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Zaman J, Teixeira L, Patel PB, Ridler G, Ata A, Singh TP. From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes. Hernia 2023; 27:635-643. [PMID: 36973467 PMCID: PMC10042403 DOI: 10.1007/s10029-023-02767-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE While robotic-assisted hernia repair has increased the popularity of minimally invasive hernia surgery, selecting between the types of approaches is a challenge for both experts and novices alike. In this study, we compared a single surgeon's early experience transitioning from transabdominal hernia repair with sublay mesh in either the pre-peritoneal or retrorectus space (TA-SM) and enhanced-view totally extra-peritoneal (eTEP) ventral hernia repair in the peri-operative and long-term post-operative time periods. METHODS We conducted a retrospective review of 50 eTEP and 108 TA-SM procedures to collect demographics, intraoperative details, and 30-day and 1-year post-operative outcomes. Statistical analysis was performed utilizing Chi-square analysis, Fisher's test, and two sample t-tests with equal variances. RESULTS There were no significant differences in patient demographics or comorbidities. eTEP patients had larger defects (109.1 cm2 vs. 31.8 cm2, p = 0.043) and mesh used (432.8 cm2 vs. 137.9 cm2, p = 0.001). Operative times were equivalent (158.3 ± 90.6 min eTEP and 155.8 ± 65.2 min TA-SM, p = 0.84), but conversion to alternate procedure type was higher for the transabdominal approach (4% eTEP vs. 22% TA-SM, p < 0.05). Hospital stay was less in the eTEP cohort (1.3 days vs. 2.2 days, p < 0.05). Within 30 days, there were no significant differences in emergency visits or hospital readmissions. There was a greater propensity for eTEP patients to develop seromas (12.0% vs. 1.9%, p < 0.05). At 1 year, there was no statistically significant difference in recurrence rate (4.56% eTEP vs. 12.2% TA-SM, p = 0.28) respective to average time to recurrence (9.17 months eTEP vs. 11.05 months TA-SM). CONCLUSION The eTEP approach can be adopted safely and efficiently, and may have superior peri-operative outcomes including fewer conversions and reduced hospital stay.
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Affiliation(s)
- J Zaman
- Department of Surgery, Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA.
| | - L Teixeira
- Department of Surgery, Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA
| | - P B Patel
- Department of Surgery, Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA
| | - G Ridler
- Department of Surgery, Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA
| | - A Ata
- Department of Surgery, Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA
| | - T P Singh
- Department of Surgery, Albany Medical College, 50 New Scotland Avenue, Albany, NY, 12208, USA
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Hiltner E, Shukla A, Patel PB, Russo M, Sethi A. PERCUTANEOUS MITRAL VALVE-IN-VALVE REPLACEMENT FOR SEVERE PROSTHETIC MITRAL VALVE STENOSIS AND HIGH RISK FOR OUTFLOW OBSTRUCTION USING RADIOFREQUENCY ABLATION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03905-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Han AY, Dhanjani S, Pettijohn K, Patel PB, John MAS. Optimal resection margin for head and neck cutaneous melanoma. Laryngoscope 2019; 129:1386-1394. [PMID: 30408184 DOI: 10.1002/lary.27465] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 05/28/2018] [Accepted: 07/02/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to examine the difference between a narrow (between 1 and 2 cm) and a wide (>2 cm) margin in the surgical resection of head and neck cutaneous melanoma. STUDY DESIGN Population-based cohort analysis. METHODS The Surveillance, Epidemiology, and End Results database was employed to identify patients who had cutaneous melanoma of the head and neck from 2004 to 2014. Outcome measures were overall survival (OS) and disease-specific survival (DSS). RESULTS Among the total of 3,583 cases of cutaneous melanoma of the head and neck with known resection margins, 2,641 individuals had narrow resection margins, and 942 patients had wide margins. Most of the tumors presented in the skin of the scalp and neck, followed by the face, external ear, and other areas. The 5-year and 10-year Kaplan-Meier OS probabilities for narrow and wide margins were 65% and 66%, respectively, compared with 49% and 48%, respectively. The DSS probabilities exhibited similar trends between the two groups at these time points. In the Cox regression model, the patients who received narrow margins had similar OS (95% confidence interval [CI]: 0.918-1.217) and DSS (95% CI: 0.856-1.352) compared with the wide resection margin group, even when controlled for age, sex, T stage, and histology. CONCLUSIONS The survival of patients with cutaneous melanoma of the head and neck depends on age, depth of tumor invasion, and histology. Within the head and neck, a wider resection margin of >2 cm does not confer any additional survival benefit compared with a narrower margin. Future studies should examine whether wider surgical margins would confer survival benefit in local or recurrent melanoma. LEVEL OF EVIDENCE 4 Laryngoscope, 129:1386-1394, 2019.
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Affiliation(s)
- Albert Y Han
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Suraj Dhanjani
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Kelly Pettijohn
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Pratik B Patel
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Maie A St John
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles Medical Center, Los Angeles, California
- University of California, Los Angeles Head and Neck Cancer Program, University of California, Los Angeles Medical Center, Los Angeles, California, U.S.A
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Patel PB, Shapiro NL. Portable, non-powered, suction-generating device for management of life-threatening aerodigestive tract foreign bodies: Novel prototype and literature review. Int J Pediatr Otorhinolaryngol 2019; 118:31-35. [PMID: 30578993 DOI: 10.1016/j.ijporl.2018.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/09/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To present a novel approach for the emergent, pre-hospital management of life-threatening aerodigestive tract foreign body aspiration using a portable, non-powered, suction-generating device (PNSD), in the context of a literature review of emergent pre-hospital management of patients with foreign body airway obstruction. METHODS The PubMed and MEDLINE databases were comprehensively screened using broad search terms. A literature review of pre-hospital management and resuscitative techniques of foreign body airway obstruction was performed. Further, independent measurements of PNSD pressure generation were obtained. Application of a PNSD in cadaveric and simulation models were reviewed. A comparative analysis between a PNSD and other resuscitative techniques was performed. RESULTS Physiologic data from adult and pediatric human, non-human, and simulation studies show pressure generation ranging from 5.4 to 179 cm H2O using well-established resuscitative maneuvers. Laboratory testing demonstrated that a protypic PNSD demonstrated peak airway pressures of 434.23 ± 12.35 cm H2O. A simulation study of a PNSD demonstrated 94% reliability in retrieving airway foreign body, while a similar cadaveric study demonstrated 98% reliability, with both studies approaching 100% success rate after multiple attempts. Several case reports have also shown successful application of PNSD in the emergent management of airway foreign body in elderly and disabled patients. CONCLUSION PNSDs may play an important role in the emergent, non-operative, pre-hospital management of upper aerodigestive tract foreign body aspiration, particularly in settings and populations with high choking risk. Further characterization of effectiveness and safety in larger cadaveric or simulation studies mimicking physiologic conditions is indicated.
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Affiliation(s)
- Pratik B Patel
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Nina L Shapiro
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
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Nagel SR, Carpenter AC, Park J, Dayton MS, Bell PM, Bradley DK, Funsten BT, Hatch BW, Heerey S, Hill JM, Holder JP, Hurd ER, Macaraeg CC, Patel PB, Petre RB, Piston K, Trosseille CA, Engelhorn K, Hilsabeck TJ, Chung TM, Dymoke-Bradshaw AKL, Hares JD, Claus LD, England TD, Mitchell BB, Porter JL, Robertson G, Sanchez MO. The dilation aided single-line-of-sight x-ray camera for the National Ignition Facility: Characterization and fielding. Rev Sci Instrum 2018; 89:10G125. [PMID: 30399712 DOI: 10.1063/1.5038671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
Crystal x-ray imaging is frequently used in inertial confinement fusion and laser-plasma interaction applications as it has advantages compared to pinhole imaging, such as higher signal throughput, better achievable spatial resolution, and chromatic selection. However, currently used x-ray detectors are only able to obtain a single time resolved image per crystal. The dilation aided single-line-of-sight x-ray camera described here was designed for the National Ignition Facility (NIF) and combines two recent diagnostic developments, the pulse dilation principle used in the dilation x-ray imager and a ns-scale multi-frame camera that uses a hold and readout circuit for each pixel. This enables multiple images to be taken from a single-line-of-sight with high spatial and temporal resolution. At the moment, the instrument can record two single-line-of-sight images with spatial and temporal resolution of 35 μm and down to 35 ps, respectively, with a planned upgrade doubling the number of images to four. Here we present the dilation aided single-line-of-sight camera for the NIF, including the x-ray characterization measurements obtained at the COMET laser, as well as the results from the initial timing shot on the NIF.
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Affiliation(s)
- S R Nagel
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A C Carpenter
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Park
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M S Dayton
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - P M Bell
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D K Bradley
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B T Funsten
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B W Hatch
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Heerey
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J M Hill
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J P Holder
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E R Hurd
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C C Macaraeg
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - P B Patel
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R B Petre
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K Piston
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C A Trosseille
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K Engelhorn
- General Atomics, San Diego, California 92121, USA
| | | | - T M Chung
- General Atomics, San Diego, California 92121, USA
| | - A K L Dymoke-Bradshaw
- Kentech Instruments Ltd., Isis Building, Howbery Park, Wallingford, Oxfordshire OX10 8BD, United Kingdom
| | - J D Hares
- Kentech Instruments Ltd., Isis Building, Howbery Park, Wallingford, Oxfordshire OX10 8BD, United Kingdom
| | - L D Claus
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - T D England
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - B B Mitchell
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - J L Porter
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - G Robertson
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - M O Sanchez
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
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Han AY, Patel PB, Anderson M, Diaz MFP, Chin R, St John MA. Adjuvant radiation therapy improves patient survival in early-stage merkel cell carcinoma: A 15-year single-institution study. Laryngoscope 2018; 128:1862-1866. [PMID: 29314048 DOI: 10.1002/lary.27031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 07/03/2017] [Revised: 10/23/2017] [Accepted: 11/06/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine neoplasm of the skin. Growing evidence supports the benefit of postoperative adjuvant radiation therapy (RT) for locoregional control, but whether it improves overall survival (OS) has been debated. Our objective was to compare the OS of MCC patients who received postoperative RT with those who received surgery alone. STUDY DESIGN Retrospective case series. METHODS Cases of MCC between 2001 and 2016 at the University of California, Los Angeles Health System were reviewed. We identified 87 unique cases of MCC. Among the patients, 74% were identified as male and 26% as female. The average age at diagnosis was 71.2 years. The median survival was 48.0 months. The OS of all the patients at 2 years, 5 years, and 10 years was 54%, 46%, and 26%, respectively. Univariate analysis showed that stage, T stage, N stage, and M stage were significant determinants of OS. The inclusion of RT was not found to be a determinant; however, when restricting the analysis to early-stage MCC (stages I and II), postoperative adjuvant RT was associated with significantly improved OS. A Cox regression model confirmed that inclusion of RT was an independent prognosticator of OS even when controlled for overall stage and negative margin status. The small sample size and retrospective nature of this study limit its statistical power. CONCLUSIONS MCC is an aggressive tumor with a poor prognosis for survival especially in elderly patients. In this study, we found that RT during early-stage MCC improves OS. Prospective randomized control trials are necessary to validate the observed benefit for MCC patients. LEVEL OF EVIDENCE 4 Laryngoscope, 1862-1866, 2018.
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Affiliation(s)
- Albert Y Han
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Pratik B Patel
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Mitchell Anderson
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Miguel F P Diaz
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.,University of California Los Angeles Head and Neck Cancer Program, University of California Los Angeles Medical Center, Los Angeles, California, U.S.A
| | - Robert Chin
- Department of Radiation Oncology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.,University of California Los Angeles Head and Neck Cancer Program, University of California Los Angeles Medical Center, Los Angeles, California, U.S.A
| | - Maie A St John
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California Los Angeles Medical Center, Los Angeles, California, U.S.A.,University of California Los Angeles Head and Neck Cancer Program, University of California Los Angeles Medical Center, Los Angeles, California, U.S.A
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7
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Kuan EC, Yoo F, Patel PB, Su BM, Bergsneider M, Wang MB. An Algorithm for Sellar Reconstruction Following the Endoscopic Endonasal Approach: A Review of 300 Consecutive Cases. J Neurol Surg B Skull Base 2017; 79:177-183. [PMID: 29868324 DOI: 10.1055/s-0037-1606293] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 03/11/2017] [Accepted: 07/15/2017] [Indexed: 12/17/2022] Open
Abstract
Objectives/Hypotheses The endoscopic endonasal approach (EEA) is the workhorse endoscopic procedure for sellar and parasellar pathology. Various reconstruction techniques have been reported following EEA surgery, ranging from no reconstruction to vascularized flaps. We review our institution's experience with sellar reconstruction following EEA and propose an evidence-based algorithm. Design Retrospective review. Setting Tertiary academic medical center. Participants Patients who underwent endoscopic EEA surgery for sellar or parasellar pathology between March 1, 2013 and August 31, 2016. Main Outcome Measures Patient demographic and clinicopathologic data were collected. Outcome measures included intraoperative and postoperative cerebrospinal fluid (CSF) leak rates and extent of resection (gross or subtotal). Results Three hundred consecutive patients were included. Depending on the presence and grade of intraoperative CSF leak, cases were reconstructed using either a free mucosal graft (FMG) or nasoseptal flap (NSF). Intraoperative and postoperative CSF leak rates were 30.7% and 2.3%, respectively. Multivariable logistic regression found that intraoperative CSF leak was associated with recurrent disease (odds ratio [OR] 2.47, p = 0.004), with no apparent predictors of postoperative CSF leak. Conclusions Based on this large series, we propose the following algorithm for sellar reconstruction: FMG for no CSF leak; fat graft + FMG ± rigid fixation for low-grade leaks; and fat graft + NSF ± rigid fixation for high-grade leaks.
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Affiliation(s)
- Edward C Kuan
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) Medical Center, Los Angeles, California, United States
| | - Frederick Yoo
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) Medical Center, Los Angeles, California, United States
| | - Pratik B Patel
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) Medical Center, Los Angeles, California, United States
| | - Brooke M Su
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) Medical Center, Los Angeles, California, United States
| | - Marvin Bergsneider
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) Medical Center, Los Angeles, California, United States
| | - Marilene B Wang
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) Medical Center, Los Angeles, California, United States
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8
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Patel PB, Kuan EC, Peng KA, Yoo F, Nelson SD, Abemayor E. Angiosarcoma of the tongue: A case series and literature review. Am J Otolaryngol 2017; 38:475-478. [PMID: 28478092 DOI: 10.1016/j.amjoto.2017.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 04/09/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE Angiosarcoma of the tongue is an exceedingly rare malignancy of the head and neck. Such lesions can be primary in nature or occur in a previously irradiated field. We examine a series of cases with relation to clinical presentation, diagnosis, management, and outcomes. MATERIALS AND METHODS Retrospective chart review of all patients with angiosarcoma of the tongue at a tertiary academic institution yielded a single case between 2005 and 2016. The MEDLINE database was additionally searched for all case series or reports of angiosarcoma arising in the tongue, and pertinent clinical data were extracted. RESULTS The clinical presentation, disease course, and management of a patient with angiosarcoma of the tongue are presented. Institutional and literature search yielded a total of eight patients with angiosarcoma of the tongue. The most common primary sites were dorsal and lateral oral tongue. Treatment consisted of surgical resection in 63% of cases with adjuvant therapy administered in 75% of cases. Follow-up times varied per patient, but 63% had persistent or recurrent disease and 67% died of or with disease within two years of index presentation. CONCLUSION Angiosarcoma of the tongue is a rare and highly aggressive tumor, accounting for fewer than 1% of all head and neck malignancies. The mainstay of treatment is surgical resection with negative margins followed by adjuvant chemoradiation for high-risk features. Due to rarity of the disease, consensus on optimal treatment approach is lacking, and multi-center prospective studies would be helpful to set clinical guidelines.
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Affiliation(s)
- Pratik B Patel
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Edward C Kuan
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kevin A Peng
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Frederick Yoo
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Scott D Nelson
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Elliot Abemayor
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
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Walton B, Vellucci J, Patel PB, Jennings K, McCammon S, Underbrink MP. Post-Laryngectomy stricture and pharyngocutaneous fistula: Review of techniques in primary pharyngeal reconstruction in laryngectomy. Clin Otolaryngol 2017; 43:109-116. [PMID: 28544550 DOI: 10.1111/coa.12905] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this study was to find a correlation between closure technique in pharyngeal closure and outcomes of both pharyngocutaneous fistula and post-laryngectomy stricture after laryngectomy. STUDY DESIGN Retrospective Chart Review. METHODS We retrospectively reviewed a total of 151 patients over a 20-year period from January 1994 to December of 2013 who underwent primary pharyngeal reconstruction after total laryngectomy specifically looking at the closure technique in relation to pharyngo-cutaneous fistula (PCF) and post-laryngectomy stricture postoperatively. Patients were excluded based on secondary pharyngeal closure. Using logistic regression modelling, we performed univariate and multivariate analyses of our data. RESULTS The overall PCF and post-laryngectomy stricture rates were 19.1% and 15.8%. When salvage laryngectomy was excluded, t-type closure had a significantly lower risk of fistula rate (P=.038) compared to vertical closure. In multivariate analysis, this statistical significance was lost (P=.23); however, non-salvage t-type closure remained significantly better than both salvage laryngectomy groups (t-type, P=.033, vertical, P=.037), while non-salvage vertical closure had no significant difference from other groups. There was no difference in stricture rate between the two closure techniques (P=.63). CONCLUSION Our study supports the role of t-type closure decreasing fistula rates in primary pharyngeal reconstruction. Orientation of the pharyngeal closure does not appear to change the risk of post-laryngectomy stricture formation after total laryngectomy. Salvage laryngectomy with primary pharyngeal reconstruction remains an independent risk factor for fistula formation.
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Affiliation(s)
- B Walton
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA
| | - J Vellucci
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA
| | - P B Patel
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA
| | - K Jennings
- Department of Epidemiology and Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
| | - S McCammon
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA
| | - M P Underbrink
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA
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Desai KT, Patel F, Patel PB, Nayak S, Patel NB, Bansal RK. A case-control study of epidemiological factors associated with leptospirosis in South Gujarat region. J Postgrad Med 2017; 62:223-227. [PMID: 27763478 PMCID: PMC5105206 DOI: 10.4103/0022-3859.188551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The current study was planned to identify the epidemiological factors associated with leptospirosis in South Gujarat region using neighborhood controls. METHODS A total of 100 cases of leptospirosis occurred in South Gujarat region during the year 2012 were selected using simple random sampling. Three neighbors of the selected cases formed the controls (n = 300). A pretested structured questionnaire was used for data collection and data were analyzed using Epi Info 2007. RESULTS There was significant association of illiteracy (odds ratio [OR] =1.82, 95% confidence interval [CI] =1.14-2.89), working in waterlogged fields during the reference season (OR = 4.6, 95% CI = 1.6-17.9), swimming/bathing in canals, open air defecation practices, storage of cow dung in or surrounding house, residence in the house made up of cow dung walls, households with access of food to rodents, injuries over hands/foot during the endemic season (OR = 3, 95% CI = 1.8-4.8), and history of skin disease during the endemic season (OR = 4.2, 95% CI = 2-8.5), with leptospirosis. Only 10% of individuals had gumboots for protection. A total of 83 (83%) cases and 240 (80%) controls had taken oral doxycycline chemoprophylaxis (P > 0.05). Cases had taken chemoprophylaxis for a median 4 weeks (range: 1-8) while controls had taken the same for median 8 weeks (range = 1-8) (P < 0.002). CONCLUSIONS Although the commonly established factors appear to be associated with leptospirosis, the role of host factors seems to play a more important role in determining susceptibility to leptospirosis in exposed individuals.
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Affiliation(s)
- K T Desai
- Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India
| | - F Patel
- Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India
| | - P B Patel
- Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India
| | - S Nayak
- Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India
| | - N B Patel
- Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India
| | - R K Bansal
- Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India
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Patel JR, Patel SB, Rathor SC, Patel JA, Patel PB, Vasava AG. New distribution record of the Forest Owlet Heteroglaux blewitti Hume, 1873, (Aves: Strigiformes: Strigidae) in Purna Wildlife Sanctuary, Gujarat, India. J Threat Taxa 2015. [DOI: 10.11609/jott.o4237.7940-4] [Citation(s) in RCA: 3] [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] [Indexed: 11/27/2022] Open
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Ray DS, Wiemann AH, Patel PB, Ding X, Kryscio RJ, Miller CS. Estimation of the rate of tooth wear in permanent incisors: a cross-sectional digital radiographic study. J Oral Rehabil 2015; 42:460-6. [PMID: 25756187 DOI: 10.1111/joor.12288] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 11/30/2022]
Abstract
This study used conventional digital radiography to estimate the rate of tooth wear (TW) of maxillary and mandibular central incisors based on a cross-sectional study design. The crown length of 1239 permanent maxillary and mandibular central incisors from 346 persons (age groups: 10, 25, 40, 55 and 70 years ± 3) were measured by three calibrated dentists. Study teeth were intact incisally, had clearly visible incisal edges and cementoenamel junctions and had natural tooth antagonists. Measures were based on digital radiographic images (N = 666) archived in MiPACS within the electronic health record (axiUm(®)) from the College of Dentistry patient database. Incisor crown length decreased at a linear rate in both arches over the 60 years represented by the age groups. The average crown length for maxillary incisors in the youngest age group was 11.94 mm, which decreased by an average of 1.01 mm by median age 70. For mandibular incisors, the average crown length in the youngest age group was 9.58 mm, which decreased by an average of 1.46 mm in the oldest age group. Males and females showed similar rates of TW. Regardless of age, females demonstrated smaller mean crown height for maxillary incisors than males (P < 0.0001). Measures by the examiners demonstrated good agreement, with an interclass correlation coefficient of 0.869 and an average intra-examiner correlation of 99.5%, based on repeated measurements (n = 100). TW was estimated to average 1.01 mm for maxillary central incisors and 1.46 mm for mandibular central incisors by age 70 years.
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Affiliation(s)
- D S Ray
- Department of Oral Health Practice, Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Dilwali S, Patel PB, Roberts DS, Basinsky GM, Harris GJ, Emerick KS, Stankovic KM. Primary culture of human Schwann and schwannoma cells: improved and simplified protocol. Hear Res 2014; 315:25-33. [PMID: 24910344 PMCID: PMC4164296 DOI: 10.1016/j.heares.2014.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 04/30/2014] [Accepted: 05/29/2014] [Indexed: 11/27/2022]
Abstract
Primary culture of human Schwann cells (SCs) and vestibular schwannoma (VS) cells are invaluable tools to investigate SC physiology and VS pathobiology, and to devise effective pharmacotherapies against VS, which are sorely needed. However, existing culture protocols, in aiming to create robust, pure cultures, employ methods that can lead to loss of biological characteristics of the original cells, potentially resulting in misleading biological findings. We have developed a minimally manipulative method to culture primary human SC and VS cells, without the use of selective mitogens, toxins, or time-consuming and potentially transformative laboratory techniques. Schwann cell purity was quantified longitudinally using S100 staining in SC cultures derived from the great auricular nerve and VS cultures followed for 7 and 12 weeks, respectively. SC cultures retained approximately ≥85% purity for 2 weeks. VS cultures retained approximately ≥80% purity for the majority of the span of 12 weeks, with maximal purity of 87% at 2 weeks. The VS cultures showed high level of biological similarity (68% on average) to their respective parent tumors, as assessed using a protein array featuring 41 growth factors and receptors. Apoptosis rate in vitro negatively correlated with tumor volume. Our results, obtained using a faster, simplified culturing method than previously utilized, indicate that highly pure, primary human SC and VS cultures can be established with minimal manipulation, reaching maximal purity at 2 weeks of culture. The VS cultures recapitulate the parent tumors' biology to a great degree, making them relevant models to investigate VS pathobiology.
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Affiliation(s)
- Sonam Dilwali
- Speech and Hearing Bioscience and Technology Program, Harvard - Massachusetts Institute of Technology, Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Pratik B Patel
- Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Daniel S Roberts
- Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Gina M Basinsky
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Gordon J Harris
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin S Emerick
- Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Konstantina M Stankovic
- Speech and Hearing Bioscience and Technology Program, Harvard - Massachusetts Institute of Technology, Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA.
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Abstract
BACKGROUND Bevacizumab a recombinant humanized monoclonal antibody was approved in 2004 by US FDA for metastatic colorectal cancer. It is reported to cause potentially serious toxicities including severe hypertension, proteinuria, and congestive heart failure. AIM To correlate adverse event tetany with the use of bevacizumab. MATERIALS AND METHODS World Health Organization's Uppsala Monitoring Centre, Sweden, for reporting of adverse drug reactions from all over the world, identified 7 cases with tetany-related symptoms to bevacizumab from four different countries. These 7 patients reported to UMC database developed adverse events described as musculoskeletal stiffness (1), muscle spasm (1), muscle cramps (1), lock jaw or jaw stiffness (4), and hypertonia (1), with hypocalcaemia. RESULTS After detailed study of the possible mechanism of actions of bevacizumab and factors causing tetany, it is proposed that there is a possibility of tetany by bevacizumab, which may occur by interfering with calcium metabolism. Resorption of bone through osteoclasts by affecting VEGF may interfere with calcium metabolism. Another possibility of tetany may be due to associated hypomagnesaemia, hypokalemia, or hyponatremia. CONCLUSIONS Tetany should be considered as a one of the signs. Patient on bevacizumab should carefully watch for tetany-related symptoms and calcium and magnesium levels for their safety.
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Affiliation(s)
- S R Anwikar
- Department of Infectious Diseases, Maharashtra University of Health Sciences, Mumbai, India
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Sawh SB, Danga A, Selveraj IP, Cotton A, Patel PB. Use of methyl-naltrexone for the treatment of opioid-induced constipation in critical care patients. Crit Care 2010. [PMCID: PMC2933990 DOI: 10.1186/cc8718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
We report the case of a 36-year-old woman with erythrocytosis due to ectopic erythropoietin production by a very large uterine leiomyoma. Awareness of this uncommon condition is important so that the correct diagnosis can be suggested prior to surgery and radical resection can be avoided.
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Affiliation(s)
- P B Patel
- Department of Radiology, Los Angeles County-USC Medical Center, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
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18
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Abstract
The single tapered dilator kit is the most commonly used percutaneous tracheostomy set in the UK. The Cook Blue Rhino and the Portex Ultraperc were compared in the laboratory on mannequin and porcine airway models. The following data were collected: the subjective ease of dilating the trachea and inserting the tracheostomy tube; the time taken and the anterior-posterior compression during dilatation and tube insertion; the incidence and extent of posterior tracheal wall damage. During dilatation, the Blue Rhino caused less mean percentage anterior-posterior compression (34.8% vs. 51.5%, p = 0.0014). There was no difference in subjective ease or time for dilatation in either mannequin or porcine airway models. During insertion of the tracheostomy tube, the Ultraperc was subjectively easier in the porcine airway model (p = 0.001); had a shorter median insertion time in both the mannequin (3 s vs. 7.2 s, p = 0.0006) and the porcine airway model (4.3 s vs. 8.5 s, p = 0.0005); the mean percentage anterior-posterior compression caused was less in the mannequin (51.5% vs. 76%, p = 0.0008). The overall incidence of posterior wall damage was 65% with 25% having deep lacerations. There was no difference in the incidence of damage between the two sets. The Ultraperc therefore has advantages during tracheostomy tube insertion that are statistically and clinically significant. The advantages are probably due to the presence of the tracheostomy tube introducer.
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Affiliation(s)
- P B Patel
- Intensive Care Medicine, The Hammersmith Hospital, Du Cane Road, London, UK.
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Rester BT, Warnock JL, Patel PB, McMullan MR, Skelton TN, Collop NA. Lysis of a left ventricular thrombus with recombinant tissue plasminogen activator. Chest 2001; 120:681-3. [PMID: 11502681 DOI: 10.1378/chest.120.2.681] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/01/2022] Open
Abstract
A 23-year-old woman with peripartum cardiomyopathy presented with a 2.1 x 2.5-cm pedunculated, mobile, left ventricular thrombus and evidence of systemic embolization. Due to the patient's poor left ventricular function, thrombectomy was not a viable option. Treatment with high-dose IV heparin was initially utilized but was unsuccessful as the thrombus appeared to enlarge on echocardiography. An accelerated weight-adjusted dose of recombinant tissue plasminogen activator (rt-PA) successfully lysed the thrombus without evidence of embolization. Although rt-PA has been used for primary lysis of high-risk ventricular thrombi, this is the first documentation of successful lysis of a left ventricular thrombus in a patient with peripartum cardiomyopathy.
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Affiliation(s)
- B T Rester
- Department of Internal Medicine, Divisions of Cardiology and Pulmonology/Critical Care, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA
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Huang H, Patel PB, Salahudeen AK. Lazaroid compounds prevent early but not late stages of oxidant-induced cell injury: potential explanation for the lack of efficacy of lazaroids in clinical trials. Pharmacol Res 2001; 43:55-61. [PMID: 11207066 DOI: 10.1006/phrs.2000.0740] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Earlier in vitro studies demonstrated the remarkable potency of the lazaroid compounds to prevent oxidant-induced early cell injury. However, the ability of lazaroid compounds to limit oxidative injury in vivo(including renal ischemia-reperfusion) has been less certain, and the early clinical trials using lazaroids to limit CNS injury or organ injury in the setting of transplantation have not been promising. Lazaroid compounds are potent inhibitors of lipid peroxidation, and their inability to influence other key injury processes, particularly during the late stages of cell injury, might partly explain the limited clinical efficacy. To test this, renal tubular (LLC-PK1) cells were incubated with 250 micromH(2)O(2)for 135 min, in the presence or absence of 2-methyl aminochroman (2-MAC, U-83836E), a lazaroid with potent ability to inhibit lipid peroxidation, or desferrioxamine, (DFO) an iron chelator with broader antioxidant efficacy. Cell injury, lipid peroxidation, DNA damage and ATP depletion were measured in the early (immediately after H(2)O(2)incubation) and late (24 h after H(2)O(2)incubation) stages of cell injury. In the early stage, 2-MAC suppressed H(2)O(2)-induced lipid peroxidation and LDH release, but not the DNA damage, ATP depletion or loss of cell replication. In contrast, DFO suppressed all of the measurements. In the late stages, despite continued suppression of lipid peroxidation, only DFO maintained significant cytoprotection against H(2)O(2), and this was accompanied by reduced DNA damage, higher ATP levels and preservation of cell proliferation. Thus, the inability of the lazaroid compound 2-MAC to sustain cytoprotection in the later stages of cell injury might provide at least a partial explanation for the inefficiency of lazaroids to limit tissue injury in clinical and certain in vivo settings.
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Affiliation(s)
- H Huang
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA
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McIlhinney RA, Patel PB, McGlone K. Characterization of a polyhistidine-tagged form of human myristoyl-CoA: protein N-myristoyltransferase produced in Escherichia coli. Eur J Biochem 1994; 222:137-46. [PMID: 8200338 DOI: 10.1111/j.1432-1033.1994.tb18851.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The enzyme myristoyl-CoA:protein N-myristoyltransferase is responsible for the attachment of a myristoyl group to the N-terminal glycine of a number of cell, viral and fungal proteins. In order to overcome the difficulties of purification of this enzyme from tissue sources, we have produced an N-terminally polyhistidine-tagged version of the enzyme and expressed this in Escherichia coli. The resulting enzyme has a molecular mass of 53 kDa and is fully active showing the expected specificity for myristic acid and causing the N-terminal myristoylation of both synthetic peptide and protein substrates in vitro. The enzyme exhibits a broad pH optimum peaking at a pH of 8.0 and has a Km for myristoyl-CoA of 7.6 microM. The two synthetic peptide substrates based on the N-terminal sequence of the catalytic subunit of protein kinase A (GNAAAARR) and of p60src (GSSKSKPKDPSQRRRY) have different kinetic parameters with Km values of 115.2 microM and 44.2 microM and Vmax values of 95 and 120 nmol.min-1.mg-1, respectively. The expressed enzyme is partially inhibited (50%) by iodoacetamide at 5 mM and fully inhibited by diethylpyrocarbonate at 10 mM. This latter inhibition can be prevented by including histidine in the incubation of the enzyme and inhibitor. Antisera raised to synthetic peptides based on sequences derived from the N- and C- terminus of the human enzyme reacted with the expressed protein on Western blots, but only the N-terminal sequence reacted with the native protein suggesting that the C-terminus may be not be accessible. The enzyme can catalyse the removal of a myristoyl group from myristoylated peptides but does so only in the presence of added coenzyme A.
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Affiliation(s)
- R A McIlhinney
- Medical Research Council Anatomical Neuropharmacology Unit, Oxford, England
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Molnár E, Baude A, Richmond SA, Patel PB, Somogyi P, McIlhinney RA. Biochemical and immunocytochemical characterization of antipeptide antibodies to a cloned GluR1 glutamate receptor subunit: cellular and subcellular distribution in the rat forebrain. Neuroscience 1993; 53:307-26. [PMID: 8492909 DOI: 10.1016/0306-4522(93)90198-o] [Citation(s) in RCA: 165] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Antibodies were made to synthetic peptides corresponding to residues 253-367, 757-771 and 877-889 of the published amino acid sequence of the rat brain glutamate receptor GluR1 subunit [Hollmann et al. (1989) Nature 342, 643-648]. The peptides were synthesized both as multiple copies on a branching lysyl matrix (multiple antigenic peptides) and conventional linear peptides using solid-phase synthesis. Rabbits were immunized with these peptides either without conjugation (multiple antigenic peptides) or following coupling to ovalbumin with glutaraldehyde (monomeric peptides). The antibodies from immune sera were then purified by affinity chromatography using reactigel coupled monomeric peptides. All the rabbits produced good antipeptide responses, and were characterized by immunoprecipitation of solubilized alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate and kainate binding activity and by their staining patterns on immunoblots. Antibody to peptide 253-267 specifically immunoprecipitated 12 +/- 3, 50 +/- 3 and 44 +/- 4% of solubilized alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate binding activity from cortex, hippocampus and cerebellum, respectively. Under identical conditions, antibody against the 877-889 peptide removed 23 +/- 4, 9 +/- 4 and 15 +/- 9% of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate binding sites from these areas. On immunoblots of rat brain membrane samples separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, antibodies labelled a 105,000 mol. wt immunoreactive band. GluR1 was immunoaffinity-purified using subunit-specific antibodies against both N-terminal (253-267) and C-terminal (877-889) residues, covalently attached to protein A-agarose. Analysis of the purified product from each column showed a major immunoreactive band, recognized by both sera at 105,000 mol. wt and silver staining identified the same major protein. After exhaustive immunoprecipitation of solubilized membrane samples with antibody against the C-terminal of the subunit, a subpopulation of GluR1 was labelled with antibodies specific for the N-terminal part of the receptor. These observations suggest that the GluR1 subunit consists of at least two isoforms possessing a common N-terminal region but a distinct C-terminus. Immunocytochemistry, using immunoperoxidase staining, was performed for the GluR1 subunit in rat forebrain with antisera raised against the N-terminal (253-267) and the C-terminal parts (877-889) of the molecule. Both antisera gave a similar distribution of immunoreactivity at the light-microscopic level. Immunoreactivity for the GluR1 subunit was selectively distributed throughout the rat forebrain. The hippocampus, septum, amygdala and olfactory bulb exhibited the strongest immunoreactivity.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- E Molnár
- Anatomical Neuropharmacology Unit, University of Oxford, U.K
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Abstract
Jejunal brush border glucose transport was studied in a patient with glucose-galactose malabsorption and in controls, using jejunal brush border membrane vesicles (BBMV) prepared from conventional jejunal biopsies. Whereas BBMV from controls showed a seven-fold enhancement of D-glucose uptake in the presence of an inwardly directed sodium gradient compared with its absence, no such enhancement was seen in the patient's vesicles. In BBMV from the patient, initial D-glucose uptake under sodium gradient conditions was only 10% of the mean control value. In contrast, sodium/proton exchange in BBMV from the patient was intact. These data provide the first unequivocal evidence that the jejunal brush border membrane is the site of a specific defect in sodium dependent glucose transport in glucose-galactose malabsorption. Measurement of glucose uptake by BBMV may well be the optimal diagnostic technique in this disorder.
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Affiliation(s)
- I W Booth
- Institute of Child Health, University of Birmingham
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Patel PB, Chakrabarti CH. Changes in the activity of some hepatic enzymes during organophosphorus insecticide-acephate (orthene) treatment in albino rats. Indian J Physiol Pharmacol 1982; 26:311-6. [PMID: 7152641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Acephate, an organophosphorus insecticide (60 mg/day/rat) disturbed the carbohydrate metabolism in albino rats (wt. between 100-150 gms). Changes in the enzyme activities in the liver were estimated in the rats after oral administration of Acephate. The specific activities of succinic dehydrogenase was decreased in experimental rats than control. A gradual decrease in blood and liver glutathione was also observed. Increase in total lactate dehydrogenase was also noted. It has been observed that in the liver homogenate of treated rats, the isoenzymes LDH4+5 were increased, LDH1+2 were decreased while LDH3 remain unchanged with respect to control value.
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Abstract
Aspirin administration for 30 days (5 mg/100 g body weight) caused a significant decrease in the weight of testis of immature rats. Decrease in the activities of sorbitol dehydrogenase and hyaluronidase was observed in both immature and mature rats. Decrease in the number of spermatids and increase in size of spermatocytes nuclei were observed. It is concluded that aspirin causes impairment of the later stages of spermatogenesis.
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