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Battaglin F, Baca Y, Millstein J, Yang Y, Xiu J, Arai H, Wang J, Ou FS, Innocenti F, Mumenthaler SM, Jayachandran P, Kawanishi N, Lenz A, Soni S, Algaze S, Zhang W, Khoukaz T, Roussos Torres E, Seeber A, Abraham JP, Lou E, Philip PA, Weinberg BA, Shields AF, Goldberg RM, Marshall JL, Venook AP, Korn WM, Lenz HJ. CCR5 and CCL5 gene expression in colorectal cancer: comprehensive profiling and clinical value. J Immunother Cancer 2024; 12:e007939. [PMID: 38212126 PMCID: PMC10806545 DOI: 10.1136/jitc-2023-007939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The C-C motif chemokine receptor 5 (CCR5)/C-C motif chemokine ligand 5 (CCL5) axis plays a major role in colorectal cancer (CRC). We aimed to characterize the molecular features associated with CCR5/CCL5 expression in CRC and to determine whether CCR5/CCL5 levels could impact treatment outcomes. METHODS 7604 CRCs tested with NextGen Sequencing on DNA and RNA were analyzed. Molecular features were evaluated according to CCR5 and CCL5 tumor gene expression quartiles. The impact on treatment outcomes was assessed in two cohorts, including 6341 real-world patients and 429 patients from the Cancer and Leukemia Group B (CALGB)/SWOG 80405 trial. RESULTS CCR5/CCL5 expression was higher in right-sided versus left-sided tumors, and positively associated with consensus molecular subtypes 1 and 4. Higher CCR5/CCL5 expression was associated with higher tumor mutational burden, deficiency in mismatch repair and programmed cell death ligand 1 (PD-L1) levels. Additionally, high CCR5/CCL5 were associated with higher immune cell infiltration in the tumor microenvironment (TME) of MMR proficient tumors. Ingenuity pathway analysis revealed upregulation of the programmed cell death protein 1 (PD-1)/PD-L1 cancer immunotherapy pathway, phosphatase and tensin homolog (PTEN) and peroxisome proliferator-activated receptors (PPAR) signaling, and cytotoxic T-lymphocyte antigen 4 (CTLA-4) signaling in cytotoxic T lymphocytes, whereas several inflammation-related pathways were downregulated. Low CCR5/CCL5 expression was associated with increased benefit from cetuximab-FOLFOX treatment in the CALGB/SWOG 80405 trial, where significant treatment interaction was observed with biologic agents and chemotherapy backbone. CONCLUSIONS Our data show a strong association between CCR5/CCL5 gene expression and distinct molecular features, gene expression profiles, TME cell infiltration, and treatment benefit in CRC. Targeting the CCR5/CCL5 axis may have clinical applications in selected CRC subgroups and may play a key role in developing and deploying strategies to modulate the immune TME for CRC treatment.
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Affiliation(s)
- Francesca Battaglin
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | | | - Joshua Millstein
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Yan Yang
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Joanne Xiu
- Caris Life Sciences, Phoenix, Arizona, USA
| | - Hiroyuki Arai
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Jingyuan Wang
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Federico Innocenti
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shannon M Mumenthaler
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
- Lawrence J Ellison Institute for Transformative Medicine, Los Angeles, California, USA
| | - Priya Jayachandran
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Natsuko Kawanishi
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Annika Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Shivani Soni
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Sandra Algaze
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Wu Zhang
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Taline Khoukaz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Evanthia Roussos Torres
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Andreas Seeber
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Innsbruck Medical University, Innsbruck, Tirol, Austria
| | | | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA
| | - Philip A Philip
- Department of Oncology and Pharmacology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA
| | - Benjamin A Weinberg
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Anthony F Shields
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA
| | - Richard M Goldberg
- West Virginia University Cancer Institute, Morgantown, West Virginia, USA
| | - John L Marshall
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Alan P Venook
- University of California San Francisco, San Francisco, California, USA
| | | | - Heinz-Josef Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
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2
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William WN, Zhao X, Bianchi JJ, Lin HY, Cheng P, Lee JJ, Carter H, Alexandrov LB, Abraham JP, Spetzler DB, Dubinett SM, Cleveland DW, Cavenee W, Davoli T, Lippman SM. Immune evasion in HPV - head and neck precancer-cancer transition is driven by an aneuploid switch involving chromosome 9p loss. Proc Natl Acad Sci U S A 2021; 118:e2022655118. [PMID: 33952700 PMCID: PMC8126856 DOI: 10.1073/pnas.2022655118] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 12/11/2022] Open
Abstract
An aneuploid-immune paradox encompasses somatic copy-number alterations (SCNAs), unleashing a cytotoxic response in experimental precancer systems, while conversely being associated with immune suppression and cytotoxic-cell depletion in human tumors, especially head and neck cancer (HNSC). We present evidence from patient samples and cell lines that alterations in chromosome dosage contribute to an immune hot-to-cold switch during human papillomavirus-negative (HPV-) head and neck tumorigenesis. Overall SCNA (aneuploidy) level was associated with increased CD3+ and CD8+ T cell microenvironments in precancer (mostly CD3+, linked to trisomy and aneuploidy), but with T cell-deficient tumors. Early lesions with 9p21.3 loss were associated with depletion of cytotoxic T cell infiltration in TP53 mutant tumors; and with aneuploidy were associated with increased NK-cell infiltration. The strongest driver of cytotoxic T cell and Immune Score depletion in oral cancer was 9p-arm level loss, promoting profound decreases of pivotal IFN-γ-related chemokines (e.g., CXCL9) and pathway genes. Chromosome 9p21.3 deletion contributed mainly to cell-intrinsic senescence suppression, but deletion of the entire arm was necessary to diminish levels of cytokine, JAK-STAT, and Hallmark NF-κB pathways. Finally, 9p arm-level loss and JAK2-PD-L1 codeletion (at 9p24) were predictive markers of poor survival in recurrent HPV- HNSC after anti-PD-1 therapy; likely amplified by independent aneuploidy-induced immune-cold microenvironments observed here. We hypothesize that 9p21.3 arm-loss expansion and epistatic interactions allow oral precancer cells to acquire properties to overcome a proimmunogenic aneuploid checkpoint, transform and invade. These findings enable distinct HNSC interception and precision-therapeutic approaches, concepts that may apply to other CN-driven neoplastic, immune or aneuploid diseases, and immunotherapies.
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Affiliation(s)
- William N William
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030;
- Hospital BP, a Beneficência Portuguesa de São Paulo, 01323-001 São Paulo, Brazil
| | - Xin Zhao
- Department of Biochemistry and Molecular Pharmacology, Institute for Systems Genetics, New York University Langone Health, New York, NY 10016
| | - Joy J Bianchi
- Department of Biochemistry and Molecular Pharmacology, Institute for Systems Genetics, New York University Langone Health, New York, NY 10016
| | - Heather Y Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Pan Cheng
- Department of Biochemistry and Molecular Pharmacology, Institute for Systems Genetics, New York University Langone Health, New York, NY 10016
| | - J Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Hannah Carter
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92037
- Department of Medicine, University of California San Diego, La Jolla, CA 92037
| | - Ludmil B Alexandrov
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92037
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA 92037
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92037
| | - Jim P Abraham
- Research and Development, Caris Life Sciences, Irving, TX 75039
| | | | - Steven M Dubinett
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA 90024
| | - Don W Cleveland
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92037
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA 92037
- Ludwig Institute for Cancer Research, University of California San Diego, La Jolla, CA 92037
| | - Webster Cavenee
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92037;
- Department of Medicine, University of California San Diego, La Jolla, CA 92037
- Ludwig Institute for Cancer Research, University of California San Diego, La Jolla, CA 92037
| | - Teresa Davoli
- Department of Biochemistry and Molecular Pharmacology, Institute for Systems Genetics, New York University Langone Health, New York, NY 10016;
| | - Scott M Lippman
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92037
- Department of Medicine, University of California San Diego, La Jolla, CA 92037
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Ma A, Kim J, Miller CE, Mustapich TL, Abraham JP, Downie SA, Mishall PL. Pointing in a different direction: a case of bilateral absence of extensor indicis. Folia Morphol (Warsz) 2021; 81:520-525. [PMID: 33778941 DOI: 10.5603/fm.a2021.0030] [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: 11/05/2020] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
Understanding anatomical variations, as well as, normal anatomy of the muscles and tendons of the hand is vital for successful clinical evaluation and surgery. A number of extensor muscle and tendon variations have been reported in the literature including duplication, triplication, and absence. We report a rare anatomical variation that includes bilateral absence of the extensor indicis (EI) muscles and bilateral duplication of the extensor digitorum (ED) tendon to the second digit in the forearm of an 83-year-old male cadaver during routine upper limbs dissection. In the present case, only three muscles were present in the deep compartment: extensor pollicis longus (EPL), extensor pollicis brevis (EPB), and abductor pollicis longus (APL) with bilateral absence of EI. The reported prevalence of bilateral absence of EI muscle and tendon ranges from 0.5 to 3.5% [1, 26]. The prevalence of an additional index tendon arising bilaterally from the ED muscle belly is 3.2 % of the population [1]. Extension of the index finger is governed by the actions of EI and ED. However, the four tendons of ED are linked to each other by juncturae tendinum (JT), restricting independent extension of the digits in certain postures, e.g. when the hand is fisted. With fisted hand, EI controls extension of the index finger. Clinically, EI tendons are used for tendon reconstruction procedures to restore function to the hand and thumb after trauma or tendon rupture. This report highlights the importance of anticipating anatomical variations and conducting pre-operative evaluations to confirm the presence of EI when planning tendon transfer procedures.
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Affiliation(s)
- A Ma
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - J Kim
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - C E Miller
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - T L Mustapich
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - J P Abraham
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - S A Downie
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States.,Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Bronx, NY, United States
| | - P L Mishall
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY, United States. .,Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, NY, United States.
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4
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Abraham JP, Magee D, Cremolini C, Antoniotti C, Halbert DD, Xiu J, Stafford P, Berry DA, Oberley MJ, Shields AF, Marshall JL, Salem ME, Falcone A, Grothey A, Hall MJ, Venook AP, Lenz HJ, Helmstetter A, Korn WM, Spetzler DB. Clinical Validation of a Machine-learning-derived Signature Predictive of Outcomes from First-line Oxaliplatin-based Chemotherapy in Advanced Colorectal Cancer. Clin Cancer Res 2020; 27:1174-1183. [PMID: 33293373 DOI: 10.1158/1078-0432.ccr-20-3286] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/30/2020] [Accepted: 12/03/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE FOLFOX, FOLFIRI, or FOLFOXIRI chemotherapy with bevacizumab is considered standard first-line treatment option for patients with metastatic colorectal cancer (mCRC). We developed and validated a molecular signature predictive of efficacy of oxaliplatin-based chemotherapy combined with bevacizumab in patients with mCRC. EXPERIMENTAL DESIGN A machine-learning approach was applied and tested on clinical and next-generation sequencing data from a real-world evidence (RWE) dataset and samples from the prospective TRIBE2 study resulting in identification of a molecular signature, FOLFOXai. Algorithm training considered time-to-next treatment (TTNT). Validation studies used TTNT, progression-free survival, and overall survival (OS) as the primary endpoints. RESULTS A 67-gene signature was cross-validated in a training cohort (N = 105) which demonstrated the ability of FOLFOXai to distinguish FOLFOX-treated patients with mCRC with increased benefit from those with decreased benefit. The signature was predictive of TTNT and OS in an independent RWE dataset of 412 patients who had received FOLFOX/bevacizumab in first line and inversely predictive of survival in RWE data from 55 patients who had received first-line FOLFIRI. Blinded analysis of TRIBE2 samples confirmed that FOLFOXai was predictive of OS in both oxaliplatin-containing arms (FOLFOX HR, 0.629; P = 0.04 and FOLFOXIRI HR, 0.483; P = 0.02). FOLFOXai was also predictive of treatment benefit from oxaliplatin-containing regimens in advanced esophageal/gastro-esophageal junction cancers, as well as pancreatic ductal adenocarcinoma. CONCLUSIONS Application of FOLFOXai could lead to improvements of treatment outcomes for patients with mCRC and other cancers because patients predicted to have less benefit from oxaliplatin-containing regimens might benefit from alternative regimens.
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Affiliation(s)
| | | | - Chiara Cremolini
- Departments of Oncology and Translational Research and New Technologies in Medicine, University Hospital Pisa, Pisa, Tuscany, Italy
| | - Carlotta Antoniotti
- Departments of Oncology and Translational Research and New Technologies in Medicine, University Hospital Pisa, Pisa, Tuscany, Italy
| | | | | | | | - Donald A Berry
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Anthony F Shields
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - John L Marshall
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, D.C
| | - Mohamed E Salem
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Alfredo Falcone
- Departments of Oncology and Translational Research and New Technologies in Medicine, University Hospital Pisa, Pisa, Tuscany, Italy
| | - Axel Grothey
- Medical Oncology, West Cancer Center, Germantown, Tennessee
| | - Michael J Hall
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Alan P Venook
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Heinz-Josef Lenz
- University of Southern California, Keck School of Medicine, Norris Comprehensive Cancer Center, Los Angeles, California
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5
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Abraham JP, Sparrow EM, Gorman JM, Zhao Y, Minkowycz WJ. Application of an Intermittency Model for Laminar, Transitional, and Turbulent Internal Flows. J Fluids Eng 2019; 141:0712041-712048. [PMID: 33437104 DOI: 10.1115/1.4042664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 01/17/2019] [Indexed: 06/12/2023]
Abstract
A turbulent transition model has been applied to fluid flow problems that can be laminar, turbulent, transitional, or any combination. The model is based on a single additional transport equation for turbulence intermittency. While the original model was developed for external flows, a slight modification in model constants has enabled it to be used for internal flows. It has been successfully applied to such flows for Reynolds numbers that ranged from 100 to 100,000 in circular tubes, parallel plate channels, and circular tubes with an abrupt change in diameters. The model is shown to predict fully developed friction factors for the entire range of Reynolds numbers as well as velocity profiles for both laminar and turbulent regimes.
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Affiliation(s)
- J P Abraham
- School of Engineering, University of St. Thomas, 2115 Summit Avenue, St. Paul, MN 55105-1079 e-mail:
| | - E M Sparrow
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455
| | - J M Gorman
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455
| | - Yu Zhao
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455
| | - W J Minkowycz
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, 2039 ERF 842 West Taylor Street, Chicago, IL 60607
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6
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Sherrill JB, Turner TR, Abraham JP, Ho CS. Identification of a novel HLA-A*02 allele, HLA-A*02:01:01:32, in a deceased Caucasoid donor. HLA 2018; 92:166. [PMID: 29920977 DOI: 10.1111/tan.13323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022]
Abstract
HLA-A*02:01:01:32 differs from HLA-A*02:01:01:01 by a single nucleotide substitution (G→A) at position 2456.
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Affiliation(s)
| | - T R Turner
- Anthony Nolan Research Institute, London, UK.,UCL Cancer Institute, London, UK
| | - J P Abraham
- Anthony Nolan Research Institute, London, UK
| | - C S Ho
- Gift of Life Michigan, Ann Arbor, Michigan
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7
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Mathew S, Rajagopalan M, Abraham JP, Balakrishnan D, Umadevi AG. Natural radioactivity content in soil and indoor air of Chellanam. Radiat Prot Dosimetry 2012; 152:80-83. [PMID: 22951996 DOI: 10.1093/rpd/ncs193] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Contribution of terrestrial radiation due to the presence of naturally occurring radionuclides in soil and air constitutes a significant component of the background radiation exposure to the population. The concentrations of natural radionuclides in the soil and indoor air of Chellanam were investigated with an aim of evaluating the environmental radioactivity level and radiation hazard to the population. Chellanam is in the suburbs of Cochin, with the Arabian Sea in the west and the Cochin backwaters in the east. Chellanam is situated at ∼25 km from the sites of these factories. The data obtained serve as a reference in documenting changes to the environmental radioactivity due to technical activities. Soil samples were collected from 30 locations of the study area. The activity concentrations of (232)Th, (238)U and (40)K in the samples were analysed using gamma spectrometry. The gamma dose rates were calculated using conversion factors recommended by UNSCEAR [United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation. UNSCEAR (2000)]. The ambient radiation exposure rates measured in the area ranged from 74 to 195 nGy h(-1) with a mean value of 131 nGy h(-1). The significant radionuclides being (232)Th, (238)U and (40)K, their activities were used to arrive at the absorbed gamma dose rate with a mean value of 131 nGy h(-1) and the radium equivalent activity with a mean value of 162 Bq kg(-1). The radon progeny levels varied from 0.21 to 1.4 mWL with a mean value of 0.6 mWL. The thoron progeny varied from 0.34 to 2.9 mWL with a mean value of 0.85 mWL. The ratio between thoron and radon progenies varied from 1.4 to 2.3 with a mean of 1.6. The details of the study, analysis and results are discussed.
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Affiliation(s)
- S Mathew
- Research and PG Department of Physics, Mar Thoma College, Thiruvalla, Kerala, India.
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8
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Saito H, Ratnoff OD, Waldmann R, Abraham JP. Fitzgerald Trait: Deficiency of a Hitherto Unrecognized Agent, Fitzgerald Factor, Participating in Surface-Mediated Reactions of Clotting, Fibrinolysis, Generation of Kinins, and the Property of Diluted Plasma Enhancing Vascular Permeability (PF/Dil). J Clin Invest 2010; 55:1082-9. [PMID: 16695963 PMCID: PMC301855 DOI: 10.1172/jci108009] [Citation(s) in RCA: 170] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The prolonged partial thromboplastin time observed in the plasma of a 71-yr-old asymptomatic man was related to the deficiency of a hitherto unrecognized agent. The patient's plasma also exhibited impaired surface-mediated fibrinolysis and esterolytic activity and impaired generation of kinins and of the property enhancing vascular permeability designated PF/Dil. The patient's plasma contained normal amounts of all known clotting factors except Fletcher factor (a plasma prekallikrein) which was present at a concentration of 10-15% of pooled normal plasma. Fletcher trait plasma, however, contained normal amounts of the agent missing from the patient's plasma and corrected the defects in clotting, fibrinolysis, and vascular permeability. Fletcher trait plasma was less effective in correcting generation of kinins and esterolytic activity, presumably because of the patient's partial deficiency of prekallikrein. The site of action of the factor deficient in the patient's plasma appeared to be subsequent to the activation of Hageman factor and plasma prekallikrein. A fraction of normal plasma, devoid of other clotting factors, corrected the defect in clotting in the patient's plasma; a similar fraction of the patient's plasma did not correct this abnormality. No evidence yet exists pointing to the familial nature of the patient's defect. Tentatively, the patient's disorder may be referred to by his surname as Fitzgerald trait, and the agent apparently deficient in his plasma as Fitzgerald factor.
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Affiliation(s)
- H Saito
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106
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9
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Raman BK, Van Slyck EJ, Riddle J, Sawdyk MA, Abraham JP, Saeed SM. Platelet function and structure in myeloproliferative disease, myelodysplastic syndrome, and secondary thrombocytosis. Am J Clin Pathol 1989; 91:647-55. [PMID: 2524965 DOI: 10.1093/ajcp/91.6.647] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Platelet function and morphologic characteristics were evaluated in 43 patients with myeloproliferative disease (MPD), 5 patients with myelodysplastic syndrome (MDS), and 7 patients with secondary thrombocytosis (ST). Platelet Factor IV (PF4) and B-thromboglobulin (BTG) showed slight elevation in ST but significant elevation in all MPDs. They were either normal or slightly elevated in MDS. Defective platelet aggregation with one or more inducers was seen in 62% of all patients. An epinephrine-induced defect was the most consistent aggregation abnormality. Hyperaggregation and spontaneous aggregation were seen in 15% of patients. Of the eight patients who showed increased bleeding tendency, all eight showed defective aggregation with two or more inducers, five showed decreased surface activation response, as well as decreased or abnormal granules and dense tubular disarray in the transmission electron microscope (TEM) study. Seven patients had clinical evidence of recurrent arterial and venous thromboses. Five of these patients showed hyperaggregation response to adenosine diphosphate and collagen and abnormal Wu and Hoak platelet aggregate ratio. Four patients showed spontaneous aggregation on aggregometer. Surface activation response was significantly increased in five patients, and an increase in platelet granules by TEM study was seen in four patients. Primary thrombocythemia could be differentiated from secondary thrombocytosis (ST) by the presence of abnormal aggregation response and significantly increased PF4 and BTG in the former, and greatly elevated plasma fibrinogen and Factor VIII, as part of acute phase reactant response, in the latter.
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Affiliation(s)
- B K Raman
- Division of Hematopathology, Henry Ford Hospital, Detroit, Michigan 48202
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10
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Gottlieb CA, Maeda K, Hawley RC, Abraham JP. Myelodysplasia with bone marrow lymphocytosis and fibrosis mimicking recurrent Hodgkin's disease. Am J Clin Pathol 1989; 91:6-11. [PMID: 2910015 DOI: 10.1093/ajcp/91.1.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Myelodysplastic syndromes and acute leukemias after treatment for Hodgkin's disease (HD) are well recognized. Preleukemic changes are commonly seen. Three patients from the authors' files are found with myelofibrosis and bone marrow lymphocytosis after treatment for HD. Although somewhat unusual, the clinical impression initially was, in each case, isolated recurrence of HD involving the bone marrow, 6 to 11 years after initial diagnosis. In each case, after single or multiple marrow aspirates and biopsies were done, the differential between HD involving the marrow and myelodysplasia with myelofibrosis and lymphocytic infiltrates was made. The absence of diagnostic Reed-Sternberg (RS) cells was useful in diagnosing the latter. All three patients died of causes related to cytopenias, with two having progressed to overt acute nonlymphocytic leukemia. Myelofibrosis with lymphocytic infiltrates in the marrow, without diagnostic RS cells, in patients' status after treatment for HD, should alert one to the possibility of myelodysplasia.
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Affiliation(s)
- C A Gottlieb
- Department of Pathology, Henry Ford Hospital, Detroit, Michigan 48202
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11
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Gruenberg JC, VanSlyck EJ, Abraham JP. Splenectomy in systemic lupus erythematosis. Am Surg 1986; 52:366-70. [PMID: 3729170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Of 860 patients with systemic lupus erythematosus (SLE) who were evaluated during a 25-year-period, 16 (1.9%) underwent splenectomy. Twelve of these patients had steroid resistant thrombocytopenia. An excellent long-term outcome occurred in eight (67%), significant improvement occurred in three (25%), and one patient died who also had chronic active hepatitis and portal hypertension. In two of three patients (67%) with autoimmune hemolytic anemia, the condition was corrected by splenectomy; in the third patient there was some improvement, but reduced doses of corticosteroids were required. One patient with severe neutropenia and recurrent bacterial infection obtained lasting benefit following splenectomy. Histologic examination of the removed spleen was not helpful in corroborating the diagnosis of SLE in these well established cases. Splenectomy had no adverse affect upon other aspects of SLE, in particular upon renal function. The authors conclude that the indications for splenectomy have proven to be of value in selected SLE patients with autoimmune or hypersplenic cytopenia.
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Van Slyck EJ, Kleerekoper M, Abraham JP, Deegan MJ. Nonsecretory multiple myeloma with osteoporosis: immunocytologic and bone resorptive studies. Am J Med Sci 1986; 291:347-51. [PMID: 3518452 DOI: 10.1097/00000441-198605000-00011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Two patients, ultimately found to have advanced nonsecretory multiple myeloma, presented with skeletal pain, diffuse skeletal demineralization, and fractures. The correct diagnosis was initially obscured by the absence of typical hematologic findings and discrete lytic bone lesions. Bone marrow examination was diagnostic. Intracytoplasmic IgA or IgD kappa was demonstrated in the myeloma cells of each case. Decreased quantitative polyclonal serum immunoglobulins and hypercalcemia were important clinical clues. The demonstration of increased osteoclast activating factor (OAF) derived from the cultured myeloma cells from each case suggests that the secretion of OAF and immunoglobulin are unrelated.
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Deegan MJ, Abraham JP, Sawdyk M, Van Slyck EJ. High incidence of monoclonal proteins in the serum and urine of chronic lymphocytic leukemia patients. Blood 1984; 64:1207-11. [PMID: 6437461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is generally considered a nonsecretory B cell immunoproliferative disorder. Conventional electrophoretic and immunoelectrophoretic methods have revealed serum monoclonal proteins in less than 10% of these patients. However, there is increasing experimental evidence from in vitro studies demonstrating that CLL cells may secrete immunoglobulins, particularly free light chains. We examined the serum and urine of 36 consecutive CLL patients for monoclonal proteins using sensitive immunochemical methods (high resolution agarose gel electrophoresis combined with immunofixation). The results obtained were correlated with the Rai stage, quantitative immunoglobulin levels, and lymphocyte membrane immunoglobulin phenotype of the leukemic cells. Twenty-three monoclonal proteins were identified in the serum or urine of 22 patients, an incidence of 61%. Six patients had serum monoclonal proteins, seven had only urinary monoclonal proteins, and nine had monoclonal proteins in serum and urine. In every instance the monoclonal protein was the same light chain type as expressed on the leukemic cells. Our findings suggest that the monoclonal proteins observed in the serum or urine of CLL patients are secretory products of the tumor cells and that their discovery is a function of the sensitivity of the method used for their detection.
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Van Dyke DL, Abraham JP, Maeda K, Weiss L, Poel M. Multiple active X chromosomes in myelofibrosis with myeloid metaplasia. Cancer Genet Cytogenet 1981; 3:137-44. [PMID: 7272992 DOI: 10.1016/0165-4608(81)90068-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A woman with myelofibrosis and myeloid metaplasia had a karyotype of 47,X,del(X)(q22),+del(X)(q22) in unstimulated peripheral blood and bone marrow aspirate cultures. The normal X chromosome was late replicating, and the two deleted X chromosomes always replicated early and synchronously. The karyotype from phytohemagglutin-stimulated peripheral blood cultures was uniformly 46,XX. Structurally abnormal X chromosomes are exceedingly rare in myeloproliferative disease. The abnormal karyotype very likely reflects monoclonal proliferation of an abnormal myeloid cell line. The X chromosome inactivation process, which acts upon embryonic somatic cells of all mammals, apparently does not react to postembryonic nondisjunction of the active X chromosome.
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Waldmann R, Scicli AG, McGregor RK, Carretero OA, Abraham JP, Kato H, Han YN, Iwanaga S. Effect of bovine high molecular weight kininogen and its fragments on Fitzgerald trait plasma. Thromb Res 1976; 8:785-95. [PMID: 960054 DOI: 10.1016/0049-3848(76)90007-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abraham JP, Ponder LD. The comparative effects of three levels of student/teacher interaction upon student learning. J Allied Health 1976; 4:32-5. [PMID: 10237913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Saito H, Ratnoff OD, Waldmann R, Abraham JP. Proceedings: Fitzgerald factor and surface-mediated reactions. Thromb Diath Haemorrh 1975; 34:353-4. [PMID: 1188803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
A newly recognised asymptomatic coagulation-factor deficiency is reported in a 71-year-old man. This factor seems to operate at an early stage in the intrinsic coagulation pathway and participates in other Hageman-factor-mediated biological reactions. The patient has an atypical cellular inflammatory response as observed by the skin-window technique.
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