1
|
Epperla N, Zhao Q, Chowdhury SM, Shea L, Moyo TK, Reddy N, Sheets J, Weiner DM, Geethakumari PR, Kandarpa M, Bruno XJ, Thomas C, Churnetski MC, Hsu A, Zurbriggen L, Tan XWC, Lindsey K, Maakaron J, Caimi PF, Torka P, Bello C, Ayyappan S, Oh TS, Karmali R, Kim SH, Kress A, Kothari S, Sawalha Y, Christian B, David KA, Greenwell IB, Janakiram M, Kenkre VP, Olszewski AJ, Cohen JB, Palmisiano N, Umyarova E, Wilcox RA, Awan FT, Alderuccio JP, Barta SK, Grover NS, Ghosh N, Bartlett NL, Herrera AF, Shouse G. Postibrutinib relapse outcomes for patients with marginal zone lymphoma. Blood Adv 2023; 7:88-91. [PMID: 36269847 PMCID: PMC9827027 DOI: 10.1182/bloodadvances.2022008634] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/07/2022] [Accepted: 09/24/2022] [Indexed: 01/18/2023] Open
Affiliation(s)
- Narendranath Epperla
- Division of Hematology, The Ohio State University, Columbus, OH
- Correspondence: Narendranath Epperla, Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH 43210;
| | - Qiuhong Zhao
- Division of Hematology, The Ohio State University, Columbus, OH
| | | | - Lauren Shea
- Division of Hematology, Washington University, St. Louis, MO
| | | | | | - Julia Sheets
- Division of Hematology and Oncology, University of North Carolina, Chapel Hill, NC
| | - David M. Weiner
- Division of Hematology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Malathi Kandarpa
- Division of Hematology, Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | | | - Colin Thomas
- Division of Hematology, Thomas Jefferson University, Philadelphia, PA
| | | | - Andrew Hsu
- Division of Hematology, Brown University, Providence, RI
| | - Luke Zurbriggen
- Division of Hematology, University of Wisconsin, Madison, WI
| | | | - Kathryn Lindsey
- Division of Hematology and Oncology, Medical University of South Carolina, Charleston, SC
| | - Joseph Maakaron
- Division of Hematology, University of Minnesota, Minneapolis, MN
| | - Paolo F. Caimi
- University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Pallawi Torka
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY
| | - Celeste Bello
- Division of Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Sabarish Ayyappan
- Division of Hematology and Oncology, University of Iowa, Iowa City, IA
| | - Timothy S. Oh
- Division of Hematology, Northwestern University, Chicago, IL
| | - Reem Karmali
- Division of Hematology, Northwestern University, Chicago, IL
| | - Seo-Hyun Kim
- Division of Hematology and Oncology, Rush University, Chicago, IL
| | - Anna Kress
- Division of Hematology, Yale University, New Haven, CT
| | | | - Yazeed Sawalha
- Division of Hematology, The Ohio State University, Columbus, OH
| | - Beth Christian
- Division of Hematology, The Ohio State University, Columbus, OH
| | | | - Irl Brian Greenwell
- Division of Hematology and Oncology, Medical University of South Carolina, Charleston, SC
| | - Murali Janakiram
- Division of Hematology, University of Minnesota, Minneapolis, MN
| | | | | | - Jonathon B. Cohen
- Winship Cancer Institute, Emory University Medical Center, Atlanta, GA
| | - Neil Palmisiano
- Division of Hematology, Thomas Jefferson University, Philadelphia, PA
| | - Elvira Umyarova
- Division of Hematology and Oncology, University of Vermont, Burlington, VT
| | - Ryan A. Wilcox
- Division of Hematology, Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | - Farrukh T. Awan
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Stefan K. Barta
- Division of Hematology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Natalie S. Grover
- Division of Hematology and Oncology, University of North Carolina, Chapel Hill, NC
| | | | | | | | | |
Collapse
|
2
|
Balasubramanian S, Ronstrom C, Shiang A, Vetter JM, Sheets J, Palka J, Figenshau RS, Kim EH. Feasibility and safety of same-day discharge following single-port robotic-assisted laparoscopic prostatectomy. World J Urol 2023; 41:35-41. [PMID: 36322183 PMCID: PMC9629187 DOI: 10.1007/s00345-022-04204-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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] [Received: 09/29/2022] [Accepted: 10/23/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The standard discharge pathway following robotic-assisted laparoscopic prostatectomy (RALP) involves overnight hospital admission. Models for same-day discharge (SDD) have been explored for multiport RALP, however, less is known regarding SDD for single-port RALP, especially in terms of patient experience. METHODS Patient enrollment, based on preoperative determination of potential SDD eligibility, commenced March 2020 and ended March 2021. Day-of-surgery criteria were utilized to determine which enrolled patients underwent SDD. Differences in preoperative characteristics and perioperative outcomes between patients undergoing SDD and patients undergoing standard discharge were evaluated. A prospectively administered questionnaire was designed to characterize patient-centered factors informing SDD perception. RESULTS Fifteen patients underwent SDD and 36 underwent standard discharge. Overall mean ± SD age and BMI were 63.6 ± 7.0 years and 29.7 ± 4.4 kg/m2, respectively. Mean operative time was shorter in the SDD cohort than the standard discharge cohort (188 min vs 217 min, p = 0.011). A higher proportion of cases that underwent SDD were performed using the Retzius-sparing approach, 80% (12/15) vs 33% (12/36) in the standard discharge cohort (p = 0.005). Rates of 90 day complication (p = 0.343), 90 day readmission (p = 0.144), and 90 day emergency department visits (p = 0.343) rates were all not significantly different between cohorts. Of questionnaire respondents undergoing standard discharge, 32% (8/25) cited pain as a reason for not undergoing SDD. CONCLUSIONS With comparable outcomes to the standard discharge pathway, SDD is safe and effective in single-port RALP. Post-operative pain and perceptions of distance are implicated as patient-centered barriers to SDD; proactive pain management and patient education strategies may facilitate SDD.
Collapse
Affiliation(s)
- Shiva Balasubramanian
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108 USA
| | - Carrie Ronstrom
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| | - Alexander Shiang
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| | - Joel M. Vetter
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| | - Julia Sheets
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| | - Joshua Palka
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| | - R. Sherburne Figenshau
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| | - Eric H. Kim
- Division of Urologic Surgery, Washington University School of Medicine, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110 USA
| |
Collapse
|
3
|
Epperla N, Zhao Q, Chowdhury SM, Shea L, Moyo TK, Reddy N, Sheets J, Weiner DM, Geethakumari PR, Kandarpa M, Bruno XJ, Thomas C, Churnetski MC, Hsu A, Zurbriggen L, Tan C, Lindsey K, Maakaron J, Caimi PF, Torka P, Bello C, Ayyappan S, Karmali R, Kim SH, Kress A, Kothari S, Sawalha Y, Christian B, David KA, Greenwell IB, Janakiram M, Kenkre VP, Olszewski AJ, Cohen JB, Palmisiano N, Umyarova E, Wilcox RA, Awan FT, Alderuccio JP, Barta SK, Grover NS, Ghosh N, Bartlett NL, Herrera AF, Shouse G. Predictive factors and outcomes for ibrutinib in relapsed/refractory marginal zone lymphoma: a multicenter cohort study. J Hematol Oncol 2022; 15:96. [PMID: 35842643 PMCID: PMC9287914 DOI: 10.1186/s13045-022-01316-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/08/2022] [Indexed: 11/30/2022] Open
Abstract
Ibrutinib is effective in the treatment of relapsed/refractory (R/R) marginal zone lymphoma (MZL) with an overall response rate (ORR) of 48%. However, factors associated with response (or lack thereof) to ibrutinib in R/R MZL in clinical practice are largely unknown. To answer this question, we performed a multicenter (25 US centers) cohort study and divided the study population into three groups: "ibrutinib responders"-patients who achieved complete or partial response (CR/PR) to ibrutinib; "stable disease (SD)"; and "primary progressors (PP)"-patients with progression of disease as their best response to ibrutinib. One hundred and nineteen patients met the eligibility criteria with 58%/17% ORR/CR, 29% with SD, and 13% with PP. The median PFS and OS were 29 and 71.4 months, respectively, with no difference in PFS or OS based on the ibrutinib line of therapy or type of therapy before ibrutinib. Patients with complex cytogenetics had an inferior PFS (HR = 3.08, 95% CI 1.23-7.67, p = 0.02), while those with both complex cytogenetics (HR = 3.00, 95% CI 1.03-8.68, p = 0.04) and PP (HR = 13.94, 95% CI 5.17-37.62, p < 0.001) had inferior OS. Only primary refractory disease to first-line therapy predicted a higher probability of PP to ibrutinib (RR = 3.77, 95% CI 1.15-12.33, p = 0.03). In this largest study to date evaluating outcomes of R/R MZL treated with ibrutinib, we show that patients with primary refractory disease and those with PP on ibrutinib are very high-risk subsets and need to be prioritized for experimental therapies.
Collapse
Affiliation(s)
- Narendranath Epperla
- Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, 43210, USA.
| | - Qiuhong Zhao
- Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Sayan Mullick Chowdhury
- Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | | | - Tamara K Moyo
- Levine Cancer Center, Atrium Health, Charlotte, NC, USA
| | - Nishitha Reddy
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julia Sheets
- University of North Carolina, Chapel Hill, NC, USA
| | - David M Weiner
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - Colin Thomas
- Thomas Jefferson University, Philadelphia, PA, USA
| | | | | | | | - Cherie Tan
- Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | - Paolo F Caimi
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | | | - Celeste Bello
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | | | | | | | - Yazeed Sawalha
- Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Beth Christian
- Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Kevin A David
- Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | | | | | - Jonathon B Cohen
- Winship Cancer Institute, Emory University Medical Center, Atlanta, GA, USA
| | | | | | - Ryan A Wilcox
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Farrukh T Awan
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Stefan K Barta
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | |
Collapse
|
4
|
Abstract
AbstractVarious aspects of electrospun fibers prepared from terpolymer of tetrafluoroethylene (TFE), hexafluoropropylene (HFP), and vinylidene fluoride (VDF) (THV)/acetone solutions at two applied voltages, THV/acetone solutions having Texas montmorillonite with two ratios, and THV/ethyl acetate solutions using two needle sizes are described. Fibers from THV/acetone and THV/ethyl acetate solutions showed shallow indentations and pores, respectively. The clay, functioning as electrospinning agent, did not influence the fiber morphology, but yielded narrower fiber diameter distribution and the thinnest fibers. Heterogeneous fiber diameter distribution and increase in the fiber diameters were observed by lowering the voltage for fibers of THV/acetone solutions. Fibers from THV/ethyl acetate solutions had the largest diameter and the broadest diameter distribution. Electrospun THV fibers having both hydrophobic characteristics with nearly 140° water contact angles and oleophilic properties with oil contact angles less than 45° might have applications in areas such as water/oil separation.
Collapse
Affiliation(s)
- Salim Ok
- Petroleum Research Center, Kuwait Institute for Scientific Research, P.O. box 24885, Safat, 13109, Kuwait
| | - Julia Sheets
- School of Earth Sciences, The Ohio State University, Columbus, 43210, Ohio, USA
| | - Susan Welch
- School of Earth Sciences, The Ohio State University, Columbus, 43210, Ohio, USA
| | - Tingting Liu
- School of Earth Sciences, The Ohio State University, Columbus, 43210, Ohio, USA
| | - Savas Kaya
- School of Electrical Engineering and Computer Science, Russ College of Engineering and Technology, Ohio University, Athens, 45701, Ohio, USA
| | - David R. Cole
- School of Earth Sciences, The Ohio State University, Columbus, 43210, Ohio, USA
- School of Electrical Engineering and Computer Science, Russ College of Engineering and Technology, Ohio University, Athens, 45701, Ohio, USA
| |
Collapse
|
5
|
Ferrara JL, Smith CM, Sheets J, Reddy P, Serody JS. Altered homeostatic regulation of innate and adaptive immunity in lower gastrointestinal tract GVHD pathogenesis. J Clin Invest 2017; 127:2441-2451. [PMID: 28581444 DOI: 10.1172/jci90592] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Lower gastrointestinal (GI) tract graft-versus-host disease (GVHD) is the predominant cause of morbidity and mortality from GVHD after allogeneic stem cell transplantation. Recent data indicate that lower GI tract GVHD is a complicated process mediated by donor/host antigenic disparities. This process is exacerbated by significant changes to the microbiome, and innate and adaptive immune responses that are critical to the induction of disease, persistence of inflammation, and a lack of response to therapy. Here, we discuss new insights into the biology of lower GI tract GVHD and focus on intrinsic pathways and regulatory mechanisms crucial to normal intestinal function. We then describe multiple instances in which these homeostatic mechanisms are altered by donor T cells or conditioning therapy, resulting in exacerbation of GVHD. We also discuss data suggesting that some of these mechanisms produce biomarkers that could be informative as to the severity of GVHD and its response to therapy. Finally, novel therapies that might restore homeostasis in the GI tract during GVHD are highlighted.
Collapse
Affiliation(s)
- James Lm Ferrara
- Departments of Medicine, Pediatrics, and Academic Informatics and Technology, Icahn School of Medicine at Mount Sinai and Tisch Cancer Institute, New York, New York, USA
| | - Christopher M Smith
- Departments of Medicine, Pediatrics, and Academic Informatics and Technology, Icahn School of Medicine at Mount Sinai and Tisch Cancer Institute, New York, New York, USA
| | - Julia Sheets
- University of North Carolina Hospital, Chapel Hill, North Carolina, USA
| | - Pavan Reddy
- Department of Medicine and University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan S Serody
- Department of Medicine and UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
6
|
Ok S, Sheets J, Welch S, Kaya S, Jalilov A, Cole DR. Tuning hydrophobicity of a fluorinated terpolymer in differently assembled thin films. ACTA ACUST UNITED AC 2017. [DOI: 10.1002/polb.24308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Salim Ok
- School of Earth Sciences; The Ohio State University; Columbus Ohio 43210
| | - Julia Sheets
- School of Earth Sciences; The Ohio State University; Columbus Ohio 43210
| | - Susan Welch
- School of Earth Sciences; The Ohio State University; Columbus Ohio 43210
| | - Savas Kaya
- School of Electrical Engineering and Computer Science; Ohio University; Athens Ohio 45701
| | - Almaz Jalilov
- Department of Chemistry; Rice University; 6100 Main Street Houston Texas 77005
| | - David R. Cole
- School of Earth Sciences; The Ohio State University; Columbus Ohio 43210
- Department of Chemistry; The Ohio State University; Columbus Ohio 43210
| |
Collapse
|
7
|
Shea TC, Walko C, Chung Y, Ivanova A, Sheets J, Rao K, Gabriel D, Comeau T, Wood W, Coghill J, Armistead P, Sarantopoulos S, Serody J. Phase I/II Trial of Dose-Escalated Busulfan Delivered by Prolonged Continuous Infusion in Allogeneic Transplant Patients. Biol Blood Marrow Transplant 2015. [PMID: 26210442 DOI: 10.1016/j.bbmt.2015.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Intensive chemotherapy or chemotherapy plus irradiation and allogeneic stem cell transplantation can be curative for patients with hematologic diseases. Reduced-intensity transplants can also achieve cure and result in less treatment-related mortality but higher relapse rates. Thus, optimizing the conditioning regimens used in allogeneic transplantation remains an important goal. We conducted a phase I/II trial to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of a continuous infusion of busulfan over 90 hours in conjunction with fludarabine followed by allogeneic related or unrelated donor transplant. Fifty-four patients with advanced hematologic malignancies were enrolled on this study. The MTD was identified as a 24-hour area under the curve (AUC) of approximately 7095 μM/min, which represents a 43% increase over the standard total daily AUC dose of 4800 μM/min given by intermittent schedules. DLTs at doses over 8000 μM/min were identified by a desquamative skin rash and mucositis. No dose-related increase in hepatic, pulmonary, or other organ toxicities were seen, whereas efficacy appeared to be improved at higher dose levels. Continuous-infusion busulfan with intermittent fludarabine provides an alternative treatment strategy that is generally well tolerated and permits an increase in total busulfan dose with encouraging efficacy. (NCI study no. NCT00448357.).
Collapse
Affiliation(s)
- Thomas C Shea
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.
| | - Christine Walko
- DeBartolo Family Personalized Medicine Institute, Division of Population Science, Moffitt Cancer Center, Tampa, Florida
| | - Yunro Chung
- Department of Biostatistics, University of North Carolina School of Public Health, Chapel Hill, North Carolina
| | - Anastasia Ivanova
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina; Department of Biostatistics, University of North Carolina School of Public Health, Chapel Hill, North Carolina
| | - Julia Sheets
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kamakshi Rao
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Don Gabriel
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| | - Terry Comeau
- Stem Cell Transplant Program, St. John's Regional Hospital, New Brunswick, Canada
| | - William Wood
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| | - James Coghill
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| | - Paul Armistead
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| | | | - Jonathan Serody
- Program in Bone Marrow and Stem Cell Transplantation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
| |
Collapse
|
8
|
Solpuker U, Sheets J, Kim Y, Schwartz FW. Leaching potential of pervious concrete and immobilization of Cu, Pb and Zn using pervious concrete. J Contam Hydrol 2014; 161:35-48. [PMID: 24748027 DOI: 10.1016/j.jconhyd.2014.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 03/19/2014] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
This paper investigates the leaching potential of pervious concrete and its capacity for immobilizing Cu, Pb and Zn, which are common contaminants in urban runoff. Batch experiments showed that the leachability of Cu, Pb and Zn increased when pH<8. According to PHREEQC equilibrium modeling, the leaching of major ions and trace metals was mainly controlled by the dissolution/precipitation and surface complexation reactions, respectively. A 1-D reactive transport experiment was undertaken to better understand how pervious concrete might function to attenuate contaminant migration. A porous concrete block was sprayed with low pH water (pH=4.3±0.1) for 190 h. The effluent was highly alkaline (pH~10 to 12). In the first 50 h, specific conductance and trace-metal were high but declined towards steady state values. PHREEQC modeling showed that mixing of interstitial alkaline matrix waters with capillary pore water was required in order to produce the observed water chemistry. The interstitial pore solutions seem responsible for the high pH values and relatively high concentrations of trace metals and major cations in the early stages of the experiment. Finally, pervious concrete was sprayed with a synthetic contaminated urban runoff (10 ppb Cu, Pb and Zn) with a pH of 4.3±0.1 for 135 h. It was found that Pb immobilization was greater than either Cu or Zn. Zn is the most mobile among three and also has the highest variation in the observed degree of immobilization.
Collapse
Affiliation(s)
- U Solpuker
- School of Earth Sciences, The Ohio State University, 125 S. Oval Mall, Columbus, OH 43210, USA.
| | - J Sheets
- School of Earth Sciences, The Ohio State University, 125 S. Oval Mall, Columbus, OH 43210, USA.
| | - Y Kim
- Korea Institute of Geoscience and Mineral Resources (KIGAM), 92 Gwahang-no, Yuseong-gu, Daejeon 305-350, Republic of Korea.
| | - F W Schwartz
- School of Earth Sciences, The Ohio State University, 125 S. Oval Mall, Columbus, OH 43210, USA.
| |
Collapse
|
9
|
Abstract
Lymphangiomatosis is a rare disease of lymphatic proliferation for which no adequate treatment is known. We report the first successful case of bilateral lung transplantation for the treatment of end-stage pulmonary lymphangiomatosis. A successful outcome was achieved with continued survival beyond 4 years posttransplant and stable lung function. The primary obstacles to significant gains in pulmonary function were thoracic, skeletal and abdominal lymphangiomatosis, which led to pulmonary restriction. Our report demonstrates that pulmonary lymphangiomatosis should be included among those diseases for which lung transplantation is considered potentially beneficial treatment but also emphasizes the importance of screening patients carefully for chest wall and abdominal lymphangiomas that may impede recovery.
Collapse
Affiliation(s)
- CV Kinnier
- Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC
| | - JPC Eu
- Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC
| | - RD Davis
- Cardiothoracic Surgery, Duke University Medical Center, Durham, NC
| | - DN Howell
- Pathology, Duke University Medical Center, Durham, NC
| | - J Sheets
- Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC
| | - SM Palmer
- Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC
| |
Collapse
|
10
|
Sheets J, Ford KL. Aunt Minnie's Corner. Superior labral tear with associated paralabral cyst in the spinoglenoid notch, and infraspinatus denervation myositis. J Comput Assist Tomogr 1999; 23:167. [PMID: 10050829 DOI: 10.1097/00004728-199901000-00033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Abstract
A biocatalytic membrane based on an immobilized enzyme molecule has been prepared. Oxidative electropolymerization of 8-hydroxyquinaldine (8-OHQ) monomers in 0.2 M, pH 7 phosphate buffer containing glucose oxidase (GOx) has been carried out to modify the surfaces of GC, Au, and Pt rotating disk electrodes. The biocatalytic properties of the synthesized membrane were characterized by studying the catalytic activities of the immobilized GOx. Signals obtained from modified GC electrodes with this biomembrane were mainly attributed to the immobilized GOx. Signals obtained from modified Pt or Au electrodes were due to the combined contribution of the enzyme and the native electrode's material. The potential analytical applications of these modified electrodes as bioelectrochemical sensors were also investigated.
Collapse
Affiliation(s)
- K K Kasem
- Department of Biological and Physical Sciences, Indiana University, Kokomo, Indiana 46904, USA
| | | | | |
Collapse
|
12
|
Abstract
Acute hemorrhoidal crisis can occur in the pregnant female. When medical therapy fails to relieve pain, operative intervention may be necessary. The surgeon, however, may be reluctant to operate due to potential complications to the mother and fetus. From July 1983 to July 1989, hemorrhoidectomy was performed in 25 of 12,455 pregnant women (0.2 percent) who delivered in our institution. Twenty-two women were in their third trimester, 80 percent were multiparous, and each had a remote history of hemorrhoidal symptoms, including intermittent pain, bleeding, and protrusion. Closed hemorrhoidectomy was performed under local anesthesia. The surgery was directed at removing only symptomatic disease, which included three quadrants in 14 patients, two quadrants in seven patients, and one quadrant in four patients. All patients experienced relief of intractable pain the day after surgery, except one patient who required a hemostatic packing during the immediate post-operative period. There were no other maternal or fetal complications. Subsequent follow-up for anorectal disease ranged from 6 months to 6 years. Six (24 percent) patients required additional hemorrhoid treatment. Hemorrhoidectomy in selected pregnant patients is safe in our experience.
Collapse
Affiliation(s)
- R G Saleeby
- Division of Colon and Rectal Surgery, Allentown Hospital-Lehigh Valley Hospital Center, Pennsylvania 18103
| | | | | | | | | | | |
Collapse
|
13
|
Abstract
A study was undertaken to analyze seton fistulotomy with counter drainage as a treatment modality for horseshoe abscess fistula. In a previous report of 27 patients with partial or complete horseshoe abscess fistula, 24 patients underwent primary fistulotomy and counter drainage with a recurrence rate of 28.6 percent. Two patients were treated by seton fistulotomy and counter drainage with no recurrence. Therefore, nine additional patients underwent this procedure. Recurrent horseshoe abscess fistula occurred in 2 of 11 patients (18.1 percent). Seton fistulotomy with counter drainage has become the authors' operative procedure of choice for horseshoe abscess fistula. This method may prove more effective if the true primary abscess cavity is identified, the seton is removed appropriately, and postoperative care of the cavity is adequate. Method of management is discussed.
Collapse
Affiliation(s)
- K Ustynoski
- Division of Colon and Rectinal Surgery, Allentown Hospital, Lehigh Valley Hospital Center, Pennsylvania
| | | | | | | | | | | |
Collapse
|
14
|
Abstract
Over a 10-year period 69 patients were treated consecutively for posterior and anterior horseshoe abscesses and fistulas. Fifty-nine patients had posterior and ten had anterior abscesses or fistulas. There were 52 patients with acute abscess. Treatment consisted of incision and drainage, incision and drainage with primary fistulotomy, incision and drainage with primary fistulotomy and counter-drainage, and incision and drainage with insertion of seton. Seventeen patients with chronic fistulas were treated by primary fistulotomy with curettage, or incision and drainage with insertion of seton. Patients were followed from three months to ten years with a mean follow-up of three years. No incidences of incontinence were reported in this series. The overall rate of recurrence was 18 percent, and included only patients with posterior abscesses and fistulas. Recurrence was related to the failure to maintain prolonged drainage in the midline after primary fistulotomy. The use of seton for delayed fistulotomy appears to promote wound drainage and precludes premature wound closure. More liberal use of the seton in the treatment of horseshoe abscesses and fistulas is advocated.
Collapse
|
15
|
Abstract
A patient with nephrocolic fistula secondary to perinephric abscess was treated successfully with nephrectomy, colonic resection, and colocolostomy.
Collapse
|
16
|
Abstract
Seventy patients with anal incontinence referred to a colorectal service over a two-year period were evaluated and treated. In each case, a comprehensive history and physical examination as well as anal manometry were performed. Anorectal angle measurement was done when indicated. Patients were separated into groups of the four major causes of incontinence: 1) external/internal sphincter dysfunction, 2) puborectalis and anorectal angle, 3) alterations in rectal compliance, and 4) sensory deficits. Treatment was dictated by categorization of the patients. All patients were followed for a minimum of one year and, with the exception of patients with profound sensory loss, each believed that their symptoms had decreased substantially, enabling them to return to normal occupational and social activities.
Collapse
|
17
|
Woodhams JT, Lester JC, Maddox R, Key C, Hunkeler JD, Knolle G, Bruhl D, Sheets J. A review of 1,147 cases of Sheets lens implantations. J Am Intraocul Implant Soc 1984; 10:185-7. [PMID: 6735882 DOI: 10.1016/s0146-2776(84)80106-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A review of 1,147 Sheets Style 30 intraocular lens implantations is presented. The incidence of complications is similar to or less than that of J-loop lenses. In-the-bag placement appears to eliminate some of the problems associated with J-loop lenses placed in the ciliary sulcus.
Collapse
|
18
|
|