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Jacobs JW, Booth GS, Stephens LD, Adkins BD, Martin AA, Lundberg GD, Glover RT, Khan SS, Silver JK, Woo JS. Industry Payments to American Society of Hematology Clinical Practice Guideline Authors. Blood Adv 2024:bloodadvances.2023012527. [PMID: 38569136 DOI: 10.1182/bloodadvances.2023012527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
| | - Garrett S Booth
- Vanderbilt University Medical Center, 1301 Medical Center Dr, Tennessee, United States
| | - Laura D Stephens
- University of California San Diego, La Jolla, California, United States
| | - Brian D Adkins
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Amarilis A Martin
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
| | | | | | - Shazia S Khan
- Yale School of Medicine, New Haven, Connecticut, United States
| | - Julie K Silver
- Harvard Medical School, Charlestown MA, Massachusetts, United States
| | - Jennifer S Woo
- City of Hope National Medical Center, Duarte, California, United States
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2
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Jacobs JW, Adkins BD, Bibb LA, Stephens LD, Woo JS, Bloch EM, Booth GS. New threats from an old foe: Evaluating the risk to the blood supply due to increasing incidence and endemicity of leprosy in the United States. Transfus Apher Sci 2024; 63:103877. [PMID: 38242725 DOI: 10.1016/j.transci.2024.103877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
Leprosy (i.e., Hansen's disease) is a chronic disease secondary to infection with either Mycobacterium leprae or M. lepromatosis. While the incidence of this disease is decreasing across the world, there is mounting evidence that it might be increasing, and becoming endemic, in the United States. Leprosy was once considered a potential threat to the blood supply, and while this threat has not borne out, it is worth revisiting the available data to assess whether it may pose a threat in the future. Herein, we discuss the evidence for and against the potential for transfusion-transmission of leprosy, and highlight future areas of research to further elucidate this possibility.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern, Dallas, TX USA3, USA
| | - Lorin A Bibb
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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3
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Jacobs JW, Sharma D, Stephens LD, Figueroa Villalba CA, Rinder HM, Woo JS, Wheeler AP, Gerberi D, Goel R, Tormey CA, Booth GS, Bloch EM, Adkins BD. Thrombosis risk with haemoglobin C trait and haemoglobin C disease: A systematic review. Br J Haematol 2024; 204:1500-1506. [PMID: 38291731 DOI: 10.1111/bjh.19313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 02/01/2024]
Abstract
The thrombotic risk with haemoglobin C trait (HbAC) or haemoglobin C disease (HbCC) is unclear. However, individuals with HbCC have demonstrated chronic haemolysis, higher blood viscosity and altered rheology when compared to individuals with wild-type haemoglobin (HbAA). These physiological alterations may theoretically translate to increased risk of thrombosis; therefore, a systematic literature review was performed to investigate the possible association between HbAC and/or HbCC and thrombosis. Twenty-two studies met inclusion criteria representing 782 individuals with HbAC (n = 694) or HbCC (n = 88). Fifteen studies described the presence/absence of venous thromboembolism (VTE) in patients with HbAC (n = 685) or HbCC (n = 79), while seven studies described patients with HbAC (n = 9) or HbCC (n = 9) and arterial thrombosis. Most (n = 20) studies were case reports or case series; however, two studies suggested a potential increased VTE risk with HbAC compared to HbAA in (i) all patients (OR 2.2, 95% CI: 0.9-5.5) and in (ii) pregnant individuals (RR 3.7, 95% CI 0.9-16). This review is the largest assessment of patients with HbC trait or disease and thrombosis to date; despite its limitations, the findings suggest HbC may be a predisposing risk factor to thrombosis. Prospective cohort studies are warranted to definitively elucidate the risk of thrombosis in this population.
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Affiliation(s)
- Jeremy W Jacobs
- Special Coagulation Laboratory, Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Deva Sharma
- Division of Transfusion Medicine, Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | | | - Henry M Rinder
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Hematology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Allison P Wheeler
- Division of Coagulation Medicine, Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Division of Hematology/Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dana Gerberi
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA
| | - Ruchika Goel
- Department of Internal Medicine, Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois, USA
- Vitalant, Corporate Medical Affairs, Scottsdale, Arizona, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher A Tormey
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Garrett S Booth
- Division of Transfusion Medicine, Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Jacobs JW, Booth GS, Woo JS, Adkins BD, Stephens LD. How the United States syphilis epidemic may portend a resurgence of an unusual hematologic condition: The connection between syphilis and paroxysmal cold hemoglobinuria. Am J Hematol 2024; 99:484-485. [PMID: 38151909 DOI: 10.1002/ajh.27190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
The connection between syphilis and paroxysmal cold hemoglobinuria.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
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Jacobs JW, Raza S, Woo JS. Managing blood product shortages: Unprecedented challenges require novel solutions. Transfusion 2024; 64:565-566. [PMID: 38488299 DOI: 10.1111/trf.17723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sheharyar Raza
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
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Jacobs JW, Martin AA, Stephens LD, Adkins BD, Woo JS, Sharma D, Wheeler AP, Glover RT, Yui JC, Walker SC, Khan SS, Booth GS, Silver JK. Gender composition and geographical representation of American Society of Hematology clinical practice guideline authors. Lancet Haematol 2024; 11:e182-e183. [PMID: 38428444 DOI: 10.1016/s2352-3026(24)00042-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Amarilis A Martin
- Department of Pediatrics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Deva Sharma
- Division of Transfusion Medicine, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Hematology-Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Allison P Wheeler
- Division of Coagulation Medicine, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Hematology-Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Raeshun T Glover
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer C Yui
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shannon C Walker
- Division of Transfusion Medicine, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Hematology-Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shazia S Khan
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA; Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Garrett S Booth
- Division of Transfusion Medicine, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA; Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Boston, MA, USA; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA
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7
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Woo JS, Zhuang L, Jackson R, Wang S, Agrawal V, Blackmon A, Pourhassan H, Yuan S. Clinical management of a patient following a granulocyte transfusion from a donor positive for COVID-19. Lab Med 2024:lmad118. [PMID: 38333931 DOI: 10.1093/labmed/lmad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Granulocyte transfusions are indicated for patients with severe neutropenia and evidence of bacterial or fungal infection who are unresponsive to standard antimicrobial therapy. With a limited expiration time of 24 hours after collection, granulocytes are often transfused before results of infectious-disease screening tests are available, and before a transfusion service can perform a risk assessment if postdonation information is provided after the collection. The case we describe herein demonstrates a clinical scenario meeting indications for granulocyte transfusion, coupled with the clinical management undertaken after the granulocyte donor disclosed a positive result for a COVID-19 self-test taken 1 day after donation. In this case, the patient did not develop new COVID-19 symptoms and tested negative for COVID-19 after transfusion of the implicated unit. These findings add to the body of evidence in the literature that COVID-19 is not transmitted via blood transfusion.
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Affiliation(s)
- Jennifer S Woo
- Department Pathology, City of Hope National Medical Center, Duarte, CA
| | - Lefan Zhuang
- Department Pathology, City of Hope National Medical Center, Duarte, CA
| | - Ryan Jackson
- Department Pathology, City of Hope National Medical Center, Duarte, CA
| | - Shirong Wang
- Department Pathology, City of Hope National Medical Center, Duarte, CA
| | - Vaibhav Agrawal
- Department Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Amanda Blackmon
- Department Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Hoda Pourhassan
- Department Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Shan Yuan
- Pathology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
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Jacobs JW, Adkins BD, Bibb LA, Woo JS, Allen ES, Stephens LD, Binns TC, Bloch EM, Booth GS. The potential association between extracorporeal photopheresis and thrombosis. Bone Marrow Transplant 2024; 59:270-273. [PMID: 37996561 DOI: 10.1038/s41409-023-02153-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lorin A Bibb
- Department of Dermatology, Mayo Clinic, Rocester, MN, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Thomas C Binns
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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9
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Jacobs JW, Booth GS, Woo JS, Stephens LD, Figueroa Villalba CA, Adkins BD. Challenges in recognising paroxysmal cold hemoglobinuria. Transfus Med 2024; 34:71-73. [PMID: 38151804 DOI: 10.1111/tme.13024] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/02/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | | | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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10
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Allen ES, Perez-Alvarez I, Woo JS, Stephens LD. How do we design a laboratory space for a hospital transfusion medicine service? Transfusion 2024; 64:6-15. [PMID: 37876315 DOI: 10.1111/trf.17577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/08/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Transfusion service laboratories (TSL) often need to renovate or design new laboratory space, and their leaders must be involved in the complex and multifaceted design process. STUDY DESIGN AND METHODS This manuscript outlines the design process and considerations for a dedicated TSL space. RESULTS Proactive engagement with key collaborators throughout the design process is essential. Major design considerations include physical features such as location, size, service/equipment needs, and zones within the laboratory; intangible issues such as efficiency, well-being, and disaster planning; and adaptations for suboptimal space and changes over time. CONCLUSION Investing in the design of the laboratory space facilitates high-quality TSL operations, productivity, customer satisfaction, regulatory compliance, staff well-being, and most importantly, patient safety.
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Affiliation(s)
- Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Ingrid Perez-Alvarez
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
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11
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Jacobs JW, Stephens LD, Woo JS, Adkins BD, Booth GS. Discrepancies among studies reporting the prevalence of positive direct antiglobulin tests in the COVID-19 patient population. Transfus Med 2023. [PMID: 38151773 DOI: 10.1111/tme.13023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/28/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Centner, Dallas, Texas, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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12
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Abels E, Adkins BD, Cedeno K, Booth GS, Allen ES, Stephens LD, Woo JS, Tormey CA, Jacobs JW. Assessing Recommendations for Determining Fetal Risk in Alloimmunized Pregnancies in the United States: Is It Time to Update a Decades-Old Practice? Transfus Med Rev 2023; 38:150810. [PMID: 38194730 DOI: 10.1016/j.tmrv.2023.150810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Abstract
The current recommended testing algorithm for assessing the alloimmunized pregnancy utilized by many obstetricians in the United States (US) fails to consider the most recent evidence, placing fetuses, and mothers at unnecessary risk of poor outcome or death. This narrative review of the current landscape of fetal red blood cell (RBC) antigen testing evaluates the history of hemolytic disease of the fetus and newborn (HDFN) and how its discovery has continued to influence practices in the US today. We compare current US-based HDFN practice guidelines with those in Europe. We also provide transfusion medicine and hematology perspectives and recommendations addressing the limitations of US practice, particularly regarding paternal RBC antigen testing, and discuss the most valuable alternatives based on decades of data and evidence-based recommendations from Europe.
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Affiliation(s)
- Elizabeth Abels
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Koraima Cedeno
- Department of Obstetrics and Gynecology, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | | | - Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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Jacobs JW, Adkins BD, Sharma D, Wheeler AP, Stephens LD, Woo JS, Khan SS, Booth GS. Assessing authorship of clinical practice guidelines. Lancet Haematol 2023; 10:e950. [PMID: 38030315 DOI: 10.1016/s2352-3026(23)00337-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Brian D Adkins
- Department of Pathology, Southwestern Medical Center, University of Texas, Dallas, TX, USA
| | - Deva Sharma
- Department of Pathology, Microbiology and Immunology, Medical Center, Vanderbilt University, Nashville, TN, USA; Department of Medicine, Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Allison P Wheeler
- Department of Pathology, Microbiology and Immunology, Medical Center, Vanderbilt University, Nashville, TN, USA; Department of Pediatrics, Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Shazia S Khan
- Department of Pathology and Department of Laboratory Medicine, School of Medicine, Yale University, New Haven, CT, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Medical Center, Vanderbilt University, Nashville, TN, USA
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Abels E, Adkins BD, Allen ES, Booth GS, DiGuardo MA, Ding JJ, Guarente J, Klein M, Stephens LD, Tormey CA, Woo JS, Jacobs JW. Updates in the care of the alloimmunized pregnant patient: A transfusion medicine and clinical laboratory perspective. Am J Clin Pathol 2023; 160:441-443. [PMID: 37471256 DOI: 10.1093/ajcp/aqad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Affiliation(s)
- Elizabeth Abels
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, US
| | - Brian D Adkins
- Division of Transfusion Medicine and Hemostasis, Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, US
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, CA, US
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, US
| | | | - Jia Jennifer Ding
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, US
| | - Juliana Guarente
- Department of Pathology and Genomic Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, US
| | - Monica Klein
- Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, US
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, US
| | | | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, US
| | - Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, US
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Jacobs JW, Stephens LD, Booth GS, Woo JS, Adkins BD. Assessing transfusion-related costs: More than just the price of blood. J Trauma Acute Care Surg 2023; 95:e49-e50. [PMID: 37518902 DOI: 10.1097/ta.0000000000004038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
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Jacobs JW, Booth GS, Stephens LD, Woo JS, Adkins BD. Considering the impact of climate change and viral hemorrhagic fevers on the safety of the blood supply. Transfus Clin Biol 2023; 30:454-455. [PMID: 37392817 DOI: 10.1016/j.tracli.2023.06.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Garrett S Booth
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Jacobs JW, Binns TC, Chooljian DM, Adkins BD, Woo JS, Stephens LD, Schlafer TD, Savani BN, Booth GS. Blood bans and COVID-19: Government attempts to influence medicine and science threaten us all. Am J Clin Pathol 2023; 160:435-436. [PMID: 37410089 DOI: 10.1093/ajcp/aqad071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Affiliation(s)
| | | | - David M Chooljian
- Veterans Affairs Loma Linda Healthcare System and Loma Linda University School of Medicine, Loma Linda, CA, US
| | - Brian D Adkins
- University of Texas Southwestern Medical Center, Dallas, TX, US
| | | | | | - T D Schlafer
- Lincoln Memorial University Duncan School of Law, Knoxville, TN, US
| | - Bipin N Savani
- Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, TN, US
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Jacobs JW, Adkins BD, Allen ES, Parra-Herran C, Stephens LD, Woo JS, Booth GS. An Assessment of Gender Equity and Parity Among "Nontraditional" Pathology Awards. Lab Med 2023; 54:519-522. [PMID: 36857473 DOI: 10.1093/labmed/lmac166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/03/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess the gender composition of nontraditional pathology recognition award recipients. METHODS Cross-sectional analysis of American Society for Clinical Pathology (ASCP) Top Five 40 Under Forty and The Pathologist Power List award recipients' gender. Gender was independently analyzed by 2 authors using pronouns. Two analyses were performed: difference in gender parity and difference in gender equity for award recipients. RESULTS From 2014 through 2022, 618 total awards were conferred. Significantly more men than women received an award overall (57.1% vs 42.9%; P < .001). Compared with population benchmarks, awards conferred to US-based nontrainee pathology physicians (men 56.2%, women 43.8%; P = .091) and US-based pathology physician trainees (men 60.5%, women 39.5%; P = .15) are equitable. Conversely, gender inequities exist among awards conferred to US-based nonphysician laboratory professionals (men 51.7%, women 48.3%; P < .001). CONCLUSION The Pathologist Power List and Top Five ASCP 40 Under Forty awards have not completely achieved gender parity, and gender inequities remain among subgroups.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Brian D Adkins
- Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern, Dallas, TX, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | | | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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Bibb LA, Jacobs JW, Adkins BD, Woo JS, Stephens LD, Booth GS. Appropriate use of sex and gender for diversity, equity, and inclusion in biomedical research. Lancet Haematol 2023; 10:e397-e398. [PMID: 37263714 DOI: 10.1016/s2352-3026(23)00115-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/18/2023] [Indexed: 06/03/2023]
Affiliation(s)
- Lorin A Bibb
- Department of Dermatology, University of Connecticut Health, Farmington, CT, USA
| | - Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06519, USA.
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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Jacobs JW, Stephens LD, Allen ES, Binns TC, Booth GS, Hendrickson JE, Karafin MS, Tormey CA, Woo JS, Adkins BD. Epidemiological and clinical features, therapeutic strategies and outcomes in patients with hyperhaemolysis: A systematic review. Br J Haematol 2023. [PMID: 37074146 DOI: 10.1111/bjh.18825] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 04/20/2023]
Abstract
Hyperhaemolysis syndrome (HHS), a severe form of delayed haemolytic transfusion reaction most commonly described in patients with sickle cell disease (SCD), involves destruction of both donor and recipient red blood cells (RBCs). As the epidemiology and underlying pathophysiology have yet to be definitively elucidated, recognition can be challenging. We systematically reviewed PubMed and EMBASE to identify all cases of post-transfusion hyperhaemolysis and characterized the epidemiological, clinical and immunohaematological characteristics and treatments of HHS. We identified 51 patients (33 females and 18 males), including 31 patients with SCD (HbSS, HbSC and HbS/β-thalassaemia). The median haemoglobin nadir (3.9 g/dL) occurred a median of 10 days post-transfusion. 32.6% and 45.7% of patients had a negative indirect anti-globulin test and a negative direct anti-globulin test, respectively. The most common therapies included corticosteroids and intravenous immune globulin. 66.0% of patients received ≥1 supportive transfusion, which was associated with a longer median hospital stay/time to recovery (23 days vs. 15 days; p = 0.015) compared to no supportive transfusion. These findings illustrate that HHS that often results in marked anaemia 10 days post-transfusion is not restricted to patients with haemoglobinopathies, and additional transfused RBCs may be associated with a longer time-to-recovery.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Thomas C Binns
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jeanne E Hendrickson
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Matthew S Karafin
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Christopher A Tormey
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Booth GS, Savani BN, Adkins BD, Woo JS, Bertram R, Trushinski J, Sharma D, Jacobs JW. Cellular therapy processing laboratory: a workforce hiring nightmare. Bone Marrow Transplant 2023:10.1038/s41409-023-01972-y. [PMID: 36991087 PMCID: PMC10054199 DOI: 10.1038/s41409-023-01972-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Bipin N Savani
- Department of Medicine, Hematology, Stem Cell Transplantation and Cellular Therapy Section, Division of Hematology/Oncology, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, TN, USA
| | - Brian D Adkins
- Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern, Dallas, TX, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Rickey Bertram
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Joel Trushinski
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Deva Sharma
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
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Jacobs JW, Stephens LD, Woo JS, Allen ES, Booth GS. Firearms and blood transfusion: an inescapable disentanglement. Lancet 2023; 401:914-915. [PMID: 36933937 DOI: 10.1016/s0140-6736(23)00110-1] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/09/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06511, USA.
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, CA, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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Jacobs JW, Adkins BD, Woo JS, Booth GS. Crowdsourcing and Social Media: An Academic Approach to Preparing Manuscripts That Address Controversial Topics. Am J Clin Pathol 2023; 159:307-309. [PMID: 36637176 DOI: 10.1093/ajcp/aqac154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/13/2022] [Indexed: 01/14/2023] Open
Affiliation(s)
| | - Brian D Adkins
- University of Texas Southwestern, Medical Center, Dallas, TX, USA
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Jacobs JW, Fabbri S, Woo JS, Booth GS. Overturning Roe v. Wade: Medical and Legal Impacts on Blood Transfusion in the Obstetric Population. J Womens Health (Larchmt) 2023; 32:129-131. [PMID: 36576800 DOI: 10.1089/jwh.2022.0441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Jeremy W Jacobs
- Division of Transfusion Medicine, Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Stefka Fabbri
- Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, Colorado, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Jacobs JW, Adkins BD, Woo JS, Stephens LD, Booth GS. Alemtuzumab and autoimmune haemolytic anaemia: Coincidence or causation? Vox Sang 2023; 118:257-259. [PMID: 36683306 DOI: 10.1111/vox.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023]
Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brian D Adkins
- Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern, Dallas, Texas, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Jacobs JW, Adkins BD, Woo JS, Lally K, Booth GS. Analysis of gender representation on transfusion medicine journal editorial boards: Comparison between 2019 and 2022. Vox Sang 2023; 118:93-97. [PMID: 36285357 DOI: 10.1111/vox.13371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES A 2019 study highlighted significant gender inequities among blood banking and transfusion medicine (BBTM) journal editorial boards. We sought to assess if the representation of women has improved in the intervening 3 years. MATERIALS AND METHODS We analysed the gender composition of nine BBTM journal editorial boards as of 13 September 2022, including the seven journals studied in 2019. We compared this to the proportion of females (term used by authors) on seven BBTM journal editorial boards in 2019 to assess change in the editorial board composition. We also assessed gender composition by editorial position (editor-in-chief [EIC], associate/assistant/titled editors and editorial board members). RESULTS Nine BBTM journals have a total of 398 editorial positions and comprise significantly more men than women (68.8%, 274/398 vs. 31.2%, 124/398; p < 0.001). Among the seven journals analysed in 2019, the proportion of women on these seven editorial boards has remained unchanged (2019: 30.1%, 81/269 vs. 2022: 31.9%, 103/323; p = 0.66) despite the addition of 54 editorial positions. CONCLUSION Women remain inequitably represented on journal editorial boards among all journal editorial positions. Although advocacy efforts are increasing, there has been limited improvement in gender equity in 3 years, despite a 20% increase in editorial positions.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brian D Adkins
- Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern, Dallas, Texas, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Kimberly Lally
- Department of Pathology, Baylor Scott & White Medical Center, Temple, Texas, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Jacobs JW, Adkins BD, Ahmad Y, Bahar B, Bulow US, Herrmann AC, McDonald MM, Jackson NR, Mills AM, Owczarczyk AB, Shafi S, Shanes ED, Wang H, Woo JS, Compton ML, Johnson JE, Wheeler AP, Booth GS. Pathology and Abortion Rights Advocacy: Considerations in a Post-Roe World. Am J Clin Pathol 2022; 158:776-777. [PMID: 36197882 DOI: 10.1093/ajcp/aqac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - Burak Bahar
- Children's National Hospital, Washington, DC, USA
| | | | | | | | | | - Anne M Mills
- University of Virginia Health System, Charlotteville, VA, USA
| | | | - Saba Shafi
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Elisheva D Shanes
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hannah Wang
- Pathologist and Clinical Microbiologist in Northeast Ohio, USA
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Jacobs JW, Karafin MS, Allen ES, Abels E, Park YA, Stephens LD, Ward DC, Woo JS, Gehrie EA, Booth GS, Adkins BD. Blood conservation strategies at United States hospitals during the COVID‐19 pandemic: Findings from a multi‐institutional analysis. Transfusion 2022; 62:2271-2281. [PMID: 36093583 PMCID: PMC9538724 DOI: 10.1111/trf.17116] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/25/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
Background Due to the coronavirus disease 2019 (COVID‐19) pandemic, the transfusion medicine community has experienced unprecedented blood supply shortages since March 2020. As such, numerous changes to everyday practice have occurred with a specific emphasis on blood conservation. We sought to determine the strategies used to mitigate blood shortages and promote blood conservation during the pandemic. Methods An anonymous, 37‐question survey was developed using Research Electronic Data Capture and distributed via e‐mail to transfusion medicine specialists across the US obtained via publicly available databases. Results Amongst surveyed [41.1% response rate (51/124 institutions)], 98.0% experienced a product shortage, with the greatest number reporting red blood cell (RBC) shortages (92.0%). This led to 35.3% of institutions altering the composition and/or number of blood product suppliers, including a 100% increase in the number of institutions acquiring blood from organizations that connect hospital transfusion services with blood collection centers (e.g., Blood Buy) compared to before March 2020. Prospective triaging of blood products was the most common blood conservation strategy (68.1%), though 35.4% altered their RBC exchange or transfusion program for patients receiving chronic RBC transfusion/exchange. As a result of these changes, 78.6% of institutions reported that these changes resulted in a reduction in blood product usage, and 38.1% reported a decrease in product wastage. Conclusions Most hospitals experienced the effects of the supply shortage, and many of them implemented blood conserving measures. Conservation strategies were associated with decreased blood utilization and waste, and future studies could evaluate whether these changes persist.
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Affiliation(s)
- Jeremy W. Jacobs
- Department of Laboratory Medicine, Division of Transfusion Medicine Yale School of Medicine New Haven CT USA
| | - Matthew S. Karafin
- Department of Pathology and Laboratory Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Elizabeth S. Allen
- Department of Pathology University of California San Diego La Jolla CA USA
| | | | - Yara A. Park
- Department of Pathology and Laboratory Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Laura D. Stephens
- Department of Pathology University of California San Diego La Jolla CA USA
| | - Dawn C. Ward
- Wing‐Kwai and Alice Lee‐Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Jennifer S. Woo
- Department of Pathology City of Hope National Medical Center Duarte CA USA
| | - Eric A. Gehrie
- American Red Cross, National Headquarters Washington DC USA
| | - Garrett S. Booth
- Department of Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville TN USA
| | - Brian D. Adkins
- Department of Pathology, Division of Transfusion Medicine and Hemostasis University of Texas Southwestern Dallas TX USA
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Jacobs JW, Adkins BD, Stephens LD, Woo JS, Booth GS. Gender inequities in Transfusion Medicine society recognition awards. Transfus Med Rev 2022; 36:82-86. [DOI: 10.1016/j.tmrv.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Perez-Alvarez I, Crews BO, Woo JS, Rezk S, Tran MH. A Patient in Need of a Red Cell Exchange? J Appl Lab Med 2020; 6:1057-1061. [PMID: 33241416 DOI: 10.1093/jalm/jfaa159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/17/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Ingrid Perez-Alvarez
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Orange, CA
| | - Bridgit O Crews
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Orange, CA
| | - Jennifer S Woo
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Orange, CA
| | - Sherif Rezk
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Orange, CA
| | - Minh-Ha Tran
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Orange, CA
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Tran MH, Brown D, Woo JS, Perez-Alvarez I, Chavan R. Diversion of prime to ameliorate citrate toxicity in pediatric extracorporeal apheresis. Transfus Apher Sci 2020; 59:102841. [PMID: 32546378 DOI: 10.1016/j.transci.2020.102841] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Minh-Ha Tran
- University of California, Irvine Department of Pathology, United States.
| | | | - Jennifer S Woo
- University of California, Irvine Department of Pathology, United States
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Woo JS, Pach D, Perez‐Alvarez I, Tran M. Transcending gender: recognizing the impact of gender identity on blood collection. Transfusion 2019; 59:2481-2482. [DOI: 10.1111/trf.15315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/29/2019] [Accepted: 03/31/2019] [Indexed: 11/30/2022]
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Woo JS, Suslow P, Thorsen R, Ma R, Bakhtary S, Moayeri M, Nambiar A. Development and Implementation of Real-Time Web-Based Dashboards in a Multisite Transfusion Service. J Pathol Inform 2019; 10:3. [PMID: 30915257 PMCID: PMC6396429 DOI: 10.4103/jpi.jpi_36_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 11/20/2018] [Indexed: 12/24/2022] Open
Abstract
Background: In hospital transfusion services, visualization of blood product inventory in the form of web-based dashboards has the potential to improve the workflow and efficiency of blood product inventory management. While off-the-shelf “business intelligence” solutions by external vendors may offer the ability to display and analyze blood bank inventory data, laboratories may lack resources to readily access this technology. Using in-house talent, our transfusion service developed real-time, web-based dashboards to replace manual processes for managing both blood product inventory and cooler tracking at two large academic hospital blood banks. Methods: Dashboards were developed using Hypertext Markup Language, Cascading Style Sheets, and Hypertext Preprocessor scripting/programming languages. Data are extracted in real time from Sunquest (v7.3) Laboratory Information Systems Database (InterSystems Cache) and are refreshed every 2 min. Data are hosted internally by our institution's web servers and are accessed on a webpage via Microsoft Group Policy shortcuts. Results: Dashboards were designed and implemented to provide a fully customizable, dynamic, and secure method of displaying blood product inventory and blood product cooler status. Transfusion service staff utilized dashboard data to maintain adequate blood product supply, modify blood product replacement orders to prevent excess inventory, and transfer short-dated blood products between our facilities to minimize wastage. Conclusions: Dashboard technology can be readily implemented at hospital transfusion services with minimal capital expenditure. The implementation of real-time web-based dashboards for blood product inventory and cooler management at our centers facilitated on-demand blood product monitoring and replaced a tedious, manual process with a user-friendly and intuitive electronic tool.
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Affiliation(s)
- Jennifer S Woo
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Peter Suslow
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Russell Thorsen
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Rosaline Ma
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Sara Bakhtary
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Morvarid Moayeri
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Ashok Nambiar
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
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Sim DS, Lee KH, Song HC, Kim JH, Park DS, Lim KS, Woo JS, Hong YJ, Ahn YK, Son YS, Kim W, Jeong MH. P4401Cardioprotective effect of substance P in a porcine model of acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D S Sim
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - K H Lee
- Kyunghee University, Seoul, Korea Republic of
| | - H C Song
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - J H Kim
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - D S Park
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - K S Lim
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - J S Woo
- Kyunghee University, Seoul, Korea Republic of
| | - Y J Hong
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - Y K Ahn
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - Y S Son
- Kyunghee University, Seoul, Korea Republic of
| | - W Kim
- Kyunghee University, Seoul, Korea Republic of
| | - M H Jeong
- Chonnam National University Hospital, Gwangju, Korea Republic of
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Kim W, Kim JM, Cho JH, Kim HO, Woo JS, Chung HM. P6400Circadian distribution of acute myocardial infarction in different age groups: sinusoidal function analyses. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W Kim
- Kyung Hee University Hospital, Seoul, Korea Republic of
| | - J M Kim
- Saint Carollo Hospital, Suncheon, Korea Republic of
| | - J H Cho
- Saint Carollo Hospital, Suncheon, Korea Republic of
| | - H O Kim
- Kyung Hee University Hospital, Seoul, Korea Republic of
| | - J S Woo
- Kyung Hee University Hospital, Seoul, Korea Republic of
| | - H M Chung
- Kyung Hee University Hospital, Seoul, Korea Republic of
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Lee KH, Zhao XX, Cho H, Lee SR, Woo JS, Kim W. P319Bay 60-2770 attenuates doxorubicin-induced cardiotoxicity by preventing mitochondrial membrane potential loss. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K H Lee
- Kyunghee University, Department of cardiovascular of internal medicine, Seoul, Korea Republic of
| | - X X Zhao
- Kyung Hee Medical Center, Cardiovascular department , Seoul, Korea Republic of
| | - H Cho
- Kyunghee University, Department of cardiovascular of internal medicine, Seoul, Korea Republic of
| | - S R Lee
- Kyunghee University, Department of cardiovascular of internal medicine, Seoul, Korea Republic of
| | - J S Woo
- Kyunghee University, Department of cardiovascular of internal medicine, Seoul, Korea Republic of
| | - W Kim
- Kyunghee University, Department of cardiovascular of internal medicine, Seoul, Korea Republic of
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Abstract
CONTEXT - A vast majority of neoplasms arising from lung or pleura are initially diagnosed based on the histologic evaluation of small transbronchial, endobronchial, or needle core biopsies. Although most diagnoses can be determined by morphology alone, immunohistochemistry can be a valuable diagnostic tool in the workup of problematic cases. OBJECTIVE - To provide a practical approach in the interpretation and immunohistochemical selection of lung/pleura-based neoplasms obtained from small biopsy samples. DATA SOURCES - A literature review of previously published articles and the personal experience of the authors were used in this review article. CONCLUSION - Immunohistochemistry is a useful diagnostic tool in the workup of small biopsies from the lung and pleura sampled by small biopsy techniques.
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Ye Q, Woo JS, Zhao Q, Wang P, Huang P, Chen L, Li X, Xu K, Yong Y, (Sung-Eun) Yang S, Rao J. Fine-Needle Aspiration Versus Frozen Section in the Evaluation of Malignant Thyroid Nodules in Patients With the Diagnosis of Suspicious for Malignancy or Malignancy by Fine-Needle Aspiration. Arch Pathol Lab Med 2017; 141:684-689. [DOI: 10.5858/arpa.2016-0305-oa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
The Bethesda System for Reporting Thyroid Cytopathology recommends against the use of intraoperative frozen section (FS) during lobectomy of a thyroid nodule with a fine-needle aspiration (FNA) diagnosis of malignant. Bethesda recommendations for FS in the FNA category of suspicious for malignancy (SFM) is less well-defined. In some institutions in China, FS examination is performed during lobectomy even for FNA-proven malignant cases.
Objective.—
—To compare the efficacy of FNA versus FS in the evaluation of malignant thyroid lesions.
Design.—
A 3-year retrospective analysis from a single institution was performed on cases with an FNA diagnosis of SFM or malignant with subsequent FS examination during thyroidectomy. The results of FNA and FS findings were compared to the final thyroidectomy pathology.
Results.—
—A total of 5832 thyroidectomy procedures were performed: 1265 cases had FNA and FS results available. Fine-needle aspiration gave a diagnosis of SFM to 306 cases and a diagnosis of malignant to 821 cases. Of the SFM cases, 10.5% (32 of 306) had benign/indeterminate, 4.6% (14 of 306) suspicious, and 84.9% (260 of 306) malignant FS results. Final pathology showed 56.3% (18 of 32), 64.3% (9 of 14), and 100% (260 of 260) malignancy rates, respectively. For the malignant FNA group, 10.0% (82 of 821) had benign/indeterminate, 4.4% (36 of 821) suspicious, and 85.6% (703 of 821) malignant FS results. The final pathology showed 96.4% (79 of 82), 97.2% (35 of 36), and 99.9% (702 of 703) malignancy rates, respectively.
Conclusions.—
Frozen section should not be performed for the malignant FNA category because FS evaluation may result in 10% falsely negative findings. Performing FS for SFM may be better justified; however, more than half of FS cases read as benign in this category had malignant final pathology. Therefore, caution should be taken for FS results even in the SFM group.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jianyu Rao
- From the Departments of Pathology (Drs Ye, Chen, and Xu, and Ms Li), Surgery (Drs Zhao and Wang), and Ultrasonography (Dr Huang), Second Affiliate Hospital, Zhejiang University, Hangzhou, China; and the Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (Drs Woo, Yang, and Rao, and Mr Yong)
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Woo JS, Apple SK, Sullivan PS, Rao JY, Ostrzega N, Moatamed NA. Systematic assessment of HER2/neu in gynecologic neoplasms, an institutional experience. Diagn Pathol 2016; 11:102. [PMID: 27770810 PMCID: PMC5075405 DOI: 10.1186/s13000-016-0553-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 10/14/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND HER2/neu overexpression and/or amplification has been widely studied in a number of solid tumors, primarily in the breast. In gynecologic neoplasms, determination of HER2/neu status has not been well studied as a predictive biomarker in anti-HER2/neu treatment. METHODS We systematically evaluated the HER2/neu reactions by immunohistochemistry and fluorescent in situ hybridization in malignant gynecologic neoplasms as experienced in our institution. RESULTS The HER2/neu overexpression or amplification occurred in 8 % of the cancers of the gynecological organs in our series. Majority of the HER2/neu overexpression and/or amplification occurred in clear cell (27 %) and serous (11 %) carcinomas. HER2/neu positivity was also seen in undifferentiated as well as in mixed clear cell and serous carcinomas. Discordant IHC and FISH results (positive by FISH but not IHC) was seen in 2 cases. Majority of the HER2/neu overexpression and/or amplification occurs in the endometrium rather than the ovary. Heterogeneity of the HER2/neu by IHC staining was in < 2 % of the tumors in our series. CONCLUSIONS We recommend the HER2/neu studies on Müllerian carcinomas of clear cell, serous, and undifferentiated types, particularly when they arise in the endometrium. Since there are some discordant IHC/FISH results, we also propose performing the HER2/neu testing by FISH when the IHC score is less than 3 + .
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Affiliation(s)
- Jennifer S Woo
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, BOX 951732, 1P-241 CHS, Los Angeles, CA, 90095-1732, USA
| | - Sophia K Apple
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, BOX 951732, 1P-241 CHS, Los Angeles, CA, 90095-1732, USA
| | - Peggy S Sullivan
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, BOX 951732, 1P-241 CHS, Los Angeles, CA, 90095-1732, USA
| | - Jian-Yu Rao
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, BOX 951732, 1P-241 CHS, Los Angeles, CA, 90095-1732, USA
| | - Nora Ostrzega
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, BOX 951732, 1P-241 CHS, Los Angeles, CA, 90095-1732, USA.,Department of Pathology and Laboratory Science, Olive View Medical Center, Sylmar, CA, 91342, USA
| | - Neda A Moatamed
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, BOX 951732, 1P-241 CHS, Los Angeles, CA, 90095-1732, USA.
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Woo JS, Fishbein MC, Reemtsen B. Histologic examination of decellularized porcine intestinal submucosa extracellular matrix (CorMatrix) in pediatric congenital heart surgery. Cardiovasc Pathol 2015; 25:12-7. [PMID: 26453090 DOI: 10.1016/j.carpath.2015.08.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [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: 04/03/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND CorMatrix is a decellularized porcine small intestinal submucosa extracellular matrix that has gained attention as a promising alternative to current materials used in cardiac repair. While animal models demonstrate integration of CorMatrix material with host tissue, the histologic characteristics of CorMatrix used in humans are less well-characterized. In this retrospective study, we report our experience with CorMatrix material used in pediatric congenital heart surgery and describe the histology of CorMatrix material and of surrounding native tissue in explanted specimens. METHODS Records were reviewed of all pediatric patients implanted with CorMatrix from a single institution (2011-2014). Histologic examinations were performed on CorMatrix and other tissues removed. Explanted samples of CorMatrix and adherent tissues were evaluated for inflammation (acute and chronic), fibrosis, necrosis, degenerative changes, eosinophil response, foreign-body giant cell reaction, neovascularization, and calcification of tissues on a semiquantitative basis (0, none; 1, mild; 2, moderate; 3, marked). Presence of degeneration within CorMatrix and necrosis of surrounding tissue were noted. RESULTS CorMatrix was utilized in 532 pediatric heart reconstruction procedures since 2011. Twelve explanted CorMatrix specimens from 11 pediatric patients including 4 valves (2 mitral and 2 aortic) and 8 outflow/septal/conduit patches were identified and evaluated. Six cases (5 patients) demonstrated clinical evidence of graft failure prior to surgery (n=6, 1%). Chronic inflammation was seen in adjacent native tissue in 11/12 cases and consisted predominantly of a mixed population of lymphocytes, macrophages, and plasma cells. Acute inflammation was seen in three cases (3/12). Fibrosis of the surrounding native tissue was seen in all CorMatrix specimens. Eosinophils were present in 6/12 cases. Calcification in surrounding tissue was present in 3/12 cases. Giant cell reaction in adjacent native tissue was seen in 8/12 cases. Neovascularization was seen in surrounding native tissue in 5/12 cases. Degeneration of CorMatrix material was seen in 9/12 cases. Necrosis of surrounding tissue was also identified in 5/12 cases. CorMatrix was not resorbed and no cases demonstrated any remodeling of CorMatrix material by integration of native mesenchymal cells or myocytes. CONCLUSION CorMatrix may be associated with a marked inflammatory response, including a foreign-body giant cell reaction and fibrosis of the surrounding native tissue. Degenerative changes of CorMatrix material are also seen in a majority of explanted specimens. No histologic differences were seen between patients with clinical evidence of graft failure versus patients requiring graft removal due to other factors. Additionally, no cases showed evidence of tissue integration or recellularization of patch material. Our overall clinical experience with CorMatrix demonstrates a favorable outcome for pediatric patients undergoing cardiac reconstructive surgery. However, there is no histologic evidence that CorMatrix acts as a scaffold for reconstitution of the native cardiovascular structures.
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Affiliation(s)
- Jennifer S Woo
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, CHS 13-145, Los Angeles, CA, United States.
| | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, CHS 13-145, Los Angeles, CA, United States
| | - Brian Reemtsen
- Division of Cardiothoracic Surgery, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, CHS 13-145, Los Angeles, CA, United States
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Horvath S, Mah V, Lu AT, Woo JS, Choi OW, Jasinska AJ, Riancho JA, Tung S, Coles NS, Braun J, Vinters HV, Coles LS. The cerebellum ages slowly according to the epigenetic clock. Aging (Albany NY) 2015; 7:294-306. [PMID: 26000617 PMCID: PMC4468311 DOI: 10.18632/aging.100742] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Studies that elucidate why some human tissues age faster than others may shed light on how we age, and ultimately suggest what interventions may be possible. Here we utilize a recent biomarker of aging (referred to as epigenetic clock) to assess the epigenetic ages of up to 30 anatomic sites from supercentenarians (subjects who reached an age of 110 or older) and younger subjects. Using three novel and three published human DNA methylation data sets, we demonstrate that the cerebellum ages more slowly than other parts of the human body. We used both transcriptional data and genetic data to elucidate molecular mechanisms which may explain this finding. The two largest superfamilies of helicases (SF1 and SF2) are significantly over-represented (p=9.2x10-9) among gene transcripts that are over-expressed in the cerebellum compared to other brain regions from the same subject. Furthermore, SNPs that are associated with epigenetic age acceleration in the cerebellum tend to be located near genes from helicase superfamilies SF1 and SF2 (enrichment p=5.8x10-3). Our genetic and transcriptional studies of epigenetic age acceleration support the hypothesis that the slow aging rate of the cerebellum is due to processes that involve RNA helicases.
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Affiliation(s)
- Steve Horvath
- Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Biostatistics, School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Vei Mah
- Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Ake T. Lu
- Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Jennifer S. Woo
- Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Oi-Wa Choi
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA 90095, USA
| | - Anna J. Jasinska
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA 90095, USA
| | - José A. Riancho
- Department of Internal Medicine, H.U. Marqués de Valdecilla-IFIMAV-University of Cantabria, Santander 39008, Spain
| | - Spencer Tung
- Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Natalie S. Coles
- UCLA Molecular Biology Institute; Department of Chemistry and Biochemistry; Los Angeles, CA 90095, USA
| | - Jonathan Braun
- Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Harry V. Vinters
- Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - L. Stephen Coles
- UCLA Molecular Biology Institute; Department of Chemistry and Biochemistry; Los Angeles, CA 90095, USA
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42
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Woo JS, Perez-Rosendahl M, Haydel D, Perens G, Fishbein MC. A novel association of biventricular cardiac noncompaction and diabetic embryopathy: case report and review of the literature. Pediatr Dev Pathol 2015; 18:71-5. [PMID: 25386687 DOI: 10.2350/14-07-1532-cr.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diabetic embryopathy refers to a constellation of congenital malformations arising in the setting of poorly controlled maternal diabetes mellitus. Cardiac abnormalities are the most frequently observed findings, with a 5-fold risk over normal pregnancies. Although a diverse spectrum of cardiac defects has been documented, cardiac noncompaction morphology has not been associated with this syndrome. In this report, we describe a novel case of biventricular cardiac noncompaction in a neonate of a diabetic mother. The patient was a late preterm female with right anotia, caudal dysgenesis, multiple cardiac septal and aortic arch defects, and biventricular cardiac noncompaction. Examination of both ventricles demonstrated spongy myocardium with increased myocardial trabeculation greater than 50% left ventricular thickness and greater than 75% right ventricular thickness, with hypoplasia of the bilateral papillary muscles, consistent with noncompaction morphology. Review of the literature highlights the importance of gene expression and epigenomic regulation in cardiac embryogenesis.
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Affiliation(s)
- Jennifer S Woo
- 1 Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS 13-145, Los Angeles, CA, USA
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Quintero-Rivera F, Woo JS, Bomberg EM, Wallace WD, Peredo J, Dipple KM. Duodenal atresia in 17q12 microdeletion includingHNF1B: A new associated malformation in this syndrome. Am J Med Genet A 2014; 164A:3076-82. [DOI: 10.1002/ajmg.a.36767] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 08/14/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Fabiola Quintero-Rivera
- Department of Pathology and Laboratory Medicine; David Geffen School of Medicine; Los Angeles California
- UCLA Clinical Genomics Center; Los Angeles California
| | - Jennifer S. Woo
- Department of Pathology and Laboratory Medicine; David Geffen School of Medicine; Los Angeles California
| | - Eric M. Bomberg
- Department of Pediatrics; David Geffen School of Medicine at UCLA; Los Angeles California
| | - W. Dean Wallace
- Department of Pathology and Laboratory Medicine; David Geffen School of Medicine; Los Angeles California
| | - Jane Peredo
- Department of Pediatrics; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Katrina M. Dipple
- UCLA Clinical Genomics Center; Los Angeles California
- Department of Pediatrics; David Geffen School of Medicine at UCLA; Los Angeles California
- Department of Human Genetics; David Geffen School of Medicine at UCLA; Los Angeles California
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Abstract
In the pediatric population, B-acute lymphoblastic leukemia (B-ALL) is the most prevalent childhood hematological malignancy, as well as the leading cause of childhood cancer-related mortality. Advances in cytogenetics utilizing array-based technologies and next-generation sequencing (NGS) techniques have revealed exciting insights into the genetic basis of this disease, with the hopes of developing individualized treatment plans for affected children. In this comprehensive review, we discuss our current understanding of childhood (pediatric) B-ALL and highlight the most recent genetic advances and their therapeutic implications.
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Affiliation(s)
- Jennifer S Woo
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 1010 Veteran Ave, 2nd Floor, room 2212 F, Los Angeles, CA 90024, USA
| | - Michael O Alberti
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 1010 Veteran Ave, 2nd Floor, room 2212 F, Los Angeles, CA 90024, USA
| | - Carlos A Tirado
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 1010 Veteran Ave, 2nd Floor, room 2212 F, Los Angeles, CA 90024, USA
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45
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Lee S, Kim MS, Kim JS, Park HJ, Woo JS, Lee BC, Hwang SJ. Controlled delivery of a hydrophilic drug from a biodegradable microsphere system by supercritical anti-solvent precipitation technique. J Microencapsul 2007; 23:741-9. [PMID: 17123918 DOI: 10.1080/09687860600945552] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to prepare microspheres loaded with hydrophilic drug, bupivacaine HCl using poly(D,L-lactic-co-glycolic acid) (PLGA) and poly(L-lactic acid) (PLLA). Microspheres were prepared with varying the PLGA/PLLA ratio with two different levels of bupivacaine HCl (5 and 10%) using a supercritical anti-solvent (SAS) technique. Microspheres ranging from 4-10 microm in geometric mean diameter could be prepared, with high loading efficiency. Powder X-ray diffraction (PXRD) revealed that bupivacaine HCl retained its crystalline state within the polymer and was present as a dispersion within the polymer phase after SAS processing. The release of bupivacaine HCl from biodegradable polymer microspheres was rapid up to 4 h, thereafter bupivacaine HCl was continuously and slowly released for at least 7 days according to the PLGA/PLLA ratio and the molecular weight of PLLA.
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Affiliation(s)
- S Lee
- National Research Lab of Pharmaceutical Technology, College of Pharmacy, Chungnam National University, Daejeon, Korea
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46
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Yong CS, Li DX, Prabagar B, Park BC, Yi SJ, Yoo BK, Lyoo WS, Woo JS, Rhee JD, Kim JA, Choi HG. The effect of beta-cyclodextrin complexation on the bioavailability and hepatotoxicity of clotrimazole. Pharmazie 2007; 62:756-759. [PMID: 18236780] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Clotrimazole, a poorly water-soluble antimycotic agent, is a promising therapeutic agent for various diseases including cancer and sickle cell anemia. The oral bioavailability and hepatic toxicity of clotrimazole were compared with its beta-cyclodextrin inclusion form which was prepared by the spray-drying method. The inclusion complex gave significantly higher initial plasma concentrations, Cmax and AUC than did clotrimazole alone, indicating that the drug from the inclusion compound could be more easily absorbed in rats. Furthermore, mice treated with the inclusion compound showed significantly higher GOT/GPT values compared to clotrimazole alone. The inclusion compound also induced hypertrophy of hepatic cells by fat accumulation and disappearance of hepatic sinusoids, indications of pathological changes of liver, suggesting that the inclusion compound could induce more severe tissue damage in the liver than clotrimazole alone. Thus, hepatotoxicity of clotrimazole seems to be correlated with the enhanced oral bioavailability by inclusion complexation. Our results suggest that, in the development of a novel oral product, appearance or enhancement of hepatic toxicity must be considered along with oral bioavailability.
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Affiliation(s)
- C S Yong
- College of Pharmacy, Yeungnam University, Gyeongsan, South Korea
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47
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Abstract
Previous studies have demonstrated that levels of tumor necrosis factor-alpha (TNF-alpha) or its mRNA expression are increased in acute renal failure of various types including ischemia/reperfusion injury. This study was undertaken to determine whether pentoxifylline (PTX), an inhibitor of TNF-alpha production, provides a protective effect against ischemic acute renal failure in rabbits. Renal ischemia was induced by clamping bilateral renal arteries for 60 min. Animals were pretreated with PTX (30 mg/kg, i.v.) 10 min before release of clamp. At 24 h of reperfusion of blood after ischemia, changes in renal function, renal blood flow, and the expression of TNF-alpha mRNA were evaluated. Ischemia/reperfusion caused a marked reduction in GFR, which was accompanied by an increase of serum creatinine levels. Such changes were significantly attenuated by PTX pretreatment. PTX ameliorated the impairment of renal tubular function, but it had no effect on the reduction of renal blood flow induced by ischemia/reperfusion. The protective effect of PTX on functional changes was supported by morphological studies. The impairment of glucose and phosphate reabsorption in postischemic kidneys was associated with a depression in the expression of Na+-glucose and Na+-Pi transporters. The expression of TNF-alpha mRNA was increased after reperfusion, which was inhibited by PTX pretreatment. The PTX pretreatment in vitro prevented the release of lactate dehydrogenase induced by an oxidant t-butylhydroperoxide in rabbit renal cortical slices, but it did not produce any effect on the oxidant-induced lipid peroxidation, suggesting that PTX protection is not resulted from its antioxidant action. These results suggest that PTX may exert a protective effect against ischemic acute renal failure by inhibiting the production of TNF-alpha in rabbits.
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Affiliation(s)
- Y K Kim
- Department of Physiology, College of Medicine, Pusan National University, Korea.
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48
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Cha KS, Kim MH, Hung JS, Woo JS, Kim YD, Kim JS. Nonselective left internal mammary artery angiography during right transradial coronary angiography: a simple, rapid, and safe technique. Angiology 2001; 52:773-9. [PMID: 11716330 DOI: 10.1177/000331970105201107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Internal mammary artery angiography is increasingly required, but the technique for left internal mammary artery (LIMA) angiography during right transradial coronary angiography is not well established. The authors investigated the feasibility and safety of a new, simple, and rapid nonselective technique. Following right transradial coronary angiography, LIMA angiography was performed using a 5 French (Fr) Judkins JL-3.5 catheter in 110 patients. The catheter, placed in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. Contrast material was injected while sphygmomanometer cuff inflation was applied to the left upper arm. In the last 50 patients, the angiography was performed twice randomly with and without the cuff inflation. In 108 patients (98%), the catheter was successfully engaged in the subclavian artery in a mean of 11 +/- 8 seconds (range, 3-136) from the time when it was withdrawn from the ascending aorta, and nonselective LIMA angiography was successfully performed. The image quality of the angiograms was satisfactory in 103 (95%) of the 108 patients. In the last 50 patients, the image quality of the angiograms was determined satisfactory in 48 (96%) and 45 (90%) patients, with and without the cuff inflation, respectively. The difference was statistically not significant. There were no complications, including arterial dissection and thromboembolism. In conclusion, nonselective LIMA angiography can be readily and safely performed during right transradial coronary angiography using a 5 Fr Judkins JL-3.5 catheter.
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Affiliation(s)
- K S Cha
- Department of Internal Medicine and Cardiovascular Surgery, Dong-A University Hospital, Pusan, South Korea.
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49
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Abstract
Total circulatory arrest with full venous drainage can result in air entering the arterial system through several possible sites such as the aortic cannulation site or collateral vessels. Air present in the arterial system during total circulatory arrest imposes a special problem. We describe a simple technique of short-term retrograde systemic perfusion to remove air from the arterial system before restarting systemic arterial perfusion after total circulatory arrest.
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Affiliation(s)
- S C Sung
- Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Pusan, Korea.
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50
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Lee ES, Woo JS, Hwang SJ, Lim HH, Suh HK. Protective role of superoxide dismutase in rat eustachian tubal mucosa against acute otitis media induced by upper respiratory tract infection. J Laryngol Otol 2000; 114:832-6. [PMID: 11144830 DOI: 10.1258/0022215001904374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Superoxide dismutase has been known to play a role as an anti-oxidative system against oxidative injury during acute inflammation. To investigate the role of superoxide dismutase in eustachian tubal mucosa during acute otitis media (AOM), an animal model was made. Sprague-Dawley rats were inoculated with Streptococcus pneumoniae through the nasal cavity following development of virus-induced upper respiratory infection. The animals were divided into three groups according to their tympanic cavity conditions following bacterial inoculation; inoculated animals with no resultant AOM (no-AOM), animals with resultant AOM (AOM) and animals with resolving otitis media (recovery). The changes of superoxide dismutase in each tubal mucosa were compared with that of the normal control using immunohistochemistry and immunoblotting methods. On Western blot, there were little changes of optical density and surface area in no-AOM (213.5 +/- 22.4, 13.2 +/- 0.8 mm2) and recovery group (219.3 +/- 18.7, 14.8 +/- 0.7 mm2) compared to the normal control (223.5 +/- 26.2, 16.7 +/- 0.4 mm2). However, a marked decrease was found in the AOM model (167.6 +/- 19.3, 6.5 +/- 0.9 mm2). These findings suggest that superoxide dismutase may play a role in protecting tubal mucosa from free radical injury during AOM.
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Affiliation(s)
- E S Lee
- Department of Otolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
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