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Hwuang E, Wu PH, Rodriguez-Soto A, Langham M, Wehrli FW, Vidorreta M, Moon B, Kochar K, Parameshwaran S, Koelper N, Tisdall MD, Detre JA, Witschey W, Schwartz N. Cross-modality and in-vivo validation of 4D flow MRI evaluation of uterine artery blood flow in human pregnancy. Ultrasound Obstet Gynecol 2021; 58:722-731. [PMID: 32898295 PMCID: PMC8072518 DOI: 10.1002/uog.23112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/06/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Clinical assessment of uterine artery (UtA) hemodynamics is currently limited to Doppler ultrasound (US) velocimetry. We have demonstrated previously the feasibility of applying four-dimensional (4D) flow magnetic resonance imaging (MRI) to evaluate UtA hemodynamics during pregnancy, allowing flow quantification of the entire course of the vessel. In this study, we sought to further validate the physiological relevance of 4D flow MRI measurement of UtA blood flow by exploring its association with pregnancy outcome relative to US-based metrics. METHODS Recruited into this prospective, cross-sectional study were 87 women with a singleton pregnancy who underwent 4D flow MRI between May 2016 and April 2019 to measure the UtA pulsatility index (MRI-PI) and blood flow rate (MRI-flow, in mL/min). UtA-PI was also measured using US (US-PI). The primary outcome was a composite (COMP) of pre-eclampsia (PE) and/or small-for-gestational-age (SGA) neonate, and secondary outcomes were PE and SGA neonate individually. We assessed the ability of MRI-flow, MRI-PI and US-PI to distinguish between outcomes, and evaluated whether MRI-flow changed as gestation progressed. RESULTS Following 4D flow postprocessing and exclusions from the analysis, 74 women had 4D flow MRI data analyzed for both UtAs. Of these, 18 developed a COMP outcome: three developed PE only, 11 had a SGA neonate only and four had both. A comparison of the COMP group vs the no-COMP group found no differences in maternal age, body mass index, nulliparity, gravidity or race. For 66 of the 74 subjects, US data were also available. In these subjects, both median MRI-PI (0.95 vs 0.70; P < 0.01) and median US-PI (0.95 vs 0.73; P < 0.01) were significantly increased in subjects in the COMP group compared with those in the no-COMP group. The UtA blood-flow rate, as measured by MRI, did not increase significantly from the second to the third trimester (median flow (interquartile range (IQR)), 543 (419-698) vs 575 (440-746) mL/min; P = 0.77), but it was significantly lower overall in the COMP compared with the no-COMP group (median flow (IQR), 486 (366-598) vs 624 (457-749) mL/min; P = 0.04). The areas under the receiver-operating-characteristics curves for MRI-flow, MRI-PI and US-PI in predicting COMP were not significantly different (0.694, 0.737 and 0.731, respectively; P = 0.87). CONCLUSIONS 4D flow MRI can yield physiological measures of UtA blood-flow rate and PI that are associated with adverse pregnancy outcome. This may open up new avenues in the future to expand the potential of this technique as a robust tool with which to evaluate UtA hemodynamics in pregnancy. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Hwuang
- Department of Biomedical Engineering, University of Pennsylvania, Philadelphia, PA, USA
| | - P H Wu
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - A Rodriguez-Soto
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - M Langham
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - F W Wehrli
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - B Moon
- Department of Biomedical Engineering, University of Pennsylvania, Philadelphia, PA, USA
| | - K Kochar
- Drexel School of Medicine, Philadelphia, PA, USA
| | - S Parameshwaran
- Maternal and Child Health Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - N Koelper
- Center for Research on Reproduction and Women's Health, University of Pennsylvania, Philadelphia, PA, USA
| | - M D Tisdall
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - J A Detre
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - W Witschey
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - N Schwartz
- Maternal and Child Health Research Center, University of Pennsylvania, Philadelphia, PA, USA
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Sikora EJ, Allen TW, Wise KA, Bergstrom G, Bradley CA, Bond J, Brown-Rytlewski D, Chilvers M, Damicone J, DeWolf E, Dorrance A, Dufault N, Esker P, Faske TR, Giesler L, Goldberg N, Golod J, Gómez IRG, Grau C, Grybauskas A, Franc G, Hammerschmidt R, Hartman GL, Henn RA, Hershman D, Hollier C, Isakeit T, Isard S, Jacobsen B, Jardine D, Kemerait R, Koenning S, Langham M, Malvick D, Markell S, Marois JJ, Monfort S, Mueller D, Mueller J, Mulrooney R, Newman M, Osborne L, Padgett GB, Ruden BE, Rupe J, Schneider R, Schwartz H, Shaner G, Singh S, Stromberg E, Sweets L, Tenuta A, Vaiciunas S, Yang XB, Young-Kelly H, Zidek J. A Coordinated Effort to Manage Soybean Rust in North America: A Success Story in Soybean Disease Monitoring. Plant Dis 2014; 98:864-875. [PMID: 30708845 DOI: 10.1094/pdis-02-14-0121-fe] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Existing crop monitoring programs determine the incidence and distribution of plant diseases and pathogens and assess the damage caused within a crop production region. These programs have traditionally used observed or predicted disease and pathogen data and environmental information to prescribe management practices that minimize crop loss. Monitoring programs are especially important for crops with broad geographic distribution or for diseases that can cause rapid and great economic losses. Successful monitoring programs have been developed for several plant diseases, including downy mildew of cucurbits, Fusarium head blight of wheat, potato late blight, and rusts of cereal crops. A recent example of a successful disease-monitoring program for an economically important crop is the soybean rust (SBR) monitoring effort within North America. SBR, caused by the fungus Phakopsora pachyrhizi, was first identified in the continental United States in November 2004. SBR causes moderate to severe yield losses globally. The fungus produces foliar lesions on soybean (Glycine max) and other legume hosts. P. pachyrhizi diverts nutrients from the host to its own growth and reproduction. The lesions also reduce photosynthetic area. Uredinia rupture the host epidermis and diminish stomatal regulation of transpiration to cause tissue desiccation and premature defoliation. Severe soybean yield losses can occur if plants defoliate during the mid-reproductive growth stages. The rapid response to the threat of SBR in North America resulted in an unprecedented amount of information dissemination and the development of a real-time, publicly available monitoring and prediction system known as the Soybean Rust-Pest Information Platform for Extension and Education (SBR-PIPE). The objectives of this article are (i) to highlight the successful response effort to SBR in North America, and (ii) to introduce researchers to the quantity and type of data generated by SBR-PIPE. Data from this system may now be used to answer questions about the biology, ecology, and epidemiology of an important pathogen and disease of soybean.
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Affiliation(s)
- E J Sikora
- Department of Entomology and Plant Pathology, Auburn University, Auburn 36849
| | - T W Allen
- Department of Biochemistry, Molecular Biology, Entomology and Plant Pathology, Delta Research and Extension Center, Mississippi State University, Stoneville 38776
| | - K A Wise
- Department of Botany and Plant Pathology, Purdue University, West Lafayette 47907
| | - G Bergstrom
- Department of Plant Pathology and Plant-Microbe Biology, Cornell University, Ithaca 14853
| | - C A Bradley
- Department of Crop Sciences, University of Illinois, Urbana 61801
| | - J Bond
- Department of Plant, Soil, and Agricultural Systems, Southern Illinois University, Carbondale 62901
| | - D Brown-Rytlewski
- Department of Plant, Soil, and Microbial Sciences, Michigan State University, East Lansing 48824
| | - M Chilvers
- Department of Plant, Soil, and Microbial Sciences, Michigan State University, East Lansing 48824
| | - J Damicone
- Department of Entomology and Plant Pathology, Oklahoma State University, Stillwater 74078
| | - E DeWolf
- Department of Plant Pathology, Kansas State University, Manhattan 66506
| | - A Dorrance
- Department of Plant Pathology, The Ohio State University, Wooster 44691
| | - N Dufault
- Department of Plant Pathology, University of Florida, Gainesville 32611
| | - P Esker
- Escuela de Agronomia, Universidad de Costa Rica, San José, Costa Rica 10111
| | - T R Faske
- Department of Plant Pathology, University of Arkansas Lonoke Research and Extension Center, Lonoke 72086
| | - L Giesler
- Department of Plant Pathology, University of Nebraska-Lincoln, Lincoln 68508
| | - N Goldberg
- Department of Plant Sciences, New Mexico State University, Las Cruces 88003
| | - J Golod
- Department of Plant Pathology and Environmental Microbiology, Pennsylvania State University, University Park 16802
| | - I R G Gómez
- Sistema Nacional de Vigilancia Epidemiologica Fitosanitaria, Centro Nacional de Referenceia Fitosanitaria, Col. Del Carmen, Coyoacan, Mexico
| | - C Grau
- Department of Plant Pathology, University of Wisconsin, Madison 53706
| | - A Grybauskas
- Department of Plant Science and Landscape Management, University of Maryland, College Park 20742
| | | | - R Hammerschmidt
- Department of Plant, Soil, and Microbial Sciences, Michigan State University, East Lansing 48824
| | - G L Hartman
- United States Department of Agriculture/Agricultural Research Service, Urbana 61801
| | - R A Henn
- Department of Biochemistry, Molecular Biology, Entomology, and Plant Pathology, Mississippi State 39762
| | - D Hershman
- Department of Plant Pathology, University of Kentucky Research and Education Center, Princeton 42445
| | - C Hollier
- Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge 70803
| | - T Isakeit
- Department of Plant Pathology & Microbiology, Texas A&M University, College Station 77843
| | - S Isard
- Department of Plant Pathology and Environmental Microbiology, Pennsylvania State University, University Park 16802
| | - B Jacobsen
- Department of Plant Sciences and Plant Pathology, Montana State University, Bozeman 59717
| | - D Jardine
- Department of Plant Pathology, Kansas State University, Manhattan 66506
| | - R Kemerait
- Department of Plant Pathology, University of Georgia, Tifton 31793
| | - S Koenning
- Department of Plant Pathology, North Carolina State University, Raleigh 27695
| | - M Langham
- Department of Plant Science, South Dakota State University, Brookings 57007
| | - D Malvick
- Department of Plant Pathology, University of Minnesota, St. Paul 55108
| | - S Markell
- Department of Plant Pathology, North Dakota State University, Fargo 58108
| | - J J Marois
- Department of Plant Pathology, University of Florida, Gainesville 32611
| | - S Monfort
- Edisto Research and Education Center, Clemson University, Blackville 29817
| | - D Mueller
- Department of Plant Pathology and Microbiology, Iowa State University, Ames 50011
| | - J Mueller
- Edisto Research and Education Center, Clemson University, Blackville 29817
| | - R Mulrooney
- Department of Plant and Soil Science, University of Delaware, Newark 19716
| | - M Newman
- BASF Corporation, Jackson, TN 38301
| | | | - G B Padgett
- Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge 70803
| | - B E Ruden
- South Dakota Wheat Growers Association, Aberdeen 57401
| | - J Rupe
- Department of Plant Pathology, University of Arkansas, Fayetteville 72701
| | - R Schneider
- Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge 70803
| | - H Schwartz
- Department of Bioagricultural Sciences and Pest Management, Colorado State University, Fort Collins 80523
| | - G Shaner
- Department of Botany and Plant Pathology, Purdue University, West Lafayette 47907
| | - S Singh
- Department of Plant, Soil and Entomological Sciences, University of Idaho, Kimberly 83341
| | - E Stromberg
- Department of Plant Pathology, Physiology, and Weed Science, Virginia Polytechnic Institute and State University, Blacksburg 24061
| | - L Sweets
- Division of Plant Sciences, University of Missouri, Columbia 65211
| | - A Tenuta
- Ontario Ministry of Agriculture and Food, and Ministry of Rural Affairs, Ridgetown, Ontario, Canada, NOP2CO
| | - S Vaiciunas
- New Jersey Department of Agriculture, Trenton 08625
| | - X B Yang
- Department of Plant Pathology and Microbiology, Iowa State University, Ames 50011
| | - H Young-Kelly
- Department of Entomology and Plant Pathology, University of Tennessee West Tennessee Research and Education Center, Jackson 38301
| | - J Zidek
- ZedX Incorporated, Bellefonte, PA 16823
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Carden CP, Frentzas S, Langham M, Casamayor I, Stephens AW, Poondru S, Wheaton J, Lippman SM, Kaye SB, Kim ES. Preliminary activity in adrenocortical tumor (ACC) in phase I dose escalation study of intermittent oral dosing of OSI-906, a small-molecule insulin-like growth factor-1 receptor (IGF-1R) tyrosine kinase inhibitor in patients with advanced solid tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3544] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3544 Background: IGF-1R is overexpressed in various malignancies, and implicated in proliferation, survival, and metastasis. IGF-1R blockade increases apoptosis and reduces tumor growth in preclinical models. OSI-906 is an oral small molecule tyrosine kinase IGR-1R inhibitor. Methods: Patients (pt) with advanced solid tumours were enrolled to determine safety, tolerability, maximum tolerated dose, pharmacokinetics (PK), pharmacodynamics (PD) and preliminary anti-tumor activity. Results: 26 pt have been treated (14M:12F, median age 61 yrs) at 10, 20, 40, 80, 150, 300, and 450 mg on days (d) 1–3 q14 d. No dose-limiting toxicities have been observed to date. Drug-related toxicities include grade 1 fatigue, nausea, rash, diarrhea, tachycardia, proteinuria, pruritis and peripheral oedema. Linear PK was observed, with median terminal t1/2 3.5 hr; AUC0-∞ 25.8 μg.hr/mL; Cmax 3.20 μg/ml at 450mg. Plasma OSI-906 concentrations above the estimated efficacious concentration (1 μM) were attained at doses > 40mg. Glucose did not increase with rising OSI-906 concentration, but plasma insulin levels showed an upward trend, indicating potential PD effects. PD data on IGFR phosphorylation were analyzed. In total, 11 pt were treated for > 12 weeks (w). Of 3 pt with ACC, 1 pt had a partial response (43% reduction in primary and multiple lung metastases) and remains on treatment after 16 w, 1 pt was treated for 32 w, and 1 pt progressed after 4 w at 40mg. In addition, 1 pt with heavily pretreated NSCLC was treated for 43 w and 1 pt with progressive myxoid chondrosarcoma remains on treatment after 38 w. Conclusions: OSI 906 had minimal toxicity, dose proportional PK at dose levels up to 450mg tested d 1–3 q14 d, with preliminary antitumor activity seen, particularly in ACC. Dose escalation with 5 and 7 d schedules q14 d continues. [Table: see text]
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Affiliation(s)
- C. P. Carden
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - S. Frentzas
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - M. Langham
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - I. Casamayor
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - A. W. Stephens
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - S. Poondru
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - J. Wheaton
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - S. M. Lippman
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - S. B. Kaye
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
| | - E. S. Kim
- Royal Marsden Hospital, London, United Kingdom; M.D. Anderson Cancer Center, Houston, TX; OSI Pharmaceuticals, Inc, Boulder, CO
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Talbot JC, Cox G, Townend M, Langham M, Parker PJ. Femoral neck stress fractures in military personnel--a case series. J ROY ARMY MED CORPS 2009; 154:47-50. [PMID: 19090388 DOI: 10.1136/jramc-154-01-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Femoral neck stress fractures (FNSF) are uncommon, representing 5% of all stress fractures. In military personnel, FNSF represents one of the more severe complications of training, which can result in medical discharge. Clinical examination findings are often non-specific and plain radiography may be inconclusive--leading to missed or late diagnosis of FNSF This paper highlights the significance of FNSFs in military personnel and alerts physicians to the potential diagnosis. We identified all military recruits, aged 17 to 26, who attended the Infantry Training Centre (Catterick, U.K.), over a four-year period from the 1st July 2002 to 30th June 2006, who had suffered a FNSF. The medical records, plain radiographs, bone scans and MRIs of the recruits were retrospectively reviewed. Of 250 stress fractures 20 were of the femoral neck; representing 8% of all stress fractures and an overall FNSF rate of 12 in 10,000 military recruits. FNSFs were most prevalent amongst Parachute Regiment recruits (1 in 250, p < 0.05). Onset of symptoms was most commonly between weeks 13-16 of training. The majority (17/20, 85%) of FNSFs were undisplaced, these were all treated conservatively. Three FNSFs were displaced on presentation and were treated surgically. Overall, the medical discharge rate was 40% (8/20). FNSFs are uncommon and the diagnosis remains a challenge to clinicians and requires a high index of suspicion in these young athletic individuals. In such individuals early referral for MRI is recommended, to aid prompt diagnosis and treatment and to prevent more serious sequelae.
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Affiliation(s)
- J C Talbot
- The Department of Trauma and Orthopaedic Surgery, Friarage Hospital, Northallerton, North Yorkshire, UK
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