1
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Turner ME, Blum KM, Watanabe T, Schwarz EL, Nabavinia M, Leland JT, Villarreal DJ, Schwartzman WE, Chou TH, Baker PB, Matsumura G, Krishnamurthy R, Yates AR, Hor KN, Humphrey JD, Marsden AL, Stacy MR, Shinoka T, Breuer CK. Tissue engineered vascular grafts are resistant to the formation of dystrophic calcification. Nat Commun 2024; 15:2187. [PMID: 38467617 PMCID: PMC10928115 DOI: 10.1038/s41467-024-46431-4] [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] [Received: 10/17/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024] Open
Abstract
Advancements in congenital heart surgery have heightened the importance of durable biomaterials for adult survivors. Dystrophic calcification poses a significant risk to the long-term viability of prosthetic biomaterials in these procedures. Herein, we describe the natural history of calcification in the most frequently used vascular conduits, expanded polytetrafluoroethylene grafts. Through a retrospective clinical study and an ovine model, we compare the degree of calcification between tissue-engineered vascular grafts and polytetrafluoroethylene grafts. Results indicate superior durability in tissue-engineered vascular grafts, displaying reduced late-term calcification in both clinical studies (p < 0.001) and animal models (p < 0.0001). Further assessments of graft compliance reveal that tissue-engineered vascular grafts maintain greater compliance (p < 0.0001) and distensibility (p < 0.001) than polytetrafluoroethylene grafts. These properties improve graft hemodynamic performance, as validated through computational fluid dynamics simulations. We demonstrate the promise of tissue engineered vascular grafts, remaining compliant and distensible while resisting long-term calcification, to enhance the long-term success of congenital heart surgeries.
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Affiliation(s)
- Mackenzie E Turner
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Molecular Cellular and Developmental Biology Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Kevin M Blum
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Tatsuya Watanabe
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Erica L Schwarz
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Mahboubeh Nabavinia
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph T Leland
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Delaney J Villarreal
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
- Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William E Schwartzman
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ting-Heng Chou
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Peter B Baker
- Pathology Department at Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Goki Matsumura
- Department of Medical Safety Management, Tokyo Women's Medical University, Tokyo, Japan
| | - Rajesh Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Andrew R Yates
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kan N Hor
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jay D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Alison L Marsden
- Departments of Pediatrics and Bioengineering, Stanford University, Stanford, CA, USA
| | - Mitchel R Stacy
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
- Interdisciplinary Biophysics Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Toshiharu Shinoka
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Cardiothoracic Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Christopher K Breuer
- Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.
- Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
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2
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Mull ES, Cohen S, George A, Krivchenia K, Druhan S, Baker PB, Kopp B. Cryptogenic organizing pneumonia: In the setting of Staphylococcus aureus endocarditis. Pediatr Pulmonol 2023; 58:325-327. [PMID: 36117316 DOI: 10.1002/ppul.26160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Eric S Mull
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sarah Cohen
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Ohio State University Wexner Medical Center, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ashish George
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Katelyn Krivchenia
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Stephen Druhan
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Peter B Baker
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Benjamin Kopp
- Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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3
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Koo SC, LaHaye S, Kovari BP, Schieffer KM, Ranalli MA, Aldrink JH, Michalsky MP, Colace S, Miller KE, Bedrosian TA, Leraas KM, Voytovich K, Wheeler G, Brennan P, Fitch J, Kelly BJ, McGrath SD, Miller AR, White P, Magrini V, Wilson RK, Mardis ER, Lauwers GY, Baker PB, Cottrell CE. Gastroblastoma with a novel EWSR1-CTBP1 fusion presenting in adolescence. Genes Chromosomes Cancer 2021; 60:640-646. [PMID: 34041825 DOI: 10.1002/gcc.22973] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/17/2021] [Accepted: 05/22/2021] [Indexed: 11/07/2022] Open
Abstract
Gastroblastomas are rare tumors with a biphasic epithelioid/spindle cell morphology that typically present in early adulthood and have recurrent MALAT1-GLI1 fusions. We describe an adolescent patient with Wiskott-Aldrich syndrome who presented with a large submucosal gastric tumor with biphasic morphology. Despite histologic features consistent with gastroblastoma, a MALAT1-GLI1 fusion was not found in this patient's tumor; instead, comprehensive molecular profiling identified a novel EWSR1-CTBP1 fusion and no other significant genetic alterations. The tumor also overexpressed NOTCH and FGFR by RNA profiling. The novel fusion and expression profile suggest a role for epithelial-mesenchymal transition in this tumor, with potential implications for the pathogenesis of biphasic gastric tumors such as gastroblastoma.
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Affiliation(s)
- Selene C Koo
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pathology, The Ohio State University, Columbus, Ohio, USA.,Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Stephanie LaHaye
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Bence P Kovari
- Department of Pathology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.,Department of Pathology, University of Szeged, Szeged, Hungary
| | - Kathleen M Schieffer
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Mark A Ranalli
- Division of Hematology/Oncology/Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Marc P Michalsky
- Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Susan Colace
- Division of Hematology/Oncology/Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Katherine E Miller
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Tracy A Bedrosian
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Kristen M Leraas
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kyle Voytovich
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Gregory Wheeler
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Patrick Brennan
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - James Fitch
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Benjamin J Kelly
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sean D McGrath
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Anthony R Miller
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Peter White
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Vincent Magrini
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Richard K Wilson
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Elaine R Mardis
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Gregory Y Lauwers
- Department of Pathology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Peter B Baker
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Catherine E Cottrell
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA.,The Steve and Cindy Rasmussen Institute for Genomic Medicine, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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4
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Kerr J, Niermeyer WL, Baker PB, Chiang T. Floor of mouth thyroglossal duct cyst: a rare embryologic course. J Surg Case Rep 2019; 2019:rjz303. [PMID: 31723402 PMCID: PMC6831953 DOI: 10.1093/jscr/rjz303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/18/2019] [Indexed: 11/23/2022] Open
Abstract
A thyroglossal duct cyst (TGDC) is a common pediatric midline neck mass. Most TGDCs occur in the region of the hyoid bone but have been found less commonly in areas from the oral cavity to the sternum. We present the first reported case of a multifocal floor of mouth (FOM)/cervical TGDC representing an atypical embryonic course. We also review atypical presentations of TGDC and provide a summary of cases involving FOM and multifocal cysts.
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Affiliation(s)
- John Kerr
- Department of Otolaryngology - Head and Neck Surgery, OhioHealth Hospitals, Columbus, OH, USA
| | - Weston L Niermeyer
- College of Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Peter B Baker
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Tendy Chiang
- Department of Pediatric Otolaryngology - Head and Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA
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5
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Abstract
William A (Bill) Newton Jr practiced pediatric pathology and hematology/oncology at Children's Hospital of Columbus, Ohio, for over 40 years starting in 1952. Newton was an original member of the Pediatric Pathology Club, which preceded the Society for Pediatric Pathology, and was its president from 1968 to 1969. He published important independent observations in pediatric pathology, helped establish systematic cooperative pediatric tumor pathology review by experts, became an acclaimed expert on the diagnosis of rhabdomyosarcoma, was a critical contributor to many pediatric oncology clinical trials, made important early contributions to tumor banking in pediatrics, and trained numerous pediatric pathology and pediatric oncology fellows. Finally, he concluded his career as a humanitarian, leading important volunteer work aimed at improving pediatric cancer care in China. This most interesting pediatric pathologist was simultaneously a Brigadier General in the U.S. Army. Bill Newton's life and career, which is reviewed in detail here, should be of immense interest and an inspiration to the Pediatric & Developmental Pathology readership.
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Affiliation(s)
- James R Wright
- 1 Department of Pathology & Laboratory Medicine, University of Calgary/Calgary Laboratory Services, Alberta Children's Hospital, Calgary, Alberta, Canada.,2 Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Peter B Baker
- 3 Anatomic Pathology/Laboratory Medicine, Nationwide Children's Hospital Columbus, Columbus, Ohio
| | - Hiroyuki Shimada
- 4 Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
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6
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Hayes D, Parekh H, Baker PB. C3d deposition and antibody-mediated rejection after lung transplantation. J Heart Lung Transplant 2018; 37:1388-1389. [PMID: 30241888 DOI: 10.1016/j.healun.2018.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/17/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Don Hayes
- Nationwide Children's Hospital, Columbus, Ohio, USA; Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Hemant Parekh
- Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
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7
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Conces MR, Arnold CA, Baker PB, Carter CM, Fung B, Prasad V, Arnold MA. A Strategy for Helicobacter Immunohistochemistry Utilization in Pediatric Practice: Insights From Morphologic and Cost-Benefit Analyses. Am J Clin Pathol 2016; 146:611-617. [PMID: 28430952 DOI: 10.1093/ajcp/aqw149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Recent studies in adults have examined the utility of immunohistochemistry (IHC) in detecting Helicobacter in gastric biopsy specimens and reached differing conclusions. Dedicated cost-benefit analysis of Helicobacter IHC in pediatric gastric biopsy specimens has not been performed. METHODS From 1,955 pediatric gastric biopsies in a 1-year period, we identified 63 Helicobacter -positive and 120 Helicobacter -negative biopsy specimens. All cases were scored according to the Updated Sydney System for the severity of inflammation. RESULTS We observed that pediatric Helicobacter infection was significantly associated with germinal center formation, active inflammation, oxyntic mucosa with moderate to severe chronic inflammation, and antral mucosa with any chronic inflammation, exclusive of mild and superficial chronic inflammation. At least one associated pattern was seen in each Helicobacter -positive biopsy specimen. In comparison with adults, pediatric Helicobacter -positive biopsy specimens are more likely to lack acute inflammation and more likely to show moderate to marked chronic inflammation. CONCLUSIONS We recommend performing Helicobacter IHC on pediatric gastric biopsy specimens with any of the above inflammatory patterns. This approach can sensitively identify pediatric patients with Helicobacter gastritis, limit IHC staining to approximately 30% of all gastric biopsy specimens, and reduce costs by up to $55,306.90 per 1,000 biopsy specimens.
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Affiliation(s)
- Miriam R Conces
- From the Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Christina A Arnold
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Peter B Baker
- From the Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Christopher M Carter
- From the Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Bonita Fung
- From the Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Vinay Prasad
- From the Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
| | - Michael A Arnold
- From the Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus
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8
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Schwaderer AL, Wang H, Kim S, Kline JM, Liang D, Brophy PD, McHugh KM, Tseng GC, Saxena V, Barr-Beare E, Pierce KR, Shaikh N, Manak JR, Cohen DM, Becknell B, Spencer JD, Baker PB, Yu CY, Hains DS. Polymorphisms in α-Defensin-Encoding DEFA1A3 Associate with Urinary Tract Infection Risk in Children with Vesicoureteral Reflux. J Am Soc Nephrol 2016; 27:3175-3186. [PMID: 26940096 DOI: 10.1681/asn.2015060700] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 01/13/2016] [Indexed: 12/12/2022] Open
Abstract
The contribution of genetic variation to urinary tract infection (UTI) risk in children with vesicoureteral reflux is largely unknown. The innate immune system, which includes antimicrobial peptides, such as the α-defensins, encoded by DEFA1A3, is important in preventing UTIs but has not been investigated in the vesicoureteral reflux population. We used quantitative real-time PCR to determine DEFA1A3 DNA copy numbers in 298 individuals with confirmed UTIs and vesicoureteral reflux from the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Study and 295 controls, and we correlated copy numbers with outcomes. Outcomes studied included reflux grade, UTIs during the study on placebo or antibiotics, bowel and bladder dysfunction, and renal scarring. Overall, 29% of patients and 16% of controls had less than or equal to five copies of DEFA1A3 (odds ratio, 2.09; 95% confidence interval, 1.40 to 3.11; P<0.001). For each additional copy of DEFA1A3, the odds of recurrent UTI in patients receiving antibiotic prophylaxis decreased by 47% when adjusting for vesicoureteral reflux grade and bowel and bladder dysfunction. In patients receiving placebo, DEFA1A3 copy number did not associate with risk of recurrent UTI. Notably, we found that DEFA1A3 is expressed in renal epithelium and not restricted to myeloid-derived cells, such as neutrophils. In conclusion, low DEFA1A3 copy number associated with recurrent UTIs in subjects in the RIVUR Study randomized to prophylactic antibiotics, providing evidence that copy number polymorphisms in an antimicrobial peptide associate with UTI risk.
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Affiliation(s)
| | - Huanyu Wang
- The Centers for Clinical and Translational Medicine and
| | | | | | - Dong Liang
- Innate Immunity Translational Research Center, Children's Foundation Research Institute at Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Pat D Brophy
- Division of Nephrology, Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - Kirk M McHugh
- Division of Anatomy, The Ohio State University, Columbus, Ohio
| | | | - Vijay Saxena
- The Centers for Clinical and Translational Medicine and
| | | | - Keith R Pierce
- Innate Immunity Translational Research Center, Children's Foundation Research Institute at Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Nader Shaikh
- Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - J Robert Manak
- Departments of Biology and Pediatrics, University of Iowa, Iowa; and
| | | | | | | | - Peter B Baker
- Department of Pathology, Nationwide Children's Hospital, Columbus, Ohio
| | - Chack-Yung Yu
- Molecular and Human Genetics, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - David S Hains
- Innate Immunity Translational Research Center, Children's Foundation Research Institute at Le Bonheur Children's Hospital, Memphis, Tennessee; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
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9
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Affiliation(s)
- Don Hayes
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA. .,Department of Internal Medicine, The Ohio State University, Columbus, OH, USA. .,Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Kerri L Nicholson
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Peter B Baker
- Department of Pathology, The Ohio State University, Columbus, OH, USA.,Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
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10
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Arnold MA, Chenever E, Baker PB, Boué DR, Fung B, Hammond S, Hendrickson BW, Kahwash SB, Pierson CR, Prasad V, Nicol KK, Barr T. The College of American Pathologists guidelines for whole slide imaging validation are feasible for pediatric pathology: a pediatric pathology practice experience. Pediatr Dev Pathol 2015; 18:109-16. [PMID: 25387255 DOI: 10.2350/14-07-1523-oa.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Whole slide imaging (WSI) is rapidly transforming educational and diagnostic pathology services. Recently, the College of American Pathologists Pathology and Laboratory Quality Center (CAP-PLQC) published recommended guidelines for validating diagnostic WSI. We prospectively evaluated the guidelines to determine their utility in validating pediatric surgical pathology and cytopathology specimens. Our validation included varied pediatric specimen types, including complex or less common diagnoses, in accordance with the guidelines. We completed WSI review of 60 surgical pathology cases and attempted WSI review of 21 cytopathology cases. For surgical pathology cases, WSI diagnoses were highly concordant with glass slide diagnoses; a discordant diagnosis was observed in 1 of 60 cases (98.3% concordance). We found that nucleated red blood cells and eosinophilic granular bodies represented specific challenges to WSI review of pediatric specimens. Cytology specimens were more frequently discordant or failed for technical reasons, with overall concordance of 66.7%. Review of pediatric cytopathology specimens will likely require image capture in multiple focal planes. This study is the first to specifically evaluate WSI review for pediatric specimens and demonstrates that specimens representing the spectrum of pediatric surgical pathology practice can be reviewed using WSI. Our application of the proposed CAP-PLQC guidelines to pediatric surgical pathology specimens is, to our knowledge, the first prospective implementation of the CAP-PLQC guidelines.
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Affiliation(s)
- Michael A Arnold
- 1 Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
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11
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Burnside MN, Pyatt RE, Hughes A, Baker PB, Pierson CR. Complex brain malformations associated with chromosome 6q27 gain that includes THBS2, which encodes thrombospondin 2, an astrocyte-derived protein of the extracellular matrix. Pediatr Dev Pathol 2015; 18:59-65. [PMID: 25299246 DOI: 10.2350/14-06-1516-cr.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This case describes the autopsy findings of a 2-month-old male infant with extensive and severe developmental brain abnormalities, including microcephaly, neocortical neuronal layering abnormalities, leptomeningeal heterotopias, commissural agenesis, and cerebellar and brainstem hypoplasia. Microarray analysis identified a gain in chromosome band 6q27, which includes the entire coding region of THBS2. THSB2 encodes thrombospondin 2 (TSP2), an astrocyte secreted protein of the extracellular matrix that promotes synaptogenesis, neurite outgrowth, and cerebellar granule cell migration. Thrombospondin 2 is not a matrix structural protein; instead it serves as an extracellular modulator of cell function, so it is considered a matricellular protein. The neuropathological findings at autopsy are compatible with perturbations in several known functions of TSP2 and demonstrate that TSP2 dysregulation can have a significant negative impact on human brain development. Furthermore, this case demonstrates the important role of astrocytes in human brain development.
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12
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Hayes D, Naguib A, Kirkby S, Galantowicz M, McConnell PI, Baker PB, Kopp BT, Lloyd EA, Astor TL. Comprehensive evaluation of lung allograft function in infants after lung and heart-lung transplantation. J Heart Lung Transplant 2014; 33:507-13. [DOI: 10.1016/j.healun.2014.01.867] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/17/2014] [Accepted: 01/22/2014] [Indexed: 10/25/2022] Open
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13
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Hayes D, Islam S, Kirkby S, Preston TJ, Baker PB. Unusual case of a vanishing bronchus of the left allograft in a lung transplant recipient. Ann Thorac Med 2013; 8:229-30. [PMID: 24250738 PMCID: PMC3821284 DOI: 10.4103/1817-1737.118495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 12/12/2012] [Indexed: 12/01/2022] Open
Abstract
We present an interesting case of a complete vanishing of the left main bronchus in a lung transplant recipient who had a successful outcome due to acute respiratory support with venovenous extracorporeal membrane oxygenation in order to perform airway dilation.
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Affiliation(s)
- Don Hayes
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA ; Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA ; Department of Cardiopulmonary Failure and Transplant Programs, The Ohio State University College of Medicine, Columbus, OH, USA
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Hayes D, Baker PB, Kopp BT, Kirkby S, Galantowicz M, McConnell PI, Astor TL. Surveillance transbronchial biopsies in infant lung and heart-lung transplant recipients. Pediatr Transplant 2013; 17:670-5. [PMID: 23961950 DOI: 10.1111/petr.12125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2013] [Indexed: 11/27/2022]
Abstract
There are limited published data on surveillance TBB for the identification of allograft rejection in infants after lung or heart-lung transplantation. We performed a retrospective review of children under one yr of age who underwent lung or heart-lung transplant at our institution. Since 2005, four infants were transplanted (three heart-lung and one lung). The mean age (±s.d.) at the time of transplant was 5.5 ± 2.4 (range 3-8) months. A total of 16 surveillance TBB procedures were completed in both inpatient and outpatient settings, with a range of 3-7 performed per patient. A minimum of five acceptable tissue pieces with expanded alveoli were obtained in 81% (13/16) of TBB procedures and a minimum of three pieces in 88% (14/16). There was no evidence of acute allograft rejection in 88% (14/16) of TBB procedures. One TBB procedure yielded two tissue specimens demonstrating A2 acute allograft rejection. One TBB procedure failed to yield tissue with sufficient alveoli. Additionally, B-grade assessment identified B0 in 50% (8/16), B1R in 12% (2/16), and BX (ungradeable or insufficient sample) in 38% (6/16) of biopsy procedures, respectively. In conclusion, TBB may be safely performed as an inpatient and outpatient procedure in infant lung and heart-lung transplant recipients and may provide adequate tissue for detecting acute allograft rejection and small airway inflammation.
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Affiliation(s)
- Don Hayes
- Department of Pediatrics, The Ohio State University, Nationwide Children's Hospital, Columbus, OH, USA
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15
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Chang H, Tran T, Billman GE, Julian MW, Hamlin RL, Simonetti OP, Ambrosio G, Baker PB, Shao G, Crouser ED, Raman SV. At-risk but viable myocardium in a large animal model of non ST-segment elevation acute coronary syndrome: cardiovascular magnetic resonance with ex vivo validation. J Cardiovasc Magn Reson 2013; 15:94. [PMID: 24107555 PMCID: PMC3852225 DOI: 10.1186/1532-429x-15-94] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/01/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) have varying degrees of salvageable myocardium at risk of irreversible injury. We hypothesized that a novel model of NSTE-ACS produces acute myocardial injury, measured by increased T2 cardiovascular magnetic resonance (CMR), without significant necrosis by late gadolinium enhancement (LGE). METHODS In a canine model, partial coronary stenosis was created and electrodes placed on the epicardium. Myocardial T2, an indicator of at-risk myocardium, was measured pre- and post-tachycardic pacing. RESULTS Serum troponin-I (TnI) was not detectable in unoperated sham animals but averaged 1.97 ± 0.72 ng/mL in model animals. Coronary stenosis and pacing produced significantly higher T2 in the affected vs. the remote myocardium (53.2 ± 4.9 vs. 43.6 ± 2.8 ms, p < 0.01) with no evident injury by LGE. Microscopy revealed no significant irreversible cellular injury. Relative respiration rate (RRR) of affected vs. remote myocardial tissue was significantly lower in model vs. sham animals (0.72 ± 0.07 vs. 1.04 ± 0.07, p < 0.001). Lower RRR corresponded to higher final TnI levels (R(2) = 0.83, p = 0.004) and changes in CaMKIID and mitochondrial gene expression. CONCLUSIONS A large animal NSTE-ACS model with mild TnI elevation and without ST elevation, similar to the human syndrome, demonstrates signs of acute myocardial injury by T2-CMR without significant irreversible damage. Reduced tissue respiration and associated adaptations of critical metabolic pathways correspond to increased myocardial injury by serum biomarkers in this model. T2-CMR as a biomarker of at-risk but salvageable myocardium warrants further consideration in preclinical and clinical studies of NSTE-ACS.
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Affiliation(s)
- Henry Chang
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
| | - Tam Tran
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
| | - George E Billman
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, OSU, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Mark W Julian
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
| | - Robert L Hamlin
- Department of Veterinary Biosciences, OSU, 1900 Coffey Road, Columbus, OH 43210, USA
| | - Orlando P Simonetti
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
- Division of Cardiovascular Medicine, OSU, 473 W 12th Ave, Columbus, OH 43210, USA
- Department of Radiology, OSU, 395 W 12th Ave, Columbus, OH 43210, USA
| | - Giuseppe Ambrosio
- Division of Cardiology, University of Perugia, Ospedale S. Maria della Misericordia, Via S. Andrea delle fratte, 06156 Perugia, Italy
| | - Peter B Baker
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
- Department of Pathology, OSU and Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205, USA
| | - Guohong Shao
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
| | - Elliott D Crouser
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
- Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, OSU, 473 W 12th Ave, Columbus, OH 43210, USA
| | - Subha V Raman
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Ave, Suite 200, Columbus, OH 43210, USA
- Division of Cardiovascular Medicine, OSU, 473 W 12th Ave, Columbus, OH 43210, USA
- Department of Radiology, OSU, 395 W 12th Ave, Columbus, OH 43210, USA
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Hayes D, Baker PB, Mansour HM, Peeples ME, Nicol KK. Interstitial lung disease in a child with antisynthetase syndrome. Lung 2013; 191:441-3. [PMID: 23652349 DOI: 10.1007/s00408-013-9468-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 04/13/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Antisynthetase Syndrome is associated with interstitial lung disease in adult patients, but this has not been described in children. MATERIALS AND METHODS A 13-year-old with interstitial lung disease due to Antisynthetase Syndrome and pulmonary arterial hypertension underwent emergent bilateral lung transplantation after a rapid clinical decline. CONCLUSION We present the clinical, radiographic, and histological findings of a child with interstitial lung disease due to Antisynthetase Syndrome.
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Affiliation(s)
- Don Hayes
- Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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Hayes D, DiPaola N, Baker PB, Kirkby S, Phillips AB, Nicol KK. Antibody-mediated rejection in a lung transplant recipient after acute stroke. Transpl Immunol 2012; 27:171-4. [DOI: 10.1016/j.trim.2012.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 08/02/2012] [Accepted: 08/06/2012] [Indexed: 10/28/2022]
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Hayes D, Baker PB, Astor TL, Preston TJ, Kirkby S, Galantowicz M, Hoffman TM. Aggressive coronary artery vasculopathy after combined heart-lung transplantation. CONGENIT HEART DIS 2012; 8:E88-91. [PMID: 22676698 DOI: 10.1111/j.1747-0803.2012.00681.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Combined heart-lung transplantation remains as a treatment option for patients with cardiopulmonary failure. There is speculation that lung grafts protect the heart from developing graft vasculopathy after combined heart-lung transplantation. This protective mechanism is more likely, at best, a delay in the onset of coronary artery vasculopathy. We present our experiences in two cases of an aggressive form of cardiac allograft vasculopathy after combined heart-lung transplantation that resulted in the death of both patients.
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Affiliation(s)
- Don Hayes
- Nationwide Children's Hospital The Ohio State University College of Medicine, Columbus, OH 43205, USA.
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19
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Hershenson JA, Baker PB, Rowland DG. Ruptured myocardial abscess causing left ventricle to pulmonary artery communication in an infant with community-associated methicillin-resistant Staphylococcus aureus endocarditis. Arch Pathol Lab Med 2011; 135:1057-60. [PMID: 21810000 DOI: 10.5858/2010-0144-crr1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Myocardial abscess perforation is an extremely rare complication of infective endocarditis. We present a case of a 12-month-old infant who developed community-associated methicillin-resistant Staphylococcus aureus bacteremia after an incision and drainage of a skin abscess. He subsequently developed septic emboli to the brain and lungs, and a myocardial cavity in the outlet portion of the interventricular septum. The cavity ruptured 4 days after diagnosis and created a left ventricle to pulmonary artery fistulous communication. The patient died secondary to embolic complications to the brain. We are not aware of any other cases of myocardial abscess rupture in this location of the heart, in a patient of this age, or due to infection with community-associated methicillin-resistant S aureus .
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Affiliation(s)
- Jared A Hershenson
- Heart Center, Nationwide Children’s Hospital, Columbus, Ohio 43205, USA.
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20
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Affiliation(s)
- Melissa Rayburg
- Department of Pediatrics, Cincinnati Comprehensive Sickle Cell Center, Ohio, USA
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21
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Iorember FM, Patel HP, Ohana A, Hayes JR, Mahan JD, Baker PB, Rajab A. Steroid avoidance using sirolimus and cyclosporine in pediatric renal transplantation: one year analysis. Pediatr Transplant 2010; 14:93-9. [PMID: 19254246 DOI: 10.1111/j.1399-3046.2009.01135.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Steroids are commonly used in pediatric renal transplantation, but have numerous adverse effects. This retrospective study compares one-yr outcomes in 22 pediatric renal transplant recipients receiving SRL and CSA as primary immunosuppression (steroid-avoidance group) to age- and gender-matched historical controls receiving CSA, MMF, and prednisone (steroid group). At one yr, both groups had similar graft survival, acute rejection, and estimated GFR. Subjects in the steroid-avoidance group had better linear growth, less excessive weight gain and were less likely to have an increase in antihypertensive medication use. Subjects in the steroid-avoidance group were more likely to be started on lipid lowering medications and erythropoiesis stimulating agents. Despite having a greater proportion of living donors, the steroid-avoidance group had a similar GFR compared to the steroid group at one month. The steroid-avoidance group was also more likely to have a biopsy for elevated Cr that was not because of rejection and had more interstitial fibrosis noted. We conclude that using a steroid-avoidance immunosuppression regimen of SRL and CSA results in comparable rejection rates and short-term graft function with less steroid-associated morbidity. However, early findings also suggest possible potentiation of CSA nephrotoxicity by SRL in some children.
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Affiliation(s)
- Franca M Iorember
- Department of Pediatrics, Section of Nephrology, Nationwide Children's Hospital, Columbus, OH 43205, USA
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22
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Martin RE, Baker PB, Ribbons DW. Biotransformations Of Fluoroaromatic Compounds: Accumulation Of Hydroxylated Products From 3-Fluorophthalic Acid Using Mutant Strains OfPseudomonas Testosteroni. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10242428709040129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Robert E. Martin
- Biotechnology Research Group, Laboratory of the Government Chemist, Cornwall House, Waterloo Road, London SE1 8XY, England, UK
| | - Peter B. Baker
- Biotechnology Research Group, Laboratory of the Government Chemist, Cornwall House, Waterloo Road, London SE1 8XY, England, UK
| | - Douglas W. Ribbons
- Centre for Biotechnology, Imperial College of Science and Technology, South Kensington, London SW7 2AZ, England, UK
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23
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Leak DJ, Ellison SLR, Murricane C, Baker PB. Methane Monooxygenase Biotransformations: Highly Stereoselective Hydroxylation of 3-Methylcyclohexene by Methane Monooxygenase: Steric and Electronic Effects on Product Distribution. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10242428809014846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- David J. Leak
- Centre for Biotechnology, Imperial College of Science and Technology, London, SW7 2AZ
| | | | | | - Peter B. Baker
- Laboratory of the Government Chemist, Waterloo Rd, London, SE1 8XY
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24
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Raman SV, Winner MW, Tran T, Velayutham M, Simonetti OP, Baker PB, Olesik J, McCarthy B, Ferketich AK, Zweier JL. In vivo atherosclerotic plaque characterization using magnetic susceptibility distinguishes symptom-producing plaques. JACC Cardiovasc Imaging 2009; 1:49-57. [PMID: 19356405 DOI: 10.1016/j.jcmg.2007.09.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Revised: 09/18/2007] [Accepted: 09/24/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We investigated the role of iron deposition in atherosclerotic plaque instability using a novel approach of in vivo plaque characterization by a noninvasive, noncontrast magnetic resonance-based T2* measurement. This approach was validated using ex vivo plaque analyses to establish that T2* accurately reflects intraplaque iron composition. BACKGROUND Iron catalyzes free radical production, a key step for lipid peroxidation and atherosclerosis development. The parameter T2* measures tissue magnetic susceptibility, which historically has been used to quantify hepatic and myocardial iron. The T2* measurement has not been used for in vivo plaque characterization in patients with atherosclerosis. METHODS Thirty-nine patients referred for carotid endarterectomy were prospectively enrolled to undergo preoperative carotid magnetic resonance imaging (MRI) and postoperative analysis of the explanted plaque. Clinical history of any symptoms attributable to each carotid lesion was recorded. We could not complete MRI in 4 subjects because of their claustrophobia, and 3 patients scanned before the institution of a neck stabilizer had motion artifact, precluding quantification. RESULTS Symptomatic patients had significantly lower plaque T2* values (20.0 +/- 1.8 ms) compared with asymptomatic patients (34.4 +/- 2.7 ms, p < 0.001). Analytical methods demonstrated similar total iron (138.6 +/- 36.5 microg/g vs. 165.8 +/- 48.3 microg/g, p = NS) but less low molecular weight Fe(III) (7.3 +/- 3.8 microg/g vs. 17.7 +/- 4.0 microg/g, p < 0.05) in the explanted plaques of symptomatic versus asymptomatic patients, respectively, which is consistent with a shift in iron from Fe(III) to greater amounts of T2*-shortening forms of iron. Mass spectroscopy also showed significantly lower calcium (37.5 +/- 10.8 mg/g vs. 123.6 +/- 19.3 mg/g, p < 0.01) and greater copper (3.2 +/- 0.5 microg/g vs. 1.7 +/- 0.1 microg/g, p < 0.01) in plaques from symptomatic patients. CONCLUSIONS In vivo measurement of intraplaque T2* using MRI is feasible and distinguishes symptom-producing from non-symptom-producing plaques in patients with carotid artery atherosclerosis. Symptom-producing plaques demonstrated characteristic changes in iron forms by ex vivo analysis, supporting the dynamic presence of iron in the microenvironment of atherosclerotic plaque.
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Affiliation(s)
- Subha V Raman
- Davis Heart and Lung Research Institute and Heart Center, The Ohio State University, Columbus, Ohio 43210, USA.
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25
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Hines MH, Schmalbrock P, Baker PB, Bolte JH. Comparison of autopsy, X-ray, and M.R.I. findings following a low speed impact to the shoulder. Annu Proc Assoc Adv Automot Med 2002; 45:215-38. [PMID: 12214351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The objectives of the study was to generate data useful to engineers improving crash test dummies and to physicians in anticipating low speed lateral impact injuries to the shoulder. Constant impact mass, distance and variable speeds were used to generate impact forces. Twelve unembalmed human cadavers were studied within 48 hours of death. Pre-test and Post-test physical, X-Ray, and Magnetic Resonance examinations were completed. X-Ray best identified bone injury, Magnetic Resonance intratendinous and intramuscular pathology and autopsy joint instability. Low speed (3.5-7.0 m/sec) impacts under these testing conditions frequently produce soft tissue and bone injuries. Sternoclavicular and acromioclavicular joint instabilities were found in 83% of the cadavers. The most frequent bone fractures were in the distal clavicle of 42% and labral or rotator cuff tears in 13% of the cadavers.
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Affiliation(s)
- M H Hines
- Department of Anatomy and Medical Education, Ohio State University, Columbus, Ohio, USA
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26
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Abstract
Hemangioma of the heart is a rare lesion, representing 5% to 10% of benign cardiac tumors. Hemangioma of the mitral valve has been reported previously in one autopsy case report. We describe the excision and repair of a hemangioma of the mitral valve in a 33-year-old African-American woman.
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Affiliation(s)
- S W Nye
- Department of Surgery, The Ohio State University College of Medicine, Columbus, USA
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27
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Baschinsky DY, Weidner N, Baker PB, Frankel WL. Primary hepatic anaplastic large-cell lymphoma of T-cell phenotype in acquired immunodeficiency syndrome: a report of an autopsy case and review of the literature. Am J Gastroenterol 2001; 96:227-32. [PMID: 11197258 DOI: 10.1111/j.1572-0241.2001.03481.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Anaplastic large-cell lymphomas (ALCL) were first described by Stein et al. in 1985 as large-cell neoplasms with a pleomorphic appearance, subtotal effacement of the lymph node structure, and expression of the lymphoid activation antigen CD-30 (Ki-l). Since their first description, these tumors have been documented in a variety of extranodal sites. We report a primary hepatic anaplastic large-cell lymphoma in a patient with advanced AIDS, who presented with hepatic failure and multiple nodules in the liver. A complete autopsy showed discrete tumor nodules throughout the entire liver without gross or microscopic involvement of lymph nodes or any other organs by the neoplastic process. The tumor cells showed typical histological and immunohistochemical features of ALCL and were strongly immunoreactive with the T-cell markers CD-3 and UCHL-1. Only one previous case of primary hepatic ALCL has been reported in the literature, and this tumor occurred in an immunocompetent patient and was not immunoreactive for B- or T-cell markers. To our knowledge, this study represents the first reported case of primary hepatic anaplastic large-cell lymphoma of T-cell phenotype. Additionally, this is the first case of primary hepatic ALCL reported in an AIDS patient.
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Affiliation(s)
- D Y Baschinsky
- Department of Pathology, Ohio State University Medical Center and Arthur G. James Cancer Hospital and Research Institute, Columbus, USA
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28
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Armstrong AT, Binkley PF, Baker PB, Leier CV. Histologic compaison of allograft myocardium between short- and long-term survivors of human cardiac transplantation. Am J Cardiol 2000; 86:1148-51, A9. [PMID: 11074219 DOI: 10.1016/s0002-9149(00)01179-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Myocardial histology of cardiac allografts differed between short-term (<5 years) and long-term (>5 years) survivors after transplantation. These differences may partially be attributable to a higher prevalence of systemic hypertension and allograft rejection in the short-term survivors, affecting hemodynamics and allograft function.
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Affiliation(s)
- A T Armstrong
- Department of Pathology, The Ohio State University College of Medicine, Columbus, USA
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29
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Baschinsky DY, Baker PB, Niemann TH, Wilmer WA. Pauci-immune ANCA-positive crescentic glomerulonephritis associated with metastatic adenocarcinoma of the lung. Am J Kidney Dis 2000; 36:E24. [PMID: 11007699 DOI: 10.1053/ajkd.2000.17727] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 66-year-old woman developed rapidly progressive renal failure several days after she was diagnosed with non-small cell carcinoma of the lung. Antineutrophil cytoplasmic antibody test performed as an indirect immunofluorescence assay was positive with a perinuclear pattern of staining (pANCA). The patient did not improve with hemodialysis treatment and died on the second day after admission to the hospital. A complete autopsy was performed and showed metastatic adenocarcinoma of the lung and pauci-immune crescentic glomerulonephritis. A literature search showed only 7 previously reported cases of malignant tumors associated with ANCA-positive pauci-immune crescentic glomerulonephritis. The clinicopathologic findings of the current and all previously reported cases and possible relationship between ANCA-positive glomerulonephritis and malignancy are discussed.
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Affiliation(s)
- D Y Baschinsky
- Ohio State University Medical Center and Arthur G. James Cancer Hospital and Research Institute, Columbus, OH, USA
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30
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Leier CV, Armstrong AT, Michler RE, Baker PB, Binkley PF. Histostructural analysis of allograft myocardium from short- and long-term survivors of human cardiac transplantation. J Card Fail 1999. [DOI: 10.1016/s1071-9164(99)91455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
OBJECTIVES To document the level of involvement and communication with nonpathology clinical personnel regarding autopsies and to document the destination of autopsy reports. DESIGN The College of American Pathologists Q-Probes format was used to collect information on 15 consecutively performed autopsies per institution or for 6 months, whichever occurred first. The following information was recorded for each autopsy: decedent's age, hospital service, length of hospital stay, whether organs were donated, who was present at autopsy, methods of communicating preliminary and final autopsy results, special techniques used to arrive at a preliminary diagnosis, activities for which the autopsy was used, and destination of final report. PARTICIPANTS Two hundred fifty-six laboratories collected information on 2755 autopsies. RESULTS The aggregate autopsy rate was 12.4% (median 8.5%). Nonpathology clinical personnel attended 35.8% of all autopsies. A clinical physician was more likely to attend an autopsy if the patient was from a surgical service. Three primary methods were used to communicate preliminary autopsy results, namely, written reports (82.5%), telephone calls (50.6%), and meetings (11.5%). The primary care physician was sent the autopsy report in 91.1% of cases. Approximately half of the autopsy cases were used in both pathology departmental and extradepartmental activities. Aggregate autopsy data were distributed in the majority of cases to various departmental chairpersons and institutional quality assurance committees. CONCLUSIONS This study provides a comparative multiinstitutional database for the utilization of autopsy results by clinicians and clinical departments. Although autopsy rates are low, autopsy results are routinely being used for hospital quality assurance activities and for educational purposes.
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Affiliation(s)
- R E Nakhleh
- Department of Pathology, Henry Ford Hospital, Detroit, Mich 48202, USA
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Zarbo RJ, Baker PB, Howanitz PJ. The autopsy as a performance measurement tool--diagnostic discrepancies and unresolved clinical questions: a College of American Pathologists Q-Probes study of 2479 autopsies from 248 institutions. Arch Pathol Lab Med 1999; 123:191-8. [PMID: 10086506 DOI: 10.5858/1999-123-0191-taaapm] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop a multi-institutional reference database for quality improvement purposes using the autopsy to define clinical diagnostic discrepancies and resolve clinical questions. DESIGN Using the College of American Pathologists Q-Probes format, institutions prospectively assessed a maximum of 15 consecutive autopsies each, excluding forensic cases and stillborn infants, conducted over a 6-month period. They documented answers to clinical questions provided at autopsy and classified unexpected disease diagnoses according to a standardized system. SETTING AND PARTICIPANTS Hospital-based autopsies performed at 248 institutions participating in the 1993 College of American Pathologists Q-Probes Quality Improvement Program. MAIN OUTCOME MEASURES Percentages of clinical questions resolved by the autopsy and percentage of autopsies with unexpected findings of graded clinical impact. RESULTS In the aggregate database of 6427 questions from 2479 autopsies, overall 93.0% were answered by the autopsy. The 3 most common question categories were (1) identify pathology to account for clinical signs or symptoms (28.0%); (2) establish the cause of death (21.0%); and (3) confirm a clinical diagnosis (19.0%). At least one major unexpected disease finding that contributed to the patient's death was discovered in 39.7% of the total number of autopsies. There were no differences in the percentages of autopsies with these major unexpected findings when the data were stratified by institutional demographics or decedent characteristics. CONCLUSION This multi-institutional study underscores the clinical relevance of postmortem examination in current medical practice by consistently providing answers to unresolved clinical questions and frequently revealing major unexpected findings that contributed to the patient's death. It is our strong belief that this postmortem-derived clinicopathologic information is a key indicator of effectiveness of care. Integration of this information into institutional quality improvement programs will improve system processes and clinician performance.
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Affiliation(s)
- R J Zarbo
- Department of Pathology, Henry Ford Hospital, Detroit, Mich 48201, USA
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Affiliation(s)
- P B Baker
- Ohio State University College of Medicine, Columbus, USA
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Hanzlick R, Baker PB, Hutchins GM. Adverse drug reactions in hospitalized patients. JAMA 1998; 280:1742; author reply 1743-4. [PMID: 9842943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Armstrong AT, Binkley PF, Baker PB, Myerowitz PD, Leier CV. Quantitative investigation of cardiomyocyte hypertrophy and myocardial fibrosis over 6 years after cardiac transplantation. J Am Coll Cardiol 1998; 32:704-10. [PMID: 9741515 DOI: 10.1016/s0735-1097(98)00296-4] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study was performed to determine the degree and time course over 6 years of cardiomyocyte hypertrophy and myocardial fibrosis of the cardiac allograft in transplanted patients. BACKGROUND Diastolic dysfunction and to a certain extent systolic dysfunction are common cardiac findings after heart transplantation. The development of posttransplant cardiomyocyte hypertrophy and myocardial fibrosis likely contributes to these derangements. METHODS Cardiomyocyte diameter and percent fibrosis were determined in serial endomyocardial biopsy specimens obtained from 1 month up to 6 years following heart transplantation in 50 patients. Endomyocardial biopsy specimens from 40 patients with primary dilated cardiomyopathy and 11 normal subjects were similarly analyzed for control data. Analyses were performed in a blinded format using a validated computerized image analysis system (Optimas 5.2). RESULTS Early (1 month) cardiomyocyte enlargement decreased to the smallest diameter 6 months posttransplant, but thereafter progressively increased by 10% to 20% over the subsequent 5- to 6-year period. Although not statistically established, principal stimuli may include a discrepancy in body size (recipient > donor), coronary allograft vasculopathy and posttransplant systemic hypertension. Percent myocardial fibrosis rose early (1 to 2 months) posttransplant and thereafter remained at the same modest level of severity. CONCLUSIONS Cardiomyocyte diameter of the transplanted heart gradually increases over time, while percent myocardial fibrosis rises early and remains in a modestly elevated plateau after 2 months posttransplant. These histostructural changes likely contribute to the hemodynamic and cardiac functional alterations commonly observed posttransplant.
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Affiliation(s)
- A T Armstrong
- Division of Cardiology, The Ohio State University College of Medicine, Columbus, USA
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Abstract
Fistulas between the aorta and left atrium, invariably a complication of aortic valvular endocarditis, are rare and infrequently diagnosed premortem. We describe a patient who presented with this entity and review the reports of five other patients for whom a diagnosis was made premortem. A number of causative organisms have been identified. The clinical course is characteristically one of rapidly progressive heart failure. Notably, only half of these fistulas were detected by transthoracic echocardiography, whereas all were identified by transesophageal echocardiography when utilized. Once the diagnosis is made, prompt surgical repair is required to avert the high mortality from rapidly developing refractory congestive heart failure.
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Affiliation(s)
- T P Archer
- Division of Cardiology, Ohio State University College of Medicine, Columbus, USA
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Webb KS, Baker PB, Cassells NP, Francis JM, Johnston DE, Lancaster SL, Minty PS, Reed GD, White SA. The analysis of lysergide (LSD): the development of novel enzyme immunoassay and immunoaffinity extraction procedures together with an HPLC-MS confirmation procedure. J Forensic Sci 1996; 41:938-46. [PMID: 8914284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A forensic procedure for the screening and confirmation of the presence of lysergide (lysergic acid diethylamide, LSD) in urine is described together with the evaluation of a novel enzyme immunoassay (EIA) and immunoaffinity extraction procedure. Following initial screening using either an established radioimmunoassay (RIA) or a novel EIA procedure, a quantitative estimate is established using a conventional high performance liquid chromatography-fluorescence (HPLC) technique following solid phase extraction. Final confirmation and quantitation, without derivatization, is established using HPLC in combination with electrospray ionization (ESI) mass spectrometry using methysergide as an internal standard. The detection limit of LSD in urine is 0.5 ng/mL. A blind trial confirmed the validity of the results. The choice of internal standard is discussed. Consideration is given to the photosensitivity of LSD solutions. A study of potential interferants in the HPLC-MS confirmation of LSD is presented and shows that for the wide range of compounds studied, there are none that would interfere with this confirmation technique. A comparison is shown between solid phase and immunoaffinity extraction/clean up procedures, and between RIA and EIA screening procedures.
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Affiliation(s)
- K S Webb
- Laboratory of the Government Chemist, Teddington, Middlesex, England
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38
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Baker PB, Zarbo RJ, Howanitz PJ. Quality assurance of autopsy face sheet reporting, final autopsy report turnaround time, and autopsy rates: a College of American Pathologists Q-Probes study of 10003 autopsies from 418 institutions. Arch Pathol Lab Med 1996; 120:1003-8. [PMID: 12049099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To develop a multi-institutional reference database of autopsy practice and performance for quality improvement purposes. DESIGN In 1990, participants in the Q-Probes quality improvement program of the College of American Pathologists (CAP) each retrospectively evaluated the 25 most recently completed consecutive autopsy reports and determined the number of deaths and autopsies that occurred in their institutions during 1989. SETTING Hospital-based autopsies excluding forensic cases and stillborn infants. PARTICIPANTS Four hundred ten institutions in the United States and eight institutions in Canada. MAIN OUTCOME MEASURES Completeness of face sheet information contained in final autopsy reports, turnaround time for completion of final reports, and institutional autopsy rates. RESULTS In the aggregate database of 10003 autopsies, the following six data items (from a total of 21) were present in 95% to 100% of the final autopsy reports in at least 85% of the participating institutions: institution where autopsy was performed, patient's name, patient's sex, autopsy number, autopsy date, and prosecter's name. The turnaround times for the final autopsy reports were as follows: 30 days or less in 47.6% of the cases, 31 to 60 days in 28.8%, and more than 60 days in 23.7%. A higher median percentage of autopsy final reports were completed in 30 days or less in institutions with the following characteristics: nonteaching (P < .004), no pathology residency program (P < .002), and rural location (P < .027). A lower number of autopsies performed in 1989 was associated with a higher median percentage of final reports completed in 30 days or less (P < .007). The aggregate autopsy rate for all participating institutions was 12.4%, and the median rate was 8.3%. Median autopsy rates for teaching institutions and institutions with pathology residency training programs were 15% and 19%, respectively. CONCLUSIONS This multi-institutional study identified a core group of face sheet data items that were consistently present on final autopsy reports. However, the majority of the face sheet data items examined were inconsistently recorded. Approximately 75% of final autopsy report turnaround times were within the standard established by the Joint Commission on Accreditation of Healthcare Organizations. Nearly two thirds of the institutions reported autopsy rates for 1989 of 0% to 10%.
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Affiliation(s)
- P B Baker
- Department of Pathology, Ohio State University Medical Center, Columbus 43210, USA
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Gephardt GN, Baker PB. Lung carcinoma surgical pathology report adequacy: a College of American Pathologists Q-Probes study of over 8300 cases from 464 institutions. Arch Pathol Lab Med 1996; 120:922-7. [PMID: 12046605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To assess the adequacy of reporting gross and microscopic pathologic findings of resected lung carcinoma. DESIGN Q-Probes study following the College of American Pathologists format. SETTING Pathology laboratories, 1991. PARTICIPANTS Four hundred sixty-four institutions. MAIN OUTCOME MEASURES Rate of reporting gross and microscopic features. RESULTS Information provided in over 8300 surgical pathology reports of resected primary lung carcinomas from 464 institutions was reviewed. Descriptors included gross and microscopic findings. The rate of reporting the descriptors from the aggregate sample is listed as follows (the corrected rate for those descriptors in which evaluation was not applicable are listed in parentheses for each descriptor where appropriate): general findings, standard report or checklist used 20.8%, type of procedure stated 89.6%, and lobe or lung of origin stated 99.1% (99.5%); gross findings, distance of neoplasm from nearest visceral pleura 61.1%, involvement or lack of involvement of bronchus 68.7%, presence or absence of involvement of veins 18.3%, parenchyma not involved by neoplasm described 80.1% (81.4%), visceral pleural surface described 83.0%, tumor size stated 97.2%, and description of regional lymph nodes attached to specimen 74.7% (82.7%); and microscopic findings, microscopic description 77.6%, histologic type of tumor stated 99.3%, grade of carcinoma stated 80.9% (88.7%), presence or absence of lymphatic vascular invasion 24.3%, status of lymph nodes stated 89.0% (95.9%), presence or absence of venous invasion 22.6%, presence or absence of neoplasm at bronchial margin 90.8%, presence or absence of neoplasm at vascular margin 30.9%, presence or absence of carcinoma in the visceral pleura 64.6% (66.9%), and presence or absence of abnormality in nonneoplastic parenchyma 72.8% (74.1%). CONCLUSION The rate of reporting gross and microscopic features varies; recommendations for reporting are made and include the use of a standard report form or checklist.
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Affiliation(s)
- G N Gephardt
- Department of Pathology and Clinical Laboratories, Kennestone Hospital, Marietta, GA 30060, USA
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Abstract
The well established 'systemic' risk factors for atherosclerosis can explain only half of the variability in its occurrence. To account for some of the remaining variability, it was suggested that certain geometric features of atherosclerosis-prone segments ('geometric risk factors') can increase the likelihood of disease locally through their influence on the hemodynamic environment of the vessel wall. Since this mediation might elicit early morphological changes in the artery, relationships were sought between the histomorphometry and axial geometry of the left anterior descending (LAD) coronary arteries of 15 angiographically lesion-free human hearts obtained at autopsy. Geometric variables were quantified by image processing of multiplane angiograms of the hearts, and morphometry was obtained from transverse histologic sections at 91 sites. The results show that: (1) total intimal and medial area are negatively correlated with the distance from the site to the origin of the LAD; (2) the angle of the branch immediately proximal to the site is positively correlated with most of the intimal and medial variables, and appears to have a major influence on the intima; (3) the area ratio of the immediately proximal branch is correlated primarily with medial variables; and (4) local curvature is correlated only with the maximum thickness of the intima and media. These observations suggest that there are significant relationships between arterial geometry and vascular morphology prior to the development of frank disease.
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Affiliation(s)
- M H Friedman
- Biomedical Engineering Center, Ohio State University, Columbus 43210, USA
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Zarbo RJ, Baker PB, Howanitz PJ. Quality assurance of autopsy permit form information, timeliness of performance, and issuance of preliminary report. A College of American Pathologists Q-Probes study of 5434 autopsies from 452 institutions. Arch Pathol Lab Med 1996; 120:346-52. [PMID: 8619745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To develop a multi-institutional reference database of autopsy practices and performance for quality improvement purposes. DESIGN In 1992, participants in the Q-Probes quality improvement program of the College of American Pathologists each prospectively evaluated consecutive autopsies performed over a 6-month period, up to a maximum of 20 autopsies per institution. SETTING Hospital-based autopsies, excluding forensic cases and stillborn infants. PARTICIPANTS Four hundred forty-nine North American institutions and three Australian laboratories. MAIN OUTCOME MEASURES Completeness of information contained on autopsy permit forms, timeliness of autopsy performance between patients' deaths and autopsy prosections, and turnaround time of preliminary autopsy reports. RESULTS In the aggregate database of 5434 autopsy cases, 7 of 11 selected data items were consistently present on autopsy permit forms in 80% of the participating institutions. The median percentage of autopsies in which permission was given for an unrestricted (complete) autopsy was 71%. The following median time intervals were obtained: time of the patient's death to time the autopsy permission was received, 5 hours, 23 minutes; time the autopsy permission was received to time the prosection was started, 3 hours, 30 minutes; and time of the patient's death to time the prosection was started, 14 hours, 52 minutes. Differences were observed in some time intervals when the participating institutions were grouped by reported demographic characteristics. Preliminary reports were completed in 2 days or less in 80.9% of the autopsies. CONCLUSIONS Through this multi-institutional study, we have documented a consistent core of autopsy permit form information requested and a wide range of time intervals elapsed between the patients' deaths and autopsy performance. We have also established that the majority of participating institutions meet the College of American Pathologists' laboratory accreditation standard of providing a documented preliminary report of the gross pathologic diagnoses submitted to the attending physicians and institutional record within 2 working days following autopsy completion.
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Affiliation(s)
- R J Zarbo
- Department of Pathology, Henry Ford Hospital, Detroit, MI 48202, USA
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Armfield SJ, Sallis PJ, Baker PB, Bull AT, Hardman DJ. Dehalogenation of haloalkanes by Rhodococcus erythropolis Y2. The presence of an oxygenase-type dehalogenase activity complements that of an halidohydrolase activity. Biodegradation 1995; 6:237-46. [PMID: 7579998 DOI: 10.1007/bf00700463] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [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: 01/26/2023]
Abstract
Rhodococcus erythropolis Y2 produced two types of dehalogenase: a hydrolytic enzyme, that is an halidohydrolase, which was induced by C3 to C6 1-haloalkane substrates, and at least one oxygenase-type dehalogenase induced by C7 to C16 1-haloalkanes and n-alkanes. The oxygenase-type activity dehalogenated C4 to C18 1-chloroalkanes with an optimum activity towards 1-chlorotetradecane. The halidohydrolase catalysed the dehalogenation of a wide range of 1- and alpha,omega-disubstituted haloalkanes and alpha,omega-substituted haloalcohols. In resting cell suspensions of hexadecane-grown R. erythropolis Y2 the oxygenase-type dehalogenase had a specific activity of 12.9 mU (mg protein)-1 towards 1-chlorotetradecane (3.67 mU mg-1 towards 1-chlorobutane) whereas the halidohydrolase in 1-chlorobutane-grown batch cultures had a specific activity of 44 mU (mg protein)-1 towards 1-chlorobutane. The significance of the two dehalogenase systems in a single bacterial strain is discussed in terms of their contribution to the overall catabolic potential of the organism.
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Affiliation(s)
- S J Armfield
- Research School of Biosciences, University of Kent at Canterbury, UK
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Gephardt GN, Baker PB. Interinstitutional comparison of bladder carcinoma surgical pathology report adequacy. A College of American Pathologists Q-Probes Study of 7234 bladder biopsies and curettings in 268 institutions. Arch Pathol Lab Med 1995; 119:681-5. [PMID: 7646323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Participants in the 1992 College of American Pathologists' Q-Probes Study of bladder carcinoma surgical report adequacy evaluated 7234 bladder biopsies and curettings from 268 institutions. In over 98% of the cases evaluated, the histologic type was stated. In over 95%, the histologic grade was stated where appropriate. Of the 7234 cases studied, 2149 (29.7%) were invasive, 4498 (62.2%) were noninvasive, and invasiveness (presence or absence of invasion) was not stated for 587 (8.1%). For invasive carcinomas, there was definitive assessment for the presence or absence of muscularis propria in 1145 (53.3%) of 2149 cases, and in 67 (3.1%) of 2149 cases no muscle or muscularis was present. For noninvasive carcinomas, there was a definitive evaluation of the muscularis propria (presence or absence) in 1349 (30%) of 4498 cases.
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Affiliation(s)
- G N Gephardt
- Department of Pathology and Clinical Laboratories, Kennestone Hospital, Marietta, GA 30060-1148, USA
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Baker PB, Cook BL, Winokur G. Delusional infestation. The interface of delusions and hallucinations. Psychiatr Clin North Am 1995; 18:345-61. [PMID: 7659603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Delusional infestation represents a unique subtype of the delusional disorder category. This article presents the phenomenology, etiology, and treatment of delusional infestation. This article also reviews historical and theoretical attempts to distinguish tactile sensory phenomena as either hallucinations or delusions.
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Affiliation(s)
- P B Baker
- Department of Psychiatry, University of Iowa College of Medicine, Iowa City, USA
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Mabee CL, Mabee SW, Baker PB, Kirkpatrick RB, Levine EJ. Fulminant hepatic failure associated with etodolac use. Am J Gastroenterol 1995; 90:659-61. [PMID: 7717333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Etodolac is a new pyranocarboxylic acid nonsteroidal anti-inflammatory agent with a unique chemical structure indicated for use in patients with painful musculoskeletal disorders and rheumatoid disease. Hepatotoxicity, in the form of reversible elevations in transaminases or bilirubin, occurs rarely. We present the first reported case of fulminant hepatic failure related to etodolac.
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Affiliation(s)
- C L Mabee
- Department of Gastroenterology, Ohio State University Medical Center, Columbus, USA
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Baker PB. Uncovering the unexpected. CAP Today 1995; 9:41-3. [PMID: 10150207] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- P B Baker
- Department of Pathology, Ohio State University Medical Center, Columbus, USA
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Abstract
A strain of a Rhodococcus sp. (termed H1) capable of utilizing heroin as its sole carbon and energy source was isolated by selective enrichment. An inducible heroin esterase was partially purified and shown to catalyze the hydrolysis of both of the acetylester groups of heroin. The enzyme displays optimum activity at pH 8.5 and appears to be a trimer of identical subunits with an M(r) or 39,000 and a native M(r) of 120,000.
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Affiliation(s)
- G W Cameron
- Institute of Biotechnology, University of Cambridge, United Kingdom
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Kass S, MacRae C, Graber HL, Sparks EA, McNamara D, Boudoulas H, Basson CT, Baker PB, Cody RJ, Fishman MC. A gene defect that causes conduction system disease and dilated cardiomyopathy maps to chromosome 1p1-1q1. Nat Genet 1994; 7:546-51. [PMID: 7951328 DOI: 10.1038/ng0894-546] [Citation(s) in RCA: 142] [Impact Index Per Article: 4.7] [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: 01/28/2023]
Abstract
Longitudinal evaluation of a seven generation kindred with an inherited conduction system defect and dilated cardiomyopathy demonstrated autosomal dominant transmission of a progressive disorder that both perturbs atrioventricular conduction and depresses cardiac contractility. To elucidate the molecular genetic basis for this disorder, a genome-wide linkage analysis was performed. Polymorphic loci near the centromere of chromosome 1 demonstrated linkage to the disease locus (maximum multipoint lod score = 13.2 in the interval between D1S305 and D1S176). Based on the disease phenotype and map location we speculate that gap junction protein connexin 40 is a candidate for mutations that result in conduction system disease and dilated cardiomyopathy.
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Affiliation(s)
- S Kass
- Department of Genetics, Harvard Medical School, Boston, Massachussetts 02115
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Brinkman AM, Baker PB, Newman WP, Vigorito R, Friedman MH. Variability of human coronary artery geometry: an angiographic study of the left anterior descending arteries of 30 autopsy hearts. Ann Biomed Eng 1994; 22:34-44. [PMID: 8060025 DOI: 10.1007/bf02368220] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A computer-based system is described to measure objectively the geometric parameters of arteries from pairs of projection angiograms. This technique, which employs back-projection to define the vessel axes in 3-D space, was used to obtain selected parameters of coronary artery geometry from radiographic images of autopsy hearts. Results of the first 30 cases are presented, focussing on the distribution of the geometric parameters of the left anterior descending coronary artery (LAD) and its first two major branches. The derived parameters include the angle between the left circumflex artery and the LAD; the angles between the LAD and its early diagonal and septal perforator branches; distances between branch points; and tortuosity. The geometric parameters vary considerably, presumably contributing to a corresponding variability in local hemodynamic and mechanical stresses. Most parameters are uncorrelated. One exception is the angle at the origin of the second diagonal branch, which is positively correlated (p < 0.01) with the distance between the ostia of the first two diagonal vessels; this correlation could reflect the existence of "target" perfusion regions. No relation between geometric parameters and age or gender was seen. In this sample, blacks had a larger angle at the left main bifurcation than whites (p < 0.05).
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Affiliation(s)
- A M Brinkman
- Biomedical Engineering Center, Ohio State University, Columbus 43210
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Sridhar R, Dwivedi C, Anderson J, Baker PB, Sharma HM, Desai P, Engineer FN. Effects of verapamil on the acute toxicity of doxorubicin in vivo. J Natl Cancer Inst 1992; 84:1653-60. [PMID: 1433347 DOI: 10.1093/jnci/84.21.1653] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Studies indicating that verapamil substantially enhances doxorubicin levels in certain drug-resistant tumor cells have led to the use of verapamil in combination with doxorubicin in animal and clinical studies of multidrug-resistant tumors. These studies have shown this drug combination to be associated with severe toxic effects. It is important to determine whether verapamil modulates the dose-limiting and potentially lethal cardiotoxicity of doxorubicin and to elucidate possible mechanisms. PURPOSE The aims of this study were to evaluate the in vivo effects of verapamil on (a) doxorubicin-stimulated cardiac lipid peroxidation and cardiac damage, (b) doxorubicin-induced animal mortality, and (c) biodistribution of doxorubicin to the heart. METHODS Male (BALB/c x DBA/2)F1 mice were treated with a high dose of doxorubicin (15 mg/kg, injected intraperitoneally), verapamil (25 mg/kg, injected intraperitoneally), or combinations of the two. Lipid peroxidation was determined using the 2-thiobarbituric acid assay for malonaldehyde. Light microscopy was used for histopathologic examination of cardiac tissue. A fluorometric assay procedure was employed to determine doxorubicin levels in the heart. RESULTS Verapamil was an effective inhibitor of peroxidative damage to myocardial lipids following a high dose of doxorubicin (15 mg/kg, injected intraperitoneally). However, mice treated with verapamil and doxorubicin had a lower survival rate and a higher initial peak concentration of doxorubicin in the heart than those treated with doxorubicin alone. They also demonstrated a higher incidence and severity of degenerative changes in cardiac tissue. CONCLUSIONS Our findings suggest that verapamil effectively inhibits doxorubicin-mediated lipid peroxidation in vivo but that cardiac lipid peroxidation is not the major limiting mechanism underlying doxorubicin-induced toxicity. A possible explanation for the excess mortality and cardiac injury in mice treated with verapamil plus doxorubicin is that verapamil alters the pharmacokinetics of doxorubicin. IMPLICATIONS Further studies are necessary for development of safer protocols and/or drug combinations to treat multidrug-resistant tumors. We are currently studying treatment of tumor-bearing animals with a cumulative dosage regimen of doxorubicin in the presence and absence of verapamil.
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Affiliation(s)
- R Sridhar
- Department of Radiation Therapy and Cancer Center, Howard University Hospital, Washington, D.C
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