal and pericardial surfaces. The majority of MMs are pleural and have been associated with asbestos exposure. Previously, pleural MMs have been genetically characterized by the loss of BAP1 (40-60%) as well as loss of NF2 (75%) and CDKN2A (60%). The rare peritoneal form of MM occurs in ~10% cases. With only ~300 cases diagnosed in the US per year, its link to asbestos exposure is not clear and its mutational landscape unknown. METHODS We analyzed the somatic mutational landscape of 12 peritoneal MM of epitheloid subtype using copy number analysis (N = 9), whole exome sequencing (N = 7) and targeted sequencing (N = 12). RESULTS Peritoneal MM display few copy number alterations, with most samples having less than 10 Mbp total changes, mostly through deletions and no high copy number amplification. Chromosome band 3p21 encoding BAP1 is the most recurrently deleted region (5/9), while, in contrast to pleural MM, NF2 and CDKN2A are not affected. We further identified 87 non-silent mutations across 7 sequenced tumors, with a median of 8 mutated genes per tumor, resulting in a very low mutation rate (median 1.3 10(-6)). BAP1 was the only recurrently mutated gene (N = 3/7). In one additional case, loss of the entire chromosome 3 leaves a non-functional copy of BAP1 carrying a rare nonsense germline variant, thus suggesting a potential genetic predisposition in this patient. Finally, with targeted sequencing of BAP1 in 3 additional cases, we conclude that BAP1 is frequently altered through copy number losses (N = 3/12), mutations (N = 3/12) or both (N = 2/12) sometimes at a sub-clonal level. CONCLUSION Our findings suggest a major role for BAP1 in peritoneal MM susceptibility and oncogenesis and indicate important molecular differences to pleural MM as well as potential strategies for therapy and prevention.
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Affiliation(s)
- Hakan Alakus
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany. .,Moores UCSD Cancer Center, 3855 Health Science Drive, Maildrop 0820, 92093, La Jolla, USA. .,Division of Surgical Oncology, Department of Surgery, University of California San Diego, La Jolla, CA, USA.
| | - Shawn E Yost
- Division of Genome Information Sciences, Department of Pediatrics and Rady Children's Hospital, University of California San Diego, La Jolla, CA, USA.
| | - Brian Woo
- Moores UCSD Cancer Center, 3855 Health Science Drive, Maildrop 0820, 92093, La Jolla, USA.
| | - Randall French
- Division of Surgical Oncology, Department of Surgery, University of California San Diego, La Jolla, CA, USA.
| | - Grace Y Lin
- Department of Pathology, University of California San Diego, La Jolla, CA, USA.
| | - Kristen Jepsen
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Kelly A Frazer
- Division of Genome Information Sciences, Department of Pediatrics and Rady Children's Hospital, University of California San Diego, La Jolla, CA, USA. .,Moores UCSD Cancer Center, 3855 Health Science Drive, Maildrop 0820, 92093, La Jolla, USA. .,Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Andrew M Lowy
- Moores UCSD Cancer Center, 3855 Health Science Drive, Maildrop 0820, 92093, La Jolla, USA. .,Division of Surgical Oncology, Department of Surgery, University of California San Diego, La Jolla, CA, USA.
| | - Olivier Harismendy
- Moores UCSD Cancer Center, 3855 Health Science Drive, Maildrop 0820, 92093, La Jolla, USA. .,Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
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Loomba R, Sirlin CB, Ang B, Bettencourt R, Jain R, Salotti J, Soaft L, Hooker J, Kono Y, Bhatt A, Hernandez L, Nguyen P, Noureddin M, Haufe W, Hooker C, Yin M, Ehman R, Lin GY, Valasek MA, Brenner DA, Richards L. Ezetimibe for the treatment of nonalcoholic steatohepatitis: assessment by novel magnetic resonance imaging and magnetic resonance elastography in a randomized trial (MOZART trial). Hepatology 2015; 61:1239-50. [PMID: 25482832 PMCID: PMC4407930 DOI: 10.1002/hep.27647] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 12/03/2014] [Indexed: 02/06/2023]
Abstract
UNLABELLED Ezetimibe inhibits intestinal cholesterol absorption and lowers low-density lipoprotein cholesterol. Uncontrolled studies have suggested that it reduces liver fat as estimated by ultrasound in nonalcoholic steatohepatitis (NASH). Therefore, we aimed to examine the efficacy of ezetimibe versus placebo in reducing liver fat by the magnetic resonance imaging-derived proton density-fat fraction (MRI-PDFF) and liver histology in patients with biopsy-proven NASH. In this randomized, double-blind, placebo-controlled trial, 50 patients with biopsy-proven NASH were randomized to either ezetimibe 10 mg orally daily or placebo for 24 weeks. The primary outcome was a change in liver fat as measured by MRI-PDFF in colocalized regions of interest within each of the nine liver segments. Novel assessment by two-dimensional and three-dimensional magnetic resonance elastography was also performed. Ezetimibe was not significantly better than placebo at reducing liver fat as measured by MRI-PDFF (mean difference between the ezetimibe and placebo arms -1.3%, P = 0.4). Compared to baseline, however, end-of-treatment MRI-PDFF was significantly lower in the ezetimibe arm (15%-11.6%, P < 0.016) but not in the placebo arm (18.5%-16.4%, P = 0.15). There were no significant differences in histologic response rates, serum alanine aminotransferase and aspartate aminotransferase levels, or longitudinal changes in two-dimensional and three-dimensional magnetic resonance elastography-derived liver stiffness between the ezetimibe and placebo arms. Compared to histologic nonresponders (25/35), histologic responders (10/35) had a significantly greater reduction in MRI-PDFF (-4.35 ± 4.9% versus -0.30 ± 4.1%, P < 0.019). CONCLUSIONS Ezetimibe did not significantly reduce liver fat in NASH. This trial demonstrates the application of colocalization of MRI-PDFF-derived fat maps and magnetic resonance elastography-derived stiffness maps of the liver before and after treatment to noninvasively assess treatment response in NASH.
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Affiliation(s)
- Rohit Loomba
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA,Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San DiegoLa Jolla, CA,Address reprint requests to: Rohit Loomba, M.D., M.H.Sc., Division of Gastroenterology and Epidemiology, University of California at San Diego School of Medicine, UC 303, MC-063, 9500 Gilman Drive, La Jolla, CA 92093. E-mail: ; tel: +1-858-534-2624; Fax: +1-858-534-3338
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California at San DiegoLa Jolla, CA
| | - Brandon Ang
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA
| | - Ricki Bettencourt
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San DiegoLa Jolla, CA
| | - Rashmi Jain
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA
| | - Joanie Salotti
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
| | - Linda Soaft
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
| | - Jonathan Hooker
- Liver Imaging Group, Department of Radiology, University of California at San DiegoLa Jolla, CA
| | - Yuko Kono
- Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
| | - Archana Bhatt
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA
| | - Laura Hernandez
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA
| | - Phirum Nguyen
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
| | - Mazen Noureddin
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
| | - William Haufe
- Liver Imaging Group, Department of Radiology, University of California at San DiegoLa Jolla, CA
| | - Catherine Hooker
- Liver Imaging Group, Department of Radiology, University of California at San DiegoLa Jolla, CA
| | - Meng Yin
- Department of Radiology, Mayo ClinicRochester, MN
| | | | - Grace Y Lin
- Department of Pathology, University of California at San DiegoLa Jolla, CA
| | - Mark A Valasek
- Department of Pathology, University of California at San DiegoLa Jolla, CA
| | - David A Brenner
- Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
| | - Lisa Richards
- NAFLD Translational Research Unit, University of California at San DiegoLa Jolla, CA,Division of Gastroenterology, Department of Medicine, University of California at San DiegoLa Jolla, CA
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Pola S, Boland BS, Lin GY, Kuo A, Sandborn WJ. Non-cirrhotic portal hypertension due to 6-mercaptopurine use for Crohn's disease. Dig Dis Sci 2014; 59:1642-4. [PMID: 24535249 PMCID: PMC5824981 DOI: 10.1007/s10620-014-3052-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 01/23/2014] [Indexed: 12/30/2022]
Affiliation(s)
- Suresh Pola
- Inflammatory Bowel Disease Center, University of California San Diego and UC San Diego Health System, La Jolla, California, USA
| | - Brigid S. Boland
- Inflammatory Bowel Disease Center, University of California San Diego and UC San Diego Health System, La Jolla, California, USA
| | - Grace Y. Lin
- Department of Pathology, University of California San Diego and UC San Diego Health System, La Jolla, California, USA
| | - Alexander Kuo
- Section of Hepatology, Division of Gastroenterology, University of California San Diego and UC San Diego Health System, La Jolla, California, USA
| | - William J Sandborn
- Inflammatory Bowel Disease Center, University of California San Diego and UC San Diego Health System, La Jolla, California, USA
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Xu RA, Xu ZS, Lin GY, Hu LF, Wang XQ, Ma JS. Effect of Repeated Wuniu Early Tea Administration on the CYP450 Activity Using a Cocktail Method. Indian J Pharm Sci 2013; 75:94-8. [PMID: 23901167 PMCID: PMC3719156 DOI: 10.4103/0250-474x.113536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 01/04/2013] [Accepted: 01/08/2013] [Indexed: 11/25/2022] Open
Abstract
Wuniu early tea (Camellia sinensis) is an important beverage consumed in China. Up to date, a lot of methods for identifying and chemical analysing have been done. However, there is no report on the effects of Wuniu early tea on cytochrome P450 isozymes. Therefore, the present objective of our study was to evaluate the potential effects of Wuniu early tea on cytochrome P450 isozymes P2C9, P1A2, P2C19 and P2B6 in rats with a cocktail approach including, matching probe drugs of tolbutamide, phenacetin, omeprazole and bupropion. These four probe drugs were simultaneously administered to rats after repeated Wuniu early tea administration. The pharmacokinetics of the probes in the plasma was simultaneous determined by high-performance liquid chromatography-mass spectrometry. The t1/2 and AUC(0-∞) of tolbutamide increased significantly and CLz decreased remarkably in test rats after repeated Wuniu early tea administration. However, the main pharmacokinetic parameters of the other three probe drugs were not significantly different between control and test rats. The findings in this study suggested that Wuniu early tea could inhibit cytochrome P2C9 while did not influence on cytochrome P1A2, cytochrome P2C19 and cytochrome P2B6.
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Affiliation(s)
- R A Xu
- The First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325 035, China
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Carrigg A, Teschendorf C, Amaro D, Weidner N, Tipps A, Shabaik A, Peterson MR, Lin GY, Hasteh F. Examination of sources of diagnostic error leading to cervical cone biopsies with no evidence of dysplasia. Am J Clin Pathol 2013; 139:422-7. [PMID: 23525611 DOI: 10.1309/ajcp6bsd0sngqlhq] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
At our institution, 17% of cervical conization specimens are reported as negative for dysplasia or malignancy. To identify sources of error, we reviewed 53 negative conization specimens and their prior and follow-up cytology, biopsy, and endocervical curettage specimens. Examination of deeper-level sections and p16 immunostaining were performed on all conization specimens and selected biopsy specimens. Dysplasia was detected in 26% (14/53) of conization specimens. Twenty-eight percent (15/53) of cones were truly negative, and the presurgical material had been overcalled as high-grade squamous intraepithelial lesions (HSIL). Forty-five percent (24/53) of cones were truly negative and HSIL was confirmed in the presurgical material. Of these, 11% (6/53) showed subsequent evidence of residual dysplasia and 26% (14/53) were negative on further follow-up. Deeper-level sections, p16 immunostains, and consensus review may help identify squamous dysplasia in conization specimens and may prevent the overdiagnosis of HSIL on cervical biopsies.
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Affiliation(s)
- Alison Carrigg
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | - Crystal Teschendorf
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | - Deirdre Amaro
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | | | - Ann Tipps
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | - Ahmed Shabaik
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | - Michael R. Peterson
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | - Grace Y. Lin
- Department of Pathology, University of California San Diego Health System, San Diego, CA
| | - Farnaz Hasteh
- Department of Pathology, University of California San Diego Health System, San Diego, CA
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Affiliation(s)
- Jinghong Li
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, San Diego, CA
| | - Andrew Yen
- Department of Radiology, University of California San Diego Health System, San Diego, CA
| | - Grace Y Lin
- Department of Pathology, University of California San Diego Health System, San Diego, CA.
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Wong D, Teschendorf C, Lin GY, Hasteh F. The clinical significance of "squamous intraepithelial lesion of indeterminate grade" as a distinct cytologic category. Am J Clin Pathol 2012; 137:753-60. [PMID: 22523214 DOI: 10.1309/ajcppejt9d2rgjfh] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The histologic and/or cytologic follow-up of 127 cases of cervical lesions termed "squamous intraepithelial lesion of indeterminate grade" (SIL) on Papanicolaou (Pap) smears by the 2001 Bethesda System was compared with 150 control cases of low-grade SIL (LSIL), high-grade SIL (HSIL), and atypical squamous cells, cannot exclude HSIL (ASC-H). A follow-up diagnosis of cervical intraepithelial neoplasia (CIN) 2 or higher was identified in 22.8% of SIL cases, which was 2.6 times higher than LSIL, 3 times lower than HSIL, and 1.5 times lower than ASC-H. A follow-up diagnosis of CIN 1 was identified in 31.5% of SIL cases, which was 2 times lower than the LSIL group, 1.5 times higher than the ASC-H cases, and 1.8 times higher than the HSIL group. We found that 22.0% of cases diagnosed as SIL were followed up by Pap smears rather than colposcopy and biopsy, compared with about 1% of LSIL and HSIL cases. Because SIL cases have a significant risk of harboring CIN 2 or greater, we recommend follow-up by colposcopy and biopsy.
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Thistlethwaite PA, Renner J, Duhamel D, Makani S, Lin GY, Jamieson SW, Harrell J. Surgical management of endobronchial inflammatory myofibroblastic tumors. Ann Thorac Surg 2011; 91:367-72. [PMID: 21256271 DOI: 10.1016/j.athoracsur.2010.09.017] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/02/2010] [Accepted: 09/07/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Endobronchial myofibroblastic tumors are neoplasms composed of clonal populations of smooth muscle cells and a variable lymphocytic inflammatory component. They represent a challenge with respect to diagnosis, classification, and surgical resection due to their infrequent occurrence. METHODS We retrospectively reviewed our experience with patients who had myofibroblastic tumors in the major airways over a 15-year period, in order to understand the incidence, natural biology, treatment, and long-term outcome of individuals with this type of neoplasm in an endobronchial location. RESULTS Between 1995 and 2010, 11 patients (9 female, 2 male) underwent surgical resection of a myofibroblastic tumor arising within the tracheobronchial tree. The mean age was 39.6 years (range, 22.3 to 53.6 years). All patients were symptomatic, with cough and dyspnea as the most common presenting complaints. Rigid bronchoscopy with endobronchial biopsy was utilized to establish the diagnosis in 9 of 11 patients. Laser-mechanical debulking was performed to relieve airway obstruction prior to operation in 10 of 11 patients. Because of wide submucosal infiltration of the neoplasms, surgical resection for complete removal was required for all individuals. Tracheal resection was performed in 3 patients, carinal resection in 1 patient, mainstem bronchial resection in 2 patients, sleeve resection in 3 patients, bilobectomy in 1 patient, and right lower lobectomy in 1 patient. Resection with tumor-free margins was accomplished in all patients. Mean tumor size was 2.3 cm (range, 1.5 to 3.5 cm). There were no operative deaths, with all patients alive and disease-free at a mean of 6.1 ± 3.7 years. CONCLUSIONS Complete surgical resection of inflammatory myofibroblastic tumors presenting in a major airway is safe and leads to excellent survival for patients with this uncommon disease.
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Affiliation(s)
- Patricia A Thistlethwaite
- Division of Cardiothoracic Surgery, University of California, San Diego, California 92103-8892, USA.
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Feng XG, Xu XJ, Ye S, Lin YY, Chen P, Zhang XJ, Lin GY, Lin XQ. Recent Chlamydia pneumoniae infection is highly associated with active ankylosing spondylitis in a Chinese cohort. Scand J Rheumatol 2011; 40:289-91. [PMID: 21469941 DOI: 10.3109/03009742.2011.560891] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate the presence of anti-Chlamydia pneumoniae (Cp) antibodies in patients with ankylosing spondylitis (AS) to determine whether there is an association with AS disease activity. METHODS Seventy-nine AS outpatients and 73 normal controls were enrolled in this case-control study. Serum anti-Cp immunoglobulins (CpIg) were detected by enzyme-linked immunosorbent assay (ELISA). Antibodies to Epstein-Barr virus (EBV), cytomegalovirus (CMV), and Chlamydia trachomatis (Ct) were also measured. Clinical and experimental data were collected, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was determined. Patients with positive Cp IgM or Cp IgA were considered to have had a recent Cp infection. RESULTS Cp IgG was detected in the majority of AS patients and also controls (88.8% vs. 91.8%, respectively). The seroprevalence of Cp IgA and Cp IgM was significantly higher in AS patients than in the controls (51.9% vs. 31.5%, p = 0.010 for Cp IgA; 79.7% vs. 20.5%, p < 0.0001 for Cp IgM). Seropositivity of Cp IgM was associated with elevation of the disease activity index, including erythrocyte sedimentation rate (ESR; p = 0.021), C-reactive protein (CRP; p = 0.007) and the BASDAI (p = 0.009). Persistent positive Cp IgM was associated with active disease, while seroreversion of Cp IgM was associated with a reduction in these disease activity indices. There was no correlation between Cp IgM or Cp IgA and symptomatic upper respiratory infections or other clinical manifestations. CONCLUSIONS Recent Cp infections occur frequently in AS patients and Cp IgM antibody is correlated with active disease. These findings indicate that Cp infections may be a triggering factor for active AS.
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Affiliation(s)
- X G Feng
- Department of Rheumatology, Dongfang Hospital, Fuzhou, P R China.
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Chen MM, Lee CY, Leland HA, Lin GY, Montgomery AM, Silletti S. Inside-out regulation of L1 conformation, integrin binding, proteolysis, and concomitant cell migration. Mol Biol Cell 2010; 21:1671-85. [PMID: 20335502 PMCID: PMC2869374 DOI: 10.1091/mbc.e09-10-0900] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The ectodomain structure and function of the neural cell adhesion molecule L1 is shown to be regulated by the intracellular phosphorylation of a novel threonine, T1172. In pancreatic cancer cells, T1172 exhibits steady-state saturated phosphorylation, an event regulated by CKII and PKC, and which further regulates cell migration. Previous reports on the expression of the cell adhesion molecule L1 in pancreatic ductal adenocarcinoma (PDAC) cells range from absent to high. Our data demonstrate that L1 is expressed in poorly differentiated PDAC cells in situ and that threonine-1172 (T1172) in the L1 cytoplasmic domain exhibits steady-state saturated phosphorylation in PDAC cells in vitro and in situ. In vitro studies support roles for casein kinase II and PKC in this modification, consistent with our prior studies using recombinant proteins. Importantly, T1172 phosphorylation drives, or is associated with, a change in the extracellular structure of L1, consistent with a potential role in regulating the shift between the closed conformation and the open, multimerized conformation of L1. We further demonstrate that these distinct conformations exhibit differential binding to integrins αvβ3 and αvβ5 and that T1172 regulates cell migration in a matrix-specific manner and is required for a disintegrin and metalloproteinase-mediated shedding of the L1 ectodomain that has been shown to regulate cell migration. These data define a specific role for T1172 of L1 in regulating aspects of pancreatic adenocarcinoma cell phenotype and suggest the need for further studies to elucidate the specific ramifications of L1 expression and T1172 phosphorylation in the pathobiology of pancreatic cancer.
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Affiliation(s)
- Maxine M Chen
- Moores Cancer Center and Department of Pathology, University of California, San Diego, La Jolla, CA 92093, USA
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Hasteh F, Lin GY, Weidner N, Michael CW. The use of immunohistochemistry to distinguish reactive mesothelial cells from malignant mesothelioma in cytologic effusions. Cancer Cytopathol 2010; 118:90-6. [DOI: 10.1002/cncy.20071] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [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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Firth AL, Yao W, Ogawa A, Madani MM, Lin GY, Yuan JXJ. Multipotent mesenchymal progenitor cells are present in endarterectomized tissues from patients with chronic thromboembolic pulmonary hypertension. Am J Physiol Cell Physiol 2010; 298:C1217-25. [PMID: 20181931 DOI: 10.1152/ajpcell.00416.2009] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Factors contributing to the development of a fibrotic vascular scar and pulmonary vascular remodeling leading to chronic thromboembolic pulmonary hypertension (CTEPH) are still unknown. This study investigates the potential contribution of multipotent progenitor cells and myofibroblasts to the development and progression of CTEPH. Histological examination of endarterectomized tissues from patients with CTEPH identified significant neointimal formation. Morphological heterogeneity was observed in cells isolated from these tissues, including a network-like growth pattern and the formation of colony-forming unit-fibroblast-like colonies (CFU-F). Cells typically coexpressed intermediate filaments vimentin and smooth muscle alpha-actin. Cells were characterized by immunofluorescence and quantitated by fluorescent-activated cell sorting (FACS) for the presence of cell surface markers typical of mesenchymal progenitor cells; cells were >99% CD44(+) CD73(+), CD90(+), CD166(+); >80% CD29(+); 45-99% CD105(+); CD34(-) and CD45(-). Cells were capable of adipogenic and osteogenic differentiation, determined by Oil Red O and Alizarin Red staining, respectively. Additionally, a population of Stro-1(+) cells, a marker of bone marrow-derived stromal cells (4.2%), was sorted by FACS and also capable of adipogenic and osteogenic differentiation. In conclusion, this study is the first to identify a myofibroblast cell phenotype to be predominant within endarterectomized tissues, contributing extensively to the vascular lesion/clot. This cell may arise from transdifferentiation of adventitial fibroblasts or differentiation of mesenchymal progenitor cells. The unique microenvironment created by the stabilized clot is likely a factor in stimulating such cellular changes. These findings will be critical in establishing future studies in the development of novel and much needed therapeutic approaches for pulmonary hypertension.
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Affiliation(s)
- Amy L Firth
- Dept. of Medicine, Univ. of California, San Diego, La Jolla, 92093-0725, USA
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40
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Yao W, Firth AL, Sacks RS, Ogawa A, Auger WR, Fedullo PF, Madani MM, Lin GY, Sakakibara N, Thistlethwaite PA, Jamieson SW, Rubin LJ, Yuan JXJ. Identification of putative endothelial progenitor cells (CD34+CD133+Flk-1+) in endarterectomized tissue of patients with chronic thromboembolic pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol 2009; 296:L870-8. [PMID: 19286928 DOI: 10.1152/ajplung.90413.2008] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by a fibrotic thrombus persisting and obliterating the lumen of pulmonary arteries; its pathogenesis remains poorly defined. This study investigates a potential contribution for progenitor cell types in the development of vascular obliteration and remodeling in CTEPH patients. Endarterectomized tissue from patients undergoing pulmonary thromboendarterectomy was collected and examined for the structure and cellular composition. Our data show an organized fibrin network structure in unresolved thromboemboli and intimal remodeling in vascular wall tissues, characterized by smooth muscle alpha-actin (SM-alphaA)-positive cell proliferation in proximal regions (adjacent to thromboemboli) and neoangiogenesis/recanalization in distal regions (downstream from thromboemboli). Cells that are positively stained with CD34 and fetal liver kinase-1 (Flk-1) (CD34(+)Flk-1(+)) were identified in both the proximal and distal vascular tissues; a subpopulation of CD34(+)Flk-1(+)CD133(+) cells were further identified by immunostaining. Triple-positive cells are indicative of a population of putative endothelial progenitor cells or potential colony-forming units of endothelial cells. In addition, inflammatory cells (CD45(+)) and collagen-secreting cells (procollagen-1(+)) were detected in the proximal vascular wall. Some of the CD34(+) cells in CTEPH cells isolated from proximal regions were also positive for SM-alphaA. Our data indicate that putative progenitor cell types are present in the neointima of occluded vessels of CTEPH patients. It is possible that the microenvironment provided by thromboemboli may promote these putative progenitor cells to differentiate and enhance intimal remodeling.
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Affiliation(s)
- Weijuan Yao
- Division of Pulmonary and Critical Care Medicine, Dept. of Medicine, MTF-252, Univ. of California, San Diego, 9200 Gilman Dr., MC 0725, La Jolla, CA 92093-0725, USA
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Domingos A, Lopes I, Waerenborgh JC, Marques N, Lin GY, Zhang XW, Takats J, McDonald R, Hillier AC, Sella A, Elsegood MRJ, Day VW. Trapping of anionic organic radicals by (TpMe2)2Ln (Ln = Sm, Eu). Inorg Chem 2007; 46:9415-24. [PMID: 17914813 DOI: 10.1021/ic701364k] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Stoichiometric reaction of [ Sm(Tp(Me2))2 ], 1, with a variety of reducible ketone- and quinone-type substrates gave thermally stable, isolable radical anions/ketyls in moderate to good yields. Thus reaction with benzophenone gave [Sm(Tp(Me2))2(OCPh2)], 2, with fluorenone [Sm(Tp(Me2))2(eta1-OC13H8)], 3, and di-tert-butylparaquinone [Sm(Tp(Me2))2(eta1-OC6H2(tBu)2O)], 4, each of which was structurally characterized. In the case of the less-hindered benzoquinone, an unimetallic semiquinone [Sm(Tp(Me2))2(OC6H4O)], 5, could be isolated, although it was unstable with respect to formation of the dimetallic complex [Sm(Tp(Me2))2]2(mu-OC6H4O), 6. Compound 6 was structurally characterized, as was its anthraquinone analogue [Sm(Tp(Me2))2]2(mu-OC14H8O), 7. When the analogous reaction was carried out between the less-reducing [Eu(Tp(Me2))2] and benzoquinone, only the europium analogue of the semiquinone 5, [Eu(Tp(Me2))2(OC6H4O)], 8, could be isolated. The use of the sterically hindered 3,5-di-tert-butyl-o-benzoquinone allowed isolation of [Sm(Tp(Me2))2(DTBSQ)], 9.
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Affiliation(s)
- Angela Domingos
- Departamento de Química, ITN, Estrada Nacional 10, Sacavém, Portugal
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Abstract
Prostate cancer has a distinctly recognized pattern of metastases: multifocal and osteoblastic lesions involving the axial skeleton and non-calcified lymph nodes in the pelvic and lumbar aortic groups. Most adenocarcinomas are capable of producing macrocalcification. We report a case of prostate cancer with de novo calcified metastases to the liver and retroperitoneal lymph nodes mimicking the pattern usually seen in mucin-producing adenocarcinomas arising from the gastrointestinal tract. To our knowledge, this is the first such case to be reported in the literature. We propose a multifactorial mechanism that supports dystrophic calcification in this case. The knowledge of atypical presentation of metastatic disease can prevent diagnostic delay and prompt initiation of therapy.
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Affiliation(s)
- P Ghosh
- Department of Internal Medicine, University of California, San Diego, San Diego, CA 92161, USA
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Zhang WJ, Yan J, Xu JJ, Wu J, Li YB, Jia ZJ, Zhou XP, Lin GY, Hou YP. Polymorphism data at AY639919 and AY639922 loci in Chinese population. J Forensic Sci 2005; 50:234. [PMID: 15831029] [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: 05/02/2023]
Affiliation(s)
- W J Zhang
- Institute of Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan, PR China
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Chen SJ, Chien FC, Lin GY, Lee KC. Enhancement of the resolution of surface plasmon resonance biosensors by control of the size and distribution of nanoparticles. Opt Lett 2004; 29:1390-1392. [PMID: 15233445 DOI: 10.1364/ol.29.001390] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A new resolution-enhanced surface plasmon resonance (SPR) biosensor offers a tenfold improvement in resolution compared with conventional SPR biosensors in the detection of the surface coverage of biomaterials. The proposed optical biosensor, based on the attenuated total-reflection method, excites both the surface plasmons and particle plasmons to enhance the local electromagnetic field by control of the size and volume fraction of embedded Au nanoparticles to increase the resolution of the device. The SPR biosensor design is based on the Maxwell-Garnett model and the Fresnel equations, and the device is fabricated with a cosputtering deposition system.
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Affiliation(s)
- S J Chen
- Department of Engineering Science, National Cheng Kung University, Tainan 701, Taiwan.
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45
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46
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Lin JJ, Lin GY, Shih C, Shen WC. Presentation of striatal hyperintensity on T1-weighted MRI in patients with hemiballism-hemichorea caused by non-ketotic hyperglycemia: report of seven new cases and a review of literature. J Neurol 2001; 248:750-5. [PMID: 11596778 DOI: 10.1007/s004150170089] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Recent studies have shown unique clinicoradiologic characteristics in patients with hemiballism-hemichorea (HB-HC) caused by non-ketotic hyperglycemia; however, there is still a limited number of patients being reported. We report 7 patients (3 males and 4 females) with this type of dyskinesia, whose ages ranged from 60 to 84 years. Brain CT of these patients showed hyperdensity in the contralateral striatum, corresponding with MRI studies that showed an increased signal intensity on T1-weighted images and a decreased signal on T2-weighted images. After metabolic control had been achieved, the hyperkinetic state of these patients abruptly ceased. Follow-up neuroimaging studies in 2 patients documentied complete resolution of the striatal hyperintensity on brain CT and MRI after 3 months and 6 months, respectively. A review of patients with HB-HC caused by non-ketotic hyperglycemia reported formerly and in the present study shows that the dyskinesia tends to occur in aged diabetic patients. The age of patients with dyskinesia secondary to cerebral infarction is generelly much lower. We also found that 86% (30 out of 35 cases) patients reported with HB-HC caused by non-ketotic hyperglycemia were Asians. The prognosis of the dyskinesia was excellent, and the radiological abnormalities are completely reversible.
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Affiliation(s)
- J J Lin
- Department of Neurology, Chushang Show-Chwan Hospital, Chushang Jenn, Nantou, Taiwan.
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47
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Liaw WF, Hsieh CK, Lin GY, Lee GH. Syntheses, reactivity, and pi-donating ligand metathesis reaction of five-coordinate sixteen-electron manganese(I) complexes: crystal structures of [Mn(CO(3)(-TeC(6)H(4)-o-NH-)](-), [(Mn(CO)(3))2(mu-SC(6)H(4)-o-S--S--C(6)H(4)-o-mu-S--)], [(CO)(3)Mn(mu-SC(6)H(4)-o-NH(2)-)]2, and [(CO)(3)Mn(mu-SC(8)N(2)H(4)-o-S-)](2)(2-). Inorg Chem 2001; 40:3468-75. [PMID: 11421694 DOI: 10.1021/ic000795a] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The preparation of the varieties of five-coordinate sixteen-electron manganese(I) complexes [Mn(CO)(3)(-EC(6)H(4)-o-E'-)](-) (E = Te, Se, S, O; E' = NH, S, O) by (a) oxidative addition of 2-aminophenyl dichalcogenides to anionic manganese(0)-carbonyl, (b) pi-donating ligand metathesis reaction of complex [Mn(CO)(3)(-TeC(6)H(4)-o-NH-)](-), and (c) reduction /deprotonation of the neutral dimetallic [(Mn(CO)(3))(2)(mu-SC(6)H(4)-o-S-S-C(6)H(4)-o-mu-S-)]/[(CO)(3)Mn(mu-SC(6)H(4)-o-NH(2)-)](2) proved successful approaches in this direction. The IR nu(CO) data of the coordinatively and electronically unsaturated [Mn(CO)(3)(-EC(6)H(4)-o-E'-)](-) (E = Te, Se, S, O; E' = NH, S, O) complexes suggest the relative order of pi-donating ability of the series of bidentate ligands being [TeC(6)H(4)-o-NH](2)(-) > [SeC(6)H(4)-o-NH](2)(-) > [SC(6)H(4)-o-NH](2)(-) > [SC(6)H(4)-o-S](2)(-) > [SC(6)H(4)-o-O](2)(-) > [OC(6)H(4)-o-O](2)(-). Proton NMR spectra of the [Mn(CO)(3)(-EC(6)H(4)-o-NH-)](-) (E = Te, Se, S) derivatives show the low-field shift of the amide proton ((1)H NMR (C(4)D(8)O): delta 9.66 (br) ppm (E = Te), 9.32 (br) ppm (E = Se), 8.98 (br) ppm (E = S)). The formation of the dimetallic [(CO)(3)Mn(mu-SC(8)N(2)H(4)-o-S-)](2)(2-) can be interpreted as coordinative association of two units of unstable mononuclear [(CO)(3)Mn(-SC(8)N(2)H(4)-o-S-)](-) and reflects the pi-donating ability of the bidentate ligand is responsible for the formation of pentacoordinate, sixteen-electron manganese(I) carbonyl complexes. The neutral bimetallic manganese(I)-bismercaptophenyl disulfide complex [(Mn(CO)(3))(2)(mu-SC(6)H(4)-o-S-S-C(6)H(4)-o-mu-S-)] with internal S-S bond length of 2.222(1) A and the five-coordinate sixteen-electron complex [Mn(CO)(3)(-SC(6)H(4)-o-S-)](-) are chemically interconvertible. In a similar fashion, treatment of complex [Mn(CO)(3)(-SC(6)H(4)-o-NH-)](-) with HBF(4) yielded neutral dinuclear complex [(CO)(3)Mn(mu-SC(6)H(4)-o-NH(2)-)](2) and showed that the amine deprotonation is reversible. Investigations of pi-donating ligand metathesis reactions of complex [Mn(CO)(3)(-TeC(6)H(4)-o-NH-)](-) revealed that the stable intermediate, not the pi-donating ability of bidentate ligands, is responsible for the final protonation/oxidation product. This argument is demonstrated by reaction of [Mn(CO)(3)(-TeC(6)H(4)-o-NH-)](-) with 1,2-benzenedithiol, hydroxythiophenol, and catechol, respectively leading to the formation of [Mn(CO)(3)(-EC(6)H(4)-o-E'-)](-) (E = S, O; E' = S, O), although any pi-donor containing the amido group is a more effective donor than any other pi-donor lacking an amido group. Also, the reactions of [Mn(CO)(3)(-TeC(6)H(4)-o-NH-)](-) with electrophiles occurring at the more electron-rich amide site support that the more electron-rich amide donor of the chelating 2-tellurolatophenylamido occupies an equatorial site as indicated by a shorter Mn(I)-N bond length of the distorted trigonal bipyramidal [Mn(CO)(3)(-TeC(6)H(4)-o-NH-)](-).
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Affiliation(s)
- W F Liaw
- Department of Chemistry, National Changhua University of Education, Changhua 50058, Taiwan
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48
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Foolad MR, Zhang LP, Lin GY. Identification and validation of QTLs for salt tolerance during vegetative growth in tomato by selective genotyping. Genome 2001. [DOI: 10.1139/g01-030] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to identify quantitative trait loci (QTLs) for salt tolerance (ST) during vegetative growth (VG) in tomato by distributional extreme analysis and compare them with the QTLs previously identified for this trait. A BC1 population (N = 792) of a cross between a moderately salt-sensitive Lycopersicon esculentum Mill. breeding line (NC84173, maternal and recurrent parent) and a salt-tolerant L. pimpinellifolium (Jusl.) Mill. accession (LA722) was evaluated for ST in solution cultures containing 700 mM NaCl + 70 mM CaCl2 (electrical conductivity, EC [Formula: see text] 64 dS/m and ψw [Formula: see text]35.2 bars). Thirty-seven BC1 plants (4.7% of the total) that exhibited the highest ST were selected (referred to as the selected population), grown to maturity in greenhouse pots and self-pollinated to produce BC1S1 progeny seeds. The 37 selected BC1S1 progeny families were evaluated for ST and their average performance was compared with that of the parental BC1 population before selection. A realized heritability of 0.50 was obtained for ST in this population. The 37 selected BC1 plants were subjected to restriction fragment length polymorphism (RFLP) analysis using 115 markers, and marker allele frequencies were determined. Allele frequencies for the same markers were also determined in an unselected BC1 population (N = 119) of the same cross. A trait-based marker analysis (TBA), which measures differences in marker allele frequencies between selected and unselected populations, was used to identify marker-linked QTLs. Five genomic regions were detected on chromosomes 1, 3, 5, 6, and 11 bearing significant QTLs for ST. Except for the QTL on chromosome 3, all QTLs had positive alleles contributed from the salt tolerant parent LA722. Of the five QTLs, three (those on chromosomes 1, 3, and 5) were previously identified for this trait in another study, and thus were validated here. Only one of the major QTLs that was identified in our previous study was not detected here. This high level of conformity between the results of the two studies indicates the genuine nature of the identified QTLs and their potential usefulness for ST breeding using marker-assisted selection (MAS). A few BC1S1 families were identified with most or all of the QTLs and with a ST comparable to that of LA722. These families should be useful for the development of salt tolerant tomato lines via MAS.Key words: Lycopersicon esculentum, L. pimpinellifolium, salt tolerance, vegetative growth, restriction fragment length polymorphism (RFLP), quantitative trait loci (QTLs), trait-based analysis.
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49
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Foolad MR, Zhang LP, Lin GY. Identification and validation of QTLs for salt tolerance during vegetative growth in tomato by selective genotyping. Genome 2001. [PMID: 11444704 DOI: 10.1139/gen-44-3-444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The purpose of this study was to identify quantitative trait loci (QTLs) for salt tolerance (ST) during vegetative growth (VG) in tomato by distributional extreme analysis and compare them with the QTLs previously identified for this trait. A BC1 population (N = 792) of a cross between a moderately salt-sensitive Lycopersicon esculentum Mill. breeding line (NC84173, maternal and recurrent parent) and a salt-tolerant L. pimpinellifolium (Jusl.) Mill. accession (LA722) was evaluated for ST in solution cultures containing 700 mM NaCl + 70 mM CaCl2 (electrical conductivity, EC = 64 dS/m and phiw approximately -35.2 bars). Thirty-seven BC1 plants (4.7% of the total) that exhibited the highest ST were selected (referred to as the selected population), grown to maturity in greenhouse pots and self-pollinated to produce BC1S1 progeny seeds. The 37 selected BC1S1 progeny families were evaluated for ST and their average performance was compared with that of the parental BC1 population before selection. A realized heritability of 0.50 was obtained for ST in this population. The 37 selected BC1 plants were subjected to restriction fragment length polymorphism (RFLP) analysis using 115 markers, and marker allele frequencies were determined. Allele frequencies for the same markers were also determined in an unselected BC1 population (N = 119) of the same cross. A trait-based marker analysis (TBA), which measures differences in marker allele frequencies between selected and unselected populations, was used to identify marker-linked QTLs. Five genomic regions were detected on chromosomes 1, 3, 5, 6, and 11 bearing significant QTLs for ST. Except for the QTL on chromosome 3, all QTLs had positive alleles contributed from the salt tolerant parent LA722. Of the five QTLs, three (those on chromosomes 1, 3, and 5) were previously identified for this trait in another study, and thus were validated here. Only one of the major QTLs that was identified in our previous study was not detected here. This high level of conformity between the results of the two studies indicates the genuine nature of the identified QTLs and their potential usefulness for ST breeding using marker-assisted selection (MAS). A few BC1S1 families were identified with most or all of the QTLs and with a ST comparable to that of LA722. These families should be useful for the development of salt tolerant tomato lines via MAS.
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Affiliation(s)
- M R Foolad
- Department of Horticulture, The Pennsylvania State University, University Park 16802, USA.
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50
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He B, Lin GY, Durbin JE, Durbin RK, Lamb RA. The SH integral membrane protein of the paramyxovirus simian virus 5 is required to block apoptosis in MDBK cells. J Virol 2001; 75:4068-79. [PMID: 11287556 PMCID: PMC114152 DOI: 10.1128/jvi.75.9.4068-4079.2001] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [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: 01/18/2023] Open
Abstract
In some cell types the paramyxovirus simian virus 5 (SV5) causes little cytopathic effect (CPE) and infection continues productively for long periods of time; e.g., SV5 can be produced from MDBK cells for up to 40 days with little CPE. SV5 differs from most paramyxoviruses in that it encodes a small (44-amino-acid) hydrophobic integral membrane protein (SH). When MDBK cells were infected with a recombinant SV5 containing a deletion of the SH gene (rSV5DeltaSH), the MDBK cells exhibited an increase in CPE compared to cells infected with wild-type SV5 (recovered from cDNA; rSV5). The increased CPE correlated with an increase in apoptosis in rSV5DeltaSH-infected cells over mock-infected and rSV5-infected cells when assayed for annexin V binding, DNA content (propidium iodide staining), and DNA fragmentation (terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling assay). In rSV5DeltaSH-infected MDBK cells an increase in caspase-2 and caspase-3 activities was observed. By using peptide inhibitors of individual caspases it was found that caspase-2 and caspase-3 were activated separately in rSV5DeltaSH-infected cells. Expression of caspase-2 and -3 in rSV5DeltaSH-infected MDBK cells appeared not to require STAT1 protein, as STAT1 protein could not be detected in SV5-infected MDBK cells. When mutant mice homologous for a targeted disruption of STAT1 were used as a model animal system and infected with the viruses it was found that rSV5DeltaSH caused less mortality than wild-type rSV5, consistent with the notion of clearance of apoptotic cells in a host species.
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Affiliation(s)
- B He
- Howard Hughes Medical Institute, Molecular Biology and Cell Biology, Northwestern University, Evanston, Illinois 60208-3500, USA
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